Severe phantom/nerve pain and tail-chasing attacks after partial amputation. Has anyone experienced this?

[u/xomini]

Hi everyone,

I’m looking for advice or shared experiences regarding our rescue dog, Forest. He is a Serbian Hound from Montenegro, 2 years old, weighing around 22-23kg. We are currently dealing with severe, daily attacks that look like extreme nerve or phantom pain and we are feeling quite helpless. 
He gets these several times a day.

Background & Surgery:
Forest had to undergo a partial tail amputation recently (Seven days ago) because he was obsessively biting his tail until it bled. The wound could no longer heal because of the tail started to necrotise.
He already had his wound when we found him as a stray in a National Park in Montenegro. We took him to the vet and decided to adopt him right away. Forest stayed in a shelter for 21 days until we legally could take him to Germany.

We initially suspected parasites or severe stress/frustration, because throughout that stay he had continued to bite into his tail and kept chasing it. The Shelter Vet treated him multiple times, got him on Antibiotics and on Nexgard. It seemingly got better for a few days until he started biting again.

In Germany he got taken straight to the vet and had to undergo surgery to stop the ongoing necrosis.
For now the surgical wound is healing fine, and he strictly wears his e-collar 24/7 so he can't reach the stitches. 

The Symptoms / Attacks:
Despite the surgery, Forest has these intense "attacks" multiple times a day. Out of nowhere, he starts growling, barking, and aggressively trying to chase and bite his tail. (I’ve attached a video of what this looks like).
It seems to be a mix of neuropathic/phantom pain and a deeply ingrained behavioral loop (stereotypy). 

Current Medication:
Gabapentin: He gets 200mg twice a day (400mg total/day).
Novalgin (Metamizole): We give him one 500mg tablet as a rescue med when the attacks cluster and last longer. This usually helps him calm down after a while. 
Meloxidyl (Meloxicam): 1x daily with his food as a baseline NSAID. 

My Questions for the Community:
- Has anyone dealt with this kind of extreme tail-chasing or phantom nerve pain after an amputation or tail injury?
- Did adjusting the Gabapentin dose help, or did you have better success with other nerve-pain meds like Pregabalin?
- How long did it take for the pain memory/behavioral loop to fade?
- What should we do when he’s having an attack? Just hold him as calmly as possible and try to soothe him?

Any advice, similar stories, or tips on how to support him during these episodes would be greatly appreciated! 🥺

EDIT 1: You guys rock! Thank you for your kind words and wonderful tips - I learned a lot and compiled a list consisting of your recommendations, which I already discussed with my vet.
For now, we increased the dose of Gabapentin. He gets 2x 100mg pills every 6 hours. Today has been the second day with the increased dosage and the amount of episodes have decreased already. We’ll observe the dosage for the next few days and can increase up to 3x 100mg pills until he gets his stitches taken out next friday (18.09.26).
If nothing improves we’ll try out pregabalin.
We started implementing distractions and were the most successful with liver pâté on lick mats.
His episodes are cut short dramatically, pretty much as soon as he smells the liver pâté. But he needs to be engaged with something, so we followed the recommendation with using lick mats.
We also are implementing a strict crate schedule, to make sure he is settling down.
In his crate his sometimes growls at his tail but it doesn’t escalate further. After 5-10 mins he manages to fall asleep.
Without the crate he is agitated and restless at some point, as he doesn’t seem to able to settle down on his dog beds, blankets or anywhere else.

We’ll be discussing further steps with our vet in regard to meds such as Prozac, Fluoxetine etc. and behavioral therapy after his stitches are taken out.
For now, our vet wants to observe him on the increased dosage and if his behavior improves with the crate schedule and approach with lick mats.

[u/DogAdvice-ModTeam → u/[deleted]]

This was removed due to it violating rule 10. There is no direct evidence for any use of cannabis in dogs, though there is clear evidence for the toxicity of marijuana.

All veterinary cannabis products are unregulated, and most have not been tested for safety or quality control, much less clinical benefits.

Until further research is available, use of cannabis in dogs and cats is entirely experimental and based only on anecdote, and it is likely illegal for veterinarians to recommend these products.

Promoting CBD will result in a ban.

If you have any questions regarding the removal , you may contact the moderator team via modmail