We will likely be helping Tshuvah over the bridge this weekend.  She is enjoying enough of her favorite activities to warrant giving her these last few days and also a passage that we believe would be her preference (at home, outdoors, with our favorite vet).  Since her condition has definitely changed in the past couple days I will be reviewing our medication protocol with our other vet tomorrow; this vet isn't the greatest for pain management in my prior experience.  We have few options, living rurally, so I'd like some input. 

Tshuvah was prescribed gabapentin 100mg twice a day back in July, about 3 weeks after her amputation, for intermittent yelping that we figured might be phantom limb pain.  She did well all summer on the evening dose only.  This week I began giving her the morning dose as well.  that was a no-brainer since it was previously prescribed by the oncology vet.  In the past two days I've been adding 1/2 to 1 tablet of Tramadol twice a day.  Tramadol seems to make Tshuvah anxious or something, not quite like herself, but I know its an important and safe analgesic.  I added it because she is having pain when walking.  I hesitate to give her any NSAIDs because her stomach is very sensitive to them.  She won't take any pills in food so I have to be careful, especially in the morning when she typically doesn't like to eat.  She's always been an afternoon and evening eater.

She weighs 40 – 45lb and her diagnosis is hemangiosarcoma.  She is 3 months past diagnosis.  I'm just looking to keep her comfortable and alert so she can enjoy a few more trips to the park, some more homemade stew, and another visit to the mountains.  You should have seen her hopping along the mountain trail on Monday!  We didn't go far but she loved it.

My question is whether Tramadol is the best addition to gabapentin at this point or if another pain med should be considered, and what meds are typical for this particular point in the end of life process.

Thank you,  Beth

I, too, don't have any advice regarding pain meds(but DO really LOVE Gabapentin)…but want to second what Shanna said…Hugs to you and your family in the coming days ahead.

Tracy, Maggie's Mom

Wish we could offer advice regarding the medication, but we can certainly offer lots of hugs & pawsitive thoughts to you! It's not an easy time for you, keep doing what you're doing – giving her lots of love & some of her favorite things!

Cathy/Jane/Spirit Skyler/Chloe

Hi Beth,

I don't have anything to add in regards to the pain meds but just wanted to say that we are thinking about you…. and will keep you and Tshuvah in our thoughts and prayers.

Brett

Thanks everyone.  I hardly feel I deserve any praise but I accept all the good wishes and blessings, particularly for Tshuvah.  I should have taken out stock in kleenex when she was first diagnosed…lots of crying going on here although not usually in front of her.  I found a great peace with her passing in talking to a highly recommended animal communicator (referred by Rita Reynolds, let me know if you want her info).  today she visited my daughter's new elementary school and then went to the park for more meets and greets.  But for the first time I had to carry her part of the way to and from the parking lot.  Nonetheless, everyone comments on how happy she looks and acts. 

I told my 5 year old daughter that Tshuvah is getting old and that the sickness that was in her leg is in the rest of her body now, so Tshuvah's body probably won't live much longer.  We haven't talked at all about Tshuvah's dying since we didn't have any idea when it would happen.  Now that we know, we decided to clue Lila in.  She took it very well.

I'll talk with our vet about the tylenol/codeine combo.  Tshuvah seems to be tolerating tramadol better today, and I'll up gabapentin to three times per day.

Its exhausting, isn't it?  The emotional part of loving her so much, wanting the best for her, holding myself together, waiting until Sunday.  There's a confusion of wanting Sunday to come right away and never ever wanting Sunday to come.  OK, more tears, better go get the kleenex.  Thank you all for loving my Tshuvah along with me.  I'll go hug and kiss her for y'all.  I'm so blessed to have found tripawds.

Beth

Beth,

We're keeping you and Tshuvah and your family in our prayers and hearts.  I agree with Shanna – you are handling this with such grace.  I'm having a hard time typing with tears, so will keep this short and sweet.  We'll hold all of you in our hearts.

Sending lots of hugs and as much comfort as possible across the miles,

Holly, Zuzu and Susan