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Botched amputation, what now?
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The Rainbow Bridge

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11 December 2017 - 10:55 am
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But i'm not sure what else to do for him right now. 

You're off to a great start by asking here. I'm sorry this has been a ruff time. You and Ivan can get through this but I think some of these ideas will speed it up:

Has Ivan seen any kind of rehabilitation therapist yet? A licensed CCRT or CCRP can help pinpoint why he is in so much pain. Please try to get him to one. Where do you live? We can help locate one and the best part is the Tripawds Foundation may pay for your first rehab visit

Don't wait until the meds wear off to give him another dose. You want to always stay ahead of the pain, by following the schedule your vet prescribed, otherwise it's too hard to control pain once it's happening. If the pain occurs before the next round is supposed to be given, let your vet know you'd like to have his schedule adjusted. One week out from surgery is not a long time and many dogs are on consistent pain medication for at least 10 to 14 days.

He probably needs more than just Tramadol and Rimadyl to manage his pain. Most dogs do. Those are bare bones pain relief drugs and the newest standard is to add in something like Gabapantin or Amantadine. If your vets aren't willing to prescribe an additional drug, please find a vet specializing in pain management. If you'd like help finding one let us know. 

All in all it doesn't sound to me like it's how the surgery was done, but how the pain is being managed (both before and after surgery). A combination of a rehab therapist and pain management team can help Ivan get back to 100%. It may take longer than you'd like but it will happen. Be strong and patient, you will both get there. Please let us know how we can help OK?

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11 December 2017 - 10:56 am
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Hi there!

I know this is scary, and even moreso for Ivan, especially with the collar. I had Huckleberry on a good 2 weeks of medicine for pain. I think week one is the hardest. First several days  the anesthesia is still in his system. Now pain management is really crucial. He is a big beautiful boy, not a tiny kitty. Most people here have kept their dogs on the gabapentin for a while from what I have read. Even Huck had it for a couple of weeks. As you know, this is a big surgery! Please keep in touch with your doc regarding the pain. This is a dog that has never bitten, it sounds like on top of being scared that he may be uncomfortable. I see a lot of people have to adjust pain meds until you get him in a comfortable place. Sutures/staples are probably starting to get itchy, and I have no doubt that he is still sore. The gabapentin helps to ease the nerve endings which can also help against phantom leg pain . See if you can speak with your doc about pain management. The fact that the incision looks good is WONDERFUL! He is well on his way to healing but you are not out of the woods yet. Please keep in touch, I know the site has been fickle lately, I am so glad you got through!

Jackie

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

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11 December 2017 - 10:59 am
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Hahah, I think we posted at the same time 🙂 I'm not an expert in the big dog area, I knew one of you would be by with more experience  in the big dog world.

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11 December 2017 - 11:46 am
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I agree that this dog could probably benefit from some gabapentin.

Pam

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11 December 2017 - 1:51 pm
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jerry said

But i'm not sure what else to do for him right now. 

You're off to a great start by asking here. I'm sorry this has been a ruff time. You and Ivan can get through this but I think some of these ideas will speed it up:

Has Ivan seen any kind of rehabilitation therapist yet? A licensed CCRT or CCRP can help pinpoint why he is in so much pain. Please try to get him to one. Where do you live? We can help locate one and the best part is the Tripawds Foundation may pay for your first rehab visit

Don't wait until the meds wear off to give him another dose. You want to always stay ahead of the pain, by following the schedule your vet prescribed, otherwise it's too hard to control pain once it's happening. If the pain occurs before the next round is supposed to be given, let your vet know you'd like to have his schedule adjusted. One week out from surgery is not a long time and many dogs are on consistent pain medication for at least 10 to 14 days.

He probably needs more than just Tramadol and Rimadyl to manage his pain. Most dogs do. Those are bare bones pain relief drugs and the newest standard is to add in something like Gabapantin or Amantadine. If your vets aren't willing to prescribe an additional drug, please find a vet specializing in pain management. If you'd like help finding one let us know. 

