Caring for a Three Legged Dog or Cat
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Now that Katie is home recovering, thought I would post in this recovery forum for some recovery advice. A quick recap: osteosarcoma; front leg amputation 12/8; came home 12/9. Katie is 11 years old and 85 lbs.
On Day 2 (12/10) I was surprised that she was doing better than I would have thought. She seemed to be in less pain than before the surgery, and that is still the case, but I’m starting to worry about her lethargy and lack of appetite. The incision doesn’t look/smell infected to me, but it is still draining quite a bit. The drainage seems to have slowed down today, compared to the last couple days.
What I’m struggling with is trying to decide what the source of her discomfort is now, and whether this degree of lethargy and lack of appetite is normal at Day 5. I guess I expected steady improvement. I don’t really get the impression she is in a lot of pain (or at least not like she was pre-surgery), but she just feels crappy and sleeps all the time and I can hardly get her to eat anything. Maybe it is just a different type of pain.
I suspect a urinary tract infection, but could be wrong about that. If so, that could be contributing to her discomfort. I will take a urine sample in tomorrow.
Her meds are the same as pre-surgery: 100 mg Carprofen 1x; 50 mg Tramadol 2x; 200 mg Gabapentin 3x My vet said to start with just 2x on the Gabapentin, after surgery, then go to 3x if she seemed to need it, but she was on 3x before the surgery so I kept on with that.
Both my vet and the vet who did the surgery are out of the office today, so no one to consult with. She goes in tomorrow morning to have her drain removed.
Would appreciate any thoughts.
Hey there! I'm so glad you decided to start a new topic here, good idea 🙂
So, it's not unusual for new Tripawds to have starts and stops during recovery. We see it all the time. Typically it's as if their body and brain are catching up to one another, and the body finally tells the brain "Hey, can you give me more time to relax and heal? I'm tired!" Her body is moving in all sorts of new ways, and it's really exhausting to get used to it. So the tiredness can be from that. Inappetence is also often caused by tiredness, but you can try perking her appetite up by adding suuuuper tasty foods like scrambled eggs, boiled chicken, etc to her bowl. Whatever you do don't mix pain meds in with her regular food or it could make things worse.
Her pain meds are standard. What is the Gabapentin dosage?
If you've been through UTIs with her before, it's smart to take a sample in. Good thinking!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Thanks for the quick reply Rene. On the lack of appetite, I have tried everything and the only thing I can get her to eat is a little Fancy Feast cat food and then after a few bites of that I can sometimes trick her into a few bites of canned dog food. The Fancy Feast was an extreme delicacy for her in the past, so it still interests her a bit. And, thankfully, she will usually take the Gabapentin willingly hidden in a cream cheese ball. The Carprofen and Tramadol I have to force down her.
She is getting 200 mg Gabapentin 3 times a day.
I started worrying that the amount of discharge from the drain is too much. So just now I talked to a Tech at my vet’s office and emailed a couple photos of the drain area to her. She thinks it looks/sounds fairly normal, maybe slightly swollen. So, I take her in tomorrow morning. Was grateful for that consult, as I did not want to put Katie through an ER Clinic visit unnecessarily.
You are so welcome. I'm in the Tripawds Chat right now if you want to talk.
So about her appetite issues. Yeah, you've done your homework there. I think the urine sample is a good call. Have you taken her temperature today?
Her Gabapentin dose is pretty low for a dog her size. Most dogs 75 lbs and over are around 300-400 mg 3x daily after surgery. Is there a reason why your vet started out so low?
The drainage sounds OK, I'm glad the tech was able to look at it. As long as the fluid is more watery than bloody it's 99% of the time normal drainage. Big dogs have a lot of it sometimes.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Got the drain out this morning and the vet said everything looks good and that the drainage should stop now. It was a lot of drainage and looked like only slightly diluted blood, so I was starting to get quite worried.
Katie reminded me today what a good dog she is. I really expected her to refuse to get into my vehicle but she very willingly scrambled up the ramp, onto the table, then in. It wasn't a perfect execution, but I'm sure she will get better at it. Staples come out 12/22 so we have a long time to recover before that trip.
Yesterday I didn't give her any Tramadol at all because I have really been suspecting it was the main appetite killing culprit, and she ate a little better yesterday, so I'm going to try it without the Tramadol. I really didn't have a chance to talk to the vet today about meds. But I can tell you it is not a situation where that vet is eager to hear my ideas about pain management . I'm just going to hold steady at 600 mg of Gabapentin per day, plus the Carprofen, and see how it goes.
