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CrawlingChaos

(1,893 posts)
Thu Jun 25, 2015, 10:35 PM Jun 2015

Managing severe pain in dogs

I was wondering if anyone could compare notes with me, if you have experience dealing with severe pain in dogs.

My dog is terminally ill; he has bladder cancer that may now have spread to his spine. He has just become paralyzed in the rear legs. I thought we were going to hear the e-word at the doctor today but they want to see if they can get his pain under control so we can resume his hospice care as before. He's a tiny dog who loves to be carried everywhere, so it's possible he could have some quality of life with a wheelchair, and me carrying him around the rest of the time, if we can get his pain under control.

Right now he's taking Tramadol, which must be the worst tasting stuff in the world, judging from the way he fights it. He's also receiving daily shots of Buprenex, which the doc said is morphine. It is truly frightening to see how little effect these heavy duty drugs are having on his pain.

Basically the plan now is to take him off chemo so he can start a course of steroids and then go through a few different pain meds to see if we can find one that does the trick. The doctor said there are a few "sister" medications to the Buprenex, which are also opiates. I'm wondering if anyone has had success switching from one to another, when the first one didn't work?

Were there any other pain management strategies that worked for you when conventional methods failed?

I know that if he does not get relief soon, I will have to make a terrible choice. I'm finding that as that day approaches, my panic and desperation are growing in leaps and bounds. I feel like the pain of losing him is going to destroy me. But I can't let my weakness be the cause of his suffering. I know that.

I feel very unsure and distraught, but I am being guided by the advice of two eminently qualified doctors and I hope when it's all over it will help to know that I tried everything within reason. Even though time is very short either way, I'm finding that every single day with him is incredibly precious to me. I'm sure we all feel that when as we get to this point.

Thank you in advance for any experiences or advice you can share.

24 replies = new reply since forum marked as read
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Managing severe pain in dogs (Original Post) CrawlingChaos Jun 2015 OP
I am feeling sad for you. I can hear your pain. glinda Jun 2015 #1
You are very kind CrawlingChaos Jun 2015 #6
Don't know about Buprenex, but Tramadol isn't very strong. OnyxCollie Jun 2015 #2
Interesting to hear you say that CrawlingChaos Jun 2015 #7
Tramadol is not strong at all... 2theleft Jun 2015 #3
I was interested in trying acupuncture CrawlingChaos Jun 2015 #8
Hugs shenmue Jun 2015 #4
Thank you so much CrawlingChaos Jun 2015 #9
So sorry to hear about your pup... Blue Owl Jun 2015 #5
Thank you so much CrawlingChaos Jun 2015 #10
I wish I had something good to say, but I don't TorchTheWitch Jun 2015 #11
I understand your response CrawlingChaos Jun 2015 #12
You have to do what's right for you... Phentex Jun 2015 #13
I wish everything could be clear when you're going through it CrawlingChaos Jun 2015 #16
My dog is on a bunch of meds for arthritis nadine_mn Jun 2015 #14
For arthritis and certain disorders of the body cold laser is wonderful. We glinda Jun 2015 #15
I'm glad you mentioned this CrawlingChaos Jun 2015 #18
I will definitely look into this - thank you nadine_mn Jun 2015 #19
I am picking up Gabapentin later today CrawlingChaos Jun 2015 #17
I am so sorry! DawgHouse Jun 2015 #20
I want to thank everyone again for trying to help me CrawlingChaos Jun 2015 #21
Bless your heart, CC DawgHouse Jun 2015 #22
Thank you so much Dawghouse CrawlingChaos Jun 2015 #23
I'm so sorry! TorchTheWitch Jul 2015 #24
I'm so sorry for your loss CrawlingChaos. He'll always live in your memories and in your heart. livetohike Jul 2015 #25

glinda

(14,807 posts)
1. I am feeling sad for you. I can hear your pain.
Thu Jun 25, 2015, 10:45 PM
Jun 2015

I cannot advise you but want you to know we are going through some issues also with our old Springer who is super lumpy, arthritic and now has a very bad cough.
I am just doing homeopathic things form online and trying to keep him as happy and comfortable as I can.
I have heard that some people have had success with acupuncture for pain and stress with their pets.

CrawlingChaos

(1,893 posts)
6. You are very kind
Fri Jun 26, 2015, 01:41 AM
Jun 2015

I hope your dear Springer makes an amazing comeback from his issues. The hardest thing in the world is to watch them suffer and to see the confusion and fear in their eyes.

