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Kitten freaking out post-amputation procedure
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2 December 2017 - 12:35 pm
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Hey everyone.

Howl's amputation surgery was on Thursday November 30 2017. Everything was going great since we brought him home; he has been using the litter perfectly fine, eating, taking his meds, and walking around the one room we have him confined to. 

On the morning of Saturday December 2 2017, around 9:30 am, Howl was sleeping in my arms in bed with me when he started freaking out. He leapt at least three feet in the air, and then launched himself off of the bed. He slammed into the wall, thrashed and rolled around, and literally flies into the air doing flips. It lasted for about 10 seconds but it felt like 10 hours. It was terrifying. I tried catching him in mid air to stop him from hurting himself, but he sliced open the palms of my hands. He finally stopped, and I spoke to him in a soothing voice while petting him. He then did it again, five minutes after the first "episode" (for lack of a better term). He thrashed and flipped across the room for 5 seconds. Within half an hour, he did this five times. He would have an episode, stop for several minutes, and then do it again. I called the vet in a panic and they told us to bring him right in. He proceeded to have one more episode in the carrier before we got to the vet.

Amazingly, he didn't rip any stitches. I am absolutely baffled how he didn't, but am glad that he didn't. The vet isn't quite sure what could be causing it. There are a lot of possibilities, but they seem to think these are most likely.

1) the medication he's on has a bitter taste, when he falls asleep and then wakes up, he tastes the bitterness in his mouth and freaks out.

2) he is having panic attacks. the sedation from surgery has worn off and he is now realizing he is missing a limb. 

He is on two types of pain medications and an antibiotic. He shouldn't be feeling any phantom leg pain as we have addressed that as well. It is terrifying, and it seems to happen upon waking up. I've put him in his crate even when I'm monitoring him now because I'm terrified that he's going to do real damage to himself soon, but even in the crate, I fear he can do some real damage. He has both a cone and a premature baby onesie that I have sewn to be functional for him. He does great with the onesie, doesn't seem to bother him, so I leave the cone off as long as I'm there and can monitor him. He has these episodes with and without the cone, and with and without the onesie on.

I am wondering if anyone has experienced this with their pets after amputation, feline and canine alike.

Livermore, CA
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2 December 2017 - 1:15 pm
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How scary!

I'm sorry little Howl is having these episodes.

Can you tell us what meds he is taking?  You said phantom pain should be managed so I'm guessing gabapentin is one? Howl is a rear amp?

From a dog owner's perspective it sure sounds like episodes of phantom pain. Although I don't think I've heard of so many episodes in so short an amount of time.

Has he had any episodes since you brought him back home? Did the vet do anything besides look at him- any meds or checking sutures? Was he wearing the onsie when the episodes started? Could the sutures be catching on the onsie?

When Tri-Pug Maggie had her first tumor removed from her side she was very unhappy and I finally figured out that the incision was pulling her skin tight which mimicked wearing a shirt which she hated.

I've read some cat members describing some 'flopping' after their kitties amp surgery- hopefully they will be along shortly with some better ideas.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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2 December 2017 - 1:36 pm
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krun15 said
How scary!
Can you tell us what meds he is taking?...

Yes and he is also on buprenorphine and metacam for pain, as well as clinacin as an antibiotic. Howl is a front left amp. He has had three episodes since we came back home from the vet. They always occur immediately upon waking up, and then more follow shortly after another in a 10-30 minute time frame before I calm him down and he falls back asleep. The vet checked his sutures and incision site and said everything looks amazing. I have lots of pain meds at home so she told me we could do a half dose of the buprenorphine when he has one of the attacks, but it didn't seem to do anything. He was actually not wearing the onesie when it first started. I had taken it off this morning to wash it as I have been washing it every morning, and he was sleeping on bed while I monitored him until his onesie was done drying. His incision was in the open and he wasn't wearing the cone. I then tried to put the cone on him after his first three episodes, and he began to thrash again so I took it off. I out the onesie back on when we came back from the vet and he has had the three episodes since then.

I'm at a loss, he was doing so well. He has no problem walking whatsoever, (considering he hasn't used that leg most of his life anyways), he's been eating well, using the litter no problem and everything seemed like it was going so well and it's heart breaking to see these episodes keep happening and not being able to help him. 