Well, we are both exhausted from our big morning, so time for a nap.
Just catching up in time to say that things ARE starting to improve actually just since yesterday.
Glad the drainage was t a problem. Guess there was jo fever and jo UTI? Glad you ditched the Tramadol. Newest studies apparently show it is not an effective pain killer for amputation. Used to be that Gaba and Tram seemed to work well together, but now the support is all in favor of just Gaba.
My guess is her appetite will,pick up mow without the drain and with that truly bitter tasting Tramadol pill off the table.
One thing you might try is to have someone come over she really like with a drive thru cheeseburger. A lot of times they'll ear for someone else!
Everything you are doing and the way you are monitoring her....spot on!! Good job!.
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!
Wow she used the ramp? That's awesome! The majority of dogs out there won't use them at all. She is so cool!
Yeah, did you end up giving the urine sample to the vet?
I'm sorry the vet isn't into discussing pain management . That's a deal breaker for me, especially after interviewing Dr. Robin Downing. She wrote the book on pain management for veterinarians (and also echoes recent findings that Tramadol is ineffective). You might want to check out this video with her about finding a vet who's up on good pain control.
Really happy to hear she's doing better.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Thanks to both of you for the words of encouragement.
And thanks for trying to help me with eating ideas, but in her case I just can’t start trying “exotic” things. She is extremely sensitive to changes in diet, so I can’t take a chance on new things that might give her a raging case of diarrhea.
Regarding the UTI – I took a urine sample in with me yesterday, but I kind of doubt that it got analyzed. It did look like pretty good urine and I have pretty much stopped thinking that she has one anyway.
Thank you for that link to the Dr. Robin Downing interview. I think you provided that previously, or I found it previously on the Pain page, but then I didn’t have time to listen to it and couldn’t find it again. I just listened to part of it and will finish later. What a great interview that was! So much good info. Also there were several links at the bottom to other Tramadol related articles and I saved those links so I can find them later.
In that interview I heard you talking about Wyatt’s experience with Tramadol and I wasn’t sure if you were thinking that it may have caused some panting or if that was just an indication of pain and that the Tramadol wasn’t helping.
I have to take this opportunity to tell you what a beautiful dog Wyatt is. I see him in many articles, modeling gear, etc. He’s gorgeous. I have a real soft spot for German Sheppards – had one as a kid. Katie is a Sheppard mix with the mix being something making her long and lean. She is white with a very long nose and large pink ears.
I think stopping the Tramadol is the right thing to do, and I wish I had done it before. But I did read some articles saying it had its place in conjunction with other meds, including Dr. Petty’s book, so I just couldn’t quite get comfortable with stopping. But Dr. Downing is quite convincing.
I continue to agonize over whether Katie would benefit from a little more Gabapentin or a little less (because of the sedation). So for now I’m going to hold where I’m at.
Next I'm going to start doing some reading on chemo. I'm leaning heavily toward No right now, but if you have any good reading material to point me toward that would be great.
Here is what has worked for me for getting Katie in and out of my vehicle - in case it might help someone else.
The ramp had to be into the side door, because she was used to jumping into that door. All past attempts to get her to use a ramp into the back of my SUV failed (miserably). I think going in the side door gives her a sense of comfort too because the door is on one side and me on the other.
So what I did is put a very stable table next to the vehicle, with carpet attached to the top. Then a ramp supported by something else next to the table. So the end of the ramp goes under the table, not over it.
When I brought her home from surgery though I had another exit contraption ready. I put a large, very sturdy, table (again, covered with carpet) at the back that was about the same height as my SUV. So I could crawl in the vehicle and help her stand up and get her out on that first table. Then a second table about 6” lower, then the ramp. It was dicey at times, but it worked.
Okay, we have to see pictures of your beautiful Katie....as well as the great idea you jad with the ramp. I think I can visualize it, but a picture would help.
So glad Katie is doing well and her pain seems managed. That's so very important.
Chemo is such an individual decision. Truly, there is no right or wrong. Some "seem" to get extended time, some don't. Some "seem" to get extended time without out, or doing the holistic route, some don't.
Jerry will give you more insight/links. I think "statistically " there supposedly a little extra edge with the chemo. But honest to goodness, just from those site it seems it may, or may not make a difference.
Some do none, some do four rounds of Carboplatin, some five, some as many as six. Finances come intomplay, as well as how your dog tolerates Vet trips, carrides, etc. You know your Katie best.
