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sciatic nerve damage and rear leg amputation?
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Forum Posts: 11
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11 January 2017 - 3:49 am
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My 10 year old male lurcher Ernie (Pointer/Greyhound) suffered an unknown accident and trauma to his sciatic nerve in the pelvic region in Nov/Dec 2014. This could have involved running free in woodland, possibly crashing into a low branch, I don’t actually know. His hind leg started to waste with (very quick) muscle atrophy which alerted me to the fact that something was wrong. He didn’t seem in any pain and continued to be really active. In Feb 2015 an MRI scan showed nerve damage on one side and muscle wastage but no obvious tumour. He was tested for Lyme’s Disease, this came back negative. He had another MRI scan in June 2015 to look at the progress of the damage and a sciatic nerve biopsy in July. The lab results showed that the axon element of the nerve was damaged and the question came back saying ‘had Ernie had a severe trauma to the sciatic nerve?’. The referral vet has only seen two cases like this, one in the foreleg which improved and recovered after a period of 4-6 months and in a terrier which had a nerve sheath tumour and was PTS. 

The nerve biopsy unfortunately took some of the function of the nerve out and Ernie started to knuckle on his rear foot. In August 2015 Ernie had a spinal operation to remove a slight prolapse, as a last attempt to free-up the potentially pinched sciatic nerve. During surgery the nerve was found to be healthy at that point and not trapped. A biopsy was take at the same time from the spine, showing that the nerve was healthy within the spine and had the ability to regenerate. The knuckling and muscle wastage in the hind leg has deteriorated since this time and despite the vet telling me there the sciatic nerve re-growth is 1mm per month, there has been no significant improvement in 5 months. 

Here we are in Jan 2017, Ernie is booked in for a rear leg amputation next Friday 20/01/17. My main concern is that he seems to have an area of pain near his spine on the side of the damaged nerve and leg. If anyone has any experience of being concerned about existing back pain and the effect of a rear leg amputation I would love you to reply. I’m worried that the spinal pain may get worse if he is weighted onto one rear leg? Lately there have been a few minor changes too:

*his good rear leg was not fully bearing its load for two days 01/01 and 02/01. I rested him and he is back to normal, but this worried me.

*For one walk recently he didn’t knuckle hardly at all. Which could be seen as improvement, but since that walk his knuckling has returned.

* Yesterday he by-passed the weak leg during a walk and it did not even touch the ground, he wasn’t using it.

As you can tell, there are a lot of unknowns above and I’m worried that amputation won’t improve things. On the other hand, he is still a very active dog, and has been on lead walks since August. If you can imagine a lurcher on a lead for almost 5 months, you’ll also know that one of my arms is now longer than the other!

Ernie doesn’t have a nerve sheath tumour, cancer or a known cause of condition. He’s lively and coping with a weak and floppy leg all of the time. Any advice would be greatly appreciated, I’m a new member today. Thank you. 

London, UK


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11 January 2017 - 8:21 am
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Hello, and welcome to you and Ernie!

What a protracted and frustrating ordeal you’ve been through! What shines out of your story is your commitment to Ernie and your determination to find a way to help him. Though I do not have specific knowledge or experience to offer, I definitely do know what it’s like to find yourself trapped on a seemingly endless roller coaster of hope and disappointment, with still no clear answers after all this time. My heart goes out you.

I am really pleased that you have posted here, as there is such a wealth and range of experience here and such a wonderful, helpful community, that I feel certain you will hear from someone with some useful experience to share.

It is great news that Ernie doesn’t have a tumour, but it is obviously extremely frustrating that you still do not know what is causing his problems. Have you sought a second opinion? Perhaps taken him to a teaching hospital? He’s clearly been very thoroughly examined, but I’m just wondering whether another vet might happen to have encountered more cases, as it is clear that this is rare.

I also wondered about seeing a rehab vet. Has he had any physio or acupuncture? I see a rehab vet regularly with my dogs and I find that because she works with dogs over an extended period of time, she sometimes has a different perspective. I would think this might be worth a try.

Is Ernie on any pain meds at the moment, and if so do they make a difference to how he uses the leg and to the knuckling?

I’m also struck by the recent walk where Ernie hardly knuckled at all. Does this show potential for improvement, even though he then regressed again? Obviously, you will have asked yourself the same thing.

I’m sure others will chime in soon so stay tuned. And I hope with all my heart that you get some answers soon.

