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26 June 2018 - 12:40 am
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heartCarol and Blitz,

I am new here and am a rookie and also was lucky enough to have adopted a dog post-surgery so I was spared the terrible emotional pain you have (and are)enduring. I read this whole thread and am SO glad Blitz is doing better. Thank you for sharing your struggle so openly. This space helps so many in so many different ways.  I related so much to many pieces you expressed along the way —-not only with my new tripawd —-but other pups I have had (“What have I done”/“The meds are horrid”/“ He needs more meds”/ “Sleepless nights” etc. and when you love them like you do, their pain is AGONY and I resonated with all of it...the frantic and desperate feelings (and fearing the vets diagnosis of psychosis!) and also the distress about meds and dosing and decisions. Just wanted to send a hug. Hopefully you are all sleeping peacefully. 

Cashew, “ShuShu”, stray shot in Armenia (where this is sport!).  Lost left forelimb at 4-6 mos. old as a result of GSW. Adopted at 19 mos. in May 2018. Currently Working hard at PT. 

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26 June 2018 - 7:10 am
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Thanks again to my faithful new friends. It is always heart warming and relieving to hear back from all of you.

Today is postop day 15 for Blitz. We did see the vet yesterday. My husband lifted him into the car hugging his underbelly and he did not flinch. He rode well, which is unusual. He typically fusses the entire trip. We shared with the vet his discomfort at home most often while trying to lie down, or sit. He is constantly repositioning himself, whimpering and crying out with each move. It is very consistent. He will walk and hobble around and go outside to do his business and walk in the yard with little if any obvious discomfort, but when it comes to laying down to rest something is not right. I thought maybe he wrenched a muscle or the like due to his change in gate, and all the extra demands of his remaining front leg. I would think this adjustment alone would hurt long past the surgical site. I also wanted to be sure we were not giving him too much activity; out to do his business, small stairs with little help, waling in the yard, and sometimes taking off after a squirrel. We have had him out with us over the weekend while we work in the yard and he wanders a bit and then lays down in the grass. We also keep the cellar slider open so he can go in and out as he wants. Another thing he does is he is always after his incision site. A tshirt and the harness has helped with this.

He was examined by the vet from head to toe and she found "No strains or signs of injury". Staples were removed, his temp was fine and incision looking good. She explained that out of all dogs Dobermans have the roughest time recovering. She said "If he were a Lab she would be very concerned but not with a Doberman". She thought an additional 20 minute leash walk would be good for him. She thinks we are doing well with our pain management, and should stick to it, but wanted to give him another med and wean off of the Tramadol. She prescribed Amitidine 100mg q12. So he will be on Gabapentin 300 q12h, Carprofen 75 q12h, Amitidine 100mg q12h and the Tramadol 100 q6 until we wean him from it. 

Last night was an ok night. Not as relaxed as the night before. Between the itchy incision site, persistence in lapping it, and can't get comfortable to rest, it was a tought night. I think finally, out of exhaustion, and maybe finding a 1/2 way decent position, he will doze off to sleep. But if he wakes to reposition, the entire process starts all over again. 

This morning he ate well, did his business outside and came in to lay down, again crying to get himself comfortable. After watching him for a while my husband does not think he is in pain, and just having a real hard time adjusting to 3 legs "mad he can't do the things he did before". I disagree, respectfully of course. I do all the research on the net and with fine people like you and I don't believe this dog is just upset and frustrated. I KNOW my dog and I KNOW he is uncomfortable and in pain when he cries out. I am thinking we may be dealing with phantom pain , and wondered what you have experienced. It would make sense. Aside from being upright and hopping around he seems to be crying out in situations where he would be using his left leg (gone now) the most; pushing himself up from lying down, adjusting himself to lay on the other side, etc.... According to what I am reading, he fits the book; lapping or trying to knaw at the amputation site, not the incision site but down further where his limb would be. He has gone from waxing and waining discomfort postop to very situational types of pain, cries out, like the pain is abrupt and sharp. I understand that phantom pain is very different from surgical pain, and even any muscle pain adjusting to 3 legs. It is a neurological response where the leg if it were there is supposed to do something. The brain sends a signal to the missing leg, but it is interrupted because the leg is not there, and instead just terminating (painlessly), the nerves elicits a sudden response experienced by the dog as shooting pain, sudden, and abrupt. My hope is that between the Gabapentin and the new drug Amitidine any phantom pain will eventually be minimized or eliminated.

