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Day 2 post amp (front leg) - 11YO American Bulldog x Boxer - restless & stairs/car q
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17 June 2023
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17 June 2023 - 4:01 pm
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Hi all, what a great site! I've read a bunch and found it very affirming, but I still have a few loose ends I've not seen directly addressed, if you could please humour me. 

We've gone through the tripawd experience a decade ago with our beautiful boxer. I'm not sure if we've purged some of the memories from our brains, or if it's just a different experience with her, but it feels much harder this time round. 

Our lovely Tori got her front leg amputated close to 2 days ago due to osteosarcoma and has been home with us since yesterday morning. She is an 11 year old Amercian bulldog x boxer (we think), and post amputation weights 31kg. The things I am struggling with are:

- we have five steps out to the carport, and I'm too scared to let her walk down them - she's not cautious at all, very gung ho in nature, so high risk of her stacking it, even with towel assistance. We tried bundling her up in a blanket to carry her to the car, but she cried out in pain. It was very distressing to know we did that to her. We'll need to take her back to the vets in a few days and I'm not sure what's the best route - how are other people managing moving their heavy dogs up/down stairs or in/out car without hurting them? It's just so awkward when she's so big and it's her front leg. Just not sure what's the better move - trying to carry her even if it hurts or risk her having a fall down the stairs?

- I was hoping that she would sleep a lot, but I think the Fentanyl might be making her unsettled. Or it could just be her adjusting to what is going on, I'm not sure. Her pain meds are the Fentanyl patch and Meloxicam/Metacam. As a senior girl, she normally sleeps most of the day pre-op, but post op, she finds it hard to get comfortable and is only getting the odd hour here and there. She tells me with her eyes and body language that she's not comfortable, but then when we help her to move, she's usually not comfortable there either. I rang the vets last night to see if there something safe I could give her to relax her, but they said they'd give her an anti-anxiety injection if she is really freaking out (but she's not that bad), or we could bring her back in and they would take her off the Fentonyl and try something else. Am nervous mucking around with her pain meds though, as it may just be her adjusting to her new life. I wouldn't say she's anxious, she's just fidgety and takes a long time to get settled. She's quite stubborn in nature mind you, so she generally never takes it easy when they are meant to be. Has anyone else had experiences with them being unsettled? The general feedback I seem to get from the forum is sleepiness if anything. And taking her back to the vet would mean getting her in that blasted car and down the stairs again, so I don't want to put her through that unless I'm certain it's necessary.

There are the only 2 things that are different to what I expected/remembered, but gosh that is plenty! I probably only got an hour of sleep last night, as I wake up every time she moves, and it can take her ages to decide to move or just fidget. I think I'm a helicopter mum! Just so scared of her falling onto her sore side and screaming (that's happened already), or face planting and landing on her remaining leg in an awkward angle (also happened).  Should I be leaving her be and only intervening/helping when necessary? I know we're not meant to compare, but sounds like other doggs are hopping around unassisted early on - am I mollycoddling her to much? I wake my hubby up every time she looks like she is going to try and move (which is often), even though they are usually false alarms - I think she wants to move but gives up because it's too hard, then gets progressively more frustrated until we help her move.

When she does go out the front for a wander (ideally for a pitstop), she can be out there for 20 minutes just hopping around (assisted), even though she is clearly exhausted. It's like she doesn't know what she wants. Sometimes she hops so quickly it's hard for us to keep up too which scares me. I just wish she would take it easy.

Hoping there are others out there who have had some similar experiences? Sorry for the long post - it's exhausting not sleeping and acting cheery with her all day, but every time she decides to move it's scary and stressful. I just feel like crying a lot! I've had my husband's help since we got her home, but he needs to go back to work today, so I got my Mum to come stay with me (even though I'm 44 lol), I just feel less overwhelmed having a second set of hands. I will be alone with her on Wednesday and Thursday and it makes me so nervous that I'll hurt her or she'll hurt herself.

Rant over, thanks for listening. I'm 99% sure things are normal and she will be fine in a couple of weeks - I will just feel better if I can figure out how to approach the stairs/car thing, and to hear that other dogs have been fidgety and not slept much either. I just think our boxer was more cautious and slept a lot, so these are curveballs I wasn't expecting. 

