PrairieProf

Oh, I am so sorry. How hard too not to get to spend the what turned out to be his last days with him. You have been very brave and loving.

Thanks, this is very helpful to hear right now (both parts). Things seem OK this morning -- the wound opened a bit on our last outing last night, but not as much as the night before, so I didn't panic; the vet says it looks good this morning. The lump of edema on her foot came back, but the vet doesn't seem worried about it so I'm trying not to be. It feels very weird to have a dogless weekend -- I'm trying to appreciate the freedom of that as well as the break from stress. Tomorrow I may go to an arts festival in a nearby city I like to enjoy a day I probably couldn't if Beth were at home, even healthy. And I'll cuddle my cat even more that usual.

Well, I'm still going to have the tech take her Saturday and Sunday -- I will feel awful about not having her hom, like I've abandoned her, but I desperately need a couple of days to get my life back. And not be stuck worrying about her in isolation from the vet for over a day and half. But I'm relieved there's progress -- if it just keeps moving ahead without more setbacks, which I can hardly believe at this point.

She's a little tender on it, but we've also pretty much stopped the tramadol. Greyhound skin can be such a pain and the feet are even worse. We've healed bigger "open wounds" so I'm not too worried. Fortunately, our dogs don't tend to be obsessive wound lickers either. You are lucky about the licking! Beth is pretty much going to have her muzzle glued on her head indoors for a few weeks. I'm still giving Beth tramadol but less -- she really doesn't seem in much discomfort at all. As of this evening there are good signs of granulation in her wounds too.

Beth is home for the night now -- the tech was quite willing to take her but I didn't want to be separated from her for that long if she was doing OK. And she is -- even I could see significant progress in the foot now. The wound is granulating -- it's dark red and dry rather than pink and moist. I also got clarified that she did not, thank God, rip out her subcuticular sutures -- they're still there doing their job. The rip was more superficial, and revealed the top knots of the sutures. But it will granulate. So the deal is no bandage in the crate, bandage just to take her outside, which is quite a pain but is the fastest way for the foot to heal and not develop more sores. One of the techs commented how funny Beth looked roaching, so I'm happy to know she's not finding her time at the hospital too stressful. What a good girl I have. Oh, and also, the vet said that the day he agreed we should go ahead and amputate the original ulceration was so deep that bone was exposed. So we really didn't have much choice -- good to know as the impulse to second-guess that decision has inevitably crept in with all the stress.

Scritchies to Stella. Interesting to see the pics and learn that she had some suture issues too -- looks a bit better than Beth's at the moment, but it's been longer since her surgery. The foot looks quite functional -- is her walking OK?

Well, confusingly positive update -- just getting back from the vet where Beth is day boarding in ICU again. He said the foot looked good!?! -- that it had already opened some yesterday when they sent her home and now it's closed up. I made him show me the foot so I could point things out even though he'd already examined it and I even drew a picture of what had happened, because I couldn't believe the raw meat and exposed subcuticular sutures I looked at all through the night aren't a huge problem. But basically he thinks it will heal as is. It will be unwrapped when she's in the crate so it gets air and no pressure on her toes, then wrapped for trips outside. The ugly lump on the top of her foot is just edema from yesterday's wrap. The wonderful news is that one of the techs will take Beth home and babysit her for the weekend after the hospital closes Saturday at noon -- she apparently does this from time to time. She has a crate and can care for the foot and have direct contact with the vets if a problem develops. I will miss my baby girl sooo much but I think everyone at the hospital recognizes that I need a break from anxiety or I'm going to lose it. I was wondering whether we could send her to a 24/7 intensive care hospital, but this is much better. Fortunately Beth is very adaptable to new places and loves everybody, so I don't think this will be too stressful for her.

Another crisis. A few hours ago I noticed that Beth's middle toe was swollen up to at least twice its normal size -- clearly from the wrap that was tight but left it exposed. I badgered the answering service into putting me through to my vet (another service was on call) and he told me to take the wrap off but bandage the foot normally when I took her out. I waited a couple of hours and finally took Beth out to potty before we went to bed -- she walked a little more than I knew was good but she hadn't peed and I wanted her to go since she was out -- she did finally poop. But when I got back in and took the bandage off, the toe has ripped open again. It's not bleeding, just oozing a small amount, and doesn't seem to hurt her. But it's deep, at least a centimeter long, and I doubt it can be sutured again -- it looks like it will have to heal by granulation as well. Also, there is a lump of swelling above the amp site that wasn't there yesterday but appeared after the rip last night (or maybe when the toe swelled up, but I couldn't see it then). Looks like another big problem. Everything gets worse and worse, it seems! Each fix for one problem creates a new problem, and healing gets further and further away. I did not sleep at all.

