Amputation Questions

[Guest HeatherDemps]

My husband and I have discussed Dempsey's situation at length and after reading over a lot of information, we are leaning in the direction of having his front leg amputated followed by chemo- assuming that osteo is confirmed and that when we do x-rays of the back legs nothing else is found.

 

For those of you who have done amputation, what kind of accomodations did you make for your dogs? We live in a ranch style house thank goodness, so there is just a slight step up to get in the front door, that is it. I have an SUV though and my husband has a truck. He can easily make a ramp for Dempsey when we need to transport him- has anyone else done this and how well did the dog do?

 

Did you have your regular vet do the surgery or did you go to a specialist? I'm assuming my vet wouldn't be doing it. We are a little over one hour from the University of Illinois and OSU is a 5.5 hour drive from here.

 

Approximately how much did the surgery and care end up costing? When I talked with one of the vets at OSU Monday morning, she did not have the info right in front of her so she gave me a wide estimate of $1500-$2500. Not sure what chemo would be on top of it- from what I've read, there's different types...

 

OSU has been great so far. My vet is supposed to be calling them today to discuss the needle aspiration, which is what they recommended over the biopsy. I don't know if my vet can do this or if we'll head to U of I for it. Should know more by the end of the day!

 

Although I'm not not-upset, I'm in a much better frame of mind than I was a couple of days ago and feel better informed to make decisions. My husband and I are going on the assumption it's osteo so that we can have our decision made with time to think, rather than waiting until it's confirmed. He's taken this harder than he expected- he really thought it was just a strained muscle or arthritis.

 

Thanks to everyone who has shared their expeeriences and said prayers- it really means a lot. The adoption group I used disbanded, so I'd really be lost without GT. I'll keep you updated on what's going on.

 

Thanks so much,

Heather

[Hubcitypam]

I've only had one amputation done and that was in Lubbock, but that was due to HBC when she got out of a foster home in a storm (front door blew open). The vets all suggested a doc that did a lot of orthopedic surgeries and he did an excellent job. Cost was $400. Ashley was a younger girl but she honestly never missed a beat after losing a front. By the time her pain patch came off she was hopping through the dog door. We have a GSD client at work missing a front and he gets in his owners SUV fine, but Gus is about 6.

 

Thoughts and prayers for you and Dempsey. Best of luck.

[SIGreyLady]

Thoughts and prayers to Dempsey and your family. I had a grey with osteo but chose not to amputate. Its a wicked, evil disease! Chloe lasted about 5 months or so with hospice like care and knew she was loved by all. Another bridge hound had lymphosarcoma and we did go with chemo. He went into remission for over a year! Several GTers have gone through the same thing you are experiencing so I hope they can give you more info. Mimi

[Burpdog]

There are a few regular vets who are good surgeons that can do the surgery but you have to be careful. Have you asked Ohio State if they know anyone close to you? What city are you in? Perhaps someone here is close enough to recommend someone.

Edited December 26, 2007 by Burpdog

[Guest HeatherDemps]

I am in Bloomington-Normal, Illinois. It is pretty much right in the middle of the state. Peoria is a 45 minute drive. Champaign-Urbana (where U of I vet hospital is) is a little over one hour from here. About 2.5 hour drive from Chicago, depending where in the city.

[Guest pmutalik2000]

The first couple of days after the amputation are the worst. The surgery sight looks very bad, the dog may be in pain and may need some pain killers. It takes them a couple of days to get used to being a tripod but most adjust to it. Build a ramp that's very helpful. We have had 2 dogs go through this and the thing I did after the first time my dog tried to use the ramp was to nail some carpet to the ramp, it gave them a better footing than just plain wood. My only advice to you would be to brace yourself and don't question your choice in the first couple of days after surgery.

 

Praveen.

[VinnieAndRexsMom]

Heather,

I can't help with surgery questins, but I have a ramp I like. I bought it when Vinnie hurt his back. I would just telescope it up and take it along. They're sturdy and have a safety rail which I thought was nice. I spent around $110-120 and it's good quality.

