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Caring for a Three Legged Dog or Cat

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Need advice for surgery vs amputation
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Member Since:
28 April 2019
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28 April 2019 - 8:05 pm
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Edit: This may be posted in the wrong section :\

Two years ago, I adopted Astrid, a 7 year old (now 9) German Shepard Husky mix who is (I'm sure everyone says this) just the best dog ever. From the moment I got her, I was aware that she had hip dysplasia, and this would require some sort of action to rectify (though I was glad when the vet discovered only her rear left leg was affected). I called a surgeon and inquired about performing the femoral head ostectomy. There was just one problem: Astrid was massively obese, weighing 110 lbs, and the surgeon informed me that she would have to lose some significant weight before they'd perform the procedure (not to mention the benefit less weight would have on the leg and her overall health). I set to work seeking to lower her weight, improve her health, and set aside money for her surgery, and in the meantime we provided cosequin as a supplement, and galliprant for the pain. Two years of dieting, exercising, playing and love later, Astrid weighs 62 lbs and her body condition has been scored as "ideal" by her vet and is considered very healthy for her age. YAY! I'd contacted the surgeon once more about the surgery when something happened last Saturday night (04/20/19). I noticed she was limping pretty bad in the early evening (she always had a slight limp, worse some days, but not quite like this) and by nights end, she was holding it up and putting no weight on it. Fortunately, she had a vet appointment on Monday and I figured they would be able to help me out. It was at the appointment they discovered that she had torn her acl in the same leg as the dysplasia (she was immediately put on galliprant for the pain, and even then, she was holding her leg up non-stop). Their advice was to contact a surgeon about performing a cruciate ligament repair to deal with the knee, then schedule a FHO a couple months down the road. As I investigated this, a couple worries started appearing to me. I was looking at longer (now multiple) recovery times, one for each surgery. I worried about future pain issues with the leg, such as arthritis, and this meant delaying her much needed hip surgery even more. And, as much as I really hate saying this, it was incredibly expensive. Truthfully, I'd probably give my last dollar for Astrid, I'd been planning and saving for her FHO from the beginning, but because of some major family problems and expenses over the last few months, I'm very worried this is not financially viable right now...yet this is not something I want to wait around on.

I investigated amputation. In the week since the injury, Astrid (still on medication) has been incredibly active, running around the yard as she always does, but she's running entirely on three legs, the rear leg always held off the ground. Seeing one leg completely useless was an obvious display that she didn't need that leg to be happy or to play with her dog friends. I work with native and exotic animals in an AZA accredited facility, so I have seen first hand on several occasions, animal welfare improve after the removal of a limb by vet staff. To me, I see several positive aspects here: one, it's a surgery that has one recovery period that's relatively short. Two, Astrid is already moving well on three legs and this could resolve the pain very quickly. And yes, three, it's a more financially sound option.

Am I wrong for considering amputation for these treatable issues? I want to ignore the financial side of it when making this decision; I'm a big believer in trying to care for your pet by any means necessary, but I also have to be realistic about my situation. The truth is I do feel really guilty and it's making me hesitate. Above all else, I want to solve these issues in a manner that eliminates Astrid's pain and allows her maximum mobility, but I feel wrong not taking the route suggested by her vet (and she does have a great vet). Do I bite the bullet and take the longer surgery route to fix the ligament then the hip down the road? Or do I pursue an amputation to try and alleviate the pain in one go? 

From the tone of the post (rather long, I'm sorry), you can tell I'm leaning a bit more towards one option, but I'm struggling here, guys. I'd love some advice, tips, encouragement that I'm going in the right direction, or even someone to tell me that this is stupid and I should get the freaking surgeries (though looking at the boards, you all seem like great, supportive folks). Astrid means the world to me; in the last two years, she has seen me through the toughest months of my life and I will inevitably do whatever I need to for her. Thank you in advance to any feedback!

On The Road


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28 April 2019 - 8:21 pm
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Hi Astrid's Pack, welcome. Your future posts won't require approval so post away. Although she has hip dysplasia, it sounds like your keeping her weight in check (good job!) has helped improve her quality of life sooo much! 

I'd like to summarize your post if that's OK, so our Fairy Vet Mother Dr. Pam can get a quick scoop on what I think it is you're asking. Correct me if I'm wrong but it seems that what you want to know is:

Is it wrong to consider amputation if Astrid's mobility problems can be fixed with two separate surgeries, a cruciate repair surgery and a FHO? 