Whatever you decide will be a dec made out of love for Katie. And that is always the right decision.
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!
Aww you are so welcome. I'm glad you were able to watch the video again. Dr. Downing is amazing. I wish we could clone her!
You are so kind about Wyatt Ray , thank you. We miss that boy (he passed just over a year ago). When it came to Tramadol, he did have a reaction that was a cross between panting and anxiety. So did our Jerry. It's not uncommon. And yes, while many vets still believe it can work well in conjunction with Gabapentin, others like Downing say it doesn't. pain management in vet med is so relatively new that it's still up for debate. Until now each animal should still be treated like an individual. If you think it isn't working for Katie, let your vet know and see how you can work together to find a better solution next time she needs one.
The chemotherapy question is a big one and there are no right or wrong choices. You have to do what works for you and Katie. Either way it's a toss-up. Statistically it gives dogs better odds at long-term survival. But it still cannot guarantee that. We see it go in all sorts of directions. Some dogs do beat the odds on chemo, some do not. Some dogs don't have chemo and still beat the odds (like our Jerry). You just don't know. You have to reach a decision that you can live with, knowing that you did what was in your heart for Katie's best interest. Many people struggle with this decision. A while back we published this post. It's still as true today although I should probably update it (can't believe how much time has passed!):
The Chemotherapy Decision: Joys and Regrets
I love the set-up for the car ramp! I'm trying to picture it in my head. At some point if you're able to take photos and who knows, maybe a video of Katie using it (I know, probably not realistic when you're just trying to get your dog in the car), I'd love to publish it in the Tripawds Gear blog for others to see. You can also feel free to put it in our Hopping Around topic.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Thanks you guys. I’ll try to take a photo of the ramp contraption sometime (no video, sorry), and then I need to figure out how to post a photo.
I’m so sorry about Wyatt Ray . I didn’t realize he had passed away.
Regarding the Tramadol, that is interesting that it caused panting and anxiety in your dogs because I was starting to suspect that in Katie, but of course kept telling myself it was due to pain. This is Day 3 with no Tramadol and she is eating better today than she has in a couple weeks. I’m really kicking myself for not stopping it earlier. It could be too, as Sally pointed out, that getting rid of the drain is contributing to feeling better too. I will try to subtly tell my vet when I see her next week about my Tramadol research and experience.
Thank you for the chemo post link. I’m about 98% sure that it isn’t for us, but I will do a little more reading. I want the rest of Katie’s life to be as pleasant as possible, and visits to the vet don’t fit into that plan. Plus, the appetite. She has gone several weeks hardly eating anything. I don’t want a set back there.
Her harness arrived yesterday (Flagline ). Looks like a good quality harness. I don’t even want to put it on her until the incision heals a little more, but will hopefully use it for the vet appointment next week.
Thanks again!
Aww no worries. Yeah we lost Wyatt just over a year ago. Miss that crazy dawg...
Don't beat yourself up about the Tramadol. I'd say most of us here learned that lesson too, same exact way. It's odd because officially, panting and anxiety isn't a "reported" side effect in vet med as far as I know, but we see those symptoms happen so often here, then disappear when the Tram is stopped, that it makes sense as being the culprit.
You're doing your research about chemo, and whatever you decide you will know that you made the most educated decision possible. It's a real comfort in this journey to know that you left no stone unturned when it comes to research.
The Flagline is pawesome, I hope you and Katie like it. If you need to use it before stitches come out, put a t-shirt on her, then the harness over the shirt. It should be OK.
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Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
I’ve been thinking for several days that Katie’s front leg is slightly swollen. I remember reading in a post that someone else experienced that, but don’t remember which post or what all was said. Is that fairly common with a front leg amputee? I guess the less she stands on that leg the better, for now (?). She doesn’t move around all that much. Spends most of her time sleeping. Or could it be that when she is lying down she always has that side down, and that is causing the swelling? I’ve been massaging it lightly, with strokes upward, but don’t know what else to do for it.
Hmmm. We do see swelling on occasion for a couple of different reasons and yep, usually in front-leggers. This is about the timeframe (10-ish days after surgery, or w/in 2 weeks) when it can happen. Typically fluid will reabsorb in the body.
I believe post you saw was about when a recovery suit was cutting off circulation and causing remaining leg swelling in the front limb. I can't find it now of course lol! A compression bandage can also do that.
Does the swelling seem to bother her when you massage? Does she react when you tough the leg?
Let your vet know just in case, so you can have one less thing to worry about.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
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