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Feeling discouraged -- 19 days post op
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Member Since:
28 July 2019
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4 August 2019 - 9:12 pm
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Hello all, 

After an initially remarkable recovery I am feeling discouraged and looking for a reality check (good, bad, otherwise). Our blog is a little delayed because I wanted to keep things chronological and got started late ...so it does not reflect our current scenario. 

Grover (recap: 10.5 yo Great Dane with left forelimb amp due to osteosarcoma) has started to have what I can only interpret as pain because he cries and/or whines.

A week ago he would cry out was when he was getting up from laying down sometimes. We were worried that it was either neck pain (he had suspected wobblers/cervical disease prior to the amputation) or pain of his remaining forelimb (it has OA and angular limb deformities). We saw the neurologist and our rehab vet -- neither found a significant source of pain on their exams. We still radiographed the forelimb to make sure nothing bad had happened and ended up getting an MRI of his neck to make sure that there were no mets or decompensated surgical disease. The radiograph of his other limb was unremarkable and the MRI was also surprisingly normal. He had a great 1.5 days after anesthesia for the MRI ... but now, he seems to be getting up and down just fine (even jumped in the car without crying to go back to the vet)... but in the evenings he will lay in bed and whine intermittently and appears to have a hard time finding a comfortable position (i.e. he is restless). It is breaking my heart and making me fear we made the wrong decision.  After the MRI the vets were hopeful that he just pulled a muscle learning how to use his body correctly and finding new sleeping positions and that he's a bit of sensitive sole pain wise. I'm not sure if it could be fantom leg pain (he never has tried to lick at the site), if he pulled a muscle or what ...

He is currently on Galliprant (a newer NSAID) in the evening, Gabapentin 3x per day and we added amantadine 3x per day starting yesterday. He is scheduled for weekly rehab but on Thursday his post chemo blood work showed he had decreased WBCs so we are home-bound until it improves (rechecking on Tuesday). 

Once he's up and going he seems happy -- enjoys going outside, hops out to his favorite hill, lays in the sun, is eating well etc. throughout the day ... but listening to him whine in these evenings/nights is hard. Are my expectations too high for him? Is this still normal? 

Thanks for your thoughts -- it's hard to think clearly when we love them so much. 

Virginia







Member Since:
22 February 2013
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4 August 2019 - 10:08 pm
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Feeling discouraged is cert understandable.  Getting to this,point in the recovery is exhausting  and stressful, to say the least.  And then add these extra challenges into the mix is an extra layer of stress.

Goodness knows you are leaving no stone unturned in trying to figure this out.  Although it's  frustrating not being able to figure out a cause yet, the fact that all the tests were "normal" is a good thing!  Amd, other than this...er..."issue", Grover is dojng well.  And I'm not taking the "issues" lightly, just saying that there is a lot of good news here.  So no, this is not a "wrong" decision.   It's  just a hurdle that needs to get figured  out.

So, if Imnreading this right, he know longer is crying  when trying to get up, so that's  good.  When he tries to settle in at night though, that's  when he gets restless and whiny again, right?  So that is, basically,  the only "fly in the ointment" so to speak, right?

And he was symptom free for a day and a half after being sedated  for the MRI.  Soooo...the sedation  is something  that would COMPLETELY  RELAX all his muscles.  That just seems like some sort of "clue". It would be worth telling the Vet avout rhe symptoms  disappearing  at that point.

When Grover lays down during the day for naps, is he symptom free at that point?

Guess the bottom li e is I'm  zero help! Just throwing  stuff out there!  Somehow it still "feels" like it's  muscle/strain related.  

Try not to second guess yourself.  Easier said than done, right?  But 2 1/2 weeks out, Grover does seem to be doing well, especially  for a big pup!! There are a lot of victories  going on for him this early on!

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!

On The Road


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5 August 2019 - 8:20 am
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I think figuring out what our dog's need to get into their new normal of a pain-free life is totally normal. We often see new Tripawds who are more painful at night, after going about their day and moving their bodies around all afternoon. Speaking of, what's his activity level like at this point? Is he taking walks? If so, how long?

Grover has everything on his side for a continued great recovery. He's got a team of people looking out for things that may be bothering him and I'll bet that at his appointment this week his therapist will have an action plan to get him on track to feeling better. Just be sure to jot down all of the symptoms, when they happen, and what happens when he reacts (this doesn't sound like phantom pain to me, by the way, but definitely ask your vet).

As Sally mentioned, mention the muscle pain. Our Wyatt Ray had it, and we addressed that problem with Methocarbomol, massage therapy and PROM exercises and it did the trick.

