Amputation Of Weight Bearing Toe

[Guest jag]

Our dog is facing weight-bearing toe amputation now. As we prepare for this surgery (in about 3 weeks), any other stories and advice are very much appreciated!!!

 

Thank you so much for starting this thread and to everyone who has shared their stories - it's been so helpful, as I've been worried sick over the idea of amputating a rear weigh-bearing toe on Chego our 4.5 year-old, 75 lb grey (2nd toe from inside). However, he has become increasingly bothered by the toe and his activity level is decreasing. After 13 months of trouble shooting, amputation of the digit appears to be the only thing that will relieve him and resolve the problem.

 

Meantime, here's our story...

 

After we adopted him, Chego demonstrated occasional lameness. At first it just seemed like sore muscles from playing/running too much. When the problem persisted we took him to a vet our adoption agency uses. The initial hypothesis was that he suffered from corns. Fast forward over 13 months... he's had many examinations from 4 different vets, x-rays, testing, including a "punch biopsy," and multiple treatments (corn cream, foot baths, antibiotics) vets have ruled out corns, fungal infection, osteo, and several other possibilities, but still a mystery with no definitive diagnosis. His pad remains very swollen and continues to drain slightly. He limps more than ever, but wearing a Therapad makes him comfortable on walks. It seems like a low-grade infection that persists but doesn't get worse. The biopsy yielded microscopic bits of sand/glass in the tissue, but the surgical specialist he is seeing now says that could be a red herring and not the cause of the problem.

 

There are 3 bacteria present, which his current vet cultured (his previous vet prescribed 2 broad-spectrum antibiotics which were only indicated for 1 of the 3 bacteria, so it's no wonder he never healed up from those). However, even after after administering the correct antibiotic (based on results of the culture), the problem continues.

 

Thank you. After the surgery we will post how he does.

[Hubcitypam]

Buddy had a weight bearing toe amputated sometime before he came here and it hasn't bothered him a bit. It is the left middle on his left rear. When he went to the Ortho last week the guy just raved and raved about how well the amputation had been done.

[Walliered]

I know you have had many vet checks, but have you taken him to a specialist? Maybe a CT scan? I speak from experience. I took mine to Charleston Vet Referral Hospital. He had disk surgery earlier this week. He was also limping on left rear foot. CT Scan pin pointed the problem.

[tbhounds]

My guess is there's a foreign body embedded in that toe. If it was me I would amputate that toe and be done with it.

[PrairieProf]

Good luck! Beth had a rear weight-bearing toe amputated after a traumatic injury about a year and a half ago. We had a somewhat hairy healing process (stitches ripped after the wrap was removed too soon because it was causing a major abrasion on her remaining toe, a large area had to heal by granulation and she had to be on crate rest for several weeks) though she was weight-bearing on it from the beginning. She is fine now, no limp, runs full out and all OK, though I am certainly more nervous/cautious about running conditions. The remaining weight-bearing toe on that foot has become quite enlarged in the knuckle and I do worry about that, but an x-ray last spring showed the joint itself was fine -- just enlargement of the joint capsule or something like that.

 

One thing I would highly recommend is using laser therapy for faster wound healing at the amputation site. My vet didn't have that at the time, but now he does and swears by it for how much it speeds up healing. It would have really helped us. Seems like lots of vets are using it now.

 

Make sure your vet amputates the CORRECT TOE ... sounds ridiculous, yet all of us on this board will recall a pretty recent horror story with another hound ....

Edited January 12, 2013 by PrairieProf

[greysmom]

If done correctly, with proper attention to bandaging and after-care, a toe amputation - weight-bearing or not - is a relatively easy way to rectify the problem. No surgery is entirely risk free.

 

Make sure the vet takes THE WHOLE TOE back to the main part of the foot, even if it seems like that is taking too much. Leaving a stump there only leads to further problems and more surgery down the road as it continues to hit the ground, break open, and lead to another wounded spot.

 

My Dude had a weight-bearing toe amped due to a break and it never bothered him at all once it was healed. His three-toed foot was on the leg left after we had to amp the other leg from osteo. Even then there was no problem with the amped foot.

[Guest MenaChego]

Thank you all for your replies re: Chego's toe and pending amputation. It's comforting to hear your stories and advice. (Note: I had to change my username, but I originated this thread)

 

Anyway... I have checked into laser vs. traditional surgery and was told "the outcome won't be different" but that begs the question about which is easier on the hound and whether they heal faster?? I was told by my surgery specialist that healing may be different but neither is faster... I wonder if this is just because she doesn't do laser.

 

I want what will be least trying and painful for hound and I'd like to get this behind us as he's been living with it for a long time. Before he has surgery, I will see if any other Drs do laser in the facility, however, the Dr. I've talked to was recommended by another Vet and she's a soft-tissue specialist (it's a surgery specialty care center in West Los Angeles). I have to believe laser offers a faster recovery, but I'm no expert! Any additional thoughts are appreciated. There is no indication of anything wrong higher up is leg or hip... It all seems centered on his inflamed toe pad. I've tried some homeopathic methods (various herbal teas and poultices) but they seem to only offer temporary relief.

 

Thanks again. Chego will probably have the amputation surgery in a week. I will post how he does.

 

[tbhounds]

Regarding laser vs scalpel --they are both tools for the surgeons hands. The only advantage I see between the two is with the co2 laser the incision is claimed to cause less pain as it seals the nerve endings as it cuts. The laser doesn't actually burn the tissue it dehydrates it-therefore causing less pain. Another advantage worth mentioning is there is minimal bleeding with the use of the laser.

Now, that said some of your best board certified surgeons don't use the laser nor will they. Personally, I would chose a qualified surgeon over the choice to use a laser or not.

[PrairieProf]

My vet does almost all surgery by laser now. But as surgeries go a toe amputation is not really complex, he gave me to understand.

 

What I would really recommend though is that you find a vet who uses healing laser therapy (cold laser) for wounds etc. -- my vet is also big on that and says it speeds up healing amazingly. I also saw what appeared a very good effect when I used it on a dog bite wound Beth had this fall. The trauma we had with Beth's toe amp was definitely with wound healing after the sutures ripped and the wrap caused a deep abrasion on her remaining toe, and I do believe that laser therapy (which my vet didn't have at the time) would have made a big difference in our weeks of stress.

[Guest MenaChego]

Thanks PrarieProf for the addional advice on cold laser to aid healing process. I've asked around and that seems to be the consensus.

 

Meantime, I've delayed the amp surgery to give one last try with a longer round of antibiotics + homepathy (foster drainage) + herbal meds (build immunity to infection). I took him to a well-regarded holistic Vet who also practices traditional medicine and what he said made sense. Plus, I treat myself with non-trad med and it works, so why not try with him? This Vet did not see a need to ruch to surgery... he's had the problem for as long as I've had him (over a year, though it went undetected before), xrays do not show much change, and the pain/discomfort is not acute plus his activity level is OK (though it has decreased), so another 1- 2 months shouldn't matter. There's a possibility he has osteomyelitis (in addition to glass/sand in his pad), which could take a lot longer to respond to antibiotics. So.... We'll see how this mix of potions work. It's more money, but if it works I will save $2000+ not to mention stress of surgery.

 

Thanks all. Best of health to your hounds!!