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Facing amputation decision - hind knee chondrosarcoma
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13 April 2018 - 11:26 am
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Our beloved 9-year-old lab mix, Miss Kitty was diagnosed with Chondrosarcoma in the patella on her hind leg.  Chest x-rays are clear.  Mitosis level low.

In hindsight, episodes of limping and previous patella fracture 2 years ago are probably attributed to the early stages of this cancer.

Orthopedic surgeon is recommending amputation, regular vet is more inclined to wait until she becomes more impaired as he says larger dogs have more difficulty recoveries.  Other trusted, knowledgeable friends and professionals are split for and against.

Any and all insights on navigating this decision will be greatly appreciated.  She has had bouts of limping and then recovers, at the moment she is putting weight on all 4’s but her gait is slightly impaired due to ligament issues in the affected knee.

The Rainbow Bridge

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13 April 2018 - 11:39 am
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regular vet is more inclined to wait until she becomes more impaired as he says larger dogs have more difficulty recoveries. 

Hi Miss Kitty’s Mom, thanks for posting. I’m in the Tripawds Chat room with you right now but for the record here is what I just replied with:

I’m not a vet, but I respectfully disagree with that approach by your vet. We have talked to many orthopedic surgeons and vets who say size (or age) alone should not exclude a dog from amputation surgery, provided that all other health factors are good to go. And at nine years young, she still has a lot of living to do.

That’s great you got an opinion from an orthopedic surgeon. Good job!

When a dog limps, the dog is in pain no matter how much we may think they are not. We limp, we are in pain, right? Well they are too. So I would decide something as soon as your able to help Miss Kitty get her happy joy back and go on living life. Amputation isn’t right for every situation but what I’m reading here is that your dog is otherwise healthy and ready to move forward with a pain-free, cancer-free life. 

If you haven’t already please see Jerry’s Required Reading List and the Tripawds e-books library for more tips on deciding. I hope this helps.

It's better to hop on three legs than to limp on four.™
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13 April 2018 - 1:24 pm
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Love the name!!!

Jist want to say a quick WELCOME and bring up a couple of pointsand will come back later.

My Happy Hannah, 125 lb “fluffy” Bull Mastiff, was up and walking like a champ within 24 hrs of surgery .  Recovery  was no picnic, but mobility  was no issue. 

As far as well intended  friends offering advice.  YOU have done your research  and YOU are armed with information  they don’t  have.  And you have this site surrounding  you with first hand experiences that cannot be found anywhere else!

STAY CONNECTED.   You’ll sort through this and make a decision out of love for Miss Kitty…and that is always  a right decision ♥️

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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13 April 2018 - 11:28 pm
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Miss Kitty update –  Notice the snazzy sleeve that Miss Kitty is wearing?    When it rains it pours.  

Just a few days before her most recent bout of hind leg lameness (and chondrosarxoma diagnosis) Miss K developed a rapidly growing lump on her left front elbow.  Our local small town vet aspirated and said it appeared to be spindle cell sarcoma and recommended removal ASAP due to their invasive nature.    She had that surgery on Monday and we have been waiting for the definitive pathology report before making a decision regarding the chondrosarcoma.

Got the call today confirming diagnosis of spindle cell sarcoma on front elbow.  Margins were fairly small (2 mm) due to the location, so there will be a possibility of a recurrence down the line.  Given the absence of a more aggressive or metstasized malignancy on the elbow,  can we now make a decision of the hind leg amputation on it’s own merits?   Do we wait a while to see how the two sites evolve?  We’ve requested follow-up phone consultations from the orthopedist who evaluated her for the chondrosarcoma and from a brilliant personal family friend who is 2 years out of vet school.  

My husband is having a difficult time with the concept of amputation.  Hopefully this group will be able to provide us guidance and comfort in these emotionally turbulent times.  Thank you in advance.

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15 April 2018 - 3:27 am
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Hi Miss Kitty and family 🌺

Gosh, what an ordeal you’re going through, sweetie …

It is really tough to know how to proceed, did you have feedback from the orthopaedist and from your vet friend?

I really do not have any advise as my baby Eurydice had osteosarcoma on her front leg so it was a clear decision to remove that painful leg. 

The only thing I can say is that was the best decision for her, although initial recovery was hard (as she was 77kg and huge) after stitches were removed she got better every day and mastered the art of living on three legs.

Please let your husband know Miss Kitty will also adjust and surprise you both with how well she will manage her new pain free life. 

