Caring for a Three Legged Dog or Cat
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Hi everyone,
My almost 12 year old Mastweiler Bruno and I live in Thailand so our resources are less than ideal compared to when we were in Los Angeles. He has been limping since December and was initially misdiagnosed as a fracture of the scapula. After a couple months with no improvement they started throwing around terms like osteomyelitis and osteosarcoma when their not so good definition xrays showed some periosteal reaction so I opted to take him to the leading University Animal Hospital in Bangkok for evaluation 2 weeks ago as they are supposed to have the best equipment and vets here. His biopsy just came back as chondrosarcoma and his chest xrays as of 2 weeks ago were clear of lesions. His pre biopsy cardiac screening shows a slightly larger than normal heart with flow ever so slightly low of normal but they okayed him for the surgery to do the biopsy.
Bruno has moderate arthritis in his left hip and some in his right but we have been successfully handling that with Glucosamine supplements and exercise for the past few years. Since his lameness his hips have gotten worse but he still manages to hop around and now I have a front and back mobility harness from Solvit that helps getting him with getting up and also with negotiating steps but he isn't very cooperative as far as walking goes so we are stuck with very limited potty outings during which he spends most of the time just laying down.
There is a huge demand for the University Animal Hospital so his CT scan for further staging cannot be done for 2 weeks and the amputation has been scheduled for a week after that which are the earliest available appointments. So while we are waiting I am looking for opinions on his prognosis as a tripawd provided that they don't find any metastasis on his CT.
I wish that I could post a video to show everyone his gait now with the lame front leg which would give a better idea of his limited mobility and the hindrance from the arthritis in his hips.
I have been looking through the threads on your forums and am hopeful but there are quite a few cons in Bruno's case. His appetite is good and he is still in very good spirits despite his lameness. Any feedback would be appreciated.
Hi Rob and Bruno, thanks for joining and registering as a member. Sorry about the diagnosis, but you did a good thing by seeking help at the university. I know the wait must be making you both crazy. Is Bruno on any pain medication in the meantime? If not please see if you can get him some, it will help him be more comfortable while you wait.
We wrote this post about chondrosarcoma in dogs a while back, you may want to review it as the information is still current as far as I know.
You may also want to consider having a U.S. university vet school review his file. Colorado and Ohio State vet hospitals are two that come to mind. Usually they will review at a nominal or donations-based cost.
Most large breed dogs will do fine on three legs as long as other conditions they have are well managed, which is sounds like you're doing. Bruno might be 12 but it sounds like he is pretty healthy overall. And 100 pounds wouldn't be the biggest Tripawd we've ever seen here. Many are much, much larger.
Did the vets there give you any idea about his candidacy as a Tripawd? It sounds like they are willing to amputate and think he's a good candidate?'
If you haven't already done so please check out Jerry's Required Reading List for many answers to things you're probably thiniking abaout OK? And feel free to ask as many questions as you'd like.
Stay tuned for more insight from members OK?
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
My Otis was 106 pounds pre-amp and also had mild arthritis in his hips which we treated with glucosamine and fish oil. He lost a front leg to osteosarcoma, but did great as a tripawd. We didn't take long walks - only about 5 houses - but he loved getting outside. He could do everything else he did before, and had a great quality of life up until the last 3 hours or so. Traction is key for tripawds, so if you proceed, make sure any tile or hard surfaces in your home are covered with non-slip floor mats or yoga mats.
Otis - 106 pound lab/Dane mix, lost his right front leg to osteosarcoma on Febuary 9, 2016. Four rounds of carboplatin completed in April, 2016. Lung mets August 25, 2016. Said goodbye too soon on September 4, 2016. Lost his adopted sister, Tess, suddenly on October 9, 2016. likely due to hemangiosarcoma.
Wherever they are, they are together.
Thanks for your replies.
Yes he is on Tramadol and Previcox while we are waiting for the surgery and pain does not seem to be an issue.
The Thai University vets really won't give an actual opinion and just say that it is up to me if to amputate so I have decided that I will let his likely survivability be the determining factor based on if the CT scan shows any metastasis.
The University will do the surgery and send us home a few hours after as they don't admit except for emergencies so I am daunted by having to handle the immediate recovery myself but I consider myself quite knowledgeable and have the time to be at home with him to see him through it. Our home is a big condo and is all tiled so I guess that i will go get a ton of yoga mats and figure out where to make his recovery room. We don't have a yard so potty means going down 6 or 7 steps to get outside which we negotiate now with the help of the Solvit mobility harness but I definitely need to come up with something with more chest support especially for the recovery period.
