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Caring for a Three Legged Dog or Cat

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Old femur break causing luxating patella and limp/pain
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Member Since:
26 June 2022
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6 June 2023 - 4:27 am
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Hey Y'all! I have a possible soon-to-be tripawd, and I guess I am just looking for any tips and advice as well as validation that we are pursuing the best choice. A year ago we adopted a guesstimated 3ish-year-old (now 4?) 80-90lb Malamute mix. The shelter told us that she had a bit of a limp in a rear leg that would only show up after a rough play session or running around a bunch but that it would go away soon after. They also said that she was super lazy and a total couch potato. They had taken her to their small-town vet who ran x-rays and found that she had a leg break that never healed properly and that it wasn't fixable, so they just left it at that. This worked out perfectly for us as we were looking for a more mellow and laid-backed dog and a disabled dog was a non-issue for us. We got her home and within a few weeks started noticing a small limp when out for our daily mile walk, and it started to progressively get worse. We took her into our vet and they reccomended we take her to an orthopedic specialist and gave us some pain meds to try out as well as some anti anxiety meds for her leash/dog reactivity.

The ortho vet was a few weeks later and we were starting to see more issues pop up during this time that pointed to her being in pain. Ortho vet took new xrays and started talking to us about the situation which is that her femur was badly broken and never set/healed properly so it is twisted, which is causing a luxating patella. They said they could do surgery but that there was a chance that one surgery wouldn't be enough and that even if everything goes perfectly the first time, she will still have about 8/10 range of mobility bc her leg is irreparably shorter than her other legs due to the accident. I asked about amputation and the ortho vet basically brushed it off with wanting to due the surgery. He quoted us $8500 to do the surgery which is not something we can at all afford especially if it's not something that we know 100% will fix the issue and stop her pain. I also have concerns about the recovery because from what I have seen online, this surgery will need months of my dog being immobile and with my dogs claustrophobia issues, it just feels more detrimental to do the surgery. The vet tech we spoke with afterwards before leaving agreed with us that amputation was absolutely an option and a valid choice in permanently taking her pain and symptoms away if we didn't want to go through with the surgery due to cost and quality of life reasons.

We went back to our vet to update on what was going on and asked about amputation and our vet seemed hesitant as our pup was still using the leg just with a limp. They asked their large dog surgeon for a second opinion and the surgeon mentioned they wouldn't feel right removing a still somewhat functional limb, so we went ahead and started her on pain meds. We have had her on Tramadol and Gabapentin to help with her with her pain however her limp has been getting much worse in the year we have had her as well as her pain symptoms.

I jokingly say that she isnt a real dog(not a real joke, this whole thing has been so literally depressing), because she sleeps all day and doesn't do anything that most dogs do in terms of play and general foolery like every dog ive had before. It is so hard to try and get her up from her bed, we typically have to spend a few minutes waking her up and bribing her with high value treats to get up and once we are able to get her out the door she now stops frequently and will refuse to move. She hardly ever plays, and almost never has zoomies anymore. She also has some incontinence issues that has been getting worse despite potty breaks fairly frequently ( every 4 hours) and her being on meds for the incontinence. I would take her out more often but I have so much trouble trying to get her up and out of the house with me because of her leg and she hates every second of not being in bed.

I know her pain meds cause her to have drowsiness but even lowering her dosage does not help and makes her limp worse. She has started to lay down on our walks, and the only walks we have been going on for the last 8 months have been quick 5-10 minute potty breaks on leash in our complex. There have also been two periods in the last few months where her limp had gotten so bad she was effectively not using the leg at all and just hopping with it off the ground. Those periods lasted 2-3 week s before getting "better" back to her normal bad limp. When she stands, she mostly lifts it off the ground and usually onnly barely uses it for balance when standing.

I have become so complacent with her being in pain that I just forget how pain free abled dogs are. This is our normal. I just want her to be pain free and I feel that amputating the limb is the best option in improving her quality of life. But I feel that our vet is pushing back on going with amputation and I just dont understand why.