Many thanks

Christine

The Rainbow Bridge



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17 June 2023 - 10:43 pm
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Christine and Tori, welcome to the club nopawdy wants to join once much less twice! I am so sorry you are going through this again,

Rest assured what you are describing is very common. Usually restlessness can be attributed to uncontrolled pain and also just feeling put of it from the pain control. Narcotic meds can really knock dogs for a loop and many will behave exactly asTori is. Do work with your vet to adjust the meds and also ask for a anti-inflammatory if she isnt getting one. It makes a big difference.

When it comes to stairs, as long as they arent slippery I would let her do the, on her terms. As a bigger dog she will likely handle the, better than you think. Longer staircases would be another story.

Going through recovery means balancing her need to try things on her own with protecting her from injury. Its tougher with certain dogs but it sounds like woth Tori, allowing her to be just a smidge more independent will be good for both of you.

I need to run now but will return tomorrow so keep us posted! Stay tuned for feedback from others.

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18 June 2023 - 12:41 am
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I hope that you get some answers to these questions.  My dog is a senior also and I’m really on the fence as to whether or not i want to put her through this. 

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18 June 2023 - 1:49 am
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jerry said
Christine and Tori, welcome to the club nopawdy wants to join once much less twice! I am so sorry you are going through this again,

Rest assured what you are describing is very common. Usually restlessness can be attributed to uncontrolled pain and also just feeling put of it from the pain control. Narcotic meds can really knock dogs for a loop and many will behave exactly asTori is. Do work with your vet to adjust the meds and also ask for a anti-inflammatory if she isnt getting one. It makes a big difference.

When it comes to stairs, as long as they arent slippery I would let her do the, on her terms. As a bigger dog she will likely handle the, better than you think. Longer staircases would be another story.

Going through recovery means balancing her need to try things on her own with protecting her from injury. Its tougher with certain dogs but it sounds like woth Tori, allowing her to be just a smidge more independent will be good for both of you.

I need to run now but will return tomorrow so keep us posted! Stay tuned for feedback from others.

  

Thanks Jerry for the info, and such a quick response. I wonder if they just let us take her home too soon - she only got the op on Friday afternoon, and we picked her up Saturday am, prior to her Fentonyl patch kicking in. It wasn't even 24 hours, more like 16! Originally they had said to call to find out the likelihood of taking her home Saturday vs Sunday. We'd assumed it would late pm rather than the morning. Our oncologist will be back onboard tomorrow (weekend was the ER staff), so I'll chat to him about my concerns. I was going to get a vet to do a home consult but I doubt they'll be keen to do much without getting her medical chart etc.

Thankfully she has improved today. Still lots of fidgeting and not much sleep, but definitely more sleep than yesterday and for longer periods. She also seemed to figure out how comfy position, so fingers crossed it's onwards and upwards. 

I also read about the potential difficulties of ongoing pain management so I will be much more on top of it next time so I don't get any surprises. It's frustrating that they pretty much send you home with a quick tip on how to do her drip and give her support with a towel and that's it. Would be good to get a one-pager re what to expect with the meds so you know when to bring them back or not. Like it's not stressful enough without having to figure this stuff out yourself...

Thanks again, Jerry smiley_clap

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18 June 2023 - 2:00 am
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Michael said
I hope that you get some answers to these questions.  My dog is a senior also and I’m really on the fence as to whether or not i want to put her through this. 

  

Hi Michael, sorry to hear you are going through it also. It just makes you feel sick, doesn't it, having to make decisions for them without being able to get their feedback.

I hope my concerns don't skew your decision - they were just the current struggles, there have been positives already. Throughout the whole process, she still wags her tail and finds delight in her smelly treats. She found a nice spot to nap in our garden today, and was enjoying all the smells and the sun on her. They are much more resilient than us I think! And it's amazing how quickly she is getting around, despite the fact that she's not feeling the best.

You know your doggo better than anyone, so I think just follow your heart/gut - at least there's plenty of info here also. For Tori, we decided it was the right decision because even though she's 11, she acts like she's 7 or 8, still lots of energy and love for life with only a bit of arthritis to monitor. So I feel confident that she will be able to manage the challenge of healing etc, and still enjoy life. She also didn't have any other physical signs of osteo in her body (of course it's still there but not visible under scans yet). She actually also has an atrial wall cancer that they found incidentally, but it's usually slow growing, and the alternative therapies will help slow it's growth, so we think the osteo will get to her first.

