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Caring for a Three Legged Dog or Cat

Tripawds is the place to learn how to care for a three legged dog or cat, with answers about dog leg amputation, and cat amputation recovery from many years of member experiences.
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How to pick a doctor for amputation
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Forum Posts: 3
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24 February 2010
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24 February 2010 - 3:58 pm
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Hi! My 10 year old black lab Annie was recently diagnosed with Syonovial Cell Sarcoma in her front leg. Her lungs look clear so amputation is the Vet’s recomendation. Through the help of this site, I’ve accepted this. However, it now comes down a bit to cost. My general practice vet referred me to Gulf Coast in Houston. They have an amazing facility and provide me with good information. The cost of the full leg amputation and the required hospital stay will be between $2500-$3500 dollars. I’m already in $1500 just to this point in diagnosing. I feel like a turd for coming on this site and even asking this question but the vet says that until they do a deeper biopsy they won’t know for certain what her prognosis is. They can either do this additional biopsy (no clue how much more that will cost) or just amputate the leg. Either way, the cost is significant. A family friend is a vet in a small town an hour away and he has done many amputations. He’s said he can do the procedure for $500 and will keep Annie for several days after the procedure for observation and to help get her up and around. However he is a general practictioner vet, not an ortho specialist. So am I being naive to think that having Annie worked on at a general Vet is fine? Again, I feel like a turd for being practical when I love my dog is much as I do. I’d love some input. Oh yeah, the reason my vet won’t do the surgery is that the Oncologist wants to test the lymph nodes as she removes them to see if cancer has spread there. My feeling is I can’t afford Chemo even if cancer has spread. But I do have a follow up question with my Oncologist to see if the lymph nodes can be sent to her with the limb after the amputation to do the additional testing she wants to do. I’d appreciate ANY advice from anyone that has been through a similar situation.

The Rainbow Bridge



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24 February 2010 - 4:55 pm
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Oh Blackdog, you are SO not a turd! You're a pawesome pawrent for even asking those questions! Do you know how many people wouldn't even get that far? So give yourself a pat on the back and know that you are doing everything right. We applaud you!

Welcome to Tripawds. We're hoppy to have you. I'll try to answer your questions and give you some of our perspective:

Cost concerns

We hate to even factor money into all this, but that's reality. It's OK to ask, and it's OK to minimize the hit on the wallet. My Mom's a proud tightwad, she understands the dilemma, totally. Something that might interest you is a recent forum post, where we asked people what they paid, just for amptuation. Check it out to give you an idea:  Costs of Amputation and Chemotherapy: What Did You Pay?

While getting an exact diagnosis and grading of the cancer (“staging”) through biopsies and lymph node testing is important to determine prosnisis and treatments, if you aren't going the chemo route, then you might want to save yourself the expense of the additional biopsy. In my case, I just had one test that confirmed I had osteosarcoma, then I had the amputation. My parents didn't do anything further because we weren't doing IV chemo.

One of our favorite dog vets, Dr. Demian Dressler, says in his Dog Cancer Survival Guide e-book,

“One of the tricky things about staging is that there can be cancer spread that is actually not picked up by any of these tests. There is a phenomenon called micrometastasis, which is the spread of cancerous cells through the ciruclation into other body areas. These cells have not yet multiplied enough to make large tumors that can be detected by tests. Since cells are so tiny, these cancerous cells are often totally invisible to our medical instruments. Micrometastasis can make cancer treatment much more difficult, because when things are undetectable we can't deal with them.”

So that's something else to consider. Even tests may not see the cancer that is really there. Lots of people here have experienced that.

Don't beat yourself up if you're not doing chemo. I didn't do IV chemo, and I went 17 months until I had mets, then lived another 7 months when I tried an oral, at-home chemo method. Other dogs do chemo and outlive their prognosis, and some do chemo and don't make it more than 3 months. Cancer is such a huge guessing game sometimes it can make you nuts, you never really know for sure what your chances are. All of the prognoses out there are really just guesses. They cannot tell you exactly what will happen with your unique, special girl. All any of us can do is hope and pray that we kick its butt and live long healthy lives despite it.

