Caring for a Three Legged Dog or Cat
Tripawds is the place to learn how to care for a three legged dog or cat, with answers about dog leg amputation, and cat amputation recovery from many years of member experiences.
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My name is Pam and my husband and I share our house with 3 dogs; Tazzie (Mastiff), Loki (Dogue de Bordeaux), and Kona (Pitbull). Unfortunately, Tazzie had a limp 2 weeks ago. I am a veterinarian, so I took Tazzie in for xrays the next day and confirmed a lytic lesion in her right front leg near the carpus (wrist joint) which is almost always osteosarcoma. Like all of you, I struggled with the decision to amputate her leg. She is only 6 years old, but has already had both of her knees repaired and she is a very big dog (165 pounds).
I found your excellent website and have been following the stories of all the dogs, especially Titan and Butch. Dogs really are so amazing and resilient! After a week of furthur testing (chest rads, abdominal ultrasound, bloodwork) we scheduled the amputation. Even though I have performed many of these myself, I just couldn't do my own dog so I had the surgeon who repaired her knees do it for me.
Tazzie had her amputation Tuesday 8/26 and is doing very well! I am planning on taking her home on Friday since we have a long weekend. I thought I could pass on some tips for any dogs that may need amputation in the future, since there is lots of new info out there. I know that different vets have different opinions but this is what has worked for me.
First of all, I would always use what is called a CRI (continuous rate infusion) of morphine, lidocaine, and ketamine (MLK) during the amputation. These drugs help prevent a lot of the pain felt after an amputation and allow you to use less gas anesthesia during the procedure. The drip is continued postop until the dog is comfortable. Tazzie's surgery lasted 3 hours and she needed the drip for 12 hours postop until she was comfy. I have to admit that I slept on the kennel floor with her all night long just to make sure she was ok.
I started her on 3 drugs the day before surgery. One is a Fentanyl patch applied to one of her back legs. This is a narcotic that lasts 3-5 days and will be removed Friday. The other drugs are gabapentin and amantadine. These are drugs used in human medicine and both are inexpensive and very safe (main sided effect is sleepiness from gabapentin). Gabapentin is used to prevent nerve root pain and thereoretically can help with "phantom pain". We can't ask our dogs about that but I think that it does exist! Gabapentin is continued for 2-4 weeks after surgery depending on the dog. Amantadine helps prevent what is called pain "wind up". Once the pain receptors are annoyed it takes more pain meds to calm them down. This drug blocks that response and can be used for 1-2 weeks postop. Lots of dogs with chronic arthritis also take this drug for flare-ups when the Rimadyl or other NSAIDs they are taking stop working.
Tazzie will also take Tramadol as needed for pain after she comes home. I will continue her glucosamine supplement (Dasequin) and add fish oil. She can't take an NSAID due to high liver enzymes but that is a great choice for other dogs. She eats Innova (Evo is also a great food but her liver can't handle it) which I supplement with veggies and chicken or turkey.
Her first chemo is 9/15. I will do Carboplatin because it has the fewest side effects and has been linked to more long-term survival rates (although median survival age is the same with all chemo drugs). I should get the biopsy results next week. On large/giant dogs with Tazzie's symptoms and radiographs I don't usually put them through a painful bone biopsy first since we don't have fungal disease in our neck of the woods (Seattle). I just send in a sample after the leg is off.
Well I know that this is a long, technical, and maybe boring post but maybe it will help someone make their decision regarding amputation. I think that almost all dogs are good candidates for this procedure regardless of size as long as they aren't severly arthritic or neurologic, and it sure beats the severe pain of bone cancer!
I will keep you updated and try to send a picture through Jerry as I am technologically challenged when it comes to computers.
Pam (and Tazzie!)
Pam and Tazzie, your post is definitely not boring. Wow.
Tazzie, we hope you have a speedy, easy recovery. All of us here send our love and happy wishes your way. Can't wait to see some photos of you!
Pam, thank you so much for the detailed information about Tazzie's surgery and follow up care. This is so incredibly helpful. You sound like an awesome vet who takes pain management very seriously. Thank you for those details.
Also, we have not heard of dasequin. What else can you tell us about it?
We look forward to hearing more.
Jerry (& Jim & Rene)
28 August 2008
10 August 2008
Tazzie and Pam,
Bonnie sends her best. She is running one day behind you so knows how you are feeling.
Bonnie is home and resting comfortably. She does not seem very inclined to walk or even try yet, but we are trying to be patient. Your details on the pain meds are really helpful and it is nice to know what is out there in case we need it.
