Forum Post

Pain Management Help - Please!

Last post 03-03-2009 7:47 PM by jessies_mom. 26 replies.
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  • 02-20-2009 7:37 AM

    • denise m
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    Pain Management Help - Please!

    I am so upset watching my dog suffering with pain in his shoulder. Is there something I can do?

    Reader's Digest version:

    - took Kobi to vet about 3 weeks ago with a slight limp in his front left leg. He had been favoring the leg for 2 weeks prior.

    - Dr. suspected arthritis, put him on Metacam, suggested xrays

    - 1 week on Metacam with no improvement

    - return to vet - added Tramadol (100mg x3/day)

    -  another week, no improvement

    - had xrays. Showed small lesion just off his shoulder joint, small amount of arthritis in joint. All other joints clear (left & right side)

    - Gave me a name of an orthopedic surgeon and added Gabapentin (100mg 1x/day), doubled Tramadol (2-100mg x3/day)

    - Booked appointment with surgeon for May2

    Kobi has been on Metacam (3 wks), Tramadol (2 wks) and Gabapentin (1 wk). His pain is quite a bit worse. He will not stand for more than a few seconds. Limp is much more pronounced.  Does not liked to be rubbed on the shoulder. Lies with his foot bent back. Foot slides forward when standing or he bends paw under. I have only been walking him 2 blocks a day. Mostly for him to go potty.

    I am very concerned that all this medication is not helping. Either it is ineffective or the pain is very severe. The vet says to keep him on the meds but I am temped to take him off and try something like aspirin. I still have a couple weeks before we see the surgeon and I hate to see him in this pain and I'm concerned with the obvious increase in pain over a short period of time. Any sugggestions? 

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  • 02-20-2009 8:08 AM In reply to denise m

    Re: Pain Management Help - Please!

    Gosh Denise I am so sorry, I have no suggestions.  I am wondering can a touch or arthritis put him in such pain?  I wonder if there can't be something more going on, pulled muscle or dislocated something?  Try PMing Callie she knows all the homeopathic things that maybe can help and she is also knowledgeable on arthritis.  How about a Chiropractor?  My GF dogs has back problems and the Chiropractor has helped him so, so much.

     Good luck!

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  • 02-20-2009 8:34 AM In reply to luvmyswissy

    Re: Pain Management Help - Please!

     Denise -- not sure (cos my computer's trashed so I have no emails that I usually save), but did you get my article? 

    Personally, I've found that it is critical when taking any sort of "NSAID" (non-steroidal anti-inflammatory drug) that it is critical to take a relaxant (which I always use an herb that's not habit-forming -- something gentle on the liver and body).

    Why?  Because when you hurt you tense up EVERY time that part moves that *hurts*.  BUT the more you tense, the **harder** bone moves on bone -- that completely normal, natural tension works **against** the arthritis and makes it worse.  Also -- when there is tension in that joint that keeps those pieces closer together and rubbing, then any nsaid you take winds up having to work on *recent* inflammation (irritation caused by today) rather than it being able to go deeper to work cumulatively to reduce the deeper inflammation.  (in other words -- there is only so much it can do -- and if this joint is irritated constantly then it's not addressing the deeper inflammation that may be boney ossifying tissue).

    You have to be careful with pharmaceutical relaxants like valium -- they are habit-forming.  Things like passion flower, valerian root ... they aren't.

    Also -- the topical essential oils (like peppertmint & wintergreen  & eucalyptus -- or blends together like White Flower Oil or the more oriental 'woodsy' blends like WoodLock Oil) do one heck of a job of reducing inflammation even from the outside.  They bring a tremendous amount of relief.

    Someone said to me (a chiropractor who should have known better) the other day "Oh, I don't want to use something OILY that will get all over" -- but frankly, that just showed me they never bothered to look at them.  These aren't heavy oils like bath oil.  These oils are mostly so thin you almost can't tell they are "oil".  They cling (so you have to wash your hands carefully and make sure you don't inadvertently rub your own eyes) but they don't just rub off on furniture or clothing.   These oils penetrate incredibly well.

    Things like BioFreeze and Mineral Ice are goopy and messy.  (Well advertised, but darned messy).  But in my opiniond the oils are worth 10 times what those messy lotions are -- there are places I put the oils that I can't even *reach* to rub -- but just drizzling a bit of oil brings great relief.  The more you *rub* the more heat you get, but the more of the oil you use also brings more heat and anti-inflammatory properties.

    I've had arthritis since I was a child.  Frankly, I control all of my pain with just 400 mg. of ibuprophen a day (and dogs can't take ibuprophen and aspirin causes stomach bleeding in a big way).  My point is 400 mg isn't even the prescriptive dose.  It's MINOR but I do take a relaxant herb with it and I work the oils into whatever joints hurt that night.