As for your current decision on which way to go the only thing I can do, if you’d like, is contact Eurydice’s oncologist and ask his opinion.

I trusted him with my adored baby girl’s life and value his opinions so I’m sure he will come back to me with his views on Miss Kitty and that will provide another opinion for you to consider. 

Sending you big hugs and tons of ear scratches to your beautiful baby girl 😘😘🐮💫✨🌟🌹

Eurydice 77kg/170lb Great Dane limping end of April 2016, amputation (right front leg/osteosarcoma) 4 May 2016 6 courses of carboplatin followed by metronomic therapy, lung mets found 30 Nov 2016. 3 courses of doxorubicin, PET scan 26 Jan 2017 showed more mets so stopped chemo. Holistic route April 2017. Lung X-ray 5 May 2017 showed several tennis ball size mets, started cortisone and diuretics. Miss Cow earned her XXL silver wings 12 June 2017, 13 months and 1 week after amputation and 6 1/2 months after lung mets, she was the goofiest dawg ever and is now happily flying from cloud to cloud woof woofing away :-) 

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15 April 2018 - 2:24 pm
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Miss Kitty update 😥

Yesterday Miss Kitty jumped on the bed and yelped, could not put weight on hind leg and knee super swollen. She was obviously in a lot of pain. Got pain pills in her immediately and ice on the knee.

Fortunately we were already scheduled for a phone consult with the orthopedic surgeon and family friend vet in the afternoon. They both concurred that the bone/ligament damage had progressed and Wait and See were not an option. We were able to get on the surgeon’s schedule for tomorrow morning.  (Good thing, because carrying an 82# dog outside to take care of business is a challenge.)

We both know it for the best,  she’s a happy, healthy dog and hopefully we will have many good years ahead.  Nonetheless, sadness is hitting us in waves.

The surgeon says she will be in the hospital for just one night, wow!  What do we need to bring her home?

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15 April 2018 - 3:30 pm
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Hey there sweetie pie 🌺

So Miss Kitty is moving forward with surgery and getting rid of that painful leg, those are good news, this will be the start of a brand new happy, happy life on three with her loving family 💕💕💕

Things you should consider before she comes back home:

– if you have slippery floors it is crucial you get carpet, rubber underlay or yoga mats to create paths where Miss Kitty can hop on safely. Slipping is a major knock on confidence building and is potentially dangerous!

– for her weight you probably will need to help her standing up and going potty in the first stages of recovery. My girl Eurydice was a front legger so we used a harness but as in Miss Kitty’s case others used a shopping bag and supported their babies by holding the handles. Please wait for others to explain this in more detail …

– also other pawrents used boxer shorts to protect the incision, getting the tail through the fly. 

– very, very important to keep a close eye on pain medicine, namely tramadol and gabapentin (for phantom pain ) and not hesitate to talk to Miss Kitty’s surgeon if you have any doubts concerning medicine schedules and/or amount to administer. An antibiotic is generally also prescribed. 

– Miss Kitty might take some days to poo, that is normal. Nevertheless, if she does not pee, you should mention it to her surgeon. 

– exercise must be kept to a bare minimum during recovery, only toilet breaks are allowed!

– also, Miss Kitty may spend a lot of time resting/sleeping, that is what she must do so don’t worry.

– if she looses her apetite you can try anything and everything to get her interested: scrambled eggs, bacon, chicken, burguers … the sky is the limit!

– if you have trouble giving her pills wrap them in ham, bacon etc or cover them with liver pate or peanut butter. 

– after stitches are out (the moment where you will see her improving greatly day by day ☺️) you should consider getting her a harness to help her going up and down stairs, in and out of the car, etc. Most of us used a ruffwear harness which is great as it has a handle on top and is very solidly built and comfortable for our babies to wear. 

– and please try to be positive as Miss Kitty will feed on your energy, the more positive you are the quicker she will feel ready to go on with her new life. 

– you may doubt your decision as a lot of us did but remember you are doing this for her, you are giving her a wonderful painfree life hopefully for many, many, many years to come ! 

And remember we are all here for you so do not hesitate to ask any questions, big or small!

