Amputation in a dog and a cat: what it involves? [veterinarian's recommendation

Amputation limbs is probably one of the most difficult decisions (next to euthanasia) that a pet owner can face.

Amputation

Unfortunately, many caregivers immediately reject this option of treating a dog or cat, not even wanting to hear what the veterinarian has to say.

However, is the removal of the limb really such a drastic move that we do not consider it?? Will the cat or the dog really cope with the disability and this kind of behavior is inhumane?

Or maybe it is quite the opposite? Perhaps by refusing an operation to an animal, we deprive it of its chance to live in comfort at the same time? Is it not so that we sift all relevant information about amputation through a sieve of our own fears, aversion, and apparent empathy, taking the animal's later disability too personally, too "humanly"?

Do we make a decision taking into account the aesthetic values ​​of the pet or - horror of horrors - the opinion of other people? Is it really we understand the essence of amputation, the reasons why this topic is discussed at all and the consequences of such a procedure?

This article aims to "get used to" the topic of limb amputation in pets. In it, I raise the issues of fears and doubts faced by dog ​​and cat owners when faced with amputation, and I also debunk myths that still persist among animal keepers, such as:

• "The dog / cat cannot cope on three legs ",
• "The animal will be unhappy ",
• "I will cause my sick dog more suffering with my decision ", etc.

It is obvious that every case is different and every decision is unique. Such complex problems cannot be rigidly locked into logarithms or diagrams. And despite the fact that most animals adapt to life on three legs at an incredible pace, there are also situations when a dog or a cat simply cannot cope. We cannot predict it.

However - as it will turn out in a moment - amputation it is not one of the methods of torturing an animal, but a way of relieving it of pain and extending its survival time. So if you are interested in the topic amputation in a dog or cat, I invite you to read this study.

• What is an amputation?
• Indications for amputation
  • Indications for limb amputation
  • Indications for finger amputation
  • Indications for tail amputation
• Course of amputation in a dog
  • Pre-operative evaluation
  • Forelimb amputation
  • Hind limb amputation
  • The amputation procedure
  • Hospitalization
• Complications after amputation
• Pain after limb amputation
• Post-operative care after limb amputation
  • The first days after amputation
  • Long-term care
• Denture
• Wheelchair for dog and cat
• Can amputation be prevented?
• Caregivers' concerns
  • Can my dog ​​/ cat handle three legs?
  • Will my dog ​​/ cat suffer from amputation??
  • Does it matter which limb is amputated?
  • Does the dog's or cat's body weight influence its adaptation after limb amputation??
  • What factors affect the speed of adaptation to moving on three limbs?
  • Are animals aware that they are missing a limb??
  • How will my cat handle a limb amputation??
  • Is amputation humane?
• Limb amputation in dogs and the owners' opinion
• Cat amputation and owner assessment
• Prognosis of dog and cat amputation

What is an amputation?

Amputation is a surgical procedure involving the removal of a body part that is sick or damaged to such an extent that it cannot be saved by other methods. The goal of amputation is therefore a rescue procedure, the basic aim of which is to prevent pain and / or suffering or to limit the spread of some aggressive forms of cancer.

It also happens that amputation is performed when other therapeutic techniques are too costly for the animal handler and euthanasia remains the only alternative.

It should be remembered that tail copying in newborns is also an act of amputation (prohibited in Poland), but performed on healthy animals has nothing to do with saving health or life.

In pets, the most commonly amputated parts of the body are:

• limb,
• finger,
• tail.

This procedure can be performed on animals of all ages and breeds, and amputation itself is often performed in veterinary practice. Since the greatest excitement is associated with limb amputation in pets, this is what I am focusing on in this article.

Indications for amputation

Indications for amputation

There are many reasons why you need to amputate a specific part of your body. Very often, the need to amputate a limb results from a serious injury (most often in a road accident), including numerous fractures and / or loss of a significant amount of soft tissues - in such cases the limb is so severely damaged that it cannot be surgically repaired.

Another common indication for amputation is a malignant tumor that affects the limb. It also happens that, despite the possibility of surgical repair of the fracture, the animal's handler cannot afford surgery, and the amputation option is less expensive.

In the case of complicated fractures, surgery can cost several thousand zlotys, while amputation is usually half the cost.

Indications for limb amputation

Indications for limb amputation

Limb tumors

Amputation is an excellent way to control the malignancy of the limb. Some limb tumors are so large that limb removal surgery is not only the only effective treatment option, but also the fastest way to relieve your pet of pain and reduce suffering.

Osteosarcoma (osteosarcoma) or bone cancer. Osteosarcoma is the most commonly diagnosed bone cancer in dogs.

This tumor is usually found in large and giant breed dogs. It can occur in young dogs (12-18 months of age) but usually affects older animals. Most often it is located just above the wrist, on the proximal part of the humerus (just below the shoulder joint) and near the bones forming the knee joint. Since osteosarcoma causes great pain, causes metastasis, and also predisposes to bone fractures, the confirmed presence of this tumor is one of the most common indications for limb amputation in dogs.

Soft tissue sarcomas are another type of cancer that can develop on the extremities.

These tumors are malignant but tend to slowly spread to other parts of the body. They are aggressive, which means that they destroy and infiltrate the body structures in their location.

If present on a limb, it is often difficult to get rid of the tumor in its entirety while still keeping the muscles, tendons, nerves, ligaments, and bone needed to function properly. An example of such a tumor is fibrosarcoma - known as injection sarcoma, which is often diagnosed in cats.

Unfortunately, many limb tumors are malignant neoplasms that may have a significant metastatic potential. Therefore, animals are thoroughly diagnosed before amputation is performed.

Complete blood count, serum chemistry and urinalysis provide information about the general condition of the animal and qualify it for anesthesia.

Chest x-rays are performed to determine if there is any evidence of tumor metastases in the lungs.

Ultrasound examination of the abdominal cavity to assess its organs.

Assessment of local lymph nodes in the area of ​​the affected limb for enlargement. In some cases, an aspiration biopsy of a suspected lymph node may be performed to confirm the possible spread of the tumor. In order to assess the nature of the changes in the bone, a biopsy is performed. The result of this test will allow the veterinarian to plan the best treatment regimen and determine the prognosis.

In the presence of aggressive neoplastic tumors, amputation is the procedure of choice. Such treatment is often supplemented with radiotherapy or a combination of radiotherapy and chemotherapy to reduce tumor growth and delay the onset of metastases.

Serious trauma

Amputation is sometimes recommended in situations where multiple fractures and extensive injuries of muscles, tendons and ligaments of the limbs occur (most often as a result of a traffic accident), and the original repair is too expensive for the owner. Limb removal is then a cheaper alternative to treating a complicated and expensive medical problem.

However, even when financial considerations are not an issue, amputation may be the treatment of choice for a limb injury where the innervation and / or blood supply are severely damaged or bone and soft tissue injuries are beyond repair with modern surgical techniques.

Damage to the nerves supplying the limb, e.g. after an injury resulting in pelvic fractures, it may be irreversible and the limb is not working properly. When moving, the animal, unable to raise the paw properly, drags it behind it, which leads to abrasions and injuries of its peripheral segment. In such and similar situations, it is recommended amputation of the affected limb of a dog or cat.

