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Caring for a Three Legged Dog or Cat

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18 y/o Strummer amputation advice pretty please
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11 August 2020
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16 August 2020 - 10:36 pm
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Yes, I agree, there are so many amazing people on Tripawds! 🙂 It's really heartwarming, to say the very least!!

Ok, that's really valuable to know that hemipelvectomies are not some incredibly specialized procedure. Thank you for that. 

Yes, I know, I'm definitely not expecting UC Davis to be less expensive than SAGE. I will admit though that I started reading their recent Yelp reviews and I got a little gun-shy. I know, I know, Yelp, Schmelp! But there were a bunch of recent reviews from folks who were saying similar things, in the vein of: "I used to think they were great, but this time they were awful." I know you can find these reviews on every Yelp page, but some of them were very compelling...and some downright scary!

I know UC Davis is an amazing teaching institution. But we've been hit extremely hard here in CA with Covid, in terms of shutdown (as I'm sure you know). I wonder if, as a public institution, they've had budget cuts that have led to lack of infrastructure that helped really hurt them in terms of the nuts and bolts of care? Anyway, I'm still calling them tomorrow, so I'll know more then. 🙂

Yes! I did read all the input from the amputation costs page. Very helpful!

Are there other good teaching hospitals  (someone recommended Colorado State http://csu-cvmb.....fault.aspx) Thoughts?

Yes, thank you, good point about the follow-up care too...

Thank you Jerry, You are a wealth of information and help!

hugs,

Jen

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16 August 2020 - 10:38 pm
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Hi again Jen & Strummer,

I had a nice long reply typed up, but it went poof!  Anyway, I am the one out in Wichita, Ks (no quarantine state) & the proud owner of Tuxedo who had a hemipelvectomy a bit over 3 years ago.  It was done at the 24 hour emergency vet clinic, by their staff orthopedic surgeon who luckily was on duty when I brought him in.  https://www.vet.....chita.com/

No guarantees that he is still working there, but if you can not find a local surgeon, might be worth making a phone call.  Their prices were very reasonable, far less than what I have read of others paying.

Hugs,

-Dawna, Tuxedo, Lilly, & Angel Dazzle

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17 August 2020 - 12:51 am
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Hi Dawna!

Ugh that sucks when replies go poof!!

Thank you SO much for that link! This is exactly what I'm looking for. Not ruling out someone local, I know there are fantastic vets/surgeons in the Bay Area. I just think there are great ones elsewhere, so yay! 

Grateful to you. 🙂 🙂 

Jen

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17 August 2020 - 1:12 am
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Hey Dawna,

Do you remember the surgeon's name? Looks like a really nice practice.

- J

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17 August 2020 - 9:42 am
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Unfortunately I do not remember the surgeon's name.  A lot of that evening when Tuxedo was attacked is a blurred bad memory, including the surgeon's name.  I checked on all the paperwork they sent home and it was not listed there.  Sorry 🙁

So guess a phone call and a few questions would be needed on that topic and others if you are not able to find a local surgeon.  However, I would be amazed if there is not one or more of the where you are.  Price though ... Well everything in CA and NY is usually 4x what it is here.  Lol, that is why I live here, so I can afford to vacation.

If you have been doing research and I am sure you have, you will have read that a hemipelvectomy is a much more involved surgery and  usually takes a bit longer to recover from than just a leg amputation. There can be other issues/complications not normally experienced such as bladder support, bowel obstruction, etc.  So you are doing the right thing in vetting the vets based on past experience.

Best wishes!

-Dawna, Tuxedo, Lilly, and Angel Dazzle

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17 August 2020 - 9:43 am
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Hey Jen

Yes CSU is amaaazing. We've interviewed their team quite a few times, and it's where Wyatt Ray gets his care.

https://tripawd.....m/tag/csu/

The thing about teaching hospitals is that while you do have the brightest minds in the vet med field working on your beloved animal, and a whole team of people versus one clinician, care can sometimes be impersonal or rushed in the sense that they just don't have the bandwidth to build that kind of close relationship one has with their family vet. It's to be expected in any institution and I don't think a lot of the angry Yelpers understand that. We have had nothing but great experiences at teaching hospitals, but we also went into the care knowing that this is what you can generally expect. 

What it comes down to is, what is more important to you--that one-on-one relationship, or the more scientific aspect of the care your Strummer will receive? It's ok to want one or both, there are no right or wrong choices. But in some private practice clinics it's possible to have both, which is why we recommend AAHA-accredited clinics if you are looking at private practices.

Also, consider the costs of travel for any out-of-area care, as well as the potential for surgery complications or any extended care Strummer might need. When you add up the costs you may end up spending just as much as you would have if you stayed within CA. Just a thought.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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17 August 2020 - 10:12 am
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Jerry, I appreciate your perspective on teaching hospitals.

When it comes down to reviews I've found every vet and clinic have both positive and negative reviews, including AMC and the vet who did my cat's amputation.