Well she's been roaching in her crate for much of the past hour even with the muzzle, so that's better than I expected... Guess she hasn't totally forgotten kennel life!

OMG -- stress city!! The vets sent her home with the foot in a short wrap so that the toes are held together but the red gross-looking middle toe is exposed to air. Good for healing that, BUT it means that she has to wear the muzzle all the time. Poor girl, poor me. So far she's settled down in her crate after fussing like crazy in the car, but I'm not expecting to sleep much tonight. I do have the Medipaw boot I can use as a fall-back, but it's not as good as full air exposure. Plus I'm nervous the new wrap will cause other problems. Her muzzle is tied on with a ribbon of gauze tied under her throat, not onto the collar, which would move around. It does seem to work pretty well, and isn't choking her so far. It now seems likely that this arrangement will continue for weeks -- obviously the foot can't be fully bandaged and obviously Beth can't be left unmuzzled until it fully heals.

Thanks for the bucking up. I hope I can read her signals -- I can't tell the difference between "c'mon Mom, let me out of the crate for a change!" and "I really have to go!" Beth is my first dog and I've always kept a rigorous outing schedule for her to avoid issues; the occasions when she's urgently needed to go out at off times have involved restless pacing etc. that she won't be able to do. Yet I do recognize she won't explode from a change in the poop routine; if she has to go badly enough she will. Or the worst thing that could happen would be she'd poop in her crate, which isn't the end of the world (especially now that she has reliably small, solid poops on prescription food). Seeing that pressure sore develop in a day really brings it home to me that walking is a problem. At least trips to and from the vet give her a chance to potty when we have to be outside anyway. I can't believe it's only been eight days since the amputation -- it feels like so long. Maybe in a week she'll be OK to have the foot unwrapped and the sores won't be so much of an issue.

Thanks for the support. You've got it right about the patience issue, Beth! I just want my dog back to at least semi-normal so badly. But I'm trying to hold on to the thought that this current plan should really help speed the healing process. And that if the eventual prognosis is good, that's the important thing.

Mixed update from vet visit this morning -- I had both vets look at her this morning so everyone could be on the same page. The surgical areas of Beth's foot are looking good and my regular vet is confident that once everything's fully healed up there won't be future tearing. I finally got clearer on what happened with the skin tearing: it tore horizontally up from the suture entry points, not in a horizontal tear parallel with the original suture line, as I'd thought. This makes more sense and does mean the tear was related to the incision not being healed enough for the stress put on it when Beth walked with the foot unwrapped. It wasn't just her skin giving way. So this makes me more optimistic. The inner toe that was previously all raw is looking good, too -- not very red any more and you can even see the hair starting to regrow. The less-good news is that she's developed a new pressure sore on the top of her remaining middle knuckle that wasn't there yesterday. My regular vet agreed with the other vet that the foot needs time unwrapped. So the deal is that Beth will be day-boarding in the ICU kennel today, tomorrow, and Saturday morning so she can have the foot left unwrapped under close observation by the vets and techs to forestall any problems. She should heal fast that way, though, both the sore and the area closed with tension sutures that needs to granulate in. I'll have to do the same thing Saturday afternoon and Sunday, which is kind of scary, but I'm reminding myself the foot will be more healed by then and less likely to have tearing issues. They rigged up something where they tied her muzzle with stool guard to her collar with a strip of gauze, so she can't easily get it off.

