Cruel to withhold pain meds?

Discuss topics ranging from general care to diet, vaccinations etc.
User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Cruel to withhold pain meds?

Postby Amanda » Fri Aug 28, 2015 1:16 pm

Zeke is on a low dose of deramax as needed. When he gets it a couple days in a row he does much better but that also means super bouncy dog. Then the next day he is ouchy and limping again. I assume from the bouncing and extra activity. Would it be cruel to withhold his meds in order to help him chill? I feel bad about it but he HAS to let the leg rest and I don't know what else to do besides drug him into a stupor which I also don't like the idea of doing. I didn't give him any this morning and he is now totally non-weight bearing on it. Literally hopping through the house. I just gave him lunch with his medicine because I feel bad for him but at the same time I really want this to heal. I have been super strict with him and not let him do anything. He just gets bouncy as soon as we open the kennel door. What to do?

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Fri Aug 28, 2015 5:11 pm

Dr. B is concerned that he may have ruptured the whole thing based on the level of lameness he is exhibiting now. So I am to continue deramax and add Benadryl to mellow him out for the weekend. If he does not improve then we will recheck him Monday. He says it is six months to heal a full rupture without surgery. I was feeling hopeful after our Monday appt. now I am feeling pretty bummed about the whole thing.

User avatar
MaisyPancakes
Permanent Resident
Posts: 8542
Joined: Fri Feb 17, 2006 11:02 am
Location: Minneapolis, MN
Contact:

Re: Cruel to withhold pain meds?

Postby MaisyPancakes » Fri Aug 28, 2015 6:16 pm

Oh no, I'm so sorry!! :( I know that the go-to protocol for gimpies seems to change all the time (rest vs keeping mobile, types of meds, etc.) so it might be worth seeing a specialist if you haven't yet, since I also know that you're made of time and money! ;)

Do tendons rupture when they're not even that active? I really hope that's not what he has! Many hugs. So frustrating. :(
Last edited by MaisyPancakes on Fri Aug 28, 2015 11:20 pm, edited 1 time in total.

Kathleen
No, I don't have a life!
Posts: 7467
Joined: Mon May 02, 2005 3:55 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Kathleen » Fri Aug 28, 2015 6:32 pm

I know there is something about chronic inflammation being bad for the heart and other organs. I also know most people I know with lame puppies do the balancing act between enough meds to keep them comfortable but not so much they can't keep them quiet.
It is expensive but I do second the specialist. Remember, the local emergency vet missed Banzai's break altogether. They took X rays but couldn't see the fracture because it was a growth p[late. They said it was a soft tissue injury and to rest him for a couple weeks. If I hadn't seen the Ortho Vet his knee would never have been right. :(

UpwardDog
No, I don't have a life!
Posts: 6524
Joined: Mon Dec 21, 2009 10:46 pm
Location: Canada

Re: Cruel to withhold pain meds?

Postby UpwardDog » Sat Aug 29, 2015 12:19 am

I can't believe you and he are still dealing with lameness and pain and more vet bills :( Awful. How do they diagnose what's going on with his knee, -xray or...? I would think if he really needs to rest and pain meds have him unable to rest it, you maybe don't have much choice?

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Sat Aug 29, 2015 10:24 am

It was with manipulation. He couldn't get a full drawer sign on the knee but he did feel laxity and slight swelling which is why he thinks the ligament isn't torn through. He said he could try it under sedation next week if he doesn't improve this weekend. But the more I read, the more I am seeing that additional manipulation of the joint just adds to the damage of an already weakened ligament. I am also reading that it takes 8 weeks of restricted activity to see improvement and several months for total healing. We are going to try extensive rest. Multiple very short (1-2 minutes at first) leash walks per day and otherwise crate or x-pen. Benadryl to keep him mellow for the weekend and maybe a bit longer but trying not to rely on that. I am going to pull him from the field test. Unless this is a pano episode masquerading as a the knee there is no chance he will be ready for the test.

I am still on the fence about the deramaxx. It is hard in his organs and it masks his pain. As soon as he can sleep without it I am taking it away. Right now though he was moaning and miserable yesterday without it so I don't want to withhold it when he can't rest comfortably.

The specialist is on my radar. We can't really afford it, but would go if it came down to it. I am skipping PT for my own shoulder at the moment because we can't spend the money right now.

UpwardDog
No, I don't have a life!
Posts: 6524
Joined: Mon Dec 21, 2009 10:46 pm
Location: Canada

Re: Cruel to withhold pain meds?

Postby UpwardDog » Sat Aug 29, 2015 10:27 am

What about tramadol instead of an NSAID so take the edge off the pain but not bother his stomach?

