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Pain meds for how long?
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4 August 2018 - 8:08 am
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Everyone here has been very helpful and reassuring me that what is happening with us is normal. It know I have all the correct meds needed after surgery but I searched the site and can’t find anything specifically on how long it is normal to be on the meds. Last night Kaiserin was unsettled and panting and let out a little whine of pain when she tried to reposition herself – this was about 45 minutes before pain meds were due. Later she was ok again. I looked at the number of days I have for each drug and am worried they didn’t give them for long enough. She had her amputation on Wednesday. So 3 days ago. I was given:

Tramadol every 8 hours (3 times a day)  for 7 days

Gabapentin every 12 hours for 10 days

Meloxicam every 24 hours for 21 days

Antibiotics twice a day for 14 days

Does this sound normal? Does stopping the tramadol 7 days after surgery seem really soon? Or am I panicking too early. Should I just wait until the week is up and see how she is doing? Thanks! 

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4 August 2018 - 9:59 am
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Hey Natasha and Kaiserin 🌻🐾

I can’t recall exactly how long my girl was on meds but she took everything until stitches removal and a bit after so it may have been 2 1/2-3 weeks in total.  

I would ask the surgeon before the end of the week, just to make sure if more meds are needed they are already in place before the time’s up.

Hugs and cuddles 😘🐮💫✨🌟🌹

Eurydice 77kg/170lb Great Dane limping end of April 2016, amputation (right front leg/osteosarcoma) 4 May 2016 6 courses of carboplatin followed by metronomic therapy, lung mets found 30 Nov 2016. 3 courses of doxorubicin, PET scan 26 Jan 2017 showed more mets so stopped chemo. Holistic route April 2017. Lung X-ray 5 May 2017 showed several tennis ball size mets, started cortisone and diuretics. Miss Cow earned her XXL silver wings 12 June 2017, 13 months and 1 week after amputation and 6 1/2 months after lung mets, she was the goofiest dawg ever and is now happily flying from cloud to cloud woof woofing away :-) 

Minneapolis, MN
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4 August 2018 - 10:13 am
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You had asked a while ago about Gabapentin and whether it should be tapered off – all my vets seemed to think it should.  

Pofi had a nerve sheath tumor and I considered the Gabapentin the most important pain remedy he had and he was on this regimen 2 weeks before and two weeks post amp:

Gabapentin – 300mg 3 x daily

Tramadol – 100 mg 3 x daily

Rimadyl – 75 mg 2 x daily (similar drug to Meloxicam)

A course of antibiotics (was either 7 or 10 days)

I found whining and most panting ceased if the Tramadol and Gabapentin were on slightly different timing – even 2 hours difference seemed to provide better coverage.  So even with doing 2 x daily, perhaps separate the schedule out just a bit for Tramadol and Gabapentin.  I would also be talking to the vet about whether the prescription for Gabapentin could be extended so you can taper down.

After the two week post amp mark, we went down to Rimadyl 1 x a day and Tramadol 2 x a day – kept Gabapentin at same dosage and frequency.  Week 4, I reduced dosage of Tramadol to 50 mg 2 x daily and went to 200 mg Gabapentin 3 x daily with 1 x Rimadyl 75 mg.  Then down to Tramadol as needed and 200 mg Gabapentin 2x daily.  Then no tramadol and 100 mg Gabapentin 2 x daily.  Then nothing.  Total about 6 weeks post op to reduce all pain meds.

Best wishes for Kaiserin and you – it seems he is doing pretty well. Talk to the vet – you should be able to consult about tweaking the pain med regimen on the phone.

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His Daddy and I miss him terribly along with his canine sister, Mia, and two feline siblings, Lucia and Cliff.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation

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4 August 2018 - 10:27 am
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It is a holiday weekend in canada so I can’t speak to the vet who did the surgery until Tuesday. But I am just trying to be prepared and stay ahead of things. I will ask about tapering off the gavapentin. We have some time to sort it out. We are only on day 3 of an10 day supply. I think maybe it wasn’t mentioned because she was only supposed to be on it for 10 days and therefore weaning off might not be seen as necessary. I am even thinking tapering the tramadol might be a good idea – rather than just stopping after 7 days and waiting to see if she is in pain. The vet is supposed to call with our pathology results next week so I can address this. 

