Join the forum discussion on this topic!At one time or another, all of us have benefited from the expertise of fellow member Dr. Pam Wiltzius, DVM, a veterinarian from Puyallup, Washington.
Dr. Wiltzius joined us in August, 2008, when her beloved 165-pound Mastiff, Tazzie, was diagnosed with osteosarcoma. Since then, she has generously shared so much of her time and perspective with us, and we really can’t thank her enough.
Tazzie’s story has always served as an inspawration to us, and we always point new members to it. Tazzie proved that if a big gal like her could live a good life on three legs, there’s hope for other dogs too. Recently we were digging through older Discussion Forum posts, and came across one of Dr. Wiltzius’ first posts about Tazzie.
“Unfortunately, Tazzie had a limp 2 weeks ago. I am a veterinarian, so I took Tazzie in for xrays the next day and confirmed a lytic lesion in her right front leg near the carpus (wrist joint) which is almost always osteosarcoma. Like all of you, I struggled with the decision to amputate her leg. She is only 6 years old, but has already had both of her knees repaired and she is a very big dog (165 pounds).”
We would like to share Dr. Wiltzius’ early experience with Tazzie’s diagnosis below, because she has some terrific advice about how she approaches pain management, amputation surgery and follow up care. We hope you find it as valuable as we do. And if you have amputation questions of your own for Dr. Wiltzius, be sure to post them in our Ask A Vet Discussion Forum topic.
Tazzie coming home: One Vet’s Amputation Surgery & Recovery Tips
28 August 2008Hello everyone,
My name is Pam and my husband and I share our house with 3 dogs; Tazzie (Mastiff), Loki (Dogue de Bordeaux), and Kona (Pitbull). Unfortunately, Tazzie had a limp 2 weeks ago. I am a veterinarian, so I took Tazzie in for xrays the next day and confirmed a lytic lesion in her right front leg near the carpus (wrist joint) which is almost always osteosarcoma. Like all of you, I struggled with the decision to amputate her leg. She is only 6 years old, but has already had both of her knees repaired and she is a very big dog (165 pounds).
I found your excellent website and have been following the stories of all the dogs, especially Titan and Butch. Dogs really are so amazing and resilient! After a week of furthur testing (chest rads, abdominal ultrasound, bloodwork) we scheduled the amputation. Even though I have performed many of these myself, I just couldn’t do my own dog so I had the surgeon who repaired her knees do it for me.
Tazzie had her amputation Tuesday 8/26 and is doing very well! I am planning on taking her home on Friday since we have a long weekend.
I thought I could pass on some tips for any dogs that may need amputation in the future, since there is lots of new info out there. I know that different vets have different opinions but this is what has worked for me.
First of all, I would always use what is called a CRI (continuous rate infusion) of morphine, lidocaine, and ketamine (MLK) during the amputation. These drugs help prevent a lot of the pain felt after an amputation and allow you to use less gas anesthesia during the procedure. The drip is continued postop until the dog is comfortable. Tazzie’s surgery lasted 3 hours and she needed the drip for 12 hours postop until she was comfy. I have to admit that I slept on the kennel floor with her all night long just to make sure she was ok.Smile
I started her on 3 drugs the day before surgery. One is a Fentanyl patch applied to one of her back legs. This is a narcotic that lasts 3-5 days and will be removed Friday. The other drugs are gabapentin and amantadine. These are drugs used in human medicine and both are inexpensive and very safe (main sided effect is sleepiness from gabapentin). Gabapentin is used to prevent nerve root pain and thereoretically can help with “phantom pain“. We can’t ask our dogs about that but I think that it does exist! Gabapentin is continued for 2-4 weeks after surgery depending on the dog. Amantadine helps prevent what is called pain “wind up”. Once the pain receptors are annoyed it takes more pain meds to calm them down. This drug blocks that response and can be used for 1-2 weeks postop. Lots of dogs with chronic arthritis also take this drug for flare-ups when the Rimadyl or other NSAIDs they are taking stop working.
Tazzie will also take Tramadol as needed for pain after she comes home. I will continue her glucosamine supplement (Dasequin) and add fish oil. She can’t take an NSAID due to high liver enzymes but that is a great choice for other dogs. She eats Innova (Evo is also a great food but her liver can’t handle it) which I supplement with veggies and chicken or turkey.
Her first chemo is 9/15. I will do Carboplatin because it has the fewest side effects and has been linked to more long-term survival rates (although median survival age is the same with all chemo drugs). I should get the biopsy results next week. On large/giant dogs with Tazzie’s symptoms and radiographs I don’t usually put them through a painful bone biopsy first since we don’t have fungal disease in our neck of the woods (Seattle). I just send in a sample after the leg is off.