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Sat Aug 29, 2015 11:01 am

I think because there is some benefit to the anti inflammatory effect. And he said no tramadol. Probably because it is too effective for pain management and it would make him too active. I don't know for sure.

Moemer
Yes, I do have a life!
Posts: 3269
Joined: Mon Jan 19, 2009 3:36 pm
Location: Ontario
Contact:

Re: Cruel to withhold pain meds?

Postby Moemer » Sat Aug 29, 2015 4:19 pm

I'd be concerned about not having the anti-inflammatories more than the pain meds - as others said, enough to stay comfortable but not want to run on it. But I wonder about potential for more damage if the inflammation keeps up. Is there an alternative? (that said, if the inflammation comes down it will be less painful... so catch 22??)

I'm so sorry this is such a chronic issue :(
Emily
Elsie (ACDX) and Arlo (FoxhoundX)
Image

User avatar
LisaT_II
Yes, I do have a life!
Posts: 3502
Joined: Fri Sep 01, 2006 6:20 pm
Location: California

Re: Cruel to withhold pain meds?

Postby LisaT_II » Sat Aug 29, 2015 11:30 pm

I dinked around with Max's knee for 6 months, diagnosed via manipulation and xray, only to finally find a chiropractor that fixed his SI joint. Took the third chiro I went to to find it. These things are a PIA, so sorry you are dealing with this still.
Max-n-Indy

Info regarding Ticks and Tick Diseases
http://tinyurl.com/3arfn6r

Forum for the GSD enthusiast!
germanshepherdhome.net/forum

Calypso
Built-in Forum Feature
Posts: 12535
Joined: Mon May 02, 2005 6:51 am
Location: Wisconsin
Contact:

Re: Cruel to withhold pain meds?

Postby Calypso » Sun Aug 30, 2015 7:58 am

Ugh. I'm sorry you have to deal with this. It just sucks.

User avatar
MaisyPancakes
Permanent Resident
Posts: 8542
Joined: Fri Feb 17, 2006 11:02 am
Location: Minneapolis, MN
Contact:

Re: Cruel to withhold pain meds?

Postby MaisyPancakes » Sun Aug 30, 2015 8:50 am

If you want to try anti-inflammatories you can use w NSAIDs, boswellia and turmeric are good ones to always give w food. Turmeric can upset some tummies, though. Ginger is a great antiinflammatory, too. I often use a combo of boswellia, mangosteen, ginger, and turmeric (called Inflatame by Jarrow.)

I wonder if you could just call a rehab specialist and ask about the use of strict rest in your case. I know that it's been a standard protocol for many years but they're finding more and more that it doesn't promote healing any better than allowing normal activity, and things like decreased circulation actually hinders tissue repair. I'm sure it all depends on the case, but even stuff like heat packs can be really helpful and they may be able to give you some very basic guidance?

I agree that tramadol plus NSAID might be too effective for pain—but it will allow you use less NSAIDs. (I think it's something ppl try when the objective is better pain management using as little NSAIDs as possible.) Maybe you could try melatonin or theanine for nighttime if he needs an extra bump? That's what my rehab vet suggested for when MP was grunty at night and early AM, although I'm not sure if it worked any better than a homeopathic sleep aid. ;) what really does seem to help for night/am is DLPA—no more morning grunties. (Also safe w NSAIDs and most things except MAOI type meds; works to block pain receptors, I believe.)

Sorry if full of typos—phone typing is sucking this morning!

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Sun Aug 30, 2015 10:55 am

Lisa, what were Max's symptoms?

Thanks for all of the recommendations. I am starting traumeel and will look into those others. I hate seeing him like this and it's very disappointing to not only not see improvement, but to see him get worse. He has stabilized since Friday, but not gotten better at all. I was reading a site called tiggerpoz.com and they said eight weeks rest is sometimes necessary to see healing. I am trying to be patient, but it's hard when it seems like we have done this whole rigamarole every other month.

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Tue Sep 01, 2015 11:33 am

I had a chiropractor out to the house this morning. He agrees there is likely a knee issue but his muscles are so tight that they are impeding his range of motion. He adjusted the hip and low spine. Cold lasered everything. Hamstrings and quads were like cords they are so tight. I am to continue to rest him, short leash walks ok. Stretching and range of motion would be helpful too. He says no more anti-inflammatories. He said traditional medicine and his practice have different goals and while he wants the inflammation to die down, he said it serves a purpose and he would rather "work it through" than block it with medicine. He also wants Zeke to self limit his activity to a degree. I haven't given any yesterday or today.