I've been dreading this moment from the day I got my little sweetie so many years ago, when I realized how desperately I was going to love him, and I immediately feared losing him. He's such an adorable little goofball, I would sometimes have trouble believing such an amazing little creature could really be mine. I thought one day the angels would come down and take him away from me, saying "sorry, too good for the likes of you". I guess now they finally are. Ugh, sorry to be so maudlin...

Thank you again for your kind words.

CrawlingChaos

(1,893 posts)
7. Interesting to hear you say that
Fri Jun 26, 2015, 01:44 AM
Jun 2015

The nurse told me it was strong, but it didn't seem to have any effect at all. Certainly doesn't seem up to the task of cancer pain.

Thanks for your input!

2theleft

(1,136 posts)
3. Tramadol is not strong at all...
Thu Jun 25, 2015, 11:05 PM
Jun 2015

I did accupuncture on my dog. It was amazing how much better she felt for several days after the treatments. I'm unsure for cancer and relief from that - my dog had cancer, by small cell, squamos cell, and they were all removable, so I didn't hae the chemo and spreading to organs/bones/etc. She had severe arthritis in her legs and back.

I don't know what to tell you other than maybe try accupuncture, and that I'm so very sorry. It's so sad when our babies our hurting and you know you are inching closer to the e word.

Hang in there, hugs and loving vibes sent to you and your pup.

CrawlingChaos

(1,893 posts)
8. I was interested in trying acupuncture
Fri Jun 26, 2015, 02:06 AM
Jun 2015

If he stabilizes enough for us to go that route. As a supplement to the drugs, it seems worth trying. Even if it could just help to calm him, that would so worth it.

And it's very helpful to hear these opinions on Tramadol, which are reinforcing my concerns that it just isn't up to the task.

Thank you so much for kind words!

TorchTheWitch

(11,065 posts)
11. I wish I had something good to say, but I don't
Fri Jun 26, 2015, 03:10 AM
Jun 2015

I'm vastly concerned about any vet that would not have recommended euthanasia before your dog ever got to this point. From what you describe your dog is WAY past basic quality of life standards, and I have to really question why these vets are putting your dog through such incredible misery and for a terminal illness that is only going to become worse. With the chemo and spine damage making your dog unable to walk on his/her own (a very basic quality of life standard), severe pain and talk of hospice care, I have to question whether your vets are just gouging you for expensive treatments at your dog's expense or believe that you cannot be moved to euthanize him.

No dog with a terminal illness should ever be in a position to have severe unrelenting pain and be unable to walk. Pain, particularly severe pain, that nothing has been able to alleviate all by itself is a horrendous quality of life issue that really demands euthanasia. Add the inability to walk and therefore the inability to go to the bathroom without extensive help are other very basic issues determining quality of life, and your vets are well aware of this.

I think you need to have a VERY frank discussion with your vets about the realistic outlook for your dog and what he is going through NOW. But first, you need to have a very upsetting frank discussion with yourself and realize what misery you're putting your dog through for your own sake and not his. We all understand the desperation and stark raving terror of having to decide to put our beloved pet out of their misery that includes the horror of having to go through life without them afterward. Having had to go through it twice, it is the absolute pits of hell... but a necessity borne from the love you bare them.

No dog regardless of their size actually naturally prefers to be carried about everywhere rather than having the freedom to walk on their own anymore than you would. If they act like they prefer it or like it, it's because that's what they have been TAUGHT. Believing that he would like to be carried because he CAN'T walk on his own is a serious loss of quality of life. Add to that severe pain, medication that isn't working and chemo that isn't working, what on earth are your vets DOING? Either they want your money at your dog's expense or they believe that you will never consent to euthanizing him.

Everything you've written raises my eyebrow on why you're putting your dog through this, and having done similar myself with my first dog, I likely know already... you want to believe that he will get better, that there is some magical something that will cure him or even take away his pain, his growing tumor and his ability to walk again pain-free on his own will come back, and you see each of his issues as entirely separate problems that can be dealt with... and all because you love him so very much, and can't bare the thought of having to live without him much less having to make the responsible choice yourself and then having to actually do it. And then there's the plague of guilt afterward that can last a lifetime beating yourself up about not having done it long before. Because you love him so and are devastated by the thought of life without him, you just aren't able to see his misery through the eyes of someone else that would recognize it for what it is and the futility of putting him through any more of it.