Please update us when you can, in the meantime I am sending you and your baby girl all the positive energy I can master for tomorrow’s surgery 💕

Big kiss and lots of cuddles to Miss Kitty 😘😘🐮💫✨🌟🌹

Eurydice 77kg/170lb Great Dane limping end of April 2016, amputation (right front leg/osteosarcoma) 4 May 2016 6 courses of carboplatin followed by metronomic therapy, lung mets found 30 Nov 2016. 3 courses of doxorubicin, PET scan 26 Jan 2017 showed more mets so stopped chemo. Holistic route April 2017. Lung X-ray 5 May 2017 showed several tennis ball size mets, started cortisone and diuretics. Miss Cow earned her XXL silver wings 12 June 2017, 13 months and 1 week after amputation and 6 1/2 months after lung mets, she was the goofiest dawg ever and is now happily flying from cloud to cloud woof woofing away :-) 

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15 April 2018 - 5:40 pm
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Thank you for all of the well thought out hints and suggestions.  A few questions:

1,  We have wooden floors in part of the house, but not particularly slippery.  Should we go ahead and get runners?

2,  Gabbapentin can make ssome people psycho, can this happen with dogs?

3.  Will she need an E-collar?

We had a cat go full-on Linda Blair Exorcist on us with a Fentanyl patch.   Now it’s funny, then we worried for our lives!

Adriana

Virginia
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15 April 2018 - 7:10 pm
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We’ll Miss Kitty and her bum leg have at least made the “forced choice decision” to amputate a clear one   Guess she made it plain she’s  ready to get on with a pain free life! 

Theresa has given you great advice chock full of information.

Yeah, even though  your floors aren’t particularly  slippery,, I would go ahead and get non- slip scatter rugs or cheap yoga mats.  Miss Kitty will be using a lot of different muscles as she adjust to her new mobility , so you want to  eliminate  any possibility  of falls and strained leg muscles, back, etc.  Once recovery takes place, then you can reevaluate  the situation.

Cats handle  pain meds differently  than dogs in many cases.  But yes, a fentynal  pa5ch can make dogs a bit whacky.   Some come home with a patch….some don’t. 

Gabapentin doesn’t  usually  make them whacky.  Sometimes  lethargic, which is kinda good so they can rest.  Tramadol  and Gabapentin  work well together.   She’ll probably  jave Rimadyl and an antibiotic  too.  She’ll jave the hospital meds in jere dor a day or so.  Adter that the pain meds may take some tweaking  ro find the best balance.

Of course, speak with your Vet  and keep him informed  how she’s  doing.  It is major surgery  and it does hurt 

Yes, most dogs spend one night…some more.  Sometimes  larger dogs need an additional day or two to get their mobility  functioning at a level where they can go home.

When you so pick her up after surgery, don’t  even bother to look at her incision!   She wants wants to see your smiling face telling her she’s  a good girl and going home!😁

STAY CONNECTED!  YOU ARE NOT ALONE!!   Try and get some sleep when you can…..and load up on chocolates!

Lots of hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too 

PS  When I finally did glance st my Happy Hannah’s  incision,  I was more shocked by the amount of fur they shaved than by the incision . They get real clipper happy. 

Most dogs do need the “cone”.  Rryinf to fet st those annoying  stitches is a favorite  past time.  I was very lucky in that my Happy Hannah  NEVER messed with her stitches and never had to wear one.  

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!

Livermore, CA
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15 April 2018 - 7:50 pm
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Hi and welcome.

You have great input from Sally and Theresa.  I’ve had two rear amp tripawds although both are/were small. TriPug Maggie lost her left rear leg to a mast cell tumor and my current Tripawd Elly, a pug mix, lost her right rear leg to a car accident. 

When Maggie had her amp I had laminate flooring in the kitchen and dining room.  The pugs could barely keep their feet as quad dogs, I knew Mag would not be able to hop on it with three.  I put down trails of anti-skid rug liner and she never left them as she hopped around.  I had the flooring removed and put down tile.  She could hop on that OK but would stay on rugs when ever possible.

I live in a different house now but with the same type of tile.  Elly can navigate it at a slow hop but will slip when she goes faster.  I can’t completly cover the floor with rugs because I live with my elderly father and he tends to trip on the rugs.  Elly has learned to go rug to rug, and avoids going through the part of the hallway and kitchen without rugs most of the time.

You don’t want Miss Kitty to slip early on and maybe hurt herself.  It also may hurt her confidence as she learns to navigate on three.

My quad pug Tani was on gaba for over a year, close to two years I think, for her arthritis and she didn’t have any reaction to it after some sedation when she first started it.  Maggie did have agitation issues with tramadol, but I have used it in 3 other dogs without any reaction except for some sedation.

