Caring for a Three Legged Dog or Cat
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Hi everyone, this is my first post.
My dog Lexi is a 4 year old sweet mutt (rhodesian mix) who was diagnosed with a lytic lesion of her left proximal tibia and had her left hind limb amputated last week on 10/21. We're waiting to hear what the pathology is but the oncologist thinks likely osteosarcoma. She did great the first few days home and then seemed to just be overly sleepy, so I asked the surgeon about weaning her pain meds. She came home on pregabalin (a drug similar to gabapentin) and rimadyl.
Well, the surgeon had me wean her pregabalin dose on post op day 6 from 100mg to 50 mg twice a day... and things did not go great. Her tail was tucked, she was shaky, and just obviously in pain. I called yesterday and we went back up to 100 mg and she's seemed to have resolution in her pain, but is now back to being super sleepy. She's a super athletic, bouncy, happy dog and right now it just seems like the sparkle has gone from her eyes. I know that it's still early, but I'm a little frustrated and nervous because both the oncologist and surgeon seemed to think she'd do really well very quickly after surgery. I don't know if I just had false expectations but right now seeing her so "blah" just breaks my heart. Has anyone had experience weaning this drug? Any insights? Thanks so much 🙂
Hello and welcome, your future posts will not have to wait for approval.
How is Lexi doing other than the meds...eating, drinking, eliminating? Can she get around OK?
While it can be hard to see our pups affected by meds at this point she obviously needs the meds to control pain. Our surgeon said only short, leashed potty breaks for the first two weeks post op. Rest is what Lexi needs now so being a bit sleepy is OK. You could also ask your vet about different pain meds that might not cause her to be so sleepy- but again- rest rest rest!
My Maggie was on pain meds for 14 days post op, lots of dogs here are on them for 2 or even 3 weeks. There are a few lucky pups who are able to get off the meds sooner, but controlling pain is key to a smooth recovery.
When you think about the scope of the surgery a dog 'bouncing back' in two to three weeks is really quite remarkable! I too was discouraged when Maggie didn't bounce right back after surgery. All the vets said 'dogs do great on three!' but none of them told me there was some recovery time first.
When I have dogs recovering from a surgery I always like to taper off pain meds to make sure they are ready. If I see pain signs I go back up to the dose that they were comfortable. Perhaps in a few days you could try reducing the meds again but maybe not such a big reduction all at once. Of course work with your vet when changing meds.
Be patient with Lexi and let her work her way through recovery. Your super athletic, bouncy and happy dog is still there- she will be amazing you very 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
Can only ditto everything Karen said so well.
Yeah, as you discovered, weaning meds on day six is too early. Being sleepy and lethargic is much better than being jn pain. As Karen said, this early on you just want Lexi up for short potty breaks then back to bed for rest.
How much does Lexi weigh? 100 mg twice a day does not sou d like a lot at all. Now, I don-t know the comparisons between Gabapentin and pregabalin, but maybe you can jave the Vet switch to the Gaba. That can cause some sedation sometimes too, but generally in larger doses. It may simply be that Lexi is extra sensitive to pain meds.
Wouldn't be concerned at all that she's resting well. That is what we hope for the dirst two weeks of recovery. Keep in mind, of a woman just went thru this MAJOR amputation aurgery, they would probably still be jn the hospital on a morphine drip!
How is her mobility at this point? Is she able to get up on her own and hop a little bit when going out to potty?
We'll look for uour feedback.
BTW loooove her avatar picture!❤
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!
Awww what a sweetie! I'm sorry you had to join our club but glad you posted so we can help make the transition easier.
Pain medication side effects can vary from dog to dog. Some can get quite sleepy, some not. Unfortunately you don't know until you go through something like this. But as long as you are in contact with your vet about Lexi's symptoms, you should be able to fine-tune the dosage and timing so that she's not so wonky. She may need a different medication that is more suited to her physiology. Did the vet mention why they used pregabalin instead of gabapentin? Just curious.
I know it's sooo hard seeing our pets go through this. But it's always harder on us than it is on them! The blahs are part of recovery for all pets though, and it's only a matter of time before she turns a corner. She will get there too! Really!
