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Pain Management For Clifford


Guest cherik
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Guest cherik

I've been reading these forums for several years but just joined specifically for ideas to help my 10 year old boy Clifford. He's our third rescued greyhound boy. Cliff was quite young when he came to us (under 2, only a handful of races). He's had some sort of peripheral neuropathy & has been hyper-reactive to any uncomfortable stimulus since we got him. We actually considered working w/ our rescue group to rehome him soon after adopting since we have young children & he had bitten or snapped at both our children & another one of our dogs for very minor contact. He's been on NSAIDS since he was 3ish, managing well on meloxicam for several years (after deramaxx went off the market a few years ago) until the last 9 months or so. We can tell when his pain management needs tweaking as he starts snapping again. Started tramadol about 9 months ago @ a very low dose, increased tramadol dose gradually based on need then added gabapentin about 3 months ago at the advice of our acupuncturist (I work @ our vet office so can get free advice & at least slightly lower $ treatment). He's been doing so well on the gabapentin, even acting playful & bouncy, which has been wonderful.

 

Unfortunately, he's started being painful on his right front leg over the last 2-3 weeks & it's worsening rapidly. We have elected to avoid any additional diagnostics as what are they likely to show (spinal issues, osteo, other badness??? - guess I really don't want to know) & with his level of anxiety @ the vet coupled w/ his tendency to bite when painful, any diagnosis or treatment would involve anesthesia & a tremendously challenging recovery (I got called in to sit w/ him after his dental as he was aggressive & beating himself up on the cage).

 

Currently he's up to the max dose meloxicam (for years), tramadol 100mg every 8 hours, gabapentin 200mg every 8 hours. He's getting worse. Non-weight bearing on his leg, crying out with any movement, panting constantly. I ended up giving him an additional 50mg tramadol & 200mg gabapentin around 3am as he was crying & restless. He finally slept for a couple hours but this morning is again very painful & only settling on the couch next to me if I pet him constantly. We are all so upset seeing him this way. For once, he's not snapping at us with his pain so I can comfort him, but that's not enough.

 

We (vet & I) double-checked max med doses on Wednesday & came up w 375mg tramadol (2.5 every 8 hours), 900mg gabapentin (I'm giving 2-3 every 6 hours based on suggestions on the forum that our greys metabolize faster). He's on this as of today but so far I see no difference. He's also started licking the leg today which I am considering another new pain sign. Panting & respiratory rate are both also increased.

 

Any other suggestions? I think we're in hospice right now so I'm not thinking long-term, only maintaining quality of life (which is not happening right now). I'm wondering about adding robaxin but would appreciate any ideas! Sorry this is so long & thanks!

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I hope someone can give you an answer but my heart goes out to Clifford. It doesn't sound like a pleasant life at the moment. You don't want to know the answer as you said no diagnostics. Robaxin is a muscle relaxer, what does your vet suggest? Again, i hope someone can help.

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Sending prayers and hoping that Clifford gets some relief from his pain, it is so upsetting when they are struggling and we cannot make it better. Sounds like you are trying to manage pain that is no longer manageable...so sorry, wish I had a solution for you..

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What tbhounds said. Get the leg and shoulder xrayed tomorrow if nobody has hours today.

 

Best thoughts for your pupper.

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You really should get that checked out. You'd feel terrible if he had something treatable, or if he had something that wasn't treatable and is suffering longer than necessary.

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I am sorry to read this. I would give him the max on the gabapentin and tramadol. Neither will really hurt or upset his stomach. I wish you and him the best.

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You really should get that checked out. You'd feel terrible if he had something treatable, or if he had something that wasn't treatable and is suffering longer than necessary.

Please give this thought consideration. There are drugs that your vet could dispense to you to give at home prior to your vet visit. (Telazol given orally works fabulously) I'm sure you would agree that you are merely treading water at this point and as much as you hesitate to do further diagnostics they need to be performed or dare I say you need to make that final decision to alleviate his pain.

I'm glad you came here seeking help. I wish your first post would have been a happier one :-(. Please accept this advice with the best of intentions--it's because we all care.

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I'm sorry that you find yourself in this difficult situation.

 

As others have noted, please rethink having an x-ray. One of your objections was the anesthesia and I wanted to mention that in many cases they do not have to put the dog under to do the x-rays. Your vet may be able to give a drug to keep anxiety down to a minimum and for just long enough to get the x-rays.

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I'm sorry that you find yourself in this difficult situation.

 

As others have noted, please rethink having an x-ray. One of your objections was the anesthesia and I wanted to mention that in many cases they do not have to put the dog under to do the x-rays. Your vet may be able to give a drug to keep anxiety down to a minimum and for just long enough to get the x-rays.

And if that's not quite enough, there are heavier levels of mild sedation that are far short of anesthesia. I hope you find an answer that will help you get rid of his pain.

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If you're already medicating the dog at that level, what harm could light sedation for an x-ray do?

 

If he were mine, I would get the x-ray, and if it IS osteo, I would let him go now. Imagine how HE feels right now. And if it is osteo, you could well come home to a dog whose leg has broken. And then how will you get him to the vet?


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Guest cherik

Thanks for the replies. I think I wasn't clear as far as our decision to not pursue diagnostics. I'm not particularly concerned re ananesthesia risk, it just wouldn't change our approach. It's clear from the level of pain he's in that radiographs aren't going to show something easy & minor. We would not consider amputation or other treatments for osteo - when I say he's stressed @ the vet, I'm talking a dog who's temp goes up to 104-105 as soon as he walks in, is muzzled & trying to bite through the muzzle, basically becomes hysterical. And that's when I'm there to help him. We also can't do anything painful or even uncomfortable to him @ home without him going into the same right response (makes nail trimming agony). It would not be fair to him. I'd kind of like to know, but since it wouldn't change anything, I would be putting an already miserable guy through a traumatic procedure just to have a label to slap on it & satisfy my need to know. Neither my vet nor I can come up with a likely discovery that would be treatable. I don't know - anyone have thoughts about something else it realistically could be? I'd love to do diagnostics if I could see a point!

 

We've basically spent the weekend debating whether we need to euthanize him in the next few days. I was hoping (unrealistically as I already knew but don't want to accept) that someone would have magic ideas that might buy him & us a few more days. I hate this decision,never gets easier. & he's too damn young.

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Well, with the much pain one must think OSA or IVDD. You already mentioned that you wouldn't pursue amp-would you pursue spinal surgery?

I guess one thing you could do is try a fentyal patch to buy some time until you decide which direction to take but, honestly the end result may still be euth.

Edited to add--you can also do a chemical restraint if you which to perform diagnostics (ace/telazol combo-I would be glad to share dosages if you would like them)

Edited by tbhounds
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As hard as it is for you, you have to remember to put the dog first. Sometimes the most humane thing is to send them on. If the increase of meds isn't making a difference I would really think about quality of life. It doesn't sound like it's good. I'm terribly sorry for what you're going through.

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