Caring for a Three Legged Dog or Cat
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My baby Louie is recovering from front right limb amputation. He had high grade Mast Cell Tumors throughout his arm, and he had stopped responding to systemic meds, so we moved forward with surgery. He is only 2 days post-surgery, and he isn’t even out of the 72-hour window where the strong pain meds are still in effect. He cannot settle despite being on Gabapentin, Amantadine, and Codeine round the clock. He also receives Trazadone for anxiety, which he had started taking a few days before surgery. He just pants miserably throughout the day and all through the night. We’ve tried all of our tricks to help him settle (pets, face kisses, singing to him, positioning him differently, potty breaks, etc.) and nothing is helping. He is still on a high dose of Prednisone, which we can now taper him off of since the tumors are gone, but it cannot be stopped abruptly. We know that Prednisone can cause anxiety, as he has been on it for four months, but the anxiety we are seeing post-op is next level. While we are trying to stay patient and are hopeful that the other side of all this will be good quality of life, we feel like we made a huge mistake having put him through this suffering. If anyone has anxiety-calming tips to offer, we are all ears.
Hi Louie & Family, welcome. I'm in the Tripawds Chat for a bit if you want to talk. Back in a sec with some feedback.
So, anxiety and pain are often intertwined during recovery, and it can be hard to tell if a dog is having too high of a pain medication dose that's causing the anxiety and panting, or too little of a dose that is responsible for breakthrough pain. They look so much alike! It does sound like he is getting good pain management based on what you described, now it's time to adjust the dosage and timing to better suit his physiology. Once you get it dialed in, things get better for everyone!
Since Louie is on Pred, I think it's very important to call for veterinary guidance about adjusting his current dosage/timing of meds. Have you called the weekend team at your clinic yet?
Trazadone is not a pain reliever, and that could be causing a lot of the issue. I wouldn't change anything about his pain medications until you talk to the vet, but IF he were my dog, reducing the Traz or eliminating it might be worth trying, since it's obviously not doing anything to mellow him out. I'm not a vet, so take that for what it's worth, that is not direct advice.
A lot of folks have also tried staggering the medications throughout the day. How frequently is he getting the meds? Does he get them all at once? Oftentimes at this point in recovery, moving from an every 12-hour dosage to every 8-hours makes a difference.
I hope this helps. Keep us posted and please call the vet asap for some direct medical guidance OK?
I’ve been in constant communication with his oncologist, who has been treating him for over a year. He authorized us to start tapering off pred today, so we’ll see if that helps. He is getting his pain and anti-anxiety meds every 8 hours, with the exception of Amantadine which is an every 12 hour med. The only new med post-surgery is Codeine, and I don’t see that anxiety is a common side-effect. I think this has to be from pain, not the meds itself. He has been yelping a lot when he rises too quickly and a few times upon waking up (phantom pain ).
Any suggestions for natural calming methods are welcome.
Sometimes heavy panting and odd behavior are secondary to narcotics and I have seen this many times with tramadol/morphine/codeine. I am not saying to reduce the dose since it is a potent pain med but I think the behaviors you are seeing may be secondary to medications. Your vet will have to decide but if anxiety really is the issue you can consider increasing trazodone or gabapentin.
Pam
Great input Dr. Pam, thank you!
Louie & family, his pain management sounds great. I hope you and the oncologist can find a way to fine tune the dosage so that he can rest and be calm. It's such a tough thing. One natural calming method that's worked for us is a calming cap. It looks funky but dogs can actually see while wearing it, and the effect was excellent in our high strung Shepherd, and now our less high strung Shepherd when we do her nails. This might be a good option for you guys.
Thank you both for your thoughtful responses. It means so much. We are on day 5 post-surgery, and I really wish I could say things have improved. Louie was up all night panting and so clearly miserable and suffering. I am at the stage where I am either crying or trying to comfort him. I am sick with worry about what he is going through. With how bad he was last night, I told my husband I would consider euthanasia if this lasts a few more days because this just feels so cruel. This is definitely not the “dogs adjust so well to amputation” that we were expecting. We understand that this is a major surgery, and recovery time is expected, but this is unlike anything we have ever seen before. For comparison, our other dog Jack had bilateral TPLO surgery a couple years ago, and we got him through a very difficult recovery that pales in comparison to Louie’s amputation recovery (basically this is not our first rodeo). Our surgeon told us that the amputation recovery should be much easier than the bilateral TPLO recovery, and this could not be further from our reality.