Sending every positive wish to you and Ernie,

Meg, Clare ane Elsie Pie xxx

Meg, Mutt, aged around 10, adopted 31/12/2009. Sudden explosive right elbow fracture 06/12 (caused by IOHC), diagnosed with End Stage Arthritis 03/15, Total Elbow Replacement 08/15, problems with healing leading to skin graft & skin flap surgery, Chronic Infection leading to implant breakdown. Became a Tripawd 9th March 2016. 
Lives with Mum, Clare, watched over by Angel Pie and Angel Billie
My life as a MEG-A-STAR 


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11 January 2017 - 11:10 am
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Hi Ernie and family, welcome! I’m sorry you find yourself here but we’re glad you decided to share his story and ask questions. And I’m SUPER glad Meg & Clare have already replied to your post, because if anyone knows about situations like this (not necessarily the same diagnosis), she does. She’s already given you great ideas, I’ll just share a few of my own:

Ernie sounds like he’s already a Tripawd. That happens more often than not, and typically makes it easier during recovery when the dog is already used to being on three legs. 

It sounds like he’s getting terrific care from specialists. I assume he’s been evaluated by an orthopedic vet who approved the amputation surgery? I agree that a second or even third opinion (from a neurologist, if possible), would be invaluable, if you haven’t gone that route. Even if they all agree amputation is best, at least you’ll know you can feel good about doing your research.

Meanwhile, we’ve had many members with existing issues, like mild arthritis, go through amputation and do fine afterward. Rehab therapy makes a huge difference in their ability to remain limber and feel good, so that may be in Ernie’s future. You seem like a super smart, conscientious pet parent who will give him all the attention and medical care he requires to be happy, that’s terrific.

Just curious, but where are you located? Meg and Clare (and Elsie Pie!) are also in the UK and we have a few other members there.

It's better to hop on three legs than to limp on four.™
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11 January 2017 - 2:04 pm
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Hi Meg, Clare and EP,

Thanks for your kind words today. Ernie is on medication, Gabapetin and Tramadol and was previously on a high dose of Prednisone (which had no effects on his symptoms). I’ve just left the vet referral and we are agreed to amputate the hind leg, despite the walk where he showed no knuckling, his foot is so swollen and the skin very sore. The muscle wasted leg frequently gets caught behind his other leg and he falls, so I’m hoping that he will regain some mobility for as long as he can. I am still nervous for him and Ernie is a difficult recovery patient. 

The vet did some extensive academic searches for neurological conditions to match, but there just aren’t any. On the up-side, the vet will remove the sciatic nerve and send larger chunks away for lab tests; he’s hoping to find a prognosis in this way.

I’m sure I’ll be back after next Friday, after the operation. Wish us luck!

Thanks again, very much appreciated, Vicky. 

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11 January 2017 - 2:28 pm
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Hi Jerry,

Thanks for getting in touch. I’ve had Ernie since he was 6 weeks old. He’s was an orphaned pup and hand-reared, so a real softy. 

I’m interested in the after care and may need more advice at that point. I feel much better to know that some Tripawds have other conditions too.

He’s been having hydrotherapy to try and rebuild muscle, which he loves a lot. Yes, the vet is an orthopaedic vet and a neurologist laboratory have been involved twice with phone calls after the each biopsy. His condition is still undiagnosed and rare. Hopefully the biopsy of the sciatic nerve after amputation will show some conclusive results. 

I’m in Nottingham, UK. If you know of anyone in the Midlands that would be a great help. 

Many thanks for your support,

Vicky

London, UK


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11 January 2017 - 3:09 pm
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Well I’m sure it will be a relief for Ernie to be rid of that swollen, painful foot, and not to be carrying a useless leg around. I hope you feel some sense of relief yourself at having come to a decision. I know it’s uncertain and you are bound to be nervous but in the circumstances whatever you do has to be a judgement call based on the evidence you have. 

In terms of Ernie’s back pain, it seems a reasonable possibility that this is being caused by his altered gait from carrying the weak leg around and, if so, the amputation may help that as well. Meg, who is a front amp, sometimes gets areas of tenderness and knotting at the bottom of her spine and in particular on the same side as the amp. We find laser and acupuncture, when needed, very effective and of course core strengthening exercises do a great deal to help.

If it is a distinct issue with his spine, perhaps a touch of arthritis or something like that then, as Jerry says, we have lots of dogs here with pre-exisiting conditions who are coping just fine post amp. Meg is one herself in fact. We were told amputation wasn’t possible for her as she has dysplasia in her remaining elbow, together with moderate arthritis and also IOHC. Ten months post amp she is doing fantastically well. Chasing squirrels and rabbits, swimming and generally everything she enjoys. For us, the amputation was the end of a desperate and protracted attempt to save the leg (because of the issues I mentioned). We did it in the end because there was nothing left to try and I was very worried about how she would manage and what sort of life she’d be able to lead. Ten months later, I look back on that day with a huge sense of relief. For us, that was the start of everything getting better. I so, so hope that it will be the same for you and Ernie.

