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Caring for a Three Legged Dog or Cat

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Phantom Limb and litter box regression
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Amanda Merlin
1
19 February 2021 - 10:32 am
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Hello all! This community has been an incredible resource! Thank you all! Our 13 y/o cat, Amelia was diagnosed with extensive osteosarcoma this past October. They did chemotherapy to start and we finally decided on a very risky hemipelvectomy January 7, 2021. It was all or nothing as the mass was wrapped around the head of her femur and had pushed her colon and was affecting her tail and bottom two vertebrae. The surgeon was very honest and didn't think he could promise clean margins, but we were close to putting her down at that point, but she had no sign of metastasis and was still eating, drinking, etc. and trying to play. She did incredible and they were 100% successful and she is in clinical remission. They were able to use the mass and make a custom vaccine to treat her, which is so cool!

Right after surgery she did great!! And for 4 weeks we did great! Right at the 4 week post op mark she started showing signs of phantom limb syndrome. She has been on Onsior, we have her on gabapentin, and she also gets biphosphonate treatment every 3-4 weeks for bone pain and as part of her remission plan. I just got the pheromone spray. She was going up and down the stairs no problem. Jumping, playing, acting totally normal. Now we have regressed ALOT. She isn't using the litter box even the modified one at all. She is hiding either under the bed or in our smallest bathroom in the corner. 

I am open to any suggestions as to how to first get her back using the litter box! And how to help with the overwhelm she seems to be having. I think I have her on a good pain schedule now, but she hates getting the medication. This week she had a full exam. And all the xrays, labs etc look great. The vet is certain its phantom limb. 

Thank you everyone!!!

The Rainbow Bridge



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19 February 2021 - 12:13 pm
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Hi Amanda and Ameilia! Wow what a journey, she's quite the one-of-a-kind osteosarcoma kitty. I'm sorry you are dealing with this but super glad it sounds like she is getting amazing care. Who is the clinic and vet you are working with? I love that they gave her an osteosarcoma vaccine. We don't know of any cats who have had one yet, just dogs. Which vaccine was it? 

What are the dosages and frequencies of the medication she's on now?

She's definitely giving pain signals , but the type of pain sounds mysterious. In general phantom pain can happen later after recovery, but when the pain hits it tends to come on suddenly and shockingly. Many Tripawds will jump, yowl or shriek out of the blue, and cats will often try to run away from themselves when it hits (sometimes by backward walking). Is she doing any of this?

If your vet thinks it's phantom pain , what is their plan for treating it? Did they refer you to rehab therapy? That's where I would go next. Did you know the Tripawds Foundation can pay for your first rehab visit too? 

I am open to any suggestions as to how to first get her back using the litter box! 

Have you seen our Litterbox Tips for Tripawd Cats article? Also, have you changed her litter at all? Or the box? Is there anything different? 

Stay tuned for feedback from our Trikitty contingent, they are masters at this kind of thing!

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19 February 2021 - 12:34 pm
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Thank you for this quick response!

We live in Oympia, WA. Her oncologist is Dr. Lisa Parshley. They actually custom made the vaccine from her tumor!!! 

Her current medications for pain are Onsior 3 mg daily. Gabapentin (I am titrating up) right now we are at .75 mg every 8 hours. Prior to surgery she had zero tolerance for the gabapentin. I couldn't give her .5 mg for 24 hours without her being a zombie. And then the bone pain medication in the office every 3 weeks. 

The pain started out of the blue. And I am seeing ALL of the behaviors you talked about. She runs away from herself. I am seeing backwards walking etc. Sudden yowls, jumps, etc. 

They felt the best path was to see if we can titrate up the gabapentin. I work in human rehab so I am wondering about at least one visit with a rehab person. That is amazing that the foundation will pay for a visit! I am just getting back to work after being sick with Covid since September. 

As far as litter goes, I had downloaded the book from the website and read through some of the forum posts prior to surgery. We made a modified litter box and bought the recommended litter. The crystals. We typically get the clay litter. She used the modified box for a couple days but within the first week she was using the regular boxes and didnt touch the modified box again. When the phantom pain started she was just pooping on the floor but still peeing in the box. Now she isnt using them at all. I was relieved at the vet that medically she is stable, but I need to figure this litter box issue out, and I want to help reduce the anxiety too. 

Thank you all so much! Truly!!

The Rainbow Bridge



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19 February 2021 - 12:52 pm
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Hi Amanda, thanks for registering. Your future posts won't need to wait for approval so post away. I encourage you to change your user name to something that's not your email address. Evil spam bots will find it and bombard your in-box.

Her oncologist is Dr. Lisa Parshley. They actually custom made the vaccine from her tumor!!! 

Ah! Dr. Parshley has a fab background! You're so lucky to be working with her. It sounds like she might have chosen the Elias Immunotherapy treatment for her? There are several types out there, I was just curious. That's some cutting-edge stuff though, and super cool that Amelia gets to have one. We will be VERY interested in following her story!