Jen, you stated you want "high quality testing (and possible treatment) for Strummie, at a more reasonable price than the continued insane quotes we are getting." Many times the price we pay goes with the types of tests and treatments. There are ways to keep the costs down. For example, CT scans are expensive and not always necessary. For feline cancers, radiation and chemotherapy treatments aren't always needed or effective and can be very stressful for cats. My cat only had a leg xray, lung xray, basic blood tests, amputation. Determine what you can afford to expect and what your goals are for your cat. I asked my cat to give me 3 more years. So far she has given me 6 years. But that's Mona - every cat, condition, and treatment will be different and it's impossible to compare.

I hope your search for a new pet clinic is productive.

Kerren

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17 August 2020 - 1:54 pm
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Kerren your wisdom here is always so appreciated and helpful!

Determine what you can afford to expect and what your goals are for your cat. 

SPOT ON! Why do diagnostics for a particular treatment path if you don't plan on pursuing it at all? Makes total sense!

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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17 August 2020 - 4:37 pm
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Help! I have a phone consult with an (highly recommende, by a personal friend and others) oncologist in 28 minutes! I want to ask him about testing, and what would absolutely be necessary.

They have previously said that the CT scan is necessary to see how far the tumor has traveled up Strummer's leg, and possible pelvis. This is, they say, to know if they can get the wide margins they need to have the surgery be worthwhile, or a risk worth taking, or however a person wants to view it.

Do they not need to do a CT scan in this case? They already have xrays - I'm confused! I will ask him, but thoughts before I do?

Anything else anyone can think of to ask?!

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17 August 2020 - 5:09 pm
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My cat did not have a CT scan just xrays. I'm not sure who told you the CT scan was necessary - was it the vet who now thinks Strummer has cancer? 

Does the consultant already have the previous xrays? You can ask if updated xrays are useful to determine the change, or, as you've stated if the CT scan provides information to determine if there are the needed margins for an amputation. Does the CT scan pick up all cancers and the spread>

You can ask if and why a CT scan is needed. What are your options if the CT scan indicates the margins would be too narrow.

What other tests an diagnostics are required?

What are all of the costs? When could they even do the surgery? The prognosis for recovery.

Personally I would weigh it all out, for example, if the scan and other tests cost $2,000 and the amputation is $3,000 and I believe my cat would live another year pain-free, would I find that acceptable? The financial costs of pet surgery and the stress to pay the bills can be a huge stressor and is important to consider. 

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17 August 2020 - 5:26 pm
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Our Jerry did have a CT scan before surgery, that isn't unusual at all. We were told the exact same reasons they gave you.

Here's a post about Questions to Ask Your Vet Oncologist that may help.

Oh, and a vintage but still applicable blog post explaining the differences between CT scans and x-rays:

X-rays vs. CT Scans for Canine Bone Cancer Staging

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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17 August 2020 - 5:43 pm
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If I remember correctly,  this place wanted around 5K JUST for testing without surgery. 

I know you get what you pay for,  but that seemed very extreme.  

It would be really nice if you could find a reputable place,  even in a less expensive state,  so that you can afford to get help.  I'm so sorry you're going through all this... especially now😪

Hugs,

Jackie, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry

Huckleberry's Blog

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17 August 2020 - 6:39 pm
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Thank you Jerry & Kerren & Dawna!

I just spoke with the Oncologist (Dr. Kiselow, still at Sage, but Sage Campbell, which I feel has a better vibe than Sage RWC...almost like they are two totally different organizations...IDK). He was recommended very highly by a friend of mine. He treated his dog for lymphoma, and I think the dog is still around, because he told me to tell Dr. Kiselow his dog said hello!

Anyway, he was GREAT. Super nice, funny, easy to understand and reasonable approach to the whole testing/staging procedure. Still not 100% certain what we're going to do, but the way he spoke about the whole process and the way he approaches it just sounded very logical and scientific (in a caring and helpful way). 

CT scan: Yes, he says that he just isn't able to see in the fine detail whether the cancer has spread into the pelvis, if so how far it has, etc. So yes, you could still do an amputation for palliative purposes but if you want to develop a prognosis of how much extension of quality life an amputation could provide, you need to do the CT scan to get the best estimate. Of course, there are never any guarantees.

Kerren - Really helpful thoughts about how to think of it all in a more specific way! Thx! Dr. Kiselow wants to do (basically in this order): blood work and an abdominal ultrasound. Then if those came out ok (no signs of spread), he'd move on to the CT Scan and a needle biopsy. 

Jerry - Thanks for those links, and all your helpful input!

Lots to consider and very little time with which to consider it...Funnily enough, I did get a random offer of 0% on all "purchases" until April 2021 from one of my existing credit cards today...LOL. (Laughter through tears!)

- Jen

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18 August 2020 - 2:30 pm
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Hi,

Pittens has started this behavior where there is a sudden jerk. Whats that about?

also her tummy   way way below the incision came back reddish. I shouldnt be too concerned right?  its where they shaved her for her abdominal ultrasound. 

everything else has been fine, no poop. but everything else fine including her termperment. 

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18 August 2020 - 3:45 pm
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sorry! I am subscribed to Strummer and pittens and thought this was pittens thread. 

I hope you are doing ok. 

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