Caring for a Three Legged Dog or Cat
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I know there are a lot of stories like this on here already, but I suppose every situation is just a little bit different and I just want to know I've tried to squeeze out every bit of information the world at large has to offer before I make a decision I can't take back. (I have already asked pretty much every friend I know what I should do, reached out to old friends I don't even talk to anymore but happen to be vets, and spent hours at this point debating my options with both my local vet and our oncologist. If anyone wants a long, melodramatic read, I've been journaling all about it.) So.
My Lab mix is 9.5 and was diagnosed with osteosarcoma two weeks ago now. We were all set to go forward with amputation this week, but then his oncologist said he and the radiologist at the University vet office were pretty sure they saw a lesion in his lung. So we put off the amputation to think about it a little bit more. I'm just finding it almost impossible to figure out what is the right decision for R. I am clear on the fact that for me the very most important thing I'm trying to achieve is a minimum of pain for R. I'm not playing for more time. I think more time would mostly be something I want. If more time means more pain for R, I'd rather we have less. I love my dog "higher than skies and deeper than oceans", as I tell him every night at bed time. But I think what R cares about most is quality of his days, not quantity.
So I'm clear on that, even though it depresses the hell out of me.
But I don't know which option is a good gamble for less pain. The way I understand it from the oncologist amputation = 100% chance of one to two weeks of moderate pain managed by a cocktail of drugs, but then a 0% chance of pathological fracture pain with only a small chance of lingering amputation pain/complications. NOT amputating = an ever growing chance of the likely rather excruciating pain of a fracture. With the lesion we're already seeing in his lungs (only one though right now!) the vet puts the median ranges at 1-3 months without chemo, 2-5 with. I understand those numbers are guesses and we can go above or below but it certainly sounds like there are decent odds we do the amputation and only get a matter of weeks afterward... Is that still the right choice? My sister (a doctor) suggested that the likelihood of R passing from metastatic complications WITHOUT the complication of a fracture first is low. She said in humans with osteosarcoma they usually actually wait until the limb fractures and then they amputate. And my vet said some people go that route too; hold off on amputation until if/when the dog suffers a fracture. But that seems to me like the very worst option for R. Now he gets both pains. I'm trying to minimize pain.
Just looking for more input, opinions. We are seeing a single lesion in his lungs. Outside chance that's something else, of course, but given the circumstances, suspicious it's the osteosarcoma. Do we still amputate? I am really lucky to have pet insurance so I think we can afford both amputation and full chemo. (And I'm working from home in COVID-times so I can afford to supervise his healing.) Just trying to decide if that's the best route given my no. 1 goal to have R suffer, overall, the least pain possible. (Also considering as one last 'hard stop' doing chest x-rays again before we amputate since that will likely take a few more weeks now to get back on the schedule and if the lungs aren't looking lots worse, yes, if we're descending at warp speed and they're filled with spots then, no on the assumption that R is leaving sooner than later.)
Even his oncologist said, "Yeah, he's a tough case." Yeah.
Hello and welcome, your future posts will not have to wait for approval.
This is never easy but you do have a tough decision to make- I'm sorry.
A few thoughts:
R (is that his name?) is in pain now even if he is being stoic and not showing it. Anything that starts to eat up bone is very painful. I can't imagine letting it go until the leg breaks... they really do that with people? I haven't heard of anyone here doing that on purpose.
There is no real reason for him to be in 'moderate' pain after amputation. With proper pain management dogs can be comfortable- there is always a bit of pain with surgery of this magnitude but it doesn't need to get to moderate.
Also- how is he otherwise? Still have a zest for life? Does he have any other issues like bad arthritis that might need to be considered?
Did the oncologist give you any treatment alternatives other than amputation? A couple I can think of are targeted radiation treatments and Bisphosphonates which help control the bone structure and pain.
Here is some info on Bisphosphonates
Here is some info on treating Lung Mets
Can you get another opinion on the xray? If there is any chance it's not a met then that would make your decision easier.
All that being said there have been dogs here who have had amputations even with known lung mets before surgery. I was looking for some links but I can't find then now... I'll keep looking.
As you know with surgery you are removing the pain. How long will you get? There is no way to know. I've seen dogs here do chemo and get only weeks after amputation. I've seen dogs not do chemo and get years after surgery.
This is a tough decision that really only you can make. Do your research, get all the facts you can, but sometimes you have to just follow your heart. You know R the best and know what is best for him. You will make your decision with love and knowing you are trying to do your very best for him.
No matter what you decide to do you are now part of our family here and we will support you no matter which path you choose.
Karen and the Spirit Pug Girls
Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.
1999 to 2010
R is Rearden. My beautiful 'monster'. I always just call him R in conversation.