A limb amputation may be necessary because of:

• ischemic necrosis,
• unresponsive to orthopedic infection,
• necrotizing fasciitis,
• unsuccessful fracture repair,
• elbow dislocations,
• severe disability due to unmanageable arthritis,
• electrocution,
• congenital deformity or other abnormalities.

The immediate cause in such situations is most often chronic pain and suffering, which - despite treatment attempts - could not be eliminated.

When amputation appears necessary, the animal's condition, readiness for surgery and adaptability after surgery, and the owner's view of the animal's disability are taken into account.

Indications for finger amputation

The most common reasons for toe amputation are trauma or a cancerous tumor. The latter are quite common in dogs. There is no specific race or gender predisposition.

The most common types of tumors in the fingers are:

• Squamous cell carcinoma is a malignant tumor most commonly seen in large breed black dogs such as:
  • labrador retriever,
  • rottweiler,
  • giant schnauzer,
  • poodle,
  • but also in dachshunds;
• malignant melanoma is often diagnosed in:
  • schnauzers,
  • Irish Setters;
• mast cell tumors;
• soft tissue sarcomas;
• other less common types are:
  • osteosarcoma,
  • histiocytoma,
  • basal cell tumor,
  • various benign tumors.

Indications for tail amputation

Tail injuries

One of the most common injuries a dog or cat's tail can experience is being pinched by a door.

Since the tail lacks heavy muscles that would weaken the force of the blow, skin, bones and blood vessels are easily damaged.

A fairly common trauma in such a situation is tearing "to the bone ", in which the skin of the tip of the tail is "scraped ", revealing the underlying bone.

It also happens that at the site of impact, the tissues are crushed, and such invisible trauma disrupts the blood supply to the tail, which may require amputation of the tail to prevent necrosis.

A similar problem exists in dogs with long, whip-like tails. Constantly slapping your tail on a hard surface can damage blood flow and require tail amputation in a dog.

Tail tumors

Lumpy lesions in the tail are not a common problem in veterinary patients. If they appear, the most common are:

• cysts,
• warts,
• infected sebaceous glands,
• benign tumors.

Tail malignancies can be any tumors usually found on the skin, e.g.:

• mast cell tumors,
• malignant tumors of the hair follicle,
• tumors of the sebaceous glands,
• soft tissue sarcomas.

It is obvious that malignant neoplasms of the tail require removal, but sometimes, even in the case of benign lesions on the tail, amputation is recommended, especially when these tumors are bleeding intensively. Due to the fact that the tail in animals is a very mobile part of the body, the heavily perfused masses on the tail are often irritated, which leads to recurrent bleeding, which in turn makes it much more difficult or even impossible to heal.

Tail infections / abscesses

This problem mainly affects cats, and most of the outgoing ones. It happens that as a result of clashes with one's kin or other adventures, there is an infection and an abscess in the tail (often at the base).

It is not a problem if such an injured person shows up at home relatively soon and the owner takes him to a veterinarian on time. Often, however, the lesion on the tail goes unnoticed, which may eventually lead to advanced changes in the form of necrosis and detachment of tissues.

In such a situation, it is often recommended tail amputation in a cat.

Course of amputation in a dog

Course of amputation in a dog

Amputation is a surgical procedure that requires the animal to be fully anesthetized. A limb amputation is usually performed after a tumor is diagnosed or after a severe injury with loss of major nerves or blood supply.

The limb is usually removed high (usually where the limb meets the body) as this prevents further injury during daily activities, and the rest of the limb can interfere with movement. Therefore, even if the tumor or trauma is located lower in the limb, the surgeon will likely remove the entire leg unless it is doing some work.

In special circumstances, a partial limb amputation may be performed for use dentures. In many cases, such post-amputation prostheses they can be used successfully, but they are quite costly.

Pre-operative evaluation

Even before the surgery is scheduled, the surgeon will carefully assess the patient's condition to make sure that there are indeed no other treatment options, and amputation is the most humane procedure in this particular case. Your doctor will likely recommend additional diagnosis prior to amputation. It will depend on the cause of the amputation, the body part being amputated, and the age and general health of the pet.

• A complete blood count, serum chemistry and urinalysis are used to assess your pet's overall health and any underlying health problems.
• In the presence of a tumor, a chest X-ray is performed, as well as an ultrasound examination of the abdominal cavity to detect possible metastases.
• For limb amputation, X-rays of the other limbs are also recommended to ensure that they can support the extra weight following the amputation procedure.
• Computed tomography and / or magnetic resonance imaging is also often recommended.

Forelimb amputation

In the case of both front and hind limb amputation, the level of amputation depends mainly on the location of the lesion.

During forelimb amputation, it is usual to remove the entire limb, including the shoulder blade, to give a smooth and cosmetic contour to the chest wall and to avoid leaving behind bones that will continue to move after surgery and which can be unsightly when the overlying muscle atrophies due to disuse.

In the case of the front leg, the most successful and cosmetic amputation is therefore the amputation of the limb including the shoulder blade. Since the front paw is attached to the chest wall by muscles, it is easy to remove the limb by separating these muscle layers and then closing the area.

This complete removal creates a smooth, well-padded area on the side of the chest that will not be subject to pressure ulcers or obstruct movement. Removal of the limb along with the scapula is also preferable for other reasons: there is no need to cut the bone, and in addition, a more aesthetic effect is obtained due to the lack of muscle atrophy around the scapula crest.

Forelimb amputation can also be performed with an incision at the shoulder joint level (enucleation of the limb in the shoulder joint) or in the distal part of the humerus.

If the tumor covers the scapula, a scapula bone resection may be performed. Up to 80% of the shoulder blade can be removed without compromising limb function.

Hind limb amputation

For the hind leg, the following techniques are commonly used:

Mid-shaft amputation

The first (and the most common) method is a mid-shaft amputation.

The mid-thigh muscles are separated and the femur is trimmed close to the hip. This technique results in a short, well-padded stump at the rump, in addition to providing good pelvic lining when the animal is lying down, and a neat appearance while maintaining the symmetry of the rump area.

However, if the lesion is above or around the knee, this level of amputation may be too close to the lesion, necessitating a hip amputation.

Enucleation of the limb in the hip joint

This procedure is often used when hind limb disease is located in the thigh area where the leg is removed at the hip joint leaving only the pelvis and surrounding muscles. This amputation technique is also very effective, with slightly weaker filling at the amputation site and a less symmetrical appearance.

Limb amputation with hemipelvectomy

A third, less frequently used, hind limb amputation procedure (usually used for tumors in the upper thigh, hip or pelvis) is a limb amputation with hemipelvectomy, which also removes part of the pelvis. This procedure changes the symmetry of the rump more than other procedures, but is well tolerated.