I got the info for another person that comes highly recommended. She does physical therapy, massage, craniosacral, acupressure, etc. I left her a message but we may see her this afternoon or tomorrow. I am feeling desperate to find a solution that produces results. I would probably have more patience if this were our first bout of lameness, but I am fed up. Two weeks of pain and discomfort with no relief is excessive and I hate seeing him like this. He looks depressed today. We are laying out in the sun on the grass now. Hopefully the treatment this morning brings him some relief and we can start moving forward. I was pleasantly surprised by the chiropractor's fee. $80 for at home service didnt seem too bad.

UpwardDog
No, I don't have a life!
Posts: 6524
Joined: Mon Dec 21, 2009 10:46 pm
Location: Canada

Re: Cruel to withhold pain meds?

Postby UpwardDog » Tue Sep 01, 2015 3:34 pm

I feel awful for you both. I suspect in your shoes, I would be strongly considering returning him to the breeder if an x-ray or whatever test is the standard determined that his knee is significantly injured, and would be expecting at least a partial refund if not a full refund or a replacement puppy. Obviously it would depend on the contract and plenty of other factors, but you've probably spent more on vet bills for him than most people spend in the first 5 years and it seems like he's been lame as often as he's been sound.

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Tue Sep 01, 2015 5:07 pm

I can only get a refund or replacement if he has a congenital defect confirmed by two separate vets. I would also have to pay for his shipment back to Hungary and the shipping on a new pup which amounts to nearly the cost of a replacement. I have been in contact with the breeder and she is still suggesting this is a result of fast growth. I am not so sure, but who knows, really. I suppose I could request a partial refund. Or maybe a discounted future puppy. The latter would be more likely as an option, I would assume.

I just rubbed him down and he squealed when I massaged his thigh. I then pinched his femur and he yelped again. Poor buddy.

Calypso
Built-in Forum Feature
Posts: 12535
Joined: Mon May 02, 2005 6:51 am
Location: Wisconsin
Contact:

Re: Cruel to withhold pain meds?

Postby Calypso » Tue Sep 01, 2015 7:21 pm

Ugh! So miserable for both of you. I'm sorry. I hope the other person you see will be able to help.

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Tue Sep 01, 2015 7:44 pm

Wondering if this is pano again with the leg pain...

UpwardDog
No, I don't have a life!
Posts: 6524
Joined: Mon Dec 21, 2009 10:46 pm
Location: Canada

Re: Cruel to withhold pain meds?

Postby UpwardDog » Tue Sep 01, 2015 10:12 pm

Well I hope it's pano and not a knee injury. Whatever it is, I sure hope he feels better soon.

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Wed Sep 02, 2015 9:27 pm

Zeke is doing a bit better today. Still very lame, but at least willing to step on the injured leg and his spirits are up. Of course that means managing him is more difficult, too. He was laying down tonight in a sphinx position. It made me wonder if he truly tore or strained the acl if he would be willing to put that much flexion on the joint. When he sits, he sits sort of sideways resting more on the opposite hip. Most of the time he tucks the injured leg under and lays on that hip, but he did the Sphinx down tonight so that was interesting. He didn't hold it for long, but still.

The girl I was recommended to check out left for Montana yesterday. I was supposed to talk to her on the phone today and she has a colleague here that specializes in dogs like she is in horses. So I will try to call her tomorrow and see what I can find out.

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Mon Sep 07, 2015 9:49 pm

Hoping I'm not getting roped into quack science, but I've had two people recommend this lady who treats dogs with an acuscope. It's a biofeedback machine that supposedly works on a cellular level speeding healing by 50%. She has a few videos on YouTube with progress made in puppies with swimmer syndrome and one she is working with right now that was both a swimmer and has a spinal injury. So she is coming in Friday and Saturday to do treatments. Hoping we can see results and I am not paying for false hope.

All in all he is doing better. Still clearly lame, but if you ask him it is time to go play at the park and forget this house.

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Thu Sep 10, 2015 9:03 pm

For anyone following my saga with Zeke, he has been on arnica and Ruta grav three times per day for the last two and a half days and I have seen significant improvement in his gait and general ability to walk and use the leg. I decided I want to wait to use the acuscope lady. I need more information before I pay $85x3 for the sessions she says are needed to get full results. Plus she said without a concrete diagnosis she really will be doing guess work and she'd rather see a full workup and diagnosis before she tries to work on a dog. She does massage and stuff too, but she's not like a licensed PT or canine rehab person. I appreciated her honesty and that she didn't push me for a sale of sessions.

