Caring for a Three Legged Dog or Cat
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We will likely be helping Tshuvah over the bridge this weekend. She is enjoying enough of her favorite activities to warrant giving her these last few days and also a passage that we believe would be her preference (at home, outdoors, with our favorite vet). Since her condition has definitely changed in the past couple days I will be reviewing our medication protocol with our other vet tomorrow; this vet isn't the greatest for pain management in my prior experience. We have few options, living rurally, so I'd like some input.
Tshuvah was prescribed gabapentin 100mg twice a day back in July, about 3 weeks after her amputation, for intermittent yelping that we figured might be phantom limb pain. She did well all summer on the evening dose only. This week I began giving her the morning dose as well. that was a no-brainer since it was previously prescribed by the oncology vet. In the past two days I've been adding 1/2 to 1 tablet of Tramadol twice a day. Tramadol seems to make Tshuvah anxious or something, not quite like herself, but I know its an important and safe analgesic. I added it because she is having pain when walking. I hesitate to give her any NSAIDs because her stomach is very sensitive to them. She won't take any pills in food so I have to be careful, especially in the morning when she typically doesn't like to eat. She's always been an afternoon and evening eater.
She weighs 40 - 45lb and her diagnosis is hemangiosarcoma. She is 3 months past diagnosis. I'm just looking to keep her comfortable and alert so she can enjoy a few more trips to the park, some more homemade stew, and another visit to the mountains. You should have seen her hopping along the mountain trail on Monday! We didn't go far but she loved it.
My question is whether Tramadol is the best addition to gabapentin at this point or if another pain med should be considered, and what meds are typical for this particular point in the end of life process.
Thank you, Beth
Beth with my beloved Tshuvah, 10 year old "TaosDog". Provisional diagnosis osteosarcoma on 6/10/10, amputation of left foreleg same day, firm diagnosis of hemangiosarcoma 6/24/10. Set free on 9/9/10. Treasured forever.
http://labrador.....ipawds.com
Don't have any knowledge on the medication question as I've never used Gabapentin, but I wanted to tell you how much I admire you. You've been through a long rough summer between Tshuvah and your sister and now you are facing the end with such dignity, focus, and love. My heart is with you.
Shanna & Spirit Trouble ~ Trouble gained her wings 3/16/2011, a 27 1/2 month cancer survivor, tail wagging. RIP sweetheart, you are my heart and soul. Run free at Rainbow Bridge.
The November Five - Spirits Max, Cherry, Tika, Trouble & Nova. 11/2008 - 3/2013 An era ends as Queen Nova crossed the Bridge.
I, too, don't have any advice regarding pain meds(but DO really LOVE Gabapentin)...but want to second what Shanna said...Hugs to you and your family in the coming days ahead.
Tracy, Maggie's Mom
Maggie was amputated for soft tissue sarcoma 10-20-09
Maggie lost her battle with kidney disease on 8-24-13
Beth, I found Tramadol and Gus didn't get along very well so we stopped using it after a couple days and had him on gabapentin and Rimidyl, of course this was after surgery so in your case not sure, but when we first took him in , the vet thought we were dealing with a muscle issue, so he had us give him rimidyl, although that didn't help at the time, but once we got rid of the cancer pain, I think those 2 drugs worked ok although he had phantom pain , but he seemed ok except when that would hit. Good luck, our thought and prayers are with you, Gus and Dan
My buddy Gus had a left front amputation on April 7, 2010 and lived a great life until July 26,2010
Wish we could offer advice regarding the medication, but we can certainly offer lots of hugs & pawsitive thoughts to you! It's not an easy time for you, keep doing what you're doing - giving her lots of love & some of her favorite things!
Cathy/Jane/Spirit Skyler/Chloe
You can use the gabapentin 3 times daily and if the Tramadol or NSAIDS don't agree with her then another option is Tylenol plus codeine (your vet will have to prescribe it). In general dogs should not take Tylenol but the codeine helps a lot and if we are talking end of life then it is worth a try. I have used it in OSA dogs before if people do not choose amputation with pretty good results. Main side effects are sleepiness but it is safe for her stomach.
Pam
That is such a good question, thank you. And thanks for your input Pam, we didn't know about this one.
Hugs to you Beth and Tshuvah, we are thinking of you. Please let Tshuva know her fan club loves her OK?
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi Beth,
What an awesome mom you are.
Maggie did not tolerate tramadol at all, even on the lowest dose she was anxious, scared, and would not sleep, and she had the same reaction to several pain killers in the same family. I like Dr. Pam's two ideas above of increasing Gabapentin since she has done well on it, or trying Tylenol.