I did some reading today about message therapy for phantom leg in dogs, and will be starting that regimine at home. Lots of great education and tips on the Tripawd site and other sites as well. I am also going to encourage mental stimulation. He does not play, or kneed his ball anymore. He does not knaw on his chewy bone toy anymore. He seems the happiest (sometimes) when he is outside in the yard, or otherwise occupied to keep his mind off his troubles. So the regime will be medication therapy, message therapy and mental stimulation.

Ok, what do you think? Am I nuts?

Green Bay, WI
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26 June 2018 - 9:02 am
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Hey Carol - no, you're not nuts , you're a mom who is worried about her boy. The phantom limb pain idea is probably spot on, and the gaba should help with that. I wonder about your vet's suggestion of a 20 min leash walk at this point, however. I would've NEVER considered this with Nitro at this early stage of recovery. I think I took him on a short walk (I use this term lightly, because Tripawds don't really walk anymore, they hop, and in Nitro's case, it was a sprint) maybe 2 months post surgery if not longer. I was super paranoid of hurting/damaging the remaining front leg, that perhaps I was a bit overprotective.

Our first summer was spent outside in the yard; I would bring a book outside, and just sit with him on his pillow and let him enjoy the sights and sounds. Eventually he started playing again - every picture I took of him seemed to be with a tennis ball in his mouth. And he started to enjoy chewing on his bones again...yes, they figure out a way to do it one-pawed.

As for the incision site, I think I used to take some lavender essential oil, mixed with coconut oil and rub it on him. And massages are always good. In my humble opinion, I think I would take the next couple weeks, get your med combination figured out, and just take is slow and easy. I also remember I was in a hurry for things to return to "normal", as you may be, but try to take it slow and not rush things. He will progress when he's ready.

Also, I'd never heard that about Dobe's having the most difficult recovery...interesting. The first 2 weeks were ruff for us, but then he came into his own, and rocked life on 3! Good luck, keep us posted. Remember you can call or text me whenever you need to. Hugs!

Paula and Warrior Angel Nitro

Nitro 11 1/2  yr old Doberman; right front amp June 2014. Had 6 doses carboplatin, followed by metronomic therapy. Rocked it on 3 legs for over 3 years! My Warrior beat cancer, but couldn't beat old age. He crossed the Bridge peacefully on July 25, 2017, with dignity and on his terms.  Follow his blog entitled "Doberman's journey"

http://nitro.tr.....27_2_1.jpg

"Be good, mama loves you".....run free my beautiful Warrior

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26 June 2018 - 9:57 am
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 I wanted to wait for a more experienced member to reply even though I read this pretty early this morning. As I was reading,  I too thought phantom pain and then just a second later you said you thought that might be what it was. Just my intuition and two cents. I also agree about 20 minute walk being totally too much. My pup is about 14 months postop… So wayyyyyy post op… And she right now is on a PT program of two separate 10 minute walks a day and she is also not allowed any free roaming in the yard without supervision. So tough but —who said “I’m not doing this to her/him but for her/him”. And yes you’re not nuts. We know when they’re suffering. You’re doing so great for Blitz and we are all with you!!

Cashew, “ShuShu”, stray shot in Armenia (where this is sport!).  Lost left forelimb at 4-6 mos. old as a result of GSW. Adopted at 19 mos. in May 2018. Currently Working hard at PT. 

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26 June 2018 - 10:27 am
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spayurpets said
...she right now is on a PT program of two separate 10 minute walks a day... 

Walking alone does not constitute physical therapy. FYI: Walks will not build strength, only stamina. Check out some of the starter exercises recommended by rehab therapists, or find many more suggestions in Loving Life On Three Legs , and consider visiting a CCRP/CCRT for a professional evaluation and a prescribed exercise regimen specifically for Blitz. The Maggie Moo Fund for Tripawd Rehab can even pay for your first consultation, thanks to Tripawds Foundation supporters.

