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Pam,

Like you it has been years since I have seen an HOD case. When I did, he

improved gradually over weeks but did eventually make a full recovery.

In terms of pain control, though, I would suggest the addition of gabapentin and

amantadine. This combination has been extremely helpful for us in terms of

adjunctive pain management in bone pain due to neoplasia - imagine it would help

here as well. Lidoderm patches over the worst lesions might also help - of

course keeping a puppy from chewing them off - that's another issue.

Good luck with the case, and let us know how it progresses.

Gwen on, DVM, CCRP

ford Veterinary Services

Ontario, Canada

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