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Possible Nerve Sheath Tumor
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6 August 2017 - 9:29 am
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hester said
Whitney, I am sorry this is rough.  Questions:

    1. Did they remove the Fenatnyl patch?
    1. Did they approve Gabapentin again?
    1. Did they suggest any appetite stimulant short term?  Mirtazapine works well for many to get over that initial inappetance.

I really tend to think the Fentanyl is at least part of the reason for screaming.  Pofi was a mess on Fentanyl in the hospital - he really did not want to eat and was way out of it.  I visited in hospital about 24 hours post surgery and got him to eat just enough that they thought they could reduce the Fentanyl drip and start giving oral meds, which was Gabapentin, Tramadol and Rimadyl plux antibiotic.  The next morning after that reduced dosage of Fentanyl and starting the oral pain med trio, he was a completely different dog - bright eyed and waiting for them sitting up in his kennel - bounded out and nearly escaped the ICU room before the doctor got him on leash.  Pulled the doctor outside so he could pee.  They were amazed.

My surgeon was a firm believer that the Gabapentin was necessary and by far the most effective for pain in particular with a nerve sheath tumor and removal of it with amp.  We talked about how whenever that tumor is poked or prodded, it sends its pain signals out the the network of nerves.  She called it "jangling" the nervous system and she believed it really could take days to settle it back down.  I used the analogy of a really large and complex spider web.  When a bug flies into it and is caught, but struggling, the whole web vibrates and reverberates with that movement.  Nerve sheath tumors just seem like they have the potential to be different from osteo amps this way. The nerves are just so much more directly impacted and have been.  I think there is just residual agitation in the nervous system.  And frankly, this is just my opinion, but the chance of phantom pain just seems like it has to be increased when there was a nerve sheath tumor.

Of course, I am NOT A VET.  But this is what I would be talking to my own surgeon about.

Sending best thoughts.

Final question, do they offer medical boarding at the hospital?  Can they take her in for day time and meds if you are working?  

She's still wearing the fentanyl patch and is taking tramadol every 6-8 hours, amoxicillin twice a day, and previcox once a day. My mom was able to get her medication, some food, and water down with a syringe this morning. She actually seemed to enjoy the food once she got used to it, so this is an improvement! I'm hoping she does this well when my husband and I try to feed/medicate her later today. I definitely plan on talking to the surgeon who performed the surgery tomorrow. He hasn't been available this weekend, so I've been getting opinions and advice from different vets who have been working over the weekend. I would love to remove the patch and start gabapentin to see if we notice a difference. When we went to the hospital Friday night, they said they didn't want to add gapapentin at this time since it was such a struggle to get the current 3 medications down. My parents have decided to come sit with her and give her medication throughout the week while we're at work, which is a tremendous help.

benny55 said
This is so exhausting, mentally and physically dor you!  Not to mention that your frustration level must ve off the charts!

Couple of things for the Bet ro check out THOROUGHLY:   They need to make sure her esophagus/trachea   are not  badly iritated from the intubation.   I think it's actually called "esophogeas",  or something like that.  

The other thing is to insist on at least trying th Gabapentin for several days.  If the screaming is phantom limb pain, that would definitely help with that.

When does the fentynal patch come off?   You may ask about getting that off now and starting the Gabapentin in conjunction with the Tramadol.  .  You do want to make sure you can at least get the pain pills in her first though.

To clarify........was her FIRST pee TWO days after coming home?  If so, the Bet REALLY needs ro check her ro make sure she isn't having something causing that.   It may simply ve all the meds, surgery, etc....but TWO days is waaaay too long!!   I may have misread what you wrote.

One more thing that we've seen happen here on ocassion.  A nerve ending xould be left exppsed and/or a stitch could be pulling or digging into that nerve ending everytime she tries to take the standing position.   Make sure the Vet checks that out. 

Not sure I buy this is "just a Beagle with low tolerance for pain" ,etc.  This IS .MAJOR SIRGERY and it hurts!!  The additional screaming "spasms" seemed to be something that needs further investigation and treatment.

Hopefully your parents can help get the pills in her steadily for a couple of doses.    Your parents, at least at first anyway, maybe able to solicit a different reaction when they try tonpill him and feed her.    It is hard to maintain a confident energy when you know your dog is  going to scream in pain and clinch his jaws shut if you try to pill her!!   You are doing a remarkable job!!!

