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Might I suggest that if you talk to Dr Couto - find out his opinion on doing tramadol (50mg) 4 times a day and the gabapentin 3 times a day but, at less of a dose (maybe 300). Just my opinion but, I found more frequent dosing worked better as you are medicating before the pain breaks through.

I agree with more smaller doses. I tried to get the vets to go that route. So I'm going to wait for Dr Couto.

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:(

 

I'm sorry for your news.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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Thinking of you and beautiful Tanzi this morning. I hope that she is comfortable. Please be aware that the Tramadol might make her seem depressed - it had that effect on my Wendy. I hated seeing my spunky, funny girl so down.

Irene ~ Owned and Operated by Jenny (Jenny Rocks ~ 11/24/17) ~ JRo, Jenny from the Track

Lola (AMF Won't Forget ~ 04/29/15 -07/22/19) - My girl. I'll always love you.

Wendy (Lost Footing ~ 12/11/05 - 08/18/17) ~ Forever in our hearts. "I am yours, you are mine".

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I am so very sorry. We were all hoping for better results.

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Cindy with Miss Fancypants, Paris Bueller, Zeke, and Angus 
Dante (Dg's Boyd), Zoe (In a While), Brady (Devilish Effect), Goose (BG Shotgun), Maverick (BG ShoMe), Maggie (All Trades Jax), Sherman (LNB Herman Bad) and Indy (BYB whippet) forever in my heart
The flame that burns the brightest, burns the fastest and leaves the biggest shadow

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Wow, I just heard from Dr Couto. He said 100 mg Tramadol 3 times a day and 200 mg gabapentin 3 times a day is maxed for her.

This amount was what she was on before I spoke to her vets after the CT. Her vets upped the amount to 1800 per day.

I'm surprised.

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So sorry to read this Years ago I gave Dusty (87 lbs) one gabapentin. He could barely move the whole day. Maybe just him though. Don't know if that reaction could increase fall risk for your beautiful girl. Thinking of you.

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I hate to say this, but Dr Couto is just flat out incorrect. I'll dig up a good article on pain mgt that includes dosages and post shortly.

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Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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I hate to say this, but Dr Couto is just flat out incorrect. I'll dig up a good article on pain mgt that includes dosages and post shortly.

I agree. Especially if you have days left, just get her back on the amount prior in the very least since she tolerated it. She shouldn't be in pain.

 

What I find interesting is that you've heard back from him. He's been silent for me since US Thanksgiving even after multiple follow-ups.

 

I wish Tanzi and you all the best. So tough.... :(

Edited by XTRAWLD

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Here is the article on pain management and dosing. Note the upper range of Gabapentin mentioned (nearly 4000 kg of Gabapentin a day for a 70 lb dog).
http://www.vasg.org/newer_options_for_chronic_pain_management.htm

 

You mentioned Gaba and Tramadol, but not an NSAID. You really need an NSAID as part of your protocol if you aren't already using one. I found Tramadol the least useful. The NSAIDs seemed to provide both of my dogs with the best pain relief but you're much more limited in dosing with those, so Gabapentin, which also seems to work very well in terms of pain reduction and has such high safety margins is quite useful.

 

If it helps, Zuri was up to 500-600 mg every 6 hours at the end.

 

You do need to be careful about wooziness. Zuri would sometimes get a little stumbly with dose increases, but within a day or two at the most it would go away. The way we mitigated that as we started increasing later on was to give more smaller doses per day (we switched from 3 to 4 toward the end, which meant getting up in the middle of the night for me, but was worth it - 2 a day is definitely not enough with the short half life of Gabapentin) and more importantly, when we increased, we only increased one dose for the day. So if has was on 300 mg 3x/day the day we increased I would give 300 in the AM and mid-day and give 400 at night. Then once side effects resolved, I would give 400 first thing, 300 mid-day, and 400 at night. And then finally I would give 400 at all 3 doses.

