From:
williamsdvm@comcast.net
Date: 2002-10-15 00:13:46 UTC
Subject: RE: 11 days post-surgery continuing pain - ideas?
To: ferrethealth@smartgroups.com
Message-ID: <22873800.1034640826121.JavaMail.root@scandium>
Author wrote:
> Hello,
> 11 days ago now, Puff had a splenectomy and insulinoma removal. ...> Puff is still in marked pain, as displayed by tooth-grinding and other
> behaviors.. She is still in her hospital/recovery cage, and shows no
> interest in getting out. After eating, she grinds her teeth the most,
> which suggests an ulcer. ... She is showing little interest in her dry food. Her stools are
> either dark and 'slick', or small, very dark and sticky. She gets .1ml
> each of Pred, Sucralfate, and Torbutrol 2x/day, and .5ml amoxi for another
> 3 days. I give the Sucralfate an hour before the other meds.
Dear Melissa:
Yes, she is showing very characteristic signs of a gastric ulcer. One problem is that the timing of Sucralfate is not appropriate. Sucralfate should be given 10 minutes prior to the feedings - an hour before renders it relatively useless.
Sucralfate is an inert substance that binds to the ulcerated mucosa of the stomach - very much like filling a hole in the road. When given right before eating, it effectively prevents the stomach acid from gettting into the ulcer, causing pain. It doesn't last long, though, and certainly not an hour. Plus, you don't mention the dosage. If the timing is off, the dosage may be too. It should be given at 75mg/lb 10 minutes prior to each meal.
Don't worry about her not eating her dry food - it would be a bad idea if she did at this point.
With kindest regards,
Bruce Williams, DVM