Hi everyone, 

I posted this in the 'Ask a Vet' forum, but wanted to post here too. I hope that's okay. I am new to tripawds.com and urgently in need of advice regarding my dog, Meg.

Meg is a highly active 7 year old rescue crossbreed (about 40 lbs) who has lived with me for the past six years and I love with all my heart. Three and a half years ago, Meg suffered a catastrophic right elbow fracture. While running on grass, her elbow basically exploded, a consequence it is believed of incomplete ossification of the humeral condyles. She had major surgery involving plates, screws, pins and almost a metre of wire. After months of rehab (which she tolerated well), she recovered very well and was back to her usual active self, albeit with a permanent limp.

Six months ago, however, I became concerned that she seemed to be limping slightly more at the end of a walk than at the beginning and X-rays revealed that she had developed very severe end stage arthritis. I took her to see several specialists and further scans showed that in addition to the end stage arthritis in her right elbow, her left elbow was also arthritic (though less severely), a consequence of elbow dysplasia. Because of this I was advised that amputation was not a viable option. In view of this, I opted for a custom made total elbow replacement. She had surgery four months ago, which at first seemed to have gone well. However, though the implant worked well, there were enormous problems getting the wound to heal, which required several further interventions, including skin flap surgery, none of which proved wholly successful and Meg developed an infection in the joint.

I have been told that because of the implant, it is impossible to get rid of the infection completely and because of the infection, the wound is still not fully healed. Moreover, the infection in her leg has now also caused the bone to retract from the implant, instead of growing around it. The soft tissue specialist, who performed the skin flap surgery, now says that Meg's only option is to amputate the leg. 

To be honest, I feel extremely uneasy about this. Meg has been through a huge amount. She has spent two of the last four months in hospital and has undergone repeated surgeries and had to cope with a very high level of restriction, basically being unable to do any of the activities she enjoys. If an amputation could give her a good quality of life, then certainly I think it would be worth doing, even at this stage, but that really is the question. Given that I was initially advised that amputation was not an option, I am worried about putting Meg through still more when the outcome seems so doubtful. Though it breaks my heart to say it, I think it may be kinder to put Meg to sleep.

I would really love to hear from anyone with experience of dogs in a similar situation. In particular, does anyone know of dogs who've done well on a single forelimb, when that limb already has elbow dysplasia and moderate arthritis?

Meg is currently in hospital (again) and I am of course listening to the advice of the specialists treating her. The soft tissue specialist who performed the skin flap is consulting with the orthopaedic surgeon who did the TER and examined the scans of Meg's left leg. They will come back to me. But I feel that the more I know about others' experience the better. I want to be as well informed as possible when I have to make the final decision as to what is in Meg's best interests.

Thank so much for reading.

All best wishes,

Clare