I work in human rehab so I am wondering about at least one visit with a rehab person. 

AWESOME! Wow what a combo, Amelia is blessed to have you. Yes, do take advantage of the program! I just published this article about kitty rehab therapy.

And thanks for reading our book too! Glad you found it useful. I will let the Trikitty contingent fill you in on more suggestions but for now, yep, if you are seeing those symptoms, it's time to get them addressed. Dry needling acupuncture and pain medications can often resolve the issue. These two directories can help you find a good clinic. Even though they're geared toward dogs, call and ask if they have experience working with cats, most do.

http://www.cani.....tion.lasso

https://www.utv.....titioners/

It's better to hop on three legs than to limp on four.™
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20 February 2021 - 9:12 am
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Hi and welcome! I am so glad you found us. I also think it is rather odd for these symptoms to be totally phantom limb related, especially at this stage of her recovery, but I am glad she is doing well with raising the dosage of the gabapentin. I found with Huck that it did make him loopy and sleep a lot in the beginning but that was very temporary. What is the higher end of the dosage that they recommended for you?

I am not a vet, but that was a major surgery and the 2 questions that come to mind is if she overdid something? Or, maybe she has other nerve endings that are still healing and tender? I also wonder if your doctor may have a different pain med in mind temporarily to help get her through this stretch. I had buprenorphine for Huckleberry and that worked very well for him. Your vet may have a totally different plan and that is great, I am just throwing ideas out there. 

If it makes you feel any better, we have seen some kitties experience this in their recoveries. Some of the senior cats take a little longer and are a bit more complicated in their recoveries. We have seen them have cat box issues, walking backwards, hiding, showing some aggression, and these have been temporary issues, however very unpleasant and worrying while they are going through them.

Another suggestion if she will allow you to, is warm compresses. If she will give you a chance, try some nice warm compresses on the general area and apply with soft pressure. I take a facecloth, run good hot water on it, wring it tightly and then shake it out until it is cool enough to not burn. Fold it and apply it to the area with gentle pressure. If you scratch her ear and tell her how much you love her while you are doing that, it may make a real sweet cuddle session and relieve some of her discomfort. 

I hope this helps some, even a little. If you have or can get some pee pads for around the cat box areas, that may help clean up until she is back to her old self. Cats can be very particular about their litter as you know, even down to scented or unscented. If you have her regular litter available, maybe placing one of the pheromone plug ins or spray around the area occasionally to help calm her. If she pulled something, maybe the way she places her body to eliminate is causing some discomfort, hence the behavior. Again, I am just throwing some ideas out there and hoping something helps you out. 

Like Jerry said, please go back and change your user name to something other than email address. There are trolls lurking everywhere on the web. We just want to make sure you don't have a bad experience. If you have a hard time changing your user name please let us know and somepawdy will assist you.

Good luck in your journey. Hopefully this is a very temporary setback for Amelia and soon she will be back to her happy self sp_hearticon2

Jackie and Huckleberry sp_hearticon2

Hugs,

Jackie, David, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry

Huckleberry's Blog

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20 February 2021 - 9:30 am
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Jackie and Huckelberry, 

Thank you so much! I think I found the name change! 

This is all great advice and good ideas. I also think she might have a pulled muscle or some overuse is involved. I love the warm washcloths. I am going to try all of these ideas. I did swap out the litter to her old, regular litter in the adapted box yesterday morning. She actually tried to go to the regular litter box yesterday for the first time in a while. But I think she struggled, so I am going to use the pads and get more plug ins for near the litter boxes! Great suggestion. I am hoping to see a rehab specialist at least once too. The vet said we could titrate the gabapentin up to 2 mg every 8 hours. Yesterday she was snowed on .75 but thank you for saying this is temporary because I think she felt better today. I was able to get her into the main living space yesterday and she was snuggly and happy most of the day. She seems so hesitant to try to move right now. So I love the warm compresses. 

She is older and the surgery was extensive, so I am sure the nerves are waking back up and a mess in that area. I feel so bad. She was soooo relieved after surgery. So happy to have that initial pain gone. I really appreciate you replying. I love the vet and the infusion she gets helps manage pain as well. Dr. Parshley wanted to see if the infusion makes a difference with titrating up the gabapentin before we add the narcotics again. Im also on the hunt for an acupuncturist for a feline, which I thought would be easier than it is! Everyone is happy to see dogs, but surprised Im asking about a cat! 

The community support is honestly so helpful. My husband and I have been so anxious and worried. She's doing better than she was a when this started 10 days ago, but I just want to reassure her. So thank you so much!



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20 February 2021 - 11:54 am
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Im glad to help.  Amputation it's a scary experience no matter what the reason and I will never forget going through it with my Huckleberry. 

I don't think you got the name change yet.  Maybe you didn't save it? I'll have to go into mine and look because I don't have memorized.... it's been a while,  lol. Let me see what I can do. 