Let your vet know what's going on and keep us posted ok?
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi Karen, Sally, and Jerry,
Thanks so much for your quick and kind replies. It's really really helpful to have your support.
Lexi had her two week follow up with the surgeon today. I had called yesterday asking about a weaning protocol for her pregabalin again (we had gotten back down to 50mg twice a day from 100mg twice a day) and she was just excessively drowsy. I started hand feeding her meals in the last couple of days ago because she stopped wanting them from her bowl. The surgeon said to stop the pregabalin yesterday, and today at our visit he said that it would take a little while to get the meds out of her system. Her incision looks great, and she doesn't seem sensitive when it's touched. He cleared her to go home, no activity restrictions. He said to follow up in 48 hours if she is still acting off.
She is still very much not herself. She really only wants to be in her crate, and her appetite isn't what it usually is. She's using the bathroom fine, and did seem to very much enjoy our 10 minute walk around the block when we got home from the vet (her first since before surgery).
I feel like I've been advocating for her to keep her pain under control (on the phone with the surgeons office probably 6x in two weeks). It's frustrating because I feel like we haven't been able to find a sweet spot. Oncology called yesterday to set up her first chemo session which is usually 10-14 days after surgery but when i described how she wasn't acting like herself yet they said it would need to be pushed back.
Honestly this post is a little bit of an outlet for my frustration. I'm an icu nurse outside of being a dog mom, and I think my type A personality is getting the better of me because not much seems to be going according to "how it usually goes." I really just want my sweet baby dog to feel better, and it just seems like we've stalled. Any advice or "we've been there" would be appreciated. I also asked the oncologist's office about CBD oil today, and didn't get much info from them. I just can't get a great feel for if something is truly wrong or if this is just part the ups and downs of recovery.
Thanks,
Laura and Lexi
PS-Jerry, the oncologist prescribed pregabalin for lexi to start prior to surgery and use for pain control. The surgeon usually uses gabapentin, but when I told them about the pregabalin at our consult he said that it was fine to use and we were told to continue with that. I didn't question it because I knew the two drugs were similar, and I had honestly not found this resource or done much research. Both the oncologist and surgeon have been practicing at the animal hospital we are going to for 20+ years, and seemed genuinely knowledgeable and kind when I met them, so I didn't question the treatment plan too much.
Hmmmm.....so at 100 mg X 2 ahe seemed too drowsy. At 50 mg X 2 she clearly showed pain signs (tucked tail, shaky, wants to hose in crate, etc), right?
How much pregabalin was ahe on before surgery..how long....dose and frequency? Did she show any drowsy signs when she took it then?
When she walked around the block, was that with a little rest stop here and there?
Obviously we are not Vets and certainly not giving Vet advice. HOWEVER, she still seems to be showing pain signals . Perhaps you can ask the Onco to give you five or six day supply of Gabapentin and see if that helps with the pain and doesn't make her too drowsy. Obviously double checking to make sure you can do the switch safely.
My Happy Hannah was on pain meds for avout three weeks. I did not start her chemo u til after the three week mark bec I did feel she had recovered enough to take on the chemo. BTW, she sailed through all four of her treatments!
It took me a solid three weeks before I could say I did this FOR my Happy Hannah and not TO her!
Hahaha.....had a slight chuckle when you said :
".... not much seems to be going according to “how it usually goes.”.
Boy oh boy do we get that!!! Recovery usually does not go at all like "expectations " of how recovery should be!!
We understand your frustration. You are probably emotionally and physically exhausted on top of everything else. We can all assure you it does get better!! She will get her sparkle back! You saw a bit of it today with her walk.
Continue ue to stay upbeat and pawsitive and full of confidence! She'll feed off your energy.
Stay connected! We're here for you and we KNOW Lexi will indeed, be Lexi again....but without that bum leg!
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!
Laura, first let me say thank you for being a nurse! You are a HERO and I'm in awe of the work you do, especially at a time like this.
So, I can only imagine how frustrating it is to be in the medical field and feeling like you can't do anything to help Lexi feel better. Vent as much as you'd like here! I know from being in this community for so long that those members with any kind of veterinary or human medical background often feel the same way when their pets aren't as on track with recovery as they'd like.
