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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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New Member… PEZ - Post Amputation
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Winnipeg
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17 January 2010 - 10:27 am
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She also said that she has seen many cases where owners have regretted putting their beloved dog through such an ordeal (amputation and chemo therapy). I think I'm okay with going through the amputation, but the chemo I'm concerned with due to the known complications/side effects. Our vet also said that if you did the amputation and didn't do the chemo it was a waste because once you cut into the bone/tissue where the bone cancer is it causes the other cancer cells (that may be elsewhere such as the lungs to grow and take over for the cancer that has been removed


Stop. Wait a minute.

1. On average, dogs with amputation and chemo have median survival of 12 months and dogs with only amputation have 4 months. But there is tons of variation. Many of us started chemo yet our dogs had mets before we finished and our dogs did not even make it to 4 months or just got there (Shilo, Yoda, me, young Barney, Wrigley, Peyton . . .). On the other hand, many of the tripawds never did chemo yet are between 6 months or one year (Samwise who posted today, Cemil, what about Jerry who lasted to 22 months?!, and others). (If I were to do this again, I'd think twice before starting chemo based on the variation I have seen and the ability to return to a fun-free life sooner without chemo.)

2. There appears to be some evidence that once the primary tumor is removed, the cells that are in the system might settle in a new location sooner. I have not seen data but an oncologist told us that in a 'chat' session and our fearless leaders will ask the LA oncologist about that point when they meet. I don't think many chemo protocols are done to take that into account, and I don't know if most oncologists agree on this point at this point in time (my oncologist said how the cancer was spreading each time Tazzie put his foot down which suggests she thought the the opposite). If oncologists did take this into account, they would probably start chemo before amputation.

3. However, the main point of amputation is to relieve the pain so the dog can enjoy the time he or she has left, whether that is 8 weeks, 6 mos or 1 or 2 yrs.

4. An alternative to chemo - which could slow progression of the cancer, could begin before amputation to reduce the problem she mentioned, and has far fewer side effects and is far cheaper - is metronomics or anti-angiogenesis therapy. But you would still need an oncologist to prescribe the pills. It involves a very low dose of a chemo drug in a pill form on a daily basis. An oncologist can give you information on metronomics . Vets usually are not familiar with it, unless they have a lot of experience with cancer dogs. (Also lots of info on this website, just search metronomics ).

5. From what I have seen most people do not regret amputation. I am stunned to hear an oncologist say that, because most oncologists I have heard or read say something to the effect that "regret about amputation is one problem that does not arise or happens in <1% of cases". The exceptions are cases where something happens, such as a heart problem, that prevents the dog from recovering. But many of those people still view it as being a case where the dog had a good chance of returning to his or her old happy self and a chance worth taking. Definitely check out the forum thread on "regrets about amputation".

I would never rule out amputation because you do not want to do chemo. However, I think I might have thought that way before we did the amputation (obviously, I had not seen as many dogs at that time). If your dog is basically happy and telling you 'it's not my time', I'd opt for amputation. I just couldn't see putting happy Tazzie down because of a bad foot which was the alternative at the time of amputation.

However, I also do not mean to say that amputation is for everyone. IF a dog has really complicating medical conditions that suggest he or she won't survive the surgery (e.g., heart trouble, major kidney and liver issues), it might not be wise. If I had reason to think my dog would only survive 2-4 weeks, I don't think it would be worthwhile. Certainly my dog was not a happy camper for 2-4 weeks post-surgery.

If I were you, I would definitely see another vet and oncologist for a 2nd opinion. I don't want to sound dogmatic but the idea that it is not worthwhile doing amputation if you don't opt for chemo as a general rule is just wrong (I can't believe I am saying that, but I will). I assume they can do the surgery to remove the entire bone and not cut into the cancerous tissue.

Pez - CSU (Colorado State University) offers a free consultation service with their oncologists (search CSU veterinary oncology). You submit a form by email or you call (calling is better because they don't always check the email). The oncologist will phone in the evening, after their regular schedule. These are highly qualified people who call back. It will probably take a couple of days before you hear back. If you submit a form today or call tomorrow, you might talk to someone by Tuesday or Wednesday. If I were starting down this road again, I'd probably head straight to CSU, but that is largely because we do not have an oncologist where I live and I wasn't thrilled with the closest one that is 15 hrs away, where we were in the summer.

