What goes up, must come down

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Yesterday Lucky was feeling very well, and was even able to blog about it. Today, not so much. It’s been a very rough day 6 for him so far. Before he went to bed last night we gave Lucky his first dose of gabapentin (100mg 1x per day) Last night was the first time he’s had middle of the night outbursts, and it happened twice (although not nearly as intense as his most intense sessions). In the morning we gave him 100mg tramadol instead of his usual dose of 150 (the surgeon said we should try to start weaning him off of tramadol). He’s been moping around all day and crying whenever he gets up at all. He also wasn’t interested in eating or drinking all day until lunchtime when we gave him his second dose of tramadol (this time we gave him 150mg because his morning was so bad). That was not too long ago, so we’ll see if things improve at all.

We’re really discouraged by this downturn. I know that everyone says the first couple of weeks are up and down, but it’s so hard to watch Lucky suffer. We’re trying to figure out if we can do something for him by changing his meds. I’ve seen lots of recommendations online (including Tazziedog’s reccomendation) for 300mg of gabapentin 2-3x per day, but I’m not sure if that’s right for Lucky, since our surgeon only prescribed 100mg. I also want to make sure I’m not just completely knocking him out all day every day, which I’ve heard gabapentin can do. He’s not on any NSAIDs, since he was on meloxicam pre-op and it upset his stomach. People seem to have good things to say about the efficacy of NSAIDs in curbing Lucky’s kind of pain, so we’re trying to decide whether or not its worth it to try a different one, like rimadyl. The really frustrating thing is that it’s impossible to get ahold of the oncologists or the surgeons who can help us out. We keep getting “they’ll call you back” from the front desks, and then no response.

Everyone has said that it gets better, so we’re trying to remain optimistic. It’s just hard to see the light at the end of the tunnel right now. I just want my best friend to feel better.

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6 thoughts on “What goes up, must come down”

  1. Welcome to the recovery roller coaster. Try to remain positive and take things one day at a time. Some dogs react well to a cold pack or warm compress, you might see if either help Lucky.

  2. Hi Jeff,

    I am no vet and Dakota did not experience phantom limb pain, so I have no experience with Gabapentin. I can’t comment on that medication or its dosage. Dakota is a golden mix, 86 pounds at surgery, so he must be close to Lucky’s size. Dakota’s dosage for Tramadol was also 150 mg 3 times daily. I gave him that full dosage until day 9, day before yesterday (today is 11 for us). He slept a lot and seemed perhaps a bit drugged (but not overtly), but he also yelped a few times when he was jostled slightly so let me know he had pain. For me, I was willing to take the tradefoff of a dopey but pain-free dog. I would want the same if I had that much pain. But that’s just me and others can make their own decisions. Besides, he’s supposed to sleep and heal right now, not be running marathons.

    Dakota also takes 1/2 of a 75 mg. tablet of Deramaxx, an NSAID, every day. For the first 5 days post-surgery, he took a full tablet.
    He takes his 1/2 tab daily for shoulder stiffness, and it helped markedly before the surgery. We decided that he would need that assistance afterwards since he’s a front amp. Shoulder stiffness could be a deal-breaker.

    That may sound like a lot of drugs. He did not come home with a Fentanyl patch like many dogs, so he only had those 2 meds. I didn’t think it was too much because of the yelping he did. Two days ago I began weaning him off the Tramadol. Yesterday, day 10, I gave him 50 mg a.m. and p.m. (way down from 150 mg) along with his 1/2 Deramaxx. Today I’ve only given him Deramaxx.

    I am not trying to tell you what to do for Lucky, not at all. I’m just giving you one example of a post-operative medication protocol. It was what was prescribed and recommended. I was told that I would know when to begin decreasing the drugs, and I did. I figured that yelping when he was jostled or bumped even slightly was a good sign that he needed the meds. Maybe Lucky needs more than your vet has prescribed. Dogs are as individual as people. I’m sure others here can tell you what their dogs required so you can compare.

    Personally, I would have little patience for paying a bunch of money to a doctor and having them not return my phone calls. I assume they’re close to you. Can you walk in and park until they talk to you? I would be inclined to stay until they answered my questions and took care of my needs. Your payment covers post-op care, too.

    Lucky will get better, and this will all pass. Good golly, if you had told me a week ago that Dakota would be doing this well today, I would have thought you were delusional. But things were rough for several days here. And if you think Lucky is hurting and his medication isn’t sufficient, you deserve to speak to the vet about it, and you deserve to be a part of the team making these decisions for Lucky. You know him better than anyone. You are his advocate. Your vet needs to listen to you. (My 2 cents, worth every penny.)


  3. bless your hearts….feeling helpless while your tripawd brother is in pain is no fun. staying calm, using the compresses that admin recommends and singing an old standard tune in 3/4 time are our recommendations. i spent several nites during the first week singing ‘the old rugged cross’ and ‘stardust’ to gayle. it will get better.

    charon & gayle

  4. It’s hard not to be discouraged, but remember that you need to be strong in order for Lucky to be strong himself. I know, easier said than done….

    Remember that oftentimes the whining is just due to feeling crappy from being doped up. It’s not that Lucky is on a downturn, it’s just that he’s confused and not sure what’s going on. The meds need to keep him doped up, it’s not necessarily a bad thing. It’s one way they can heal. Hard for humans to experience though, for sure.

    Meanwhile, if you’re not getting what you need from your vet office, go down there and tell them you will sit in that lobby until you do. That’s ridiculous when someone pays so much money for services and then can’t get follow-up help.

    Oh as for NSAIDs, I did really well on Metacam, but not so much on Rimadyl.

  5. THANK YOU SO MUCH for the advice and encouragement. With all the money dropped on the surgery and upcoming chemo, we’ll take every penny we can get :-). We’re getting Lucky’s meds figured out, and he had a much better day today. We met with someone new today and he’s having us move up the gabapentin to 300mg once a day (at night) and 100-150mg tramadol 3x per day. So we’re going with the dopeyness (especially with the gabapentin at night) because that’s a heck of a lot better than waking up to him yelping.

    Charon and Gayle, I’ve been singing Lucky his favorite lullaby, Swing Low Sweet Chariot. I like to think it helps him calm down, but maybe he just quiets down to get me to shut up!

    Thanks again everyone!

  6. THANK YOU SO MUCH for all of your advice and encouragement! Lucky had a much better day today. We got fed up with the unresponsive vets so we went to see a new oncologist recommended by Jerry to get his medication figured out. We’re going for the dopey but comfortable dog, and we’re moving his gabapentin up to 300mg once daily (at night to knock him out) as well as 100-150 tramadol 3x a day. Thanks for all of your advice on NSAIDs. After talking to the vet today, we decided that we’re going to see if we can control his pain without them, since his stomach seems to be very sensitive to them. Shari, thanks for your 2 cents. After forking it over for the surgery and the upcoming chemo appointments, we’ll take every penny we can! 🙂

    Charon and Gayle, I’ve been singing Lucky’s favorite lullaby, Swing Low Sweet Chariot. It seems to calm him down, but maybe that’s just because he’s trying to get me to shut up!

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