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French Bulldog with Phantom Limb Pain
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Member Since:
17 April 2024
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20 April 2024 - 6:59 am
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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

Virginia







Member Since:
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20 April 2024 - 10:29 am
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Hello Andy and Arnold.    Your post has been approved and now members will be able to help support you.

I am absolutely astounded at what your sweet Arnold has been through. You clearly have done, and are doing, everything possible to help him. He has been thrown more hurdles in the past several months than most dogs ever have to deal with in a whole lifetime. You were staying strong though and continue to  advocate for him and that says a lot about the bond you two share.

First of all,I'm so glad the Pregabalin has helped! Huge victory!  

As hard as it is to be patient right now, try to take some deep breaths and realize that Arnold isn't throwing in the towel yet. You witnessed him getting to be Arnold again in the last 24 hours or so.

  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 

 

To me, that does indeed give you reason to hope!!!!  Seeing him feel better and be more engaged is what we hope can continue!

There is one thing I want to bring up as we have seen ot on ocassion. While I do t have the medical termin down, it's basically  a 'dangling nerve" that didn't  get fully c.osed off during surgery.  It presents ts as PLP with the episodes causing extreme pain and usually lasts longer than seconds though.   Nothing seemed to stop the pain.    It's worth mentioning  to the Surgeon.  Unfortunately  it does require going back in for a surgrry  to repair,  but it's at least not a HIGE major undertaking. 

 

  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

FWIW, A chemo treatment is often delayed for one reason or another. Sometimes there might be a low blood count, or a variety of other reasons.. so to have a treatment delayed a week it's done all the time. In your case, if you can get Arnold eating a little better it might simply be that it's delayed a couple of more days rather than a whole week. Call your uncle Monday and explain that you warned him feeling a little bit better before the Tuesday appointment and you'd like to maybe reschedule it for a couple of days later.  As you know there are no guarantees with Chemo one way or another. I certainly understand why you want to stick to the scheduled appointments though

As much as you want Arnold to have excellent nutrition right now, getting to him to eat anything is still a victory! So even if you have to fix WARM  rotisserie chicken, scrambled eggs, cheese pizza, stinky liverwurst.... whatever it takes right now to get his appetite back on track is progres

A brand you might try is called Fresh Pet It's in the refrigerator section. It's ago to food for a lot pf dogs who turn their nose up to their regular food.

Thank you so much for taking the time to give us all of the backstory. I hope you can find some reassurance here, even if the specifics might be a little different from what you were going through,  IMO hope is achievable

((((((((((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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20 April 2024 - 10:41 am
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Thank you so much for taking the time to read/respond and for your recommendations. I will look online for the food and talk to the surgeon on Monday re. possible nerve damage. Also, you put my mind at ease when mentioning the delayed chemo - you are right, a couple of days won't make a difference. It's such a tough time right now because my other dog, a pug, was diagnosed with Mesothelioma 1 week after Arnold's diagnosis. And then he was diagnosed as diabetic.

These dogs are killing me 🙂 But they are worth it. Truly.

Thank you again!

Virginia







Member Since:
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20 April 2024 - 10:54 am
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OMD.... you and your dogs are the epitome of when it rains it pours! Yes, they are worth every second of it though. Your pups are very lucky to have you as their hooman.

Did want to mention that, everything else aside,  Hemipelvectomy surgery takes longer to recover from, regardless of all the other issues too.

I'll try and find a link to the dogs who have had the "dangling nerve" .  If I recall, one dog was even at the Vet for 24 hr pain drip for PLP that didn't  help.  Seems like that's  when they went back in and found the nerve that needed to be closed.  The pain stopped instantly. 

Also, possibly you could get the vet to prescribe Arnold an appetite stimulant. If he is showing any signs of nausea, Cerenia might be helpful too.

Hang in there!

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!

Virginia







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22 February 2013
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20 April 2024 - 10:59 am
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PS....Just found the link to dog Ollie who jad the nerve thing

https://tripawd.....mputation/

     

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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21 April 2024 - 4:19 am
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Thank you so much for the link - I just read the whole thread and it's really helpful. I'm trying to stay positive, especially since Arnold has refused all medication/food today. And, of course, he had another PLP episode. 

The Rainbow Bridge



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21 April 2024 - 6:02 pm
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Hi Andy and Arnold. I'm so sorry for this rough time! You've gotten some great insight from Sally, and Ollie's story was the one I was thinking of too. Also, here's another story about Bender's really bad post-op pain issues that were resolved. 

It sounds like your vet team is really current on pain management , which is awesome. Attempting to break the pain cycle they way they have been doing is terrific. To that I might add, you may want to ask for a referral to a physio, for dry needling acupuncture, which is one of the best remedies for phantom pain . Also, there is a pretty new wearable device on the market here in the states, I hope where you are too, that delivers low dose ketamine over several days at a time. You may want to ask about this.

I know this situation sucks, but you're not alone. Others have been through tough recoveries and survived. Arnold can too! Please keep us posted.

