When Is It Time To Increase The Osteo Pain Meds?

[Guest Shermanator]

I am trying to balance Echo's quality of life and pain management. She was diagnosed with osteo 1 & 1/2 weeks ago. Since then she's on rimadyl, tramadol and gabipentin (sp?).

She's not showing distress, but the limping is getting worse. She's not using her leg. I let her play at the bark park on Friday night. Could this be soreness from the park, or the osteo getting worse? Does it happen this fast?

Do I increase her meds? Do I wait until she shows pain signs? What is the right balance? She's still her goofy, normal self, but with a hop and a limp.

Thanks!

[Guest normaandburrell]

I think it is different for every dog. If you think she is in real pain, give her more meds. If she seems happy and able to manage the pain by not using the leg, then wait.

[4My2Greys]

If she's limping she's in pain . What are the dosages she is on right now of these drugs?

[marion]

I think, I would not increase her pain meds too fast, as a 'little bit of moderate pain' might prevent her from doing too much exercise.

If you see her still being her normal self and so far happy, I agree with Normaandburrell to wait a bit...

I hope she still has some quality time left with you...

 

Greetings,

Marion

[4My2Greys]

If you see her still being her normal self and so far happy, I agree with Normaandburrell to wait a bit...

I hope she still has some quality time left with you...

 

Greetings,

Marion

I respectfully disagree with this. If she is limping more the pain has increased and thus the pain relief should be increased. It doesn't mean you have to increase it to the point she's in a drugged stupor, just enough to take away the increase in limping that has started.

[Houndtime]

When we talk managing pain, indicates that there is pain. You don't want her to be in any pain, if you can help her, so let her have increased meds. I am so sorry you have to make these decisions.

[GeorgeofNE]

I would NOT take a dog with osteo to a park. There is a real possibility of a fracture, and it would be a horrible thing to happen at a park where other dogs could possible gang up on her.

[4My2Greys]

I would NOT take a dog with osteo to a park. There is a real possibility of a fracture, and it would be a horrible thing to happen at a park where other dogs could possible gang up on her.

Sad, but very true.

[greysmom]

Limping, panting, tri-podding, whining, difficulty rising or laying down - these are all signs of pain. Osteo is hideously painful (we know this from humans who have the disease), so when you begin to see signs of pain, it's time to increase the pain meds. I always tell people to have the pain meds in small amounts so they can be adjusted easily - 100mg pills vs 300mg pills, for instance.

 

It's hard because they still want to play and jump around, and in they act like nothing's wrong for long periods of time. You may not be seeing any outward evidence of the cancer at this time. But it's there. So restricting her activity will help prevent a catastophic break. If that happens you will only have two options - amputation, or letting her go.

[Guest Shermanator]

I am distraught. She's hopping now full time, tiring more easily. But not showing and pain signs. She's eating, drinking, using the dog door. I am struggling to handle this, I feel so bad for her.

[Batmom]

If she's not using the leg, she's in horrible pain.

 

I'm so sorry you and your girl are facing this.

[Guest Shermanator]

Oh God. I don't want that. We will be increasing her meds this morning. I can't handle seeing her in pain. Thank you for all the support.

[Guest Greyt_dog_lover]

You need to get another xray as soon as you can. This disease can progress in days, not weeks or months. I had a girl that we had xrays 3 weeks apart and the bone went from normal with slight loss of density around the edges to more than 65% moth-eaten. From the diagnosis to our sending her over the bridge was 2 weeks. It is so difficult to deal with, may your grief be brief.

[IndyandHollyluv]

Oh, so sad. I am sorry. I am NO expert on osteo and not sure how old Echo is?? but my angel Lucy, 14-1/2, limped a bit one weekend in February 2014. I watched and monitored her but then she seemed to be "okay" after that weekend. Then one morning in April after she woke up, she struggled and collapsed in her bed. Remained there all day. For a couple of days, she mostly stayed in bed. I fed and gave her water bedside.

 

No crying, whining. Very stoic. You would never have known she was not well. Ate and drank water. Just wouldn't get up. One morning she seemed to really want to go out in the backyard (it was the last time). I helped her as she limped outside. Clearly, it was her front right leg. Not sure if it was the shoulder or lower.

 

Because of her age and how stressful a vet visit was for Lucy, I decided it best to say goodbye within a matter of days as I didn't want her to further suffer. I didn't request a definitive dx but have to believe it was osteo. I previously lost five hounds - but none to osteo. In Lucy's case -- because of her sudden collapse, no x-rays, no meds other than Tramadol.

 

I guess my point is -- while something sinister had clearly been brewing: when it hit, it hit hard. Fast and furious. I heeded the words of everyone here on GT who has been down this tearful road.

 

On the day I said goodbye, I fed Lucy bedside and she ate six cans of canned chicken. She hadn't lost her appetite for meat! Little carnivore.