She is (assumed) to be a younger dog and has so many years ahead of her. I feel that putting her through a grueling surgery recovery which at best will leave her with less than 100% mobility (and at worst the surgery fails and we have to shell out another 8k that we dont even remotely have) or we can just leave her on pain meds for her whole life that dont seem to be helping and causing her incontinence.

At this point we are just hoping that with how much and how quickly her leg has gotten worse that they actually agree that amputation is a viable option. My spouse has been wanting to take her in for months because of her limp getting worse and I keep pushing us to wait longer because I just know they aren't going to agree with amputation because she hasnt progressed far enough and we cant afford the $200 every few months just for them to say that we need to stick with her pain meds for now. Its just so hard though on everyone under our roof, and especially for her.

Money isn't the only thing driving this decision. If we knew 100% that doing surgery to save the leg would work in actually saving the limb and wont cause her any pain or mobility issues, than we would do it no problem regardless of cost. Its just the answer we were given is that even if everything goes perfect, she will still have mobility issues. And if it doesn't go well, that's more recovery/pain and still a possibility of needing to amputate later down the line.

Am I right that amputation is the better way to go? Or am I just poorly imformed and we should just continue her pain meds? Does anyone have recommendations or tips on how to better advocate for her?

We love our vet and its hard to get into other clinics in the area not to mention this being the best one. Im just feeling so helpless and all the pushback from our vet has me feeling like maybe we are wrong to want to amputate.

TLDR : My dog has a luxating patella due to twisted femur injury from some time ago that didnt heal properly and surgery to fix it is too expensive monetarily and quality of life during recovery wise. Her limp and symptoms have gotten significantly worse in the year we have had her and our vet wants to only do pain meds as they feel she still uses the limb some and dont want to amputate a viable limb. We want to go through with amputatioin as it is the more cost effective and a more sure way to make her pain and symptoms stop.

Thank you in advance for any advice or recommendations y'all have and just for reading this far. Your time and experience is greatly appreciated!

The Rainbow Bridge



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6 June 2023 - 10:39 am
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Hi and welcome! Your future posts won't need to wait for approval so post away.

I'm sorry you are dealing with this situation, and getting so much pushback on what is a viable option to help a dog be pain-free, and not bankrupt you in the process. We are not "pro amputation" by an means, and always advocate to do what is possible to save the dog's leg before jumping to amputation. But in cases where pain is involved (and those are pain signals she is giving, the lethargy, incontinence, the sitting down, limping, etc.), it's so important to get the facts and act as quickly as you can while giving the dog every chance to keep their leg. It's a fine line as you know.

We may be facing the same thing with our Nellie, who has a wonky 4th leg. So far we've gotten 3 different opinions on what to do, and tomorrow the vets at Colorado State will be the tie breaker because they are the world-class experts on the subject. We will do what it takes to keep her leg, within the confines of our financial limitations and her overall quality of life now and as she ages. And whatever we decide is not going to be the best decision for someone else, every case is different.

The fact is, any orthopedic vet surgeon wants to do anything possible to save a leg. They do surgery, they live for seeing dogs rebound from it and they do not like amputation at all. In fact one really awesome vet, Dr. Marcelin-Little, introduced himself to me by saying "Amputation is my enemy!" in a half-joking way. I get that, totally. So it's no surprise the vet you saw still wants to do the surgery.

As for your vet not wanting to amputate, I can also see their side of the story. A functional leg is a functional leg. But my concern is her pain and that it is not adequately being addressed now or in the future by the vet. My guess is that this is an unusual case they haven't seen much of before now, and aren't sure what to do. Sure, they might be the best general practice clinic around, but this is a time when you want specialty care practice to guide you through these decisions. Specialists see a lot of unusual cases, and provide more detailed guidance.

SO here's my suggestion: Have you taken her to a canine rehabilitation therapist? A "CCRT" or "CCRP" who is also a vet will see things from an entirely new perspective than a general practice or specialist vet. That is the move i would make next, to get another take on this. If you'd like help finding a practitioner, just DM me your location and I'll help.