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26 June 2018 - 10:33 am
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Yes yes yes. I should’ve clarified. I’m so sorry. The walking is 1 out 10 strengthening exercises and other things we are doing. It is not the sole component of her PT. blush

Cashew, “ShuShu”, stray shot in Armenia (where this is sport!).  Lost left forelimb at 4-6 mos. old as a result of GSW. Adopted at 19 mos. in May 2018. Currently Working hard at PT. 

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26 June 2018 - 2:19 pm
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I agree with Paula and ShuShu's pawrent regarding the 20 minutes. That seems like a huge start. I would def start smaller, way smaller. Like how about up the street and back and if he sits before he gets to the end let him rest a minute and then straight back home. As you well know, this was major surgery, it's going to take time not only for the surgical site to finish healing, but for his body to adjust.

Baby steps ❤️❤️

Hugs,

Jackie, David, Mitchell, Andy Oscar, and the coolest feral tripawd kitty Huckleberry

http://paws120......pawds.com/

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27 June 2018 - 4:09 am
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Does anyone know how long phantom pain lasts? I hope it is not a chronic issue. I also learned the Amantadine will take a week to become therapeutic. I am convinced this is phantom pain and found a nice article on it from a sled dog owner who recommended mild compression using an ace or spandex over the missing leg site. I have coincidently been doing this wth Blitz and it definitely helps. 

https://tripawds.com/wp-content/blogs.dir/1/files/2007/10/caninephantomlimbpain.pdf 

Green Bay, WI
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27 June 2018 - 9:38 am
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I don't believe its a chronic issue, it should eventually stop...but I don't know the timeline for this.

Paula

Nitro 11 1/2  yr old Doberman; right front amp June 2014. Had 6 doses carboplatin, followed by metronomic therapy. Rocked it on 3 legs for over 3 years! My Warrior beat cancer, but couldn't beat old age. He crossed the Bridge peacefully on July 25, 2017, with dignity and on his terms.  Follow his blog entitled "Doberman's journey"

http://nitro.tr.....27_2_1.jpg

"Be good, mama loves you".....run free my beautiful Warrior

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27 June 2018 - 11:26 am
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I am so sorry that you are having such a hard time with recovery.  You have received lots of great advice.  I agree advocate for pain control.  I don't  think the phantom pain should last forever.   We never had to deal with the phantom pain .

I agree 20 minute walks this early is probably way too much.  I just let Sassy walk around our yard and did a leash walk around the house and that was a little too much so we backed off ( have a pretty big yard). 

I also agree if you don't believe you have the best care with your vet or they are not listening.  Consult another vet.  We are an advocate for our babies. I believe you are doing the best you can. 

Also, I remember awhile back that someone's dog had an issue with a suture that was internal that was pulling.  I can't remember how they determined that but they finally figured it out.  Just maybe an idea since he acts like it's pulling when he moves around and lays down

hugs

Michelle & Angel Sassy

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Sassy is a proud member of the Winter Warriors. Live long, & strong Winter Warriors.
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07/26/2006 - Sassy earned her wings 08/20/2013

"You aren't doing it TO her, you are doing it FOR her. Give her a chance at life."

Minneapolis, MN
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27 June 2018 - 1:20 pm
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Hello - I am sorry you are having ups and downs with how Blitz is feeling.

I do think being steady on the multiple meds (they are different modalities and act in concert) is wise and will be key to getting you through this.  I have found, in our own experience and in sharing with others in the past, that sometimes it is frequency - getting full coverage, that is at play.

Pofi had a nerve sheath tumor which is also very painful and gabapentin is really crucial pre and post op, but still in conjunction with an opiod and an NSAID.  He actually took 300 mg every 8 hours before and after surgery.  I initially thought some of the symptoms you have described meant it was too much.  I think at first (pre-op) he was prescribed 200 mg every 8 hours and the vet agreed we could try backing down and that was much worse.  Switching to 300 mg every 8 hours was hugely impactful. 

