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Having a Rough Time with Pain Meds
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14 December 2018 - 7:56 am
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I don’t blame you at all. Some dogs just don’t do well with some drugs. I would definitely ask about a tramadol alternative, there ARE other meds out there. Bypass the nurse and ask to speak with the doctor directly, the doctor should be able to suggest an alternative.

Good luck heart

Hugs,

Jackie, David, Bo, Andy, Oscar, Angel Mitchell, and the coolest feral tripawd kitty Huckleberry

https://paws120.....pawds.com/

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14 December 2018 - 11:13 am
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Update: I spoke with the after-hours surgical nurse and she said “sounds like she’s in pain, give her pain meds.” She said their alternative to tramadol is the gabapentin, so I’m to keep her on that until Monday. Basically it sounded like “pick your poison” – anxiety or pain. I told her I was frustrated that I was told to take her off pain meds and now I don’t know what’s wrong with my dog. She said everything I’m telling her sounds normal, that just like humans, dogs have different post-op pain and medication thresholds, and it will all even out after the sutures are out and we can take her off the meds completely. 

She said she may be nauseous from the medications, so give her anything that tastes yummy. Keep her on the Carprofen 1x a day. 

The panting will make her warm, but that’s normal. The bruising right above one part of the incision is normal too. 

The ONLY thing that made me cringe was she said “You have her in small room, right?” She’s been in the living room, with 3 beds all lined up next to each other. She keeps getting up to adjust herself, and that could be too much movement, but she is staying in that space and doesn’t even want to move elsewhere. We go out to potty 3-5 times a day just to make sure she’s getting relief. 

I still feel uneasy, but I also feel like I have no choice but to try everything until I can be in front of the actual doctors on Monday. I hate feeling like I’m making all the wrong choices. Just praying we get through this weekend ok. 

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14 December 2018 - 11:24 am
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Oh man, i am so sorry. This is not a pick your poison kind of deal, and that”nurse” is not a doctor. That is not the only drug available but if i had to choose just one it would probably be the gaba. Her boss should know about how smart she is when you visit.

Please don’t panic!! If your girl is staying quiet, readjusting, quick potty breaks that’s perfect! The size of the room is directly affected by the activity level of the patient. You have that covered! If she was bopping all over and not resting i would suggest limiting her activity but she is not active so no worries. If that changes then you know you’ll need to restrict her. 

We see pain medication wars all the time. It truly amazes me how the limb of an animal could possibly be different than the limb of a person, you know?!?

Hugs,

Jackie, David, Bo, Andy, Oscar, Angel Mitchell, and the coolest feral tripawd kitty Huckleberry

https://paws120.....pawds.com/

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14 December 2018 - 3:05 pm
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Dang only 100 mg Gabapentin twice a day? Our irie girl is 57 lbs and we give 200mg (2 100mg tabs) twice a day and the surgeon said if needed we could do 3 times a day but she was okay with x2. We find the Gabapentin worked more than Tramadol. I think there is some room to go up in doseage for the Gabapentin since your dog weighs so much. 

I agree with paws I would not talk to the nurse anymore, next time when you call say “I don’t feel comfortable without having an answer directly from my dogs doctor. I am concerned the pain is not managed which will effect her healing, I can wait on the line for her/him.” The nurse isn’t the doctor or the medication expert, I would def fight to talk to the doctor that is honestly unprofessional. 

Once you talk to the vet ask about the Gabapentin dose and if it can be increased (might be other reasons they started low).

In case you want an idea Our regimen is: between 8-9am with breakfast: 2 capsules of Gabapentin (200 mg), 1/2 tab Carprofen (50 mg), and antibiotics 

around 12 pm – 1 pm 2 tablets of Tramadol (100 mg total) 

8-9 pm with dinner: same as morning dose 

11pm – 12pm: 2 tabs of Tramadol.   —-> before we were doing 3 times a day but it gave her anxiety (whining, panting, can’t move) so we tried to do 1 tab mid-day, didn’t work, we found twice a day with the dose at night closer together worked because pain is always worse at night.  

