cancer-pain control in our German Shepherd - Page 2

That doesn't mean there are no options for your girl, however; for example, for the most severe degree of cancer-associated pain fentanyl transdermal patches can be cut into quarters or halves and applied to the dog's skin, but great care has to be taken to ensure that the patch is placed where the dog cannot reach it to remove it and no humans or other pets can accidently come in contact with it.

 

Hexe, I did a lot of palliative care when I was nursing, and you NEVER EVER cut a Fentanyl patch! That allows the medication to leak out in an uncontrolled dose along the cut edges.

What you CAN do is put an adhesive barrier like Duoderm (used to cover bedsores) underneath half of the patch, so that effectively the dog or person is only getting half a dose. Even this method is not approved by the company that makes the patches, but I saw it done all the time, and it does seem to work. Fentanyl now comes in smaller patches than it used to, too, though for a dog you would still probably need to block off half or even three quarters of the patch.

And yes, it definitely has to be placed where the dog can't reach it. If it were to chew the patch, it could easily get a fatal overdose.
 

I did not mess with the fentanyl patch but Phantom was an 80-85 lb female.  My vet showed my how to apply it properly and I followed directions.

When I was filling the prescription, the pharmacist recommended the softgels of ginger to soothe her tummy and keep the appetite up.  She was surprised that they script was for a dog.  It is a special type of script-not every vet can prescribe fentanyl.

Michele

"Hexe, I did a lot of palliative care when I was nursing, and you NEVER EVER cut a Fentanyl patch! That allows the medication to leak out in an uncontrolled dose along the cut edges."

[smacks self in head] Derrr!  You're right, Sunsilver--lidocaine patches can be cut, fentanyl patches no-no-no. Good catch! Thanks!!

I plead temporary insanity due to my air conditioning system malfunctioning...I do not deal well with heat and humidity; it scrambles my brain.

Many vets are becoming comfortable with morphine infusion pumps that can go home on the dog, they are injected into subcutaneous tissue, so no worries about infiltrated venous access, & are very small. They inject a low dose of drug continuously, have a cartridge loaded with enough drug to last about a week at a time....same like we use for home hospice patients, basically. Fentanyl is a very strong drug, & shouldn't be used by opiate naive humans or animals...I'd be afraid to use it on a dog that hadn't been on pain meds for a while, & I'd be afraid of accidental ingestion. It also comes in a gel or lozenge that can be absorbed transmucosally, but that also has a lot of risk associated with it's use. I personally like morphine; it has a lot of beneficial physiological side effects, & in practise no ceiling for dosing, as tolerance developes the dose can safely be increased; I was very happy when my son's dog came home from her surgery with a morphine pump. It is gratifying to see that more veterinary practises are truly addressing the comfort needs of our four-legged friends. jackie harris

John,
You must face the fact that the dog will suffer and should at some point be put down.
It's up to you.
The dog cannot tell you what hurts or how bad, drugs are not the answer to your problem.
Consider the animal first.

Best wishes,
Moons.

Quote: Jeff, if the dog is eating and has a good quality of life, aside from having some level of pain, and that pain can be controlled without destroying the quality of life, why would you consider euthanasia to be the best choice?  I'm not saying it's a *wrong* choice, necessarily, but the OP didn't ask if or when they should consider euthanasia--they asked about other pain control options.

Aside from some level of pain ? I guess that is up to the owner. I have seen way way too many owners that should have put their dogs down, but will not because "they couldn't bear it". I have seen dogs work through incredible amounts of pain. For me, it is part of dog ownership. You got all the good times, but when the dog has to take medication for pain ?? For me, that is ridiculous. I feel that by the time a dog is showing pain, most people if they had to go through that would never ever get out of bed. I am not willing to put my dog through that just so I can have more time with him/her. 

I'll throw a couple more cents into the ring...."acceptable level of pain"? This is a tough one. I wouldn't put down a dog for having pain.....many function with some pain & have pretty good lives, both dogs & humans & others. Dogs don't invest in their pain emotionally, like we humans do. That's why people are often given sedatives with their pain medicine, so they don't 'feed the pain' with emotion. Many pups have pain with pano or other issues, we don't euthanize them.....but with dogs it's very difficult to judge how bad it is. I sometimes think we are saving ourselves the pain of watching them suffer...(?)...with a quick PTS. But the OP knows their dog, & hopefully will have a plan made with their vet to monitor their dog & prevent needless suffering. This is a good discussion topic. jackie harris

Hi
Thank you to all who posted.
We managed a family holiday last week and the pain-killers kept her comfortable,chasing her ball on the beach a few days, however today it was obvious that she was in distress. So she was put to sleep today.
Not a good day, however no more pain.
Thanks
John

John, your loss is one common to us all here, and no matter what one's philosphy is regarding veterinary hospice care, all of us empathize with your sorrow today.  Pain can no longer assault her, even as yours now intensifies.

It is good to read that your girl was able to not only attend, but actually enjoy, a beach holiday with her family, and that you all have those images to remember when you think about her--that in spite of the cancer's best attempts to prevent it, she experienced the pleasure and joy of playing ball at the beach with her people again.  I'm glad you were able to share that extra time with her in this way.

God bless you John, you did right by your girl. Such a short time we have to spend with our dogs,  & such love & devotion they give us during that time; your girl was lucky to have an owner who cared for her as you did,  who would put her comfort before all else. May your loving memories comfort you. jackie harris