Managing Post Amputation Recovery

[JoanBelleIsle]

My Avery has osteo in his right rear leg. On Friday, the leg and the source of the pain will be amputated, and I will be Nurse Nancy for the recovery. From those folks who have been to this movie with their own dogs, I'd like to hear your about your experience with the post surgery recovery and any advice that you can pass along.

 

I've lived with Greyohunds for more than 20 years and had handled the usual assortment of booboo's and catastrophies, but somehow this one has me a little spooked.

 

Thanks

[MandysMom]

I have no advice, but send lots of prayers for Avery.

 

Winslow's Diary is one of the most detailed diaries of the journey through amputation. There are several others, I'm sure others will chime in.

[Tallgreydogmom]

Joan, I am so sorry you have to go thru this. We have amputated 6 times and each time it is a little different. Post surgery recovery can be from them walking out after the amputation like nothing was up to having to carry the greyhound from the surgeons office to our vet's office for a week of veterinary aftercare to get him on the right track.

 

We have amputated both front legs and back legs. I think the front leg is easier. The hardest time will be the first two weeks for you. Avery will probably be on pain meds and be very content.

 

Hugs,

 

Cora amd the furkids

[RhodyGreys]

Joan --

 

I am so sorry to hear about Avery. I have been through amputation twice - with Lucky in 2000 and with Stretch in 2004. Best pieces of advice I remember/can think of:

 

* Let the vet keep them as long as the vet suggests, and while they are under the watchful eye of veterinary care, sleep. You'll need it later!

 

* Be aware that the pain meds may affect their behavior. If a Fentanyl patch is used, be aware that it gets absorbed very differently by greyhounds and it can make them very anxious. Same has been seen with tramadol.

 

* Lots of cushy old comforters and blankets. There is likely to be seepage.

 

* An infection may occur. Stretch had a doozie. This too will pass, and warm compresses are your friend.

 

* Bring the water to them. They will drink more if they don't have to struggle up for the water.

 

* I cut polar fleece to make a sling. It will need to be under their tummy. Use it one day longer than you think you should, to protect against balance related falls. Keep the sling, you may need it again in new or slippery areas.

 

* Cover potentially slick surfaces with area or runner rugs. Even if they look like hell, it's going to take him a while to get his sea legs.

 

* Don't be afraid if they are not hungry at first, or they want something different for a while. Between the antibiotics and the pain pills, I think I would be nauseous too!

 

* I don't know how your vet is planning to do the amputation, but if he is leaving a stub or partial bone, be sure it is well-padded. <shudder>

 

I can PM you my phone number if you want to have someone to call in the middle of the night if you have a question.

[Guest Smiley]

Jen (Bigorangedog) created an amazing page on what to expect post-amp. Here's a link for you and I hope you find it helpful: Blog Link

 

I'll be keeping you and Avery in my thoughts and prayers this Friday. Having gone through osteo twice this year, I know how scary this whole deal is. Many hugs to you both . . .

[MP_the4pack]

Hi Joan. Sorry you're joining the amp club.

 

Diamond had a front leg amp. She did develope an infection that we needed to treat before chemo. But other than delaying her treatment, it really wasn't a concern.

She was panting, anxious and uncomfortable for 2 weeks post op, but as soon as we took her off pain meds she settled down. So it was more the meds than the surgery. She wore a snug T shirt to keep her from licking. She was good about that.

And due to the fact that she was 12 and already having difficulties doing the stairs (always had), I built a ramp for her.

She had a very good 6 months before it showed up in another leg. Her lungs were clear to the end.

Also, I took the drive out to OSU. It was worth it. They check the dog out thoroughly before surgery to ensure they can actually live as a tripod. They keep the dog as long as they think is necessary (and you can still get free chemo). I'm in NJ, if you're in Mass, I think it would probably be a 12 hr drive. (Mine was 9 hrs) It's worth it in my opinion. And contact Joejoemom on this board, she'll help you find free rooming. There was SO MUCH support when I went out there that all I had to concentrate on were my babies. (I went twice, once in Oct for Diamond and then in Jan for Pearl)

I'm sorry to hear the news. Good luck.

[NeylasMom]

No advice on the post surgery treatment, just wanted to say that I'm sorry you are going through this. I'm currently doing palliative care only for Neyla as amputation wasn't for us in this situation so I know some of what you are feeling. One thing you may want to look into for after the surgery is artemisinin. I am unclear about whether it can be administered with all kinds of chemo and it cannot be administered around radiation, but it may help to prevent metastases down the road. There's a good yahoo group: artemisinin_and_cancer I think.

 

I will be hoping for a smooth surgery and recovery for your pup.

