cancer-pain control in our German Shepherd - Page 1

Hi Our eight year old German Shepherd has recently been diagnosed with cancer. She has a large lower abdominal lump which we initially thought was an abcess but the vet has confirmed that it is a tumor and has spread to her liver. We are treating her with Metacalm and Tramadol twice or three times a day(put in a yoghurt or raw egg). The pain killers sem to be working as she is panting less than prior to starting them, however I'd like some advice on what to do if these don't control her pain. Currently she is still fairly active-going for walks and chasing a ball, but her tumour is obviously getting larger. Any advice on how to keep her comfortable would be much appreciated. Thanks John

Tramadol is a good choice for moderate pain, but morphine may eventually be needed to control more severe pain. Make it known to your vet that you do not want your dog to suffer needlessly, & you should be able to make a plan with him/her on what your next option will be. Of course, if your dog becomes so painful that you consider morphine, you may want to also plan for the merciful ending of your dog's suffering. Sometimes it helps to know that this has been planned for, so there is no agonizing decision-making when the time comes. Good luck to you & your dog, may you still have some happy times to share! And thanks, for caring about your dogs comfort, the world needs more owners like you. jackie harris

I would put her down before she is in even more horrible pain. I have seen dogs play ball with broken hips and ribs. It has nothing to do with quality of life, as they do not have self pity, so they just go on. It is a horrible decision to make. 

As jackie said, the tramadol and metacam won't cover severe, constant pain, and eventually your girl may need to move up to the bigger gun meds; you'll want to discuss this with your vet *before* your girl needs to be placed on something stronger, because not every vet is comfortable with handling these situations and you may need to get a referral to an oncologist who's accustomed to working with this degree of pain. What you're basically doing for your girl is providing hospice care--keeping your dog comfortable until she passes from her illness or the illness becomes so advanced that there is no longer anything which can be done to provide comfort and freedom from pain. Trouble is that there's really no veterinary pharmaceuticals that address that level of pain, so anything used is a product formulated for humans...and there are presently no time-release delivery systems that are designed for use in dogs.  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.

A web search using the term 'veterinary hospice' will point you toward a trove of information on the subject.  I wish for you as much time as possible with your girl, knowing that it will still never be enough time no matter how long you have with her.

When my beautiful Phantom was diagnosed with a tumor in her pelvic bone at eleven, I went through the hassle to get fentanyl patches and Tramadol.  I also gave her Ginger in gelcaps (softgels) because the narcotics make the stomach queasy.  The Ginger took care of it and she had a healthy appetite and a whole lot of fun until I had her pts.

I couldn't bear losing her and Pharaoh could not even more so.  At the first sign that the pain control I set up was no longer working, we said good bye.  Up until then, she had a lot of fun and all kinds of fantasy treats, like fancy cat food, people food, anything she wanted.

Michele

my 4 year old wl male was diagnosed with lymphatic cancer. instantly we put him on prednisone and they gave me tramadol for pain if he showed it. well he never ended up showing any signs of pain panting or anything he just couldent eat food any more as his lymph nodes where too large in his neck it was blocking his airway aswell. please concider the dog not just your self it was heartbreaking for me to let my boy go but in all it was a option for the better. i dont think i could have forgiven my self if i let him get into pain.  and living with a few family members who have had cancer no pain meds cancel out the pain once its goin relly inless its knocking them out.

My GSD died of pancreatic cancer at age nine, he never showed any sign of pain or discomfort, he started to have diarrhea and vomiting, vet opened him up and he was joust full of cancer,i never saw any changes in his behavior, 

Some show it, some do not, but keep this in mind:  LOVE THEM ENOUGH TO LET THEM GO, do not let them linger or suffer.  They are too stoick and even though some don't show the pain it can be there.  So listen and watch your dog, they will tell you, look into their eyes and learn to read those eyes, they will let you know.  BOL  Nan

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.

Pharoah, I'm not surprised you ran into difficulty getting tramadol or fentanyl patches for Phantom, especially WRT the fentanyl since it is such a tightly-controlled drug even for human use...It's only been fairly recently that general practice veterinarians have become aware of the concept of veterinary hospice care, and not all of them are comfortable or equipped to provide that type of care--now there are vets who now specialize in it in some of the more metropolitan areas, actually.  Tramadol, although being used off-label, has become a fairly stock item in most general practice vet clinic's pharmacies in the past five years or so, most often being used as an adjunct for treatment of arthritis pain because it can be given along with the non-steroidal anti-inflamatories such as Rimadyl, Metacam, etc. While no vet is going to start handing out scripts for fentanyl patches willy-nilly, more are becoming comfortable prescribing them in cases such as the OP's dog where there's a terminal illness that's not going to result in immediate death and isn't destroying the dog's quality of life if the pain can be successfully and completely controlled.

To the OP, it is important to be able to read your dog, because they *can* mask pain or misery effectively from us; you need to not only watch your dog as she interacts with the family, but also observe her when she's not aware you're doing so--watch her respiratory rate, how easily she settles into a resting position and retains that position, how readily she's able to rise and get around on her own when nobody's looking...  Keeping her with you as long as you can keep her comfortable and pain-free is desirable, but you do need to know when it's time to let her go, too. That's the responsibility we take on when we take a dog into our lives.  I hope you get as much good time as possible.

well i was told by someone who felt they where god and knew everything that i should have put my male down the moment i found out he had cancer as he would never show me signs if i would have done that i would have never forgiven my self he NEVER did show signs of discomfort just he started coughing and chokeing when he was eating and started to lose some weight never did he pant heavely he always panted. or even show signs i was soo hard to convince people yes he is sick yes he will die young. this dog a week before we put him down did some schutzhund i didnt allow him to be pushed as i know his neck had to be some what painful but i didnt know what a working dog i had untill after he was diagnosed.


all im saying is Watch your dog carefuly and be prepaired for the inevatable i know its hard to read or think about trust me i know. but i have also seen many dogs suffer at the hands of their owners who feel its just not time to let them go....  today may not be the day nor the next few months but when the time is close and if you truely love your friend you will know when the time is right.. dont do it because some stranger says its time. or if some person on here says only you and your dog will know when the time is especialy if you have a deep true bond with your loved one.