Well I know that this is a long, technical, and maybe boring post but maybe it will help someone make their decision regarding amputation. I think that almost all dogs are good candidates for this procedure regardless of size as long as they aren’t severly arthritic or neurologic, and it sure beats the severe pain of bone cancer!
I will keep you updated and try to send a picture through Jerry as I am technologically challenged when it comes to computers.
Pam (and Tazzie!)
1 September 2008
Hello, I just wanted to give everyone a quick update on Tazzie. She is really doing well on 3 legs! I am very surprised that it is day 6 and she can go out by herself to pee and finally had a bowel movement yesterday. She is back to eating dry kibble (if I hand-feed her) and her pain seems well controlled.
My other 2 dogs are treating her very well and so far we have had no mishaps like fighting for food or attention. Her incision is a little puffy but so far no seroma! I am keeping a body bandage and tshirt on her just to be safe, until her staples come out.
I still have to figure out the harness I bought. Has anyone tried this with a giant breed dog? I plan on using it to help get her to her chemo appt on September 15th but it just doesn’t seem like it will support her huge body!
I sent a postop picture to Jerry and I had done another post answering some of your questions but I don’t see it here. If he can’t find it I will repeat it later.
Good luck to all,
Pam and Tazzie
7 September 2008
I just thought I’d post an update on Tazzie. She is still getting around very well, and is eating and drinking like a champ. She has been trying to figure out how to get back on the couches and bed but can’t quite get there yet with just the 1 front leg. My husband moved our kingsized mattress on the floor and we all sleep there so she won’t feel left out!
She has developed a firm cellulitis over her incision area.
I sent some pix to Jerry in case anyone is interested. It is not painful or red, and not soft like a seroma. I think that the deeper tissues like muscles and fat are healing at different rates so it feels lumpy.
Also, she developed a bad bladder infection and had a flare-up of hepatitis post-op when she was still in the hospital so we had to change her antibiotic. Her incison was a little infected then and I think that also has contributed to her problems now. I sent blood to the lab today to see if her liver enzymes have returned to normal. She was actually jaundiced for a day or two (kind of scaryFrown).
I am planning on removing her staples on Tuesday Sept 9th and then the next step is chemo. For now she wears her Led Zeppelin tshirts and feels like a rock star!
To follow along on her journey, here are all of the posts Dr. Wiltzius wrote about Tazzie.
Tazzie earned her wings on October 18, 2009.
Tomorrow is Bellas (Great Dane). 1 week post op . Front leg amputation , she has been doing amazing until yesterday . She started with a yelping pain when she puts her front paw down . I sent pics to her vet of the incision, he thought it looked great. I dont know if that is phantom pain or what it is. She wasnt doing good on both Tramadol & Pregablin . They took her off the Tramadol .
Lee we replied to your post here:
https://tripawds.com/forums/hopping-around/is-this-phantom-pain-2/
She should have been on gabapentin beginning the day of surgery and continuing for at least 2 weeks lost op. You did not mention this, so thought I would mention. I hope she feels better.
Hi, all! I have a cattle dog, Akira, with hind leg amputation 6 years ago; she is 9 years old. I have always worried about her good hip going bad and noticed she wasnt able to go on longer walks, so took her in to xray her hip….her hip looks perfect, no arthritis at all…. but her ankle is so bad….bone spurs and terrible arthritis. It remains swollen all the time. As a physical therapist….I would rather her hip be arthritic, it’s a larger joint.
Her ankle continues to worsen and she is gaining weight while eating less….due to lack of activity. I bought her a brace for her ankle, which seems to help a little. I know I need a heavy duty brace for her delicate ankle joint, but can only find the softer ones that velcro over. Up until a few years ago….she was as fast, and faster, as our younger cattle dog. It is so hard to see her struggle to walk and not be able to walk more than 15 minutes.
Can anyone point me in the direction of a better orthotic for her hind ankle?
Thank you!
Mary Saalman
Please consult with a certified canine rehab therapist and/or veterinary orthopedic specialist who works with a reputable orthopedic device manufacturer. We only recommend custom fit braces, from companies like Orthopets and Hero Dog Braces. Check out this Tripawd Talk Radio episode and these video interviews for much more helpful information.
Hi All! Question. How long is a dog hospitalized after amputation. My dog is have an right front amputation today, and they want to send him home this afternoon. From what I’m reading pets are kept for days , or week? I’m a little confusedl
Best wishes for your pup Linda! Please review our Reading List for lots of helpful information or download the Tripawds e-books for fast answers to most common concerns.
Every dog is different, as is every vet. Most dogs spend one night in the hospital, perhaps longer if complications occur. We normally do not recommend dogs coming home the same day, unless the vet does not offer overnight supervision. Please post in the forums and search the blogs for much more feedback from members than you will get here in comments on this post.
