Firstly, apologies for the length of this post. Life for my Frenchie, Arnold, has been awful for the last five months and it feels important to give as much information as possible. That way anyone who has time to read/respond will know everything. To clarify: I’m hoping to hear from people who have managed to come through the Phantom Limb Pain stage because, right now, we are considering euthanasia on Monday. We really don’t want to lose him – he’s only 8 years old and he’s been through so much that he deserves a ‘payday’ – but seeing him in pain is unbearable.

So, everything started in November, 2023, when Arnold lost full function of his hind legs. We took him to an orthopaedic specialist who diagnosed Subarachnoid Diverticulum. Arnold underwent surgery in December to have the scar tissue removed and a metal plate fitted to brace his spine and keep the scar tissue from reforming. Everything seemed good. The surgery was a success and he healed well. However, his post-op medication included a course of Prednisolone and, once finished, his lameness returned. To clarify: I saw the CT scans of Arnold’s spine and, as far as I am concerned, Subarachnoid Diverticulum was an accurate diagnosis. That said, his lameness returned after finishing the course of Prednisolone, suggesting something far more serious.

We took him back to the orthopaedic specialist because we assumed that he had IVDD (his pre-op CT showed dry discs). Also, since the previous CT scan was six weeks before and no tumours were found, we didn’t even consider cancer. The orthopaedic specialist did another CT and found a tumour inside Arnold’s pelvis that had grown large enough to cause asymmetry of his internal organs. The reason why the initial CT scan didn’t pick up the tumour was because the scan didn’t extend far enough beyond Arnold’s spine and, at the time, the tumour wasn’t large enough to cause internal asymmetry.  

In February, 2024, Arnold was referred to an oncology surgeon who diagnosed osteosarcoma. Given the location/size of the tumour, the only solution was a hemipelvectomy. We were unsure whether or not to put him through such an aggressive surgery but the surgeon was fantastic and put our minds at ease. The surgery was performed on February 13th and we collected Arnold on February 20th. Two days later, he exhibited signs of what seemed to be Phantom Limb Pain. After couple of days, the pain grew so intense that we took him back to the vet. The oncology surgeon discovered that Arnold’s bladder had herniated (some of the tissue used to rebuild the abdominal cavity during the hemipelvectomy had failed) and we assigned the pain to this issue. The surgeon recommended emergency surgery. It was a tough decision to make as Arnold’s issues seemed never-ending and we felt that he had been through too much already (at the time, he also had surgical-wound infection). But the surgeon said that without this surgery, Arnold wouldn’t reap the benefit of everything he had been through so far, and we agreed.

Arnold had his third surgery in as many months. The surgery went well, and he came home. A few days later, the pain returned. It was classic PLP: jumping up suddenly from a rested state, screaming and running away from nothing. By this time, Arnold had been signed off from the surgical team and assigned to oncology for chemo. The oncologist was (and still is) fantastic. As soon as we described what we believed to be PLP, he was on the ball. Arnold started medication that included 300mg Gabapentin and 125mg Paracetamol 3x per day, and Metacam 1x per day. The pain seemed to lessen for a week or so, however, it returned with a vengeance. We took Arnold to our local vet (much closer) and a subcutaneous ketamine injection was administered. This was five days ago.

Three days ago (April 17th) Arnold refused all medication. And when I say ‘refuse’ I mean every possible method of administration. We tried everything from hiding the capsule in multiple types of meat/food (often cooked to order), dissolving the contents of the capsule in stock, mixing it into a small quantity of vanilla ice cream (not the best food choice for a dog but a last-ditch option). We even paid a ridiculous amount of money for chicken-flavoured liquid Gabapentin to squirt directly into his mouth – after a few successful doses, he grew so disturbed by the process that he bared his teeth/snapped for the first time ever.

The following day (as a result of refusing medication), Arnold experienced intense PLP and refused to eat. We spoke to the oncologist again. This time we mentioned euthanasia. The oncologist suggested that Arnold still had options. He suggested that Arnold could be experiencing ‘windup’ pain and recommended a CRI of ketamine and lidocaine, adding Amantadine to his medication, and possibly switching from Gabapentin to Pregabalin. While the change of medication wouldn’t make giving the pills any easier, we hoped that resetting Arnold’s pain threshold with the CRI would mean that he would no longer refuse food and, possibly, take the pills.

Arnold had his CRI yesterday. Once we brought him home, he had two PLP episodes (completely unexpected given the amount of drugs in his system). That said, he did start eating a little (not dog food but meat/sausages – everything he shouldn’t be eating). Because he had an interest in food, we managed to give him a Pregabalin, and all I can say is: wow. That stuff is AMAZING! The Gabapentin has never been able to manage his PLP completely but 40 minutes after giving the Pregabalin, he was more himself than he's been in the last five months (he even played with his toys a little). Plus, he went the whole night without one PLP episode – something that hasn’t happened since this situation started. He did have another PLP episode this morning but, again after a Pregabalin, he is completely settled. My point: the Pregabalin has given us hope.

So why, if Pregabalin has given us more hope than we’ve had in months, am I typing this ridiculously long post about possible euthanasia two days from now? Well, for two reasons:

1. He still isn’t eating his meals. He only eats human food. He is meant to have his second chemo on Tuesday and, unless he eats normally before then, his chemo won’t be possible. It’s important to note that while Arnold’s cancer is clear (macro) it is highly aggressive and extremely fast growing, making the chemo schedule so important.
2. His PLP literally breaks my heart. Even though Arnold’s pain only lasts for a few seconds and, for the majority of the time, he’s ok, his PLP screams still kill me. If his pain can’t be managed, I worry about his quality of life.

I don’t want my dog to die – who would? – but more than that, I don’t want my dog to suffer.

The reason for this post is simple: I’m hoping that there’s someone out there who has experienced this situation and managed to pass through it – to have their dog pain-free. Even though I understand that all dogs are different and that another dog’s recovery doesn’t guarantee Arnold’s recovery, I just need to know that recovery is possible. And I would love to have an idea of how long this pain could last from people who have actually experienced it. That said, I’m trying to be a realist. If there’s anyone out there who decided not to allow their dog to endure this, I’d love to hear your experience, too. The thought of Arnold not being here two days from now breaks me completely. But the thought of him being in pain two months from now breaks me so much more.

Thank you so much for reading.

Andy