The amputation procedure

The amputation procedure includes:

1. Induction of full general anesthesia:
   • The amputation procedure will be preceded by administration of anesthetics and painkillers (usually morphine derivatives). Their administration before surgery aims to block pain receptors in the brain even before pain occurs. They can be given as injections or through a special patch that is placed on the shaved area of ​​the skin about 6-8 hours before the procedure.
   • In the case of a hind limb amputation, an epidural may be used to reduce post-operative pain. Nerves will be clipped during the procedure and blocked with local anesthesia to further reduce the discomfort.
   • After the operation, painkillers will continue to be administered, ensuring a comfortable recovery. Oral pain relievers and anti-inflammatories may be administered by the owner at home for approximately one week after surgery.
2. Trim the hair from the affected area and surrounding areas.
3. Scrubbing the area with disinfectant to maintain surgical sterility.
4. Preparation of the operating field.
5. Proper treatment. The surgeon makes an incision in the skin, cuts the muscles, cuts the bone, and then - after removing the limb or part of it - closes the tissues and skin.
6. Limb stumps are usually left uncovered, while amputations of fingers or dog / cat tails may require post-operative dressing.

The amputation procedure in most cases takes about 1.5 to 2 hours, along with the time necessary for patient preparation and anesthesia.

Hospitalization

Hospitalization following an amputation procedure usually involves only a one-day hospital stay with 24-hour monitoring and medication administration by veterinary staff.

Amputations are procedures that involve short-term, but severe pain. Therefore, in the postoperative period, various drugs and techniques are used to relieve pain, and patients are discharged home only when their pain is under control.

• Local and regional nerve blocks with a drug called bupivacaine completely stop pain signals from reaching the brain and spinal cord during forelimb treatments.
• If it is a hind limb amputation, epidural and local anesthesia can also be used.
• In the case of front or hind limb amputation, the so-called. constant rate infusion (CRI). The CRI usually contains 1 to 4 different pain medications and is administered through an intravenous catheter before, during, and immediately after surgery.
• In the immediate postoperative period, the following can be used:
  • non-steroidal anti-inflammatory drugs,
  • a long-acting opioid drug (e.g. fentanyl - prolonged-release patch),
  • a medicine called gabapentin, which helps to close some pain signals in the spinal cord.

Most pets start to get up the very next day and are discharged home. The length of stay in a veterinary hospital may differ between clinics, and additionally depends on the type of amputation, the patient's clinical condition, and the occurrence of possible complications.

Before taking your pet home, however, make sure you are 100% clear about what you need to do in post-amputation care. Ask for written instructions so you can double-check them later, and don't hesitate to ask the doctor as many questions as you need about your patient's surgery.

After a period of post-operative discomfort, pets usually recover extremely quickly. The recovery period is surprisingly short, and complications after surgery, such as e.g. swelling or infections are usually not common.

Phantom limb pain, which is common in amputees, does not appear to be a problem in animals.

The amputation wound can appear quite large, especially in small dogs and cats. However, don't worry - it will heal quickly.

It is possible that the patient will have a drain in place during the operation. Such drainage avoids the accumulation of fluid under the skin. Don't worry, it's temporary - the drain can be removed even before your pet comes home.

Complications after amputation

Possible complications

Overall, the risk of surgery is low. The greatest risk comes from:

• general anesthesia,
• bleeding,
• postoperative infection,
• wound dehiscence at the incision site.

The complication rate is also not high, but serious complications can lead to additional surgery or even death.

Possible complications:

• Often, after amputation, bruises and haemorrhages appear around the wound - they should disappear within a few days.
• In the first two weeks, a serous discharge or soft swelling may appear near the lower extremity incision.
• Infection.
• Neuroma formation: Very rarely, nerves severed by amputation form small masses of nerve tissue which may be painful. This may require additional surgery or pain medications.
• Hernia formation (sometimes with hemipelvectomy).
• Bleeding from the wound.
• Wound edges detach, requiring re-closure.
• Pain at the site of the amputation.

Pain after limb amputation

Phantom pain

Phantom pain is a debilitating condition that affects some people with limb amputation. They experience extremely unpleasant pain that their brain feels is felt in an area of ​​the leg or arm that they no longer have.

In human medicine, the phantom complex has been defined as a complex of sensations, consisting of:

• painless sensations of phantom limbs,
• stump pain,
• phantom limb pain.

Unlike stump pain that goes away, phantom limb pain can gradually worsen and become chronic neuropathic pain.

Phantom limb pain has not been studied extensively in veterinary medicine. Veterinary questionnaires on limb amputation in animals focused primarily on the degree of adaptation and satisfaction of the animal owner. Additionally, assessing an animal's pain perception is difficult due to the animals' inability to verbalize.

It is commonly believed that phantom limb pain in dogs and cats is rare. However, it should be remembered that our knowledge is strongly limited by the lack of scientific data on this problem, as well as poor knowledge of clinical symptoms and possible risk factors related to the occurrence of phantom pain.

In 2015, neuropathologist Marco Rosati from the Institute of Veterinary Pathology in Munich, Germany, conducted an interesting study on phantom pain in dogs, showing that:

• 53% of dogs experienced pain more than a month before surgery (69% were former oncology patients), while the remaining 47% experienced pain from 24 hours to 4 weeks before amputation;
• 9% of dogs experienced pain between 1 and 3 months after surgery;
• 5% felt pain from 3-6 months after the surgery;
• the dogs showed different types of pain or discomfort:
  • 35% showed muscle twitching around the stump,
  • 23% licked the stump,
  • 19% whined,
  • 17% screamed,
  • 16% were anxious,
  • 11% chewed the stump,
  • 8% scratched the stump.

According to Dr. Rosati, 14% of owners believed their dogs felt pain 1 to 6 months after surgery with or without accompanying behavioral changes. Similarly, in humans after amputation, 5-10% of patients report a persistence and worsening of pain beyond the post-operative healing stage, leading to a debilitating neuropathic type of pain.

Pain hyperalgesia

One of the most difficult (but fortunately not common) problems faced by patients and their owners after amputation surgery is the development of some kind of hyperalgesia (increased sensitivity to pain), which is the result of the survival of untreated pain states.

The spinal cord can respond to a continuous flow of pain signals by actually increasing its sensitivity to incoming pain stimuli and by recruiting non-pain nerve fibers (e.g. touch) and making them also pain fibers.

Such changes may become permanent. In such a situation, the veterinarian may recommend the use of appropriate medications, such as.:

• Gabapentin - a drug that not only blocks pain signals, but actually modulates a brain cell called glial cell, which is associated with chronic pain conditions.
• Amantadine - a drug used mainly in the treatment of Parkinson's disease, but in neuropathic pain it closes the pain pathway of the central nervous system (similar to ketamine).
• Non-steroidal anti-inflammatory drugs are used to reduce inflammation and control pain at many levels of the pain pathway from the nerve to the brain.

Myofascial Pain Syndrome (MPS).

MPS is often one of the biggest pain problems in amputees. In animals, it is a disorder that is difficult to diagnose and therefore rarely treated.

The myofascial pain syndrome is associated with the tension of the strand of muscle fibers inside the affected muscle and most often it is the result of the constant maintenance of the muscle in a slight contraction.

This painful condition can often become the primary source of pain and may not even be in the affected limb, but elsewhere entirely. The reason for this may be compensating for the missing limb by subtle or more obvious shifting the body weight to the "healthy " leg.

Although this condition can be difficult to diagnose, it is relatively easy to treat. The most effective method of treating MPS is the so-called. "Dry needling ". It involves inserting acupuncture needles into the muscle bands that have MPS, which causes the muscle to contract involuntarily. Once the contraction is gone, the animal immediately feels pain relief.

