Time Between Med Doses

[NeylasMom]

For the love of god, someone please put me out of my misery. I can't tell you how much time and angst have been spent over med schedules in the past month.

 

I finally called my vet to ask about it because I was stressing about 2 days of the week where it's not always possible for me to be home at the designated time and they set my mind at ease about varying it an hr or two in either direction. But then we switched a med from every 8 hrs to every 6 hrs. Well that eliminates the wiggle room in my mind. So today when I was forced to be 2+ hrs late I'm doing calculations trying to decide if dosing every 5ish hrs or every 7ish hrs is better until we're back on schedule.

 

Honestly, it's approaching comical at this point, but when you have a dog with bone cancer you don't really want to f up this very important bit, you know?

 

So if someone would please tell me this is all for naught and 2 hrs this way or that way won't matter, that would be great. What I'd ask my vet if I had access, the med that's every 6 that I had to give 2 hrs late, could I have just given the next dose in 4 and then resumed our normal every 6 schedule? I was too nervous to do that (and it's too late now) as we're toward the higher end of the dose range as is (I'm giving 300 mg of Gabapentin every 6 hrs). The Tramadol every 8 and the Robaxin every 12 are so much easier. Also, neither of those require a 4 AM wake up call. <- me getting a little maniacal from all of the stress of dealing with this stuff

[tbhounds]

Let's see if this helps--both Tramadol and gabapentin are very flexible in the times that can be given. It's fine to give Tramadol every 6 hours. To make life easier I would give the gabapentin and the Tramadol together and not worry if you give them a bit earlier or later than you would have hoped to.

[XTRAWLD]

Gaba super flexible. 300 a dose certainly on the upper end poor thing. Kasey had a bit of a side effect when coming off it and muscles would slightly shake .... so that was pretty easy to see when he needed it again!

 

I'm not sure if this will help your sanity but it certainly helped mine, but write it all down on a piece of paper and get a pill dispenser (I got one that had room for a bunch of pills in one section but also had 4 slots - Breakfast Lunch Dinner Bedtime which you could think of as "times" instead) and load it for the week.

Edited July 1, 2016 by XTRAWLD

[llm51807]

This is all such great information. I'm dealing with the same thing with Cecil. I was late getting home from work yesterday and missed his dose of gabapentin by 3 hours and he's been doing so well the last few days. I felt awful. So then I was afraid to give his nighttime dose so close to the midday dose because if was late (he's on 200mg 3x/day), so I took it to bed with me and put it on the nightstand. I thought I'd wait to midnight to give it right before I fell asleep. Well, I fell asleep and woke up at 6AM and sat straight up and yelled OH CRAP! Needless to say his meds are totally off now and I'm wondering about throwing in an extra 100mg midday today to get the total amount in his system up. Does it even work that way? He seemed OK this morning - no worse, but I feel horrible. I'm going to pick up a pill case this weekend to be sure this doesn't happen again.

 

Ay yai yai! When you find someone to put you out of your misery, please send them over here next!

[NeylasMom]

 

Ay yai yai! When you find someone to put you out of your misery, please send them over here next!

Well not that I'm glad you share my pain, but it's reassuring I am not alone in my neuroses. If it makes you feel any better, I have 8, EIGHT! alarms set up to go off daily on my phone to remind me when it's time to give each round of meds.

 

As for Cecil, if he doesn't seem to be feeling worse, I'd say just resume your normal schedule. Are you doing every 8 hrs now or did you decide to bump to every 6?

[Guest Sportingfields]

I hope this helps, for humans in nursing homes and assisted facilities, they have the permission via doctors and state inspectors to give dosage within an hour either way of whatever time that med is scheduled. All my med instructions come with if a dose is missed, take it as soon as possible, if it is near the time it should be given, then skip that dose and resume regular schedule. If it was me and I was 2 hrs late giving a med, that was a 6 hr dosage, I'd give the med, then bump to 5 hrs for the next dose and resume regular schedule there after. I've done this with Tramadol, it lasts in the system for a good while, so being a bit late is fine and taking the next dose 5 hrs later doesn't overload with side effects. I asked a friend whom take Gabapentin and they agree for this med too.

 

For professional advice, call your pharmacist, they will actually be more knowledgeable, sometimes even more than doctors and certainly know more than rambling cyberfriends

[llm51807]

Well not that I'm glad you share my pain, but it's reassuring I am not alone in my neuroses. If it makes you feel any better, I have 8, EIGHT! alarms set up to go off daily on my phone to remind me when it's time to give each round of meds.

 

As for Cecil, if he doesn't seem to be feeling worse, I'd say just resume your normal schedule. Are you doing every 8 hrs now or did you decide to bump to every 6?

We're still on the every 8 hour plan. I didn't want to change anything until after his chiro adjustment and acupuncture to see how that helped. It did help. I think we'll stick w/200mg every 8 hours and supplement with tramadol. We've got loads of room on the tramadol dose and we've only been doing 1 every 8 hours; sometimes I add in another capsule and give 2 if he seems gimpier than usual.

 

I just got a Fitbit watch the other day, and this morning I set alarms for each of this pill times. We also dose homeopathic liquid remedies 4-5x per day that cannot be at mealtimes, so I totally get your 8 alarms! I should have set alarms sooner!

 

Do you think the zoledronate has kicked in for Zuri? That will be our next decision...whether to do another one of those.

[NeylasMom]

Sportingfields, thanks, that is helpful. And asking the pharmacist is a great idea. Although I get all of my dog meds at Costco to save money and think they are a bunch of idiots.

 

Do you think the zoledronate has kicked in for Zuri? That will be our next decision...whether to do another one of those.

He was running around like a crazy dog again last night so I started to get hopeful, but it's too soon to tell. If the trend continues that way despite increased activity then I'd say yes. He wasn't more gimpy this morning and he trotted a bit more on his walk than usual so those are good signs. I hesitate to say anything though because I don't want to jinx us!

[greysmom]

On a six-hour schedule I would probably not give them early, but would definitely give them within a couple hours late. Especially the gabapentin as it's very forgiving, and greyhounds tend to metabolize it faster than other breeds (according to Dr Couto). Though, you are dealing with a terminal illness, so to some extent, worry about side effects and dosing schedules can be put aside in favor of keeping their pain in check. In my opinion.