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SOME ADVICE NEEDED
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Forum Posts: 100
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7 December 2018 - 12:26 pm
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Hi everyone – it’s been a bit since I’ve posted, but I come here regularly and read, read, read.  Yesterday my great dane girl Maddie (front leg osteosarcoma, amputation 10/17/17) was not herself.  She went out to potty in the afternoon and dropped to the ground and wouldn’t move.  This in itself is not that unusual as she loves to lay outside as long as the ground isn’t wet (and we take her out on her lead so we’re used to her plopping down!).  However, even after 10 or 15 minutes she wouldn’t get up.

My daughter was home with her, she eventually coaxed her up and took her back in to her bed but at that point it was obvious something was wrong.  She was trembling/shivering and sort of moaning.  So immediately off to the vet (where of course she acted absolutely fine – no pain signs at all).  She did have a fever though – 105 (she runs about 103 at the vet) and her eyes were very red and one was sort of weepy). 

The doctor checked her legs and she showed no signs of discomfort when he was moving them around.   He suggested lung xrays, which she hasn’t had since a cat scan a couple days before her surgery.   She sadly has lung mets.  The xray is going to a radiologist, but her regular vet and I looked at it and saw at least 5 dime to nickle size spots.  He said her breathing is fine (we’re monitoring) and we went home with tramadol and instructions to take her temp regularly and monitor her breathing (if she gets close to 30 breaths a minute, that’s a concern). 

We got her home, she ate like a champ but couldn’t seem to settle down and sleep.  She was moaning again and when when laying half on her bed, she tried to push herself the rest of the way with her back leg and that made her cry out.   She was still in obvious pain so at about 1 a.m. we gave her gabapentin which enabled her to sleep some. 

This morning she had a hard time standing up to go out to potty.  Her front half hops up, but she struggles with her back half.   The vet wanted to give her the weekend on pain meds to see if maybe she pulled something or twisted something.  This morning she did eat and she took her Deramax and an hour later four tramadol. 

I came into work for a bit and my daughters been sending me updates, Maddie has been resting and is very sleepy.  The good news is her temp is now about 102 which is great and her breathing seems fine.  Her eyes aren’t nearly as red, and her gums are fine.   

Long prelim to my question – can lung mets cause this kind of reaction?  Could her struggle and pain be from that despite the fact that her breathing seems fine?  Has anyone ever encountered this? 

She didn’t injure herself.  She was okay yesterday morning – got up, went out to go potty, ate her breakfast, and was fine.  This was pretty sudden it seems.  Anyone have any suggestions or thoughts?  As always, thank you all for your kindness and good advice.

Bobbi & Mads  

Bobbi & Maddie a/k/a ManiacMads

Front leg amputation 10/17/17 due to Osteosarcoma

She's Madeline, She's Madeline

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7 December 2018 - 3:02 pm
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Bobbi, I’m sorry about the mets, they’re a heart breaker. And now this behavior on top of it, well you must be worried sick, I can’t blame you. But first, let’s try to look at the whole situation so that you can feel less overwhelmed.

First, her breathing is good so YAY for that! And her fever is down and she’s doing a little better than yesterday. That’s a couple of good victories to celebrate!

Honestly I have no idea what could have caused the sudden pain symptoms. No, mets don’t usually cause any kind of signs like this until they are impacting breathing. So this could be anything. Maybe she did slip and fall when you weren’t looking? Did the vet happen to take x-rays anywhere else? Or suggest doing so?

Is she on Gabapentin regularly, on a routine schedule? If not, talk to your vet about dosage. Gabapentin is not an “as needed” drug the way Tramadol is given. It does sound like she has some unaddressed pain issues. Have you considered any kind of acupuncture or other pain relief modalities? When severe pain happens, usually you need at least a couple of different methods (medication + therapy) to control it. 

There is a condition called Hypertopic Osteopathy that sounds something like the symptoms you are describing. A few members here have dealt with it. I don’t want to worry you, so keep in mind that it often shows up with leg swelling. Did the vet notice anything like that? Or mention “H.O.”?

I would keep your vet in the loop and let them know if you have any concerns at all OK? And keep us posted. We are keeping our paws crossed that her recovery continues.