Post-operative care after limb amputation

Post-operative care

Dog or cat limb amputation is a major operation.

The patient usually takes about 2-3 weeks to fully adjust to the new circumstances.

The animal may experience sudden pain as it heals, but this should decrease over the first few weeks.

During this time, you should support your pet by using painkillers recommended by a veterinarian and limiting the pet's activity. After a period of convalescence and adaptation to life on three legs, animals are generally very good at carrying out normal daily activities, although their agility and endurance may be somewhat impaired.

The first days after amputation

A quiet room

After surgery, your dog or cat will need time to recover. Share a quiet, peaceful and comfortable place away from the hustle and bustle of home.

It can be a small room, cage or playpen, adapted to the size of the animal.

Also provide a soft bed for your cat or dog and encourage your pet to lie on the operated side up. In such a comfortable and safe room, the animal should be kept for about 24-48 hours after the operation or until it is stable on its feet.

Do not allow free access to stairs or slippery floors. You can put in the room bowls with water and food and - for the cat a litter box.

Your pet may feel tired and / or overly calm for the next few days. He may also moan or seem more restless than usual - this could indicate pain, discomfort, or side effects from medications. If you are concerned about your pet's well-being, call your vet - you may need to modify your medication doses or even add additional painkillers.

It is normal for recovering cats (and some dogs as well) to look for secluded places and hide - often under the bed. Usually it is enough to bring them water and food and leave the litter box nearby, however you should monitor your appetite and behavior at all times. If the problem persists, you may need to see your veterinarian.

Traffic restriction

In the early stages of healing, a surgical wound is very prone to rupture until the scar becomes stronger. The first 10-14 days after the procedure is the time when the greatest care should be taken.

Immediately after the amputation procedure, walking is required - in the case of dogs, movement should be limited only to short walks on a leash.

A dog harness, harness, scarf or even a towel can help to lift and maintain the dog's balance (especially on slippery or uneven surfaces). In animals after amputation of the front leg, such a sling is placed under the chest, and after amputation of the hind limb - under the abdomen.

Do not allow your dog to run, jump or jump (e.g. for furniture, car, etc.). Consider using stair gates and ramps.

The cat should only be indoors. Access to tall cabinets should be blocked - the sense of balance may still be impaired and the cat may have problems landing on three legs. Improper landing can lead to further injury.

In order to prevent running, jumping or climbing, the patient should be isolated, even confined in a large dog cage or playpen.

Limiting contacts with other animals

If you have other pets, it's best to keep them separate or at least supervise their contacts with your amputee. Until you are sure your dog or cat is capable of taking care of itself, try to isolate it from other animals.

Healthy animals are able to notice any physical or emotional changes in their companion and their response may vary. They may not understand what has happened and harass or try to play too hard with the convalescent. Therefore, slowly introduce the patient to the "environment" and always keep an eye on how the animals interact with each other.

If your cat is concerned about the current situation and seems confused, it may be a good idea to use plug or collar pheromones to calm the pet down. Cats may be confused, but things should be back to normal soon.

Dressing

After forelimb amputations, a soft dressing is usually placed over the operating site. The bandage protects the wound as well as absorbs pressure and makes the animal feel more comfortable.. It also reduces swelling and fluid build-up at the surgery site. Dressings are rarely used for hind limb amputations.

If your dog or cat has a dressing, change the bandage daily and make sure the wound is clean and healthy.

The dressing should be dry. If it gets wet or slips, you should change it.

Anxieties

Initially, the recovery from amputation can be very painful for the animal as the procedure involved a significant degree of injury and it is important to provide adequate pain relief during this time.

Besides being emotionally unpleasant, pain also delays healing. Therefore, it is extremely important to soothe this unpleasant feeling in amputees not only to bring them relief, but also to potentially aid recovery.

• Pain management can involve the administration of several types of drugs as they often act synergistically.
  • Some patients also use self-adhesive fentanyl patches.
  • Anti-inflammatory drugs such as carprofen, meloxicam, robenacoxib, and firocoxib.
  • Pain medications - tramadol (for dogs) and buprenorphine (for cats) are often used.
  • Usually, after the procedure, antibiotics are administered, such as, for example,. amoxicillin with clavulanic acid.

Postoperative wound management

Wound monitoring

It is very important to carefully monitor the post-operative incision for the appearance of exudate such as blood or pus, swelling, excessive bruising, or an open wound.

Immediately after the operation, the area around the incision may be swollen and slightly red. A small amount of exudate (usually serous or serous-blood) may also ooze from the wound for a few more days.

Edema and fluid build-up may be present, but they are temporary, occur with major surgery and should not be worried about. Some bruising is normal and will go away in 5-7 days.

Sometimes there are sutures on the outer surface of the skin, sometimes they are subcutaneous sutures. Usually, if you see stitches, they should be removed in 2 weeks. If you cannot see them, they are under the skin and will dissolve on their own.

It should be remembered that the more active the patient is immediately after surgery, the more swelling, bruising and bleeding may occur. The amount of exudate from the incision can be minimized by keeping the animal calm and restricting movement.

Check the postoperative wound twice a day. It should be dry, slightly red at the edges and slightly swollen. It should lose its redness and swelling within a few days.

Contact your vet if you notice:

• separation of the edges of the wound (the edges of the wound should touch exactly),
• discharge (other than a small amount of serous exudate) or heavy bleeding,
• swelling (other than the slightly raised skin near the edge).

In the event of bleeding or local accumulation of serous fluid, apply pressure to the area with a dressing (around the chest or pelvis).

If you notice discharge after treatment, you can use a warm, damp wash cloth to keep the area clean. The wound should not be touched unnecessarily, over-wet, or bathed. Keep the surgical site clean and dry.

In the first week after surgery, you can apply cold compresses to the incision area twice a day for 10-15 minutes. Continue them for 7 days to reduce pain.

Postoperative wound licking prevention

Do not allow your pet to lick or chew the area around the surgical wound. Animals tend to lick early in healing, which may predispose to infection, impede healing, and even cause wound dehiscence.

• An Elizabethan collar is usually required to prevent interference with the wound. The animal should stay in it for the first 10-14 days after the procedure, which prevents biting, licking or chewing the area of ​​the surgical incision.
• A T-shirt or boxer shorts can be a good cover for wounds on the body of large dogs, but make sure they are changed regularly and do not stick to the wound.
• If your cat is licking, biting or scratching its seams, you can try putting on a kids' T-shirt over it. The T-shirt will cover the incision and prevent direct contact with the sensitive area. This solution works quite well for some cats, but will not cover the incision after amputation of the hind limb.

Monitoring of physiological functions

• Make sure your dog or cat has urinated within 24 hours of returning home. If not, or you notice any problems urinating, be sure to report your findings to your vet.
• Monitor your pet's appetite and well-being. If they do not improve within 2-3 days please call your vet.
• Some animals may not eat for several days after major surgery; this is the right time to bring out all your favorite treats and encourage eating. However, if your dog or cat refuses to eat any food 24 hours after surgery, talk to your doctor as it may be necessary to intervene.
• Make sure your pet has easy access to its food and water bowls - especially if it wears an Elizabethan collar which can make it difficult to eat from the bowl.
• You can expect to have a bowel movement within 5 days. Some animals take longer to have a bowel movement depending on when they last ate before surgery and when they started eating after surgery. The feces may be of an unusual color and consistency for 2-3 days. If you have any concerns, please speak to your healthcare professional.