We’ve been in communication with the surgeon and scheduled a re-check for tomorrow morning. The only reason we chose not to take him in today is he finally settled at around 4 am and has been mostly calm for about 9 hours (with the exception of a 15 minute or so anxiety spell a little while ago). We are attempting to scale back the Codeine to see if this could be the culprit for his inability to settle.
I am posting because I need to know if any of this is "normal." Is it expected that he would still be this miserable 5 days after surgery? Our surgeon is honestly very dismissive of our questions, which has made all of this 100 times harder because we feel like we are navigating the post-op care alone when neither of us have a medical background. While our oncologist is very responsive and cares so much for Louie, he is understandably deferential to the surgeon regarding our post-op questions. Pleading to know whether anyone else's recovery felt this bad, and if so, when did you finally see improvement?
By the way, here are the positives: he is eating, drinking, and going to the bathroom normal. His incision looks pretty good, although he does have significant swelling and fluid build-up (no leakage though). The surgeon told us the swelling could take up to two weeks to resolve. He is walking decently well but is exhausted after a few steps (understandable).
Sorry for such a long post, just wanted to get all the info out.
I'm so sorry things have been so tough for all of you. Sleep depravation doesn't make things any easier. I'm glad he settled a bit, and hope the Codeine change helps. It's an opioid, and many dogs become dysmorphic on them, so it's possible that you made an important change that will help him.
I am posting because I need to know if any of this is "normal." Is it expected that he would still be this miserable 5 days after surgery?
Yes, it is in some ways, because every dog's physiology is unique and some will react differently to meds than what is hoped for, or "typical." It can take a week or sometimes longer to get that magic formula that works for certain dogs. We see this happen quite a bit, so yes, it's normal in that sense.
One thing to keep in mind is that what you are seeing is very likely a reaction to the pain medication, and not a reaction that points to a poor quality of life. It's far too early to discuss euthanasia right now, and I'm confident that you won't even need to bring it up again once you get the pain control issue handled.
If you aren't getting the information you need from the surgeon, what about talking to your primary vet?
Pleading to know whether anyone else's recovery felt this bad, and if so, when did you finally see improvement?
Yes, totally. Just search for "hard recovery" or "difficult recovery" and you'll see lots of examples. Also see:
Two Tripawds’ Tough Amputation Recovery Stories (and Comebacks!)
and
Tripawd Tuesday: Bocce is Greyt After Tough Recovery
and
You Can Make a Tripawd’s Amputation Recovery Hard, or Easy
By the way, here are the positives: he is eating, drinking, and going to the bathroom normal. His incision looks pretty good, although he does have significant swelling and fluid build-up (no leakage though). The surgeon told us the swelling could take up to two weeks to resolve. He is walking decently well but is exhausted after a few steps (understandable).
This is WONDERFUL! Seriously, you've just listed some of the most worrisome and challenging aspects of recovery, and he's got them DOWN, conquered like nothin! No joke. I'm not seeing a quality of life issue that's happening here. I am seeing a very normal recovery, with a pain control challenge. I'm not a vet, but this sure sounds like a pain control situation that needs to get pinpointed. Once that happens, you'll see even more positives.
Never apologize for the length of your posts. We are always here to help you through the worst and best times sure to come!
Your response made me cry and feel so supported. Thank you so much. It helps to know that a cookie cutter approach to/expectation for recovery isn’t actual reality. It makes me wonder how many veterinary professionals have actually provided the at-home care needed during amputation recovery. I’m sure it’s easier to say “Dogs do so well!” when they only see the typical dog looking good at the recheck.
Anyway, thank you for this, and thank you for sharing the stories of other dogs that have had a rough road. It’s terrifying that some of these dogs took several weeks to recovery- really hope that’s not my Louie baby’s situation. But, hearing about the poor greyhound who spent two weeks in the ICU definitely gave me some perspective. I will continue to post updates (hopefully with good news) over the next few days.
Oh gosh, so sorry this is part of the journey is causing so much stress for you and Louie.
I really can't add much to the safe, insight you have gained from Jerry and Dr Pam.