All in all it doesn't sound to me like it's how the surgery was done, but how the pain is being managed (both before and after surgery). A combination of a rehab therapist and pain management team can help Ivan get back to 100%. It may take longer than you'd like but it will happen. Be strong and patient, you will both get there. Please let us know how we can help OK?  

Thank you so much! He is supposed to go to the vet by the end of the day for a walk in check up, but he's not in the mood to move. We are waiting for them to call us back, after 5pm EST. His oncologist also recommended Gabapentin, so I am going to try to get that for him today, if not by tomorrow. I know they didn't carry Gabapentin on site, so I'd have to get it called in by his oncologist. 

Ivan's temperament makes this all much more difficult. He's aggressive towards strangers and medical professionals. He won't attack for no reason, but you're certainly not allowed to approach him, or me. Because of this I'm dreading the day he needs to get his sutures out. Any X-Ray he gets we have to sedate him, and it makes everything cost more. It also makes me nervous about taking him to see an orthopedic specialist or physical therapist. I could muzzle him and let them feel him out, but overall it's a chore. 

I just gave him his first dose of CBD oil. I'm hoping it helps alleviate the side effects of all the pain meds, and helps with apoptosis. Does anyone else know if this can be helpful for pain too?

I'll keep everyone posted after I speak with the vet, or if I can get him there today for his post op check up. Hopefully I can get him on a third main management medicine by the end of the day. 

Guardian to Nikolay the tripawd, Co-Guardian to Ivan the tripawd.

Silas Sebastien 2009 - 2017 

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11 December 2017 - 2:14 pm
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paws120 said
Hi there!

I know this is scary, and even moreso for Ivan, especially with the collar. I had Huckleberry on a good 2 weeks of medicine for pain. I think week one is the hardest. First several days  the anesthesia is still in his system. Now pain management is really crucial. He is a big beautiful boy, not a tiny kitty. Most people here have kept their dogs on the gabapentin for a while from what I have read. Even Huck had it for a couple of weeks. As you know, this is a big surgery! Please keep in touch with your doc regarding the pain. This is a dog that has never bitten, it sounds like on top of being scared that he may be uncomfortable. I see a lot of people have to adjust pain meds until you get him in a comfortable place. Sutures/staples are probably starting to get itchy, and I have no doubt that he is still sore. The gabapentin helps to ease the nerve endings which can also help against phantom leg pain . See if you can speak with your doc about pain management. The fact that the incision looks good is WONDERFUL! He is well on his way to healing but you are not out of the woods yet. Please keep in touch, I know the site has been fickle lately, I am so glad you got through!

Jackie  

Thank you! Yes, it seems that Gabapentin in addition to what he's already taking would be more beneficial to him. Today is a bad day for him because my dad waited until he ran out of medicine before he went to the vet to go refill, and he went too long without taking anything. I told him him to please never do this again. 

On top of taking care of Ivan as much as I can, it's mostly monitoring my dad to make sure he's doing everything he is supposed to do. He's stubborn, kind of difficult and slow to change. So it's been rough getting him on board with how life needs to be now. 

Ivan has aggression issues and has tried to bite people before, but never, ever me or my father. So that tells us he's having a very hard time. His stitches must be itchy too, and overall just very uncomfortable. 

Today is actually the first day he hasn't eaten yet, and doesn't want to try and go outside. But hopefully some additional medicine will make him feel better. 

Thanks for the advice, I'll be sure to keep you all posted. 

Guardian to Nikolay the tripawd, Co-Guardian to Ivan the tripawd.

Silas Sebastien 2009 - 2017 

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12 December 2017 - 9:41 am
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Okay so we got the biopsy results back, it is osteosarcoma. Last night we took him to the vet to have his incision looked at. There's a little fluid build up but otherwise he's healing well. 

He gave us Gabapentin, but the also said that the Tramadol could be the reason he's acting so frantic and that we should stop it before giving him the gabapentin.

Now my dad has him on that and Rimadyl, didn't give him a tramadol today. Have people been giving their dogs all three post surgery? Gabapentin, Tramadol and Rimadyl? I told my Father to call the oncologist and ask for her opinion on the matter. We are supposed to start chemo next week, but I have to wait until I have enough money. I cannot believe how expensive it is!