The first thing you need to remember is there are no “right” or “wrong” answers when it comes to cancer. What matter is preserving Annie's quality of life, which means making the best decision for the both of you that will cause your pack the least amount of stress.

Family Vet versus Specialist

Having a surgery done by a board-certified specialist is the gold standard of veterinary care. While family vets can certainly do amputations, they may not have the most modern equipment or staff available to monitor dogs 24/7. We read about this in the book, “Vet Confidential.

There is nothing wrong with asking your family vet: do you have 24/7 monitoring? If not, do you work with a critical care facility? What kind of anesthesia are you using? What kind of pain management procedures do you use? And look around the practice; are modern, asceptic surgical techniques being used (i.e., scrubs, surgical clothing, sterile gloves and gowns).

Not all of us have a specialist do our amputations. However, I will be honest and say that we have had a few dogs here who have contracted infections, possibly due to unsterile conditions. Also, a couple have even died while staying overnight in facilities without overnight monitoring of patients. Still, even dogs who have been at the best hospitals have had complications. My feeling is that the risk of complicatioins is greater when the facility is lacking in basic modern techniques. Family practice doctors for humans and vets can be awesome, I'm not saying they're not. My own parents had a family practice doc for themselves that saved them tons of money on simple procedures that specialists would've charged them much more for. All I'm saying is that you should consider what your family friend's facility is like before you make the decision.

I know this is a lot to take in when you have so much on your mind. But if you can get through this first hurdle, you can get through anything.

You're asking some GREAT questions here, and we thank you for that. Let us know how else we can help OK? Good luck, and keep us posted.

It's better to hop on three legs than to limp on four.™
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24 February 2010 - 5:50 pm
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It would be pretty hard to add anything technically to Jerry's great posting, but I would like to voice some support. I am sure you are like most of us, and this diagnosis came as a total suprise. It really knocked me for a loop. You are doing the very best possible for Annie, and that is what it is all about. When it comes to this additional testing, ask youself what difference it would make in the direction of treatment. If the answer is none – move on and accept it. I am not trying to be harsh, but rather Annie will be looking to you for guidance. You are the “Pack Leader” and as long as you are upbeat and positive, she will respond the same way. Do not beat youself up because you cannot aquire the “Gold” plated treatment you want for Annie. You do the very best you can, give Annie all the love possible, and enjoy every additional day you can have together.

Paws Crossed and Sending Pawsitive Thoughts,

Spirit Cherry's Dad

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24 February 2010 - 8:00 pm
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Well, I think Jerry had a lot of really good things to say, as did Bob, Cherry's Dad.  I can't really add much to it other than to reiterate you are not a turd for asking these questions.  Unfortunately finances have to be taken into consideration.  That is life and does not mean that the person paying $3000 loves their dog more than the person paying $500.  Your family friend is willing to observe Annie for several days.  Does that mean the facility has overnight care.  If there is not overnight care maybe you could consider hiring a vet tech to sit with Annie and ice her incision and monitor her care.  It would still be cheaper than using the other facility.  You said the vet has done many amputations so he should know what he is doing!

As far as doing additional tests, Bob has a point.  Is it going to change your decision on chemo?  If you are doing chemo anyway why do additional tests?  If you aren't doing chemo would you want to know if the cancer has spread?  Jerry is so right.  Look how long he lived with no chemo.  Emily was in a very promising drug study and she made it less than six months.  The important thing is to treasure each and every moment and store memories in your heart to pull out when you need them.  Be strong for Annie.  Feed her spirit and yours, as well.  

You and Annie are in my prayers.  

Debra & Angel Emily

Debra & Emily, a five year old doberman mix, who was diagnosed with an osteosaecoma. She had a right rear leg amputation on May 19, 2009. On November 10, 2009 she earned her wings and regained her fourth leg.

Storm
5
25 February 2010 - 1:49 am
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We were in pretty much the same boat as you are in now.  Koda was diagnosed my our general vet.  We then went to the Oncologist at the specialist hospital for them to look at XRays taken by our general vet and then they also did an ultrasound to check if the cancer had spread and did needle biopsy (I don't think this is the right word, but it is where they use the syringe to get a small sample to test it and see if they can determine the type of cancer).  It is not an acutal biopsy as that is more invasive cutting a piece of the bone out….   So we had all of that done which was approx $700.  No mets showed up in the ultrasound thank goodness and his lungs all clear.