You can get pee pads,  incontinence pads on Amazon or even grocery or pet stores if it's safe for you to go out and get some.  I got the large ones for people and they were cheap and easy.  I have a ton here but it would take too long for you to get them. 

I'll go look in my profile and see what's what. 😊

Hugs,

Jackie, David, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry

Huckleberry's Blog



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20 February 2021 - 12:19 pm
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I have put in a request for help in our Technical Forums HERE

Let's see what advice our admin can give sp_hearticon2

Hugs,

Jackie, David, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry

Huckleberry's Blog

The Rainbow Bridge



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20 February 2021 - 2:45 pm
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All good, I see your new user name. Great job! And thanks Jackie, appreciate your pointing this out to us.

That's terrific Amelia is making progress. How is she today? Did she use the litter box again? 

I would ask Dr. Parshley if she knows any acupuncturists who will work with cats. If not, give Dr. Ostermeier a call. She's in Portland and runs an excellent clinic, and loves working with cats and non-traditional acupuncture patients. We interviewed her here:

All About Acupuncture for Tripawd Cats, Dogs, Rabbits and Other Pets

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

Support the Tripawds Foundation!



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20 February 2021 - 4:03 pm
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Whew! I cleared my cache and it worked smiley_clap No more email address. Good job, sorry my cache may have worried you smiley9

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Hugs,

Jackie, David, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry

Huckleberry's Blog



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22 February 2021 - 4:06 am
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Just checking in to see how you guys are doing. Hope things are settling down for you.

Jackie and Huck sp_hearticon2

Hugs,

Jackie, David, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry

Huckleberry's Blog

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22 February 2021 - 11:19 am
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Thanks Jerry and Jackie!

Sorry! I am following up on acupuncture today. I will follow up on the lead in Portland for sure! 

She had a decent weekend. And did use the litter box twice finally--adapted box with old litter. Yesterday, I tried a recovery suit that I had tried after surgery but seemed irritate her. In human amputation, we add compression sleeves approximately 4-6 weeks post op. She was so happy in the suit, but I could NOT get to her to give her her afternoon dose of gabapentin-- She got the PM dose. She ended up having an accident, we had quite the mess in the middle of the night, but it also gave me the opportunity to trial some warm compresses as she needed some cleaning. 

So, I feel like we are making some progress. I really feel like acupuncture is the missing piece pain management and I do think I need to get at least one rehab visit so we can see how to reacquaint her positions in the litter box. I watched her and she kept trying to put weight on the limb that is gone and falling over. Then she yelps and runs away from herself. 

Thanks so much for checking in! We definitely appreciate it!

The Rainbow Bridge



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22 February 2021 - 11:41 am
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You are so welcome, no apologies necessary, you have your hands full. Yes, talk to Dr. O, I know she'll have great input for you.

Sounds like steady progress, I'm sorry about the accident though. I do love how you put a pawsitive spin on the situation. That takes a strong, optimistic personality at 3 am, you are handling this so well!

You may want to check out the Farabloc pain relief blanket. It's often used for human amputee patients to help with phantom limb pain:

https://gear.tr...../farabloc/

Keep us posted!

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

Support the Tripawds Foundation!



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22 February 2021 - 6:17 pm
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It sounds like you are headed in the right direction,  yay!!

Im looking at the glass half full as one accident with efforts to finally use the box.  An eye blink ago that wasn't even there,  right? 

Hope the compresses helped.  

The recovery suit is really geared more towards protecting the incision. For cats it's been more successful simply because cats and cone of shame usually = ugly 😖 Everything with cats is a crap shot (no pun intended,  lol) and trying to keep them from ripping incisions apart and starting over again can be a challenge. 

I have seen lots of older cats in here get a bit frustrated trying to find their new normal but it does happen.  For Huck (right rear amp) having a lower entrance and higher sides worked.  He likes to lean on the side sometimes for balance assistance. 

Thanks for checking in,  I know you're crazy busy right now!

Hugs,

Jackie and Huckleberry❤

Hugs,

Jackie, David, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry

Huckleberry's Blog

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2 March 2021 - 1:55 pm
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So Friday we totally regrouped and went back to total litter retraining. I found where she has been really going to the bathroom!! Oy! Anyways I set up the post op room again and we are now almost 48 hours no accidents and using the litter box successfully. I had multiple options in the room to see what she would choose. If we have another successful night I will start trying some time outside the room tomorrow, but I am now suspecting that she might have also become constipated. Based on some behaviors we initially were able to observe once we got her contained and all eyes were heavily on her. She is VERY content the past 48 hours. Purring and extra snuggly. I think she's feeling better and less overwhelmed in general. 

I am thinking about making her a LARGE litter box that she can walk into and lean against a side. But so far we are making some great forward progress sp_hearticon2 I really appreciate all the tips. They were perfect!

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