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Caring for a Three Legged Dog or Cat

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Have to choose between two types of amputation for dog, advice needed.
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Member Since:
5 December 2016
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5 December 2016 - 8:46 pm
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Hello,

I have a eight year old, 109lb,  female St. Bernard mixed with a Polish Sheep Dog named Saba. She was diagnosed with Osteosarcoma on Black Friday. Her limp was originally attributed to arthritis, but then she developed a bump on her ankle on her left foreleg the Monday before thanksgiving and we quickly called a vet.

The vet, Dr. Smith, sent us to a specialist, Dr. Alice. Dr. Alice stated that we have three options:

1) Amputation: Dr. Alice recommended an amputation as Saba is underweight and her cancer is lower on the leg and is still "early" enough that there is a *small* chance she may live longer than a year. Dr. Alice stated that the amputation should be a Thoracic amputation, which is an amputation to the shoulder. She stated that she's been recommending this approach for over 35 years. According to Dr. Alice, the benefits of this amputation is that there will be A) Less weight for her to balance on, B) She won't be at risk of Muscular Atrophy (degeneration of unused / exercised limb), and may have fewer Phantom pains. She recommended a traveling, board certified veterinary surgeon that gave me an estimate of $2,000 - $2,500.

2) Treatment through chemo, but Dr. Alica says this may cost at the lest $400-$500 a month and her pain will still be present.

3) Put her down: However, she is showing a clear desire to live. On Wednesday 11/30 I came home to her whining incredibly loudly and not moving. I thought we were going to have to put Saba down... but prior to that day she had only been limping and was still running around and demanding to go on walks. Dr. Alice put her on Gabapentin, Tramadol, Amantadine, Lumostine (the chemo drug), and a vitamin and she's back to normal, running around, eating, and demanding to go on walks (we stopped them for fear of fracture).

I want to do the amputation, however there is an issue.

Dr. Smith, our primary veterinarian, only feels comfortable amputating as high as her elbow. Which means she would have part of her limb. He says that there are a few advantages to this option:

     A) The operation is less invasive, less complicated, and according to him dogs recover quicker from these.

     B) Dr. Smith says the only reason to get Thoracic amputation (up to the shoulder) is to prevent them from leaning and balancing on the limb and getting sores, which he said is not too common.

     C) Its cheaper (he quoted us at $2,300), and since we are merely buying her more time, it may not be worth it and that the cancer wont be cured.

Dr. Alice (the oncologist) on the other hand, agrees with Dr. Smith that it is less invasive and says that an amputation to the elbow is ok and will still benefit Saba. However, she says that she has been doing Thoracic amputations 35 years sees a few benefits to them:

    A) There is less weight for Saba to handle and balance on after the amputation.

    B) There is less of a chance of her having muscular atrophy (degeneration of the muscles due to lack of use / exercise)

   C) Less chance of phantom pains since the leg is not there.

   D) She reffered us to a specialist that estimated the operation to cost between 2,000 to 2,500.

I do not know which one is better for Saba. I respect Dr. Smith and Dr. Alice both. I am purely concerned by which procedure is "better" for Saba. I feel alone and confused as I feel like there is no one else to consult with this question. Would anyone have any advice?

Thank you!

I want to go with the amputation, I do

Livermore, CA




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5 December 2016 - 9:21 pm
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Hello and welcome to you and Saba.

I'm sorry you are faced with this decision, but you have found a great place for information and support.

There have been a few dogs here with partial amputations and I think most of them ended up having another surgery to remove the rest of the limb.  From what I've seen here dogs with a partial front limb have all kinds of trouble with the stump a constant source of injury and infection because the dog 'walks' on it or bangs it into things.  It would also throw off balance although I think a dog would get used to it and learn to balance with it.  The only reason's I've seen for a partial amputation is when a prosthetic would be used.

I can't even think of one example here of a vet recommending a partial limb amputation when dealing with cancer.

It seems to me that without amputation you would need to treat the leg pain in addition to doing chemo.  Bone cancer is very painful and only gets worse, the chemo will not help with the pain.  Pups who are not good candidates for amputation are sometimes treated with radiation therapy or bisphosphonates.  It's great the meds are helping with the pain now but you will continually have to increase the dosages and with bone cancer there is a point when the meds won't help enough.

I certainly understand your financial concerns, they are part of the decision process.  It would be great if we all had unlimited funds, but alas most of us do not.  You have to do what is right for you and Saba.  I'm just a little confused about the vet recommending a partial amputation.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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5 December 2016 - 9:30 pm
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Hi Karen,

Thank you for the welcome, I have been searching ever since the diagnosis for a website and am glad I finally found an active one.