Its not fair to you or your pup for her to still be in pain! I hope the vet talks to you and sending positive vibes your way. 

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14 December 2018 - 3:37 pm
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Thank you so much! I don’t want to sound like a pushy broken record, honest!

I hate when people go through the “medication run around” 

Hugs 💖

Hugs,

Jackie, David, Bo, Andy, Oscar, Angel Mitchell, and the coolest feral tripawd kitty Huckleberry

https://paws120.....pawds.com/

The Rainbow Bridge



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14 December 2018 - 5:24 pm
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I’m on my phone now so keeping this short, but yes, x2 what the others have said. There are better pain meds than Tramadol and it does not work in the same way that Gaba does, it’s apples to oranges. If the vet won’t budge on the regimen, it’s your right to find a new vet. Frustrating and not what you need now, but it pays off.

This is when you find out what good veterinary care looks like, or does not, unfortunately.

Hang in there! You can do this!

It's better to hop on three legs than to limp on four.™
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14 December 2018 - 7:35 pm
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Thanks guys – I feel validated here. The good thing is she seemed calmer today on the Gabapentin. Some panting yes, but not as bad as when she was on the Tramadol.  Will be giving her the 2nd dose soon. But I will definitely be asking for an increase in dosage – some sort of change – from the DOCTORS on Monday. More Gabapentin, more Carprofen, whatever it takes. 

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14 December 2018 - 7:59 pm
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If they are open short hours tomorrow i would make the call. Tell them you want to speak with the doctor and accept no less. 

If they have email or if you have the doctors text number that would work too. 

If this doctor is that hard to reach then you may want to reach out to another facility. The hard thing with this is once you have pain break through it can be harder to manage. Waiting another three days is really not acceptable. 

I’m glad the gaba is helping a little more. It is a great medication to help phantom leg pain , and it does have a calming effect. I cannot speak for the dosage because my 9 pound cat dosage was 100 mg. I think i ended up giving him 50 mg twice a day but he was a cat, not a dog. 

You might want to check around and see if there’s another place that will see you tomorrow just in case you can’t get in touch with your doc. Fyi… That doctor needs to know how hard they have been to reach. It might make a difference. When Huck and Mitch had surgeries, my vet gave me their cell to text updates. With Huck it was the doctor. With Mitch i had all the care i needed right away. Once you reach your vet you’ll have a better feel for the situation.

Big hugs,

Jackie and Huck ❤️

Hugs,

Jackie, David, Bo, Andy, Oscar, Angel Mitchell, and the coolest feral tripawd kitty Huckleberry

https://paws120.....pawds.com/

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14 December 2018 - 10:30 pm
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tramadol has been so poorly reviewed lately…  many vets  now wont use it solo bec it does not help for pain.. with other meds.. maybe it is  helpful..    given with gabapentin.. seems to be ok.   

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15 December 2018 - 7:35 am
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Update from my phone: they are closed weekends so I called after hours nurse, same person as yesterday. She was more or less irritated that I called to ask if we could up her dosage of the Gabapentin to 3x day. That she “already told me” what to do yesterday, and the after hours line was for emergencies which is NOT what I was told. Didn’t get into it with her, am reserving it for the doctor on Monday. His staff should not be giving out mixed messages.

I am clearly not trying to overdose my dog, but as she pointed out yesterday, they can only go off what I tell them. I’m being the best advocate I can and really, they see this day in and day out, but that might make them biased to putting everyone’s individual experience in a box without budging. I trust the doctor, he did a great job on the surgery. But relying on nurses for pain management has not been a good experience.

I hear you all on switching doctors but I’m afraid that will be more difficult at this point since we are starting chemo on Monday. I’m still going to talk to the doctor about the struggles we had and that this nurse in particular did not like dealing with me. 

The good news is she does seem improved. A little tired from the medication but not agitated or anxious like before.

will check back in on Monday after our appointment!