 

Ramp: http://www.dogramp.com/?wcw=google&gcl...CFQ6CPAoddBzuVw

 

 

Sending hugs to you and Dempsy

 

[Bevd]

For those of you who have done amputation, what kind of accomodations did you make for your dogs? We live in a ranch style house thank goodness, so there is just a slight step up to get in the front door, that is it. I have an SUV though and my husband has a truck. He can easily make a ramp for Dempsey when we need to transport him- has anyone else done this and how well did the dog do?

 

We have one step up into our front door and Darcy managed this from day one, with no real problems. We also just lifted her into the car as necessary but after a few days, she jumped into the car on her own (even if we didn't actually mean for her to do it!).

 

Did you have your regular vet do the surgery or did you go to a specialist?

 

My own vet did it, but he's a very experienced vet. I would imagine though that most people would need a specialist to do it.

 

Approximately how much did the surgery and care end up costing? When I talked with one of the vets at OSU Monday morning, she did not have the info right in front of her so she gave me a wide estimate of $1500-$2500. Not sure what chemo would be on top of it- from what I've read, there's different types...

 

My figures are in UK pounds so make of them what you will but the initial consultation, x rays, surgery and overnight stay plus pain meds to bring home were around £1200 (so that will be approx $2400 I think). Chemo so far (2 lots of Carboplatin and 1 of Doxorubicin) has been around £1100 and we still have around the same again to be spent, if not about £1600 (depending on how many carboplatins we do). So, a rough total approximation taking us to the end of the chemo would be possibly £3900 which includes all relevant blood tests during the chemo.

 

[Guest LittleGreys]

The vets in the practice where I work all do amputations. I don't see why you would need a specialist. A front leg on a Greyhound sized dog would be about $450 at our practice. Our amputations are generally hit by car dogs. Pending other injuries, they are usually up and around doing well the next day. We do a few osteosarcs...........

[Batmom]

Don't know if UI Champaign-Urbana has a small animal clinic? Might ask Dr. Couto at OSU if he knows anybody there.

 

UW-Madison does have a small animal clinic. I was very pleased with them but did not have surgery, just diagnostics. They are @ 90 minutes north of us (Rockford).

 

QCGA gets a lot of broken-legged dogs and has an orthopedic practice in the Chicago area that they like. I'll PM a couple members and see if they will post here for you.

 

Hugs and best luck with your pupper.

[Guest HeatherDemps]

U of I does have a small animal clinic there. I took Dempsey there years ago for some tests with his eyes (trying to determine if he had pannus or not). Thanks for your help!!

[Batmom]

Edited 'cause we were posting at the same time. Link to UI's ortho clinic in case you don't have it handy:

 

http://www.cvm.uiuc.edu/vth/MedServices/Sm...Orthopedic.html

Edited December 27, 2007 by Batmom

[Guest MorganKonaAlex]

Each of our dogs' amputations were done by an ortho. specialist and were ~$3000. From what others have posted in the past, it was on the high side. I think a front leg amp. is a little harder for the dog to get around than a hind leg. They will learn stairs. If you have any slick floors, I would suggest rubber-backed throw rugs. Previous to Morgan's amputation, he had a few episodes of 'throwing his neck out'. He had one after his amputation that I thought was aggravated by the stress of landing on his solo front leg jumping off our step landing. As a result, we did build a ramp for him about a year ago. He hasn't re-injured it since. Morgan jumps into my SUV but I lift him out. We bought a sling to help him with the stairs, but he hated it and wanted nothing to do with it. You could also use a towel sling to help support him while he learns his new balance. He will fall down sometimes and for me, that was the hardest thing to watch.

 

Kris

[Cully]

QCGA uses Dr. Turner at the VCA beerwyn animal hospital 708.749.4200. I also called a friend that took her greyhound with osto to Dr. Whitney at Whitney Vet hospital in Peoria 309.685.4707.