I too was puzzled at the suggestion of a partial amputation. I respect our primary vet but I suspect it may be because he is not a board certified surgeon and does not feel comfortable performing an operation of that complexity. With your reply I am leaning towards the full amputation, especially if its only a few hundred more than the partial amputation and I am running a GoFund Me page which has so far raise 60% of the cost... so I am not overly concerned by the upfront cost. She will be on Lumostine for the remainder of her life to slow the cancer if it has already metastasized into the blood.

The oncologist, Dr. Alice, says that Saba has a "better" prognosis since the cancer appears to be in its early stages. Have you heard of any stories on the forums of dogs living past the 6-12 month range? Dr. Alice said the typical patient she sees will have cancer diagnosed in their lungs by 6-9 months, and live around 2 months after diagnosis, while a minority outlive 1 year. She said some of her patients have made it 2-3 years. I have a skeptical nature and am just hoping she is not trying to sell to me based on hope.

I am reading a lot on this website. I feel unease about an amputation, as I know everyone is. My worry is that she will be upset / depressed without the leg and that it may be difficult for her to adjust. What I am reading on this website does give me some ease, but nonetheless its hard not to worry.

Michigan
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5 December 2016 - 9:40 pm
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Ditto to Karen lol

I've been here for about 3 1/2 years now with Murphy.  From what I've seen on here, it seems that a partial leg amputation is usually done when someone wants to fit their dog for prosthetics .  That a dog will often try to use their stump and end up with injuries, sores on the stump, things like that. 

Where do you live?  Are you able to see an orthopedic specialist?  If you are near a teaching hospital, they are often cheaper than a private vet, and more experienced with amputations.  We drove 1 1/2 hours to Michigan State University for Murphy's surgery and to see the oncologist after.  They also worked with our regular vet for blood work and for taking out his staples afterwards.  His surgery was about $2500, but he's about 50 lbs, so a little smaller than your Saba.

The phantom limb pains that the oncologist referred to don't usually last forever - most dogs recover in a few weeks, and with adequate medications can do well.  Gabapentin can be prescribed to help with nerve pain.  Recovery takes 2-3 weeks for most dogs, but could be longer since Saba is larger (sometimes they take a little bit more time to figure things out).

Donna

Donna, Glenn & Murphy 

Murphy had his right front leg amputated due to histiocytic sarcoma at 7 years old. He survived 4 years, 2 months & 1 week, only to be taken by hemangiosarcoma at 11 1/2 years 6/12/17  
Read about Murphy's Life on Three Legs

Donna.png

Member Since:
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5 December 2016 - 10:01 pm
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I live in Los Angeles (the San Fernando Valley). I have thought about a teaching hospital but I am unsure of how to search for one. The oncologist we met with refereed me to a specialist surgeon who gave an estimate of $2-2,500. I am having a consultation with him on Thursday.

Saba is currently on 3 pills per 8 hours (so 9 daily) of Gabapentin, 2 pills of Tramadol at night, 1.5mg of Amantadine, 2 Riymadyl's a day, Vitamins, 2 tablets (2000mg) of Glycoflex Glucosamine and 5.4mg of Lumostine. 

Our oncologist said she texted photos of our dog's legs to a orthopedic doctor who said Saba would be a candidate for amputation. But I have not be with one and not sure if I can afford to at the moment. The oncologist said the surgeon would check whether her right foot (the non cancerous one) can bear the weight of the rest of her body. She was diagnosed with the mildest form of arthritis possible, our regular vet says that this shouldn't be too much of an issue.

I guess I shall pursue the full amputation as a prosthetic is probably out of my budget. I do no want her to injure herself by leaving a portion of her limb.

The doctor also said I can keep costs down by taking her home the same day. Is there a thread somewhere the deals with tips on how to deal with the first night? I read that the first night is the most problematic.

Thank you,
Marcin

Michigan
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5 December 2016 - 10:11 pm
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Marcin ~

There's a lot of people here from California, so I'm sure someone can chime in about where to look.

Are you giving Saba all of her pain medications at the same time?  You'll get much better coverage for her if you can space them out.  For example:  8am Gabapentin; 12noon Rimadyl; 4pm Gab.; 8pm Tramadol; 12midnight Gab.  This gives her a pain pill every 4 hours except the middle of the night.

An orthopedic specialist should be able to do a phone consult.  Many dogs here have had surgery even with arthritis.

Donna

Donna, Glenn & Murphy 

Murphy had his right front leg amputated due to histiocytic sarcoma at 7 years old. He survived 4 years, 2 months & 1 week, only to be taken by hemangiosarcoma at 11 1/2 years 6/12/17  
Read about Murphy's Life on Three Legs

Donna.png

Virginia




Member Since:
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5 December 2016 - 10:19 pm
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YOU ARE NOT ALONE, OKAY? We are ALL right here by your side! We understand the fear, the uncertainty, the stress AND the deep love you have for Saba! A y decision made out of love is the right decision!