I am looking at the 3 local veterinary clinics for possibly admitting him for the first couple days but they are quite rudimentary and he may be better off at home under my care.
Will he be on a drip after the surgery? When he had GDV last year he was kept for a couple days in the clinic and was on a drip until sending him home.
It is good that you have time to prepare. My first thought is that post amp surgery recovery does require a high level of monitoring; however, if there are no clinics that can admit and monitor, would there be the possibility of having/hiring a vet tech to stay with him or monitor him for the first 24-48 hours post amp? Or figuring out what an " emergency" means to the University? Although some dogs do come home quite shortly after surgery, it is not ideal. Between the wearing off of the aneasthesia and the new mobility issues, simply peeing is a necessity and one which some take some time to do. Also, big dogs usually do take a bit longer to recover and to become mobile. Mmmmnnnn, let me think about this a bit longer. Also, there are many dogs, as you likely know, of the larger breeds who really do just lie about so likely being less mobile will not be much of an issue? In our case, we ended up with the rare TwoPawd, and, yet, our Heffalump led a very, very happy and full life for another 8 months as a TwoPawd. And he was in the 130+ category! Wow, Bangkok...so, let me think about this a bit...
Bruno is a true Mastiff in that he prefers laying down and typically only gets up to follow me when I leave the room so at least we have that going for us. The standard of care here is much different than in the USA. There is no such thing as a vet tech around here, only brand new vets, more experienced vets and then the clinic staff who are basically minimum wage helpers so I really would have to monitor him myself but I do have a good relationship with one of the newer local vets so I can keep her on close call if required but realistically she would not come stay in my home during the post amp period (cultural issues).
Also the University hospital is a 3 hour drive from our home so just bringing him back from surgery in my SUV will take a bit of preparation. I just now am in the process of custom making a high density foam bed to fit the back of my SUV AKA Doggie Ambulance.
Also I am going to install some kind of grass on part of my 250 sq ft balcony and start him using that for potty so that his required movement is minimized.
I just ordered the Ruffwear Web Master Plus harness and K9 Float Coat so hopefully those can help him getting up initially.
I am going at this full steam - no holes barred to be as prepared as I can be for this transition so any suggestions/advice is appreciated.
You are not the first member who has brought your new tripawd home same day. If there is no 24 hour, staffed facility, then Bruno is best with you. Can you get a copy of the post-op instructions now, including the meds Bruno will come home with? pain management is important, and although we are not vets, we can help you to advocate for the right meds. You might also want to PM magsdad - he hasn't been on the site recently, but he is a retired police officer who cared for his Maggie at home that first night. He seemed to have a really good handle on it, and might be able to provide advice. Also, please let us know the day. We have members in the UK and other places who can be watching for posts that day, and many if us in the US can check up during our night, as well as being around during your night.
Otis - 106 pound lab/Dane mix, lost his right front leg to osteosarcoma on Febuary 9, 2016. Four rounds of carboplatin completed in April, 2016. Lung mets August 25, 2016. Said goodbye too soon on September 4, 2016. Lost his adopted sister, Tess, suddenly on October 9, 2016. likely due to hemangiosarcoma.
Wherever they are, they are together.
Thanks so much for ordering from Tripawds! It was fun speaking with you today and like I said, we are very interested in following Bruno's story so thank you again for being a part of the community.
The outdoor balcony yard sounds so perfect! We can't wait to see photos (here's a post about adding images to the forums).
Meanwhile, yep, we also agree that he's better off with you at home if he won't get overnight care. You definitely seem to have all the know-how needed to make him comfy and have a great recovery.
Keep us posted on how he's doing, we'll be thinking of you.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
It has been 2 weeks since my last update and finally we got the CT scan done yesterday at Chulalongkorn University Small Animal Hospital in Bangkok. The wait for the slot was excruciating but at least the cost of the scan was not, only about $230 which I believe is great compared to back home.
Anyway as usual it was good news and bad news depending on your perspective. The radiologist said it would take a week for the full report to be complete but she went over the images with me and the oncologist right after the scan.
The chondrosarcoma is pretty much isolated to the right proximal humerus with some proliferation of the medulla but the scapula is clear although it is showing a periosteal reaction now.