Good luck

[Guest gottaluvgreysindy]

Deuce had his front leg amp and chemo done at OSU. We are about 3 hours from there, but it is completely worth the drive and Deuce loves it there. We left him there after getting a second opinion at OSU on Wednesday, he had surgery on Thursday. They got him up and moving and rehabilitating and we picked him up on Monday. The bill was around $2500. He luckily got into a study they had going on there at the time and the five chemo treatments where free included in the study. I absolutely LOVE LOVE LOVE OSU. Seeing him for the first time without his leg was no big deal to me, I was so happy to see him. There was a short time when I thought I did the wrong thing when he was having phantom pain, but that soon passed and he is his goofy but loving momma's boy now.

[Guest Bodie]

Bodie had his amputation done at OSU and I'm really glad he did because everything that could possibly go wrong, as a result of surgery, did for Bodie. I really feel if he hadn't been there, among the greyhound experts, he wouldn't have made it. His surgery cost was around $3,000, but then he was there 6 days, longer than normal, because of the stuff going wrong.

 

The wonderful thing about having chemo done at OSU is that the chemotherapy drug is free, so all you are charged for is associated tests.

 

We live in a two story house with hardwood floors in the downstairs hallway and linoleum in the kitchen and we have made no special accomodations for Bodie. He does the stairs without a problem (they are carpeted). He fell once in the hall, but just picked himself back up and continued on. He jumps into the back of my station wagon (which is SUV height) on his own. He would jump out, also, but I don't let him since I don't want him to stress his only front leg, so I lift him out.

 

Dr. Couto told us that greyhounds adapt very easily to 3 legs - they just get up and get on with life. He also told me that I would mourn the loss of Bodie's leg more than Bodie does and that is true. Others have said that the fourth leg in a greyhound is merely an accessory and that is true. Bodie does everything my other four-legged grey, Rainy, does.

 

The first two weeks home are rough. Plan on sleeping near Dempsey if he can't sleep near you. We took turns sleeping on the first floor with Bodie as he was prohibited from doing stairs until his stitches were out. Get some rest now as chances are Dempsey will be getting you up in the middle of the night until he starts to feel better. Just remember this is major surgery and it takes time to heal. He will get better as time goes on.

 

Please feel free to PM me if you have any other questions.

[Guest CyndiW]

Is Dempsey's cancer in the front leg or shoulder? Odysseus' was in his hip and they of course had to take his hip on that side and his leg. An orthopedic surgeon performed the amp. A surgeon should be able to "confirm" osteo without needing an aspirate. We were told not to do an aspirate or biopsy before surgery because it could break off more of the cells out into the body (maybe this is just a myth) causing metastasis to happen sooner . The surgeon took one look of at his x-rays (taken 4 weeks apart) and said without a doubt it was osteo. He said the only other thing that would look like that would be a fungus and either way the affected areas must be removed. After surgery, the places were sent off for a true confirmation of osteo.

 

We used a ramp and Odysseus took one look at it and realized it was the only way he was going to get in and out of the SUV independently. He was a very independent guy so this suited him just fine. He was always great about using it. Now my other boys are getting older but refuse to use it. They would rather try to jump or let us lift them. Ody's ramp had the non-skip plastic surface which worked great with his footing.

 

The first couple of weeks were rough with Ody after the amp. He had van-willibran's and I almost lost him a couple of times to bleeding once I got him home. If both of you are there to take turns and help with his care, this should go much smoother. I was in a state with no family, my husband was overseas, and I had to work during the day. I never thought we were going to survive but we did. I took Ody to Medvet which is close to OSU for his surgery and chemo. It was about 3.5 hours from home. Once we got through the initial few weeks, life was back to normal only better because he was no longer in pain! In fact, his pain was gone immediately after surgery. It was just the bleeding issue that set him back at first.

 

Good luck with Dempsey and don't ever second guess any decisions you make for him. Every grey is so different and you will know what is best for your boy every step of the way.