He had another rough night last night. Lots of pain whenever he tries to move while laying down. He's not in pain when he walks around, and he's great on his walks. He is so very stubborn, and refuses to turn around to come home on his walks. Usually he goes for a two hour walk in the woods, and when he sees he's not going to the woods, he stops and refuses to move.  This has actually made him very depressed, but I'm happy to see he's acting like himself, wanting to do the things he normally does. 

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Guardian to Nikolay the tripawd, Co-Guardian to Ivan the tripawd.

Silas Sebastien 2009 - 2017 

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12 December 2017 - 1:00 pm
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Thanks for the update! Those three medications are a common quality pain management regimen.

Virginia
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12 December 2017 - 9:45 pm
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IVAN!!!  YOU ARE QUITE A HANDFUL YOUNG MAN!!!  A VERY HANDSOME HANDFUL!!!    AND YOU AND YOUR DAD ARE CERTAINLY MAKING "SISTER'S" LIFE ....ER....INTERESTING! 🙂    Okay....challenging!! 🙂

Yeah,as Admin Guy said, those three are  ost often given together.  However, Tramadol can make some dogs a bit whacky snd restless.  Sometimes the pain meds are hit and miss for a couple of tries untile you fi d the right dose, the right combo, given at the right time

So most of his pain allears when hes laying down?  Maybe try some good massagr all over, up and down his sline, arpund his neck, etc. See if he shows any tension. . Maybe laying down causes the incision to be a bit more pai ful.  Just throwing stuff out there.

I didw start my Happy Hannahw chemo until week three as I felt like she just hadn't recovered enough from surgery u til then.  So the threee week amrk is still "within range".

A d remee, Ivan doesn't care about anynole diagnosis!  That "report" doesn't mean squat to him!  Hesw gon a get throw this recovery and his sparkle will be bzck.....slowly at first, then it starts coming back faster and faster!

I have to say, the more I get to know Ivan and all his feiistyness, the more I adore him!! 

Keep js updated....and we @ove pictures of this hancsome voy in his red harness!

Higs

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

PS. I have a human  acquaintance who uses CBD for pain and says it works well! 🙂

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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14 December 2017 - 1:19 pm
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Ivan is not getting any better. Every night is sleepless and filled wit pain. I'm heartbroken and feel helpless. His oncologist and his veterinarian are telling me two very different things and his oncologist continually tells us that we aren't giving him enough pain medicine.  

He continually has what seem to be spasms of pain, especially at night when he tries to sleep. He can't get comfortable and just yelps out in pain, this happens about every half hour. He'll be sleeping just fine, then he wakes up yelping and turning in circles, looking for something or someone to bite.

She (the onco) is calling in a bigger RX of the gabapentin and told us to slowly increase his dosage and take him off of the tramadol. So he will now be on Rimadyl and gabapentin. 

It's been 10 days since the surgery and I'm not seeing any relief for him at all. I'm beginning to wonder if this was all worth it. I've been so consumed by getting to heal and be pain free that I haven't even gotten to devote the proper attention to his cancer. Has anyone else had this problem?

I'm considering taking him to a third vet, that specializes in surgery, just to see what their opinion on why he isn't getting better is. The wound is healing, but the rest of him is not. How long are they supposed to feel such horrible pain for? This wasn't even a full amputation, which I'm told, is more painful.  

Thank you everyone for your help and responses so far in the two posts I created. It's been so helpful for me and my dad, just knowing we aren't alone and being able to talk to others in the same position. heart

Guardian to Nikolay the tripawd, Co-Guardian to Ivan the tripawd.

Silas Sebastien 2009 - 2017 

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14 December 2017 - 1:49 pm
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I'm so sorry, this is ruff but not too unusual. I would agree with your oncologist and am betting that once you up the gabapentin dose you will see an improvement. Sometimes however, more needs to be done. I am keeping my paws crossed that this will be the ticket. Be sure to give it a few days to kick in though and never stop it suddenly or you can create more problems. See: 

http://tripawds.....dogs-cats/

I'm considering taking him to a third vet, that specializes in surgery, just to see what their opinion on why he isn't getting better is. The wound is healing, but the rest of him is not. How long are they supposed to feel such horrible pain for? 