Try to keep in mind that she's still not that far from her surgery day. A human would be in much worse shape than she is. Hopefully by tomorrow, getting the pregabalin out of her system will put some sparkle back into her personality.
And if you're not seeing her old self return by Thursday or so, then call your vet back. And also mention that it couldn't hurt to get a second opinion from a veterinary pain management specialist. See if they will give you a referral to one. A vet pain specialist is the ticket to finding out out what's going on when untreated pain cannot be diagnosed by a general practice vet. Check out our news post about next week's webinar with Dr. Downing, and our pain management articles for some ideas. Let me know if you'd like help finding a specialist, I'm happy to help.
You are doing all you can to advocate for her needs, and the effort will pay off! She is young and strong and has a mom with a great attitude and skillset. You'll see Lexi return before you know it. Stay strong and keep us posted on how she's doing.
P.S. Have you tried tempting her with some crazy awesome human food that she will find irresistible? See if that helps perk up her appetite.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi again,
I really just want my sweet baby dog to feel better, and it just seems like we’ve stalled. Any advice or “we’ve been there” would be appreciated.
Definitely been there! I said before that Maggie didn't really 'bounce back' but it took her way longer to get back to normal than almost any dog you read about on this site. Mag had her amp before Tripawds existed so we went it alone- all I had to go on was the vets saying dogs do fine on three.
It was 6 weeks post op before Maggie would play with me again! I spent that whole time convincing myself that I had made a terrible mistake. No medical complications, she was hopping on her own the day of surgery (rear amp, mast cell cancer). She never lost her apatite (Pug!) but spent most all of her time in her bed. In hindsight it made sense- Maggie had always been very stubborn and set in her ways, she hated any change to her routine. But in the midst of the recovery it never occurred to me that Maggie was just being true to herself.
Is Lexi sensitive in any way? Assuming her pain is managed maybe she just is not ready to be OK with her new normal. The last two weeks have been very different for her- maybe working toward a bit more of normal life will perk her up. You said she really enjoyed her short walk- maybe try and do that once a day- working her activity level up slowly. Try driving her to her favorite park so she can smell the smells. Are there any people she really likes? One thing I remember during those first weeks with Maggie was that she really perked up when my Mom or Dad visited or she spent time at their house.
I've only had limited experience with lack of appetite- it was when Maggie developed renal failure so different circumstances. But one thing I will mention is to be sure you are calm and not stressed when trying to get her to eat. One thing Mag would do is read my mood- I was soooo frustrated trying to get her to eat- she would actually leave the room while I was fixing food! If you are really worried about getting calories into her then try anything, but it could also be her out of her routine. You could try leaving her food in her bowl as normal and see if she will eat when she gets hungry.
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
Hi Everyone,
Thanks so much for the replies and resources. We had a really rough day Wednesday, I left Lexi alone downstairs while I went to fold laundry and came down to find her licking her incision to the point it had started to bleed. When I went to look at the incision, she yelped and snapped at me... which is the furthest from her docile self I've ever seen. That was the tipping point, I called the vet in tears. They got us in early yesterday morning and started Lexi on gabapentin twice a day.
WHAT. A. DIFFERENCE.
After one dose she was a completely new dog. Tail wagging, treat begging, eating great, so much more like herself than she had been in the last two weeks. She's started to move around on her own (before I had to coax her to do anything). The proverbial weight that's been on my shoulders has been lightened so much. It's so encouraging to see a little bit of a light at the end of the recovery tunnel 🙂
We did push back chemo by a week to make sure she continues to recover and become more herself, and I think we are are excited to start building back up to our active little life.
Oh. My. Dog. YESSS!!!
Thank you for sharing this story. This is why we sound like a broken record about never feeling guilty for advocating to get additional pain management . I'm SO glad things are better and life is getting back on track! YEAH!! You are doing such a great job with her, be proud!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Soooooo glad you got her on the Gabapentin!!!! Isn6 it wonderful to know her pain is getting control now and she can REALLy start the healing process now? I'm so relieved for her....and for you😎
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!
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