Assistance in movement and daily activities

The animal's ability to stand up and move the day after surgery usually depends on the degree of fitness of the limb prior to surgery. It very often happens that if it is necessary to perform an amputation, the patient has stopped using the limb for a long time. Even before the operation, he is limping, limping or not putting any strain on the diseased leg.

The most common reason for this is a tumor that causes great pain - in the later stages this pain is present whether the limb is used or not. Such animals are accustomed to a change in gait, therefore many dogs or cats with bone tumors are well adapted to a three-legged life, and their recovery is often surprisingly quick.

This means that after anesthesia and post-operative discomfort have subsided, most patients adjust exceptionally well. Some animals are even noticeably livelier, happier and more mobile after surgery as they no longer feel pain from the affected limb.

Most dogs even get up the day after amputation. Within a week or two, dogs almost forget that they are completely missing one leg. They can run, jump, play, swim and even climb stairs almost as well as other dogs. They adapt very quickly to having only three limbs.

Young dogs that adapt well to amputation may not need any help getting up or moving after recovery. For larger dogs, you may need to help guide them outside, especially if they are overweight or not limping before surgery. If the tumor does not produce significant lameness or the amputation is performed due to a sudden trauma, the dog is overweight, other orthopedic problems such as hip dysplasia or is elderly, getting up and moving after surgery can be more difficult and additional support and encouragement may be required.

The situation is no longer so predictable for cats. It may take several days for them to learn how to move on three limbs.

Some cats have problems with this at first, but they will also deal with it quickly. At this point, there is little you can do to help them adjust.

In the case of an amputated front leg, you can stimulate your cat to shift the weight to the remaining foreleg by gently lifting the pelvis to force the pet to shift weight to the front. This will help him to concentrate on the front leg.

An amputee animal will need supervision and support until it can walk independently. As I mentioned, some patients get up very quickly and move around on their own, while others may need help for several days.

• Initially, the stairs are quite a big challenge (and at the same time a danger) for animals after amputation. Remember to exercise extreme caution and supervise your dog when climbing stairs until you are sure that he can handle himself.
• Slippery floors and uneven surfaces can become a real problem for a three-legged animal. In such situations, carpets and treads with anti-slip pads work very well.
• Keeping the claws short and cut can also help to prevent slips.
• Standing up on your own can be a problem for a dog after a limb amputation. Pets may require additional assistance within a few days after surgery, especially when rising from a recumbent position.
  • The light support needed to stand up and hold the dog outside can be provided by a makeshift sling made of a scarf, towel, or a canvas shopping bag with handles. If the front leg is amputated, suspend it under the chest, and for the amputated hind leg, place a sling under the abdomen. Be sure to stand on the same side as the amputation site to act as a counterweight to your dog learning to balance.
  • If necessary, use this support under the abdomen or chest during the first 7-10 days to help the dog and prevent it from falling on slippery surfaces.
  • If additional support is needed, you can purchase a complete harness that supports both front and rear legs and is sized to fit your pet.
• The dog or cat will have to learn to adapt the way it deals with its physiological needs to maintain balance at the same time. As a rule, animals learn this quickly, but it may take several days for them to defecate as they often stop defecating while learning to adapt to new conditions.
  • Initially, the dog may need help to maintain proper posture to defecate; supporting your pet's hind leg or holding it under its belly can help with this.
  • It may be difficult for your cat to get in and out of the litter box. For the first two weeks after the treatment, it is recommended to replace the litter box with a newspaper or a hygienic pad, and then with a low litter box. Another solution might be to cut out one side of the litter box so that the cat can access it more easily.
• Amputee animals may find it harder to get to their favorite places, so be sure to help them. Provide ramps or steps to higher areas and / or furniture where the dog or cat loves to nap. Also, make sure your pet can get to food, water, and lair without jumping or climbing.
• If your cat has lost a front leg, it may be difficult to groom around its neck and head. You can help him with this by using a damp cotton ball or a clean cloth to clean hard-to-reach areas. Groom and scratch areas of the body where cats could use a missing limb.
• Keep your cat away from other cats. It is recommended that an amputated cat no longer leaves the house alone, as it would be exposed to potential fights or other dangers.

Post-treatment control

The first post-operative follow-up usually takes place on the third day after amputation. Skin healing is assessed as well as the patient's condition and the way he moves.

If your recovery is smooth, the sutures will be removed 10-14 days after surgery. This is also when the recovery progress is assessed. Most amputation wounds in animals are fully healed within 2-3 weeks.

Make sure to show up at any follow-up appointments to make sure your pet is healing and the amputation wound is healing well. If you have any questions or concerns, now is the time to speak to your doctor.

Exercises

It is important to restrict movement and rest carefully for the first few days after surgery to protect animals from injury. During this time, patients regain their strength and learn to coordinate again. However, after a few days, the animals should be encouraged to stand up and move slowly on three limbs to stimulate the muscles.

Learning to walk and then consolidating a new way of moving usually takes about 4 weeks. Many animals try to walk on their own in the first week after surgery.

In the early stages, you need to help them keep their balance, especially on slippery surfaces. In the first month, exercise is therefore recommended, but you should avoid excessive activity and avoid fatigue.

Short walks on a leash are recommended, but you will have to wait a little longer with longer hikes or jogging.

Once they are able to move around without fear, it will be possible to let them return to their favorite activities and games. If your pet likes water, swimming is great physical therapy.

Depending on the cause of the limb amputation, it may be advisable to rehabilitate the animal so that it can recover faster and improve emotional stability.

After the amputation procedure, the animal will use different muscles and move differently than before, so it is important to help it strengthen muscles and build strength in the early stages of adapting to life on three legs. A veterinarian and / or rehabilitation specialist can develop a special set of exercises for an amputated dog or cat to recover faster.

Remember that your pet will take time to adjust to living with three legs, especially if it lost a limb in adulthood. As soon as it gets used to balancing and moving only on three legs, you'll be surprised how well it does, sometimes with just a little help.

Long-term care

Animals can survive and even do great on three legs. If a pet is born with a missing limb, it learns very quickly and naturally on three paws, often not noticing the difference between itself and any other animal. It travels easily, in most cases without assistance.

Four-legged animals that lose a leg after amputation will have a varyingly long adaptation period, but learn really fast! Definitely faster than a human.

Caring for an amputee animal can be challenging, but there is no reason why a dog or cat that is missing one limb should not lead a happy and healthy life.

