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Buffy's Amputation - Post Op Questions


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Guest asaccamora

Long post ahead. Its been 3.5 days since Buffy got her front leg amputation. There was no post op bleeding through 3 days and the doctors discharged her to us last evening.

 

Meds:-

She has a 100mg/hr fentanyl patch which she was transitioned into from IV opiate on day 1.5 (not sure which IV opiate).

She gets 2x 50mg Rimadyl.

 

Concerns:-

What I am trying to get a handle on is who much rest did your hounds 3 days after surgery? I was expecting her to be more sedated than nervous.

I dont know if the Fentanyl side effects are bothering her or if her pain meds are not sufficient. She lets me pick her up and doesn't complain or go after her incision/shoulder. Would like to know what your experiences have been.

 

Behavior:-

She was sedate when we picked her up but she has slept 2hrs in two half hour installments and one time a full hour since she came home.

She was nervous on car ride.

She came home and straight away went to her water bowl so she realizes she is home.

In the space of 12 hours she has asked to go out ~ 5 times. We are tying to get her into a 3X schedule today.

 

Things I expected:-

2 days on not eating = not the greatest of poops last night and she has an upset stomach.

She was super dehydrated, drank almost 3, 8" bowls of water after coming home. She is peeing.

She still likes her peanut butter so pills are going in

She has eaten a bit of food, treats and peanut butter her but appetite is not 100%. Thats normal when her stomach is upset.

Also looks like opiates can do funny things to their stomach too.

 

Thing I didn't expect:-

Constant panting and crying. She is not a moaner/complainer but granted these are extenuating circumstances.

She pants she is nervous but she usually tires herself out and settles down with 15-20 mins. This is going on for hours (13 and counting).

She seems fine laying on her left side (amputated her left arm).

 

 

 

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Taylor stayed in the hospital for 6 nights due to serious edema and swelling, even with Amicar.

He was off the patch after 4 days, and then on to 200 PM of Tramadol every 8 hours and stayed at that dose until stitches came out at 2 weeks, and then over the course of 4 days, reduced the Tramadol to nothing.

That Tramadol did make him whiny and pant, but he did sleep most of the time.

There was LOT of peeing the the first few days at home. Out at least 3 times from 11:00 PM till 7:00 AM, and then every 2-3 hours during the day to get rid of the edema.

Don't try to "schedule" her peeing. Let her out to pee as needed. Need to keep things flowing.

 

Constant panting and whining sounds like she is being under medicated for pain.

It is critical that pain be managed the first couple of weeks.

 

Take a look at my thread in this section, "My boy Taylor" started the day he was diagnosed with Osteo.

There might be some things there to help you.

Edited by Beachbum1
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Guest asaccamora

Taylor stayed in the hospital for 6 nights due to serious edema and swelling, even with Amicar.

He was off the patch after 4 days, and then on to 200 PM of Tramadol every 8 hours and stayed at that dose until stitches came out at 2 weeks, and then over the course of 4 days, reduced the Tramadol to nothing.

That Tramadol did make him whiny and pant, but he did sleep most of the time.

There was LOT of peeing the the first few days at home. Out at least 3 times from 11:00 PM till 7:00 AM, and then every 2-3 hours during the day to get rid of the edema.

Don't try to "schedule" her peeing. Let her out to pee as needed. Need to keep things flowing.

 

Constant panting and whining sounds like she is being under medicated for pain.

It is critical that pain be managed the first couple of weeks.

 

Take a look at my thread in this section, "My boy Taylor" started the day he was diagnosed with Osteo.

There might be some things there to help you.

Thanks! Buff tolerated Tramadol + Rimadyl very well before surgery. Mostly she was loopy and sedate. I am going to call the docs this afternoon if things dont improve.

 

Noted on the peeing, Its a lot of effort for her to get up and pee multiple times, thats the worry.

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Guest asaccamora

She is at least dreaming about chasing and catching rabbits. Thats good. She has slept for 2 hours this morning. Perhaps exhaustion? Who knows.

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Some greys don't tolerate a fentanyl patch well. She might do better on oral meds if you are around to give them regularly.

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Guest asaccamora

Meds will make them anxious.

 

It seems the hardest part is the first 2 weeks. Hang in there.

 

Thanks. Hanging in there.

 

Some greys don't tolerate a fentanyl patch well. She might do better on oral meds if you are around to give them regularly.

I called the docs to see what they would recommend. The patch is supposed to come off on Tuesday.

 

In continuing observations, she sleeps for about an hour after she gets her morning and evening Rimadyl. This leads me to think that she is perhaps not receiving enough pain meds.

