Subcutaneous ketamine

Unicorn

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Sorry, slightly waffly request for more advice for creaky dog. Has anyone used (or knows anyone that has used) sub cutaneous ketamine injections for an arthritic dog?

My vet is pushing this quite strongly as the next step for my dog and I’m wary. I’ve not been able to find much in the way of information but as I understand it, it’s dissociative and makes the pain less relevant rather than being an actual painkiller and I worry that it would lead to her doing more damage.

For background she’s a 9 year old GSDxRottie, with significant elbow dysplasia and is now getting quite sore in her hips too. She’s already on Librella, paracetamol and gabapentin, and has regular physio and hydrotherapy. We tried adding memantine but it made her quite odd – almost like she was hallucinating. She can’t tolerate NSAIDs.

And just because she's gorgeous

IMG_20240127_150826~01.jpg
 

Boulty

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I’ve not personally used it for that purpose (and would imagine the paperwork for doing it would be a nightmare) but the basic idea behind using ket for pain relief if that it helps with / prevents “wind up” pain (which is basically what leads to chronic pain / to things being more painful than they should be for the level of damage). As you say it’s not going to prevent further damage but it may help take the edge off. (Probably not to the point that dog is going to start running around like a loon IME)

Normally it’s a relatively short acting drug but you’d need to discuss with your vet exactly what form it would be given in / how long it would take to wear off.

If you’re not keen on this route ask about suitability of laser therapy/ if they or another vet or physio in the area offers it. (Maybe your current physio or hydro might as a lot are starting to) It can be helpful for keeping on top of inflammation alongside giving appropriate medications especially if you can’t use NSAIDs. Does normally need a loading phase where you initially do it several (2-3) times a week but then you gradually reduce frequency of treatment. Obv not a miracle cure but does seem to generally have positive effects and the main negatives are the cost (especially of the initial loading period) and the need for eye protection whilst doing it.
 

Unicorn

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No experience. But am following for interest if you don’t mind.

She’s beautiful ❤️
Please do! And thank you 🙂
I’ve not personally used it for that purpose (and would imagine the paperwork for doing it would be a nightmare) but the basic idea behind using ket for pain relief if that it helps with / prevents “wind up” pain (which is basically what leads to chronic pain / to things being more painful than they should be for the level of damage). As you say it’s not going to prevent further damage but it may help take the edge off. (Probably not to the point that dog is going to start running around like a loon IME)

Normally it’s a relatively short acting drug but you’d need to discuss with your vet exactly what form it would be given in / how long it would take to wear off.

If you’re not keen on this route ask about suitability of laser therapy/ if they or another vet or physio in the area offers it. (Maybe your current physio or hydro might as a lot are starting to) It can be helpful for keeping on top of inflammation alongside giving appropriate medications especially if you can’t use NSAIDs. Does normally need a loading phase where you initially do it several (2-3) times a week but then you gradually reduce frequency of treatment. Obv not a miracle cure but does seem to generally have positive effects and the main negatives are the cost (especially of the initial loading period) and the need for eye protection whilst doing it.
Thank you! I hadn't even thought that it might involve paperwork. I'd seen a few references to it helping with wind up pain, but they all seem to be referring to an infusion. And that's a useful point to discuss with vet...she was talking about injections every two weeks initially, withe the caveat that they might make her 'a bit ketaminey' for a day or two, but was all a bit vague.

I'll ask vet (and probably physio) about laser therapy too.
 

druid

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Yep, I use it a lot in my palliative/hospice side of work and for end stage dogs it can bring a lot of relief when other things aren't working anymore or you've already got the dog on several options and you still get pain break through. I give it as subq injections, not an IV infusion.
 

Unicorn

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Yep, I use it a lot in my palliative/hospice side of work and for end stage dogs it can bring a lot of relief when other things aren't working anymore or you've already got the dog on several options and you still get pain break through. I give it as subq injections, not an IV infusion.

Thank you druid, that's good to know. Do you find it does make them a bit spaced out for a while?
 
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