So I am watching and waiting on this further treatment. I may take him to another vet for a second opinion. Not sure yet. Right now he is steadily improving. Going to keep him on restricted activity, but add some more walking on leash and see where we are next week.

User avatar
JudyL
No, I don't have a life!
Posts: 5930
Joined: Mon Dec 17, 2007 9:53 pm
Location: Delaware

Re: Cruel to withhold pain meds?

Postby JudyL » Fri Sep 11, 2015 12:42 pm

Oh man, I'm really glad you are seeing the improvement and your plan sounds sensible to me. Are you leaning toward this as being another pano episode then instead of a ligament problem? I'm asking because I'm wondering if a ligament problem would cause referred pain to the point of causing Zeke to squeal during the massage or pinching his femur.

UpwardDog
No, I don't have a life!
Posts: 6524
Joined: Mon Dec 21, 2009 10:46 pm
Location: Canada

Re: Cruel to withhold pain meds?

Postby UpwardDog » Fri Sep 11, 2015 4:01 pm

I'm glad he's steadily improving! Super hoping this is the last pain/lameness episode.

Points in the acuscope person's favour that she wants an actual diagnosis to be able to tailor treatment accordingly. I did a wee bit of googling and don't have a clear understanding about what it is other than that it sounds similar to TENS.

My personal bias, especially when dealing with a serious or prolonged issue, is to go with more conventional/ proven treatments or certified practitioners.That said, I swear by a really good chiro, and some people think it's tantamount to witch doctoring based on "magical thinking"
Homeopathy doesn't work any better than placebo in a multitude of studies. It's temptation for me is when it's an $8 tube of arnica /sugar pills over a much more expensive option for a dog with a sensitive belly.

It sure would be nice if dogs had a good way to tell us what hurts and where and what relieves it.

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Fri Sep 11, 2015 5:04 pm

Well, placebo or not, $16 to have him weight bearing and now today, not limping, was worth the risk. My vet suggested traumeel too, which is basically the same thing. I think it works. Maybe not as well or completely as deramaxx, but it has no side effects either. So, oh well. Maybe I'm just a sucker. lol

I will probably shell out for the chiro again. He is a vet, so I know he has the licenses and stuff to back him up.

User avatar
Amanda
Permanent Resident
Posts: 8127
Joined: Mon May 02, 2005 12:51 pm
Location: California

Re: Cruel to withhold pain meds?

Postby Amanda » Fri Sep 11, 2015 5:07 pm

Oh and Judy, I still have no thoughts with regard to pano vs acl. It could have been referred pain, though when I tried it I really tried to maneuver around the soft tissue and just get the bone. The vet tested him for femur pain originally though and he didn't show any. He showed increased lameness after messing with the knee then, so...??? Guess work at the moment.

User avatar
Jen
Built-in Forum Feature
Posts: 14310
Joined: Sat Aug 06, 2005 8:34 pm
Location: Portland-ish, OR

Re: Cruel to withhold pain meds?

Postby Jen » Fri Sep 11, 2015 6:00 pm

I'm glad you're seeing improvement! I've been thinking about Zeke and hoping he was improving!

Calypso
Built-in Forum Feature
Posts: 12535
Joined: Mon May 02, 2005 6:51 am
Location: Wisconsin
Contact:

Re: Cruel to withhold pain meds?

Postby Calypso » Fri Sep 11, 2015 6:44 pm

So glad to hear this episode might be over. I hope it's your last one!!!

User avatar
MaisyPancakes
Permanent Resident
Posts: 8542
Joined: Fri Feb 17, 2006 11:02 am
Location: Minneapolis, MN
Contact:

Re: Cruel to withhold pain meds?

Postby MaisyPancakes » Fri Sep 11, 2015 7:03 pm

My rehab vet who is super badass and a pain specialist said Zeel is awesome and she believes it works, so, me, too! ;) Since MP's gimpies, I'm a total believer in specialists, so if you ever do get a second opinion, I'd say spring for a specialist—like the acu- person said, all practitioners of other modalities will likely benefit from having a solid diagnosis. I think of it as going to my regular doctor and asking about my teeth vs. going to the dentist. Good luck!!

EllaBella
No, I don't have a life!
Posts: 6054
Joined: Fri Mar 03, 2006 11:44 am
Location: raleigh, NC
Contact:

Re: Cruel to withhold pain meds?

Postby EllaBella » Sun Sep 13, 2015 7:04 am

I really hope this gets better and is the last round of this I'm glad to hear there's been improvement.


Return to “Care, Health & Nutrition”

Who is online

Users browsing this forum: Bing [Bot] and 3 guests

cron