• Be careful with your pet. Although dogs and cats recover fairly quickly from amputation, you should still exercise caution and - if possible - prevent injury.
• Keep the cat indoors. It goes without saying that an amputee cat should be kept indoors at all times (or supervised if it is released outside for short periods). Although three-legged cats are very adaptable to their handicaps, they find themselves at a disadvantage when faced with the dangers outside.
• An amputee animal may have difficulty walking on slippery floors. Provide your dog with extra traction with non-slip shoes or socks that help them stick to the floor while walking. The support they receive from wearing non-skid shoes will further increase their self-confidence as the dog begins to regain balance.
• Slippery floors are even more dangerous for a dog that has a prosthetic leg. Slipping may cause a serious fall or a potential knocking down of the prosthetic limb. To prevent this from happening, it is a good idea to cover any smooth and slippery surfaces with sturdy rugs, and ideally the rug should be secured so that it does not curl or slide.
• Take care of your pet's other limbs - they are now even more important than before (especially the opposite leg to the amputated one). If one of the healthy limbs begins to deteriorate in any form, it can cause a serious mobility problem. So you need to make sure that the other limbs are strong enough to support the extra weight. Watch your pet's movements every day to make sure it doesn't become slower or weaker. If you notice fatigue or a problem with walking, you can use a harness if necessary, which can take the strain off your limbs.
• Both dogs and cats after limb amputation must maintain a low body weight. Monitor your dog or cat's weight closely, especially if they have had a limb amputation and are moving less than before. Weight gain will put more strain on the other legs and will make it much more difficult to heal and regain balance. In small animals such as small breed dogs or cats, even one kilogram may affect their mobility. Any minor orthopedic medical condition can progress over time, so carrying less weight will ease the pressure on the joints of the other three limbs. The following information can help you monitor your pet's condition after amputation:
  •  the animal should have an "hourglass figure" when viewed from above,
  • the animal should have a tucked up belly when viewed from the side,
  • you should feel the ribs and pelvic bones, but not see them.

As they age, three-legged dogs are more susceptible to injuries to the remaining limbs. An older dog that has undergone an amputation may find it more difficult to adjust to living on three legs. He may need some extra help to move around, especially if you have had any previous medical problems.

Be alert and watch your pet for signs of exhaustion or pain while moving. After the front leg is amputated, the other, healthy limb has to take on more weight.

In the event of a pelvic limb amputation, the animal changes its gait so that the other leg is directly over the body for better balance. Such gait corrections and attempts to maintain balance can cause pain, fatigue and possible problems in the near or distant future.

As time goes on, the remaining healthy leg begins to show signs of fatigue, joint strain, or an injury. Regardless of race or weight, no animal is immune to the problems caused by altered gait.

In the long term, an older dog may need a dog's wheelchair or a lifting harness to help him move around.

• Watch for signs of fatigue or pain. If you see your dog slowing down, pausing frequently, or pausing and / or panting while walking, do not insist on extending the walk. Your mentee will show you when he or she wants to return home.
• A disabled cat also needs a lot of time and understanding to adapt to new conditions and rehabilitate. However, the muscles strengthen quite quickly and the animal masters the art of moving on three limbs.
• Introduce a daily joint supplement to the diet of your pet. Preparations containing chondroitin, glucosamine, as well as collagen and other chondroprosthetics should be used until the end of the animal's life.
• Provide the pet with something like an elevator. If your cat does not have a back leg, it will most likely need help moving from the floor to a higher surface. If you want the pet to be able to jump from the floor to the chair or lap, you may have to pick it up if it cannot do it alone. You can also set up objects of increasing height that will allow him to gradually climb to the top. Cats without a front leg may not need this kind of help, unless they are trying to make a very high jump.
• Help with scratching. If your pet has been stripped of a hind limb, it will not be able to scratch its ear or its neck on the same side of the body. You may notice him trying to scratch with his phantom leg. Help him by scratching him gently in these places.
• Occasionally pets will experience phantom pain in a removed limb, so if you suspect your pet is experiencing discomfort, talk to your vet as it may require further treatment.
• Be in constant contact with a veterinarian so that in the event of any crisis or discomfort in the animal he can react immediately.
• Look for a support group. There are many online support groups and blogs for the three-legged pet owner community. Ask your veterinarian to put you in touch with other pet keepers who have chosen to amputate their pets. They can offer many great tips, and listening to others' experiences is comforting.

Denture

In recent years, there has been significant improvement in the treatment of pain, but there is also a shift in the approach to amputation itself.

The dominant way of removing a limb in a dog or cat is the so-called. high amputation - that is, removing the limb as high as possible (in the case of the front paw, often together with the shoulder blade).

The rationale for this approach to amputation is to protect the remaining stump from injury or damage should the animal attempt to use the rest of the leg to support itself.

Provided that the amputation is not due to oncological indications, the operation may be "softened". As is the case in human medicine, animals can benefit from saving as much limb volume as possible - this is where possible applications are at stake dentures for dogs or cats.

Partial limb amputation and the use of artificial limbs in pets are a new treatment option for some patients. In this procedure, the amputation is carried out lower on the lower leg, leaving a suitable stump for the insertion of a specially fitted prosthesis.

Many dogs function normally with a prosthetic limb and tolerate an artificial limb very well.

Unfortunately, when a dog's leg requires complete amputation, as is the case with bone cancer, a prosthesis cannot be attached. If, on the other hand, medical considerations do not prevent your dog from having a prosthesis, and you are considering it, there are a few important points to keep in mind:

1. Before the amputation, contact a reputable manufacturer of prostheses. Do not look for opportunities and do not buy a ready-made prosthesis, as it should be made to order. A reliable manufacturer of prostheses cooperates with the surgeon, presenting him with guidelines on how he would like the stump to look like after an amputation of a specific animal or adapt the prosthesis to the anatomical conditions of a given dog.
2. Once healing is complete or as recommended by the denture maker, get ready for the denture and begin rehabilitation. Expect it to be every 2 weeks, maybe more often, and it may take several months for the dog to learn to move with the prosthetic limb.
3. Caring for the stump and using a prosthesis in an animal requires daily care and constant commitment.
4. Some dogs may need multiple dentures throughout their lives.

Wheelchair for dog and cat

Wheelchair for dog and cat

Use wheelchair usually not necessary for a three-legged dog, although it may be a convenient option. It can prevent fatigue during long walks.

Moreover, such a cart can be used when the animal is getting used to the three-legged walking after amputation. Older dogs may develop inflammation and / or degeneration of the joints caused by loading the extra weight on the remaining limb. In this case, the stroller - by minimizing the pressure exerted on the other limbs, can keep the dog active and mobile.

In the event of a hind limb amputation, a wheelchair with wheels on the rear supports both hips. The owner supports the dog from the front, helping him to maintain correct posture and move in a more natural and balanced gait.

In the event of an anterior amputation, a fully supported wheelchair or a four-wheeled stroller provides both front and rear support. The dog can therefore move more confidently because it is fully supported by the wheelchair.

Can amputation be prevented?

Prevention of amputation is often not possible as it is a last resort treatment. However, in some cases, amputation may be indicated due to financial constraints, e.g. when the costs of specialized fracture repair are high.

In such cases, a different course of action is often possible (e.g. surgical treatment), and the only obstacle factor are economic considerations.

Unfortunately, there is little that can be done to prevent cancer from growing, which is the primary indication for amputation.

However, if an injury is the cause, steps can be taken to avoid it. For example, providing a high fence and controlled walks on a leash can substantially reduce accidents in dogs.

On the other hand, castration of males, by limiting their migrations, can significantly reduce the risk of injuries, being hit by a car or exposure to attacks by other animals.

