Parker said
After the usual hiccups post op with meds and lack of appetite Parker our Bernese Mtn dog was starting to reappear as himself. He was moving well, engaged in life and wagging his tail whenever anyone came into the room. He had some episodes of phantom pain every once an awhile early in his recovery, but nothing out of the ordinary. Now, out of the blue the pain seems to have escalated where he goes through episodes where he whimpers and vocalizes constantly. We put him back on Tramadol and started gabapentin 2 days ago, but he still appears to be experiencing a lot of discomfort. Has anyone else gone through this at 3 weeks post op? Hot and cold packs don't seem to have much of an effect. Sometimes just having us come into the room makes the whining start. Sometimes it is a sharp yelp, but often it is whimpering. How long can phantom pain go on? Do the nerves eventually settle down or is this perhaps permanent?

We originally removed his front leg to give him better quality of life and I am concerned we have given him less. It is heart wrenching to see him like this. Any help on this issue would be appreciated. I have read all the articles posted on this site, but would really like to talk to someone who has experienced it first hand.

Have you noticed spasms? My dog had phantom limb pain with spasms and gabapentin didn't touch the pain, but adding methocarbomal, a muscle relaxant, made a world of difference because it stopped the spasming. Sometimes it takes a few tries to find the right combination of medications / other treatment to get over this hump. I also found the tips admin linked to helpful, especially the cold packs. 

Do talk to your vet and try to talk to a specialist. It might also help to take a video of an episode so that the vet can get a good idea of what's going on. 

Things do get better!

Thanks for the responses.  Parker was doing well before this and had the odd yelp for pain, but nothing like what is happening now. Since Thursday he is pretty incapacitated with this pain. He is on Tramadol 3 times per day and 300mg of Gabapentin 3-4 times per day. Due to the tramadol he is pretty dopey, but we are just trying to keep him comfortable at this point. He has the sharp pain, but also will just lie there whimpering. He has an appointment with the specialists tomorrow. We have seen some small improvement in that the intensity of the episodes is somewhat reduced, but they are still coming very regularly. There is no rhyme or reason to them. He is not moving around much, but they come whether he is moving or not. We see the odd twitch of his muscle, but this doesn't seem to cause him any discomfort at this point.

Wondering DCJack how long the phantom pain lasted with your dog and at what stage of his recovery did it become an issue?

Could it be back spasms from walking differently?  Murphy had a lot of stiffness in his back legs a little while after surgery.  Massaging his back & his back legs seems to help.

Donna

I'm glad to know you already have a follow-up visit planned. I don't fully recall when the phantom pain kicked in, I think it was about 1.5 weeks after the surgery and I saw near fully improvement by 3 weeks after the surgery. It was earlier than what you're experiencing, but every dog is different. 

Can you pinpoint where the pain is coming from? Does it seem to be the amputation location (Jack would lick at the site during episodes and look toward it, so I could tell that she was experiencing pain at the site) or somewhere else, like his back? 

I am actually thinking that he might have hurt his back. He is holding his back leg oddly and perhaps he is suffering from back spasms. Will know more tomorrow I hope.