Just came from a meeting with my regular vet -- though he didn't want to do a second bandage change today, so he (along with the other vet who's been treating it) will look at it tomorrow morning. I'm rather confused. He is pretty adamant that the foot just hadn't healed enough from the surgery, and that if we give it a solid (further) two weeks of healing with minimal activity the skin will knit together and not rip. He explained but I really didn't follow how the skin rather than the stitches ripping was part of this. But I guess it's good news that he's pretty confident the skin will all hold together if we give it enough time, even with the stress of the new foot configuration. The bad news is that he implied I've been walking Beth too much, even though she's mostly been on crate rest. I feel guilty -- I thought I was doing everything right. The two or so blocks out, two blocks back we did twice a day so she could poop was too much -- I have to do the equivalent of just walking her around the yard (I don't have a yard I can use for this) and when she has to poop badly enough, she'll go -- she's on low residue food so it won't be too often. We'll do daily bandage changes to make sure the skin isn't getting raw -- he agreed that if we need to leave it unwrapped because of the skin not healing enough, kenneling her at the hospital for part of the day might be the way to go, since techs can babysit her and rewrap her foot if she has to go out. Beth created a bad scar from licking the surgery site on her back, so he's really concerned about not letting her lick the foot (her muzzle with stool guard and the Medipaw boot I got yesterday are the likely options). In the good news category, her test results came back and she's heartworm negative, titer shows she doesn't need to be revaccinated for the second year in a row, and best of all her TLI is even further down than on the last check so her pancreas is doing great on her low fat diet.

Thanks for all the info, jjng! The Orthovet Bootie Splint looks to me like it might be just the thing -- I'll tell the vet about it this afternoon. The thing is just to prevent her toes separating too widely while still getting air to them. The bandage was never padded. Probably what you saw was just the white cloth tape around the top.

Finally some positive news! We went back to the vet this morning because I was too anxious to wait until our appointment this afternoon, and she said Beth's foot looks much better -- the rawness is decreasing, the area she couldn't suture and had to leave open is closing already -- it's not much more than pinhead size now. She thinks the subcuticular sutures she put in will really help (and apparently she did take out most of the previous skin sutures that she thinks may have irritated things; they're just left down near the pads where they weren't bothering anything). There are still issues ahead with how we will transition to no wrap so that the skin doesn't tear again (she's actively thinking about options and on my urging will call OSU), but it is GREAT to have something to feel optimistic about. As long as I know she IS healing I think I can deal with the situation. She also reminded me she put in the subcuticular sutures with the toe in a "tension" position, so that they should help hold things together as it moves. They tested the toe this morning and it has a full range of motion with no suture issues. We'll see my regular vet this afternoon as he'll finally be back from vacation, but I have to say this other young vet in the practice has been absolutely wonderful, skilled, concerned, and supportive. (She said she worries at night about her charges too, and sometimes comes in to the clinic at 1:00 a.m. -- texting the tech that she's there!) She's already texted my regular vet (who's driving in this morning after a late night flight back to Des Moines) about Beth's situation.

Hmmm. This is like the whole air/no air thing from the original ulceration. The vet was swearing it needed to be exposed, and I could really see that. All the bandaging except on Monday was done by experienced techs or vets. It is very upsetting that they didn't pad it and evidently didn't do it right to prevent these problems -- I can affirm that it never got wet. Where I first saw the skin torn was where it's been red and abraded and moist from the very beginning of the injury (on the inside of the remaining middle toe). It has never healed. A friend asked me if that made it more prone to tear -- I'll have to ask the vet. Otherwise, if the skin tore just from the stress of the toes spreading as she walked for a very short distance, that's almost scarier, since I don't know how it won't keep recurring.

Thanks for the encouragement. It was a rough evening with her whining for hours (post-anesthesia, I think, not pain). Finally she slept -- I'm hoping she is less wobbly this morning. I want to believe it can heal but it's so different when you're talking about a foot, a foot that now is changed in how the skin pulls and moves. And where the skin evidently tears like wet tissue paper. Having had the abraded skin and the ulceration NOT heal before the amputation, I'm terrified. I lay awake trying to think of how it could get air with ripping again -- I wonder about crating her at the vet during the day with the wrap off, and the techs there to keep an eye on it and wrap the foot again if she needs to go out to potty (I guess I could do this at home after a couple of days, but right now I'm afraid to have her foot unwrapped out of the hospital). But would the skin rip when she even stands up to turn around in the crate, as she inevitably does? Could they mildly sedate her or something? A friend also suggested a Therapaw -- it does look like that has good air circulation and might keep the toes from spreading too wide when she stands? I've actually never seen one "live," only in GT pictures. The fitting seems pretty complicated -- would I need a custom order for that foot?