Do I bite the bullet and take the longer surgery route to fix the ligament then the hip down the road? Or do I pursue an amputation to try and alleviate the pain in one go? 

You are such a great parent for asking these tough questions! And please remember there is nothing wrong to factor money into this equation. It does matter, and Astrid doesn't want you stressing out over vet bills that will be difficult to pay off. She is so lucky to have you. 

I'm going to let Dr. Pam take it from here so that she can give you her perspective. For now I just want to say that there's no way you can make a wrong decision for Astrid, since you are doing all your research and making a very educated, loving decision for her. 

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

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28 April 2019 - 8:25 pm
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Thank you jerry!

Yes that's a great summary (I admire your skills narrowing my small novel down to a single question!). 


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29 April 2019 - 8:21 am
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Has she been doing well with her hips since she lost weight? If so she may not even need hip surgery anymore.  It doesn't necessarily matter what the hip xrays look like; I have had two large dogs with hip dysplasia that never needed surgery for the hip and my pitbull Kona who weighed about 70 pounds had knee surgery on both rear legs and recovered fine both times.  Can you post her most recent xrays?

Pam

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29 April 2019 - 9:19 am
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She has been doing better with less weight, but the hips are still an issue. When I got her, she pretty much laid around all day, now she does run and play, but with a slight limp (before the ligament tear). She's always struggled and whined when laying down or getting up or if she bumps into something, and you can tell it's really sore in the evenings (even on galliprant). She also naturally sits with her right leg under her to keep that left leg from bearing weight. It's always been immediately obvious just looking at her that she has some leg and mobility issues.

Unfortunately, I don't have the x-rays; I'm trying to get my vet office to send them over (I think the doctor is actually out of town).

On The Road


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29 April 2019 - 9:46 am
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twaser said
Unfortunately, I don't have the x-rays; I'm trying to get my vet office to send them over (I think the doctor is actually out of town). 

Let us know if you'd like help adding images to the Forums OK?

Thank you so much for your insight Pam!

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

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30 April 2019 - 3:56 pm
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I'm kind of at a loss now. I visited a different vet today (mine is currently unavailable) to get more ideas on what treatment to pursue; they were not as helpful as I had hoped. Again, they suggested repairing the ligament now, and performing the FHO a few months down the road. I explained that first, I have no way of paying for that (going through a divorce and living with my parents atm), but I was also concerned with the recovery. We are looking at months of recovery and I'm gone for work up to 15 hours some days (my parents keep an eye on her, but during recovery would be a lot to ask). When I asked them about the possibility of an amputation, they told me it was an option, but they wouldn't recommend one since the leg can be fixed surgically, and they worried about future soreness in the other legs that would have to compensate. Their other option was to just treat with medication and wait for now until we might be able to do surgery, keeping her activity lowered. Being part husky, you can imagine that she's an active dog; I worry about further injury...not to mention she is still in some significant pain even on medication. I can't really imagine waiting on this.

On the way home (complete emotional wreck), I hate to admit I had to finally consider the option of euthanasia. I'm just horrified and angry at the idea; I think it's completely stupid since she is such a great dog and otherwise in good health, but she's in considerable pain, and it's affecting her ability to run, jump, play, and just be Astrid. I will of course avoid this option at all costs, but I need to figure something out that alleviates that pain.

Maybe I'm being unreasonable, but I'm still really favoring the amputation. I understand maybe it will make her other legs sore as she gets older, but she's in pain right now. She's also already only operating on three legs so we don't do anything to help by waiting (soreness will happen either way, why suffer with the bad leg).

I apologize for another long winded post; I'm worked up to say the least. I'm not sure what anyone can offer in the way of advice, but am I pursuing the correct course?

Virginia







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30 April 2019 - 6:50 pm
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So sorry you are on such an emotional  roller coaster.  I know uou are agonizing over what to do for Astrid.  You are NOT being long winded at all!  You are processing "out loud' and that is a healthy  thing to do!

Obviously  I'm not a Vet and  not giving Vet advice.  While we wait for our Dr Pam to chime in, the only thing I will add is, sometimes  when there are no clear answers, you just have to go with your gut...your inner voice.  You know uour dog.  You know your personal  finances.  You know your personal  circumstances.

This stood out to to me,  

twaser said

Maybe I'm being unreasonable, but I'm still really favoring the amputation. I understand maybe it will make her other legs sore as she gets older, but she's in pain right now. She's also already only operating on three legs so we don't do anything to help by waiting (soreness will happen either way, why suffer with the bad leg).