All I can advise is to try to put your personal feelings aside for a moment and see what a stranger would see in his quality of life though I know just how impossibly hard that is to do. Cry, scream and rail at fate or God or whatever else if that helps. I can't say it really helped me though I did it all anyway... there's not a single thing about any of it that will ever help. I can't even say that in time it gets better. The only thing that ever really helped me was getting another dog to love and cherish.

And remember one thing... euthanizing a beloved pet for THEIR sake no matter what it costs YOU is the last and most profound act of love you could ever give them.



Add to that one of these... since probably all of us have been in your shoes, and it without doubt, it's a ghastly place to be.

CrawlingChaos

(1,893 posts)
12. I understand your response
Fri Jun 26, 2015, 04:35 AM
Jun 2015

Ever since we got the diagnosis, I've been giving myself a similar talk, because I was afraid I wouldn't have the strength to make the decision. But seeing him suffer, I now realize that I can. Nothing is worse than seeing him suffer.

I should clarify, all of this is very new. One week ago you wouldn't have even known this dog was sick. He was responding beautifully to chemo, and his last ultrasound showed his bladder tumor had shrunk to almost nothing. His doctors told us we could expect a few months of high quality of life.

His pain has only really gotten bad in the last two days. The paralysis only happened today (preceded by a week of increasing wobbliness). It is also a big maybe as to whether the cancer is causing the paralysis. It may instead be a slipped disc (his x-rays showed disc issues). For this reason they want to try a burst and taper of steroids before giving up on him. But I am concerned about back pain being an ongoing issue for him, and I would NOT keep him around if he were only going to be in pain. But if he does show a marked improvement I want to do everything I can to manage his pain.

His doctor talked to us at some length about prospect of a wheelchair and she said she has a number of wheelchair dogs as patients and many dogs do very well, have good quality of life, etc. My dog is a Maltese and they really do enjoy being carried - I spent half the day walking him in my arms today and he seemed calm and relaxed while I walked him. Of course he would prefer to be able to walk normally. So far he is peeing and pooping without problems. That is one of the things we watch for closely, ever since his diagnosis, since the doctor told us that would be cause for swift euthanasia with his type of cancer.

I don't think I am being gouged - his vet bills are not that large. He's just getting a simple course of chemo and the usual exams and tests. They're certainly not making much money off the steroids and pain meds. If we don't see a huge improvement in his pain very soon, I WILL do what I have to do.

We have seen some definite improvement in the last few hours. He ate dinner and he's resting quietly beside me. I at least want to see what the steroids are going to do before I kill him. I'm sorry, I'm crying my eyes out as I write this. It's very, very, very hard to make perfect decisions when your heart is being ripped out of your chest, but I will do what I have to do if he continues to be in significant pain.

Phentex

(16,334 posts)
13. You have to do what's right for you...
Fri Jun 26, 2015, 12:33 PM
Jun 2015

and it's never an easy decision. With my last dog, we spent a small fortune when he reacted to his vaccines and shut down. He was young then and it was worth the price to us. And he could have died anyway but we had to try and save him. And we did.

A couple of months ago, when he was much older and in his grandpa stages, I just couldn't put him through a ton of tests and treatments. Of course, after he passed I had a lot of what if's and doubts about not doing enough. But I know in my heart there was nothing left to do.

If you are comfortable trying to keep him alive and without pain, then do what ya gotta do. I am very sorry for all that you are going through.

CrawlingChaos

(1,893 posts)
16. I wish everything could be clear when you're going through it
Fri Jun 26, 2015, 06:00 PM
Jun 2015

I'm always worried that my emotions will cloud my judgement. That's one of the reasons I sought out the most highly regarded veterinary hospital in our city - so I could have as much confidence as possible in their guidance. It still helps a lot to talk to other pet caregivers about what they've been through.

I have rolled the dice with treatment options for my pets in the past and had great outcomes. I guess I could just have easily had poor outcomes and be looking back with guilt. I don't know how anyone ever gets through a lifetime of pet caretaking without at least some haunting regrets. It was an easy decision to treat my dog's bladder, based on his otherwise excellent health and the relative ease of the course of treatment. Now things are suddenly a lot murkier. I am looking to him for signals that he's had enough. If the pain can't be stopped, then it's obviously the end of the road.