Do stay connected to this site as you prepare for Ernie’s surgery and throughout his recovery. There is so much experience here and such a tremendous body of support. It’s been an absolute life-saver for us. 

I’m based between London and Norfolk and there are a few UK/European members. At some point we will have to arrange a Tripawd get-together. Maybe in the Spring. Ernie will be back galloping by then, I’ll bet.

All best to you both,

Meg, Clare and Elsie Pie xxx

Meg, Mutt, aged around 10, adopted 31/12/2009. Sudden explosive right elbow fracture 06/12 (caused by IOHC), diagnosed with End Stage Arthritis 03/15, Total Elbow Replacement 08/15, problems with healing leading to skin graft & skin flap surgery, Chronic Infection leading to implant breakdown. Became a Tripawd 9th March 2016. 
Lives with Mum, Clare, watched over by Angel Pie and Angel Billie
My life as a MEG-A-STAR 


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11 January 2017 - 5:11 pm
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Can’t speak to your specific circumstances – my Otis lost a front leg to cancer.  But he did just fine on 3, even though he had mild arthritis in his hips.  Much shorter walks, but everything else was absolutely the same!

Otis - 106 pound lab/Dane mix, lost his right front leg to osteosarcoma on Febuary 9, 2016.  Four rounds of carboplatin completed in April, 2016.  Lung mets August 25, 2016.  Said goodbye too soon on September 4, 2016.   Lost his adopted sister, Tess, suddenly on October 9, 2016. likely due to hemangiosarcoma.  

Wherever they are, they are together.

Virginia




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11 January 2017 - 7:05 pm
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Ernie is STUNNINGLY HANDSOME!! I know your bond is very special on so many levels, but especially when it starts with hand feeding his as a puppy! 🙂

I also have no insight into Ernie’s specific, very unique, situation.

I just want to say weecome and to let you know we are here to support you in anyway we can.
Maybe you can tell us more about how Ernie is a “difficult recovery patient” and we can offer some tips along those lines.

Stay connected and update when you can. We are here for you no matter what!

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!

Vacaville, California


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11 January 2017 - 9:35 pm
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My what a gorgeous dog!!!  this group is a great source of information, support, and love!!

as to worrying about how your baby will do on three legs…… my dog Sessy is an 11 yr old greyhound who had her back leg amputated 1/2/17.  I worried a lot about how she would do as a tripawd.  She was a senior, her legs were long, her good back leg quivered, and a 100 other things.

She is doing great!!! I think the quivering in the good leg was caused by supporting all that dead weight from the bad leg.  She was pretty lazy the first few days, but still managed to go out 3 times a day.  ( of course she’s still on pain meds)  Today she finally ran down the hall to go for a walk. I do limit her walk because she tends to think she can go farther than she should…….then walk back slow because she overdid.

Im not sure if this applies to Ernie since he is only part greyhound…..but just in case, greyhounds blood dont always clot like other dogs…… so there could be additional bleeding.  I had to get aminocaproic acid to give her before surgery, and several days after.  Not all animal hospitals have this, so it needed to be ordered before.

GOOD LUCK…….Good thoughts and prayers coming to you from California.

Sessy’s mom Gayle

Gayle - mom of beautiful greyhound Sessy.  Sessy diagnosed with osteosarcoma on 12/26/16, left back leg amputated on 1/2/17.  Feline siblings Mooshe, Tinkerdude, Odie and Bean

Virginia




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11 January 2017 - 9:53 pm
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Gayle, good advice for the Greys, or Grey mixes, going into surgery! Glad Sessy is doing well!!

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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15 January 2017 - 5:58 am
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Wow, so many replies, thank you. This really is the place to be for support. He is a handsome lad thanks, but I’m biased obviously. He’s also a bit of a comedian and a food rustler! 

Today Ernie’s foot is very, very swollen, so I’m limiting his walks. However, I also have a smooth-haired Saluki (age 6) who is a speed maniac and is feeling a bit under-exercised I think! It’s tricky to manage the two ends of the scale, but I have found some fallow fields for Pharaoh to stretch his legs. 

Ernie had a spinal operation last year and was hospitalised. However, due to his howling and restlessness the vet asked me to collect him early. He was in serious distress, panting, disorientated and not sleeping. I phoned an out of hours vet who told me Valerian tincture would help on top of his pain meds. He did calm down eventually, with constant stroking and hugs but Ernie’s threshold to pain is pretty minimal, which is why I said he was a ‘difficult patient’. As the vet is going to completely remove the sciatic nerve on the damaged side, the original source of the pain will be gone, so the new pain will be the surgery site, which I’m hoping will subside. 