 

Hugs to you and Echo. Don't wait too long.

Edited October 28, 2014 by IndyandHollyluv

[Saharasmom]

I'm so sorry! I'm glad you are increasing her meds & I hope it gives her some relief.

 

My Sahara had a soft tissue sarcoma that invaded the bone in her wrist. She also acted fairly normal, just limping and then tripodding. Once she stopped putting weight on her leg (with max pain meds), we made the decision to let her go. We were worried about her having a catastrophic break and also that she was in pain without it showing outwardly. It took awhile for the tumor to progress, but once it did, it was very quick.

[cleptogrey]

listen to her at night. if she's crying and can't get comfortable, she's in terrible pain. emily who had osteo ate until the very end. nothing could stop that gal from eating, but i could not let her be in constant pain and discomfort. it's terribly hard to let go, but think of the pain. so, sorry...

[robinw]

I am distraught. She's hopping now full time, tiring more easily. But not showing and pain signs. She's eating, drinking, using the dog door. I am struggling to handle this, I feel so bad for her.

She's in pain. My vet told me that they are great at masking it, but that osteo is a very, very painful disease, even with pain meds. I have lost three hounds to osteo, and I let them go when it got to where pain meds needed to be increased. I'm sorry

[carronstar]

Having just gone through this, my heart hurts for you. Cancer stinks. Pain stinks. This is just too unfair. Keeping you in my thoughts and prayers.

[NeylasMom]

I think, I would not increase her pain meds too fast, as a 'little bit of moderate pain' might prevent her from doing too much exercise.

If you see her still being her normal self and so far happy, I agree with Normaandburrell to wait a bit...

I hope she still has some quality time left with you...

 

Greetings,

Marion

There are lots of appropriate ways to restrict activity in a dog with an injury or in this case, bone cancer, but limiting pain relief is absolutely NOT one of them and especially with a disease as painful as bone cancer and with animals who cannot actually tell us whether their pain is completely managed or not, I think doing this borders on inhumane. Ways to restrict activity: crates, x-pens, baby gates, preventing the dog from getting on/off furniture, a ramp to get in and out of the car, leash walks instead of off leash time outside, spending extra time providing mental stimulation through stuffed kongs, puzzle toys, feeding meals in a grass feeder or other device where the dog has to "hunt" for it's food, etc. to expend pent up energy, working on training cues that will be useful for management (2 benefits here) like wait, stay, settle, etc. and so on.

 

Limping, panting, tri-podding, whining, difficulty rising or laying down - these are all signs of pain. Osteo is hideously painful (we know this from humans who have the disease), so when you begin to see signs of pain, it's time to increase the pain meds. I always tell people to have the pain meds in small amounts so they can be adjusted easily - 100mg pills vs 300mg pills, for instance.

 

It's hard because they still want to play and jump around, and in they act like nothing's wrong for long periods of time. You may not be seeing any outward evidence of the cancer at this time. But it's there. So restricting her activity will help prevent a catastophic break. If that happens you will only have two options - amputation, or letting her go.

To the OP, sounds like you've already decided to increase meds so I can only emphasize what greysmom has already said. Also consider other signs of pain that may not present as direct symptoms, things like decreased appetite and less desire to play.

 

Not sure if you've been in the osteo thread, but I still find this article very useful for understanding the types of bone cancer pain and how to stay ahead of them. You could also consider radiation (discussed in that article) or IV pamidronate if your dog is a candidate rather than relying on just meds.

 

I'm really sorry you're facing this. I've been there and I know how difficult it is.

[a_daerr]

If she's not using the leg at all, she is definitely in a tremendous amount of pain. Realistically speaking, you're heading towards the advanced stages. I can't stress enough that now is not the time to be conservative with pain meds, even though they may affect her behavior, energy level, or her ability to act like herself.

 

As the others have said, restricting activity is almost equally important. OSA causes lesions that make the bone weak, almost like a piece of swiss cheese. The bone cannot handle the force and energy involved in running and heavy exercise. One misstep, and the bone will break. Not "may" break or "could possibly" break... WILL break. And a catastrophic break is not the way you want to let her go, because the pain is unfathomable.

[winnie]

Osteo is a terminal disease. That is the reality you're facing. Many of us, including myself, have walked this path before. If your dog is showing ANY signs of discomfort, increase the meds.

 

We were able to keep my heart hound, Faye Oops, comfortable for about six weeks after she was diagnosed. We did a couple of medication increases, but the first night she was unable to sleep comfortably was her final.

 

I'm so sorry to you and everyone else who has ever faced this monster.

[lukasmom]

I sent my girl to the Bridge 4 days after confirmation of bone cancer. I could not ask her to stay in pain for me. It is the hardest thing to do but the last thing you want is to have her suffer longer. It is the last gift you can give her. Know that so many of us here have been in your situation and know the incredible sadness in your heart.