I can tell ypu that when I joined this community my first post was something like, "Help! It's day six and I fear I have made a HORRIBLE decision!" I was completely consumed with fear, mental and phusical exhaustion. second guessing my decision, etc. Over and over and over I was saying "What have I done TO my dog?"
While I cant rem the specifics, my Happy Hannah seemingly whined and cried and was restless for the first five days and nights. I'm sure tweak g the meds, adjusting the dose, frequently, etc turned things around.
And you're right. Surgeons do their job at amputation successfully. Tjey do not go home and watch what goes on during the first two weeks of recovery. And like you, like others, like myself, thank goodness for the Tripawds community who can calm is down with their vast knowledge!
STAY CONNECTED!! YOU ARE NOT ALONE!!!
Hugs
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!
PS. I found eating chocolate did wonders during all that time!
Also, my dogs have had three TPLO vetween them. One seemed harder, or equally as hard as amputation. The other two did seem "easier"
That seems to be the "phase" you are in now. So continuously remind yourself you are in the middle of the hardest part of recovery, tweaking pain meds, major surgery healing, etc. You are doing this FOR Louie!!! We all know it and you will soon grasp that mantra too.
I also want to reiterate the BREAT news that Louie is drinking, eating, peeing, pooping and doing some mobility hopping! Really quite impressive!!!
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!
Tripawd mom here for almost 11 years (my dog lost his leg at 7 months old). But I want to tell you about my very recent experience with one of my other dogs who is not a tripawd, and particularly our experience with prednisone.
Petey, a chihuahua/Italian greyhound mix, recently had a herniated disk collapse in his neck. He needed emergency surgery to remove the disk, plus hospitalization for 3 days. After we got him home, he was on TONS of medication. This is a small dog who already had a serious anxiety problem. Two things happened from the medication: 1) his anxiety went through the roof. 2) If you just touched him he would SCREAM. This was particularly true if he had fallen asleep beside me on the bed or couch. If I moved, it would wake him up and he would SCREAM. But then we would touch him all over and move him around and he was fine. It was being so sound asleep from the drugs that we think he was hallucinating (one of the side effects of tramadol, actually is hallucinations and vocalizing).
He was on tramadol, gabapentin, diazepam, and prednisone for two weeks. The prednisone was the worst, followed by the gabapentin. During the withdrawal from prednisone, Petey had a severe vomiting episode and went downhill fast. He was vomiting every half hour for about 15 hours. He lost two pounds "overnight" and he's so skinny now his bones are sticking out. He did not eat for three days -- no matter what we tried. Like you, this was not our first rodeo. No matter what we gave him, he refused to eat. I even spent $85 on special food from the vet. Nope! Flatly refused to eat. Thankfully, he was drinking water and urinating. Dogs can go without food for a while, but not water. Seeing regular urination meant his body was functioning properly. He finally ate after three days of fasting, and now I am happy to say he is almost back to normal with his eating. The prednisone gave him nightmares, anxiety, hallucinations and vomiting when he was withdrawing.
HOWEVER, while he was actively taking prednisone, he was "invincible". He was running and jumping when he wasn't supposed to be. He was barking and carrying on. It was all I could do to physically hold down this 10 pound dog so that he wouldn't re-injure himself or blow out the staples in his neck. Prednisone increased his anxiety 10-fold, too. So, I think this is what you're seeing with your dog. You are seeing your dog "amped up" on prednisone. Things will normalize once your dog is off the medication. BE VERY CAREFUL to make sure you give the stomach-acid medicine even when you are weaning your dog off of the prednisone (hopefully your vet prescribed this, as mine did). This was the mistake I made. I read the instructions wrong, and on the skip days, I did not give him anything. I know now that I was supposed to give the stomach medicine alone on the skip-prednisone days. Because I did not (I gave zero meds that day) Petey developed this horrible bout of vomiting and he probably could have died because he was so weak from the surgery and recovery to begin with.
I just wanted to share this because it literally just happened to us less than a week ago, and it's fresh on my mind. When I saw that your dog is also on prednisone, I figured it can't hurt to share our story. I hope it helped you somewhat.
I hope your pup recovers quickly. Having had a front amputee for almost 11 years now, I can tell you dogs really DO do well after amputation.
Thanks for listening!