Hi! We are Terry & Carey from Denver. We have a 71/2 year old St Bernard/Great Pyrenees dog called Mudi. We’ve had him since 8 weeks adopted from a puppy rescue. He’s been a fabulous companion and SO healthy til diagnosed with osteosarcoma 10 days ago. We are really struggling about options…especially amputation. Your stories are inspirational and extremely helpful in our decision. Also he is clear everywhere else. Does anyone have suggestions about financial help for surgery? We just lost our Lab, Janis, to old age but left us maxxed out. It’s been a bad month but feeling a bit more optimistic now. Thanks for your stories.
Thanks for the comment and best wishes for Mudi! Be sure to bookmark Jerry’s Required Reading List for LOTS of helpful links, or consider downloading the Tripawds e-books for fast answers to common concerns. Overwhelmed? Start here and feel free to call the toll-free Tripawds Helpline any time.
My furbaby Sumo is a 160lb Great Pyrenees who was diagnosed with osteosarcoma 3 weeks ago. After much soul searching and being convinced by his oncologist that it had not spread to his lungs, my husband and I decided to go ahead with the amputation of his left rear leg. He stayed at the hospital for a week, and was kept comfortable with alot of good pain meds! We were able to bring him home one week ago today! Everyday he gets a little better, his appetite and thirst is back to normal, but he still has trouble standing on his own (he reminds me a litlle of a drunk sailor 🙂 ). We are hoping this site will give us tips and more information to keep the level of his quality of life as high as he deserves!
Hi Dawn, Sumo and family, welcome. We are glad Sumo is doing better and better. Hop over to our Discussion Forums and post so we can all join in and help you with our best Tripawd tips and more OK? Plus we want to see photos of your sweet pup.
Hi I am Krizzy,
My Dogue de Bordeaux Zambor, 130lb – 59 kg, has had his surgery yesterday, osteosarcoma right front leg near the wrist joint. I am very grateful that I am able to get 1st hand information from Dr. Wiltzius and Tazzie who went thru this same operation as my big friend Zambor.
It allows me to ask the correct questions to the doctors that are treating Zambor.
Krizzy
Hi Krizzy, I hope you and Zambor have a long healthy hoppy life together. Come to the discussion forums where you can find even more support from our community. Keep us posted.
wow, guess i’m so out out of it i didn’t even say what boone was post op from. bonne had bone cancer in his front left leg. so my wife and i, went through with the amputation and have just gotten him back from the vet.
hi, my nameis robert and my dogs name is boone. boone is a boerboel (mastiff) he is 21 hours post-op. he is laying for the moment, but he keeps trying to get up and then starts crying. not sure what to do. i just tell hime to calm down and try to get him to lay back down. boone is a large breed dog and when he wants to do somthing it can be hard to stop him. although i can controll him, it is hard to do because i am afraid of hurting him. i have been trying to get him to drink water but he wont. he did eat a hot dog, but the end of the world would not stop that. i guess i’m justlooking for pointers. boone is 4 years-old and i have owned him sence 7 weeks. i will do antthing to help him. any pointers, thanks.
Robert, we are so sorry that Boone got diagnosed with bone cancer. Your best bet right now is to hang in there, things WILL get better. The first few nights and even two weeks can be challenging, it’s so hard to see our pups in pain. Did Boone receive any pain meds from his doctor? The right pain management protocol makes all the difference in the world. His appetite and thirst should pick up very soon but if you are at all nervous please call your vet for suggestions. The surgery pain meds will affect his appetite and he probably won’t even poop for a couple of days either. To encourage him to drink water, try putting no-salt chicken broth in his water, or even a bit of gatorade. Don’t worry too much about him not eating, dogs instinctively know not to eat too much right now becuase their bodies are saving their energy to recover from the surgery.
Please visit our Discussion Forums’ Treatment and Recovery Forum for immediate support and help from folks who’ve been there. Also, check our Chat Room and leave the window open for a while to see who stops by. We usually try to be there throughout the day and into the evening. Also, see our Required Reading List and ebook, “Three Legs & a Spare” for more insight.
Good luck, we hope you’ll come to the Forums for more support.
Thank you for posting this helpful information! I’ve never heard of one of the drugs Pam used…the Amantadine? Does it go by another name by chance?
Tracy, Maggie’s Mom
You’re welcome!
Hey Maggie, the brand name is Symmetrel, and Wikipedia says “Rimantadine is a closely related derivative of adamantane with similar biological properties.”
I hadn’t heard of it either until Pam’s mentioning of it. Apparently it’s just now starting to be used in vet medicine.