Sorry it's been a while since I've posted here...  It's been a busy few weeks between my work and home life.

Beamer is definitely doing better than when I last posted.  Since then, we've been back to CSU to remove her sutures, and we saw a new surgical oncologist, Dr. Nicole Ehrhart (Dr. Worley was unavailable).  While Beamer was at CSU for the suture removal, they observed her in hopes that she would display the whining/crying out behavior for their analysis, but of course, she didn't.  However, they did do some more analysis of her symptoms and films, and consulted with a neurology specialist (with a specialization in pain), and an acupuncture specialist to look at Beamer's case.  I went to work while Beamer stayed with them for the day, and Dr. Ehrhart called me around midday to discuss their findings.

She said that they believe that Beamer's episodes are caused by nerve damage from the amputation surgery, specifically a condition called peripheral neuropathy.  Essentially, the peripheral nerve that goes from Beamer's spinal cord to her amputated limb area is misfiring, causing her to feel sharp feelings of pain or burning.  It's common for these symptoms to be worse at night, so that would make sense.  She said that she had never had a dog experience this condition after amputation, but all of the symptoms and etiology fit the diagnosis, so it's their best guess at this point.

The treatment strategy for peripheral neuropathy is to treat the pain with pain medications that focus on the nerve, like gabapentin (which she was already on from the start) and amantadine.  So, we added amantadine to her meds and doubled the gabapentin dose.  Eventually, the nerve damage will heal on its own, and the meds will no longer be necessary.

However, on the same phone call, Dr. Ehrhart and I also discussed Beamer's other issues:

• Her hip joints both show signs of arthritis
• Her right knee shows signs of a partial/full cruciate ligament tear
• Her remaining elbow joint shows signs of arthritis

Treatment for the arthritis in her hips and elbow is essentially NSAIDs and pain meds, and the cruciate ligament will either need surgery ($$$) or a custom knee brace (also $$$) in the long term to get better.  At the time, these issues plus the extreme pain Beamer seemed to be in (it did get worse between my last post and this phone call) caused us to start seriously reconsidering how long we were prepared to make her suffer...  We were pretty close to making the decision to euthanize her.

On that phone call while Beamer was in her care, I told Dr. Ehrhart that our plan was to try the increased Gabapentin and Amantadine, give it 5-10 days for the medicine to get to a sufficient level in her blood, as well as a free initial acupuncture session that Dr. Ehrhart recommended, and see where she was after all that.  Well, 10 days later was this past Friday, and Friday night was the first night Beamer slept through without any pain episodes.  The frequency and seriousness of her pain episodes had slowly been tapering off throughout the week, and her demeanor was steadily improving as well (she wags her tail again now!).

So our current position is this:  I'm going to call Dr. Ehrhart today and give her an update on Beamer's status, and get the ball rolling to start her chemo (we put it on hold last week since we weren't sure whether or not we would be putting her down on Saturday), and find out her opinion on how soon we can start tapering off the Gaba/Amant.  She's not showing visible signs of pain from her joints anymore, so we are just going to take that as it comes and treat any pain she gets with pain and AI meds.

Wish us luck!

(Should I start a new thread for this?  It feels like we're long past the "Presentation and Diagnosis" stage by this point...)

Thanks for all the replies!

@Benny, the surgeon (Dr. Worley) is definitely aware of the nerve issue, as she was the one to whom I first reported it, and who started us in troubleshooting the issue.  She was very upset about the new symptom (crying out in pain) being introduced, and I can definitely say that I consider her to be a very outstanding veterinary surgeon.

@Fetchon3, yes, she can walk and run (well, hop fast ) just fine most of the time.  I'd say that her leg joints gave her issues about 15% of the time before the amputation, and now that she's putting 33% more weight (averaged out, yes, I know it's not distributed evenly) on each leg, she's having 33% more trouble, meaning she has issues 20% of the time.  It's not something we're extremely worried about-- we'll just take it as it comes.  She's had the osteoarthritis and torn cruciate ligament for at least 5 years and a Glucosamine/Chondroitin every day has kept everything in decent shape.

@Tails a waggin', thanks for that perspective.  We will look into those options.

@Jerry, actually, the Gabapentin didn't seem to do much to help her pain episodes, as she was on it the whole time.  We added Amantadine and doubled her Gabapentin dose, and then over the course of the next 10 days, her pain episodes slowly decreased and then disappeared (*fingers crossed*).  No matter what happens from here on out, I don't think Beamer will be having any more surgery...  She's been through enough already that if we are faced with the option of surgery or putting her down, we'd have to be assured of a *very* positive surgical outcome (eg. instant regained youth ) to make surgery the better option.

Thanks again to everyone for the kind responses and well wishing.  It's much appreciated.