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2nd TPLO/TTA failure, facecing rear amputation due to lack of bone healing. | Beyond Cancer

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2nd TPLO/TTA failure, facecing rear amputation due to lack of bone healing.
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18 February 2018 - 8:54 pm
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Hi everyone. 

Im new here but have been reading many stories and struggles by all. A lot of it has been uplifting to me, which has helped with some of the decisions I might be facing within the next few weeks.

My dog kody (65 pound Siberian husky, 5 1/2 years old) has grown up with rear leg deformities. (Extreme tibia plateau angle) when he was a puppy his legs were perfect, but as time went on and he grew up, he developed a severe Tina plateau angle. We were successful in performing a TPLO & TTA closing wedge osteotomy a year and eight months ago on his left real limb. Everything went as planed and while nerveracking, went well. Fast forward to October 2017, we went to perform the same procedure on on Kodys right real limb. Everything seemed to be going as planned until at the 10 week checkup we learnt that the implant had catastrophically failed complete with pulled and broken screws. A surprise to us all given how well he appeared to perform in rehab activities. (stretch excercises) We opted to perform the sugary again. This time things seemed to be going well yet again, though two weeks ago kody all the sudden started walking with a stange inward step.  We took radiographs right away and found that absolutely no bone healing has happened since the surgery. (a months time) and in fact a piece of bone has since chipped away for some reason. Also the implant is started to slip and fail. Suffice to say I was devastated.  To date my local vet doesn’t quite know what to say, though I’m lucky I have a close working relationship with her, and could even call her a friend. She has been very supportive (and also has a Tripawd) The surgeon hasn’t called me as of yet (expecting that call on Tuesday) but I know one of the things he will likely recommend is an external pin system to keep the bones together and a 3rd try at this leg. Personally I don’t want to go this route as I think for any dog, crated or not, could lead to disaster and suffering. -there is no way I can keep him from moving for 10 weeks or more with pins and support bars sticking outside of his leg. Not only that, but there is no guaranty that kodys bones can heal at this point. Even with the bone graft he had this time he has abnormal healing. My local vet, surgeon, and three other surgeons have looked at this case and nobody can say why this is happening.  Kody has been layed up for three years while we have tried our best to do well for him, but I feel that enough is enough. I don’t want to put him though another surgery that has no guaranty of working. More pain, more crate rest, etc. He developed these issues when he was 1yr old and is now almost six.  (Rehab turned out of be considered a failed attempt when he was four, which is when we started surgery options) 

My main concern is that his other leg, while healed, still isn’t top notch, and while i’m considering amputation on the (not as of yet) failed limb, I don’t know what to expect. On the plus side he already has been using his good leg mostly and not even using his bad leg and has gotten around really well considering.

My end goal is to give kody his life back and try to make the best decision I can for him. I personally don’t think another surgery will work, and my local vet doesn’t believe so at this point either.  Three TPLO’s are enough. All kody seems to know these days are surgery(s) and crate rest. Its not fair to him. At least one of the surgeries worked. Even if I wanted to do another surgery I’m financially tapped out. I have $17K into kodys endeavors to date and as bad as I feel to say, I just simply can’t afford another major surgery anyway. I’m lucky to know my vet on a personal level and she has given me good advice. I felt really good after talking with her for over an hour and a half the other night and she discussed performing the amputation for the cost of anesthesia. Prefably if we could work out a similar deal with the surgeon it might be prudent to do it at his facility due to him having better means to perform the removal since he is one of the best in the state and has a state of the art facility for these types of things. But I digress. Like I said, I felt good the other night but today I woke up filled with anxiety and feeling unsure about the entire situation.  I’ve been fighting back tears writing this in fact.  My biggest fear is that Kody will never have the life he once had early in life. If his other leg can’t hold up, I don’t know how we could care for him. I work long hours and my mom and aunt (in their 60’s and 70’s) care for him while I am working. (They can’t lift him at all) I know the only thing we can do is try as best we can for him, but so far that hasn’t been enough.