Kaiserin sat outside this morning on a blanket and enjoyed some fresh air. She seems to be maneuvering a bit better – can take a few steps that seem stronger and more steady (with me holding the handle of the harness just in case). I do however see some improvement. I figure every day is getting just a tiny bit better so we might be ok. 😊

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4 August 2018 - 10:31 am
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I just thought …….I am wondering if the pain regime may be different depending on the type of amputation. Kaiserin had a mid femoral amputation so the hip is still there and there is a stump of the femur. My surgeon did say when’s they take out the whole hip, the recovery is a bit harder and subsequently perhaps painful longer. So I am wondering if maybe our pain meds seem to be stopped sooner than some people based on the type of amputation???

Virginia
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4 August 2018 - 10:51 am
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You are doing an excellent job of monitoring  your girl! And good for you for advocating  for proper pain meds!  Yeah, you’re  adequately  covered for now, but I woild definitely  get an extension on the Tram, and the Gaba.  If you end up not using it, you’ll at least have it on hand.  Sometimes  it’s  a matter of tweaking  amounts and timing until you get the right balance.  Just a guess based on my experience  with Happy Hannah, you may need the Tram for more than just seven days.  And some dogs seem to dow well without pain meds, or a minimal amount at the end of twelve to fourteen days.  It realkymis case by case.

My Happy Hannah  was quite resrless and unsettled for seceral loooong  nights when she first came home.   I don’t  think she and I slept more than a couple of hours those first couple of nights.  I was really second guessing my decision  for about three weeks! Once recovery  was complete,  I can tell you, it was a great decision!!!!

As you can see from Pofi’s post, you still have some leeway to add another dose of Gaba AFTER speaking with your Vet, and inly after conferring  with your Vet!  Her idea of staggering  the doses of Tram and Gaba always seems to help.

Her mobility  will get better.  Sloooow and easy for now.  Literally  one step at a time!  And the Gaba can cause woozy and dizziness,  so walking is a bit hard for awhile.

The fact that she is enjoying  being outside is a good sign.  Dogs seem to always feel better when they can be outside catching  all the scents on the breeze. 

Give yourself  a pat on the back.   Youre doing great, and so is she!.  

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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4 August 2018 - 1:40 pm
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 I searched the site and can’t find anything specifically on how long it is normal to be on the meds.

That’s because it’s always on a case-by-case basis. It doesn’t necessarily have anything to do with the type of amputation, but about the patient’s health history, age and tolerance for certain drugs. The pain regimen you described does sound “typical” as a baseline for recovery. Some dogs will start with that but then the medication gets adjusted somehow…either more, or less, longer, or shorter amounts of time. It varies depending on how the dog responds to the initial regimen. So don’t panic. Your vets have prescribed a typical pain management plan.

Where in Canada are you? We are near Prince George this week, headed toward Banff eventually. It’s lovely weather if a bit smoky and overcast this week. Glad she was outside enjoying it.

It's better to hop on three legs than to limp on four.™
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4 August 2018 - 3:53 pm
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I never really thought about that – but I guess it does depend on each case and the age of the dog and other conditions. Kaiserin is 7. We are lucky that she has 3 other good legs with no other orthopedic issues . We had her hips x-rayed before surgery and they are fine! We are also lucky she does not seem to need any further chemo treatment after. She has had autoimmune issues with drugs in the past so they would want her to be on medications for as little time as possible. Glad my pain regime sounds fairly typical though 🙂

We are in London, Ontario, Canada – a long way from Banff!

The Rainbow Bridge

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4 August 2018 - 5:11 pm
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Absolutely. And Kaiserin has everything going for her, she is gonna kick some butt when this is all over. Heck she already is! Try not to worry.

Yes you are on the other side of the country! Oh well. Wyatt Ray was so hoping he could pawty with her. Some other time!

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4 August 2018 - 8:39 pm
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Maggie the TriPug had her mid-femoral amp back in 2006.  She came home with a fentanyl patch, tramadol and a NSAID, gabapentin wasn’t available for dogs back then.  Maggie took the tram for two full weeks but we were tapering down the last couple of days.  Maggie was quite a drama queen and always let me know when something was bothering her.  The tram and NSAID kept her comfortable during recovery.

I remember the surgeon telling me that the mid-femoral amp was easier on the dog.  But it still involved cutting through the femur.  In my experience with my own surgeries any time the bone is involved there is more pain. 

I always try to taper down from pain meds. That way if the dog isn’t ready the pain doesn’t get too bad and you can ramp back up with meds. 

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

 

              Maggie's Story                  Amputation and Chemo

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