This week marks the one year "Gotcha Day!" for Honorary Tripawd Nellie B. Dawg. Last June we brought her into our life as a foster (haha!), and immediately fell in love with our 3.5 legged gentle German Shepherd.

Every day she makes us smile, and reminds us about what really matters in life.

Over the last year we've lived and worked in our RV all over the west, and Nellie has never skipped a beat as our co-pilot. She is an easy traveling dog who is at home in the truck, and wherever we land.

Nellie was clearly a gift from her predecessors, Tripawds Spokesdog Jerry and Wyatt.

She is still an "honorary" Tripawd.

Her leg is not straight, and her foot is still. crooked. A relative gave her the cute nickname "pata chueca," meaning crooked foot in Spanish slang.

When we adopted her, we mistakenly assumed that her leg was causing her so much pain that it would require amputation. How wrong we were! Nellie still uses that crooked foot and leg. She doesn't bear a lot of weight on it, but uses it for balance and grasping objects. Officially she has a "carpal contracture," meaning that her wrist is essentially frozen from an old, untreated injury.

She's seen several vets from Oregon to California, and we got different suggestions on what to do. Since we couldn't get at least two vets to agree on the same direction, we decided to take her back to our home base in Fort Collins, and let Colorado State University's Orthopedic Medicine and Mobility (OMM) department be the tie breaker.

What is Nellie's Future as a Three and a Half Legged Dog?

During her visit to the OMM department she received an extensive evaluation from the team. They spent an incredible amount of time with us, and here's what they've concluded about her condition:

The official diagnosis for Nellie:

"Flexural deformity of left carpus - suspect flexor carpi ulnaris and flexor carpi radialis muscle contracture secondary to prior trauma. Suspect right elbow dysplasia. Intermittent right hindlimb lameness- lumbosacral disease vs hip dysplasia vs other."

Dr. Lindsay Elam, Colorado State University

To determine the next steps, they recommend better radiographs and an ultrasound for "identifying extent of lesion and determining if there is enough muscle fibers left for us to consider certain treatment options."

A "Tenoctomy" to Fix a Carpal Contracture on an Adult German Shepherd Dog?

We discussed splinting her leg with a custom orthotic, but Dr. Elam says it's likely that a brace would result in ongoing pressure sores. "It would be a $2,000 experiment," she told us.

Then we mentioned the possibility of a partial amputation so Nellie could use a prosthetic. The OMM team does not recommend that route.

"We discussed full amputation .... is not recommended at this time given right elbow osteoarthritis and possible hind end weakness."

Dr. Lindsay Elam, Colorado State University

The last option: a veterinary orthopedic surgery called a "tenectomy" or tendon lengthening.

Basically the OMM team would cut her wrist tendons to give more mobility.

A tenectomy could "cause hyperextension that can be managed with an orthotic or a pancarpal arthrodesis (fusion of the carpus into a more normal angle to allow for ambulation)," Dr. Elam explained. So even with surgery, she would have to wear a custom brace.

Also, Nellie is a rare breed. No studies exist in orthopedic vet medicine that could point to a potentially good outcome for this surgery on an adult dog. It's been documented as a successful surgery for puppies who were born with a contracted carpus. But no studies point to success for older dogs with a carpal contracture.

Coping with the High Cost of Vet Care: Our Decision (for Now)

Surgery comes at a cost of about $7,000 to $8,000 for everything; diagnostics (to show the tenoctomy could work), surgery, and a custom brace. She would also need rehab therapy, which adds to the cost.

Nellie has great pet insurance with Embrace, but her condition is pre-existing and not covered. So now what do we do?

After much debate, we feel like a tenectomy surgery to fix her leg feels like a huge, and expensive gamble that we are not in a position to pay for right now. We just can't do it without going into serious debt. We still might do the diagnostics, just to make sure about a tenectomy as a future possibility.

But the fact is that Nellie has been living this way a long time. Vets agree she is not in pain. And her condition isn't a life-or-death matter (where debt, if necessary, would be justified in my opinion). Taking those three things into consideration, we decided that surgery is not an option for us.

We will continue managing our happy "pata chueca" German Shepherd as best we can, without surgery.

Nellie will still get her usual mix of gentle strengthening exercises, daily pain management (NSAID and Gabapentin), regulated activity, and daily dog stroller rides. Our happy girl is enjoying the best life she's ever had, and that will never change. Surgery may be an option later on down the road, but not today.

Veterinary care has come so far since we started this community. Pet parents have more options than ever before to help our pets stay healthy. But the hardest part is finding a way to pay for that higher level of care.

In our opinion, pet insurance on any pet is necessary these days. But when it comes to pet insurance for a three-legged dog (or a three-and-a-half legged one!), it's important to be aware that even the best pet insurance won't cover orthopedic conditions that result from being an amputee dog or cat before the policy was acquired.

We love Nellie with all our heart, and will do our best to continue giving her the happy, pain-free life she deserves. May we have many more years of joy with our three-and-a-half legged Spokesdog!