It's better to hop on three legs than to limp on four.™
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7 December 2018 - 6:06 pm
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Thanks for the response Jerry.  No on the H.O. and leg swelling, the doctor didn’t mention either and I don’t notice any swelling.  They did try to xray her back but she wasn’t having it (she wasn’t knocked out since this was sort of an emergency).  He suggested we try sedating her and doing back and legs xrays IF the tramadol and Deramax don’t seem to resolve her pain this weekend.  We’re sort of taking a wait and see approach.  He also said if she got worse over the weekend to take her to the ER.  She was on Gabapentin on and off since her amputation (when she had MRSA and was in bad pain).  I have not given it to her today, but it does knock her out (even just one capsule) and she was in such discomfort last night I just wanted to give her some relief.  I put a call in to the vets office today to ask about putting her back on it, but the doctor she’s been seeing is out till Monday so I asked for one of the others to call me back (this was 10 this morning) and I never got a call.  I tried at 5 pm and the office was closed! I’m going to call them again in the morning.  The good news is that she got up much easier when I walked in from work. and she asked to go out to potty.  So we went out (on lead)  and she did her business then wanted to hop around a bit.  This is a HUGE improvement since just this afternoon.  I fed her dinner and gave her the second dose of tramadol and she is laying her sleeping now.  I’m thinking she must have hurt herself – otherwise she wouldn’t seem to be getting better (I hope).  I don’t know how she could have = she was absolutely fine yesterday morning, she went out fine and ate all her food.  My daughter had a job interview, so when she got home she was also fine.  Then when she took her out a couple hours later, BAM.  My daughter swears she didn’t trip or stumble or even limp on the wait out.  It is so weird.  Maybe she tweaked something when she plopped down to lay in the leaves (she loves to do that!).   I don’t want to grasp at straws and I definitely do not want her to suffer, but if this is something that she can get better from, I want to give her that chance.  It’s such an awful disease.  I just hate it.  I am happy that I went thru with the surgery because she has had a good year of happiness and enjoying her life.  I knew that lung mets would probably happen and as long as she is breathing okay, I’m trying to put them out of my mind.  We do have an vet who does acupuncture in the area so I will definitely look into that!  I haven’t really looked into anything like that because she has been pretty pain free for the last year.  This is so weird and sudden.  I just pray it is something that she can bounce back from.  My poor girl.   

Bobbi & Maddie a/k/a ManiacMads

Front leg amputation 10/17/17 due to Osteosarcoma

She's Madeline, She's Madeline

Virginia




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7 December 2018 - 9:47 pm
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Certainly  not a Vet and not giving  Vet advice, but this seems to me to be completely  unrelated to the crap mets

And btw, YAY for no symptoms from those crap mets!!  And glad to hear the fever and runny eyes cleared up!

Do you have access to a Rehabilitation  Specialist?  Often they can diacocer6 tweaks of the joint t’s, muscles or spine that  aren’t  as apparent to regular Vets.  Has the Vet eliminated dosc issues, neck, shoulder issues?

And Tripawds can very, very easily tweak something with  so very, very easily.  Keep her confined as much as possible  and keep her on an anti inflammatory   and the pain med.  It may take a week or two, or more, if it’s  a soft joint tissue injury.

Try rubbing up and down her spine and see if she shows any tension …same for around her shoulder  and neck muscles .

When my Happy Hannah had mets,, what you jave described was NOT a symptom, or side effect .  I dis drove myself nits counting her breaths for awhile.  Sometimes they were more shallow and rapid, sometimes not.  I filled ally jist stopped FOCUSING stuff like that, and focused  on the fact she was enjoying life and had no awareness of having mets!

Keep us posted and let us know how tjat sweet girl is  doing . 

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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8 December 2018 - 7:09 am
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Thanks Sally.  We do massage her muscles regularly – legs, back, shoulder.  Our regular vet gave us a little tutorial on it when she was recovering from the infection last year.  She enjoys it.  Thursday night she did not want us to rub her back or leg.  When you touched her she’d swing her head around and jump a little with her ears back, definitely like it hurt everywhere.  Last night she was back to enjoying her little massages.  Both my daughters (and son in law) have been very involved in her care since pre amputation.  They’ve been to every vet visit and have been doing just as much as I have to keep her happy and healthy.  My daughter swears she got up from her bed fine, hopped outside fine and was her normal goofy self until bam, pain.  Since she’s been so involved, I know that just like me, she’s very attentive to Maddie so I don’t think she missed anything.  You know how it is, in this situation, the entire household and all our lives revolve around Maddie’s health!  It’s possible when she was at her job interview Maddie somehow did something, but we do not let her roam the house when we’re not here.  We keep her confined to the family room just because I worry she may fall even with the walking mats everywhere.  The family room has carpet and her bed (which takes up half the floor space).  Now the good news is  she does seem to be feeling better so I guess the tramadol is helping.    She slept well last night, no moaning or trembling and she is eating and drinking.  Her breathing is about 22 breaths per minute which I understand is good so I’m starting to calm down a bit about this being related to her lungs.  She gets Apocaps and K-9 Immunity so i’m hoping these continue to help extend her time with no cancer symptoms.  I have seen a lot of posts about CBD (?) oil.  I’m going to read up on that today and see if it’s something that may also help her.  I really appreciate you and Jerry responding.  It helped me to see that this is not a typical symptom and maybe look a little at the bright side!  You know when you’re scared and upset, you see the negative much easier.  It helps to have someone point out the positive.   The lung mets totally suck.  It’s just devastating news.  Honestly, I was half expecting it when he said “chest x ray”.  It’s been 15 months since her diagnosis and at that time they said she already likely had lung mets (although they didn’t show up on the cat scan).  We just want to make her life happy and pain free and we hope to have plenty of time with her.  I set these little milestones in my head – after surgery I thought, I want her to get to enjoy Spring, then I want her to get to enjoy summer, then her ampuversary, now it’s her birthday in March.  She’ll be 9. 

