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Surgery 8 days ago. Mastiff still has drainage tube, catheter to pee. Not m
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Virginia
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18 April 2017 - 8:24 pm
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Dr. Pam, I'm posting the link to Bruno, 120 lb Mastiff/Rottie mix who had amputation surger eight days agonin THAILAND.

http://tripawds.....-amputate/

As you can imagine Bob, Bruno's Dad has had very little expert help offered there. He has done an INCREDIBLE job on basically on his own from the day he brought him home hours after surgery.

I KNOW it's a lot to read vut, please, when you can, see if you can offer insight.

http://tripawds.....-amputate/

I'll try and highlight a couple of things in the thread.

They noted a benign cyst (or tumor) on his kidney. Said that was to be expected with "older" dogs. Think this was "determined" only from an xray, not sure though.

They noted 2 nodes in his lung (2mm) but Thai Vet couldn't determine if they were benign or not. Told him they woukd recheck in a couple of months.

Bruno has had a drainage tube in since amp and Bob has been changing bandaging in his own. Yiu will see in his post the amount of fluid he has been getting each day....it's right much!

After 48 hrs of not peeing the Vet finally put a catheter in. Bob has posted pictures of the blooody urine that was coming out of tube at first. Urine looks better now. Vet put him on lots of antibiotics.

Six days now and catheter is still in as Bruno won't pee.

Eight days still no poop.

Vet noted some arthritis in remaining leg prior to amp. Only gets up when helped. Can maybe take a few steps.

Again, I know this is a lot to read and I haven't done justice in trye to highlight some stuff.

Bruno and his Dad have really been through so much and doing it basically on their own and with the help of friends

We could never, ever thank you enough for being here for all of us!!

With sincere appreciation always

On behalf of Bob and Bruno,
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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19 April 2017 - 3:33 pm
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Dad is Rob, not Bob.smiley

Otis - 106 pound lab/Dane mix, lost his right front leg to osteosarcoma on Febuary 9, 2016.  Four rounds of carboplatin completed in April, 2016.  Lung mets August 25, 2016.  Said goodbye too soon on September 4, 2016.   Lost his adopted sister, Tess, suddenly on October 9, 2016. likely due to hemangiosarcoma.  

Wherever they are, they are together.

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19 April 2017 - 5:54 pm
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Is he still on pain meds?  The drain tube may be able to come out because after 7 days it can act as a foreign body.  Most dogs will eventually pee when ready so I would not leave the same catheter in that long or he will get a wicked UTI, even on antibiotics.  If available I would give gabapentin 300 mg twice daily, an NSAID and maybe tramadol but only if truly painful.  He needs to turn him over several times daily and get him up twice daily if possible.  Make sure the ground is padded to prevent pressure sores and use toe grips if needed on slippery floors.

Pam

Virginia
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19 April 2017 - 6:00 pm
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Okay....trying tp copy and paste....hope it works....

His wound drainage is slowly reducing from the initial 170ml per day but is still around 100ml per day and that drain was supposed to be out 3 or 4 days after surgery. My high school friend said that I should take it out once the drainage is down to 20ml per day but that seems far off still.

He just finished his Previcox (NSAID) last night and now is on Tramadol 150mg every 12 hours, Gabapentin 300mg every 12 hours, and also Cephalexin 1250 mg and Augmentin 1000 mg every 12 hours. I think he is not in pain now but he has always been a big panter so I can't really judge by that symptom. He has 3 days of Gabapentin left and about 1 week of Tramad

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

Virginia
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19 April 2017 - 6:18 pm
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Sorry to keep trying to cooy and paste ...but I know Bob's link was a lot to read through.

Here are some .ore "highlights....this was his post six days agoAFTER Bruno jad not peed the previous 51 hrs and they got 2.2 (or .aybe 2.5) liters out.

This morning he had 500 ml of urine in the bag at the 12 hour point so that looks good but now 2 hours after emptying the bag he had only passed about 10 ml and it was reddish in color when viewed in the catheter line. As I write this he is passing a tiny amount through the tube and it is yellow again but I see what looks like a couple clots in the urine.

IMG_20170414_115549.jpg

My guess is that his bladder and or urinary tract is a bit distressed from the distention yesterday and maybe even infected. They took blood last night and his WBC count was pretty high and RBC was a bit low indicating infection but no idea if that would be from the surgery or from the lack of peeing. He is already on a high dosage of Cephalexin which is the treatment for UTI anyways so I will just keep him drinking as much as possible and see if it flushes out. The local Vets are pretty much all gone until the 18th now so hopefully he won't require another intervention.

He did vomit a very small amount of undigested food a couple times but he sort of did that

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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19 April 2017 - 8:57 pm
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Hi Dr Pam,

Just to clarify a few points with Bruno's case.

9 days post op and he has not peed on his own yet, most likely because he cannot stand on his own for more than 20 seconds or so yet. The urinary catheter came out again about 14 hours ago so I have left it out and will take Bruno outside of our building to his usual pee spots and see if he will pee on his own today. He has pooped every 3 times since surgery but so far only when he was laying down inside but again he has not been able to stand so can't expect him to poop standing yet.

