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Caring for a Three Legged Dog or Cat

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Post-op Day 10 - Signs of Pain? Or Medication side effects?
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Forum Posts: 1
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20 January 2018
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20 January 2018 - 12:25 pm
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Hi – our 3.5 year old English Lab Aspen (60lb) had her front right leg amputated last week (10 days ago) and she has been doing OK for the most part. She stayed at the vet for 48 hours, and had a drain placed. Her amputation was a bit more than others I think? as the tumor was on the top of the scapula – and required the scapula to be removed completely as well.

The first weekend she seemed tired and lethargic but was able to move around to potty fairly well, even post op day 1. Her drain was removed last Monday but she has been showing what we thought were signs of pain – painting, short breathes while laying down, back legs trembling/spasming from about post op day 4 or 5 onward. We called the vet earlier in the week and they suggested higher doses of meds. We upped her to 150mg tramadol every 8 hours, 300 mg gabapentin every 8 hrs and 60mg galliprant every 24 hours (she can’t take rimadyl due to GI interactions).

That didn’t really seem to change her ‘pain’ – she still went through panting spells – sometimes for up to 30 / 45 mins and her back legs were still trembling / twitching. 

So we went into the surgeons office yesterday to have her looked at. He said the wound looked good and actually removed the sutures yesterday instead of her scheduled day on this Tuesday. He also said maybe instead of pain, these symptons were related to over medicating so he is having us taper her down on the dosages. With 100mg tramadol and 200 mg gabapentin every 8 hours in the past 24 hours it seems to still be pretty similar.  Is it typical for a dog to still be very painful 10 days out of surgery? Could this be phantom limb pain or something else?  Or is it possible it is side effects to the pills? 

Thanks

Ryan

The Rainbow Bridge



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20 January 2018 - 1:14 pm
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Hi Ryan, thanks for posting about Aspen. It does sound like she has a great vet team. And many dogs here have their scapula taken so that’s not too unusual, our Jerry was one of them. We learned that dogs don’t really need it even if the leg isn’t being amputated. Weird!

To answer your questions:

Is it typical for a dog to still be very painful 10 days out of surgery? Could this be phantom limb pain or something else?  Or is it possible it is side effects to the pills? 

Aspen could definitely be having a reaction to too much pain medication. It’s odd that too high of a dose of pain meds can cause the same symptoms as too little of a dose, but it’s true. And very common, especially with Tramadol, which can make some dogs crazy (our own Wyatt Ray can’t tolerate it for that very reason, it makes him too anxious). The first week or so is a matter of fine-tuning that dosage so that the patient can stay comfortable. Sounds like your vet is doing a good job of that. I’ll bet that you’ll see a difference by tomorrow. 

Oh and Phantom Pain is something quite different, and if you click on the link you can read more about the symptoms (sharp unpredictable yelps, constant licking at the leg, and other pain signals). 

So for now, follow the new dosages your vet has provided and keep them informed. As long as you are staying ahead of the pain and sticking to the schedule this should resolve quickly. Let us know OK? 

It's better to hop on three legs than to limp on four.™
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20 January 2018 - 10:10 pm
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Yeah, tweaking pain meds usually makes a difference.   Just want to add you also .might gentle  massage up and down her spine, her neck and shoulder area xeveral times a dsy.  .  She’s using muscles in ways she didn’t have to do with four legs.

Also, she just needs to be doing short potty breaks at this point and then just rest, rest and more rest.

The length of time  dogs need pain meds  really does depend on the individual dog.  My Happy Hannah was in them to some degree for three weeks.

Let us k ow how she’s doing.  Recovery doesn’t last forever…..it just seems like it!

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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21 January 2018 - 6:40 am
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Otis did great and then 10 days in had a bad day or two. Turned out he had an infection with an abscess that ruptured. It was a lot of panting and he was clearly in pain. It coincided with two days off of his anti inflammatory. His wound was also twitching. It was awful to watch. I am in no way suggesting that your dog has an infection or fever BUT for us, other than getting some new antibiotics to help him, the key to making him comfortable again was adding back in his anti inflammatory. It made a huge difference and both our GP Vet and Surgeon said that he may need to stay on that and his gabapentin for another week while we taper him off the tramadol. So every dog is different…and after having been through this experience with Otis, I can only say that if you think your dog is in pain, he or she definitely is. It sounds like you’re doing all the right things and trying to figure out the medicine combination that will work best so I’m just sharing how we got Otis comfortable again and also that yes, at 10 days, our dog was still in pain!

Camille and Otis

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21 January 2018 - 8:04 am
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Hi Aspen and Ryan

Sorry to hear that Aspen is having some issues. It sounds like you are right on top of things with your vet team! I have not seen Stewie have any kind twitching or trembling in his back legs.

Stewie had his front left leg (and his scapula) removed in July of last year. Stewie was having issues about a week into his recovery. He had formed a seroma (build up of fluid under the incision site) and I had to take him in to the vets a few times to get it drained. There was one day that Stewie was super restless and so I took him in. My vet kept him for the afternoon, taking him off all of his meds, so that she could observe his behaviour. We were super happy when she reported that he was a bit more normal and we took him home. Our vet took him off his penicillin because he didn’t have a temperature, but she put him back onto his (2-300mg) Of Gabapentin at bed time and the following day, after checking in how Stewie was doing, asked me to reintroduce the Metacam daily.

I think Sally had a great idea to try and massage along aspens spine (and LOTS of rest) … anything might help… otherwise you are doing a great job of keeping your vet informed of Aspens progress. Every dog is different in their recovery, so staying on top of any minor issues, will help avoid any larger ones.

All the very best

Petra, Stewie 🐾  and his Pride  >^…^<

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