[Guest HeatherDemps]

Thanks so much for the insights so far- I really appreciate everyone's responses.

 

Dempsey's lesion is in his shoulder, front side. My vet sent the x-rays to OSU for an oncologist to review, so hopefully we should hear something more today. My vet had indicated that Dempsey's x-rays do not look like "classic" osteo. Nothing with this dog has ever been "classic" when it comes to symptoms, so I guess I'm not suprised. To OSU, it may appear classic... She also talked with the oncologist this morning about the FNA so for right now, we're planning on having that done on Jan. 2. I don't think I could amputate his leg w/o first doing this unless OSU has little doubt it's infact osteo. My vet also discussed amputation as well with OSU. Dr. Couto is on vacation until Monday but he has responded to my emails and also been a big help to me. I've talked to my vet about having the back legs x-rayed while he is sedated so that we can make sure this isn't showing up there as well before moving forward...

 

I definitely feel a bit calmer now that we're starting to form an action plan. It's reassuring to hear that others have made it through this (dogs and their people!) and done well.

 

Heather

[krissn333]

Don't know if UI Champaign-Urbana has a small animal clinic? Might ask Dr. Couto at OSU if he knows anybody there.

 

UW-Madison does have a small animal clinic. I was very pleased with them but did not have surgery, just diagnostics. They are @ 90 minutes north of us (Rockford).

 

QCGA gets a lot of broken-legged dogs and has an orthopedic practice in the Chicago area that they like. I'll PM a couple members and see if they will post here for you.

 

Hugs and best luck with your pupper.

 

Cully has already chimed in, but yes, we've taken many dogs to Dr. Turner (orthopedic specialist) at VCA Berwyn in Berwyn, IL. It's right off of I-55 on Harlem Avenue. They have a lot of specialists there so I wouldn't be surprised if they had an oncologist as well. Couldn't say enough good things about Dr. Turner and the staff there. Several of the vet techs and veterinary interns have ended up adopting dogs from us because they've fallen in love with our greyhounds during their stays at VCA Berwyn

[Guest MorganKonaAlex]

She also talked with the oncologist this morning about the FNA so for right now, we're planning on having that done on Jan. 2.

 

You probably know this, but just in case. A negative FNA is not conclusive. Alex's FNA was negative, but he had OS. It's worth a try, but I wanted to point it it's limitations.

[queenwinniesmom]

Lots of good advice here, even though each dog is different. But there is a common thread---don't second guess your decision once you have made it. It's good that you are clear in what you think is best. Your are doing everything right---asking questions, moving quickly, being realistic, consulting with the most knowledgeable vets. For us, the most agonizing time was before we decided to do Winnie's amputation, and in retrospect, I wouldn't have waited that long. But we hadn't dealt with osteo before (only lymphosarcoma), and didn't know what to expect. But we learned a lot, and so will you. I hope you'll check back here often, for support and info, and also to let us know how your boy is doing. We did do the biopsy, but I don't really think, looking back, that I would do it again. It does weaken an already weak area, and the leg needed to come off anyway because it would have shattered (which it did when they did the amp). You mentioned X-raying the back legs. I could be wrong, but I don't think osteo usually moves to the other limbs right away. It would more likely metasticize in the lungs first. You should do the chest X-ray. If there are lung mets, the osteo has already progressed. I think we would have just chosen palliative treatment had Winnie's X-rays shown lung mets. But the X-rays were clear, so we did the amp (right hind leg). She was a textbook case of everthing RIGHT! And we were extremely lucky. Our regular, wonderful vets did the surgery, and I felt totally comfortable with that. An amputation, though the surgical site looks ghastly if you don't know what to expect, is mostly soft tissue trauma. Of course, more may be involved with the front leg amp if it is in the shoulder. I almost feel bad saying this, but our vet charged us $200! Yes, that's $200, not $2,000, which is what I had expected! And that included 5 days hospitalization because they didn't want us taking her home right away, due to the steps she needed to do to get into our house (we have a tenant on the first floor, and live on the second and third floors). Aside from not doing those steps for almost a month (we'd fixed up our tenant's Florida room for her), she had almost no problems. But I've known dogs who had lots of problems. It helps to have knowledgeable, experienced vets---OSU's the best---but cancer is a crapshoot. That's kind of my mantra. We do everything we can, and sometimes it's enough, and sometimes it isn't. Just know, and remember, that your decisions are made out of love, and what you believe is right for your boy. Though we chose not to do the chemo, we were blessed to have Winnie with us for 3 1/2 years after the amp, kind of a record, I think. When we lost her in October, it was due to kidney failure, not the osteo. I'm glad to see that Deuce from Indianapolis is still fighting the good fight. Winnie was kind of an inspiration for his family, and we and Winnie were lucky to meet him and his Mom and Dad in Gettysburg. Now maybe he can be your inspiration.