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10 June 2023 - 12:06 am
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Thank you so much for your response. It is very relieving and validating to hear your take on it. We just took her in to see a different vet in our usual clinic who also agrees that her leg has progressed to a point where amputation would be a good option to more or less permanently fix her pain and mobility issues. They had to refer us to the in-clinic surgeon again for a consultation to see if they were now willing to go through with amputation since they previously didn't feel comfortable doing so 6ish months ago. That consult is in a few days and we are really hoping that the surgeon agrees that it's necessary now because seeing our pup struggle and suffering as much as she is is so mentally taxing. We want so badly for her to have a chance at being a happy and healthy dog.

At our visit, we did ask about our pups current weight because when they weighed her it was at 106lbs, which I think 6ish months ago it was 93lbs. They wanted to put her on a diet to try and get her back down to 80-85lbs so she will be at a good tripawd weight. (Her body condition score I think is about a 6-6.5/10 at the moment, and 80-85lbs was kind of the perfect weight for her) We are switching her to a low cal dog food and limiting her various treats and goodies to help get her back to a good weight. So, that's kind of our main focus at the moment and just trying to figure out the best way to "bribe" her to go outside for potty breaks which has been a major struggle because of her leg, even with treats. They also added Galliprant which seems to be helping her pain a lot. She has started playing with her toys a bit more and I even caught her drag a detached part of our AC to her bed to destroy! This is so out of character for her in the past few months, so I was actually kinda excited to see that she had actively picked it up and brought it to her bed, and also very happy that I heard it happening so I could run in and switch it out with a chew toy, because if I hadn't been there it would've really sucked LOL

We called one of the vet teaching hospitals in our state to get an estimate on the cost of a rear limb amputation which was $4500-6900 with Oregon State University for a 80-90lb dog.(Just in case someone in the future is looking for pricing estimate info). Depending on how much our vet gives us in terms of an estimate, we may need to be referred to a teaching hospital instead. There are a couple of other teaching hospitals that would be a bit more of a trip, but if they are even a couple thousand less in cost, then we will likely just make the longer trip to try to save some extra money. 

I had been researching rehabs in our area for when we finally need to go through with amputation and just hadn't thought that seeing them beforehand could be a good idea to get their advice. We are definitely going to set up a consult with our local rehab specialist if our vet is still unwilling to go through with amputation just to get a different opinion like you suggested. Thank you so much for your recommendations and I really hope Nellies appointment went okay and that CSU was able to help y'all in making your decision!

Virginia







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10 June 2023 - 10:14 am
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Oh gosh!  You and your pup have veen through soooo mich.  And CLEARLY your sweet girl is in pain and it appears to be increasing. If a dog is limping, she's in pain!  They will. ise that painful leg out of necessity  and stoicism...until they cant.  .And all the other ways she is showing you she's hurting magnify  that she is in pain. 

I'm glad the Galliprant  has helped a little, but overall she  is showing you she hurts.  What other pain meds is she on?

As Jerry said, it's not that we are "pro-amp" if other reasonable options  are are available  AND practical.. 

The amputation  is ONE surgery guaranteed to remove the pain.  Recovery  is about  two weeks with good pain managemen, rest (lots of it) and short  potty breaks. 

As you've already seen here from research,  dogs adapt  amazingly  well to three and usually  quite quick too. 

If you jave stairs, rear leggers have a harder time fping up as they use their rear legs for propulsion.  An easier time gping down.

You'll want non slip scatter rugs for traction if you have     hardwood floors. 

And yes, reducing her weight is a big plus too. And it's really quite easy with dogs because we can control their food intake.

I'm certainly not familiar with the prices for amputation surgery in your area. I know in Virginia it would not be as high as you were quoted  from a regular Orthopedic Surperon, and I would expect less than that from a teaching school here.   Just guessing. 

And yes, after surgery getting a consult  with a Rehabilitation  Specialist  can help with techniques to keep her core strength strong and joints and muscles safe..I

Is it possible to get an app with an Orthopedic  Surgeon who is not at the same cljnic?  I really can't  imagine,  based on what you've described and knowing f orpt can only get worse, that amputation  wouldn't  be the best solution  to give her quality, pain free life.

Your pup is so lucky to have you advocating for her. She is clearly adored and loved. Whatever decision you make, it will be one from a place of love and that is always the right decision.

