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6 weeks post op - declining health
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Member Since:
21 November 2017
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22 November 2017 - 12:35 am
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First let me start by saying this website is awesome.  We're from the states but we live in Northern Uganda right now where our vets are phenomenal for the little training they've had access to, but we have REALLY benefited from this resource to fill in some of the gaps.  That being said, we're getting very worried about our tripawd Giggs and our vets don't have any idea what is wrong.

We're officially 6 weeks post op, and everything went really well.  They removed the front shoulder entirely along with a massive tumor underneath it.  He had a seroma but we all got through it (despite how gross it was without a drain).  Even the second day after the surgery he was so much happier than when he had the tumor, and he just kept getting better and better.

Then last week he started acting different.  A lot of his symptoms seem in line with phantom limb, but it just seems so much more extreme than what I've been reading.  He is shivering a lot, he yelps out in pain often when he is getting up or rolling over, but sometimes randomly as well.  He always seems uncomfortable and anxious either refusing to sit or lay down (but not moving) or refusing to get up (but crying).  If he's not always whining for attention he is finding places in the house or yard to be completely removed - neither behavior is anything like him.  We've tried cold/warm packs, and we've got a tight shirt on him for compression (probably not the most effective one though) and we just can't tell if they're helping.

He's starting moving VERY strange as well.  His back is never straight, either arched up or sideways with his head on the opposite side from his good leg.  He is taking very small quick steps on his front leg and moving his back legs as if the two aren't working together and have a mind of their own.

He's not currently on any regular pain killers although we've given him tramadol a few times (doesn't seem to help much).  Our vets told us NOT to give him gabapenten because they only know it for seizures.  I think we could get the drug without them but I don't know about dosage or length of time.  But honestly I can't tell if its pain or anxiety or both.

There is a good chance we're reading too much into this, and are extra scared because our vets told us they haven't heard of phantom limb (perhaps a language barrier problem).  Either way, we would really like some feedback from anyone who might know whats going on with him.  Thanks!

On The Road


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22 November 2017 - 10:31 am
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Hi Giggs and family, welcome. We are so glad you found us too! Tell us a bit more about Giggs. What was the reason for Gigg's amputation? How old is he and what kind of breed type? And what's his appetite like? 

I left this here for our Fairy Vet Mother, Dr. Pam, so hopefully she can give you her vet perspective. To me (and I'm not a vet so take that for what it's worth), what you are describing sounds like classic pain signals animals give, and then some. It could be caused by not enough pre or post-surgery pain management , or he could have pulled a muscle recently. Either way he does need help so he can feel better. Once you get a handle on the pain you can find out what's causing it.

If the vets are not familiar with Gabapentin I encourage you to show them a copy of the latest American Animal Hospital Association Pain Management Guidelines. Inside they will see that Gabapentin is recommended for pain management

Gabapentin

Gabapentin is an anticonvulsant with analgesic properties that may
be primarily derived by down-regulating calcium channels.61
Because of its efficacy and tolerability, gabapentin is widely used
in humans with neuropathic and other maladaptive pain
conditions.62

Along with published clinical case reports in animals,
the data suggest a strong rationale for using gabapentin in dogs and
cats with similar conditions.

63,64 One canine study suggested a
disease-modifying effect in experimental DJD, but clinical studies
are lacking.65 In cats, one unpublished study demonstrated a
benefit of gabapentin in naturally-occurring DJD (E. Troncy,
personal communication 2013), and one case series of chronic
musculoskeletal pain has also been published.66

The evidence for gabapentin in human postsurgical pain is
encouraging, but not yet in dogs and cats.67–72

An 8–12 hr dosing
interval has been suggested based on one publication.73 The
primary adverse effect in dogs appears to be somnolence (also the
case in humans), which usually resolves with patient acclimation
over several days, allowing for a tapering-up schedule.

You can also show them our article, 

All About Gabapentin for Tripawd Dogs and Cats

Meanwhile you can try gentle massage and see if that helps OK? Please keep us posted and tell us how he's doing. We are here for you even all the way across the oceans.  

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

Virginia







Member Since:
22 February 2013
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22 November 2017 - 12:54 pm
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While waiting for our Sai t Dr Pa to chime in, just want to ditto some of Jerry's comments.

Also want to add that my "rescue" Frankie is  a front legger . His situationtuatiin is different in thwt I've been owned by him for over two years now (guessing he's about four yrs) and have no idea of reason for amp. I'm sure he overdid it long before I adopted him, as he certainly has had a couple of  "unauthorized vacarion freedom runs" in my care for several days and was found miles away. He's jumped ofover dexk railings, which I jave now made higher.  Anyway, you get the lixture. 

He has started having a lot lf issues with his remaining,rra ging from weakened shoulder muscles in his front leg, sort of holdi g o e of his remaining rear legs out straighter as he walks.  This has been "diagnosed" as scar rissue that form over a torn ligament (which, in an awful way, is sort of good as an operation and recovery time would have been a challenge).  And he has arthritis!   And my Frankie is definitely forming a more exaggerated "S" curve with his baxk.

