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ADVICE URGENTLY NEEDED! IS AMPUTATION A VIABLE OPTION? PLEASE HELP!
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London, UK


Member Since:
15 December 2015
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15 December 2015 - 8:26 am
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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

Ruby, Staffy, born June 2022, became a Tripawd, 23 November 2023, adopted 12 January 2024.

Also Angel Tripawd Meg (aka The Megastar), who died in April 2023, aged 14, after seven glorious years on three, and Angel Staffies Pie and Bille. In the pawprints of giants...

The Amazing Adventures of Ruby Tuesday 

My Life as a Megastar

On The Road


Member Since:
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15 December 2015 - 10:06 am
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Hi Clare, welcome. Your future posts won't require approval.

We are sorry to hear about Meg, what a ruff time you have had. But wow you are really so dedicated to her good health, it shines through. Whatever you decide to do will obviously be in her best interest, a decision made with compassion and love. Since you have been through so much already, and some very difficult surgeries, amputation recovery will likely be a breeze for both of you. She's young and doesn't weigh a lot and sounds like she still has a lot of spirit and many great years ahead as long as everything works out. Of course there is the situation of her elbow displaysia and arthritis that makes this so tough.

Now, what does the surgeon think about her being a good candidate for life on three legs? Have they advised what kinds of bone strengthening/arthritis treatments and orthotic braces or even a wheelchair that might be an option? The more opinions you can get the better (I know it already sounds like you are working with a great vet team!). A vet teaching hospital is also a good idea for another opinion, perhaps your vets can send your case to them for review?

We've had many members here who have gone through amputation with mild arthritis or displaysia (just search the Forums for "Arthritis" and you'll find tons of results). Most do just fine after surgery. With Meg being smaller, that is a huge advantage. Others will chime in soon so stay tuned OK? Oh, and we removed your duplicate post in "ask a vet"...duplicates confuse things and bog down the forums and our current fairy vet mother isn't able to chime in quite so often because she so busy, so we thought you'd find faster input from others here). Thanks again for joining, I hope we can help you reach a good decision for your sweetheart.

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

Norene, TN
Member Since:
21 October 2014
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15 December 2015 - 10:24 am
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Howdy and welcome!

Well, I can tell you everything Jerry said was exactly what I was going to say. There are so many remarkable stories here regarding pups who, not only lost a leg, but had issues in their remaining legs, hips, backs, etc. And I would wager that Meg could totally rock a wheelchair .

Don't give into despair my friend. Any decision you make from your heart will be the right one.

pam

Harmony became a Tripawd on 10/21/14 (MCT). She left us way too soon on 11/1/14.

"We miss you so much; our love, our heart, our Harmony."

- Pam, Ron and Melody, Meesha, Doublestuff and Mariah Carey

Schofield, WI
Member Since:
13 August 2015
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15 December 2015 - 11:07 am
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Our Max had amputation and had a remaining back leg that had a previous injury with arthritis in it.  He's on rimadyl for the arthritis but does well and is back to his normal patrolling the yard and loving life.  Now keep in mind Max is a very long legged 110# German Sheperd. Meg being much smaller should do very well as a tripawd.  Dogs are amazing and quite quickly adapt.  Your sweet girl will be able to be out of pain for good after recovery.  Your love for her shines through. Make your decision based on that and you can't go wrong.

Linda & Max

London, UK


Member Since:
15 December 2015
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15 December 2015 - 11:15 am
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Thanks so much for your responses. I feel so overwhelmed by the situation and it's tremendously helpful and also comforting to hear about other people's experiences.

The hospital Meg is in (Fitzpatrick Referrals) is in fact a teaching hospital and one of the leading orthopaedic hospitals in the UK. People bring their dogs from all over Europe to consult her surgeon, though he is currently in hospital himself, having undergone surgery yesterday (really, you couldn't make it up!) so I'm not able to speak to him right now and I'm not certain when I will be able to. It was he who said, quite categorically, that amputation was not an option because of the state of her other elbow. It's the soft tissue surgeon who is now saying that amputation is her only option, but clearly he needs to speak to the orthopaedic surgeon (when he gets out of hospital...) If the orthopaedic surgeon has changed his position (and he may not have done) then I guess I really need to understand why he now believes amputation is a viable option for Meg.

In the meantime, I'm trying to educate myself as best as I possibly can. I didn't even realise there were front end wheelchairs, for example, so thank you for the link and I want to know more about orthotic braces and what other options there are. Meg is a hugely positive character, a real 'bounce back' dog, and I want to give her every possible chance but I also need to be a compassionate and responsible Mum and to recognise when enough is enough. That is what is so impossibly hard.

Thanks again. I cannot tell you how much I appreciate your input.