Caregivers' concerns

Amputation may be the only therapeutic method that will realistically eliminate pain and extend the life of the animal, but the decision to remove a limb from a pet may be very difficult for the owner, most often due to emotional concerns.

Caregivers are often worried about how their pet adjusts to three-legged walking, and they are also concerned about their own reactions and feelings when they see a disabled dog or cat. This uncertainty is often amplified by the comparison to the amputation of limbs in humans, in whom such a situation can in fact be painful and traumatic.

This emotionally marked attitude may be unconsciously aggravated by the veterinarian himself, who - qualifying the patient for surgery - presents the owners with a therapeutic plan. So they learn, for example, that:

• "Amputation of the thoracic limb is more difficult than the pelvic limb ",
• "In older dogs the risk of surgery and anesthesia is high ",
• "The dog is too heavy to amputate a limb ",
• "The coexisting degeneration of the remaining joints disqualifies the dog from the amputation procedure ".

No wonder that the caretaker of a sick dog or cat feels confused and treats any difficulties, contraindications or uncertain prognosis as confirmation of their fears and becomes even more negative. So let's take a look at how it really is with this one amputation in a dog or cat, is there really anything to be afraid of, and above all let's try to look at the situation through the eyes of our pet for a moment.

Can my dog ​​/ cat handle three legs?

Amputee animals do great in most cases and have a good quality of life. Dogs function exceptionally well on three legs and are able to run, walk and play without pain or discomfort, and small dogs are almost as fast on three legs as they are on four.

Cats will still be able to hunt and climb trees.

Undeniably, the life of an amputee dog or cat will change significantly, but the animal quickly gets used to the new situation, and the lack of pain and discomfort makes it healthy and happy.

In fact, the ability of dogs and cats to compensate after amputation is stunning. In a study of American pet owners after limb amputation, nearly three-quarters of respondents did not notice any changes in their recreational activities.

Using MRI and gait analysis in hind-amputated dogs, researchers in Germany showed that dogs regained full mobility within 10 days of amputation. No bone or muscle damage due to limb loss was detected at the 4-month postoperative evaluation.

So - to answer the question - a dog or cat can survive and function amazingly well after a limb amputation.

Will my dog ​​/ cat suffer from amputation??

Amputation is usually associated with pain and suffering.

Owners perceive the quality of life of an amputee animal through the prism of observing people who underwent such surgery.

It should be noted that such anthropomorphization in relation to the feelings of dogs or cats after amputation may be an erroneous and harmful procedure, because it assigns features and emotions to purely human animals, which are fundamentally different from us. Hence, many misconceptions arise regarding the further life and functioning of the animal.

There are profound differences between animals and humans in physical, social, and emotional factors that affect quality of life after severe or mutilating procedures.

The most common concerns of owners are that their dog or cat will suffer after surgery or may not be able to tolerate concomitant arthritis in the remaining limbs. However, in the vast majority of cases, quality of life after amputation improves as the source of pain and discomfort is removed.

Very often the animal has already got used to shifting the weight to other limbs, because the diseased leg was too painful to stand on it.

Does it matter which limb is amputated?

Carberry and Harvey concluded that the dog's function would not be affected by whether a fore or a hind limb was amputated. In contrast, according to Budsberg et al., The weight distribution for each limb in a standing position is 30% for each forelimb and 20% for each hindlimb, suggesting that adjusting to walking on three legs may take longer after forelimb amputation.

Generally, a pet is more adaptable to navigating after a hind limb amputation compared to an anterior amputation.

In quadrupeds, the front paws carry more weight than the hind paws, and at all stages of gait (except canter) they act as individual limbs rather than as a pair.

Therefore, it is a bit easier for cats and dogs to recover after pelvic limb amputation, as they carry 60% of their body weight on their pectoral limbs. Not surprisingly, forelimb amputations are generally more debilitating.

Nevertheless, the function of each limb may change following amputation. In a normal dog, the function of the forelimbs under load and movement is different from that of the hind limbs.

The front limbs contribute significantly more to the walking inhibition phase than the pelvic limbs to the propulsion phase. But even forelimb amputations in large dogs can be extremely well tolerated.

Animals do not have psychological problems related to their own image. Most of them adapt extremely quickly after amputation. This is especially noticeable when the immediate cause of the amputation causes pain and limp beforehand, as the muscles in the other limbs will continue to strengthen until the time of surgery.

As a rule, dogs and cats do really well on three legs whether they have lost a fore or a hind limb. They learn to balance on three legs quite quickly and the vast majority of amputated patients walk well without assistance.

Does the dog's or cat's body weight influence its adaptation after limb amputation??

The size of the animal is a frequently raised argument against the amputation of a dog's limb.

It is believed that the heavier breeds may have more difficulty adapting to three-legged races than the lighter breeds.

Indeed, many veterinarians advise against amputation in heavy dogs, believing that such dogs will have a lot of trouble adapting and moving around. In general: the smaller the animal, the less strain on the limbs left over from amputation will be, making cats and small dogs extremely successful.

More current contraindications for amputation, however, include severe orthopedic or neurological disease involving other limbs and / or extreme obesity.

It turns out that medium to large dogs can still have a great quality of life, but they will be slower.

For larger dogs, however, other factors (such as age, general health, presence of other orthopedic issues, etc.) should be considered when planning an amputation.) to assess if they can handle it on three legs.

The situation is completely different in the case of obesity. The fact is, a large obese dog won't do that well with just three legs. Here too, however, patient weight loss can help to optimize quality of life after an amputation.

What factors affect the speed of adaptation to moving on three limbs?

Compared to the amputation of human limbs, animals usually recover faster and more efficiently. This is mainly due to their anatomy.

After an amputation, the animal has three more legs, and humans have only one. Dogs and cats adjust quickly to distributing their weight over the three limbs. In addition, animals do not suffer psychologically from loss as humans do, and many dogs and cats with three legs do not know that they are different.

Most cats and dogs do not have major motor problems after surgery, but some animals recover and function more easily and more quickly.

The agile nature of cats allows them to adapt quickly, and younger and smaller dogs get up and walk on their own faster. Dogs with inflammation / degeneration of the joints or neurological complications may have difficulty adjusting to a new situation.

Also in older dogs and cats, the recovery period and adapting to life on three legs may take a little longer. The direct cause of the amputation sometimes plays a key role: paradoxically - removing a limb with a tumor may cause the dog or cat to walk the next day, because the surgery eliminates severe pain.

Are animals aware that they are missing a limb??

There is a saying in veterinary circles that perfectly describes the essence of amputation: that animals have three spare legs.

While the forepaw or hindpaw procedure may seem too radical to us, animals do not experience the same mental sense of loss or mental suffering as humans, and the vast majority adapt very well to the loss of a limb.

Dogs and cats don't suffer from the humiliation people feel about their new looks, so they focus all their attention on trying to cope without one paw.

The primary purpose of a limb is movement. Since animals do not need to have perfect fine motor skills, they adapt easily to having only three legs.

How will my cat handle a limb amputation??

The loss of a limb can affect the normal behavior and activity of cats. While these animals usually find a way to adapt and lead a happy life, the adaptation process may deteriorate due to the stress of the incident or disease that led to the amputation.