Kathy
Cooper (11/11/11 - 3/29/24) was a hound-collie mix "mutt" who was badly injured as a puppy and lost his leg at 7 months of age. We adopted him after the operation. He' was wonderful companion and comforting presence in our family for 12 years. He lived a fabulous life on three legs and was an inspiration to all. We will never forget our Coopie-Doopie-Doo.
WOAH Kathy! Thank you so so much for sharing your wisdom. This is super good information, and you addressed side-effects that I never would have considered. I just don't have that much experience with dogs on pred.
I can't thank you enough for offering your insight. And I'm super happy that Petey is doing better now. What a scary time!
Hi everyone,
Thank you again for all of the helpful information and for expressing your care and concern for Louie! We are about 15 days post-surgery. Louie’s stitches are out now and his incision is healing well. He does have some fluid build-up that the surgeon isn’t concerned about. I would say overall, Louie is doing very well. Our biggest challenge right now is pain regression on some days. He had pretty much stopped yelping and seemed to be doing better, but over the past 2-3 days he started yelping again, usually when he goes from laying down to standing. The surgeon told us we could stop pain meds, but we are still giving them to him around the clock based on what we’re seeing. While we believe he is on the right track, we hope that we get to see our normal, happy guy in no time!
My question right now is this: How many weeks did it take for your baby to be “back to normal”? We know that “normal” will look different now, but what I mean is, when did you start recognizing your dog again? I can’t picture Louie attempting to run anytime soon, and we are of the camp of wanting to take things very slowly and follow his lead. Just curious what kind of timeframe you saw for your pet. I recognize every dog’s journey is different, so I welcome any and all perspectives. Thank you!
Welcome back! What a really good update about Louie! 
Everything points to a recovery that's on track.
So regarding the yelps, I know you're taking it slow, but when the incidents happen, is it just random? Like not after he was attempting to play earlier in the day?
I don't think I mentioned this but Tripawds Foundation can pay for your first rehab visit . It would be good to get him into a therapy center to have them evaluate Louie, and look for the source of his discomfort. Often they can do it faster than a general practice vet or surgeon, because pain management is one of their specialties. They can also show you how to help him feel better with things like gentle massage, and the Foundation can pay for your first rehab visit so please take advantage of the program.
My question right now is this: How many weeks did it take for your baby to be “back to normal”? We know that “normal” will look different now, but what I mean is, when did you start recognizing your dog again?
This is such a difficult thing to answer but many people want to know and I can't blame them. Yes, every dog is different. IF I could put a number of days on it, I'd say that a dog in mid-life with no other health issues, no weight issues, would have sparkle come back around 14-20 days. Now that's not saying the dog will be 100%, but just that they will be playing with toys, eating, moving well, and not having sudden pain signals . But that doesn't mean the dog won't have ups and downs afterward.
If a dog is older, or has other health issues like cancer, I'd say about 3-4 weeks minimum before you start seeing the same.
And if a dog of any age sees a rehab therapist, they generally recover faster and stronger than a dog who doesn't.
It took us about 3 months before we felt like we knew how much activity our Jerry could safely handle after amputation, and I'd say that's pretty common. He was definitely his spunky self about 3 weeks later, but still had pain issues and things we had to figure out along the way.
Again, every story is different. Remember, Louie is his own dog and on his own schedule. He will find his way back with your help, he is already well on the way!
Please let me know if you'd like help finding a therapist OK? DM me your location if you want to take him.
I k ow two weeks out seems like an eternity, but it really is still relatively early in recovery
Can't remember all the particulars, but I know I had my Happy Hannah on pain meds extending beyond two weeks. I know at the two week mark I did not feel like Hapoy Hannah was doing particularly "better" and I was seeing very little "sparkle".
At the end of three weeks "some" sparkle. It took me about five weeks before I could say I was doing this FOR my happy Hannah and not "to" her, Tail wags were more frequent and, of I recall, ot was at that time that she was getting up and greeting me at the door with her "food bowl". Yes, she carried her food bowl around like most dogs carry their stuffy or their "baby:.
Maybe before he goes from laying to standing position, try and give him so e gentle massaging all up and down his spine, his neck and shoulders. If he is having stiff or sore muscles, this may help.As Jerry said, a Rehab visit can help
Louie will be Louie again and running around being a hapoy boy!
Oh, just one more question, mCan you think of a thing that was different when he didstio the yelping, verses when the yelps started again?
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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