Caring for a Three Legged Dog or Cat
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My 5 yr old lab sawyer has soft tissue sarcoma on the outside of his front paw . In Feb we did mass removal surgery. Incomplete margins grade 1. We were told it had an 7 %chance of reoccurance. That lasted 4 months and it's back and worse than it was before. We talked about partial foot amputation with ect treatment to follow and not 100 % cure rate or full amputation that is curative if it's not spread already to his lymph.
The specialist cost is almost 8000$ High end for the surgery ( we are in pittsburgh pa)
My regular vet at our vca hospital said she can do it for 2300. She has done 5 front limb removal surgeries in her career and admits that a 24 clinic has a better pain control capability because they can do blocks and fentanly patches. While she would be able to prescribe nsaids and gabapentin.
The price is a huge difference for us. I can't afford to pay the specialist. But don't want to loose him either.
Has anyone used their regular vet for removal and had a postive experience? Im really concerned for proper care and pain relief but financial constraints are not going to allow for specialist care. The experience of 5 amputations does not make me warm and fuzzy either but I feel like I might be stuck. I do trust her tho and feel like if she didn't think she could preform a good surgery she would tell me as much
I'm also caring for his 13 yr old dog brother that also has cancer and doesn't have much time left so I feel like I'm emotionally at the end of my rope.
How often to dogs need to stay the night at the hospital? Is overnight a regular thing? My regular vet cannot provide that service. Ughhh! I'm just not sure what the right thing is. Thanks for reading!!!
Hi Keri and Sawyer!
You have come to the right place for support and information. Your post has been approved and now others will chime in too.
So sorry you were dealing with, not only your issues with sawyer, but also with his 13-year-old brother. I know one thing for certain, Sawyer and his brother are very lucky to have your love and care all these years.
I understand all too well the frustrations of financial constraints when it comes to trying to get top of the line care for our pups.
Obviously, the very best case scenario is to have the surgery done by an orthopedic surgeon and in a clinic that provides 24/7 care.
The main concern I think you were facing is the fact that your veterinarian has such limited experience in amputations. While it's best that a dog does stay at a fully staffed clinic for the night, often members do have to bring them home the same day for a variety of reasons. So, to me that would be doable if you have to bring him home at the same day; however, again, my concern is the limited experience the vet has with amputations, as well as pain management this type of surgery requires.
Of the surgeries she has done, I would want to know if there were any complications that arose and also would want to know the size of the dog. When my Happy Hannah had to have her amputation, her regular vet who had done numerous amputations through his twenty give years, said that he would not feel comfortable doing an amputation on a larger dog. Granted, my Hsppy Hannah weighed 125 lb at the time of surgery, but still, I would consider Sawyer a large dog also
One thought, do you have any other veterinarians in the area who have done more amputations and are more familiar with providing the surgery meds?
Also IF you do need to go forward with uour regular Vet, possible you could arrange to transport Sawyer to an ER to spend the night. K know some members jave done that and, alth costly, possibly doable.
Do you possibly have a teaching University somewhat close to you in the area? If so, they provide reduced prices.
Also, the Tripawds Foundation does have a program to provide some financial assistance for surgery.
What area are you located?
Stay connected and maybe others will have some other suggestions for you.
((((((((Hugs))))))))
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!
PS. Check out this link for the financial assistance grant. Asap. ASAP
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!
Hi Keri, I'm sorry to hear about Sawyer's tumor recurrence. That is not uncommon around here. Nobody wants to take a leg but many people opt for a tumor resection only to have it come back. It sucks, no doubt about it.
I'm happy that your vet told you about electrochemotherapy , there aren't many out there doing it and I don't know why. It's a great option for dogs who aren't good amputation candidates. Was that the specialist who told you about it or your regular vet? Just wondering.
First, please don't beat yourself up for not being able to pay the specialist. That is a huge amount of money and we all get that these decisions need to be made. I've been there myself with our own dog for a non-cancer situation, so I understand what a tough decision this is. Plus, you've got the added stress of your other dog having cancer too so yikes! Be kind to yourself, you are doing your best and your dogs know that.
Many people opt for their primary vets to do the amputation surgery. The cost your vet gave you is about what we see in many places. All vets learn how to do amputations in school, not all do them regularly. If your vet has done 5 and is relatively young appearing, that makes sense. If they have been practicing for decades, that would make me nervous.