They are not supposed to feel any horrible pain if the medication protocol is correct and current with modern standards. As I mentioned earlier, a consult with a vet who specializes in pain management could be a tremendous help for Ivan. Even surgeons don't have the background on pain management that these folks do. See:

http://tripawds.....-and-dogs/

You are most definitely not alone.

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14 December 2017 - 4:34 pm
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You are holding yourself together better than you realize!!  It is soooo hard seeing our beloved pets in pain and not beiw avle to do anything about it.  It's easier said than done, but try notmto despair!  🙂 Challenges like this do shownuptme to time.  Latience, time and the RIGHT PAIN MEDS, THE RIGHT DOSE, AT THE RIGHT TIME usually do the trick.

How much does Ivan weigh?

How much Tramadol was he on before and what dose interval?

What will his Gabapentin dose be and frequency?

There is another thing or two  that we do see around here sometimes.  Sometimes the pain may be a rogue staple that's causing some pain when henlays down in a certain position.

Also, sometimes there is an exposed nerve that wasn't taken care of during surgery.  DO get that third opinion from a qualified Surgeon.  They can better asses that type of situation.  It can be repaired if that's the case.

As Jerry said, the proper dosing of Gabapentin shoukd make a difference.  It won't be overnight, vut should kick in fairly quickly.  It can have a little sedation effect in some dogs, vut rest is good!

Everything else okay?  Eating, drinking, peeing, pooping?  Clearly he feels good enough he wants to walk and his mobility is good.

And his personality is shining through!! 🙂  I had a chuckle when you said he was looking for someone or something to bite! 🙂 🙂

STAY CONNECTED!!  We're all cheering for Ivan!

Lots of 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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14 December 2017 - 5:14 pm
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So sorry you are having such an awful time! I agree with the pain med maybe not being enough. From my own personal experience some vets think 3 days painkillers and all done. And they may not be generous with the dosage. I think an oncologist would understand pain better given their field. He is not in a place yet that pain meds are uncalled for. How bout this? Right down the middle. Let your oncologist give a better dosage of pain meds, you should see a difference pretty quickly, like within a day or so. If he's still not responding try another opinion of a vet you can trust. Hang in there, you are doing awesome!! You are his biggest advocate and you're doing a great job!!! I love how you have just plunged in, did research, and demand his comfort. And he's been difficult! Your unconditional love for this boy is simply amazing heartheart

Hang in there, we are all behind you!

Jackie

Hugs,

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

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

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14 December 2017 - 5:16 pm
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benny55 said
You are holding yourself together better than you realize!!  It is soooo hard seeing our beloved pets in pain and not beiw avle to do anything about it.  It's easier said than done, but try notmto despair!  🙂 Challenges like this do shownuptme to time.  Latience, time and the RIGHT PAIN MEDS, THE RIGHT DOSE, AT THE RIGHT TIME usually do the trick.

How much does Ivan weigh?

How much Tramadol was he on before and what dose interval?

What will his Gabapentin dose be and frequency?

There is another thing or two  that we do see around here sometimes.  Sometimes the pain may be a rogue staple that's causing some pain when henlays down in a certain position.

Also, sometimes there is an exposed nerve that wasn't taken care of during surgery.  DO get that third opinion from a qualified Surgeon.  They can better asses that type of situation.  It can be repaired if that's the case.

As Jerry said, the proper dosing of Gabapentin shoukd make a difference.  It won't be overnight, vut should kick in fairly quickly.  It can have a little sedation effect in some dogs, vut rest is good!

Everything else okay?  Eating, drinking, peeing, pooping?  Clearly he feels good enough he wants to walk and his mobility is good.

And his personality is shining through!! 🙂  I had a chuckle when you said he was looking for someone or something to bite! 🙂 🙂

STAY CONNECTED!!  We're all cheering for Ivan!

Lots of hugs

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

Thank you so much!

Ivan is about 82lbs right now. Normally, he is about 100 🙁 He had a bad kidney infection back in august that brought him down to about 88. Then the day of surgery he was down to 85, now he's 82.

