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Thread: Pain Signs.

  1. #1
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    Default Pain Signs.

    There is probably a thread on here that this should be added to instead of me trying to start a new thread but I can't find out where it fits. This is a message I cross posted to the CKCS-SM and Arnold-Chiari_dogs list. If there is a better place for this message, I count on you, Karlin to help me by moving it.

    There has been a lot of discussion about whether or not scratching means pain. I think I have found out. With respect to Levi, anyway.

    I haven't posted for a few days because things are rather strange here. Among other things, I was supposed to be tapering Levi off his pain and this is NOT going well. I have followed the instructions about decreasing the time between doses for about three days and finally I have called LIVS and they will call me back sometime today.

    One thing I can tell al of you for sure is that scratching IS a sign of pain, not just neuropathic itching or something like that. Levi was getting his Tramadol every eight hours and I was supposed to decrease it to every 12 hours. In theory, Tramadol should not be stopping neuropathic symptoms and he is still on the same dose of gabapentin so the neuropathic symptoms should be the same. About two hours after he would have had his usual dose of Tramadol, he starts scratching A LOT. I have been trying to interrupt the scratching physically and/or by distracting him but it really does not work. The scratching or attempts to scratch continue until after he gets his next dose of Tramadol. He has not vocalized, but he is CLEARLY in pain and is showing it by scratching.

    For me, this settles the issue of whether dogs with SM who just scratch are in pain. THIS one is FOR SURE. For Levi, scratching is a sign of pain not just an odd sensation.

    Trust me, this is NOT making me at all happy and I am wondering if he will just need to continue to be on Tramadol every eight hours indefinitely. I will let all of you know when I find out anything. Until I do, I am just going to go back to the every eight hour schedule as it is just too difficult for him otherwise.

    I am going to cross post this message to the CKCS-SM and ArnoldChiari_dogs lists as I do not have anything else to say about this...yet, anyway.

    Except, d--n it, anyway. This is not what I had hoped would happen at all.

    Kathy
    --
    " It is hard to fight an enemy who has outposts in your head"----Sally Kempton

  2. #2
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    The need to itch is an intermittent signal to the brain.
    http://www.nytimes.com/2009/04/07/health/07itch.html
    The scratching calms the nerve.
    Or it will harm the skin and cause irritation, infection and more itching and pain.

  3. #3
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    I do know that has been the controversy about the scratching, is it just an odd nerve symptom or a symptom of pain? The Tramadol is a pain reliever, though, while the gabapentin is for the neuropathy. Levi's gabapentin dose has remained the same and the only thing that has changed is his pain medication. He clearly becomes disturbed and withdrawn as the Tramadol is wearing off and begins that ominous scratching behavior. I don't think he is just having an odd nerve symptom like a tingle or an itch. He is in pain. And I don't think it is like when your foot "goes to sleep" or something like that, either. As the Tramadol for pain wears off, his symptoms start increasing until it is time for another dose. It was even happening yesterday when he had a good reason to be distracted as I took him for a ride in the car (in his crate) and a VERY SHORT walk into the place where I got glasses for my son. Maybe 30 feet at the most. He was trying to stop and trying to scratch all the way. I think he is in actual PAIN.
    --
    " It is hard to fight an enemy who has outposts in your head"----Sally Kempton

  4. #4
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    Quote Originally Posted by antigone View Post
    I do know that has been the controversy about the scratching, is it just an odd nerve symptom or a symptom of pain? The Tramadol is a pain reliever, though, while the gabapentin is for the neuropathy. Levi's gabapentin dose has remained the same and the only thing that has changed is his pain medication. He clearly becomes disturbed and withdrawn as the Tramadol is wearing off and begins that ominous scratching behavior. I don't think he is just having an odd nerve symptom like a tingle or an itch. He is in pain. And I don't think it is like when your foot "goes to sleep" or something like that, either. As the Tramadol for pain wears off, his symptoms start increasing until it is time for another dose. It was even happening yesterday when he had a good reason to be distracted as I took him for a ride in the car (in his crate) and a VERY SHORT walk into the place where I got glasses for my son. Maybe 30 feet at the most. He was trying to stop and trying to scratch all the way. I think he is in actual PAIN.
    Even when we feel itching-- it can be from a hair tickling down your arm to a feeling like something has fallen asleep (like you mentioned) to a full blown case of poison ivy. The poison ivy itch is FAR more disturbing, relentless than a simple tickle of the skin.
    I am agreeing with you that it can be irritating to the point of painful.

  5. #5
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    Interesting analogy with the poison ivy. I've had it, and it feels so uncomfortable that you want to scratch your skin off.
    Trisha in Southwest Florida
    Cavaliers: Casey, Ollie, & Winston and usually a foster or two! Cats: Pebbles & Benson

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