    I also use the Knox Nutra Joint on both me and the dogs -- it takes about 3 months usually to work, but particularly when you have one bothersome joint it helps.  Now, that's not available in Canada but you can take just gelatin powder with some calcium (if you can't find someone in the States to send it to you).

     Any of Dr. Fox's books on dog massage are very very good.  http://www.petmassage.com also gives really good advise.

     http://www.morningstarhealth.com is where I get all my massage oils/anti-inflammatory oils from.

     But the one other thing I'd strongly suggest for you to try is acupuncture for this dog.  If you go to the Chi Institute website http://www.tcvm.com -- on the left UNDER the "locator" is a sentence link that will take you to a huge list of "out of the US" practitioners and there are TONS in Canada.  In fact, aren't you near Toronto?  There's one of the Toronto vets I know.

    Acupuncture is one of the chief ways I control my own pain (and Billy and Kee get acupuncture every month).  It does not hurt -- Kee falls asleep and Billy has no problem with it (in fact I uploaded a video of him getting needled just so people could see it).  Helps enormously with pain management.


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  • 02-20-2009 2:26 PM In reply to denise m

    • cakana
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    Re: Pain Management Help - Please!

    http://community.dog.com/forums/t/87489.aspx?PageIndex=2

    Check out this thread Denise. The Cetyl M has helped so much with Buffy and she was having the same type of pain symptoms as you've described. It's not cheap but it's well worth it. I ordered it thru PetCo but you can google and find other places that have it too. I was pretty sure it was helping but when I ran out for a couple weeks, I was shocked at quickly Buffy went back to limping. I've had her back on it about 2 wks now and the limp has disappeared again. I'd love to hear that it worked that well for Kobi.

    ~ Cathy ~
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  • 02-20-2009 5:04 PM In reply to denise m

    • denise m
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    Re: Pain Management Help - Please!

     Thanks for the replies. I really appreciate it. I am definitely going to get a relaxer and I want to try the CMO as well. I ended up phoning the vet. He has been very nice and has called a few times to check on Kobi. He suggested switching the Metacam for Previocox to see if Kobi responds better. He also gave me a Rx for a pain patch. He said if he is no better on the new meds to bring the patch and he would apply it for me. He also told me to call the surgeons office and explain my situation. They are going to see Kobi om Thursday. Yay! Until I find out if he is going to operate and when I will continue with the meds + muscle relaxer. I mentioned acupuncture to the vet but he wasn't receptive. Said something about studies indicating it was a placebo and of course that wouldn't work with dogs. Anyways, I see on the surgeons website that they offer acupuncture so I will speak with him.   Do you think I should go ahead and start him on CMO now or wait 'til I speak with the surgeon?

     

    Thank again! 

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  • 02-20-2009 6:58 PM In reply to denise m

    Re: Pain Management Help - Please!

     Such closed-mindedness is simply fear -- what if they can get relief without meds???  OMG it will put us out of business!

    No -- it's the union of western and eastern medicine that works SO well.  And I'll tell you ... use of acupuncture in agricultural areas BECAUSE it works so awesomely on horses is incredible.

    You know who got ME to go to an acupuncturist the first time?  It was Dr. Clemmons at the University of Florida.  This is the guy who does all the internationally known work on DM in Shepherds and Wobblers in Dobies?  He's the head neurosurgeon at the University of Florida.  

    He's a SURGEON.  I mean, come on ... there are doctors and then there are doctors ... and a SURGEON usually isn't the type of vet/doctor you'd think would be particularly "holistically minded"??  I mean usually it's the knife or meds -- it's what surgery IS, right?

    Except ... no.  he's STILL the head neuro-surgeon.  But he's also on the teaching faculty at the Chi Institute (that http://www.tcvm.com link) -- and the other one who has been the huge proponent of it at the University of Florida is Dr. Chrisman -- she was the HEAD of the neuro dept.  But both of them saw the incredible healing that acupuncture provides -- and neuro people, aside from working with seizures, tend to be all 'about' injuries to the spine, and geriatric stuff like arthritis and spondylosis, etc.  

    But I was sitting at dinner with this guy and he noticed I had arthritis and he asked ME what I did for *my* arthritis.  Then he showed me HIS hands (and a surgeon with arthritis?? ewww -- not good, right?) and HE uses acupuncture for HIS arthritis. 

    From there we tried it on the dogs,  and eventually when *my* pain got so severe I almost couldn't work, yeah -- *I* tried it.

    Dumb dumb dumb ... why I did I wait???  It doesn't hurt.  It works.  It works incredible on the dogs.

    And you know what?  Placebos don't WORK on dogs.  Because they don't KNOW that taking the pill is supposed to make them feel better (particularly when we go to great lengths to make the pill EASY to take, right??)

