Canine Cancer Surgery: Dog Owners…Check on the pain control!
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Updated: December 14th, 2018
I have been focusing a bit on osteosarcoma, since this is a common cancer.
This info applies to any big surgery involving cancer in dogs though. I thought that a few bits of vet-only knowledge would be nice for dog owners. That way you can discuss the important topic of pain control at the time of a major cancer surgery.
Before the procedure, you might want touch base with the vet about pain control. Pain is a major negative in life quality.
Different vets will have different ideas on pain control. Those those a bit more on the ball will most definitely be giving pain control a priority.
More modern vets will use a CRI, which is a Constant Rate Infusion of pain controlling drugs. This is a nice thing to do. It means the drugs are constantly flowing into the body through the IV.
Some will give an epidural, which is an injection of pain controlling drugs into the fluid around the spinal cord. Another nice technique to use in combo with other drugs.
Many use a Fentanyl patch, which is a fairly good way to control pain. You have the patch applied to the dog a day or so before the surgery and it releases fentanyl through the skin. I like to combine it with some other agents for pain control.
My opinion is that one or more of these be used for major cancer surgeries, along with injections of other drugs as needed after the surgery.
Good options for take-home meds are sustained-release morphine and tramadol. These should be combined with some anti inflammatory like metacam or possibly deramaxx or rimadyl.
Some vets really into new stuff will start the dog on Gabapentin before surgery, or possibly amitriptyline. You can start these days before surgery and they can help with pain control in combination with other drugs.
Drugs I don’t like for real pain in major dog cancer surgery? Buprenex (buprenorphine), only a moderately strong drug, not a big enough gun in my opinion. Torbugesic (torbutrol) in dogs for take-home pain control is too wimpy and too short-acting.
So, the take home message? First, control that pain! Multimodal analgesia, or using different ways to accomplish pain control is where it is at.
So be your dog’s health advocate and make sure pain is under control.
Best,
Dr Dressler
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Dear Dr. D.,
My 15 1/2 year old poodle has nasal cancer which I was told to just let him live out the rest of his days at his age. I have watched him lose both eyes sight now and the cancer has spread throughout the rest of his body. My main concern was pain also so I have used 50 to
100 mcg patches and amitriptyline. It seems to make him calm for a brief period, then he gets hyper. Any suggestions?
E
Oops..spelled it incorrectly…AMANTADINE NOT amandatine…..
My dog was getting spaced out on Tram…so now my vet has prescribed Amandatine and he is doing just phenomenally! Never heard of this drug before…but it is a wonder drug- at least for my dog….He takes 200 mg once a day in the morning with 40mg of pred…..and then 20 mg pred at night…working great…my dog has terminal cancer…covering the cranial vault, C1-C2, and in the left mastication muscle…docs were not able to de-bulk the tumor…was diagnosed in Nov. 2007 had 15 radiations and 6 chemos- completing them all in april 2008..on 30 chinese herbs in the am and pm and on a special diet I make in the crock pot once a week…Chiropractic and acupuncture once or twice a month……We’ve had our ups and downs in the past three months but he is still here and right now— doing great!!
Hi there,
Our dog has cancer and we have looked everywhere for some clear information on outer limits of dosing for Tramadol. He recently started once per day Gabapentin and that seemed to boost his relief, but now I’m thinking he is in pain again. He currently gets Tram 100mg 3x/day, are there any studies that support a higher dose? How high can we go before another med becomes the better choice?
You are welcome and good luck!
D
I just wanted to say thank you for posting this information. My 6 yr old Lab/Chow mix started limping in Jan. But the x-rays only showed inflammation at that point, which we attributed to him compensating for the other leg (my vet “put his other front leg together,” after he was clipped by a car, and the first “parent” surrendered him due to the cost of surgery. I adopted him 3 months later when he was then 7 months old)
Deramaxx worked well until October. At which, a 2nd set of x-rays were done on Oct 15th, and the results of an extremely slow growing bone cancer were apparent.
2 Tramadol every 6 hrs worked well for about 4 weeks. We then bumped up to 3 Tramadol every 8 hours (every 6 hrs seemed a bit much for him)
And now ( Nov 25th) I just returned from picking up Gabapentin (yeah, I know. I have a “new” and hip vet. She’s the greatest!) I’m hoping that this new med on top of the others, will get my boy back into a more comfortable state again, for as long as *sigh* well, as long as possible I guess..
In the end, we really are the health advocate of these wonderful lives which have been loaned to us. Thank you again for your postings (this was the only one I found regarding bone cancer and gabapentin use!!)
Keep your fingers crossed for as many pain free days as possible.. 🙂
🙂
D
I have a “rottie”rescue and have seen way to much pain. This wonderful loving breed( as well as all animals )suffer to much because people don’t know how to read the signs. People have done things to these big”pups”that thank God most people don’t know can be done.When I get a new rottie the first thing is a trip to our vet.Any problems are taken care of Pain being among the first.I treat them as I hope to be treated when I can not speak for myself. Thank you for talking about this important part of their life .. peggy “rottie rescue”
Indeed! Any pharmaceutical has potential side effects, including Rimadyl and all others listed or not listed here (and most biologically active supplements and herbs for that matter). Each of the items listed above has potential reactions which must be factored in when coming up with an individual treatment plan for a given patient. Hopefully the reader’s veterinarian will keep them abreast of what to look for not only related to drug use, but also post surgical monitoring, diet, allowed or promoted activity, and more. As this sometimes does not always happen as much as one would like, I encourage the idea of becoming your dog’s personal health care advocate.
D
Hi Dr. Dressler,
I agree that any pain is negative to the quality of life. We never want to see a best friend suffer. But I think before any pain medications should be given, the dog owners must be informed with the pros and cons ahead of the time. For example, with Rimadyl, which is a common dog drug associated with NSAID, most people do not know to look for the side effects.
It’s all about education.
Geng