Every day is different, some days he eats and then today he only ate a little. He is relieving himself normally most of the time, but he hasn't wanted to go out all day and now it's 7pm EST here in the US. 

He was prescribed 100MG Gabapentin. The vet that did the surgery initially told us to give him just one pill, once a day. When we realized on Tuesday that it clearly was not enough, we called his oncologist. She said we need to give him 4 pills every 8 hours. He's not quite up to that dosage yet, as I've read from multiple sources that animals need to build up and wean off of this particular drug. 

He was taking tramadol twice a day, but now we have him off of it. His stitches are like a thick plastic thread, and not sutures. 

It does make him very tired though. Right now he's passed out beside me. Some days are better than others but overall I expected him to be feeling a little better at this point. He's always so wiped out, and though he wants to go out, he takes awhile to go a short distance and overall does not have the strength or stamina. 

I'm currently looking into a supplement to give him. I read in Dr Demian Dressler's book about a product called K9 immunity . It's not cheap but it has great reviews. My father and I decided we are going to hold off on chemo until he shows us he's feeling better and that his pain has died down a little. He's supposed to start next week after his stitches are removed, but I don't think he's ready and I don't want to put his body through something else while he's still trying to heal. 

I never thought an exposed nerve could be the problem, but I really hope not. It's been a huge financial stress too and the bills are adding up coming in faster than our paycheks. I'm sure people here can relate to being in that boat. 

Thanks again for your response. I'll be sure to keep everyone posted. Hopefully we will notice a difference when we are up to giving him 4 gabapentin at once. I hate to see him so drugged up, but it's better than seeing him having his pain spasm freak outs :/ 

<3 

Guardian to Nikolay the tripawd, Co-Guardian to Ivan the tripawd.

Silas Sebastien 2009 - 2017 

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14 December 2017 - 5:25 pm
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paws120 said
So sorry you are having such an awful time! I agree with the pain med maybe not being enough. From my own personal experience some vets think 3 days painkillers and all done. And they may not be generous with the dosage. I think an oncologist would understand pain better given their field. He is not in a place yet that pain meds are uncalled for. How bout this? Right down the middle. Let your oncologist give a better dosage of pain meds, you should see a difference pretty quickly, like within a day or so. If he's still not responding try another opinion of a vet you can trust. Hang in there, you are doing awesome!! You are his biggest advocate and you're doing a great job!!! I love how you have just plunged in, did research, and demand his comfort. And he's been difficult! Your unconditional love for this boy is simply amazing heartheart

Hang in there, we are all behind you!

Jackie  

Thank you Jackie, that's so kind of you to say! We are now working up to 4 Gabapentin every 8 hours, as per the oncologists instructions. We will give this a day or two to see if it's changed, and if it does not we will call in for a third opinion. 

He had his highest dose yet a few hours ago, and he's been sleeping and groggy for the most part, but no pain spasms. I just worry about how long this will go on for. He still has cancer in his lung and this situation has distracted us from making sure we are on top of that as well as his post op care. 

Seeing him in so much pain makes me feel like maybe we did the wrong thing and should have just let a dog of his size and age live his last days not recovering from major surgery. But, I'm trying to stay strong and I pray and meditate on all major decisions before going through with them. I thought this was the right thing to do, but I hate seeing my boy cry out in agony. He even managed to bite my father today and break skin during a pain panic freak out session. I know he didn't mean to do it, he just throws his head around barking and yelping, snapping at things until he gets a bite of something. It's absolutely heartbreaking to watch. 

I'm hoping this upped dose will do the trick. We had to take him off the tramadol too so now he's only on Gabapentin and Rimadyl and I wonder if that's enough. Ugh, haha. I'm determined to figure this out though. The CBD oil doesn't seem to be making a difference for his pain, but I will still give it to him because of the alleged benefits it has for apoptosis. 

Thanks for checking in, I appreciate it. I'll update everyone soon. 

Guardian to Nikolay the tripawd, Co-Guardian to Ivan the tripawd.

Silas Sebastien 2009 - 2017 

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