The lungs have 2 small (2mm) nodules in the right lobe but she said that she really cannot tell now if it is early stage metastasis or if they are benign, another scan in 2 or 3 months would be required for a conclusive determination but I know the odds are that it has metastasized as they are in the right lobe nearest to the tumor.
Also found a benign cyst in his kidney which is most likely just from old age per the radiologist.
She said that she will spend more time on the scan and give me the full report next week or let me know if she notices anything else of significance.
Based on these findings I think the amputation is the right thing to do for him. Even with the OA of his hips I think that he will have a longer and better life than if we just let the cancer consume him.
I spoke to one of the surgeons about his follow up and she could not give me specifics yet on his after surgery pain management other than it would be a combination of opiod and NSAID and it would be determined by the actual surgeon performing the amputation. She did mention that he may get a Fentanyl patch depending on how the procedure goes.
I believe that I can advocate for his pain meds on the day of surgery if any members can suggest what they think would be best for Bruno's situation. He is currently 45 KG and for the past 2+ weeks he has been on 100mg of Tramadol twice daily so he is definitely opiod tolerant and they are giving him Previcox 227 once daily as well as 400 mg of Doxycycline twice daily.
His recovery room, AKA cordoned off area of the living room, is the size of 3 side by side yoga mats which may actually be too big but I can scale it down as needed.
His balcony real lawn grass patch is about 2.5 by 5 foot and I also have a 3 by 6 foot Astroturf but so far he is not in the least way interested in either of them. It will take a lot to overcome his 11+ years of being trained never to go potty in the house.
I look forward to any suggestions from other members about his pain management meds.
Hey Rob we were just wondering about you and Bruno, thanks for the update! So it sounds like you're moving forward and I know it must feel good to have a plan. Even if nobody wants to lose a leg, it's still good knowing you're on track and doing something to help him.
His home setup sounds wonderful! I think the 3 yoga mats are fine for a dog his size. Bruno's a smart boy, he'll figure out the astroturf potty spot soon I'll bet.
The pain management described is akin to what would be offered here. If you want to know all your options, the AAHA Pain Management Guidelines are a good place to start. Also, our articles with pain management tips from vet expert Dr. Mike Petty will give you additional info.
I hope this helps!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Otis came home with the Fentanyl patch, Tramadol (opiod), Rimadyl (NSAID), and an antibiotic, so it sounds like your vet is on track. Many dogs also get gabapentin for nerve pain. We ended up giving the Tramadol 3x a day until the staples came out, and then tapered off over the next week or so.
Otis - 106 pound lab/Dane mix, lost his right front leg to osteosarcoma on Febuary 9, 2016. Four rounds of carboplatin completed in April, 2016. Lung mets August 25, 2016. Said goodbye too soon on September 4, 2016. Lost his adopted sister, Tess, suddenly on October 9, 2016. likely due to hemangiosarcoma.
Wherever they are, they are together.
Yes that looks like good reading and I will get stuck into it as soon as I can. So far I have found no rehab therapy for dogs here beyond hydrotherapy so it looks like Bruno will not be able to get the benefit of profession post operative rehab but again I will do what it takes to learn some things that I can do with him.
Thanks #otisandtess for that info. I will be sure to ask about Gabapentin on the day of surgery.
it looks like Bruno will not be able to get the benefit of profession post operative rehab
Ah but he can! Dr. Debbie Gross has a DIY at-home course that is basically a PDF of the awesome six week course we took with her a few years ago. See:
DIY Canine Rehabilitation Therapy for Tripawds Course
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
So it is almost 11pm here now the night before his surgery and Bruno is sleeping like a log totally oblivious to what will happen tomorrow, how I envy him. The alarm goes off at 4am and we will head to Bangkok about 30 minutes after that to arrive about 7am. The surgical appointment is at 8am so that will give us some time to get in a final potty break which have been coming less frequently and are about every day and a half now. With a bit of luck he will "empty out" in the morning because he is really overdue.
Who would have thought that my biggest concern would be Bruno's bowel movements but from reading other posts I see that it is a common occurrence in the tripawd community.
Still have to do some negotiating with the surgeon tomorrow to try to get Gabapentin in addition to the Fentanyl patch and Tramadol. When I spoke to her on Saturday after our blood bank appointment she said that she would be doing a nerve block before the procedure and didn't plan on giving him Gabapentin.
I will post again once we are back and settled in for the night.
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