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No advice, but thinking of you. As I've read on many other posts, the first few days and even weeks are trying. Hang on and keep helping her fight and carry through, and try to stay ahead of the pain.

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Often Rimadyl has a kind of sedating effect (at least that's what has been my experience).

 

Pinky slept a lot, would pant and whine when she needed to go out. It was like the idea of the effort she knew that getting up and going out was going to require made her a little bit whiny. She allowed me to help her though.

 

If the restlessness and panting continues, I'd ask about getting the Fentanyl patch off of her and getting her onto oral meds. Be aware that tramadol might cause the same effects though, if she's prone. We had Pinky on Deramaxx and tramadol. You might ask about gabapentin too-helps with nerve pain, and also can have a sedating effect. Obviously you don't want her so sedated she's loopy, but, if it will help her rest comfortably so that her body can work on healing, that's always good.

 

Might also ask about trazodone. Clarice had a vulvoplasty two weeks ago and it was a GODSEND for keeping her chilled out about her incision.

 

Are you checking her temperature regularly? Keep an eye out for an elevated temp...often your first clue to a post-op infection.

Kristin in Moline, IL USA with Ozzie (MRL Crusin Clem), Clarice (Clarice McBones), Latte and Sage the IGs, and the kitties: Violet and Rose
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Guest asaccamora

No advice, but thinking of you. As I've read on many other posts, the first few days and even weeks are trying. Hang on and keep helping her fight and carry through, and try to stay ahead of the pain.

 

Thank you! This form and its people are wonderful. So are the pups.

 

Thanks. Hanging in there.

 

I called the docs to see what they would recommend. The patch is supposed to come off on Tuesday.

 

In continuing observations, she sleeps for about an hour after she gets her morning and evening Rimadyl. This leads me to think that she is perhaps not receiving enough pain meds.

 

The doc recommened that I take the fentanyl patch off but buff screamed bloody murder when I tried. It seems very stuck onto her skin and hair. Might have to go to our local vet. I am taking away my hypothesis since she actually lets me touch the incision site and she also lays on her incision!

 

Often Rimadyl has a kind of sedating effect (at least that's what has been my experience).

 

Pinky slept a lot, would pant and whine when she needed to go out. It was like the idea of the effort she knew that getting up and going out was going to require made her a little bit whiny. She allowed me to help her though.

 

If the restlessness and panting continues, I'd ask about getting the Fentanyl patch off of her and getting her onto oral meds. Be aware that tramadol might cause the same effects though, if she's prone. We had Pinky on Deramaxx and tramadol. You might ask about gabapentin too-helps with nerve pain, and also can have a sedating effect. Obviously you don't want her so sedated she's loopy, but, if it will help her rest comfortably so that her body can work on healing, that's always good.

 

Might also ask about trazodone. Clarice had a vulvoplasty two weeks ago and it was a GODSEND for keeping her chilled out about her incision.

 

Are you checking her temperature regularly? Keep an eye out for an elevated temp...often your first clue to a post-op infection.

I think buffy has done some of the whining as a way to ask to go out and a preemptive complaint to go walk. Buffy actually tolerated tramadol+rimadyl very well pre-op. Haven't checked temperature but she doesn't feel much warmer than usual. I might take her to the vet to get her patch out tomorrow and rewrap her compression wrap.

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You can use baby oil/mineral oil/vitamin E oil on a washcloth to help peel back the patch so it doesn't pull her skin. :) Just get some of the oil up under the edge, then continue to wipe at the underside of the patch while you pull on it. It'll come right off :)

Kristin in Moline, IL USA with Ozzie (MRL Crusin Clem), Clarice (Clarice McBones), Latte and Sage the IGs, and the kitties: Violet and Rose
Lovingly Remembered: Sutra (Fliowa Sutra) 12/02/97-10/12/10, Pinky (Pick Me) 04/20/03-11/19/12, Fritz (Fritz Fire) 02/05/01 - 05/20/13, Ace (Fantastic Ace) 02/05/01 - 07/05/13, and Carrie (Takin the Crumbs) 05/08/99 - 09/04/13.

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I haven't been through this exactly, but we went through something similar a few weeks ago when Jake broke his femur. I'll echo what everyone told me then because it is so true- the first week will be bad, but it gets better after that. The peeing and drinking is normal and just let her go as much as she wants. If she is having a hard time getting out you can put pee pads down and try to let her know it's okay to go in the house. Jake got to the point where he would just lay and pee on himself which was awful, but he was just in pain :( The hard part was only about a week or even less for us and then he learned how to manage on 3 legs for awhile. Also he lived on canned food for a good two weeks. Good luck!