[SIGreyLady]

No experience with amputations just to you and Avery.

[Charlies_Dad]

Have you read 'Bigorangedog's blog about amputation? I hope I got her GT name correct as she has gone through this a lot lately. I am very sorry to hear Avery is going through this and I wish you and him all the best with a successful surgery and many, many months of happiness together.

 

Yup, got (Jen's) GT name right. If you go to Advanced Search and enter that name as author, you'll see she responded recently to 'Re-homing dog'. There is a link at the bottom of her signature that will take you to her blog.

Edited June 23, 2010 by Charlies_Dad

[DaisyDoodle]

Joan,

I'm so sorry to hear about Avery. I do not have personal experience with Osteo, but I would recommend consulting with Dr. Couto's group, and especially asking your vet to administer the drug Dr. Couto recommends to keep late hemorrhaging from happening.

[mom2four]

Joan, so sorry that you have to down this road too. We will be thinking of Avery and you on Friday. Everyone has given good advice so far:

 

Sleep, get as much as you can! Cover slippery areas with runners. Put old blankets etc on the floor, there will be leakage.

Has anyone suggested joining Circle of Grey? Link It's a Greyhounds with Cancer group, it's very supportive.

 

We'll be thinking of you on Friday! Jamey sends good tripod thoughts to Avery!

[MaryJane]

My heart goes out to you as I know that this was likely a difficult decision.

 

Many on the thread have already responded with great information on "3-legged proofing" your house. I found that corners in my house were especially difficult for my boy and I had to go get more slip-resistant rugs. Getting into the car was going to be another difficult area so I went and traded in my SUV and bought a mini-van - not sure if you have a challenging car or not....

 

I changed my dog beds (got rid of loose comforters and so on) so that they provided good padding but were not likely to "catch" his back foot when he hopped on them.

 

My boy came home in less than two days and he had a real difficult time with steps. You need to be prepared to have some type of sling if you have stairs.

 

The first day or two was difficult because my boy had to figure out how to maneuver with three legs but, he caught on and after a few more days he was doing pretty well. With the leg gone, the pain from the cancer (very hard to control) was also gone and it seemed that the pain from the amputation was controlled by the pain meds.

 

After a few weeks my boy was running in the yard and it was beautiful sight.

 

Good Luck

[Guest bigorangedog]

Hi Joan,

Sorry to hear you are dealing with this. Yes, please do check out my blog entry (link in my sig) and feel free to write anytime with questions!!! Wishing you both an easy recovery.

Jen

[krissn333]

Sorry to hear you're going through this

 

My Sutra has osteo in his right shoulder and we have chosen not to amputate, given his age and physical condition.

 

I think that you will find that Avery will do very well post-surgery. From what I understand, learning to get around after amputation of a rear leg comes a little bit faster than front leg amputation. Do have a look at Jen's blog, and read about Winslow's journey as well, as he's a rear leg amputee.

 

Wishing you the best of luck and a swift recovery for your sweetie. I bet he will be running around in no time!

[joejoesmom]

It sounds like you have the surgery scheduled for tomorrow. However, if you decide to come to OSU, let me know.

 

Your vet should treat your greyhound with Amicar (aminocaproic acid), whether or not he shows a poor clotting factor. Many vets do not stock Amicar but I understand you can get it from a pharmacy. OSU's research shows that many greyhounds do not form strong clots, despite perfectly normal presurgical testing. To avoid potential bleeding out, greyhounds should receive Amicar. It will also reduce post-surgical bruising. The dose of Amicar is normally 500mg orally every 8 hours for 5 days starting in the immediate postoperative period. Your vet can find out more from the OSU Greyhound Health Team at 614-247-6757 or (614) 247-8490. FYI, OSU does more greyhound amputations in a week than most vets do in a year or more.

 

Your vet should also be aware that greyhounds are prone to developing malignant hyperthermia during anesthesia. This is a genetic condition, if they did well with anesthesia before, this shouldn't happen during subsequent surgeries. However, they can also develop a fever due to muscle fasciculations during recovery. Therefore, your greyhound's temperature should be closely monitored in surgery and recovery.

 

Many greyhounds do not do well in a hospital situation. They tend to be quite vocal and get very anxious. OSU has found that it is best to "dope up" post-amputation greyhounds for a few days. Unfortunately I don't remember what medicine their protocol calls for but your vet can check with them.

 

Many greyhounds refuse to eat in a hospital environment. This should not be the only reason to keep them in the hospital.

 

At OSU, the greyhounds go into an intensive care unit for 2 to 3 days after surgery (staffed 24/7 by veterinarians). After that, they may go into a step down unit for 2 to 3 days where they are also monitored very closely. They come home 3 to 6 days after surgery.