We've also found a holistic vet who is going to give her supplements and a vitamin c infusion to support her through chemo, as well as physio, hydrotherapy and acupuncture to manage the health of her remaining joints. We've got a ramp coming to conquer those ruddy stairs, and I'm looking at the 3D prosthetic. I've not seen much of it on here, it seems unlike the others, they don't need a stump remaining. They have already said she is a good candidate, so just waiting for 3 weeks before we proceed. Not cheap but I think it will help her remain active and help her other legs out - 3D Pets (3dpetsprosthetics.com).

I know every doggo is different, but with our boxer, she was also a senior but adjusted well to the amputation, it was like a new normal after a couple of months, and we were lucky to get another 12 months with her. 

Good luck in making your decision sp_hearticon2

Christine

Virginia



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18 June 2023 - 6:14 am
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Will come back later, but just a ,quickmpop in before going to work.

My Happy Hannah was BERY restless the first several nights, could not get comfortable, etc.  So yes, some dogs do NOT sleep through the first several days.

For you, the patchmis also causing  some confusion,  etc.  Would ask the Bet about removal and going  with Gabapentin  and Amantadine...alternate.

Aorry for quick reply.  This WILL get better!  Major surgery does not recover overnoght.

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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18 June 2023 - 10:35 am
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Thank you for that response Christine.  I am happy to hear that yours is doing well considering.  This has been absolute torture for me.  She was diagnosed on Thursday morning and i feel that she’s gone down hill since even then.  I don’t know how I’m going to make decisions so quickly when i feel so unsure about whether I’m doing it for Ophelia, or for me.  

This has just been devastating.  .  

The Rainbow Bridge



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18 June 2023 - 12:20 pm
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We are here to help! Just glad she's doing better now. There IS a light at the end of this scary tunnel I promise!

Yes talk to the oncologist and let us know what they say. I think that they send people home without a ton of info because they might be afraid of overloading the client with too much to think about all at once. The good thing is that vets usually encourage calling or emailing with any concerns. How many of us go home after a monumental day like getting our dog from the clinic, and forgetting everything we heard the vet say?

Write down your questions ahead of the conversation and you'll be well equipped!

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19 June 2023 - 10:21 pm
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Hi all

Thanks for your feedback and support sp_hearticon2.

To give an update:

I called the specialists on Monday when they reopened, and as of yesterday, removed the fentanyl patch (early) and overlapped with Gabapentin and ad-hoc Trazadone (while continuing the Meloxicam). It did freak me out when she had them all in her system as she was so out of it, but it got better as the hours progressed. She has slept more in the past 24 hours than she has all week (although we haven't, as she decided to sleep on the floor in our bedroom - after we moved our mattress to the lounge room lol. I'm too old to be sleeping on floors seemingly!).

We saw the vet today when they took out her drip (yayy!) - we discussed our concern that she may not have enough pain medication when the Fentanyl runs out, and how she's still a little fidgety, so we've also added human paracetemol to the mix. They seem confident that this combo should be sufficient to see her through, and said they'll tweak it with us over the phone if need be.

Was very stressful figuring out the stairs/car situation, but we remained calm and pre-planned our strategy. We ended up guiding her down the stairs super slowly, with me standing half way down so it forced her to take her time instead of trying to do them all in one hit quickly. We got her in the car ok with the help of the towel, then got the vet nurses to get her in and out using a stretcher at the vets. They made it look so easy! We were surprised how they handled where her shoulder used to be and she didn't scream, but the vet explained that bit wasn't sore, it's where the stitches are where all the nerves and muscles are. So good to see professionals do it and know of another place we can hold if needed. 

She had a bit of a crummy time at the vets, she screamed when they pulled out her drip which made me bawl. She hasn't pooped yet, so to be sure they gave her a rectal exam to make sure she wasn't too compacted. We then ended up giving her an enema (to save the risk of having to come back the next day if the suggestions they gave didn't work). So she was thoroughly over it by then. 

We made the most of having her in the car and took her for a long drive and spoiled her with a puppacino and a cheese and bacon roll (with her meds hidden in it). I think we also needed the R&R to recover from the stress of moving her around.