Hugs 

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

PS.  So she thinks AC is a toy??????  Crazy girl!

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!

The Rainbow Bridge



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11 June 2023 - 2:39 pm
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Ahhhhh sounds like some progress has been made. This made me ROFL!

She has started playing with her toys a bit more and I even caught her drag a detached part of our AC to her bed to destroy! 

GOOD TIMING!!!!

Galiprant works so well for some dogs and once her weight is down she may not even need it. Nellie lost 15 pounds after we got her and it made a huge difference in her mobility. So yeah Focus on the weight loss ... super helpful! See our Tripawds Weight Loss tips for some ideas that may be useful. 

As for bribing her to go outside, you could try adding some lightly sauteed meat to her dinner and just feeding her that way, bribing her with some of that dinner so she's more willing to get up and it's not counting as extra calories.

Where in Oregon are you located? Our Nellie's main GP vet is in Eugene. Small world. If you do anything with OSU they have a good rehab department.

Thanks for the good vibes on Nellie's CSU appointment! We are doing some better diagnostics next week hopefully so we can decide on the best way to proceed. We had an incredibly useful consult ...2.5 hours with the team! You really get your money's worth at vet teaching hospitals. I plan on doing a write up of how it went for Tripawds News, once the diagnostics are done.

I just shared this in another post, can't resist. We need to see some pics of your girl! Here's how adding images works, let me know if you'd like help (Pics need to be hosted somewhere like a photo sharing site such as imgur.com, or your own Tripawds Supporter blog , then you copy the image and return here to paste it into your forum post).

 

060823_NellieCSU1.jpgImage Enlarger

The Rainbow Bridge



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11 June 2023 - 2:40 pm
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And I keep forgetting to ask, hope I didn't miss it, but what is your dog's name? 

Virginia







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11 June 2023 - 5:28 pm
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Beautiful  photo of sweet Nellie.  Yes, we'll be looking forwa to seeing how things are unfolding  for Nellie after testing, etc.

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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23 July 2023 - 10:13 pm
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Heya! Sorry for the late response, I had something typed up and lost it then just forgot to retype it. Her name is Persephone and she is a huge sweetheart and LOVES meeting new people! We live in the Willamette Valley and yes it is such a small world! We have family in Eugene! I hope all is well with Nellie and she is so regal and beautiful in that pic!

We went to see the surgeon at our local vet office and the surgeon does agree with us that it is now time to pursue amputation and can do it for $3500 (which includes the removal of a small unrelated mass on her eyelid). We were pretty surprised that our vet was actually half the price of the closest vet teaching hospital. We are going to go through with amputation with our vet's office as soon as we can get the funds together for it. I'm currently looking for work in hopes that I can land something and we can pay for it, but it's looking like we may need to start crowdfunding to cover the cost. We also chose a rehab specialist for post-op, there was only one in our area so that made choosing one pretty easy LMAO! We have yet to schedule anything with our surgeon and the rehab but we are hoping to do so before October at the latest.

She is currently on Tramadol, and Gabapentin, and started Proin and Galliprant about a month ago. She's also taking Fluoxetine because she is pretty anxious and leash reactive which we think/hope is due to her being in pain. The Galliprant seems to be helping some with her pain and she is no longer laying down on our brief potty walks. But her limp is still prominent and she messed up her leg the other day trying to mark and its been pretty bad since. It's not exactly abnormal that it gets worse after she tweaks it and this would be the third time this year that she tweaked it causing her to have a much worse limp. The Proin has been helping so much more than her last incontinence med. We haven't had an accident since starting it last month which is a huge relief for us and her. She hated having pee pads on her beds under the cover and she is so much less restless now that we don't need them anymore.

We haven't weighed her but she seems to be losing some more weight and I hope it's helping some. She's definitely getting some of her healthy dog shape back. Im sure she misses her dental sticks and various treats though. We have been giving her low-calorie dog food and cutting way back on treats and things. Due to the fireworks this last month has been pretty rough though so she still gets a handful of high-value treats because nothing else works to convince her out of the house.

