Hi Julie,

OK so a few questions: what is his age/breed type and what does his activity look like during the day? Also, what is the dosage for Gabapentin? And is it only morning and night?

Trazadone is a sedative, not a pain reliever. Tramadol is not as effective as once thought. So both of these meds probably aren't doing anything at all, and the Tramadol might even make things worse because it tends to cause anxiety-like symptoms in a lot of dogs. CBD is usually not going to do anything at all in these instances. Most products are mildly helpful if at all, and treats are calories so use sparingly.

Please don't be afraid of using pain medications to get the pain under control, it's part of a pain management strategy that also often requires other therapies like acupuncture. But use meds with guidance and a vet professional who understands pain. Our most recent tripawd talk episode is a must listen (or read) for you right now:

Help Your Tripawd Avoid Pain, with Vet Expert Dr. Tamara Grubb

Often we see that painful episodes happen when a new Tripawd resumes activity that his body isn't ready to do just yet. 

What exactly did the vets recommend for helping him with these episodes?

Did you know the Tripawds Foundation can pay for your first rehab visit ? Get your dog evaluated so a therapist can figure out what is causing the pain and how to treat it. These experts are amazing and can help pinpoint issues like this relatively quickly (usually). Please let us know if you'd like help finding a therapist so they can find out what's going on with your pup.

Hi Julie,

Thanks for filling us in. It's tough being in a small town with fewer veterinary options but there are things you can do to get him pain relief. He's been through so much, you guys have got to be so exhausted from all of the care. Hopefully things will turn around soon, with your advocacy it can.

I'm so glad Kati came here to share her experience because her Forrest also had some recovery pain issues that they were able to resolve in time with good pain management .

Your dog (what's his name?) is getting a good dose of Gabapentin but spacing meds apart (3x daily) is usually more effective to provide more consistent relief. The NSAID he is getting is good!

So the medications Katie and Dr. Grubb mentioned are super helpful for pain relief:

• Gabapentin OR Pregabalin
• Amantadine
• Methocarbomol if it turns out to be a skeletal muscle strain

As far as the Trazadone, I get why you are using it (many people do it for the same reasons). But since it's only a sedative, basically what happens is that it does knock out the dog, but it doesn't do anything for pain. So if his body is still experiencing pain, the source of the problem is not being addressed, and the pain will persist even through the fog he is in, only he can't show you he hurts when he's dopey.

 I tell my vet that it doesn’t seem to work and thus far haven’t given me anything else. 

Time to advocate! In a kind and respectful way, let them know that you learned from studies that Tramadol has been shown to not be effective for acute post-amputation pain. Let them know you want to explore better pain relief in addition to Gabapentin. Be strong, request the Amantadine, and I would ask for the Pregabalin since the Gabapentin is not touching the pain. Read this post so you can explain why you are asking for it. 

Glad you found the rehab therapist! YAY! That should help tremendously and address the source of the pain, once it's controlled with medication (always the first step before rehab). Let us know what they say. Make it clear about your dog's amputation pain situation so they can get him in sooner.

Remember, this isn't a linear trajectory as Forrest's story shows, there will be ups and downs but he WILL get to a healed and happy place!

Hope this helps! Keep us posted.