I knew amputation was our only answer so I rang Kodas breeder who uses a local country vet outside of the major city and she had done a couple of amputations and was highly trusted by my breeder, as  your vet is a friend and has said they have done plenty I would think that they wouldn't risk stuffing it up on you and if they have done quite a few then I am thinking they have the experience.  That is what we went with.  We could have paid $2500 + for Koda to have the leg amputated by the specialist but we trusted our breeder to use the vet that she fully trusts and it only cost us $800 including pain meds and an overnight stay.  Then we had a biopsy piece sent away for testing and it was confirmed that Koda has osteosarcoma.  That was 7.5 months ago now…  The saving of money was a bonus because we would have gone which ever way Koda's breeder said to go as she has had dogs a lot longer than me and she is a good friend.

We didn't know the type of cancer until the leg was removed so I don't know if they will want to take the scapula also with the type of cancer Annie has but our vet that amputated did consider taking his scapula also (Koda is a front right amputee), but she tested his glands under his leg (possibly lymph nodes but not sure) and could not detect any cancerous cells under there so we took the gamble that hopefully it hadn't spread too far.  We tossed up whether to take the scapula and my very first post on here was “My dog is on the operating table, did I do the right thing by not taking the scapula” (or something along those lines)…..  We decided with the help of the vet that if we only have a short amount of time ahead with Koda we want the quickest recovery possible to spend as much time with him healed as possible so we decided she would amputate quite high (which she did) and there will not be as much recovery to go through as the shoulder will still be intact.  That was our theory anyway and we were comfortable with that for us.  From what I have read all specialists and most people will take the scapula in case it gets damaged or causes problems with the dog being tripawd.  But Koda hasn't had a problem with it (touch wood) and recovered very quickly without signs of high levels of pain.  He has no stub as it was taken off quite high, it runs in line with his body and nothing sticks out…

So we basically had the same options in front of us as you and chose the normal vet who had successfully completed several amputations before and Koda is still with us 7.5 months later.  You never really know as some of the dogs on here have had the leg removed by specialists and they have only lived several months.  You just never really know and have to make the best decision possible after all the research and we were lucky to have our breeder helping us and I know she would not have recommended her vet if she didn't think she could cope with it. 

Funny thing is my breeders vet had to move down south so my breeder now has to use the specialist at the aminal hospital for her emergency caesars anyway. 

All the best in your decision making.  Let us know what you decided to do.

Storm and Koda:)

P.S.  Koda is also a lab but a yellow one and is 8 years old.  He has a soft spot already for Annie and sends her a big tripawd hug!!!! 

Storm
6
25 February 2010 - 1:53 am
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P.P.S  (You would have thought I would have said it all above, I know hahaha).  I just wanted to add that we chose not to do chemo with Koda.  But I did a lot of research on diet and we feed him a quiality dry food to cut out as many cereals as possible, and give him raw mince and those dog biscuits every night for dinner.  And we have lots of cuddles and fun time!!!!

San Jose, CA
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25 February 2010 - 1:56 am
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I'm so sorry you are going through all this, as I know it's hard since we had Mika's amputation just last week. I guess I'm a turd like you (ha ha!), because we cheaped out too and went with our general vet who did an AWESOME job. We were charged $1,700 vs the $3,700~$4,800 we would have paid the specialist. It's been almost a week and she is doing FABULOUSLY!! Honestly, if you have budgetary constraints and are comfortable with the person who has offered to help you out, then I would say go for it! None of these decisions are easy to make, but as others have said, you know what's best for Annie and there are no wrong answers.

FWIW, my preschooler wants to rename our dog “Annie” after we got her the book, “Annie Loses Her Leg but Finds Her Way.” :)

Big hugs!
Mari (Mika's mom)

Storm
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25 February 2010 - 1:57 am
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Just read Jerry's post and fully agree with overnight care and facilities.  Koda was checked on several times though the night and the facilities were of a good high standard.  And the vet was held in high regards by not only my breeder but her associates in the dog world around our area.

San Jose, CA
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25 February 2010 - 2:00 am
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Oh, and we also opted not to do the biopsy since we won’t be doing chemo and I DON’T want to know the results! That saved us some money too.