R definitely still has some enthusiasm for life. He still begs me to play fetch. And tug. And 'find it' with the squeaky squirrels. Still wants to go for walks (he wanted to go a whole, slow mile today). Still eating. Still begging for cookies.
I think that's why I can't imagine letting him go right. now. (One of his two vets summarized, in her opinion, the choice was, "We take the leg or we put him down.") It would feel wrong to me to euthanize a dog that's still panting-grinning at me every day. So I have to do something for his pain for as long as he still seems to be enjoying being here. I'm just worried amputation will suck the joy from what might be his final days.
Aaaaall that said, things have moved faster than I realized they would. We talked to the oncologist again today. They could actually schedule him for surgery Tuesday. So I think we're going forward with amputation. Both his vets agree that other than the lung lesion he's a good candidate for surgery. It's a back leg. He's lean and otherwise healthy. I just really hope he's not going to spend his last few weeks recovering from surgery. Even if he only has weeks left though, his oncologist argued eeeeeven in that situation the amputation might be best to remove the risk of fracture those last few weeks. It does sound like they have excellent pain relief options at the university vet. He's going to have some kind of tube in the incision (?) by which they'll be dripping some heavy duty liquid pain relief directly to the site which supposedly should keep him pain free through the first few days. (I'll learn more details Monday; they have you drop him off the day before surgery. I'm guessing so you can ask your 200 questions.)
My gut has gone back and forth on the decision. My first knee jerk reaction to the diagnosis was: We'll do everything to fight it. My second thought was: I don't want to keep him here longer than he's enjoying this life. My third thought was: Lung mets. Shit. My fourth: I really don't want to do amputation. But I'm starting to think that's more a me-problem than an R-problem. I'm going to find it heartbreaking to see him with such a big wound. And I wish I could prevent him the pain of amputation. But the more I've read and talked to people, it seems like leaving the leg on is signing us up for likely fracture at some point, which is a pain we can avoid... by amputation. So.
Let me say right off the bat, your determination to do what's best for Reardon is genuine and pure. Your devotion to R and commitment to his well being clearly is at the forefront of every decision you make.
You are processing everything as best you can under such a stressful situation. Thank you for sharing your thoughts "outloud ". Although the met addd another layer of concern ,to your decision, you are doing an excellent job of analyzing what R would want. Not gonna a lie, it's an agonizing decision.
That said, your Vet team has offered some pretty good guidance as far as proceeding with amputation. I hope you find their expertise reassuring. They made some good points.
In the past, Vets generally didn't support proceeding with amputation if there were mets. Now though, most Vets DO proceed. As your Vet mentioned, there's the risk of fracture. Additionally, and probably equally as import, none knows how much time any of us have. And no one knows how long a dog jas with, or without a met. Jerry loved life large for many, many months after mets were found.
Recovery is no picnic for a couple of weeks. It is MAJOR surgery, all while adjusting to three. Every dog is differen. Every recocery is different. pain management is important and clearly your Vets are on top of that.
Karen always suggests making notes of why you are ma,king the dec you are. In this case, you've already noted R has a zest for life and enjoys being R! That's hugely important!
The other thing I would add is, which way would you second guess yourself more? As humans, we always second guess ourselves! If you didn't proceed, would you furever wonder..."what if..." , .."If only...". If you do proceed, could you accept that decision even if you didn't get much time? Could you know without regret that you HAD to give him a chance? Could you accept that it was better to give him a chance with the hope things would turn out well, even of they didn't ? From what you've written, it appears you need to give R a chance.........because that is what R would want.
So yeah, sit still with R. Let your mind be open to his thoughts. You two are clearly connected. Listen to R's"voice".in the stillness. You'll know what he wants. I think you already do.
We are here by your side every step of the way. We will be cheering madly for him and look forward to cele the many victories he'll be having.
Lots of hugs, peace and claeity
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!
PS. Try this link for adding images
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!
CITENESS ALERT!!! INTRODUCING THE ADORABLE OLOVE AND HER PACK!!! And yes, Ollie jas her very own high chair
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!
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!
I think ultimately I've come to feel like maybe this wasn't really much of a choice at all. If we don't take R's leg, the chance that he passes from metastatic complications with that leg intact is apparently very low. So it sounds like we take his leg now or we suffer fracture later. It's pain or pain. Which is a shitty choice. But one pain we can predict and try to manage proactively.
R's definitely not ready to go yet. Realizing today might be the last day we have the opportunity to play fetch in the backyard with 4 legs (his vet said we could still play fetch if we weren't doing crazy leaping catches, based on how compromised the bone looks at the moment) we took advantage... and R ran around after his ball and chomped on it contentedly in the grass for 45 minutes. We went for a walk and smelled all the cool smells around the block. Now he's contentedly napping on my bed on the floor in the living room. (Previously off limits, but he's figured out pretty much there are no rules anymore these days. Smart little sh**.)