  

((((((((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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1 May 2019 - 8:26 am
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I would have to see the xrays to see how bad her hips are in order to determine how she might do on 3 legs.  If her hip dysplasia is severe then she might not be a good candidate for amputation since that other leg will bear more weight. Even though she is doing okay on three legs now it does make a difference when you completely remove the leg.

Is she on gabapentin?  Adequan? NSAID?  Many times ACL injuries can even heal without surgery (although she will get more arthritis in her stifle); if you control the pain it becomes more of an instability issue until the body can make scar tissue which takes about 12 weeks. 

Pam

On The Road


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1 May 2019 - 9:38 am
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Thanks as always for your wisdom Pam. It makes total sense.

twaser, good for you for getting another opinion. I'm sorry that they didn't have any easy answers for you. This is a tough situation.

I totally agree with Dr. Pam's thoughts about controlling the pain. Our Jerry had an ACL injury and we managed the pain and limited his activity while it healed without surgery. It can be done.

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

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1 May 2019 - 3:48 pm
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Thank you all so much for the support and thank you Dr. Pam for the help! She is currently on both gabapentin (2 x 100mg tablets every 12 hours) and galliprant (1 x 100mg tablet every 24 hours). We got new xrays today and I will upload those as soon as the vet sends them over. The left leg is pretty nasty with the dysplasia (looks like even a bit of possible fusing); the right leg is showing some light signs of wear though looks far better for the time being (and again, I will upload these as soon as I'm able!).

Today was SO much better. I found an AMAZING vet...well worth the 3 hour drive round trip to go see her. Within literally three minutes of meeting Astrid, she discovered something that none of the other vets had: due to her chronic limp, Astrid has very little muscle in her left leg. Because the Femoral Head Ostectomy relies on muscle to function, she told me she didn't think an FHO was even possible for that limb (this is a huge discovery for me since we've planned for this for 2 years). She advised that, since the hip was a minor source of discomfort, we should forgo dealing with it for now and focus our efforts on the ligament that's clearly causing severe pain. With this discovery, she was the first vet to seriously consider the possibility of an amputation; it was of course not her first choice as she felt it was a bit of a gamble, but at least reassured me it was far from an unreasonable thing to investigate. Her worry is that the xray did show some light signs of dysplasia in the right hip, and that on three legs, this could be more problematic down the road (she couldn't tell if the hip would go bad in 5 months or 5 years). She recommended some different strategies to combat the pain and hopefully strengthen the leg, some different types of medications that could alleviate pain, products that could improve mobility and therapeutic techniques to employ (she was incredibly sympathetic and understanding of my financial and living situation). She said the goal of these treatments was two fold; try to reduce pain and improve her mobility from the left leg, but also increase muscle mass in her (pretty) good right leg. This way if we did perform an amputation or ligament repair, she would stand a better chance of recovering.

The (horrible) journey is not over, but this was a huge boost to morale. I'm able to accept the reality that, while this is not a fixable problem, its one we can improve on enough to hopefully provide Astrid with a few more quality years!

Virginia







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1 May 2019 - 8:40 pm
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Again, not a Vet and Dr Pam can give her professional advice. 

I can say this though, I can "hear" the relief in your voice  and "" feel " the hope in your emotions!  I am soooo glad you were able to get  Astrid in for this Vet.  She looked at Astrid with fresh eyes and clearly did a thorough assessment.    It really sounds like she hsd a reasonable  an,d well thought out plan for a path forward.

(((((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!

On The Road


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2 May 2019 - 8:51 am
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Wow sounds like you are on the right path! What a great vet it sounds like. Thank you for sharing, your relief definitely comes through! Feel free to give a shout out to her in our Veterinary / Specialists Referral Forum topic.

 She recommended some different strategies to combat the pain and hopefully strengthen the leg, some different types of medications that could alleviate pain, products that could improve mobility and therapeutic techniques to employ (she was incredibly sympathetic and understanding of my financial and living situation). She said the goal of these treatments was two fold; try to reduce pain and improve her mobility from the left leg, but also increase muscle mass in her (pretty) good right leg. This way if we did perform an amputation or ligament repair, she would stand a better chance of recovering.

Please feel free to start a new topic in Hopping Around if you'd like, we would love to hear more about her recommendations there.

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

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