    No -- it just plain works.  Incredibly well, and with no trauma to the stomach, liver or kidneys.  Not permanent, but it helps healing after surgery incredibly (that part IS permanent) but it also does a ton to reduce inflammation and ease pain.


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  • 02-20-2009 7:22 PM In reply to calliecritturs

    • denise m
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    Re: Pain Management Help - Please!

    I hear you Callie!  

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  • 02-20-2009 9:06 PM In reply to denise m

    • BCMixs
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    Re: Pain Management Help - Please!

    I can't offer much other than personal experience.  Indie was dx'ed by more than one vet with severe arthritis in his back hips.   Hydrotherapy and the addition of turmeric and ginger and glucosamine over a 12-16 week period made a dramatic difference and when he went for a recheck they said there way NO sign of arthritis or crepitus in his joints.  Whether he actually had arthritis or was experiencing a temporary issue is up for debate, but for safety's sake, he's on daily doses of ginger and turmeric with fantastic results.  There have been studies on turmeric for arthritis in humans with good results as well.  I take it and ginger in capsule form when my joints are bothering me and it does help.  Good luck!

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  • 02-26-2009 11:17 AM In reply to denise m

    • denise m
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    Re: Pain Management Help - UPDATE from surgeon

     Well Kobi saw the orthopedic surgeon this morning and he has referred us to a neurologist. His examination showed a lot of discomfort in the neck area. His best guess is that he may have a ruptured disc, which could be causing the lameness.  He also took him off all meds except the Gabapentin.  So I have a few more days to wait, but hopefully we are getting close to a diagnosis and Kobi will soon have some relief. He is such a "good boy" considering.

    I wasn't home 5 minutes when our vet called. He apologized over and over for not examining Kobi's neck throughly. I could tell he felt really bad. What could I say?  

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  • 02-26-2009 1:46 PM In reply to denise m

    • cakana
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    Re: Pain Management Help - UPDATE from surgeon

    I know how badly you want answers to what's going on and I'd be the same way. It sounds like you're on the right track though. That was nice of your vet to give you a call and apologize. I'd imagine that diagnosing these types of things is really tricky, especially if a vet hasn't had a lot of experience with it. I hope you get some concrete answers from the neurologist. Will they need to do an MRI or mylegram (?) to know for certain?

    ~ Cathy ~
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  • 02-26-2009 5:07 PM In reply to cakana

    • denise m
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    Re: Pain Management Help - UPDATE from surgeon

     I guess if on examination the Dr.  can determine it is a muscle problem or the sore neck is related to the shoulder injury as opposed to the other way around an MRI won't be required. The surgeon did warn me that if his suspicions are right they will do an MRI. I  am bracing for the cost of all this but at this point I just want my old Kobi back ASAP. Thanks for caring, I appreciate it!

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  • 02-26-2009 6:31 PM In reply to denise m

    Re: Pain Management Help - UPDATE from surgeon

    Denise,

    I have no answers for you.  I read your thread in hopes of finding some information for Aspen.  I DO know what you mean about wanting your old boy back.  I'm the same way right now & I'm hoping that the neurologist has the answers you're looking for.  It really stinks when your buddy is hurting & you can't do anyhting for it.  Please give him some rubs from me.


    Wag More, Bark Less
    I Survived Bugsy Kisses
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  • 02-26-2009 7:40 PM In reply to denise m

    • 4HAND
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    Re: Pain Management Help - UPDATE from surgeon

    If only they could tell us just where it hurtsSad We are pulling for Kobi.Such a good boy.

    Tena

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  • 02-26-2009 7:49 PM In reply to 4HAND

    Re: Pain Management Help - UPDATE from surgeon

     Denise, I hope you get your old Kobi back soon. It really sounds like you're on the right track; sending pain free vibes for Kobi.

    Janice
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  • 02-26-2009 8:14 PM In reply to 4HAND

    • denise m
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    Re: Pain Management Help - UPDATE from surgeon

    Thanks Guys. I've never had to deal with a sick or injured dog before, so I'm kind of at a loss. I read stories here all the time about some really tough situations that members have/are dealing with. I admired the efforts people have gone to for their dogs but never totally appreciated the emotional stress involved in these situations. Having to limit Kobi's walks feels like I'm punishing him. He tries to go in the other direction when I turn to go back home. He wants to keep going so badly. The last little while he has started coming up to me an offering his sore paw. It's like he's asking me for help. Breaks my heart that I can't manage to get him pain free. The waiting is hard. I know I will feel better once I get a final diagnosis and start some sort of treatment. 

    4HAND:

    If only they could tell us just where it hurtsSad

    Ain't it the truth! 

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