I think I'm going to feel really guilty when I take him to the university vet on Monday. He's going to be scared but trust me and I'm going to feel like I'm betraying him by leavening him there to have his leg lopped off but... I know, logically, that's not true. I'm trying my best to help him however I can.
You have a whole pack of pups! I can barely keep up with one!
R:
[Image Can Not Be Found] (https://www.instagram.com/p/CB1gGhFBNj6/?igshid=1buz9ibsfryua)
Looots more R on my Instagram. Like, 90% of my Instagram.
OMD he is so handsome! Look at that gorgeous boy 
I read your blog and this post here but I was not in a place that I could reply properly.
You are not doing this TO your heart dog, you are doing this FOR him. Please never ever forget that. Absolutely everything you have done has been from the heart. When you consider your pup and HIS needs you will never make a wrong choice. And even then we always doubt ourselves.
I know of several on here (no, I cannot remember the thread now but I will look) that had lung mets and still lived a very long life... I believe there is one right now hopping on very happy and thriving even with the mets.
Not to compare, because we are all similar yet unique in our experiences, but we all struggle with something. In my case Huck was a feral cat that lived his whole young life outside, and very content to be that way. I was never able to lay even a finger on him no matter how I tried to sweet talk him. When he disappeared for 6 weeks and came back dragging a leg I was a true mess. When we trapped him and I was given 2 options.. amputation or euthanasia I wanted to crawl under a rock. I knew I could not end his life. I knew odds were that I would have to release him back out with three legs if I could not domesticate him. He is now a happy indoor kitty that will always have a wild heart but he sleeps on my pillow at night after months of working on his trust and loving him.
So, in no way does this compare to your situation, however our struggles are very real and yours is even worse in the sense that you are dealing with that 
cancer.
You have made your decision. R does not see it the same way. Yes, he will be scared for a short time but once it is done he will be ok. And he will be out of pain. And he will move on and leave that all in the past. You will fret, cry, feel guilt... but you will rehabilitate him, nurse him through recovery, and enjoy his kisses and his love for whatever time he has left. He will be pain free and happy. There really is no choice here.
I am not a vet, but I believe he deserves the chance you are trying to give him. None of us know what the outcome will be, but you will have a Tripawd nation sending you love, support, and healing vibes from across the world. We will all keep our fingers, toes, tails, and paws crossed for a successful and uneventful procedure that will lead him back into your arms.
Please stay in touch. Recovery can be a rollercoaster ride for a couple of weeks, and many here can help you through the things that pop up along the way.
Sending you a ginormous hug. I wish you the very best in your journey.
Jackie and Huckleberry
Hugs,
Jackie, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry 
HOLY No good deed goes unpunished!!!!
OLIVES mom wasn't able tompost the pics so I had her send me some and I told her I would post them!!!
And I did........on the wrong dang thread!!! R, please excuse me!!
It was close to one o''clock am when I finished and ppsting.TO THE WEONG PLACE!!! Anyway, there were a lot of wo derful pictures Helena sent.. as you may know, with a tavlet it's a vit of time and focus as you hace several steps and can only post one at a time...then go back and repeat
So to R and Olive, I apologize! I'll try amd straighten thi gs out later and get them in the eight place
And to sweet Jackie who alerted me in such a kind way that I "may" have put the pics in the wrong place❤❤❤ Thank you Jackoe🙏👍
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!
I think the guilt is going to be hard to work through, but there doesn't seem to be a way around it. And if the decision is difficult for a me-reason then that doesn't mean it's wrong for R... Besides, I'll also feel guilty if he breaks his leg. He yelped at like 4am a few weeks ago (that's why we went back to the vet, actually) and I'm sincerely hoping not to hear that sound again. (Which, I probably will post-amputation. But I'm hoping to minimize it, I guess.)
I think it's awesome you managed to help Huck. I imagine it felt like a betrayal to trap him too, but you knew it was the best way to help. So, yeah, probably kinda similar emotions involved. Great to hear he's happy and loved.
I re-read my post.. I am so sorry. 4 cups of coffee and I think I went too fast. What I meant is that you will be very emotional and feel bad. Your boy won't see it that way. They just dont see things the way we do. He may be scared being separated from you, but they are going to give him a cocktail that will bring him to a happy place.
His pain will be gone. And you will need to manage that closely throughout recovery. He will not see this as you DID this to him. His pain will be gone and he will be a happy pup again.
I can see how my wording was not quite what it should be.. apologies.