Does Giggs bob his head up and down in a very exaggerated way and does his front leg sometimes"collapse"?

After saying all  of this, none of it may apply to Giggs.  Just want you to know that rest, Rimadyl and Adequan shots seem to help Frankie.  Im looking into other options also.  Back issues, sprained muscles, disc issue, etc can definitely happen at the drop of a hat during the first couple of months of recovery.

Give Giggs a big smooch for us!

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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22 November 2017 - 1:37 pm
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Hi!  Giggs is a German shepherd although we think there's some local dog in the mix too.  We think he's almost 6 years old.  His amputation was a very long process because we don't have access to MRIs and very very poor X-rays here (Uganda for those who missed that bit).  So it took us a very long time to diagnose his limp, despite trying every kind of treatment.  We and the vets here were treating his leg, but it turns out it was a massive tumor growing under his shoulder.  A vet in the big city was able to do the amputation and said it was an extremely clean cut, and the tumor was actually only attached to his nerves and his leg.

It was all going fine until last week.  His appetite has been very normal, and he still gets very excited about eating.

I wouldn't really describe his movement as head bobbing, but I'll look closer at it the next time he's up and about.  We're thinking his other front shoulder is bothering him because he seems to be holding it weird (maybe a bit bowed out, if that makes sense?), but at the same time he doesn't seem to be favoring it or trying to stay off it.  It definitely seems weak and like he doesn't have the kind of control over it he did a couple weeks ago.  We have tile floor so he slips a lot but we don't know if that's from weakness or the tile (we put down carpets but he just avoids them).

Thanks so much for your help everyone!!


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22 November 2017 - 2:26 pm
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It sounds like a soft tissue tumor.  Was a biopsy done?  Unlike bone tumors these are difficult to completely resect especially if the origins were at the nerves. Possibilities include nerve sheath tumor, soft tissue sarcoma, or fibrosarcoma.

It sounds like your dog is exhibiting spinal or other neurologic pain.  I know you do not have access to an MRI but in some cases an xray may show bony lesions.  I would certainly add the gabapentin at 300 mg three times daily and use either an NSAID such as Deramaxx or go straight to prednisone.  Prednisone is better than an NSAID for spinal pain but the two drugs can't be given together.  You can however give gabapentin with either drug and it is okay to continue Tramadol.

Pam

On The Road


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22 November 2017 - 2:35 pm
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Thank you Pam! Great insight as always, you are the BEST!

Meanwhile about ...

We have tile floor so he slips a lot but we don't know if that's from weakness or the tile (we put down carpets but he just avoids them).

That silly dog. Did you try putting the carpets in his usual routes around the house? Also, trimming the fur between his toes can help too.

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

Member Since:
20 September 2017
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23 November 2017 - 5:47 am
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Hi there!  I'm surely not an expert but Giggs behavior sounds a lot like my Mads' recent behavior: 

"Then last week he started acting different.  A lot of his symptoms seem in line with phantom limb, but it just seems so much more extreme than what I've been reading.  He is shivering a lot, he yelps out in pain often when he is getting up or rolling over, but sometimes randomly as well.  He always seems uncomfortable and anxious either refusing to sit or lay down (but not moving) or refusing to get up (but crying).  If he's not always whining for attention he is finding places in the house or yard to be completely removed - neither behavior is anything like him.  We've tried cold/warm packs, and we've got a tight shirt on him for compression (probably not the most effective one though) and we just can't tell if they're helping"

I could have written that description about Maddie.  First we thought phantom limb or some sort of spinal/neck/back pain from tumor or injury.  She was also 6 weeks post op and doing great but went from hippity hoppity all around to barely moving and in a LOT of pain.  This happened virtually overnight and each day was worse. She lost 5 lbs in as many days and we were at our wits end.  Deramaxx made her feel a little better and then WAM incision explosion (that is not an exaggeration!!).  turns out she had a seroma that became infected.  The only indication besides her behavior was her incision was warm and she had a very slight fever.  The doctors didn't catch it, her surgeon didn't catch it - and we specifically ASKED them to check it.  They said it was fine - so this obviously is hard to miss.  Then it burst and almost immediately all the other symptoms vanished and her only problem was bleeding (and obviously infection - but no more horrid pain!).  

I don't know nearly as much as the others on this forum, but given the similarity, maybe it's worth asking the vet to check?  Is the incision warm?   Maddie's was NOT swollen enough that it was noticeable.  I do not think that this is that common so it's not the first thing the vets (or family) may think of.   

Having just been thru what you are going thru, I want to tell you - hang in there.  It's so terrifying and upsetting and frustrating for no one to be able to figure out what's wrong with your baby.  You feel helpless.  If it wasn't for the people on this forum encouraging me and agreeing that her behavior wasn't "right", I think I probably would have had a breakdown or worse, given up.  Best of luck to you and to Giggs.  

Bobbi and Maniac Mads 🙂

Bobbi & Maddie a/k/a ManiacMads

Front leg amputation 10/17/17 due to Osteosarcoma

She's Madeline, She's Madeline

Member Since:
21 November 2017
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24 November 2017 - 3:20 am
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Thank you for all the feedback and encouragement.  Still no improvement, he may even be a little bit worse.  The good news is we were able to find the gabapenten and have started him on it this morning.