But, I'm glad your vet mentioned the pain management she can offer, and that she doesn't have overnight care. This is because good recoveries start with good pain control. A nerve block is so important for good relief, and an easier recovery. Remember, severing the leg severs many nerves and vessels, it's a major surgery and it makes the body very confused and angry if the pain isn't managed before during and after surgery.
Sure, many folks bring their dogs home the same day. It can be done. And some dogs do come home with only gabapentin and an NSAID (ours did in 2007), and have been for years. But if you have options (not necessarily the specialist so keep reading), this is not ideal. Dogs without good pain control often recover with phantom pain , and sometimes it's really bad, lasting a long time. This can also lead to trips to the ER clinic, which can end up costing way more money than if good pain control was used at the get-go.
Also, most vets are not using fentanyl anymore, because they're finding that dogs don't feel relief with it the way it was once thought (same with Tramadol). One medication called Nocita is super helpful instead.
Less than ideal post-op pain is a very stressful situation to go through for both of you, especially when bringing home a dog the same day of surgery. All of this can be prevented with aggressive pre-and-post op control. I would not skimp there. But that doesn't have to mean an $8k specialist either. What I would do is to ask your vet if she can refer you to a primary vet who does do more aggressive pain management with a nerve block. That doesn't have to mean sending you to a specialist, either. Many GP vets will do amputations this way.
Check out our interview with Dr. Tamara Grubb:
Help Your Tripawd Avoid Pain, with Vet Expert Dr. Tamara Grubb
I'm happy to help you look for another vet you can talk to if your vet doesn't know any, just message me your location OK?
Thanks for the replies. Sorry it's taken me so long to respond but I didn't know how to find my original post😄
Update so far. I was able to find another specialist in my area (Pittsburgh pa) that has over night care for around 4k-6k. I'm willing to spend that ( thanks 401k) but 2- 4 less expensive sounds really good rn!
As far as the ect treatment the first specialist we spoke with is the ine who told me about it. Nobody in my area does it. They originally wanted me to go to Virginia to have it done but with some research I was bale to find a clinic in Cleveland that did it for 2k. Only 2 hrs from us. But what they didn't explain fully was I had to have it treated within a month of his first mass removal or it won't work. She said we had time and if it regrew then we could seek ect out. By the time it grew back it was to late. The oncologist explained that to me when I called to set up the appt.. 😕 I've spent so much on consults already.
I've read about nocotia and have asked about it and nobody seems to use it around here because of the cost. Thats unfortunate. I work in oral surgery and we use it's human counterpart all the time and it's only 260 a bottle.
Our vet is young so that's why she has limited experience. While I still have faith in her and after reading both your comments I've decided against it. I don't want him to be in pain cause quite frankly I'm not sure I can handle it and it goes without saying it wouldn't be fair to him. It's my responsibility to protect him and I'll have to dig deep to do that.
Our second consultation with the new surgeon is tomorrow and I will be making sure I get all my questions answered before I leave.
I'm also taking him back to his primary to have blood work ,chest xray and lymph node aspiration done before I proceed with removal. I'm terrified that it might be in his lymph and then I don't think I'll have an option but to let him go.. I definitely can't afford chemo.
This decision has been so paralyzing and terrifying I'm just beside myself with worry. I see all of these dogs with great outcomes and it encouraging. I'm so concerned what his future will look like. We do so much hiking and swimming and fetch that I'm so worried he won't have the same quality of life. Steps which I have a ton of are now my biggest enemy.
We are going to our cabin this weekend for most likely our older guy last swim in his favorite creek and Sawyers last creek swim with 4 legs. It's going to be a rough but fun day!
Ok I'm done whining 😒
Thank you again for the responses and I'm sure you'll see my name around here.. Lots!!!!
Hi Keri,
Thanks for explaining everything. Very enlightening about how the electrochemotherapy would work in your pup's situation.
It sounds like you are on the right track, and you have a very good idea about the importance of pain management too. That is really sad about the lack of vets offering Nocita. In the big picture it costs far less to bring pain under control sooner rather than later.
I'm glad you found another surgical option, and confident you will ask the right questions and your dog will do well with recovery. In case you forget something to ask, here's a blog post with some tips:
Top 10 Questions to Ask Vet Before Amputation Surgery for Dogs and Cats (Part 1)
And yes, life will be different when that leg is gone. But we call it the "new normal" and it's really not all that different than what you would normally do when caring for a senior dog, which is such a privilege! You will see Sawyer in an all new light and be blown away by his resilience. Not right away, but you will get there. Check out our Quality of Life surveys if you haven't already for a boost of confidence.
Keep us posted!
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