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22 April 2024 - 5:38 am
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Jerry, thank you *so* much for these links - they are exactly the type of stories that I needed to read. It's so important for me to know that the situation I'm currently experiencing is not unique to Arnold and that there is still hope.

Today was the day we had intended to say goodbye to Arnold. We said that if he continued to refuse medication/food over the weekend, there was no other option because we'd tried everything - literally everything - to get him to eat/take the meds. That said, we managed to medicate him for the last 2 days using honey water. He still doesn't like it but he tolerates it - for now, at least. All that's left is for us to break the food/medication association. He needs to eat. If he eats, we will have turned the corner. I cannot bear the thought of euthanising him. But, at the same time, I will not allow him to suffer unnecessarily.

Flipping dog - he's so beautifully difficult 🙂

Andy

Virginia







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22 April 2024 - 10:50 am
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Flipping dog - he's so beautifully difficult   

Love that description!

Okay, you do have a victory  with the meds, so celebrate  that.

Just one other quick thought, often getting your pup back to the vet for fluid therapy can help with the appetite. Also, did you ask your vet about any of the appetite stimulants mentioned?

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!

The Rainbow Bridge



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22 April 2024 - 11:17 am
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Andy that's GREAT NEWS! 

Honey water ... genius! I swear it's never been mentioned here, so thanks for the tip.

Also I forgot to add, here are some ideas for appetite and pilling when a dog or cat doesn't want to eat or take meds.

Keep us posted this week OK? 

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22 April 2024 - 12:26 pm
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Sally: thank you for the fluid therapy info. I will mention this to the vet during my next visit. The plan for the next two days is to offer Arnold his normal food at regular meal times and lay off the treats/meal alternatives. Apparently, this is the best method to try first off. I'm pretty sure he will refuse food for the rest of the day (so far, he's eaten nothing at all) and, while I hate the idea of him feeling hungry, perhaps that will persuade him to eat in the morning. If that doesn't work, I will absolutely be pushing for appetite stimulants.

Jerry: thank you for the appetite/pilling links. Unfortunately, I've tried all pilling methods possible and every one has failed. So far we're good with the honey water though. I'm hoping the honey water will be the go-to from now on, especially since the eating issue we're trying to resolve currently is the result of hiding pills in food. I *really* need him to understand that there won't be medication in any of the food we offer. Once he begins to trust food again, I'm hoping he'll follow my lead and stuff himself silly. The appetite info is something I will definitely try. If he doesn't eat in the next two days, I need to change tactics.

Why oh why are clever dogs so flipping dumb 🙂

Ok, it's dog-feeding time here in the UK. Fingers crossed he eats.

I will keep you updated. And thank you so much for taking the time to offer all this amazing advice. Before reading the information available on this site, I was completely lost. 

Livermore, CA




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22 April 2024 - 1:50 pm
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Hi Andy,

You and Arnold have been through so much! 

You've gotten great advice from Sally and Jerry but another idea just occurred to me.  Is there a vet pharmacy that you or your vet can access?  I've had Pugs and Pug mixes for many years and often meds they need don't come in small enough pill form so they are instead compounded at the vet pharmacy into liquid and then they add a flavor like beef or chicken. One of my Pug's was taking Gabapentin for years for arthritis and we always go it compounded. Not sure if Arnold's meds can be compounded but it might be worth a question to your vet.

I hope things get better for you guys.

 

Karen and the Spirit Pug Girls and Boy

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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23 April 2024 - 2:48 am
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Hi Karen,

Thanks so much for your reply. You are right - sometimes the pills seem way too big for our pugs/pug mixes to swallow. I tried chicken-flavoured Gabapentin compounded liquid before the Pregabalin, and he hated the process so much that he eventually refused and got extremely angry. In essence, I suppose I'm creating my own compound by dissolving the capsule contents in honey water. The good thing is that he's much more into honey because, I suppose, the sweetness counteracts the bitterness. 

Andy

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24 April 2024 - 10:07 am
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Just a short update. Arnold died today. We took him to the vet for an appetite stimulant and, while there, had his tummy scanned. He had a large mass inside his stomach and, well, there was no hope. Thank you for all your help/advice. My heart is completely broken.

Virginia







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24 April 2024 - 10:21 am
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Nooooo!!! Unbelievable!!  Shocked and stunned!!!  This piece of s**t disease is so cunning and brutal and vicious.   Cant even begin to wrap my head and heart around how this jas happened. 

No one, no one could have done more for Arnold!  He had THE best care and you left no stone inturned.  Aich an unexpected turn of events.

There really are no words right now so I wont even try.

Just know your whole Tripawd  family grieves with you today.  We are just so very, very sorry.  We got to know Arnold  through you and we got to see the love and devotion and dedication   you had for him. That is such a privilege ,and we are so grateful  to meet this very special  boy who was so well loved.

For now, all I can do is snd you our love.  Know in the days to come we are here for you and shall continue  to be right by your side.

Run free sweet Arnold. When you get to The Rainbow Bridge  you will be healthy and whole again.  Yoj will run through the fields  and nap in the warm sun.  You'll eat one feast after the other with fisto.

 

Love and light

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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