His drain is a local version of a Jackson-Pratt drain. Day 1 started with 167ml collected and has steadily decreased to 62ml yesterday but still above the target 30ml recommended before removal of the drain. The bandage around the drain has not been wet and only has a small amount of exudate at the incision. I am anxious to remove the drain as the surgeon initially said that she expected it to be in about 4 days or so and now also about your comment about the drain acting as a foreign body after 7 days but the drainage is still around 60ml per day.

He is on Tramadol 150mg every 12 hours, Gabapentin 300mg every 12 hours, and also Cephalexin 1250 mg and Augmentin 1000 mg every 12 hours. The Gabapentin will run out in 2 more days.

I do not have access to the simplest things that are available in the USA like Toe Grips so have been using yoga mats everywhere. Also I do not have easy access to the University Hospital surgeon who did the amputation for any kind of follow up as we live 3 hours away from the University and they never offered a direct method of contacting the surgeon. They operate on a first come first served basis with 6 hour waits being typical so just going back and going through that avenue is not practical at all.

Virginia
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19 April 2017 - 9:20 pm
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So glad you posted Rob....much better than me trying to pick out the "highights". I had forgotten about his wbc being high bedore they put the catheter in. He may still have an infection going on that, as Dr P me tioned, the antibiotics may not do the trick

Glad to hear Bruno has pooped! It doesn't matter where, just the fact that he has is good!

AND, AS ALWAYS, WE APPRECIATE OUR GOOD VET's HELP!! 🙂 🙂 🙂

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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20 April 2017 - 7:23 am
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Dr Pam,

They did not have him on Gabapentin prior to the surgery and gave him enough for 10 days which will run out tomorrow but there is another week of Tramadol which they did have him taking for 2-3 weeks pre-op. Should I get more Gabapentin?

He seems to be doing well on his current dosage of Gabapentin and Tramadol but I worry what will happen now that he is getting more active.

BTW he did pee on his own for the first time today at lunch time but I had to drive him to a local park as he would not do anything around our home after an hour or so outside. I took him outside our home again this evening but he did not pee again but he was wiped out from his activity at the park. Will try again in the morning.

I would appreciate your opinion regarding continuing the Gabapentin.

Thanks

Rob...

Virginia
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20 April 2017 - 9:06 am
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SUCH GOOD NEWS ABOUT THE PEEING ON HIS OWN!!!!! ESTATIC FO HEAR!!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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20 April 2017 - 9:25 am
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Me too!!!

And Rob, that's not a BTW! That's a shout it from the rooftops, open the fizz and celebrate. This is a HUGE step. I know the location thing is a pain, but that will sort itself out in time. The fact that Bruno has peed on his own is MASSIVE! 

We're celebrating with you.

Meg, Clare and Elsie Pie xxx

Meg, Mutt, aged around 8, adopted 31/12/2009. Sudden explosive right elbow fracture 06/12 (caused by IOHC), diagnosed with End Stage Arthritis 03/15, Total Elbow Replacement 08/15, problems with healing leading to skin graft & skin flap surgery, Chronic Infection leading to implant breakdown. Became a Tripawd 9th March 2016. 
Lives with Elsie Pie, & Mum, Clare, watched over by Angel Billie
My life as a MEG-A-STAR 


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20 April 2017 - 3:33 pm
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The Augmentin should cover any bladder infections so continue that as well as the cephalexin (good for the skin).  I would continue the Previcox since he may still have inflammation and wean off the tramadol which can sometimes cause muscle weakness and lethargy.  I would continue the gabapentin at 300 mg twice daily.

He should be able to pee when he needs to as long as he doesn't have bladder stones (should have been visible on rads).  Mastiffs can hold their urine over 24 hours but I would still get him up twice daily to try to encourage urination.  Can he support his weight with his rear legs?  Does he move his legs if you pinch his toes when laying down?  If not then he might have  neurologic issues such as FCE which is not painful like a disc but could cause loss of function of  rear legs and bladder.  More likely he is just not ready to get up yet.

Pam

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20 April 2017 - 6:30 pm
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Yes he does move his legs when I pinch his toes although it seems like I have to pinch his left leg quite a bit harder before he moves it but that leg was under him when I tested as he lays on his left side which is opposite the amputation.

I will try to get more of those meds that you suggested locally for another 5 days or so or would you suggest longer?

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23 April 2017 - 10:46 am
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I would give the Previcox until he is up and walking.

Pam

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26 April 2017 - 11:09 am
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Dr Pam

Tonight Bruno started doing something really weird. Earlier he was being a bit antsy after we came back inside from his "walk". He kept getting up often and moving around the house, eventually he went out on the balcony and laid down so I took the opportunity to go for a swim in the pool. Then he got up and started hopping around but really springing his back legs in an awkward way and he was going pretty fast for a few steps before I managed to stop him. He had a strange look in his eyes but calmed down as soon as I was holding him. After a little while he was half asleep as he usually is and then suddenly he started doing it again until he lost his footing and fell onto his belly. I thought that maybe some critter was biting his foot because he really was kicking his left hind leg so I gave him a good brushing and checked him thoroughly and could only find one small tick on him which him probably picked up from laying in the dirt outside.

Has anyone seen this bucking bronco behavior during a recovery?

He seems all calm again now but I am guessing that it will start again soon.

Virginia
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26 April 2017 - 2:44 pm
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Leg cramps?? Phantom limb pain? Pinched nerve in his back shooting down his leg? Any tension spots massaging up and down his spine? Just throwing a couple of things out there until our good Vet chimes in.

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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