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Caring for a Three Legged Dog or Cat

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2 weeks post op and still frightened of everything.
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8 August 2019
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13 August 2019 - 11:24 pm
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Hello,

My Baby Bear is 2 weeks post op from a complete front leg amputation.  The vet took everything including the shoulder and shoulder blade.  There was a very fast growing tumor that invaded her bone.  The first vet said nothing could be done but keep her comfy and gave a grim 5 day to a ‘possibly a month’ prognosis.  By the grace of God everything worked out where I found an amazing vet for a 2nd option. They rushed her back the same day for an amputation even though it was just regular apt scheduled.  The time that passed between the first vet and 2nd vets visit was 4 days. In that time the tumor was growing so quickly that she was having a hard time swallowing her food.  The new vet saved her life. 

Heres her information.  She is 11 yrs old and healthy.  Pathology came back as soft tissue sarcoma.  She did have a rough first couple weeks...

3 days post op she jumped in the tub.  Actually she fell in the tub.  I didn’t realize she didn’t want to walk until that night when she peed her bed.  The next day, (day 4), after the Onsior wore off she was in a lot of pain and her back leg had a noticeable lump on it.  It was Saturday and the vets office closed at noon ~ the Onsior wore off after 1 pm.  She stopped eating and drinking.  I still gave her her bupropion for pain that night.  The next day (Sunday) I realized she hasn’t gone to the bathroom since Friday night and she wasn’t drinking anything. She looked and fit every detail of dehydration.   I rushed to the store and bought pedialyte and gave her that mixed with bone broth (that I made for her on Tuesday) via a 1cc syringe.  In fear that the medication could mess up her kidneys and liver since she wasn’t going to the bathroom or drinking any fluids I didn’t give her her am pain meds until around 4pm (and only half a dose to take the edge off).  Finally around 9 pm she finally went to the bathroom.  I gave her approximately 4-6oz of fluids throughout the day and felt comfortable that her organs were ok so I gave her the other half of syringe of pain meds.  (ps the emergency vets in my area are HORRIBLE so that wasn’t an option.  You know there’s a problem when over 50% of the reviews say don’t go here if you want your pet to live). 

When we arrived at her vets office for our emergency Monday morning appointment.  The surgeon that did the amputation removed the bandages and gave her an anti inflammatory shot for the swelling in her leg.  Said it was only a soft tissue bruise.  

From Friday forward she refused to use the litter box and peed in her bed. She still didn’t want to eat or drink.  Finally mid week she slept in her litter box and peed in it.  I left the urine in it so she would know that’s where she needs to go and it worked!  No more accidents! :D. I gave her a bath and all was good until Saturday when she pulled her stitches out and chewed open her wound. Another emergency visit on Monday but the vet said it was ok that it needed to granulate over to heal.  ~ I’m sure you are wondering why I didn’t put the cone on her. She was barely eating and drinking as it was. The cone prevents her from being able to consume anything by herself...she can’t reach to food in the bowl. 

I have learned a few things over the course of this experience.  1) lay yoga mats on the floor for traction and when they fall it will be cushioned. (I wish I knew about this when I brought her home, she slipped and fell so many times from losing her balance that it just crushed me).  2) Have unflavored pedialyte and homemade bone broth on hand.  They don’t want to eat or drink because of the meds and pain. The bone broth has so many nutrients that will help recovery, it also entices them to drink.   3)  Be very cautious of the medications and duration they give to your cat.  Cats do not have the enzymes in the liver to break down NSAID’s among other medications. The NSAID’s by themselves and especially w combination of other medications can cause your cat to get liver toxicology and go into organ failure.   4). Stasis Breaker works!  It’s a prescription and only available through a Traditional Chinese Medical Vet (TCMV).  I did a bunch of research on it..please look it up there is hope!  This link will get you started https://miracle.....r-animals/

Now here is where I’m needing assistance.  I have been slowly introducing her back to her old habits and trying to treat her as if nothing happened to her.  Even though I absolutely dote over her and she IS my baby.  She walks when she wants to etc so mobility is not an issue.   She will be fine, then 30 seconds later she will be ultra scared and runs and hides.  How can I help her get over the stressed out scared of her shadow issue she’s having?  

Sorry this is soooo long, but I wanted to make sure you realized her 2 week recovery period had a few bumps and hiccups along the way. 

Thank you for all of your help.  

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14 August 2019 - 10:20 am
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I'm so glad you shared so many details, it really shows how much thought and care you put into Baby Bear's needs, especially at a time like this. KUDOS to you for finding that second vet! It never ceases to amaze us how many times we hear similar stories. You are a pawesome advocate!

Baby Bear's recovery would make a great Tripawd Tuesday feature. If you'd like us to spotlight her, message me and I'll send you details.