Also, I'm not sure what the dosage of Gabapentin or Amantadine is for him but he may need it boosted (as an example, Wyatt gets 400mg3x daily of Gaba, among other pain management drugs). Let your vet know.

Try not to think the worst, you're doing everything right and it sounds like Grover is otherwise having a happy life on three even at this early stage. Let us know how the exam goes this week. 

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

Member Since:
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5 August 2019 - 8:20 pm
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Thank you both for your kind and rationale replies. I am the first to admit that when I don't sleep (which we haven't really since Friday with his night time behavior) that I get irrational and a little crazy ... which I already probably am on a normal basis regarding Mr. G. 🙂 

I got to talk to the behaviorist today and since he is on a good pain management plan (in her opinion) she Rx'd trazadone for the night to see if it helps us all get some sleep and perspective and then if his WBC count is good tomorrow she will schedule him for a behavior appointment to see if he may be developing canine cognitive dysfunction (apparently those dogs can have "sun downing effects" like humans with Alzheimers) and antidotally can be set off or worsened by anesthesia which of course he has had ... the good news is that he is still himself during the day, so if that is the case we may be able to make it better with treatment. 

During the day he is 99% Grover. He layed outside today on the grass on his side with no complaints, later this evening on his outside deck bed with no concerns and now is laying half on and half off the living room dog bed chewing a bone. He is eating great and personality wise acts like himself during the day. I repeated this if for no other reason than to remind myself that he still acts like him and is not miserable all of the time. We have been limiting his walking to once around the outside of our apartment building 3-4x per day (basically enough to encourage him to potty) to try and limit any muscle strain. Luckily we have a ground floor apartment with a patio that opens to a grassy lawn. 

Doseage wise G is on 100 mg galliprant once daily (about 2 mg/kg), 600 mg gabapentin q8h (about 15 mg/kg) and 200 mg amantadine q12h (about 4.5 mg/kg). 

Hopefully his WBC counts are up tomorrow, we all get some sleep tonight and we can get into the clinic for more PT and acupuncture. 

Thank you for letting me freak out and for being reassuring. I really appreciate this community. 

Virginia







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22 February 2013
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5 August 2019 - 10:15 pm
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Nah, you arent "freaking out", not to us  anyway!  You are just a loving  advocate for your boy who wants nothing but the best for him.❤

You are, however, based on your post, very sleep deprived.  Lack of  restful sleep  is, indeed, an enemy to the hoomans  on rhis joirney.  It does make every "little" bump in the road of recovery  seem like an insurmountable  mountain!

Had to laugh that the Vet said to give a dose of Traz so you could ALL get some rest!!😉  Keep in mind that the Gaba can have a little sedation  affect (sometimes, not always). So of he's a bit groggy the next day, that could be why.  

Really glad you recapped his day where he is 99% Mr G., because all of us reading  that can definitely  confirm that for you!!   He really, really, really, REALLY is doing very, very, very, VERY well!!!😎

Hopefully a good night's sleep might "break the cycle" of Grover not  being avle ro sleep  soundly.

We'll be looking for updates!  Take care and get some good ZZZZ's

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!

On The Road


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6 August 2019 - 1:42 pm
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Oh I hoped the Trazadone helped. How'd it go last night?

You can recap his days as much as you want here, that's why we exist. Yes, he does sound like his normal self. Try to think of it like this: we aren't always at our best when we are not feeling well, are tired or sore from exercise or an injury, and we collapse into bed at the end of the day. Dogs are no different. 

Your vets sound excellent. I like the approach they are taking with him!

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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7 August 2019 - 9:15 pm
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I am happy to report that (knock on wood) we have all had two good nights of sleep and two good days. The first night we used trazadone and last night we just left the lights and TV on (I can’t sleep through the dog whining but lights and TV, no problem) and clinically he is doing well. Bright, interactive, no crying (evening jumping in and out of the car), and eating great. Unfortunately his white blood cell count was lower this week so no PT but the rehab vet gave us some exercises to do at home. In the words of our oncologist “missing a week of PT won’t kill him ... but getting a hospital acquired infection might.” Ok, yes ... very wise advice haha. If his blood counts are up next week he will get to see the behaviorist too. Fingers crossed for a third night of good sleep for all 🤞

Virginia







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22 February 2013
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7 August 2019 - 9:29 pm
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SOOOOO HAPPY TO READ THIS!!!!  😁  Sounds like Grover is turning  the corner now and you are off the recovery the roller coaster ride!  Yes, knocking on wood!!

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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