Northern Indiana
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25 February 2010 - 10:36 am
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“Blackdog”,

As you see by your responses above there are many different ways people go.  We were fortunate because Morris Animal Hospital where Paris went in Granger, IN is owned by a husband/wife vet team….and he, Doug Morris is an orthopedic surgeon.  We were able to do the surgery close to home and Paris' regular vet, Dr. Terry had experience and was well versed on chemo.

We have all walked different paths and there are no right or wrong ways to chose.  The money issue is tough….we used a “Care Credit” account for Paris, for us we did whatever we could and never had any regrets. 

Take care and I wish you wisdom & peace as you face these decisions.  Sending good thoughts for “Blackdog” also!!

Ginny & Angel Paris

Grateful for every moment we had with Paris…..no regrets!

Honoring her life by opening our hearts & home to Addy!

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27 February 2010 - 8:02 am
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Guys,
Thank you so much for your replies. The info you all provided help me make a decision, and I’ve selected a doctor. We have another consult setup for Monday. I’m hoping to get her amputation done ASAP after the consult since to date there is no evidence of spreading. I’ll keep you guys posted but say a little doggy prayer for Annie and my family! Until then, I’ll be reading this site to help prepare us for what to expect and how to make her new life easier!

My heart lives at Rainbow Bridge
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27 February 2010 - 9:01 am
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I just wanted to add that what you decide is best for Annie and you, is a good decision.  We are close enough to have considered Gulf Coast also, but ultimately we decided we didn't want to be 2 hours away from Trouble's primary care for something as critical as cancer.  Our second opinion vet was willing to do the surgery and had a staff on duty to oversee her care in the evening.  He has a really nice clinic.  We, too, opted not to do a biopsy.  I felt it was added expense for little benefit.  It is very pricey to do the amputation and the chemo, we came out cheaper on the chemo having the local vet administer it as well.  He consulted with the oncology group and A&M and followed the protocol they recommended.  We've had great success and are happy we made the choices we made.

Good luck to you and Annie as you begin your journey.  There are lots of amazing folks here that will be happy to lend an ear when you need one, and offer suggestions and ideas of what worked for them.  While no two dogs are alike, and no circumstances are alike, we learn so much from each other.

Shanna & Spirit Trouble ~ Trouble gained her wings 3/16/2011, a 27 1/2 month cancer survivor, tail wagging. RIP sweetheart, you are my heart and soul.  Run free at Rainbow Bridge.
The November Five - Spirits Max, Cherry, Tika, Trouble & Nova. 11/2008 - 3/2013 An era ends as Queen Nova crossed the Bridge.

The Rainbow Bridge



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27 February 2010 - 11:20 am
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That feels good to make a decision doesn’t it? The first step, now take each one little by little and you won’t feel overwhelmed.

Paws crossed for Annie, please keep us posted OK? Let us know how we can help.

It's better to hop on three legs than to limp on four.™
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The Rainbow Bridge



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27 February 2010 - 11:28 am
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hugapitbull said:

We've had great success and are happy we made the choices we made.


In case you didn't see this Blackdog, Trouble just celebrated her 15 month ampuversary this week! Totally pawesome!

It's better to hop on three legs than to limp on four.™
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Read my story here.

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Las Vegas, Nevada
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27 February 2010 - 2:03 pm
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As we know I overpay at my vet's all the time; Cha-ching, Cha-ching Comet ! 

BUT I would not pay $2500-$3500 for amp either!  No way.  Not when your regular vet who studied Vet medicine, too and can do it.  It's not like the leg anatomy on a dog changed from when you vet graduated school!  I only use a specialists because of more knowledge in one area. 

It's interesting that I vaguely remember when were to get Comet's leg removed in 1999 that the cost wasn't more than $400, maybe $500.  It's not even enough for me to remember and I would have considered the cost back then.  Of course it didn't happen because she got sick.   I remember the first time I did a femur head removal on a dog, it was $1000 in 1996.  I thought it was outrageous!

Her Retired AvatarComet - 1999 to 2011

She departed us unexpectedly  January 23, 2011 at the age of 12 1/2.

She was born with a deformed front leg and a tripawd all of her life.

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