# Pain management...other issues



## Thecowboysgirl (Nov 30, 2006)

Regarding Ruger, see "greatest dog who ever lived" post...

He has a huge tumor that is basically inoperable. He was started on Tramodol by the referral hospital that did the CT scan, and we could tell a big difference.

I can also tell when he is nearing needing another dose. He gets grumpy and gets this look like "don't touch me". 

He is not himself anymore. He has been so reliable with other dogs that I used him for fear and aggression rehab cases as the unflappable other dog. Now I notice him being grumpy with our pup and grumpy with other dogs that he used to be very tolerant of.

He is not on the highest dose of pain meds...I was trying to leave us somewhere to go when that didn't work anymore.

I guess as long as he is still enjoying most of his day we're okay. I am going to take him back in to his primary care vet to talk about palliative care I guess. I don't want him to suffer or lose any time if he is not yet ready to go....


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## Shade (Feb 20, 2012)

I had a 15 year old foster last year, Tramadol was awesome for helping with the pain but as you said near the end it was obvious when the dose was wearing off. We upped the dosage twice in under three weeks, knowing it's palliative it's all about keeping them comfortable, when it was over we basically were at a level of dosage that any higher would have made him a zombie but I had no hesitation asking for more while there was some quality of life


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## maxtmill (Dec 28, 2010)

Palliative care is definitely appropriate for your dog! I am a Palliative Care/Hospice RN, and I worked with my vet and provided end of life care for my last two elderly dogs. There is much that can be done. Your dog may be very uncomfortable if he is grumpy. Poor baby ( and you as well!). Let us know how things go!


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## Thecowboysgirl (Nov 30, 2006)

I think it's been at least a week, maybe a week and a half, on lowest dose of Tramodol. My vet told me two weeks would be a lot for this dog to live and that was already 3 weeks ago. But that was also assuming the tumor itself had hemorrhaged, when it turns out that what actually happened was that the tumor invaded something else that bled and the hematoma is now acting like a plug which is why he is still alive.

I overslept this morning and he didn't get his morning pills till 8am. It didn't cut it, so we gave him another one. He still seems off....I guess it could just side effects of Tramodol? He doesn't show signs like he did when he was actively bleeding so I don't think it is that. 

My mother died of a cancer, big tumor in almost the same place as Ruger's, and her pain was just awful.

I know this dog is stoic as **** because they found evidence that he had already had a bleed prior to this one that we didn't even know about


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## jaudlee (Mar 28, 2013)

As hard as it may be for me to say this, but he sounds like he is in a great amount of pain and quality of life is a huge issue right now. If it were me I would make the judgement call. Bleeding from within is like a ticking time bomb and surely not a way I would like to see my pup go. I am sorry for your situation, it is surely a tough one. Give him the best few days of his life and make a decision.


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## Thecowboysgirl (Nov 30, 2006)

We have considered scheduling the euthanasia instead of waiting for something critical to happen...but sometimes he is just so happy, begging for food & we just can't bring ourselves to do it. I am making sure I refill his Tramodol before it gets too low so we have a whopper dose to give him if he starts to bleed again since it is a 40 minute ride to the vet, part of which is on dirt mountain roads. 

I am monitoring his quality of life. I will not make him wait for my own selfish reasons. If he is no longer enjoying his day but hasn't yet had another bleed, we will do it. I just don't feel we're quite there yet


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## DutchKarin (Nov 23, 2013)

I so feel for your pain in this as well. I don't know if this helps but the way I think of it is less that there is a RIGHT specific time for euthanasia, more that you enter the range and once in, anything is okay. That seems to calm me at these end of life decision times.

Warmest regards,
Karin


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