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Guest asaccamora

You can use baby oil/mineral oil/vitamin E oil on a washcloth to help peel back the patch so it doesn't pull her skin. :) Just get some of the oil up under the edge, then continue to wipe at the underside of the patch while you pull on it. It'll come right off :)

So the trouble was that there was a large adhesive bandage on top of the fentanyl patch. That bandage was stuck on good and no wonder she wasn't happy when I tried to pull it off. In order to get at the patch, they needed to cut off her existing bandage+wraps (it was pretty much right on the base of her neck).

 

It took the vet tech ~ 5 mins and plenty of spray to get it off! Poor pups skin was raw and bloody at the end of it.

 

I haven't been through this exactly, but we went through something similar a few weeks ago when Jake broke his femur. I'll echo what everyone told me then because it is so true- the first week will be bad, but it gets better after that. The peeing and drinking is normal and just let her go as much as she wants. If she is having a hard time getting out you can put pee pads down and try to let her know it's okay to go in the house. Jake got to the point where he would just lay and pee on himself which was awful, but he was just in pain :( The hard part was only about a week or even less for us and then he learned how to manage on 3 legs for awhile. Also he lived on canned food for a good two weeks. Good luck!

Poor Jake! Buff is doing much better today. Ill post an update in a separate post.

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Update on Buff

 

She was less disturbed last night and slept a couple of hours. Her poops are fine thanks to the probiotic :thumbs-up . She eats a cup - cup and a half of dog food + pumpkin + boiled chicken pieces.

 

Took her to our local vet to get the patch + adhesive bandage off and man it was a process! The trouble was the bandage on top of the patch was large and stuck on pretty hard. Good thing we didn't try that again at home. I gave her 100 mg of tramadol at noon and man she is so much calmer and is sleeping now.

 

The incisions and sutures looked good and there was some slight oozing, no discharge per say. Our vet wanted to give her an antibiotic for a few days and a recheck on Friday.

 

Buff wants to go out on walks to her usual spots around the block. She is done with the backyard apparently. I am trying to make sure she doesnt exhaust herself and mostly carrying her back home. Her endurance is picking up slowly but thats a mixed blessing since now she will just arg around the back yard till we go out. She said hi to 2 of her dog friends and some of her human friends so that helped a bit.

 

She still manages to do downward facing dog and lay like a sphinx (aka super girl pose in our house), amazing will these guys have :bow2

Edited by asaccamora
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It's truly amazing how fast they adapt :heart

 

For her skin where the adhesive was, Bag Balm is your friend :)

Kristin in Moline, IL USA with Ozzie (MRL Crusin Clem), Clarice (Clarice McBones), Latte and Sage the IGs, and the kitties: Violet and Rose
Lovingly Remembered: Sutra (Fliowa Sutra) 12/02/97-10/12/10, Pinky (Pick Me) 04/20/03-11/19/12, Fritz (Fritz Fire) 02/05/01 - 05/20/13, Ace (Fantastic Ace) 02/05/01 - 07/05/13, and Carrie (Takin the Crumbs) 05/08/99 - 09/04/13.

A cure for cancer can't come soon enough.--

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Guest asaccamora

It's truly amazing how fast they adapt :heart

 

For her skin where the adhesive was, Bag Balm is your friend :)

Yes indeed Bag Balm is good. The docs put a ligament on before rebandaging her. We will check again at the end of the week.

Edited by asaccamora
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Guest asaccamora

Update on Buffy:-

 

First off thanks for all of your help and positive thoughts.

 

She is doing good with eating, drinking, hopping around. She has been letting me sleep through the night mostly which is awesome. She has figured out how to climb up and more impotently down a couple of of the stairs on the front porch.

 

She tolerates the tramadol so much better than the fentanyl patch! There hasn't been any crying/incessant panting since she transitioned off the patch.

 

We checked her bandages at the vet today the sutures look good and the bruising is thankfully almost all gone from her under carriage. We are thinking about starting some hot compress from today and also removing her bandages for good tomorrow morning. At least we will be around to keep an eye. Once she was back home her digestive system bounced back quick and her potty routine is getting closer to usual. She still needs a couple of extra pee breaks but at least she is comfortable doing that in the back yard.

 

We have a visit with the oncologist on Tue.

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That is great news!

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:clap hope she continues to do so well

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Guest GoingGrey

Glad you finally got that patch off!

 

My elderly fella recently had a horrible reaction to fentanyl. It was all the panting, restlessness and whining, and it didn't abate until I demanded they remove the patch. The e-vets didn't think his pain would be manageable with just oral meds and didn't want to do it, but they were wrong. He improved to the point of being able to be discharged once they removed it. Just doesn't agree with some greys apparently.

 

Hope she's continuing to improve--and let you sleep some. :-)

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