Hugs,
Jackie and Huck
Hugs,
Jackie, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry
benny55 said
CITENESS ALERT!!! INTRODUCING THE ADORABLE OLOVE AND HER PACK!!! And yes, Ollie jas her very own high chair
Oops! Sally meant to post Olive's photos here.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
I loooove R's photo!! His real photo, not the photos I put in of someone else's dogs!🤪
He really is a handsome boy!
I'm going to paste a post made by Razbeg's hooman about his protocol. He also had a met at the start of this and is still living life to the fullest, happy and pain free!!
Okay, here it is....if I don't screw it up !!
RAZBEG PROTOCOL:
Now Razbeg’s having chlorambucil (Leukeran). He gets 4mg daily, except only 2mg every third day. Leukeran is quite new thing to us, so I can’t yet say if it’s been beneficial or not. We haven’t been able to check his lungs for 4 months now, because we have been concentrating on curing his cystitis, and also corona virus has messed thing up, because Razbeg finds taking x-rays stressful and at the moment I can’t accompany him to the procedure. He’s doing well, though, no visible signs of having anything wrong with his lungs. Generally speaking chlorambucil seems to have fewer side effects than cyclophosphamide, but cyclophosphamide has more scientific data behind it. And of course, leukeran is not entirely without side effects, either, for it can cause bone marrow suppression.
As others have said, there’s no right or wrong, and different things work for different dogs. Some onclogists indeed seem to think that metronomics aren’t that useful that they once were hoped to be, and I don’t know whether cyclophosphamide and chlorambucil have helped Razbeg, but I want to know I have done everything possible to help him, and now, after a year of being on metronomics , he’s still doing fine. At the moment, metronomics are the only option we have after chemo. We are fellow Europeans (living in Finland), and unfortunately immunotherapy vaccines are not available here. I don’t think they’re available anywhere in Europe, although I cannot be entirely sure.
These were some of my thoughts. To sum up, I think metronomics are worth trying, although they might have side effects and their effectiveness is disputed.
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!
paws120 said
I re-read my post.. I am so sorry. 4 cups of coffee and I think I went too fast. What I meant is that you will be very emotional and feel bad. Your boy won't see it that way. They just dont see things the way we do. He may be scared being separated from you, but they are going to give him a cocktail that will bring him to a happy place.His pain will be gone. And you will need to manage that closely throughout recovery. He will not see this as you DID this to him. His pain will be gone and he will be a happy pup again.
I can see how my wording was not quite what it should be.. apologies.
Hugs,
Jackie and Huck
Oh no. I got that. Your words were just right. But, yeah, I just meant I'm going to feel guilty regardless of reality. Sounds like R is going to have a CRI drip so he should be super duper numbed up for the first few days.
Yes, and that will be a good thing. When he comes home, there should be gabapentin, a pain med possibly for after the hospital med wears off, and maybe antibiotic depending on what they give him at the hospital. I say possibly and maybe because there are long acting injectable antibiotics, and long acting pain meds which will wear off in a number of days depending on the choice of meds. You may not need more antibiotics but you'll most likely need more pain meds.
You can probably add that to the list of 200 questions. Please make sure he has enough meds to last about 2 weeks. Gabapentin works well and it helps to control phantom limb pain. You may or may not need that much for pain meds, and you may need more. This is where it becomes very individualized but it sounds like your vet has good protocol for pain management .
Throw rugs or yoga mats are great in areas for slick flooring so he has traction .
Stock pile some favorite foods because the pain meds can mess with the appetite. Table food... scrambled eggs, ground beef, rotisserie chicken might be good to have on hand. Low sodium bouillon is good if he's not drinking enough.
If you have a safe area for recovery that would be good. He will need tons of sleep, food, hydration, short walks to potty only(on leash or other support) ... repeat. No walks, no up on couch or bed, no exercise, nothing strenuous for a couple of weeks. Too much activity can cause problems that can set you back. Im glad you'll be able to be his full time home nurse❤
Once in a while they need to have protection for their bedding. A few pee pads may be helpful in the beginning if he dribbles urine while sleeping it off. Worse case you have doggie beds to wash.
I see you are a well read person and you like to have data for what to expect. Surgery is coming soon, so these are some tools to help you in the what to expect department.
You may want to have or make a sling to help him up to potty the first few days. You can easily make one out of a beach towel or a bag with handles.
You've got this. Meditate, draw in pawsitive energy and concentrate on that instead of sadness and guilt. You will be surprised at how well tripawds adjust and thrive.
I hope this helps some.
Check out Griffins thread. That should lift your heart a bit❤
Hugs,
Jackie and Huckleberry❤
Hugs,
Jackie, Bo, Andy, Oscar, Phoebe, and the coolest feral tripawd kitty Huckleberry
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