If she can get to the incision then she will need an e-collar or equivalent.  I used one of those inflatable donut type collars when my quad pug Obie had his knee surgeries.  Some have used boxer shorts on rear amps- the tail goes through the fly. 

Good luck with surgery tomorrow.  I’ll be looking for an update.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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16 April 2018 - 12:47 am
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You guys are great!

We have about a 30’ run of wooden floor between our carpeted bedroom where Miss Kitty sleeps with us and the carpeted office where she has her Command Post to keep guard over the driveway to watch for encroaching deer, bears and FedEx trucks!   I think we may add a “runway” of carpet squares between them for her.

She sleeps on our bed which is about 20” off the ground and her command post sofa is about 18” high.  How do they/we handle the mechnics of getting up onto the bed or sofa with only one hind leg?   Putting mattresses on the floor during recovery is not an option due to space contraints.  

Miss kitty is a full size lab.

Adriana

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16 April 2018 - 3:28 am
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Hi Adriana (lovely name) and Miss Kitty 🌺

During recovery she should really sleep on a mattress on the floor but if that is impossible then you have to help her getting in and out of your bed and in and out of her couch.

Always, always pay attention so she does not try to do it on her own! 

Once recovery is over she will jump in and out just like she did on 4 legs, no worries ! 

And being a lab she probably will try to hop around during recovery so, if that is the case, you gotta not let her do it until recovery is over.

She will need to exercise progressively and steadily.

Once she masters the art of hoping on 3 she will run as fast as the wind again and that’s a promise !

Please let us know how op went, sending you kisses and cuddles 😘😘😘🐮🌟💫✨🌹

Eurydice 77kg/170lb Great Dane limping end of April 2016, amputation (right front leg/osteosarcoma) 4 May 2016 6 courses of carboplatin followed by metronomic therapy, lung mets found 30 Nov 2016. 3 courses of doxorubicin, PET scan 26 Jan 2017 showed more mets so stopped chemo. Holistic route April 2017. Lung X-ray 5 May 2017 showed several tennis ball size mets, started cortisone and diuretics. Miss Cow earned her XXL silver wings 12 June 2017, 13 months and 1 week after amputation and 6 1/2 months after lung mets, she was the goofiest dawg ever and is now happily flying from cloud to cloud woof woofing away :-) 

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16 April 2018 - 3:32 am
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When I say hop around doing recovery and you not allowing it, I mean if she is overdoing it, going for toilet breaks or gently hoping around the house under your supervision is ok. 

😘😘🐮💫✨🌟🌹

Eurydice 77kg/170lb Great Dane limping end of April 2016, amputation (right front leg/osteosarcoma) 4 May 2016 6 courses of carboplatin followed by metronomic therapy, lung mets found 30 Nov 2016. 3 courses of doxorubicin, PET scan 26 Jan 2017 showed more mets so stopped chemo. Holistic route April 2017. Lung X-ray 5 May 2017 showed several tennis ball size mets, started cortisone and diuretics. Miss Cow earned her XXL silver wings 12 June 2017, 13 months and 1 week after amputation and 6 1/2 months after lung mets, she was the goofiest dawg ever and is now happily flying from cloud to cloud woof woofing away :-) 

The Rainbow Bridge

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16 April 2018 - 9:52 am
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 How do they/we handle the mechnics of getting up onto the bed or sofa with only one hind leg? 

It’s perfectly OK that you can’t put your mattress on the floor. Lots of people do it, but veterinarians have told us that it’s more important to keep your normal routine and sleeping arrangements during recovery. So if she is used to sleeping on the bed, and she will not sleep on the floor at all, then a Ruffwear Webmaster harness is the best way to assist.

Do what you can to prevent her from jumping down, if possible. Also set up some pet steps and get her trained asap to use them. Here’s an article that may help you train her for ramps and stairs: 

http://gear.tri…..-training/

And yep, carpet runners are a great idea and so helpful for a Tripawd (or any dog with mobility challenges). You ask great questions. Good job!

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16 April 2018 - 3:41 pm
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Miss Kitty did great in surgery!  The surgeon x-rayed her knee and said there was a big piece broken, so we did the right thing not delaying.  We are so glad to have this behind us.

She is supposed to come home tomorrow.  I’m sure you’ll see me over in the recovery forums.

Adriana

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