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2 December 2017 - 1:45 pm
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hexicsparx said
He shouldn't be feeling any phantom leg pain as we have addressed that as well...

How have you addressed phantom pain? Nor Gabapentin? Hot/cold compresses?

Interesting take your vet has there...the symptoms certainly seem to indicate phantom limb pain. Pain management can be tricky, especially nerve pain, as can identifying pain symptoms in cats and dogs.

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2 December 2017 - 1:58 pm
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Yes, as well as some light massaging in the surrounding area. He seems to have less episodes when he is wearing the onesie, as he has over 5 without it on and has had 3 with it on. He also seems to do better if I wrap him up in a blanket (like a burrito) and hold him (almost like a makeshift thunder shirt). The vet tech suggested to try that because they believe he is having post-surgery panic attacks, and it seems to comfort him and stop the episodes but I can't exactly hold him 100% of the time until he gets over this.

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2 December 2017 - 2:07 pm
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Goodness me 😳

Poor you and poor kittie ...

That is totally scary, I wish I had any advice but I don't know what to say ...

I was owned by a Great Dane and thankfully she never had anything similar happening to her. 

You've already had good advice reg phantom pain and I'm sure others will chime in to share their experiences.

Sending you a big hug and keeping fingers and toes crossed Howl will ger back to normal soon 😘😘🐮💫✨🌟🌹

Eurydice 77kg/170lb Great Dane limping end of April 2016, amputation (right front leg/osteosarcoma) 4 May 2016 6 courses of carboplatin followed by metronomic therapy, lung mets found 30 Nov 2016. 3 courses of doxorubicin, PET scan 26 Jan 2017 showed more mets so stopped chemo. Holistic route April 2017. Lung X-ray 5 May 2017 showed several tennis ball size mets, started cortisone and diuretics. Miss Cow earned her XXL silver wings 12 June 2017, 13 months and 1 week after amputation and 6 1/2 months after lung mets, she was the goofiest dawg ever and is now happily flying from cloud to cloud woof woofing away :-) 

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2 December 2017 - 3:06 pm
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For clarity- is he taking gabapentin or no?

My quad pug Obie had an allergic reaction to something (we think, never did find the reason it started) which transitioned into what we think was something like a panic attack.  He didn't jump around but he was agitated, drooling a ton and hyperventilating.  After benadryl did not slow him down we had to go to a tiny amount of a tranquilizer called acepromazine to calm him.  I generally will not use these types of meds but it was the only thing that calmed him down.

I would first make sure his pain is being managed.  Buprenorphine is often given to cats (from what I've seen here).  Metacam is an anti-inflammatory which offers limited pain relief but will help. I would talk to the vet about maybe adding gabapentin (if he is not on it) and maybe increasing the dose or the frequency of the buprenorphine. 

Do the episodes seem to occur some time after the pain meds have been given? Maybe he is having breakthrough pain.

I'm sorry you are dealing with this!  Hang in there and keep talking to your vet about what you are seeing.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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2 December 2017 - 3:35 pm
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krun15 said
For clarity- is he taking gabapentin or no?

My quad pug Obie had an allergic reaction to something (we think, never did find the reason it started) which transitioned into what we think was something like a panic attack.  He didn't jump around but he was agitated, drooling a ton and hyperventilating.  After benadryl did not slow him down we had to go to a tiny amount of a tranquilizer called acepromazine to calm him.  I generally will not use these types of meds but it was the only thing that calmed him down.

I would first make sure his pain is being managed.  Buprenorphine is often given to cats (from what I've seen here).  Metacam is an anti-inflammatory which offers limited pain relief but will help. I would talk to the vet about maybe adding gabapentin (if he is not on it) and maybe increasing the dose or the frequency of the buprenorphine. 

Do the episodes seem to occur some time after the pain meds have been given? Maybe he is having breakthrough pain.

I'm sorry you are dealing with this!  Hang in there and keep talking to your vet about what you are seeing.

Karen and the Spirit Pug Girls  

Yes to the gaba. His buprenorphine dose is already high, and his first episode was less than an hour after he received his medication. The last episode was about half way between his doses (every 6 hours) so "I topped him up" as the vet suggested but it didn't seem to calm him. I started a chart, and I'm keeping track of when the episodes happen and what he's doing, and they always begin the second he wakes up. All of the medication he is on, he has been on before and never had an issue until this morning. He has been on the buprenorphine and metacam ever since I adopted him (so exactly three weeks today), he started the gaba before the surgery, and he had this antibiotic when we first adopted him for an infection. I'm at a loss for what if could be other than as the vet explained "kitty post traumatic stress" 

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2 December 2017 - 5:49 pm
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Poor Howl, and poor you! This sounds extremely stressful. 