For now, keep thi gs chunked down. Yku can ddecide on chemo later.

As yku can already see, al ost all dogs here (if not all), have the full amputation, leavi g no "stump".

Also, most dogs here have the surgery done by a Board Certified Orthopedic Surgeon. My Happy Hannah's refular Vet said he would not be comfortavle doi g her rear leg amp and referred ner to a Specialist.

ASo, an Orthopedic Surgeon will have Saba stay overnight with 24 hr care, whereas your regular Vet won't have overnight tech staff. Jist like with humans, all sjrgery has risk. Having someone there after surgery with all the proper medical knowledge and equipment helps to eliminate at least most of the risk.

Now, the most important thing you can do right now is NOT give much credence to "statistics"! Every dog is different and NOT a statistic! This whole statistie/prognosis thing is pretty much a crap shoot!

Six months quality pain free time is over THREE YEARS in human terms! One year in doggy years is SEVEN in human years.

Besides, Saba does NOT have a timeframe stamped anywhere on that fluffy butt of hers! Go ahead, take a look! Yerl, no timeframe stamped there!

The important thing is to not let ANYTHING rob you of your time together with Saba! She sure isn't! She doesn't care about days on aa calendar or about what any ole' doctor says! She does care about living a d spoiling a d treats and tummy rubs and cheese pizza and ice cream!

STAY CONNECTED! Let us know how we can help. Take some deep breaths, eat some chocolatea d go give Saba a big smooch and watch her tail wag! All is good in Saba's world!

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!

Virginia




Member Since:
22 February 2013
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5 December 2016 - 10:32 pm
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As usual, by the time it takes me to typo my post, mine is already obsolete!

Yes, some DO take their dogs home the same night. It's rough but it's certainly doable. Sometimes as the anesthesia ks wearing off, and the heavy pain meds are kicking in, there can be a lot of vocalizations and restlessness. And some dogs are fairly zonked out. But for the most part, it can be .....er..."disturbing" for the first night or two, but it does eventually get better!

You'll want to put non slip rugs over hardwoods for traction . You'll want him comfy is a stable bed that isn't too aquishy as they need the support to try and stand.

The Vet will give you detailed instructions of any red flags to look for. Hopefully, helle give you his contact number should you need any help the first night or two. And you have your Tripawd Family as a strong support system too!

Lots of bugs!

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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5 December 2016
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5 December 2016 - 11:46 pm
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Sally and Donna,

Thank you for your advice.

The oncologist referred me to a board certified specialist, unfortunately he is a traveling surgeon and doesn't have a clinic himself. I am not sure if the clinic at which we operate will keep her, but I will find out. I was told it may be significantly more expensive to house her though. 

For the pain pills, I have to check with my family members (they are home more so they can have given her medication). I believe we give the 3 Gabapentin pills at 6am (thats when I give it), then 2pm, then 10pm. We give the Rymadil at 8am is and then before bed. We give 2-3 tramadol before bed, and 1.5 amantadine tablet per day. I will ask my family if we space it out.

How quickly should we decide / agree to the amputation and go through with the procedure? No one is pressuring us, but I understand that with cancer time is of the essence. It was diagnosed on 11/25 by our regular vest, confirmed on 11/30 by the specialist.

Virginia




Member Since:
22 February 2013
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6 December 2016 - 12:00 am
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Actually, many of us have our dogs "misdiagnosed" with arthritis or sprains at first. They are treated with Rimadyl and the limp would go away off and in before xrays were done and it was determined osteo. And many times the surgery will be delayed even further because a Vet may want to do a biopsy.

Anyway, just trying to say that you certainly have time to process things and do all your research, talk to Vets, 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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6 December 2016 - 7:41 am
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My Otis was a 106 pound lab/Dane mix.   He had a full amputation, including the scapula of his front leg, and it worked out well.   He had a good recovery, and got around great thereafter.  Like someone before mentioned, I would worry about injury to the partial amp, and wonder if it might be harder for the dog trying to use the partial leg.  (But I am not a vet, so speaking only as the owner of a big dog who had an amputation).

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.

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6 December 2016 - 8:29 am
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I'm a bit confused about the distinction between two surgeries you're discussing. A conversation that comes up every couple of months here is non-scapular v. scapular amputation (see here, for example), which is what I think you're referring to. There's also sometimes the option of leaving part of the humerus so they have a stump, which can be used for a prosthesis. 