 

Most vets know that greyhounds are sensitive to certain anesthesias. Thiobarbiturate anesthetics should never be used in a greyhound. Greyhounds tend to be sensitive to acepromazine, so this should be administered in smaller doses if it is used. Greyhounds have lower concentrations of the drug metabolizing enzyme hepatic cytochrome P-450 (CYP) in the liver, which can cause an erratic metabolism of certain medications. If your dog is taking a drug that is metabolized by CYP enzymes, it will take substantially longer to recover from the anesthesia.

 

Dr. Feeman has an excellent article on greyhound idiosycrases here:

 

http://www.animalmedicalcentreofmedina.com/files/vet/21/e369c6e9.pdf

 

I would give a copy to your vet and review the above info with them prior to the surgery.

 

Others have given you very good advice and links to post-surgical care at home.

 

Let me know if I can help in any way.

 

Jane

Edited June 24, 2010 by joejoesmom

[Guest Winslowsmom]

I just happened to see this. If you need anything, PM me. Glad to talk to you about this.

 

Here's a link to Winslow's Diary:

http://forum.greytalk.com/index.php/topic/169522-winslows-diary/page__hl__Winslow

 

Best of luck to you and Avery.

 

(Winslow and Glynis)

[JoanBelleIsle]

I want to thank everyone for their support and advice. I'm comfortable with my vet. He knows Greyhounds really well and had treated a lot of them over the years -- both racers and pets. I've given him all the information from OSU. He has met Dr. Couto before. Although he runs a general practice, he is mostly a bone guy. I think my biggest worry is being able to handle whatever may come up by myself. Avery is a big boy. If I need to lift him, we are in BIG trouble

 

Thanks, again for all the support. I'll let everyone know how we make out.

[RobinM]

You've gotten greyt advice. I too had a member of the tripod club. I am sorry you are now a member.

 

In addition to some things mentioned, ask your vet to put a compression type of shirt on Avery immediately after the surgery which will hold the dressing in place. With the compression, there is no bruising. Polli wore the compression garment for 4 days post amp and she had 0 bruising which was amazing.

 

Stay on top of the pain meds even if you think she doesn't need it. it's harder to get pain under control when they are already in pain. Give as prescibed. You may want to ask for valium (not for you! ). Sometimes, they get very stressed about the aftermath and they are very frightened. it's sad and scary. I am so grateful I had it in the house for my sweet and beautiful Polli- to be woken by her screams of terror were quite unnerving and broke my heart.

 

Careful about your bed and couch, steps etc. She shouldn't jump for a while. We took our bed off the box spring until we lost her. She went up and down the steps within 5 days but she tripped going up one time so for the 5 months we had her after her amp, we happily was her servant and carried her up the steps 9 million times a day. All 61 pounds of her.

 

best of luck to your sweet girl.

[Tallgreydogmom]

Looking for an update on Avery. Praying the surgery went well.

[JoanBelleIsle]

Good morning,

 

Avery's surgery went fine yesterday. The bone is being sent out for biopsy so we should know what kind of BAD it is. Not that that will change anything. He is going to be a guest at the vet's at least through the weekend so that they can keep him sedated and medicated for post-op pain.

 

So far, so good.

 

I suspect that I'm having more trouble with the whole thing than Avery is

[Tallgreydogmom]

Thanks for the update. I'm at the point (age, etc.) where I leave them at the vet for rehab until they are on the move.

 

Rest up, this is harder on you than Avery.

Edited June 26, 2010 by Tallgreydogmom

[MandysMom]

Thanks for the update. Sending prayers to Avery

[cacky]

Prayers and good luck. Hugs from my boys.

[krissn333]

Sending good, calm, restful thoughts to Avery, and to you Joan. Rest up while he's away resting up. Odds are, your first night with him being home might be a little bit restless. Hoping for the best for the both of you

[JoanBelleIsle]

Hi,

 

Just got back from picking Avery up at the vet. I was surprised and delighted that he is moving so easily without the missing rear leg. When we got home, we did a little walk in the yard where he peed and pooped without a problem and without the need for any additional support.

 

The only thing that I'm a little apprehensive about is the amount of bruising and swelling that he has. I wish that Dr. Dunn had administered Amicar to help with the post-surgical bleeding, but it's too late now .

 

Now it's going to be a matter of keeping Avery more or less quiet until he is healed. He wanted to head directly for my bed as soon as we got home. Didn't think the x-pen in the living room was up to his standards -- new dog bed or no new dog bed!

 

I know that we are not out of the jungle yet, but I'm feeling a much better about the outcome. Thanks, again for the advice and support.

 

Cheers,

 

Joan