That said, I know everyone here has a lot of expereance and possible advice to give.  I’d be curious to know if anyone has an idea as to what to expect. I know it’s impossible to make assumptions due to his other leg and enevitable arthritis that will develop (lucky non yet) but how mobile are rear leg amputated dogs?  I still plan on doing rehab at the center that performed kodys surgery’s  but I feel like I’m in a whirlwind of just not knowing anything about anything anymore. I haven’t seen too many posts on here that have resulted in similar situations (if there are Its my ignorance in not knowing how to to search the site properly, so sorry in advance if that’s the case) it’s just, I have no idea what I’m in for, or how well kody will adapt to three legs, since his other one isn’t technically tip top. I know even after the TPLO surgeries he has a difficult time using the bathroom (and even got an anal gland infection because lack of squatting at the time) 

Anyway, thanks in advance everyone. If nothing else it just helps to write this stuff out. Even better if someone has advice, ideas, or... anything, yaknow.. I really hope I’m doing the right thing. 

Also, Sorry in advance for spelling or any grammar errors. Currently writing this on an iPhone.. looks like my post turned into a wall of text.

Livermore, CA
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18 February 2018 - 10:52 pm
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Hello and welcome, your future posts will not have to wait for approval.

I hope you don't mind that I moved your post here to Beyond Cancer- it's the best place to start when not dealing with cancer.

Wow- you and Kody have been down quite a road!  I'm sorry so much of his young life has been surgeries and recoveries. 

I did a forum search and got these results for failed TPLO. There might be something useful for you there.

The only thing left to do in my mind is maybe get another opinion from a certified ortho vet. Don't feel bad about financial concerns- we all wish we had all the money in the world to spend on our pups but sometimes that doesn't matter.

What does the vet think about Kody being a Tripawd? Do they think the other leg will hold up?

I've had two rear amp Tripawds but both small and with OK other back legs.  My first, Maggie the Tripug, lost a rear leg to mast cell cancer.  She was 7.5 years old at the time of surgery and really not ridiculously active- she never had issues with her one back leg.  My current Tripawd Elly is a little pug mix who lost her right rear leg after being hit by a car at 7 months old.  She is now just over 3 years old and doing well.  I do worry a bit about the one back leg, especially since she will be a Tripawd for most all of her life. To help keep her strong and fit we work every day on core strength or balance, things really important for Tripawds.  We play food games and puzzles, work on obedience and trick training or do balance/core strength exercises.  I spread things out over the week so not to overdo anything.  I also try and keep her on the lean side to reduce stress on the remaining legs.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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19 February 2018 - 10:31 am
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Hi Karen, 

Thanks for the reply and link!  And sorry about that, I didn’t notice this section (still getting use to the forum structure in general)

I can say originally my vet didn’t think it was the best option at the time, due to his other leg being in the conditionin it’s in, but now she seems to think that it might bet he best option for kody since the bone just won’t heal with no exact explanation as to why.  His other led is fully healed and is in rather good condition but again, being that it too has issues it is a concern. She seems to think that kody will do okay as long as we are proactive with preventing as best we can, arthritis. (Caraprofin or similar anti inflammatory) 

Luckily Kody, for a husky, is unbelievably laid back so he’s not typical in that sence. He doesn’t get hyper in the house, and generally is well mannered on leash walks. (he loves walks and exploring. Even on bad days when his poor legs wouldn’t let him, he’d try as best he could to keep going. When I’d cut the walks short he’d just stare at me wondering why we’re not going futher)  

Hopefully I will hear what the surgeon has to say tomorrow.  The one thing that does concern he is he can be a huge drama king, and I worry he’ll go nuts if he has phantom limb pain, or just tenderness in general.  I’ve seen a lot of people say that an amp surgery seems to be an easier recovery than a tplo, but I don’t know if they mean in recovery or overall. 

It sounds like you have been though quite a lot as well.  I’m glad to hear Elly is doing well. She is lucky to have someone like you!.

Anyway, thanks so very much for your time.  I’m going to check that link you provided and see what I can find there!