To get her out of the car, we used a ramp but let her decide when she was ready to have a crack. Meant hanging out in the car for a couple of hours, but it felt better than having to coerce her out against her will.

The vets were great and we are four days down and she is wandering around a lot less. She still gets fidgety but at least she'll got for a wander for ten minutes and settle down again (rather than an hour!). Knowing we have the Tradazone to help her is reassuring too.

In hindsight, I wish I'd just booked the week off work. I had incorrectly thought she would just be sleeping it off with odd toilet break. Thankfully my work has been marvellous and have been fine with having unplanned time off. The lack of sleep has been the biggest thing really, as everything is harder and more overwhelming. 

Still feeling positive about where we are headed. Just want to get to the fun recovery bit 🙂

Colorado
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20 June 2023 - 1:08 pm
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It looks like you have it pretty much figured out, but I have a big dog (7 year old great pyrenees mix 97 pounds) who had her forelimb amputated.  I know exactly what you mean when they give you the "look" saying they are uncomfortable, it's gut wrenching.  One thing I didn't see mentioned that seemed to help Ellie a lot was having a cold hard spot to lay down on.  She is about 10 weeks post op, and her favorite place to nap is still on the hard concrete (before surgery it was her nice (and expensive) orthopedic bed , which she now hates) or outside before it gets too hot. I ended up lifting up a runner carpet so she always had a patch to lay on. She is snoozing there now, haha.

I don't have stairs, but I did get a ramp for my suv you to get her in and out.  She was in a clinical trial so we were going to the vet 1-2 a week for like 6 weeks (we were both thoroughly over it). This is the one I got I like it because since it's longer it really cuts down the angle (I have an xterra, so it's pretty high off the ground).  It's pretty easy to move around, but kind of clunky, I'm very thankful for it though, it's worked out fantastically, and felt very secure, I like it's width too, I think that makes Ellie feel a little more secure on it as well.

I know it's hard not to step in and help, but sometimes it's for the best to let her try it out on her own.  If she's getting around well enough that you have to run to keep up, it might be time to let her go unassisted.  For what it's worth, Ellie refused to let me help her at all- she wouldn't move if I put the sling on. I kept her hold-em-up harness on for a few days so I could quickly give support when needed, but rarely used it and it really was more for my anxiety than an actual need

Follow what your vet says, of course, but be wary of the Trazadone.  It sounds like your girl is pretty laid back (as is my Ellie), and the trazadone made Ellie into a total zombie and it made things so much worse (she was peeing all over herself because she was too drugged up to get up). you really only need it if Tori is being too active.  With that said the vets have commented how sensitive Ellie is too sedation, so maybe we just say the extreme so this is just my two cents. 

I'm glad your work is being so flexible!  I was thanking all the stars that I work remote, it was a godsend that first week.

Virginia



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20 June 2023 - 7:10 pm
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You are doing such a good job of caring for your sweet Tori and making sure all her needs are met. She is so very lucky to have you as her hoomans.  She really is dping very well th9s early on.  Getting g her pain managed  cert helps kee her on track f0r a good recovery. 

Br sure and take care of you!  It is so exhausting  mentally and physically  getting to this point.  Now that Tori is resting more comfortably,  hopefully you can get some solid sleep.

Keep on keepin' on Tori!  You've got this!

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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21 June 2023 - 1:26 am
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Many thanks Whitney sp_hearticon2and Benny sp_hearticon2.

Another day of highs and lows, it feels like 2 steps forward, one step back. But at least we're going in the right direction :).

The Good

Last night Tori slept in our bed (we were on either side) all night! And she didn't get figety til the wee hours of the morning. I did end up giving her a Trazadone and she settled then, but after your comment Whitney, I rang my vet (as she also said it's more when she's too active, not just fidgety). I knew it probably wasn't the right thing to give her, but I didn't want to risk giving her too much painkiller without speaking to the vet, so figured it would do the job til I spoke to them. 

The vet said based on how I described it, she's probably a bit uncomfortable, not necessarily in pain, so said I could up her gabapentin to 2 tabs at night (or as needed). So I feel like we are getting another step closer to her magical pain management potion!

So it felt marvellous to have a half decent sleep, feel like a new woman today comparatively!

