Hello friends,

We have been lurking on this site now for a bit over 2 weeks and this group has been a comfort - especially the volunteers working the the help line. Thank you Renee and thank you Gale.

On 11/1/21 our companion - an 82 lb, 11 year old, male pit-mix named "Map" was diagnosed with a possible osteosarcoma lesion on his front-left humorous. A follow up with an oncologist on 11/5 all but confirmed the cancer. The oncologist's prognosis was positive; no visible cancer in the lungs, so amputation will remove the pain and chemo will likely give him another 3-12 months. But we had to act quickly. Map has been with us since he was 8 weeks old and he is the sweetest, most expressive, and most loving mut you could ever ask for; so our hearts demanded that we try. On 11/12, his leg was amputated.

As some of you surely know, the pandemic has strained the vet industry just like it has everywhere else. We called all the vet surgeons that were recommended in our area and we were not able to find an available surgeon on our own who could do the operation soon enough. Our oncologist stepped in and got the medical Director of her hospital to agree to perform the operation. The Director told us he was not "a board certified surgeon" but he assured us that he had done several amputations and that it was fairly routine. Time was so important, so we were grateful, The surgery would be that Friday, a mere 4 days after his oncology diagnosis.

We were so anxious about our decision the evening of the surgery. "He's big, he's fairly old, it's a front leg, and he already has some arthritis... can this possibly be right?!" But our vet team was quite sure that dogs like him tend to do just fine as tripawds, and that amputation was actually the best way to get rid of the pain. We chose to amputate for all of these assurances, and we planned that he would need intensive recovery and rehab, but that he would be free from pain within a week or so once the surgury site healed.

The first night he went into surgury we were worried sick, but they told us later that night that he had made it out of surgury and did well under anesthesia, and they would call us the next day to update us and pick him up. When they called the next day it was to tell us that we could not take him home yet because he was still not able to urinate or eat and they had to catheterize him in order to deal with the lack of urination. We went to visit him and were able to get him to eat chicken, and as we left we were so sad and worried. That was the first time we called the Tripawds help line; We spoke with Gale and she was so sweet and informative - she helped us calm down. He was able to urinate on his own the next day-Sunday (11/14)so we took him home. There was plenty to be grateful for.

Initially, his recovery was somewhat normal. He was dopey and uncomfortable for a couple days. The fentanyl patch came off and he was starting to occasionally get up on his own. He was eating, drinking, pooping and peeing with our assistance, and sometimes on his own. Though we still weren't sleeping through the night, some sweetness and energy was coming back to him. We had a couple of good days.

His meds at the time (11/14-11/20) were:

• 1 Gabapentin(300mg) 3x daily
• 1.5 Tylenol(300mg) w/Codine(30mg) 2-3x daily
• 1 Rimadyl(75mg) 2x daily
• 1.5 Trazodone(100mg) 2-3x daily
• Antibiotics 1x daily for 10 days

(So many drugs! We we're keeping a paper journal but have since switched to an app called "Dog Log" that is working quite well for us.)

On Friday (11/19) on week after the surgery his pain seemed to be getting worse again - much worse. That evening, he began whimpering. Then, occasionally he would appear to spasm slightly in the area of his former shoulder and then cry out a scream that would just break your heart. Sometimes the cry/Yelp/scream seems to come in response to moving or touching him,  but sometimes it seems to come out of nowhere while he is lying, or while he is sitting down; it’s not consistent. This went on for hours. Pets, warm compresses, ice, scritches, nothing helped. We called the Tripaws help line again, left a message and Renee called us back.

Renee will be the first to tell you she is not a vet, but she is very knowledgeable and talked us down that evening. On our own we gave him an extra gabapentin and he seemed to relax. First thing the next morning (Sat 11/20), we took him to the surgery/oncology hospital. The checked his incision site everything looked really good with that, but he was still having this new pain. They upped his meds: gabapentin to 2 pills every 6 hours and the Tylenol/codine from every 8 to 6 hours. This helped. This would knock him out and when knocked out he was not apparently in pain. During the day on Sunday (11/21) he was even bouncing around on his own, going in and out of an open door to watch us do years work in the back. Those were good moments.

That evening was rough. We called the vet hospital and they were surprised - this is not what should be happening at 9 days our from the amputation. They told us we could give him as much as 2.5 Tylenol/codine each 4 hours. They also added 1x daily amantadine. We had another great conversation with Renee of  the Tripawds help line and she helped us find a rehab center in our area and we sent them an email, filled out some e-forms, and left a voicemail.

Monday (11/22) and Tuesday (11/23) were hard. We had a phone conversation with the vet who performed the surgery and he said this was very abnormal and he had a glum outlook; if this new pain cannot be controlled with the meds as is then there is nothing else we can do. Tuesday afternoon we took him into the Rehab Clinic. The vet there spent an hour and a half with us. We did some acupuncture, some laser therapy, and some "tens" electro therapy. He seemed to relax. She listened to our story and made some med adjustments downward  hoping that some of this discomfort was being caused by excessive dysphoria/confusion as a result of to much opioids. She recommended that we reduce the codine, Gabapentin, and trazadone and apply regular ice-packs to his back where the shoulder used to be and that we get our own "Tens" device and use it liberally. The emerging theory is that he is a) dysphoric from the pain drugs, and b) he may have "phantom limb" pain or some other nerve issues. She recommended we give it all we got for 5-6 more days, but if the pain can be controlled with these therapies/drugs, it might be time to let him go...

We were supposed to have his first chemotherapy appointment Wednesday 11-24 but we postponed it in order to try and get control of his pain first. His oncologist agreed. She was also somewhat resigned to the "let him go" timeline. A phone conversation with the surgeon took a similar tone.

We were crestfallen yesterday (Wednesday 11/24) He's slept ok the night before but only because of heavy sedation. My wife and I have no children and so Map (and his brother Compass) are all we have. Yesterday is the first day that he has refused his breakfast... maybe ever.

Being told "confidently" that amputation would take away the pain and the chemo would extend his life at a moment when we were already preparing to let him go was so lovely. But now it seems we have essentially tortured him for many days and spent thousands of dollars for our trouble.

I know that many, many of your stories are much better than ours, but right now we are all crushed.

If anyone has had any similar experiences that were turned around, we would be so grateful to read them.

Thank you so much if you got this far, we will update as things unfold.

Sincerely,

Harue, Butch, Map & Compass.