-Jace and Kody

The Rainbow Bridge

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19 February 2018 - 11:28 am
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Jace and Kody, welcome. I agree, you two have been through a LOT. And I don't blame you one bit for considering amputation after all that you've both endured. Nobody wants to lop off their pet's leg unless they absolutely have to, and clearly you've given this a ton of thought (and invested a ton of cash as well).

What I've learned through the years is that surgeons will keep trying to repair a situation like this, because that's what they are skilled at doing. They absolutely hate amputation, and I can't blame them. Without orthopedic surgeons we wouldn't have a lot of advances in vet medicine. But the breaking point of when to say when and stop the repairs is different for everyone, and you've clearly reached yours. 

Yes, from what we've read here is that TPLO is a way harder recovery than amputation! So after all that you've been through, amputation recovery should be relatively easy. And the fact that he's a Husky, and has tolerated all these other surgeries so well, speaks volumes about his strength and tenacity. That boy should do great on three, even with the additional issue of an arthritic hip. Your vet is right, as long as you are proactive about good pain management he should be fine. Check out Spree's story as an example of how even a dog with many other issues can do well on three.

Spree the Tripawd Breaks Leg But Bounces Back Beautifully

It's better to hop on three legs than to limp on four.™
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Livermore, CA
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19 February 2018 - 2:03 pm
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Hi again,

As far as recovery goes after amp- I've been through it with Tripug Maggie who was THE drama queen!  Elly was amputated before I adopted her so was healed though not very strong when I got her about 2.5 months post amp.

I have been through 2 knee surgeries with my quad pug boy Obie.  Not TPLO  but still quite invasive as his knee caps would not say in place and the surgeon had to re-form (cut new grooves) the bones to make things work correctly, in addition to the tightrope CCL repair procedure. Obie is quite stoic actually, I didn't even realize he was having trouble with his first knee, no yelping or limping, until I noticed his hip muscle was way smaller than the other side.  Anyway- both surgeries required 8 weeks of crate rest (ex-pen rest in our case) followed by 6 to 8 weeks of limited, no jumping, always on leash activity.  In both cases he was on tramadol for pain for 4 to 5 weeks, he also had a fentanyl patch post op.

Maggie on the other hand ALWAYS let me know when something was bothering her big-grin.  She was very quiet for several weeks after her amp surgery.  We managed he pain quite well I think, we had no medical issues, no phantom pain , but she would not play with me for 6 weeks after surgery!  During her recovery I was sure I had made a mistake choosing amputation- she was just not herself.  In hindsight it made sense- she was the definition of a stubborn pug who hated any change to her routine.  Once she got used to her new normal she hopped happily through life for almost 4 years. Physically she was hopping the day of surgery and never really had problems getting around.  At first she would only hop a few steps then sit down- she slowly built strength and endurance.   Back then I didn't know how important core strength was for Tripawds and honestly more focused on the cancer issues.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

Virginia
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19 February 2018 - 2:53 pm
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You are an outstanding advocate for your Kody!!  You are very tuned into him! 'Having been owned by a Husky before, I know they are strong and resilient dogs!  And yes, Kody is the exception if he's a laid back Husky!   You rarely see that as a description!

As Jerry said,  there is a rime ro say enough is enough and to move forward with a better option for Kody!

And since you asked, YES, YOU ARE DOING THE RIGHT THING FOR KODY!!!

   Karen has already given you her first hand eexperience wirh her precious (and somewhat srubborn) Pugs.  As you can see,  everyone recovered in their own way and in their own timeframe  just beautifully.

IF phantom pain develps, it IS managed with Gabapentin, among other things.  It usually happe s out of the blue, results in the dog trying to "move away quicly from the pain".  Fortunately, that type of nerve pain only lasts for maybe about thirty seconds, if that.  And it is NOT  a given in any way shape r form that phantom pain will even happen.   My Happy Hannw never had it.  Those who did deal with it can give good insight IF that happens.

Yes, recovery from surgery is no picnic for about a week or two.  The GOOD news is that you are now dealing with ONE surgery, ONE recovery period and them Kody is onto living a pain free life that allows Kody to be Kody!! 🙂 🙂 🙂   You won't be dealing with months of crate or extremely limited activity.  On surgery...one recovery....BAM!!  DONE!! 🙂 🙂

You can ask your Vet about starting Kody in Adequan injections  and other joint supplements to take a proactive approach.