Virginia




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15 December 2018 - 9:23 pm
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Glad to hear she is doing better.  I KNOW that’s  a huge  relief   Sounds like she’ll be okay through the week end.  Then you can get things straight with your Vet.

Sorry you’ve had such a rough time trying  to communicate  with the “nurse”.  You’re  doing an excellent  job of advocating and I’m  sorry you’re dealing with a human brick wall.

Update us Monday and try and get some rest.   And just so youll know, I didn’t  start my Happy Hannah’s chemo until the third week because I didn’t  feel she was quite up to snuff to start it.  Aomof you need a few days delay for any reason, it’s  still within a good window of time to be effective.

Try and get some good💤💤💤💤💤

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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16 December 2018 - 7:46 am
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One day left, hope you had a smooth evening heartI know it has been a long weekend for you sad

I would seriously think about taking “highlight” notes to bring with you to the doctor tomorrow. Use this thread for guidance if you need to refer back to symptoms, how many times you tried to reach the vet, options (or lack of) given, how she compared the 2 drugs even though they are not the same medicine and do different things… all of it.

From my own personal experiences as well as my prior professional experiences in the veterinary field, that precious time you get with the doctor is so limited, and it is incredibly easy to get off on a tangent discussing one thing and then poof.. the next thing you know you are on your way home when the light bulb goes off and you think damn… I forgot to mention this and I really wanted to talk about it. And it was important. 

I don’t know if the difficulty reaching the doctor is just this practices normal, or if it is a bad technician (nurse). I can tell you for certain that it is not the norm in most places. Most veterinarians are a lot more hands on and even call their clients to see how a pet is progressing. So if your doctor is relying on this from his staff he may have no clue what is really going on. 

Ok, ok.. I am done with my speech, hope I didn’t over extend or push too hard. I may no longer do the work, but I am still passionate about proper care and I get really frustrated when I see somebody not being cared for properly. 

I hope you have a smooth day, please give your girl extra ear rubs for me and a HUGE hug to you heartheart

Jackie and Huck heart

Hugs,

Jackie, David, Bo, Andy, Oscar, Angel Mitchell, and the coolest feral tripawd kitty Huckleberry

https://paws120.....pawds.com/

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16 December 2018 - 11:28 am
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Thanks Jackie and Sally. Unfortunately, we hit a new low. The Gabapentin alone seemed to work until this morning. She had it in her system an hour and started to whine, which she really doesn’t do. Then the pain symptoms of panting, whining, restlessness, cannot get comfortable, etc. started to show themselves, this with her being off the Tramadol for 2 days. So I felt I had no choice but to give her the Tramadol, which has seemed to work with the combination. I’m trying everything I can to make her comfortable. This has been a nightmare!!

I know we only have to get in there tomorrow, but I am so confused and disheartened. She just doesn’t seem to be coming around and I’m sick about it. I have a list of questions for the surgeon and the oncologist.  If we can’t get her pain under control, I’m not sure I can go through with the chemo tomorrow. 

heart

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16 December 2018 - 11:38 am
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Oh, so go back to using the Tramadol with the Gaba. You managed it and it is working. As you can see, the pain meds are important, and using those together are fine. I think most people space them out, not given together anyways so just do what you need to until your appointment tomorrow. 

The hard thing about pain break through is that it gets trickier to manage. Hopefully your doctor will fix that tomorrow. What time is your appointment? I am on Eastern time. 

I truly feel bad that you are so stuck right now, but you are making this work!! Please hang in there… you are doing an outstanding job of caring for your girl!!

(((((((( Ginormous hugs ))))))))))))

heartheart

Hugs,

Jackie, David, Bo, Andy, Oscar, Angel Mitchell, and the coolest feral tripawd kitty Huckleberry

https://paws120.....pawds.com/

The Rainbow Bridge



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16 December 2018 - 1:56 pm
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I’m so sorry about the frustrations. Glad the Tramadol helped. Do keep in mind that the two drugs can compliment each other usually so hopefully this will continue.

It's better to hop on three legs than to limp on four.™
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