Then she slept through til 2pm! It was a lovely deep sleep with dreams rather than a drug addled one, so it was lovely to see her catch up on her zzs. We also left her to her own devices (after heeding comments to not coddle too much), as she can't hurt herself on the bed, and she managed to get comfortable and adjust herself unaided, which was lovely to see.

And we also got her stair ramp and memory foam (3.5mm) mat come today which all helps.

The Not So Good

Thinking it was probably the drama of yesterday's vet visit, but when she did wake up, she had no interest of getting up and didn't look very happy (no tail wags). She actually shook when I coaxed her to get up, poor love. She's not been like that before. So that definitely is a setback. But still eating and did allow me to get her up with some pleading.

A few hours ago is day 5 post op, and she's still not defecated. Even after the enema yesterday, and me giving her lots of watery food and pumpkin hidden here and there. So today after speaking to the vet, I added a laxative in the hopes of us not having to take her to the vet to get sedated and manually evacuated. The thought of having to go back so soon fills me with dread! We've taken her out the yard (even though she wants to go back to bed), and still no sign of interest. 

So I think I'll book her in for a late pm appointment in the hopes something miraculous happens. The vet said she wouldn't want it to go past tomorrow. It's bizarre, as she's been eating the whole time post-op, so I can't see how she's not getting any impulse to go. 

It was so great to see her sleeping so well, so a bit disappointing to see her scared now to do anything, and another vet visit tomorrow will probably just make it worse.

Thanks for the rant, this is like therapy lol! It's nice waking up in the morning to some words of reason and reassurance.

Hugs to you all, you're a godsend

Christine

Colorado
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21 June 2023 - 7:45 am
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Hey Christine,

If I had to put money on it, I would bet the trazadone has her feeling really zonked out.  I did exactly what you did I remember it so clearly it was the night of day 4 post op and Ellie couldn't get comfortable and kept getting up and moving around and then settled on the shower floor but looked miserable I really wanted her to be able to sleep well and realized that most likely the local pain relief that they injected at the incision site had probably worn off, but I was also scared to give her too much extra pain medication so I gave her 100mg gabapentin (she was getting 400 3x/day) and then a full dose of trazadone.  It took a solid 24-36 hours for it to completely wear off, she was so zombie, she just laid there and ended up peeing all over herself, no interest at all in getting up to go outside. She did still eat though (god bless that dog and her appetite, it has been my saving grace through all this, haha)

I'm glad your vet okayed more gabapentin.  I'm not a vet, but I have researched gabapentin more and more and it's a really safe drug in how much you can give without worry of bad side effects (usual dosing is anywhere between 5-30 mg/kg 2-3 times a day, most of our dogs are given 10mg/kg). I hope once the trazadone wears off and the gabapentin does it's job everything will be a bit smoother.  

I'm so happy to hear you were able to get some decent sleep too! It's so easy to not take care of ourselves out of worry for our pups.  Thank you for keeping us updated, you are doing absolutely amazing and Tori is in excellent loving hands!

You guys are on my mind and I hope she has a massive poop ASAP!! sp_hearticon2poopiconpoopiconpoopiconpoopiconsp_hearticon2

The Rainbow Bridge



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21 June 2023 - 9:26 am
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Whitney your insight is spot on! Yes that is all true about Gabapentin, and although scientifically speaking the jury is still out according ot our vet (just not enough research on dogs & cats yet, but there is on humans), most vets and pet parents are finding that it does help with acute surgical pain control and long-term chronic pain too.

Christine, i love that your vet is so good about pain control, and adjusting it as needed. YAY! Better pain control = better sleep and better days ahead. You are doing all the right things to help her heal. And when you least expect it that massive dump is going to happen! We've seen dogs go up to 7 days without pooping, the pain medications just do a number on the system (ask any human who has used them and they will say the same thing). Paws crossed for poopiconpoopiconpoopicon!

Virginia



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21 June 2023 - 4:58 pm
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Ditto, ditto, ditto about the Ttaz causing  sedation and not really doing. anything for pain.  Don't  be afraid of the Gaba.  Trying to fight pain while trying to heal takes energy that needs to be focused on recovery.

When my tripawd Grankie had  TPLO surgery on one of his remaing back legs it was day seven before the poop! The Vet wasnt concerned and never even suggested  an enema or laxative, etc.  

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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