I let Maggie go because I could not manage her pain without unacceptable side affects.
Bless you for giving Tshuvah a wonderful summer, and for being unselfish at the hardest time in this journey.
Karen
Hi Beth,
I don't have anything to add in regards to the pain meds but just wanted to say that we are thinking about you.... and will keep you and Tshuvah in our thoughts and prayers.
Brett
I have nothing to add as information about pain meds but please no you and Tshuvah are in my prayers and thoughts as you face the days ahead.
Jo Ann & Tasha
Tasha 8 years old, First cancer diagnosis 6/26/09, Last cancer diagnosis 9/26/09, Amputation 10/01/09, Loving our girl moment by moment.
Tasha lost her battle and became my Angel on May 4 2011. Forever in my heart….
Thanks everyone. I hardly feel I deserve any praise but I accept all the good wishes and blessings, particularly for Tshuvah. I should have taken out stock in kleenex when she was first diagnosed...lots of crying going on here although not usually in front of her. I found a great peace with her passing in talking to a highly recommended animal communicator (referred by Rita Reynolds, let me know if you want her info). today she visited my daughter's new elementary school and then went to the park for more meets and greets. But for the first time I had to carry her part of the way to and from the parking lot. Nonetheless, everyone comments on how happy she looks and acts.
I told my 5 year old daughter that Tshuvah is getting old and that the sickness that was in her leg is in the rest of her body now, so Tshuvah's body probably won't live much longer. We haven't talked at all about Tshuvah's dying since we didn't have any idea when it would happen. Now that we know, we decided to clue Lila in. She took it very well.
I'll talk with our vet about the tylenol/codeine combo. Tshuvah seems to be tolerating tramadol better today, and I'll up gabapentin to three times per day.
Its exhausting, isn't it? The emotional part of loving her so much, wanting the best for her, holding myself together, waiting until Sunday. There's a confusion of wanting Sunday to come right away and never ever wanting Sunday to come. OK, more tears, better go get the kleenex. Thank you all for loving my Tshuvah along with me. I'll go hug and kiss her for y'all. I'm so blessed to have found tripawds.
Beth
Beth with my beloved Tshuvah, 10 year old "TaosDog". Provisional diagnosis osteosarcoma on 6/10/10, amputation of left foreleg same day, firm diagnosis of hemangiosarcoma 6/24/10. Set free on 9/9/10. Treasured forever.
http://labrador.....ipawds.com
Oh Beth,
Yes, you do deserve praise! It's so mentally exhausting to see your precious furchild and not know what tomorrow would bring. So many would have taken an easier path especially under your circumstances. But you didn't. You chose to live life to the fullest for sweet Tshuvah until the end. You made her a happy dog again.
Your love and dedication has touched many of us. I know the end is near but Tshuvah will live forever in our hearts.
Sending you thoughts of strength and tender hugs.
Comet - 1999 to 2011
She departed us unexpectedly January 23, 2011 at the age of 12 1/2.
She was born with a deformed front leg and a tripawd all of her life.
Beth,
We're keeping you and Tshuvah and your family in our prayers and hearts. I agree with Shanna - you are handling this with such grace. I'm having a hard time typing with tears, so will keep this short and sweet. We'll hold all of you in our hearts.
Sending lots of hugs and as much comfort as possible across the miles,
Holly, Zuzu and Susan
Holly joined the world of tripawds on 12/29/2009. She has a big little sister, Zuzu, who idolizes Holly and tries to make all of her toys into tripawds in Holly's honor. And she's enjoying life one hop at a time!
http://anyemery.....ipawds.com
Beth,
I, too am having a hard time typing through tears. My prayers are with you.
Debra
Debra & Emily, a five year old doberman mix, who was diagnosed with an osteosaecoma. She had a right rear leg amputation on May 19, 2009. On November 10, 2009 she earned her wings and regained her fourth leg.
Hi Beth
I am sorry for what you are going through with Tshuvah. I remember that stage well. It was not so long ago for us. I didn't know Tshuvah was small enough for you to carry her.
During Tazzie's last week of pain meds, he used Gabapentin during the day and Gabapentin and tramadol at night. The tramadol made him too clumsy for the daytime. He was still romping in the park and pretty active, even the very last day of his life. So I guess his situation was quite different than Tshuvah. But that pain regime worked well. We only got a few days on Gabapentin before the pain become too much - his pain was due to an enormous (think watermelon) lump over his flank so again a different situation than yours.
We will be thinking of Tshuvah and her family.
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