Wishing the best for Dempsey.

 

[Guest HeatherDemps]

Thanks so much for your feedback- it is really helpful and gives me hope.

 

Our vet would not do the surgery and has been in touch with Dr. Fan (oncologist) at U of I. I have his number and am going to call him today. Our clinic does not have 24/7 staff and I would not be comfortable with that. I have a list of questions to ask him. X-rays have been sent to him and OSU so hopefully we'll have opinions on those soon. Chest x-rays were done at the same time as the front legs and those were clear, although they of course are assuming something is there and just not seen yet.

 

I've looked at pictures online of greyhounds soon after surgery to try to prepare, although I know it isn't the same as actually seeing Dempsey. I will definitely keep everyone updated on what's going on. For now, Dempsey continues to be his usual self and we are trying not to let him run and jump around like he usually does- especially now that the stupid snow is back!!

[Guest HeatherDemps]

Yes, I have been told that. What did you do when it came back inconclusive? I'm trying to figure out what the next step will be for us if this is the case. U of I told my vet that the needle can bend so the FNA wouldn't work if that happens. I'm hoping that by sending the x-rays to OSU and U of I that they can tell us more than my vet can. She is surprised that the leg would be amputated w/o confirmation first, but I guess they see it enough that they don't make a big mistake like that! And, in Dempsey's case, with the breed, age, location, we aren't expecting different news here...

 

She also talked with the oncologist this morning about the FNA so for right now, we're planning on having that done on Jan. 2.

 

You probably know this, but just in case. A negative FNA is not conclusive. Alex's FNA was negative, but he had OS. It's worth a try, but I wanted to point it it's limitations.

 

[Guest MorganKonaAlex]

Yes, I have been told that. What did you do when it came back inconclusive? I'm trying to figure out what the next step will be for us if this is the case. U of I told my vet that the needle can bend so the FNA wouldn't work if that happens. I'm hoping that by sending the x-rays to OSU and U of I that they can tell us more than my vet can. She is surprised that the leg would be amputated w/o confirmation first, but I guess they see it enough that they don't make a big mistake like that! And, in Dempsey's case, with the breed, age, location, we aren't expecting different news here...

 

She also talked with the oncologist this morning about the FNA so for right now, we're planning on having that done on Jan. 2.

 

You probably know this, but just in case. A negative FNA is not conclusive. Alex's FNA was negative, but he had OS. It's worth a try, but I wanted to point it it's limitations.

I would not recommend the course of action I took; I've learned. Our ortho recommended taking a FNA and a bone biopsy at the same time. He would send in the FNA. If it came back negative, he would send in the core biopsy. I underestimated the amount of pain Alex would be in from the bone biopsy. He was on rimadyl, tramadol and neurotin for the pain. Alex's FNA came back negative, core biopsy came back positive and we amputated. Personally, I would use FNA and radiographs for diagnosis alone (taking additional x-rays if necessary and having specialists read the x-rays). OS is so common, I now would amputate without 100% certainty. Believe me, I know the guilt feelings that come with making the decision.