Caring for a Three Legged Dog or Cat
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My cat Benny had his rear right leg amputated on April 24 - previously I adopted him and he had a nub that needed to be properly amputated. He's two years old and otherwise healthy. He's doing well and is still on 50mg of Gabapentin every 12 hours. But every time I try to take him off of the Gabapentin, he gets sudden jolts of pain, especially when he stands up from sleeping. He's even fallen over a couple of times when he didn't have enough Gabapentin.
He saw the surgeon for a post-op exam and they said he's doing well, and I had an at-home vet come for other reasons and she said he's doing well too (so it's not something else causing the pain).
I'm just wondering how worried I should be about this? The surgeon gave him another two months of Gabapentin so I'll see how he's doing after that - just looking for any advice on those who have gone through this. I searched the forum but apologies - I couldn't find a ton on this.
Thanks!
Thank you for rescuing Benny and giv9ng him a loving and caring home.
Your post has been approved and now others can chime in with some feedback.
The pain you are describing, does ot fit the description of phantom limb pain? It's basically a quick jolt of sharp pain put of the blew....lasts for less than a minute... but leaves the cat or dog frightened for a few minites afterwards.
Basically it's when the brain is sending out signals to nerves for a leg that is no longer there. Humans describe it as sort of a quick Electric Shot type jolt.
It's odd that the pain shows up mostly after he is just waking up. Just wondering if it could possibly be a leg cramp or even the leg "falling to sleep" so to speak. If you can, try massaging him before he tries to stand, just in case it is some sort of leg cramp.
Anyway, residual phantom limb pain can occur even a couple pf mo ths out. Does the Gabapentin resolve the issue when he is in it??
I know I'm jumping around s lot, but another thought would be to try and get in toich with a Certified Rehabilitation Specialist. The Tripawds Foundatiin will pay for the first visit.
The falling over may be a sign he needs to strengthen his core muscles, etc. Could you make a video for us, as well as the Vet? It reminds me of a senior kitty who was falling over a lot and had a lot of remain leg weakness. Therapy did help.
Bottom line, try not to worry as could pain management and some Rehab therapy should help resolve the problem
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!
Thanks! It's like he recoils or flinches on the side where the leg was removed and if he's just getting up from sleeping on the couch, he can fall off. His core muscles are quite strong because he was a tripod before but with a long nub. He actually can balance on his two front paws before he falls over due to the pain. So it's more that he gets surprised by the sudden shock of pain.
However, when he's on the Gabapentin it's all good - so that's why I'm thinking it's nerve pain as he had a comprehensive examination done by two vets in the last two weeks (so it's not something else going on). The surgeon also thought it was nerve pain - what she said was a rare complication of the surgery. She said that scar tissue can build up and can put pressure on the nerves, and that I was to give him 2 months of Gabapentin and that we'd need to get him rechecked after that if he hasn't improved.
Anyways, I guess I'm just worried that he'd have to have the surgery done again but I'm hoping that this lasting pain resolves. I appreciate you mentioning the residual pain can last for up to two months, so I'll try to be patient! I'll look into rehab but I'm in Canada, so the resources might be different here. Thanks again 🙂
Hi Katie and Benny, welcome!
It does sound like there is some residual nerve pain and possibly a condition called "hyperalgesia", which is not too uncommon in our little corner of the universe. Because we see nothing but 3-legged animals here we tend to see more side-effects of surgery than most practices even. But that doesn't make us vets, so keep working with the team to manage his pain.
Pain expert Dr. Mike Petty talks about hyperalgesia here:
Let’s take a look at the hyperalgesia first. The spinal cord can respond to a constant barrage of pain signals by actually increasing its sensitivity to incoming pain signals and by recruiting non-pain-sensing nerve fibers, such as those used for touch, and turning them into pain fibers as well. These changes can become permanent if not treated, and maybe even if they are treated. If I have a patient with hyperalgesia I do several things:
I make sure that I am correcting the underlying cause of the initial pain, if still present.
I use gabapentin, a drug that not only blocks pain signals , but actually modulates a brain cell called a glial cell, which is implicated in chronic pain states.
I use amantadine, a drug used primarily for treating Parkinson’s disease, to shut down a pain pathway within the spinal cord called the NMDA pathway.
I use an NSAID to help control pain and inflammation at many levels of the pain pathway from nerve ending up to the brain.
You might also want to check out this very helpful post about desensitizing the area after surgery:
Understanding and Treating Nerve Pain After Amputation for Dogs: Tripawd Talk Radio #124
In this podcast we talk about some really simple things you can do at home to help decrease his response to pain and touch in that area. Our guest explains how her VitalVet Desensitization Protocol can help rewire the brain after limb amputation. It makes so much sense! Check it out, try the protocol, and let us know if that helps!
Katie if you're still online I'll be in the Tripawds Chat for about an hour.
Thanks! I'm still at work so I'm unable to join but I'll look at your message and resources more closely this evening. Thanks again!
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