Meanwhile about her behavior patterns. Do you think it could possibly be phantom pain ? Does it happen when she's just sitting still, then from out of nowhere she gets up, runs and hides? Two weeks out isn't that long of a time and if she had a hard time with all that pain immediately out of surgery, it could be affecting her now. Is she on any meds now?

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

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14 August 2019 - 12:05 pm
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Hi Jerry,

Yes adding her story to Tripawd Tuesday would be great!

Im not too sure if it would be phantom leg, because she doesnt have any part of that extremity, shoulder nor shoulder blade. (i can send you a pic of her incision if you like, it is not a normal amputation because the growth was so aggressive.)    

She will be normal, just sitting there as I pet her or even by herself and then ‘Bam’ out of nowhere she will freak out and hide.  She is stressed out even when I introduce her back into her previous normal environment.  I will be holding her by the window looking out it, she will do her normal rub on the blinds and then something small like a noise freaks her out.  Or I will go to pick her up and she will start growling, but once shes in my arms she is calm and purring.

She was only on pain meds for 5 days.  2x daily (for 5 days) bupropion, and 1x daily (for 3 days) Onsior.  Liver toxicity is a huge concern for cats that a lot of vets don’t recognize.  When the first vet wanted to give her a NSAID and bupropion I mentioned the liver toxicity concern.  Her statement was and I’m quoting her “Liver toxicity is her least concern, thats not what’s going to do her in...”  I went home and read more about the harmful effects off NSAID’s on cats and it specifically said never give NSAID’s w any other medication.  

The link I shared is a God send.  It allowed me to find the other vet who saved her life.  Hopefully someone else will be able to benefit from that information too.

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14 August 2019 - 2:50 pm
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Ditto Jerry! You are such a powerful advocate for your Bear!!!   She is certainly a well .loved and well cared for kitty❤

WOW!!!  What a scary first couple of weeks!!!!!  Hopefully the bulk of hurdles arr vehind uoh now!!

It does sound like a "pain reaction",  as well as "anticipatory pain" reaction.    As far as "anticipating",  Bear is probably tired of all the initial prodding and poking prior and after  surgery, that she growls just at the "thought" that maybe, somehow, someway, you are going to give her an ouch!!!

It does sound like, to some degree anyway, some of  her out of rhe blue reaction mimics phantom pain .  Of course, I'm  not a Vet.  Phantom pain is all about the brain  firing off messages ro nerves that are no longer there.  The nerve endings fire off pain signals until the brain figures out the nerves no longer go,to a limb (or shoulder,  etc)..

Just curious, did your Bear have kidney or liver alarm bells go off when blood work was fone before surgery?  

Kitty members can chime in on pain meds, etc, but usually  Gabapentin stops that type of pain.  Lots  of knowledge  from our kitty members about bupa (never can remember  name/spelling), other meds, interactions, positives/negatives, etc.  I do know that some days and dogs stay on low dose of pain meds long term.

And thanks fot sharing all the good tips  for other kitty members  just starting  this journey😎

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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14 August 2019 - 3:55 pm
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I'm sorry to hear your cat's recovery has been difficult. Thankfully she's improving.

It's quite normal for the scapula to be taken with the front leg as it was with my cat Mona. Initially my vet was only going to remove Mona's leg but the big city surgeons said the modern procedure is to also remove the scapula.

I have different information and experience on NSAIDS for cats and have had a number of cats take Metacam for Cats as an anti-inflammatory and pain relief. For Mona's recovery she was on Metacam and Buprenorphine. I think she acted a little crazy from the Buprenorphine as she would suddenly race around the house. I came to realize that the pain was better managed to give the meds 4 times a day rather than 3 times and to give the two meds at different times rather than at the same time.

I would think the surgery pain would be gone after two weeks so perhaps it is phantom limb pain. A number of cats here were prescribed Gabapentin (which Sally referred to). I also gave Mona hot and cost compresses on her surgical site and she seemed to enjoy them. After 1 month I took her in for chiropractic treatments and learned how to massage her. Mona loved the treatments and slept through them.

I'm so happy for you and Baby Bear that you found a vet to save her life.

Kerren and Tripawd Kitty Mona

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14 August 2019 - 4:24 pm
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Yep, Sally explained phantom pain pretty well. My guess is that's what it sounds like based on what you are describing. The pain is nerve-related, it doesn't have anything to do with the limb itself other than the fact that nerves were cut when it was removed. I would discuss this with your vet.

You may want to check out our interview with feline pain management expert Stephen Cital, it's super informative about NSAIDs and the newest thinking in feline pain management :

https://tripawd.....ment-tips/

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

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14 August 2019 - 5:30 pm
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Great interview Rene! It's good to know about the advances in pain management for cats.

Kerren

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15 August 2019 - 2:25 am
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Thank you everyone for the great information!  