(p.s. If there is something special about Pez's case, which means they have to leave cancerous tissue, maybe that is a different story. But I am just trying to make sense of her point.)

Winnipeg
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17 January 2010 - 11:16 am
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Hi Pez

Yes, I know I have said enough Blush.

But I just checked back at your original posts. It seems that the one question you need to face now is whether the other fore limb (and hind limb) can carry the weight. That seems to be the main thing to consider in making the amputation decision.  Whether or not to pursue chemo usually comes up after amputation. (At a few places they consider starting earlier. But since Pez's leg is fractured, you don't have the luxury to wait - plus most places don't start earlier anyway. You can ask an onco about metronomics and that could begin now.)

I am curious: when Pez was first dx and advised against amputation, did the vet and onco suggest the alternatives of palliative radiation, bisphosphonates to strengthen the bone? Those treatments, and the combo of those two, are typical alternatives where amputation is not advised. Did they advise you start chemo then?

Wishing you all the best Pez. Just take one step at a time. Don't worry about figuring out eVeryTHINg (chemo or not) all at once.

Okay, sshhhh Tazzie, you've said enough Blush

On The Road


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17 January 2010 - 12:26 pm
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csmpez said:

...rather then going through the ordeal of amputation, chemo/rad treatment she opted to put her dog to sleep. She also said that she has seen many cases where owners have regretted putting their beloved dog through such an ordeal...


Oh My! Wow, that's the first time we've ever heard such a thing from a veterinarian. Personally, it doesn't sound like she's being very objective and may have some issues about her own experience that she's passing on.

Anyway, please consider reviewing this topic where many members provided feedback regarding regrets about amputation for their dogs.

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


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17 January 2010 - 1:56 pm
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How is Pez doing now that the leg is fractured?  If he is getting around okay on 3 legs then I would definitely pursue amputation.  When our large Mastiff Tazzie (185#) was diagnosed with bone cancer I was initially a little unsure if she could handle walking on 3 legs due to her huge size and the fact that she had ACL surgeries on both of her knees in the past.  Well she did just fine!  She also tolerated chemo well (most dogs can handle carboplatin injections every 3 weeks for 4-6 treatments with minimal side effects.  Adriamycin is an alternative drug that appears to hit them harder).

I do agree that the limiting factor here is how the dog will fare on 3 legs with other orthopedic issues . Pit bulls are so stoic and do not show pain readily but they also have tons of heart and are very brave so Pez might be able to handle the surgery better than you think.

Pam

csmpez
20
17 January 2010 - 3:26 pm
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Hi all…

I've done more research and we went by the oncology/surgery center today to ask some questions. We will be calling tomorrow to speak with the full time oncologist tomorrow. Our primary vet discouraged us on the amputation due to Pez's past history with the ACL and left front elbow arthritis. If we amputated her right front leg, this only leaves her balancing her front weight on the left front which has arthritis. However, given what I've read here there are a number of options to strengthen the bone/joint and manage the pain if we decide to amputate.

In reference to metronomics and anti-angiogenesis therapy, it has never come up in our conversations with any vet/oncologist. In reference to our vet and oncologist suggesting alternatives of palliative radiation, bisphosphonates to strengthen the bone, none of that has ever been brought to our attention. It was either amputate, radiate and chemo or "here are some pain meds to manage her pain until Pez dies in 2-4 months." Oh and when they said radiate for the pain we were told that it will weaken the bone, so there is a greater chance of pathological fractures. Those were basically our two options according to our vet/surgeon. So we started holistic meds, changed her diet completely, acupuncture along with proxicam and Trimodal. It was amazing how she went from limping badly to running and playing and rolling around on the ground stretching her front and rear limbs out as if life couldn't get any better… all within a couple months.

Pez in general is a strong, healthy, good spirited dog. Her favorite thing to do is go for rides in the SUV. In fact, the only reason we drive an SUV is for her benefit. All the seats in the back are laid down flat, we have blankets back there along with a therapeutic K9 mattress that she lays on during long rides. She gets at least one ride a day. In fact we just came back from one a little while ago where she does pretty good balancing herself on three legs as the bad one she still keeps tucked up and rarely puts it down.