I’ve got 10 days off work afterwards, does anyone think I’ll need more? 

Gayle, thanks for letting me know about the bleeding issues with greyhounds, the vet hasn’t mentioned it, but did say he needed to make swift work of the amputation due to minimise blood loss. 

I’ll keep updating his progress. Thanks again. Extremely glad to have found the forum.

All the best to you and your dogs, Vicky (the rainy UK). 

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15 January 2017 - 6:01 am
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Meg, the vet has ruled out arthritis in his spine. Like you say, he often gets the weak leg trapped behind the other so I think he must have tweaked or pulled a muscle from the awkwardness of his gait.

Thanks, Vicky. 

Minneapolis, MN
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15 January 2017 - 1:33 pm
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Hello and welcome to you and handsome Ernie.  So glad you found us.

My boy was also a Lurcher – a sled dog cross Lurcher.  Likely Malamute with some Saluki or Grey in the mix.  He had a long misdiagnosed nerve sheath tumor in the brachial plexus and therefore was intermittently lame or completely none weight bearing for about a year before someone finally attributed the muscle wastage to a nerve issue and likely STS.  He had his front left leg amputated shortly after and did brilliantly as a Tripawd immediately.  The relief of not having to drag around that leg and the relief from the pain was an incredible lift for him.  

Unfortunately, because the diagnosis had been missed for so long and attributed to other red herrings, his cancer was very advanced and we had just 6 months before it took him from us.  But amputation was absolutely the right choice for him and for us.  I only wish it had been done much sooner.  He only took pain meds in the weeks before and after surgery and then again in the final weeks with return of cancer – he was weaned completely off the Gabapentin and Tramadol and Rimadyl within a month of surgery and he roamed and romped in the dog park and lake and in our yard and home with no issues.  He had a happy 6 months.

I am no expert on the nerve damage your Lurcher is dealing with, but it surely seems like you have given the healing and regeneration approach a good, long try.  Yes, there are unique concerns with him becoming a Tripawd – risks with the remaining limb as he won’t have “a spare” any longer.  It will, I think, have to be about quality of life.  Where is his quality of life right now?  Do you think, even with some risk attendant with becoming a Tripawd that his quality of life will be improved if the source of pain is removed and a leg that is troublesome is out of his way?

I know your path is less clear than ours was and I don’t envy that.  There is more to making this decision for you.  Wishing you and Ernie the best.

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His Daddy and I miss him terribly along with his canine sister, Mia, and two feline siblings, Lucia and Cliff.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation

London, UK


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16 January 2017 - 12:00 am
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I’ve got 10 days off work afterwards, does anyone think I’ll need more? 

Every recovery is different, of course, but I would think that would be fine.  A lot of people have to go back earlier. Would there be someone able to check on him at all during the day? It is likely Ernie will come home on Metacam (or another NSAI), Tramadol and Gabapentin. Times and dosages may need a bit of adjustment but it should be possible to manage any discomfort. My hunch is that, given that Ernie has been effectively a Tripawd for some time, he will adjust to three legs quite easily. And you may well find that with the source of pain gone, you see a rapid improvement. Meg was also very unsettled the first time she was in hospital for her total elbow replacement. I was also asked to pick her up earlier than planned. When she had to go back for further surgery, she was much more settled though, so you may find Ernie reacts quite differently this time. I do hope so. We will have everything crossed for you on Friday.

Meg, Clare and Elsie Pie xxx

Meg, Mutt, aged around 10, adopted 31/12/2009. Sudden explosive right elbow fracture 06/12 (caused by IOHC), diagnosed with End Stage Arthritis 03/15, Total Elbow Replacement 08/15, problems with healing leading to skin graft & skin flap surgery, Chronic Infection leading to implant breakdown. Became a Tripawd 9th March 2016. 
Lives with Mum, Clare, watched over by Angel Pie and Angel Billie
My life as a MEG-A-STAR 


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16 January 2017 - 4:17 am
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I think I took 5 days off, with a weekend in between, and it was fine.  And as Clare notes, many people have no choice but to go back earlier.

Otis - 106 pound lab/Dane mix, lost his right front leg to osteosarcoma on Febuary 9, 2016.  Four rounds of carboplatin completed in April, 2016.  Lung mets August 25, 2016.  Said goodbye too soon on September 4, 2016.   Lost his adopted sister, Tess, suddenly on October 9, 2016. likely due to hemangiosarcoma.  

Wherever they are, they are together.

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