Clare

Ruby, Staffy, born June 2022, became a Tripawd, 23 November 2023, adopted 12 January 2024.

Also Angel Tripawd Meg (aka The Megastar), who died in April 2023, aged 14, after seven glorious years on three, and Angel Staffies Pie and Bille. In the pawprints of giants...

The Amazing Adventures of Ruby Tuesday 

My Life as a Megastar

On The Road


Member Since:
24 September 2009
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15 December 2015 - 11:39 am
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megstamum said
I want to know more about orthotic braces and what other options there are...

Please watch our Orthopets Video Interviews for details and follow the links in the articles to contact them directly for more information.

Use the Advanced Search function above the forums to find many topics with feedback from members for any specific concerns. Or, search all blogs here .

Hope this helps!

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

Virginia







Member Since:
22 February 2013
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15 December 2015 - 1:45 pm
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Your dedication to dping whatever will give your beautiful Meg a quality life does, indeed, come shining through!!!

A d her avatar picute....the sweentness and gentleness just jumps right through the screen

Needles to say, I'm certainly not a vet. However,I can tell you as Jerry and Linda have already noted, we have DEFINITELY seen dogs go through amputation who jave deao with similar circumstances. We are all focused on solutions and options here! As you have seen, and as far as we are concerned, it appears you have both!! We are also very big on second and even third opinions!

It sounds like .eg hasn't been on any special treatment for her arthritis in her "good" leg, is that right? Anyway, point being, Dasequin, Rimadyl, Adequan ...there are a lot of promising treatments to help. Now, make no .istake about it, every now and then a dog is just not suitable for amputation and we see it here on occasion. We've even seen where a dog appears to be an okay candidate, but still nas mobility issues for whatever reason. Rare, but it does happen.

One of our "family" members here was Atlas, a Great Dane diagnosed with osteosarcoma. He had Wobblers as well as hip issues(if I remember correctly). His human was told by two different vets he would not do well with amputation and he just be "put dow ". The third vet disagreed. Atlas had an additional TWO YEARS of @oving and spoiling and treats and a pain free life because his human and the third vet believed he would bou ce back after ampu! She also incorporated a lot of acupuncture and holistic therapies that were very helpful.

I know you feel like you are stuck in a nightmare. We see this kind of thing all to often where surgeries, infections, etc.results in amputation anyway. The cumulative pain just becomes too great and amputation at least guarantees the lain will be removed. Recovery is no picnic though. It is major surgery. But at least the recovery gets easier with each passing day.

Another beloved family member..Murphy...had an amputation and, a couple of months later, a hip replacement!

YOU KNOW YOUR MEG BETTER THAN ANYONE! You know yourself better than anyone! Clearly you both are resilient and positive energy souls. It's very, very difficult when there are no clear answers or you are dealing with known risks going in. Sometimes it just boils down to which decision you would second guess yourself the most. We are humans. That's what we do!

Talk with Meg. See what she says. You two are tuned into each other.

P@EASE stay connected and update us as soon as you can. In the meantime perhaps you can line up another opinion.

Sending you and Meg a whole lot of love and support!

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!

Maryland
Member Since:
28 March 2015
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15 December 2015 - 3:22 pm
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I'm sorry you find yourself in such a terrible situation. And I'm sorry that poor Meg has been through so much. I don't have any experience that would be relevant unfortunately. But I do know one thing---that the surgeons may be absolute top-notch and have tremendous skills, but they don't know your Meg like you do. As a tripawd, Meg might be restricted in what she can do or not do (long walks for example) because of her bad elbow. Only you can decide if the limitations of being a tripawd would diminish her quality of life so much that it would not be fair to her. 

If you feel in your heart of hearts that Meg could do well as an tripawd then I would not let them dissuade you. Sure, she may not be the optimal candidate for a tripawd, but neither probably was my 100 lb Pyr mix. Or Sally's mastiff Hannah. Or any of the other pups with secondary health issues. It isn't a great choice to have to make in any of those cases but we all did it. I wish you the best in making a decision for your Meg. 

Denise, Bill and Angel Ellie. 

Active 10+ Pyr mix suddenly came up lame with ACL tear in left rear leg. Scheduled for a TPLO but final pre-op x-rays indicated a small suspicious area, possibly OSA, which could have caused the ACL tear. Surgeon opened the knee for TPLO but found soft bone. Biopsy came back positive for OSA. Became a Tripawd 9/18/14. Carbo6 with Cerenia and Fluids. Pain free and living in the moment. Crossed the Bridge on 7/12/15 after probable spread of cancer to her cervical spine. A whole lifetime of memories squeezed into 10 months. Here's her story: Eloise

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