Is this the Orthopedic Surgeon you are going to?  Anyway, you may want to get a second opinion if you don't get any feedback from some of the things Ive mentioned.

STAY CONNECTED!  You'll get through this ROUGH period!   There ARE things that can be done to make sure she gets past all these issues!   Please keep js updated!

Lots of hugs!

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!  

I am definitely going to ask the surgeon about the gabapentin tomorrow when he's back in the office. They didn't want to add it on Friday because she was already struggling to get the 3 pills down. The fentanyl patch is supposed to stay on until Tuesday/Wednesday. I'm hoping we can remove it and switch up the medications tomorrow after I speak with him, though. She peed at the vet on Friday morning before we picked her up and then again last night. We were just worried when she didn't drink all day Friday, but she finally started drinking a bit yesterday afternoon. I'm feeling a little better now that we got some food, water, and medication in her this morning via syringe. The syringe and mashed up medication seemed to be a lot less traumatic for her than the pill gun. I will also ask the vet about her esophagus tomorrow. There have been a couple of times where she'll start to bark, because her sister barks, and that throws her into a screaming fit. So, I definitely think something could be going on with her throat. 

Thank you all! I feel like we're progressing very slowly, but hopefully I can get some more answers/advice from her actual surgeon tomorrow.

Virginia
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6 August 2017 - 9:33 am
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Good....remember the teeny tiny bit of progress during recovery is HUGE PROGRESS!! 🙂

And you have the best parents in the world!!! 🙂

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

Schofield, WI
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6 August 2017 - 10:17 am
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As Sally says some progress is huge progress!  Have you tried buying those purée jars of chicken baby food?  You could add a bit of low sodium broth and make it quite runny to be able to syringe it in case there is an issue with the throat.  I used to use that with sick barn kitties mixed with mother kitty milk replacer and the protein really helped perk them up.  Sending healing thoughts and prayers and hoping each day is an improvement from the one before it!  Hugs!

Virginia
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7 August 2017 - 4:20 pm
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Oh my goodness, I'm just seeing all of this. My Jake was very very loopy on tramadol. He wasn't a vocalizer, but I thought for sure he was going to bite me a few times and he was staring at walls etc. We had to take him off it. I haven't had a pet on Fentanyl, but I can tell you that they gave it to me one time in the ER many years ago and it was wicked scary stuff. I didn't know my ass from my elbow. It has to be really scary for them to be all doped up like that and have no clue whats going on. I agree with everyone on Gabapentin, especially with the NST. The way the vet explained it to me was that when they cut those nerves, they continue to try to fire off but with no where to go. 

So glad she ate a little bit! Chicken baby food mixed with broth is a great idea. 

Mom to Tripawd Angels Jake (2001-2014) and Rosco (2012-2015) and Tripawd Tanner. “Whatever happens tomorrow, we had today; and I'll always remember it”  

      

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9 August 2017 - 12:20 pm
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Just a quick update! Molly is doing SO much better today. It's a night and day difference. I just went home for lunch and let her out of the crate while I fixed my food and she managed to jump up on the couch in the 30 seconds that I was gone. It scared me half to death, but she was busy fixing a bed out of one of the blankets on the couch when I came back in the room. Clearly we're going to have to start watching her a little more closely, but I'm thrilled that she was comfortable enough to move on her own! She's still getting her food, meds, and water via a syringe, but she actually took a treat from me while I was home. I usually give her and Maggie, her sister, a treat before I leave to go back to work and she actually followed me into the kitchen to get it. We took off the fentanyl patch yesterday and started her on amantadine again last night, which is what she did so well with before. Words can't even begin to describe the relief/happiness that I'm feeling now that we're seeing glimpses of her old self. Now to hold her back from any more shenanigans for the next 9 days before the staples come out!

Virginia
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9 August 2017 - 1:19 pm
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YAAAAAAAAAY FOR MOLLY!!!!! 🙂 🙂 🙂   Absolutely thrilled to hear you are seeing improvement!!!!   And to see it this early on is sooooo exciting!!   

I always marvel at the delight dogs take in being able to master getting back up in THEIR couch again!!!   To me, that's a real turning point for human and dog!!! 🙂 🙂    MAde my day!!  Huge grin going on iver here!!! 🙂 🙂  

Hugs!  

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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