I'm getting nervous because he seems to be having a harder time controlling his legs (trying to get up or lay down).  We haven't been able to reach the vet who did the surgery to ask about a biopsy, which I think they performed because it was at a school and they were very excited to have such a large tumor to study.  He said after the surgery that he is very sure it was a one off tumor and he got it all (and despite being in a developing country we've been told by vets from all over the world he's one of the best they know).  Our local vet came by and said his heart beat is irregular, but she doesn't know what could be wrong.  She didn't seem worried about his behavior or symptoms.  She wants to wait a few days to see how things play out.

No matter what happens he is so much happier than when he had the tumor, so we don't doubt our decisions for him up to this point.

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24 November 2017 - 6:33 am
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Good morning,

So sorry to hear that Giggs is having so much trouble. After giving the gaba, don't be surprised if it knocks him out a bit. It may make him very groggy for a bit but I think they get used to it pretty quickly. Huck was out cold after the first dose, third eyelids up and everything. So much of what you describe sounds like pain and discomfort. Have you been able to take his temperature? 99.5F to 102.5F is a good "normal" temperature range. If you see 103 or higher then he has a fever. Sometimes a slightly high side of normal can be due to stress or pain. Rectal temp is the best way to get an accurate reading. 

Is the shirt you have on him too tight? Please make certain that you haven't wrapped him too tightly. Hiding can definitely be a sign of discomfort too. If by chance he had a seroma , too much pressure may be painful and not help his situation. 

If he needs assistance getting up, you can take a large towel, sling it under his abdomen so that you can grab each end from the top of his back, and assist him in getting up. It can be more helpful if you have 2 people to help him up. If he is wobbly you can use it to help steady him while he is walking. This is hard for me to describe here, I found a great video using a reusable shopping bag which would be even more helpful because of the handles. 

I hope the gaba gives him relief, it really is a wonderful medication for post op amputees. I hope this information can help you.

Take care,

Jackie

Hugs,

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

Huckleberry's Blog

Member Since:
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24 November 2017 - 7:40 am
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"After giving the gaba, don't be surprised if it knocks him out a bit."

Thank you!  He's been knocked out all day and I was REALLY hoping it was the gaba and not getting worse!

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24 November 2017 - 7:47 am
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Yes, it can have that effect! I noticed that after several doses Huckleberry could still get sleepy but not totally knocked out. Glad that took some of the worry away smiley

Hugs,

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

Huckleberry's Blog

On The Road


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24 November 2017 - 8:26 am
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We have our paws crossed the gabapentin helps! Remember you can time it so that you give the doses closer to bed time and hopefully that will help him be less groggy in the day. See our article we shared above for pointers.

Also please considering starting a new topic in 'Hopping Around' now that Dr. Pam has answered your question. Thanks.

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

On The Road


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24 November 2017 - 8:28 am
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 I found a great video using a reusable shopping bag which would be even more helpful because of the handles. 

and here is the lovely Codie Rae modeling a Tripawds grocery bag sling.

IMG_0239.jpgImage Enlarger

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

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21 November 2017
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25 November 2017 - 12:33 am
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Hahaha, he's an alpha and very unexcited about the sling support.  He's not ready to admit he can't do it all on his own. laughing

So we've observed these things in the last couple of days, and we're trying to figure out what they might mean.

  • We've noticed he cries in pain when moving his neck in odd ways (which may also explain why he's crying when getting up because he's been using his neck to help with that) Also when laying down on his side he's started just plopping his head down pretty hard which is new.
  • The base of his incision is noticeably warmer than the rest of his body and it seems like there's something somewhat hard or solid underneath, maybe the size of a marble (or a bit bigger).
  • No change in behavior except extra rest because of the Gabapenten.  When it wears off he is anxious again.  We can't tell if he's doing better or not.
  • The vet examined him a day and a half ago and said he had no fever but did notice an irregular heartbeat (leg removed was the one by his heart, and the tumor was up to the rib cage).

tazziedog said
 I know you do not have access to an MRI but in some cases an xray may show bony lesions.  

The X-ray we could get in our town is very very unclear (and fun fact: done at the human clinic because no vets here have that kind of equipment - we get a LOT of looks laughing ).  The only way to get a clear x-ray is to take him back to the big city which is a 6 hour trip (one way).  If it is really important that we do that we can, but would prefer to not put him through that again.  When we x-rayed him pre-surgery we got a very good look at his spinal chord and the vet said everything was clear.  Could they have come this quickly?  He was very confident he got it all.

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25 November 2017 - 8:58 am
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Good morning,

Do you have a regular thermometer that you can take his temp at home? If it is noticeably warmer he may be fighting off infection, may have fluid buildup in there that is festering. Can you have it looked at by somebody there locally? If you can take his temp at home and it is elevating he may need antibiotics. Just a thought.

Jackie

Hugs,

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

Huckleberry's Blog

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