We had a non-scapular foreleg amputation on the recommendation of Dr Pasternak at Helping Hands. She told me she favors that method because the scapula can offer protection for the rib cage and healing can be less complicated. I was so torn before the surgery, but she assured me that she's never seen wasting of the muscles around the scapula or had concerns about balance. I've been happy with the surgery - it's been two years and Jack is doing well. The bone doesn't protrude at all. My only complaint is that she sometimes hikes her shoulder up and those muscles get tight. There are sometimes concerns about getting good margins for cancer and the scapula is taken to make sure all the cancer is out, but it sounds like that's not a concern for Saba. All in all, people seem to have had success both ways and it can come down to what method the vet was originally trained in. 

A partial limb amputation where some of the humerus is left for a prosthesis often comes with more complications, and I think that's what is being discussed above when people are referring to problems with dogs using their stumps (correct me if I'm wrong!). That's a totally different ballgame - we don't often see that here, and when I have seen it, it's often in reference to dogs who need to have a second surgery because they have problems with healing on the remaining leg. 

Los Angeles, CA
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6 December 2016 - 11:09 am
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I'm in Los Angeles so I can weigh-in. Have you checked out ACCESS? http://accessan.....itals.com/

I had Shelby's surgeries, including her amp, done at the Culver City location but they have a branch in the valley. It would be worth a consultation perhaps?

I don't know anything about partial amputations so I can't really offer any advice there but I can vouch for this hospital. They are a bit on the pricey side but I like that they are all in one and have 24 hour care.

Feel free to message me if you have any questions!!

Alison with Spirit Shelby in her heart 

Shelby Lynne; Jack Russell/Shiba Inu mix. Proud member of the April Angels of 2014.

October 15, 2000 to April 8, 2014

Our story: Broke rear leg in June 2013 - non-conclusive results for cancer so leg was plated and pinned. Enlarged spleen in September 2013 and had it removed and was diagnosed with Hemangiosarcoma and started chemotherapy. Became a Tripawd January 8th, 2014 and definitive Hemangiosarcoma diagnosis. Three major surgeries in 7 months and Shelby took them all like a champ only to lose her battle to cancer in her brain. We had 8 amazing extra months together and no regrets. #shelbystrong #loveofmylife

On The Road


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6 December 2016 - 11:27 am
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Marcin and Saba, welcome. I'm just now catching up on your story. Here is a blog post that may help clarify things a bit:

Partial vs. Full Leg Amputation for Pets, What’s Better?

After talking with vets and surgeons through the years, we've learned there is still no set way to do this procedure. Much of it comes down to a vet's preference and what they were taught in vet school. Through the years we've seen quite a few dogs go back for the full amputation procedure after experiencing healing issues. Not every dog will, but there's that risk. Aesthetically, removing the scapula looks cleaner. Not saying that's a reason to do it, but as a bonus, you won't have to worry about random twitching at the stump area, which can go on for the dog's life. Our Jerry had a full scapular amputation.

What your primary care vet says about amputation is a clear sign that she's a good vet. I'm glad she told you about her comfort level with amputation surgeries. She will not be insulted if you have a board-certified surgeon do the procedure.

Yes, many animals have outlived the osteo prognosis. Our Jerry lived two years, many have gone longer. Not every one will but even those who didn't, their humans almost always say they're glad they did it. We have lots of examples throughout the community. Have you perused our member blogs yet?

As far as when to decide, the sooner the better. Imagine walking with a slowly disintegrating leg bone. Ouch. Please make sure she's on strong pain medication in the meantime, she'll thank you for it.

Whatever questions you have, ask away. We do have members in CA and I'm there too. I'm not familiar with vets in the Valley but I know firsthand that the clinic that Alison recommended is AWESOME.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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8 December 2016 - 12:25 am
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Hi Alison and Jerry,

Sorry for my silence, I needed a break from the constant researching. It was taking a toll on me. Thank you for your replies.

Alsion, I did go to Access to meet with Dr. Alice, the oncologist. She said that Access is good but will charge quite a lot. Would you mind if I asked how much they charged you?

I am going to meet with the board certified surgeon she recommended for me tomorrow for a consultation. After reading what everyone has had to say, I think I will likely go for a full amputation. I was told an estimate of $2000 - $2,500 -- I shall see if that is true. 

My next biggest concern is immediate post operation care. Dr. Alica said that in order to save money Saba can be taken home after the surgery. I have read on here and above in this same thread that it may not be a great idea to do so. Are there any tips for me if I were to take her home after the surgery?

Alison, did you leave your dog at access? Would you happen to know how much that costs additionally? Unfortunately I am a recent college grad and though I have a decent paying job, money is an issue (as it is for everyone). Thankfully I started a GoFundMe page that so far has 60% of whats needed.

Thank you for all your responses, I greatly appreciate them.

- Marcin

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