Many dogs here have had successful recoveries even though they had arthritis and/or hip dysplasia BEFORE surgery.  Rehab is important and monitoring his activity so he doesn't do any crazy activities.   Tripawds can still chase frisbees, but they need to be thrown low to the ground so there isn't any high jumping where they land hard in their joints.

We'll @ook forward to updates AND pictures AND followw Kody's adventures as a pain free tripawd! 🙂

Hugs

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 February 2018 - 8:45 pm
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Our Murphy was hit by a car and after having one of his rear legs amputated, he had a total hip replacement on the other side. Our orthopedic surgeon was the one who recommended the amputation because Murphy's femoral nerve was damaged so badly that he had no retraction response. He just dragged his bad leg.

In answer to your curiosity as to what a rear leg amputee can do, Murphy did just about anything he wanted to do after he healed from the THR.

Here is a video that was taken six months after the THR.

Kathi and the Turbotail April Angel...and the Labradork

Murphy is a five year old Lab/Chessie cross. He was hit by a car on 10/29/12 and became a Tripawd on 11/24/12. On 2/5/13, he had a total hip replacement on his remaining back leg. He has absolutely no idea that he has only three legs!

UPDATE: Murphy lived his life to the fullest, right up until an aggressive bone lesion took him across the Rainbow Bridge on April 9, 2015 and he gained his membership in the April Angels. Run free, my love. You deserve it!

Virginia
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19 February 2018 - 8:59 pm
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Sooooo glad Kathi saw this!!!   Murphy and his pancake eating buddy Gus (or was it waffle) are two of our most beloved members!heart

As you can see, Murphy absolutely THRIVED on three legs, even after amputation and THR!!   If this doesn't inspireire you and give you hope I don't know what will!  He truly is one of our Miracle  pi4ls who had the most decotey hoomans a dog could have! 🙂

Love you Kathi!!  How bout an Oliver update!! 🙂

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 February 2018 - 6:46 am
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Thank you everyone for all the inspiring stories and help during these times!  I do feel a lot better about this now.  One more surgury, and it sounds like Kody will finally be done with the misery he’s endured by the sounds of it. 

I’m hoping to get the call today from the surgeon to see what he says, and I plan on telling him that if another surgury is recommended, I was it to be an amputation.  I’m still holding out to see if this is a delayed union, and if the bone will start to heal or not, but from what it looks like so far, that doesn’t seem to be the case. If the inplant can hold out it still might work out for him, but at least I know the direction in which were going from this point on. 

Jerry:  Thanks so much for all have done with this site, and all you do.  Its an amazing place with amazing people. 

Murphsmom: Murphy looked so happy in that video!  I cant wait for a day in which kody can have good days just like that! -Thanks for your story!

Benny55: Thanks for the perspective on the recovery and beyond.  It really helps take the anxiety down while thinking about all this stuff. Ive had many sleepless nights trying to figure everything out. I will certainly be taking a proactive approach in meds for sure. I’d like to try and make this last surgury as easy as I can for him!

Krun15: Kody is very much the same way. Very routine oriented, though for the last year its been crate rest so I think hell be happy to be able to do anything other than just resting constantly.  -Thanks again for all the info and sharing your experience!

I will certainly be updating in the future for sure.  I still am unsure where all this will lead but I am certainly hoping for the best!

Thanks again everyone! 

-Jace 

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20 February 2018 - 1:31 pm
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I did happen to think of another question, if anyone with expereance can answer?  

How much more pain after an ampuation surgury can I expect my dog to be in compaired to a TPLO surgury.  My initial thought would be that it might be more painful at the incision site after an amputation but was wondering what to expect.  How long does it typically take before they feel comfortable putting weaight on it while laying down?

(Kody is a drama king and screams sometimes when in pain and there’s nothing more stressful than waking up at 3am when that happens) 

Still no news from the surgeon today. Still awaiting his thoughts and ideas for moving forward.