 

Hope that helps and I'm sorry for the bad news. :(

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Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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It took 2 days, cerenia, metronidazole and Prilosec before she started eating again after a week of Rimadyl.

 

I don't know what nsaids would work, and the vets didn't offer another alternative to Rimadyl.

 

But I've already broke all the doctors advise.

The Tramadol is staying the same, but I'm giving 200 mg 5 times a day. It is 100 more than the vets said. But I'm stretching it out.

 

Thanks for the article.

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Any NSAID would work. You could ask your vet which might be easier on the stomach, but Galliprant might be a good option. There's another medication in a totally different class (info in that link) called Amantadine, but it's supposed to enhance the effect of other drugs so likely wouldn't be a good idea if you don't have an NSAID on board. There's also Tylenol (it is safe for dogs - talk to your vet about dosing) and then there are options like Codeine, Fentanyl, etc. but you're really getting into side effect territory with those. But if she can't do the NSAID the Tylenol might be worth trying.

 

The only other thing I will add - based mostly on my conversations with a vet who specializes in hospice and end of life care - Tramadol doesn't work the same in dogs as it does in humans. It doesn't actually relieve pain, supposedly it simply blocks pain receptors. Her feeling is it doesn't do all that much except cause sedation. She was much more in favor of Gabapentin. So I would focus on upping that as you move forward though you could switch to giving the Tramadol dose every 6 hours as well if you feel it's helping.

 

I think you're saying you're giving the Gabapentin 5 times a day? That's probably excessive - 4 times per day is sufficient. I would probably alternate 200 and 300 based on what you're already doing, so 200/300/200/300 and then if there are no side effects and you aren't happy with the pain relief you can increase another dose to 300 and then another.

 

ETA: And then there's always hemp or CBD products.

Edited by NeylasMom

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Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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Liquid meloxicam is easier on the stomach than any other nsaid in pill form, and you can dose it much more accurately. I've also had much better pain control with codeine sulfate than with tramadol, on multiple dogs.

 

But, if you only have a short time with her, you don't want to waste it running back and forth to the vet and the pharmacy. Use what works out of what you have, and when you can't control her pain any longer, it's likely time.

 

{{{HUGS}}}}

Chris - Mom to: Felicity (DeLand), and Andi (Braska Pandora)

52592535884_69debcd9b4.jpgsiggy by Chris Harper, on Flickr

Angels: Libby (Everlast), Dorie (Dog Gone Holly), Dude (TNJ VooDoo), Copper (Kid's Copper), Cash (GSI Payncash), Toni (LPH Cry Baby), Whiskey (KT's Phys Ed), Atom, Lilly

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I was doing 200/200/100/200/200 which is less than what you had down in 4 times a day.

 

I'll talk to my vets about some of the options you mentioned.

Sorry if I wasn't clear. I meant excessive in times per day, not amount. Your total per day could be way higher, I just don't think you benefit much from dosing 5 times a day rather than 4.

gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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How is Tanzi doing today? How are you holding up? God, this sucks! I hate that you two are going through this. Gentle hugs.

Irene ~ Owned and Operated by Jenny (Jenny Rocks ~ 11/24/17) ~ JRo, Jenny from the Track

Lola (AMF Won't Forget ~ 04/29/15 -07/22/19) - My girl. I'll always love you.

Wendy (Lost Footing ~ 12/11/05 - 08/18/17) ~ Forever in our hearts. "I am yours, you are mine".

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My above info was only for gabapentin. Tramadol is 100/3 times a day.

 

She slept very well last night, getting up twice. Once to change position and once to go out.

She woke up with piss and vinegar. Feeling very good. Even attacking a toy.

So we went to the bank, one of her favorite places. I told them it was probably her last visit.

On the way home she was very whiney and couldn't sit still. I finally pulled over and took her coat off.(it's 7 degrees here)

That was it. That stinker. Here I'm all worried she's in pain, or the meds are making her anxious. The visit was too much. And she just didn't want her coat on.

 

So yesterday I was wondering if she was going to make it a week. Today I'm almost sure she will.

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