Bonnie has diabetes and I have been told by my normal vet to stay away from glucosamine and chondritin because the work against glucose absorption. I am anxious to learn more about dasequin also.
Best of luck on your recovery Tazzie. We have great support here.
Chris - Bonnie
Hi Tazzie and Pam,
Wonderful to have a vet persepective on the operation and followup and very helpful. I did have a question about your protocol and how you would change it for sighthounds who can be very sensitive to anesthesia and some pain meds.
Big hugs to you and Tazzie. I know even an experienced vet can be "mom" first and vet second emotionally so hang in there - Tazzie will be back to herself in no time. Radar is now 4 weeks post op and has totally shocked us with his resilience and his happy outgoing personality and love of life have returned in full.
Connie & Radar
Tazzie, Pam and Family
I am so relieved to hear Tazzie is recovering well. He i svery lucky to have a mom and vet in one. I appreciate you posting all your tips. I know our vet and surgeon gave us no tips. Jerry posted some of Titan's seroma pics in the gallery you may be interested in checking out. There is also a couch potatoe picture to show he is back to his lazy routine. Titan also takes dasequin (the joint supplement). Our vet never talked to us about this until Titan was 5yrs old. I am curious since you are a vet most articles I read don't mention mastiffs as a breed who commonly get osteosarcoma. Do you see that it is becoming more common in their breed?
You guys are in our thoughts!
Heidi and Titan
27 July 2008
I'm sure everyone here is as thrilled as I am to have all the technical info you provided. One thing about Fentanyl that some people do no understand is that it is not good for post-op pain. It says so right on the patch. The IV-drip Morphine is a much better choice. Fentanyl is excellent at stopping chronic pain, but it acts too slowly to be of any benefit with acute pain. I take Fentanyl and, as a human, was freaked out when they just added more patches to the ones I already had on me for chronic back pain when I had my lung surgery, it did not stop the pain at all; it never was meant to stop acute pain unless given IV. It's unfortunate that even doctors do not understand this. I really liked your post and copied it to my email, so I could readily find it and yes, I truly belive that dogs suffer from "phantom pain " just like humans when they lose a limb. Thank you for spending so much time explaining all the meds you recommend. You really know your stuff! We need informed people like you on this website. It's reassuring to others who have just gone through this to know there are excellent answers right here on tripawds.com.
Thanks, Pam and I hope Tassie keeps feeling better. You are a great help.
Sincerely, Vicki Tankersley
Hello, I just wanted to give everyone a quick update on Tazzie. She is really doing well on 3 legs! I am very surprised that it is day 6 and she can go out by herself to pee and finally had a bowel movement yesterday. She is back to eating dry kibble (if I hand-feed her) and her pain seems well controlled.
My other 2 dogs are treating her very well and so far we have had no mishaps like fighting for food or attention. Her incision is a little puffy but so far no seroma ! I am keeping a body bandage and tshirt on her just to be safe, until her staples come out.
I still have to figure out the harness I bought. Has anyone tried this with a giant breed dog? I plan on using it to help get her to her chemo appt on September 15th but it just doesn't seem like it will support her huge body!
I sent a postop picture to Jerry and I had done another post answering some of your questions but I don't see it here. If he can't find it I will repeat it later.
Good luck to all,
Pam and Tazzie
Great to hear from you Pam and Tazzie. Sounds like Tazzie is making excellent progress. Just seeing how well they adjust and handle this makes us look at them with new eyes and wonder at how amazing they are.
Good to hear your updates on her recovery. Since Tazzie has staples, we would love to have your input on the "Stitches vs staples" thread.
Hugs to you and Tazzie
Connie & Radar
Tazziedog, we are so glad to hear about your progress! Poopin', peein' and eatin' . . . is there anything better?!
About the harness...you'll see how helpful it will be! Especially when it comes to helping get you in and out of the car, or up and down stairs, or out of an awkward position when you're laying on the floor. I could go on and on. Just remember, the best part about the harness is that it helps your human help you, more than act as a support brace for your side of the body that's missing a leg.
As a front leg amputee, you will notice that occasionally the harness will slide over a little to the opposite side on occasion. This is normal, and in no way affects how the harness works. My Mom and Dad just move it right back over so the handle is right on top of my back.
P.S. We don't see your other post here, but we did get your photos and will add them as soon as we can. Mom and Dad have today off so they should be able to get to it, as soon as we're back from some "jeeping" up a mountain, whatever that means!