We are currently looking at getting a ramp for getting out of the car since she has been having significant problems doing so in the past month and we are starting to look at rugs for the two small areas that aren't carpeted. I'm also wanting to start working with her more on some minor exercises to build her core strength to kind of help preps her for post-op. She is already getting up/down using only her good legs already though and has been moving and standing like a tripawd. She still uses the bad leg to stabilize herself and some while walking, but she really stays off it when standing and mainly uses her good legs. We just know as soon as she doesn't have her bad leg anymore that she will have a much easier time getting around and not having the chronic pain will help with everything she's being medicated for.

I will try adding a pic of Persephone and hope y'all (and your pups) are doing well!

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23 July 2023 - 10:17 pm
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[Image Can Not Be Found]Here she is!

 

The Rainbow Bridge



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24 July 2023 - 9:00 am
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Aww pretty girl! I love her name too!

I'm glad you found a vet who can do the surgery for you. Just make sure they have overnight, 24/7 care. Many times when there is such a huge price difference between clinics, that's one reason why; a smaller clinic can be cheaper because it doesn't offer overnight care, or cuts corners on pain management . You don't want that for your girl, at least cutting corners on pain control. If you want to use that clinic and they don't have overnight care, it's best to take her home the first night. Not easy to do but others have done it. Better than leaving her alone.

Pain can certainly cause aggression and reactivity. Hopefully you'll see a difference in her behavior once her painful leg is gone. Meanwhile I wouldn't try any exercises with her right now since she is in so much pain. There will be time for those later and you don't want to make it more painful for her (being sore after exercise is something we can all relate to!). As long as she is losing weight safely (ask your vet), she will be in better shape to cope with recovery.

Glad you found a rehab therapist who can help. I know the choices in the area are limited. We do know a really good CCRT therapist, Alex of Rogue River Rehab, who is a mobile practitioner based out of Grants Pass. Not sure how far south you are, but he's willing to drive or meet halfway. 

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24 July 2023 - 5:22 pm
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I'm glad you found a vet who can do the surgery for you. Just make sure they have overnight, 24/7 care. Many times when there is such a huge price difference between clinics, that's one reason why; a smaller clinic can be cheaper because it doesn't offer overnight care, or cuts corners on pain management . You don't want that for your girl, at least cutting corners on pain control. If you want to use that clinic and they don't have overnight care, it's best to take her home the first night. Not easy to do but others have done it. Better than leaving her alone.

Yeah, they mentioned they don't hold overnight and I was a bit concerned (and still am) because I had read on this site that it's best for them to have overnight medical care. We are still going to go through our clinic because it's just the easiest/cheapest option and they have treated us really well. Plus, we live right next to a 24/7 Emergency vet clinic and I intend to stay up with her to monitor her. I know it's not as good as a trained professional, but it's the best we can do at this point. I fully intend to ask them 101 questions about how best to care for her those first nights as well as call the emergency vet with any and all concerns that may pop up after our vet clinic closes. 

Pain can certainly cause aggression and reactivity. Hopefully you'll see a difference in her behavior once her painful leg is gone. Meanwhile I wouldn't try any exercises with her right now since she is in so much pain. There will be time for those later and you don't want to make it more painful for her (being sore after exercise is something we can all relate to!). 

That's our hope that it's all just pain related and doesn't carry over post-op! Thank you for mentioning waiting on the exercises. I hadn't even thought of it possibly contributing to her pain, I definitely see how it would make her sore. We will definitely wait until post-op and after taking her to rehab. 

Thank you again for all the great advice and recommendations! This site and community have been such a huge help in helping us make good decisions in regard to her health and well-being. I am eternally grateful for all the hard work everyone at Tripawds does to provide this priceless resource for us pet parents. Thank you!

The Rainbow Bridge



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26 July 2023 - 9:17 am
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As long as you can be there for her during that first night, she's in good hands. It won't be easy but others here have done it and you can too!

Yeah I'm going to bet that she will have a lot less pain. Take a picture of her expression now, and then wait a week or so after surgery and take another one. Compare them side by side and you'll most likely see a huge difference. It's so hard to tell our dogs are hurting when they are in the throes of it.

I'm so glad we can help. Ask any questions, you're not alone in this.

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