Virginia
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20 February 2018 - 2:11 pm
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Not to sou d @ike a broken record, but every recovery really can vary, and every dog reacts differently during recovery.  Thus, it's hard, to some degree, to say what to "expect".  We can give you our experiences and that way you'll have a wide range of "boundaries" for your observations of your Kody

It is MAJOR surgery and it does hurt!    I don't think a dog is "faking it" at all when he cries during recovery.  Humans would probably be on a morphine drip for days!

Some dogs actually lay on their amp side within a few days.  Some take two  or three weeks.  And then you have my Happy Hannah who took arou d five weeks before she was completely comfortable laying on her amp side!

I have an adopted tripawd Frankie) who recently had cruciate repair surgery done on one of his remaining rear legs.  Not sure that I can actually make a comparison "pain-wise" between that and my Happy Hannah's amp.  I do know he was indeed in pain and very, very vocal.  This from a very sturdy gritty kind of guy.  My Happy Hannah cried out also,  but was more whining than shrieking like  Frankie.  It took about three days before I got him on the priper pain med balance of Tramadol, Gabapentin and Rimadyl.  Getting up and trying to lay back down remained pai ful for him for a couple of weeks.  Of course, he was basically using two legs as the third leg was just to painful to ise for awhile.  REHABE STARTED A LITTLE AFTER TWO WEEKS AND IT WAS INVALUABLE!!

Others will chime in with their experiences.    Ain thi g, STAY CONNECTED.  Let us know how things are going and we can help guide you of anything seems out of the "nor ".  Obviously, we are not Vets and not giving  Vet advice, merely sharing our  experiences.

Hugs

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!

The Rainbow Bridge

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20 February 2018 - 4:37 pm
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How much more pain after an ampuation surgury can I expect my dog to be in compaired to a TPLO surgury. 

When pain management is handled well, there shouldn't be any noticeable pain indicators. If there are, the pain management methods need reworking. That often happens but once you and the vet dial it in, Kody shouldn't be screaming out in pain.

It's better to hop on three legs than to limp on four.™
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20 February 2018 - 5:13 pm
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Thanks so much Jerry and Benny55.

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22 February 2018 - 4:12 pm
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For anyone following so far, or someone with future issues as these, here’s a small update. 

I spoke with the surgeon today.  We discussed everything I already knew. Kody thus far has a condition considered a delayed union. After six weeks of healing, there is in fact no evidence of healing.  In fact, it apears that there has been bone absorption. While it is still possible that kodys bones could kick in and start healing, there is a slim chance of that. (About 10%). We discussed a few options, one of which were external pin supports (which he himself didn’t recommend) and the other, amputation. I told him that at this point I’d prefer  amputation, and while he was surprised, he agreed (I’m assuming he wasn’t aware I’d already put a lot of thought and consideration into this) 

That said, The plan for Kody right now is to wait and see if this delayed union takes hold and starts to heal. We are fighting time as the implant has started to bend. (Luckily not by much to be a problem)  if it continues to bend Kodys tibia will not line up properly and even if it did heal at that point we would be facing amputation anyway due to pain issues (who wants to walk around on a deformed tibia, that would hurt!)  Its also important to note that kody is in absolutely no pain. So waiting to see isn’t as bad as it sounds. He wants to run and play and do all the things he use to do before the surgury, its just that darn bone wont heal!  This also gives us a chance to prep and plan for the amputation surgery itself (time off work, etc) 

I will continue to update major events as they unfold.  -likely X-ray day, which will guide our journey down whatever path is meant to be. (The current situation will make our decision for us) 

Thanks again to everyone for everything.  This site has been a huge help to my sanity and I already have a really good idea as to what I need to buy and prep for when the day comes to perform the surgery! 

-Jason

Virginia
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22 February 2018 - 9:18 pm
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Thanks so much for the update!

  Sounds like you have a well thought plan and one that's supported by your Vet too.  Really good to hear that Kody is NOT in pain.   Thus, like you said, "waiting isn't as bad as it seems".

Yep, whatever's meant to be, you've prepared well.

Hugs

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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