Pofi was likely a similar weight and was a deep chested, tall, front leg amputee and weighed about 75 lbs.  For two weeks before and two weeks after surgery he took:

  • 300 mg Gabapentin 3x daily
  • 100 mg Tramadol 3x daily
  • 75 mg Rimadyl/Carprofen 2x daily

For better coverage, I did not actually give Gabapentin and Tramadol at same time - did a two hour gap between them.  After about 2 weeks, we cut down to Tramadol 2x a day and then in another week I cut the twice daily dosage in 1/2 to be 50 mg twice daily.  In another week I cut down to 1 Tramadol a day and one Rimadyl a day.  Then I cut those out and started reducing dosage of Gabapentin and frequency.  He was down to no pain meds by week 5 to 6 post op.  

Consult with your vet, of course, on mixing up the schedule and frequency and if you think you aren't being heard, say that. Say, "I really need to feel you hear me on this."  And I echo concerns that 20 minutes walking may not be what is right for Blitz at this point.  Dogs are individuals.  

Sending warm thoughts for you all to feel better. heart

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His Daddy and I miss him terribly along with his canine sister, Mia, and two feline siblings, Lucia and Cliff.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation

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27 June 2018 - 4:31 pm
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I don't think you are nuts at all, phantom pain is very real in many Tripawds. Did you happen to have a chance to connect with the acupuncturist at your clinic? Dry needling acupuncture is one of the most helpful tools for alleviating phantom pain .

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29 June 2018 - 10:46 am
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Hi Everyone, Blitz is postop day 18. It will be 3 weeks Monday. Yesterday was a good day, thought maybe we finally hit the tipping point where he will feel better progressively, but today not so good. Yesterday he had probably 5 episodes of sudden cries, mostly early morning and early evening. Today I have stopped counting. Vet wanted me to start weaning the Tramadol then when I called about his pain they wanted to add Percocet. Too many vets and one does not know what the other is doing. I am going back to my regular vet, who has an accupuncturist we will see today at 4pm. Hester your story is interesting. Blitz was 93 lbs, now 87, and on Gabapentin 300mg, Carprofen 75mg, and Amantadine 100mg 2x daily. I was giving the Tramadol with that 100mg q6 but vet thought we should wean off.  I tapered down to 1 tab and last night was first night without it. This morning about 8am I was sure he needed it and gave it to him.

How much pain is acceptable? I say little to none. 

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29 June 2018 - 10:59 am
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Carol,

Ugh. I’m so sorry. I know what it feels like to have many vets on the scene who are not communicating and it is extremely difficult. I have started to research phantom pain and found this paper which may or may not be helpful. I hope it’s ok to post the link. I put it below. I always think vet journals are a great place to go. 

I want to echo others that someone else may need to take a look at Blitz but I’m sure they will share their knowledge shortly regarding the phantom pain issues and Blitz. I also am a strong believer in acupuncture so hoping it helps. I am worried maybe there is a nerve issue as someone else suggested earlier. 18 days out seems like quite a bit for yelping cries pain but anxious to hear others weigh in. 

This paper, however, suggests it may last for I believe four weeks approx. Agree that little to none is ideal and I guess the question is when to expect that...

https://www.journalvetbehavior.com/article/S1558-7878(17)30090-4/pdf

Cashew, “ShuShu”, stray shot in Armenia (where this is sport!).  Lost left forelimb at 4-6 mos. old as a result of GSW. Adopted at 19 mos. in May 2018. Currently Working hard at PT. 

Virginia
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29 June 2018 - 11:27 am
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Sorry for quick response,  but jist wamted to mention again, TWO THINGS TO GET THOROUGHLY  CHECKED,OUT:

Because this omly seems to happen more when he's  trying to lau down or fetmup, it still seems a rouge staple is hirting him OR  Airgeon needs romgo in and check to make sure their are jo dangly  merves that need ro be xlosed.....not sure of medical terms

Phanton USUALLY  is out of the vlue wild screams and dog gets up and tries to run away from it.  It's  not necessarily  relat3d to certain  movements.   Dog can be sound asleep.  It generally lasts seconds as opposed ro minites.  Anuway, if this is just trlat3d to those movements  you were  describing,  ,ay be time to check out the other possibilities. 

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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