I'm sorry I don't have any sage advice... but I'm sending you both good thoughts. Hopefully this will shift soon! How scary for you all!

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2 December 2017 - 7:51 pm
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I'm sorry to hear Howl is having these episodes. First you said that Howl did very well when he came home - that was to fool you. The meds from the surgery were still in his system. They've now worn off.

My cat Mona was also on Buprenorphine and Metacam. I think Mona went nuts from the Buprenorphone. She even jumped up onto a window sill where the window was partially open and crawled up the window screen between the screen and the glass. It turns out that full grown cats without a front leg and scapula can go very flat.

Buprenorphine is an opioid and opioids can cause dysphoria in cats. Dysphoria is the opposite of euphoria - the cat is restless rather than blissed out. Here is an article at may be helpful: https://www.mspca.org/angell_services/pain-vs-dysphoria/

Mona's dosage was 3-4 times a day. I was giving it to her 3 times a day and in retrospect it may have been better to give a smaller dose 4 times a day. I also learned that the Buprenorphine and Metacam should not be given at the same time and it's better to space them out. Mona was only on the Buprenorphine for 3.5 days and did much better with Metacam only from then on.

I hope this helps and Howl can soon manage with just the Metacam. Gabapentin can have it's own challenges and who knows what effects numerous pain meds have mixed together.

I hope Howl gets to acting "normal" soon. I like your idea to wrap him up like a burrito. Mona seemed most comfortable to be close to me and being massaged.

Kerren and Tripawd Kitty Mona

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2 December 2017 - 8:16 pm
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A chart is a great idea.

Kerren makes a good point about a reaction to the meds.  From personal experience opioids can really cause you to lose your mind! I could process what was happening (sort of) but for an animal it could really freak them out.  TriPug Maggie acted like something was chasing her whenever she took strong pain meds.  I didn't really understand it until I had to take strong meds after one of my surgeries. 

I really hope Howl can settle soon! 

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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3 December 2017 - 5:19 am
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Well, as I feared, Howl injured himself. During one of his episodes last night, he broke his back nail and it is sideways and basically only hanging by a thread. I called the vet clinic last night and they said as long as it wasn't actively bleeding, I could keep him at home and bring him to them this morning where they will have to remove the nail. I haven't slept in a few days because I have been constantly worried and monitoring him, so his vet clinic offered to take him and monitor him for the day at no cost so I could get some sleep. 

This poor guy can't catch a break. Here's a photo of a stoned kitty taking a good nap in his premature baby shirt that's still a little too big on him (it's impossible to find a baby shirt small enough for a >4 month old kitten.

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3 December 2017 - 6:37 am
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You poor thing! So sorry you are all going through this. Huckleberry did not experience anything like that. He did have times though, that he would jump out of nowhere and then frantically groom. Something just doesn't sound right, I wonder if maybe he IS reacting to one or more of the meds somehow. The buprenorphine did mess with Huck a bit, I wonder if they should take it away and see how he reacts on just the other meds? I know its not too comforting, but I am glad it was only his nail and not something worse that he hurt. Maybe him being monitored by the animal hospital will give you all some leads on what is going on. He is not having seizures is he? 

Take the time to get some rest, it sounds like you are in serious need of it, I hope you are able to figure more out so that you can get to the bottom of it. 

Hugs,

Jackie

Hugs,

Jackie, David, and Huckleberry

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3 December 2017 - 8:37 pm
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I can't believe how hard this recovery has been for Howl, it's got to be one of the hardest I've seen here.

I sure hope the vets can figure out what is going on while the monitor him- this is definitely not normal.

I hope you got some rest today, and some answers.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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4 December 2017 - 3:41 am
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Good morning,

I hope you were able to get well needed rest. Keeping fingers crossed that Howl is doing better, poor little guy. Praying they get an answer that makes some real sense and can finally get him comfortable.

Big hugs 

Jackieheartheart

Hugs,

Jackie, David, and Huckleberry

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