Nare's Journey

Nare’s owner had told their vet that she wasn’t eating and not acting right for several appointments. Each time bloodwork would be performed or meds/taken home with nothing helping her. Nare’s owner knew something was wrong. She was doing everything she could to help Nare and nothing helped. We were lucky enough to see Nare on emergency prior to the opening of the Pet Pain Management Center. Nare was very thin from weeks of vomiting and not eating. She could barely stand let alone walk. Her owner was in tears stating she keeps seeing Nare worsen and nothing is helping.

We started with X-rays and bloodwork and a very special liver profile. Nare’s general bloodwork was normal other than dehydration but the liver panel showed very high bile acids. Elevation in bile acids can cause “crystals” formations in the joints and stones in the bladder and kidneys. Luckily Nare did not have any kidney or bladder stones but it was believed her joints were affected since every joint was painful.

First and foremost we sketched out a multimodal pain treatment plan. Pain can no longer be treated with a single medication. And chronic (long-standing) pain evolves to link to movement so even moving becomes painful

Nare was immediately given buprenorphine for her severe pain and then a micro dosing of ketamine. A ketamine micro dosing protocol helps raise the pain threshold and helps other pain medications work better.  Pain medication was sent home for dosing every 8 hours. She was also sent home with a NSAID meloxicam (similar to Tylenol for humans-which is toxic to the liver in dogs). This would help decrease inflammation in her joints.

Fluids were given for dehydration and an antiemetic to stop her nausea and vomiting. Cold Laser was used to help decrease pain and inflammation in her neck and back.

Due to pain, lack of movement and abnormal posture Nare’s back was arched and she took tiny steps (pain in joints).  Many of her joints were no longer moving in their correct space or range of motion. Due to deterioration of her symptoms a “snowball” effect of joint changes had occurred. Joint movement and massage was given to help relax her muscles that were spasming due to the joints no longer being in correct alignment. Only 3 joints were addressed at each consultation to manipulate back into their normal alignment.  

Nare’s liver was a concern since she needed her liver working to take the medications. Nare’s mom agreed to make her a daily homemade diet that would help her liver recover. And it worked-the liver values kept falling back to normal.

Nare improved daily. Nare’s mom had to fill out a pain assessment daily when she returned for her reevaluation and cold laser (performed daily due to the severity of her condition).

Nare’s neck was the worst since changes had twisted her neck into an abnormal angle and causing her head to tilt. An assissi loop was used over her neck while Nare and her mom waited for bloodwork results. Nare’s mom said she would become so relax that she would sleep with this treatment.

Nare came to us almost daily showing improvement in movement, straightening of her neck, more awareness of her surroundings, eating every 2-4 hours and gaining some weight. Her arched back almost became normal and her steps were longer.

Nare had a setback that required her to see a specialist and Nare passed in her sleep before she could be seen by the specialist. Though Nare’s owner (and our entire staff’s) heart was broken she was thankful that we were able to help Nare live without pain in her last months of life.

We love you Nare. You will not be forgotten.