Bobbi & Maddie a/k/a ManiacMads

Front leg amputation 10/17/17 due to Osteosarcoma

She's Madeline, She's Madeline

The Rainbow Bridge



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8 December 2018 - 12:04 pm
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Things sound so much better for Maddie! How’s today going for her? I hope the medication is still helping. Amazing that she is so sensitive to pain medication, a big gal like her. What a sweetheart!

It was about 17 months when we found out our Jerry had mets, and we still enjoyed almost eight months of quality time together afterward. A mets diagnosis doesn’t have to be the end of the road, not by a long shot. Once Maddie’s pain is figured out Maddie can very likely keep on hoppin for many more good times!

Cancer tries so hard to steal every bit of optimism from us, but you are doing a great job not allowing it to do that. Keep on staying pawsitive, you and the whole family is doing such a great job caring for her.  

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




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8 December 2018 - 10:20 pm
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You and your family are doing a steller job of caring for Maddie!!😁😁   She’s  a lucky girl to have such a loving  family ❤

So glad she is doing better.  Again, the fact that she gets better, and msymeven have a little setback and then better again, etc, sounds so much like a tweak.

Ahhh yes, we all know about those “milestones”.  We are so happy when one is reached, and then we  move ine again and creste another milestone , etc.  The important thing, as you know, this journey is  all about celebrating  the gift of every moment, as well as the milestones.  To the adorable Toby, every moment is pure magic😎

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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10 December 2018 - 2:25 pm
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Thanks so much for the responses – they calmed me down for sure!  Maddie is pretty much acting like her normal self again – but still on tramadol twice a day and an increased dose of Deramaxx.  I talked to her vet this morning, he got the radiologist report back and we talked a bit about what we could do if she starts to show symptoms, especially coughing (which she’s not).  He wants us to start to dial back the tramadol and see how she does on one dose a day.  If that goes well, then try none.  That makes me nervous, but we’re going to skip the a.m. dose tomorrow and just watch her closely.  As for the radiologist report, he sent it to me and it says there are multiple 2.5 cm nodules as well as something called “consolidation” of one of the lung lobes.  The report said it is unclear if that’s part of the metastatic disease or another “benign” cause and recommended a CT scan.  Maddie’s vet doesn’t think we need or should do a CT scan at this point and I tend to agree.  What’s it going to tell us?  It’s something or it’s nothing and there is already “something” in other places.  She isn’t a candidate at this point for surgery to remove the nodules, which the doctor pretty much already told us.   

 

Bobbi & Maddie a/k/a ManiacMads

Front leg amputation 10/17/17 due to Osteosarcoma

She's Madeline, She's Madeline


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12 December 2018 - 9:40 am
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Regardless of whether she tweaked something or has spinal mets I would consider keeping this dog on Deramaxx and gabapentin long term to control pain.  Tramadol isn’t that great of a pain reliever and does nothing for inflammation but if you think it helps you could use it in addition.  The Deramaxx is often used in metronomic chemotherapy to help slow down tumor growth.

Pam

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12 December 2018 - 10:51 am
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Dr. Pam your expertise is priceless. Thank you for being so specific about Tramadol. I wish more vets would move on to other medications. And great point about the Dramaxx, I had forgotten about that benefit.

Bobbi I can relate to your choice about not doing a CT scan, we also took the same approach when we knew that Jerry’s mets were not treatable. I hope your girl has a long, long time ahead of her even with those nasty mets. By working with your vet team, she just may have more time than anyone expected. We’ll keep our fingers & paws crossed for you two. 

It's better to hop on three legs than to limp on four.™
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2 January 2019 - 3:26 pm
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Hello again!  I just wanted to update you all on Maddie.  She is exactly the same as she was in early December….  We tried weaning her off the tramadol and she immediately started having difficulty standing up again and add to that, she was limping on her back leg (which was new).  I talked to her vet again and given that the tramadol does seem to work for her, she’s going to stay on it.  She’s been on Deramax since her surgery and we’ll keep her on that.   When she’s on that combo, she acts absolutely fine – she hops around, sleeps well, eats well, etc.  But even cutting the tramadol in half I noticed a difference.  After her surgery the surgeon also told me that tramadol doesn’t seem to do much for pain but for whatever reason, it seems to work for Maddie.  She does much better on that (along with the Deramax).  So right now we’re just in a holding pattern.  Keeping her on the meds as long as she stays comfortable and happy.   We’re just taking it day by day and hoping that she’ll continue doing okay.  Thank you all again and I will keep everyone updated!

Bobbi & Maddie a/k/a ManiacMads

Front leg amputation 10/17/17 due to Osteosarcoma

She's Madeline, She's Madeline

Virginia




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2 January 2019 - 3:37 pm
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Thanks soooooo much for rhe update,  and it’s  a pretty darn good update st that!!!   Great way to start the New Year!😁

You seemed to have found the perfect “treatment ” plan for Maddie and that’s  such good news!  You’ve found what combo works for Maddie, good job of sorting  it out.  She’s  happy, she’s comfortable, she’s loved, she’s  spoiled and she’s  treated like the Queen she is.  No dog could ask for more❤😎

Keep on keeping on sweet Maddie!  We’re  cheering for you!

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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