I'm so sorry you lost your boy recently. I'm sure you did the right thing but I sure do understand the nagging doubts. No matter what choices we make, it seems we are always second guessing ourselves. I'm sure you still miss him very much.

Thank you so much for your kind words.

nadine_mn

(3,702 posts)
14. My dog is on a bunch of meds for arthritis
Fri Jun 26, 2015, 02:24 PM
Jun 2015

She is on Tramadol, Gabapentin, meloxicam, and amitriptyline. I don't think the Tramadol is that strong. But she would agree wholeheartedly that is the nastiest stuff on earth. She takes all her other pills without too much fuss (we hide them in a marshmallow - she could dig them out of cheese, peanut butter on bread, and meat) but the fight to get her to take the Tramadol was intense.

We had a beautiful short haired collie who had spinal disk damage and we were able to manage her pain. But the minute the pain meds wore off, she was in so much pain, but she was pretty out of it when the drugs kicked in. It was so hard for us to make the decision to euthanize. We cried for days, and I was torn. But one day I looked at a picture of her on the fridge and saw that spark and light in her eyes of when she was a little younger. And I realized that the spark was gone...replaced by glassy eyed drugged state or just sheer pain and that is when I knew.

This is the hardest decision a pet guardian ever has to make - quality of life vs just a few more precious moments. I am so sorry you are going through this.

glinda

(14,807 posts)
15. For arthritis and certain disorders of the body cold laser is wonderful. We
Fri Jun 26, 2015, 03:19 PM
Jun 2015

used it on two of our dogs and it helped immensely for well over a year.

CrawlingChaos

(1,893 posts)
18. I'm glad you mentioned this
Fri Jun 26, 2015, 06:26 PM
Jun 2015

I'm googling this now and I like the sound of it and what I'm reading. And it is available at the vet hospital we're currently using. If he winds up being with us a little while longer I am certainly going to explore this. Thanks!

nadine_mn

(3,702 posts)
19. I will definitely look into this - thank you
Sat Jun 27, 2015, 05:49 AM
Jun 2015

She is 14 but her spirit and joy is so strong! You can see that she wants to do more (go on longer walks etc) and I really want to help improve her quality of life and ease her pain. She doesn't complain at all so it is so hard to tell how much pain she is in.

CrawlingChaos

(1,893 posts)
17. I am picking up Gabapentin later today
Fri Jun 26, 2015, 06:20 PM
Jun 2015

I'm anxious to see how this is going to work. If I understood the doc correctly I think it's supposed to complement the Tramadol. Yeah, the Tramadol... it's got to be the hardest med ever to get down. I hadn't thought of a marshmallow - I think I will try that! He *really* loves anything sweet but he's getting pretty tired of the honey peanut butter I've been using. I can still pique his interest with cheese, but the marshmallow could be my back-up.

I'm so sorry about your sweet collie and what you went through. I can tell from what you wrote that you were in a similar place as I am now. Thank you so much for your kind words.

DawgHouse

(4,019 posts)
20. I am so sorry!
Sat Jun 27, 2015, 02:29 PM
Jun 2015

I don't have any advice to give you about the pain question, but I know that you will do what is right for your pup.

I had a great experience with a vet who specialized in elder dog care. He kept things in perspective for me. It's really about quality of life for our pets. If there is no joy in your pup's life, it is time to make that decision that only you can make.

(((Hugs)))

CrawlingChaos

(1,893 posts)
21. I want to thank everyone again for trying to help me
Sun Jun 28, 2015, 01:53 AM
Jun 2015

It is over now and he is gone. I feel like I'm dying but I know it's just sorrow. I can't thank you enough for your kind words.

TorchTheWitch

(11,065 posts)
24. I'm so sorry!
Fri Jul 3, 2015, 04:59 AM
Jul 2015

I was afraid you'd be posting this. You'll live, but it IS that horrible that it feels like dying. Our fur babies can mean more to us than any human.

I wish I could be with you to give you a huge hug and let you cry all over both my shoulders. Time will dull the agony, but it can take a terribly long time. The only thing that ever helped me was getting another fur baby to love and cherish though every once in a while I still cry for my fur babies that I've lost.

<---- how ever many you need, always.



livetohike

(22,172 posts)
25. I'm so sorry for your loss CrawlingChaos. He'll always live in your memories and in your heart.
Fri Jul 3, 2015, 04:09 PM
Jul 2015
Been there so many times myself.....the last being this past March. Crying with you.
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