Some of my family are saying that if we amputate her leg it's only for our own benefit and selfish reasons. Just end Pez's suffering and say good bye to a good friend. However, when you look into Pez's eyes and see her smile and wag her tail, I can't see putting her to sleep when she could have so much more time to live. I'm only praying that this new vet and oncologist will be able to shed some more light on Pez's condition and if there is or isn't a pathological fracture in her leg.

We'll keep you updated on what we find out… Thanks.

Scott, Charlotte & Pez

On The Road


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17 January 2010 - 3:38 pm
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csmpez said:

...saying that if we amputate her leg it's only for our own benefit and selfish reasons.


Some people just don't get it, and never will. Confused

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

Edmonton
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16 February 2008
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17 January 2010 - 3:38 pm
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csmpez said:
when you look into Pez's eyes and see her smile and wag her tail, I can't see putting her to sleep when she could have so much more time to live.


Amen. This is a good enough reason.  No one else knows Pez better than you and your wife. 

I am also praying that you will get more objective opinions and answers from this new vet, and that they can help you during this decision making process.

Give Pez a big hug!

My heart lives at Rainbow Bridge
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28 November 2008
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17 January 2010 - 4:12 pm
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Genie said:


Amen. This is a good enough reason.  No one else knows Pez better than you and your wife. 

I am also praying that you will get more objective opinions and answers from this new vet, and that they can help you during this decision making process.

Give Pez a big hug!


I have to agree.  As long as your heart says it isn't time, then it isn't.  I'm so hoping you find a caring and compassionate vet who can objectively give you options and help you with the choices you must make.  I am so thankful now that my husband would not accept that surgery was a bad option for an overweight dog.  Our sweet pittie has been with us another 13 months and counting.

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.

csmpez
24
18 January 2010 - 2:40 pm
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Just an update... We went by the family vet's office today to pick up the film and Pez's medical history file. We were also able to schedule a consultation visit with an oncologist at a veterinarian surgical center for tomorrow morning. This will replace the appointment we previously had with the other vet for a second opinion. They at least have digital x-ray equipment and will be able to get better images of Pez's leg, shoulder and chest to see what's going on. She's been getting around fairly well, however, it is extremely tiring for her as she can only go a few steps and then sits on her backside and rests. I hate having to pick her up to go outside and down the stairs as it must shift the bones/joints around and she cries out sometimes. Hopefully the bedside manners of this oncologist will be better then the previous experiences... keeping our fingers crossed.

Scott, Charlotte & Pez

My heart lives at Rainbow Bridge
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28 November 2008
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18 January 2010 - 3:52 pm
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I'll so be thinking of you guys tomorrow.  Lots of good thoughts coming your way.

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.

csmpez
26
18 January 2010 - 4:40 pm
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Just wondering but has there been a median and average cost analysis done associated with amputation, chemo, etc? Also, any cost information on metronomics or anti-angiogenesis therapy?

Scott, Charlotte & Pez

My heart lives at Rainbow Bridge
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28 November 2008
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18 January 2010 - 4:47 pm
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I think the pricing varies considerably.  We paid almost $1000 for Trouble's surgery and 2 days of care, there are others here who have gotten by for about 1/2 that. I have no experience with the other therapies.

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.

csmpez
28
18 January 2010 - 4:53 pm
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So amputation is roughly around $1000 dollars?

My heart lives at Rainbow Bridge
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18 January 2010 - 4:56 pm
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You are in a major city, I would suspect it may not be quite as expensive in the Houston/Galveston area.  Trouble had her surgery in Beaumont.

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.

Winnipeg
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13 July 2009
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18 January 2010 - 5:05 pm
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I thought $1000 was at the low end of amputation. Several people have said they paid around $2500 at a specialist clinic and I know mine was higher than that (well, not "mine" but you know what I mean!).

I think the cost of cytoxan as part of metronomics comes to about .70/ 25 mg pill that Tazzie took each day (some dogs take that every other day), plus some doctors add additional pills (Actos). But those are relatively low-cost prescriptions. The other costs involved in metronomics are blood and urine tests to make sure nothing bad is happening. The tests probably cost more than the prescriptions.

Good luck tomorrow Pez and let us know when you find more out!

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