My Baby never had any bloodwork done prior to the surgery.  I was honestly taking her to the vet for the Stasis Breaker, and  never had any intention of any type of surgery.  The 2nd option Vet was so amazing the way she handled me. ~ Mind you I had no desire to nor could I eat and was crying for 4 days.  She was incredibly compassionate and told me what I didn’t want but needed to hear.  She then went into the O.R. to ask the surgeon if he could work my Baby in the schedule that day...they took her back to surgery within 2 hrs and saved her life.  

The reason I am very cautious of liver toxicity and kidney problems is a vet over medicated and killed one of our cats years ago. 

Thank you for sharing that interview.  I am excited over the possibility of breakthroughs in pain relievers for cats.  I really loved his passion for his work!  He did mention there was a 28 day study, (but he couldn’t remember the exact number for sure), on the effects of Onsior. The studies that I found was on a 21, 42 & 6 mo studies.  The research is disclosed on the package insert and also on drugs.com.   On the 21 day study, what the scientists described as well tolerated I guess is subject to interpretation.  Chronic intestinal nephritis, lower kidney weight, a large intestinal erosion, multifocal necrosis of one lobe in the liver and a large renal mass were only a few of the findings.  (They ‘terminated’ the cats to see what the medication did to them.)  This experiment was done on 6 cats.  (2 in the control & 4 in the experimental group) Pretty grim findings considering only the 4 in the experimental group received the medication.   Yes the cats did receive a higher dose of the medications, but Onsior was the ONLY medication they was given to those cats for those 21 days (3week) experiment.  Most of our cats are given more than one medication to take.  Onsior is a NSAID.   While I am all for pain relievers when needed.  (nobody should have to experience debilitating pain.)   I think the pharmaceutical companies should be more transparent and not try to downplay their negative findings.  Vets also need to let us know what the possible side effects could do to our pets by mixing or giving medications for too long of a duration. This way we can be aware of and can make informed decisions.

I completely agree on the poking and prodding playing a significant part in my Baby being stressed out. I didn’t look at it from her perspective.   We have had 2 emergency vet appointments since her surgery on 7/30...today is only 8/14. That’s one a week and she’s only 2 weeks post op!  Lol. Then she has me who’s always trying to get her to eat and drink...And then the phantom leg pain .  Right there that’s a huge ball of complete stress.  Lol.  Does anyone have any suggestions on how to help her get through her  vulnerable scared state?

Kerren, how long after surgery did you start the compresses for Mona?  Is there any tips that you suggest?

Thank you again everyone I really do appreciate your help, feedback and support.

Cindy ~ The Bear’s mom

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15 August 2019 - 8:44 am
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kazann said
Great interview Rene! It's good to know about the advances in pain management for cats.

Kerren

  

Paw shucks, thank you so much. There's so much more to learn, feline pain control doesn't get the justice it deserves, but slowly it's changing.

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

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15 August 2019 - 10:33 am
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Hi Cindy and Bear,

You have done excellent research on the medication! It's not easy because we need to go with what is available particularly for emergency and critical surgery such as an amputation. I'm in Canada and we have Metacam for Cats (Oral Suspension) and I don't believe it's available in the US. The Metacam in the US is only approved for dogs. I believe the difference in the Canadian product (also used in Europe and Australia) is that the concentration is much lower than the product for dogs (0.5 mg/mL for cats compared to 1.5 mg/mL for dogs). Mona was on it for about 7-10 days and on the opioid for 5 days. 

I started the compresses when Mona came home after surgery. I used an ice pack wrapped in a towel for maybe up to 5 minutes and would use a hot damp facecloth to clean any guck off around the staples and would just drape it over her when it cooled to warm. After a couple of days, I'd take her to a patio door to look out and she would lie down on her surgical side on the cool tile. She made it clear that she liked a cool compress! Mona loves to be stroked, brushed and fussed over so she makes it easy.

The nursie types might be able to suggest a different regime.

By the way, the vet sent Mona home with canned kitten food which she devoured. It has high moisture content and is high in protein so was good for her during recovery but not for the long-term.

Emergencies probably set Bear back in healing. Are the stitches/staples out now? Is she off all medications now? I think when Mona had a couple of freak-outs it was due to the Buprenorphine. Mona has become a diva going to vet clinics or even cat kennels and is considered their best cat patient/guest. Yet at home, she stays away from guests. It's strange because she wasn't like that before the amputation.

After Mona healed, she did have a couple of strange body jerks and spins but they didn't occur after a few months. A physiotherapist said her spinning when getting up from the floor was likely related to proprioception which is the body's sense of knowing where the limbs are. Mona's body would spin not knowing the one leg was no longer there. She no longer spins.

Hugs to you and Bear,

Kerren and Tripawd Mona

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