I hope you're right -- I think all the stitches held. I don't recall if she said specifically about the part in the mid-point that's now open. But the vet said that the stitches make the surrounding skin weaker, or something. I can't believe my poor baby now has two lines of sutures in her poor toes, regular and subcuticular. It did seem like she knows her business as a surgeon, which is reassuring. The vet said I'm the best pet owner they see in the whole business, though.

Really really bad and complicated news. It was a lot to take in and I felt nearly beside myself, so I hope I'm getting it all right. The stitches didn't tear -- they are healing very well. Her skin tore above the stitches. The vet put in subcuticular sutures to heal what tore, and that's closed up well along her toes. But the inner part (right on the foot where the toe joined) tore too, and that can't be closed all the way because it would be too tight or something and would just probably tear again -- a small square has been left open, closed loosely with what I think she called tension sutures, to granulate in and hopefully form some thicker scar tissue. She may need to have those tightened eventually, another anesthesia procedure. But she said that the bandage really did have to come off, the raw toe is in bad shape and she's still worried about it -- we may have to take these bandages off pretty soon too (daily bandage changes for now). And there's nothing to say the same tearing won't happen again when the bandage comes off and her toes spread; they may have to come up with some kind of two-toed bandage or support. So it's a balancing act between getting the skin to heal and protecting the raw toe. How can I deal with this?? Nothing like this happened with any of the other toe amputation stories I read. What will prevent her skin from just ripping and ripping?

I am so sorry. A setback today with Beth, but news like this reminds me what really bad news is. to you and Stella. "Digital sacrifice" ... sounds like a bizarre religious ritual.

She's had a little "cigarette" of rolled telfa where the missing toe is, so I assume they'll put that or something similar back there. Oy, so nervous. She should be in or recovering from the procedure now. Waiting for the tech's call that she's awake again..... Edited to add: OK, got the call, she's fine. I'll pick her up in about an hour, and will get to talk to the vet. That reversible anesthesia is really nifty stuff.

What was your wrap exactly -- did you have padding under the vetwrap? Beth just had telfa where the amped toe was and vetwrap around the foot -- she will have what the tech calls "cast padding" under the vetwrap now. I do think that basically she just needed to be wrapped longer for the incision to heal better before she put stress on it by letting the toes spread. But now that area will need two weeks more.....

The innermost toe was pretty much raw all over. That one is more of a concern than the other middle toe, according to the vet. And that too is more raw near the top, if I remember correctly. Weirdly enough, when I got home and noticed the suture-line bleeding, the inner toe already looked better (dried off).

Very bad news; we have had a setback. I took her to the vet this morning, and she said we did indeed need to take the wrap off her foot so some toes getting raw could get air and heal. The innermost toe looked a LOT worse than yesterday. We went over all the techniques were were going to use with muzzle, sock, Medipaw boot at various times. But by the time we got home, there was blood on the sock, coming from the suture line near the top of her remaining middle toe. So I immediately took her back to the vet, where the most experienced tech confirmed that several sutures had ripped out on the foot as the toes spread out. So I left her there and she will be anesthetized (about the fourth time in six weeks!) for re-stitching this afternoon. The tech said that with a pressure dressing it was fine to wait until my regular vet is back from vacation tomorrow afternoon, but putting in a few stitches is simple and I decided to just go ahead -- they all know the greyhound issues regarding anesthesia (I checked) and that tech promised to do the anesthesia and monitor her closely. Meanwhile, this means she's going to have to wear a wrap for weeks still until those stitches, now six days behind the rest, heal enough to hold reliably, and what's going to happen to her poor skin? The tech said they'd put cast padding under the wrap so there wasn't vetwrap rubbing on skin directly. But I'm scared about that; the vet was pretty clear about the wrap needing to come off. So six days was just too soon to remove the wrap for her middle toe amputation with how the toes spread wide when she puts weight on the foot -- I can see how it wouldn't be a problem with an outer toe amp that doesn't get as stressed. It's just a good thing I didn't take it off yesterday and have her bleeding all night! I don't know how I'm going to keep coping with this stress -- I'm trying to remember it's just about three stitches, it doesn't mean the foot isn't going to heal. And I did get to see in our short trips to the car and the house that she seemed to walk OK on the unwrapped foot. Also on the positive side, she walked very well yesterday afternoon/evening and this morning before we went to the vet. This morning she even tried to chase a bunny that shot away right near us.