A cat's adaptation to life on three legs will depend in part on its personality. And indeed - it can be a really difficult time for a pet. He has not yet forgotten about the pain and fear associated with the situation leading to the loss of a limb, and a new stressor has appeared on the horizon in the form of the need to adapt to new limitations.

• In the first days after hospitalization, the cat may be anxious, especially as it has to wear an Elizabethan collar to prevent damage to the wound.
• Adapting a cat to a life on three legs alone is not easy. After the treatment, the tripod cat will learn that for some mysterious reason it is no longer able to perform some of the tasks that it could have easily done before. Frustration and anxiety can make your cat feel restless and in some cases can lead to nervousness and behavioral changes.
• The cat may become depressed and inactive, stop playing, purr, and give up grooming, even after leaving the litter box. He may compulsively engage in behavior that is still pleasurable, such as. food.
• Physical adaptation can be further complicated by phantom pains. Your pet may feel as if it can rely on a missing limb, and thus it will take longer to find alternative ways to cope with daily tasks. It happens that the cat tries to scratch itself with the missing leg for a long time after amputation or reacts strongly when touching the stump. However, these types of changes usually go away.
• Another problem may be the use of the litter box. Initially, the cat can be helped to enter the litter box and bury the waste. Over time, your pet will gradually learn new habits and adapt to the situation. If our convalescent does not wash after using the litter box, you can help him by cleaning the perineal area with a damp cloth or baby wipes. Soon his skills will improve, he will learn to keep his balance and his normal grooming habits will return.
• The weight of the three-legged cat should be kept under control as overweight may exacerbate the difficulties of adjusting to life. It may be useful to eat low-calorie foods, especially as the cat will be less active (at least in the beginning) and especially if he starts eating excessively.
• The owner plays a key role in adapting cats to life on three legs. It can help you through this difficult time, motivate your cat, help you learn again or develop new skills. Some cats adapt faster than others, but sometimes, especially if there is a crisis, the role of the owner cannot be overestimated.
• While the amputation of a cat's leg may seem like a drastic move, it may actually be the only chance to ensure that your pet has a happy, pain-free life. This treatment is definitely not the end of fun or enjoyment for your cat - it has been saved from suffering and can still enjoy life.

The vast majority of cats adapt very quickly to moving on three legs and will be able to perform most of the activities that are their current routine. Of course - depending on the place of the amputation - the tripod may no longer climb a tall tree, jump straight from the ground to a high place or run like lightning. But the truth is that - with the right help - such cats can be happy and fulfilled just like their four-legged kin.

Animals do not have the same emotional attachment to limbs as humans, and in the absence of one limb, they learn to simply cope on three legs.

Three-legged cats can run

Although walking may seem difficult, an amputee cat is surprisingly good at running.

Walking is more difficult because it is a four-stroke gait, meaning each leg is placed individually on the ground, but a canter is a three-stroke run, meaning a tripod cat does not need to have four limbs to accelerate.

Cats with three legs can climb

This will be much easier in cats with a hind limb amputated, but even a pet with a missing front paw can pull up.

Three-legged cats can jump

A cat that does not have a hind leg may have trouble jumping out of the ground to a high surface, as animals use pelvic limbs to kick up.

This does not mean, however, that they cannot jump from one surface to another, e.g. from the table to the couch. Jumping is even easier for a cat that lacks a front leg.

Though amputated cats can do great things, they may need help in some areas of their lives. From time to time there may be problems with balance, getting into the litter box or jumping out onto a tall piece of furniture.

However, in the long term - because they do not need to hunt or avoid the dangers of being outdoors - cats have few problems with moving and functioning on a daily basis. In fact, most owners are surprised at how quickly these animals adapt to the situation.

Is amputation humane?

One of the more serious dilemmas that owners face is whether limb amputation in an animal is ethically sound. After all, a three-legged dog or cat is a disabled animal, and there is no reason why it should suffer.

Amputation is sometimes believed to harm the animal's integrity, so euthanasia should be preferred. However, research reports that while amputation may change the functional status and behavior of a dog or cat compared to a healthy quadruped, this change should not prevent an animal from living a good quality life.

It turns out that limb amputation can be a good therapy in many cases. Half of the dog owners surveyed had serious concerns about limb amputation prior to surgery, but these appear to be based more on emotional grounds and the perceptions of people who lost a limb than on a rational judgment of the facts.

After the amputation procedure, none of the owners regretted their decision, so this procedure is a legitimate option.

Of course, after amputation, as after any surgical intervention, complications can occur and therefore close cooperation between the guardian and the owner of the animal is important, but the mortality rate due to amputation is extremely low.

The main reason for the death of the treated animals was the presence of tumor metastases. And it is precisely the delays in the owner's decision to amputate an animal that can negatively affect the survival time or increase complications.

Limb amputation in dogs and the owners' opinion

Limb amputation in dogs and the owners' opinion

Several studies have been conducted to evaluate the effects of limb amputation in dogs and cats from the owners' perspective.

Two studies conducted in Canada and the USA showed that virtually all surveyed owners were satisfied with the functional state of their amputee pets. Similar studies have been conducted in the Netherlands to assess dogs 'fitness for limb amputation and their owners' satisfaction with the procedure.

Most dogs adapted to three-legged walking within a month, which is faster than most owners expected. Few complications occurred after amputation, although behavioral changes were observed in approximately 1/3 of the dogs.

Owners of 44 dogs were contacted by phone and interviewed via a standardized questionnaire. Here is what information was obtained in this study:

Dog's body weight

The weight of the dogs varied by 4 to 60 kg, 6 dogs were small, 15 for medium and 23 for large.

It is widely believed that a large dog will have more difficulty adjusting to walking on three limbs than a smaller dog. Half of the owners had serious concerns about the amputation due to the expected appearance of the dog after surgery and possible problems with adaptation.

However, the results of this study do not support this hypothesis. The weight of dogs did not have a significant relationship with the speed of adaptation and therefore should not be a criterion when deciding whether to amputate a limb.

Age at which the limb was amputated

The age of the dogs ranged from 1 to 14 years; Nine dogs were classified as young, 25 middle-aged dogs, and 10 elderly dogs.

An old dog's limb amputation is often rejected due to anticipated problems with the quality and speed of adaptation. However, no significant relationship was observed between the dog's age and the quality and speed of its adaptation, which suggests that age should also not be a criterion when deciding whether to amputate a limb.

However, the reaction of friends will be much more negative for an amputee in an older dog.

sex

Twenty dogs were male and 24 were female.

Removed limb

The forelimbs were amputated in 25 dogs and the hind limbs in 19 dogs. The statistical analysis and methods of adaptation in this study do not support the notion that adaptation to walking takes longer after forelimb amputation.

Cause of amputation

The main causes of amputation were tumors, followed by fractures, inoperable injuries, post-operative infections, and other causes.

Factors that influence the decision to amputate

Several variables can influence the speed and manner of an amputation adaptation, such as the dog's weight and age, or whether a fore or hind limb was amputated.

These factors are also often the reasons why owners reject amputation as an important therapeutic option.

Initial reservations expressed by the owner

Twenty-two dog owners initially opposed the recommended amputation. The main concerns concerned the unsightly appearance of their dog after surgery and possible mobility problems, or a combination of these factors.

• After the amputation, 19 owners said their objections were unfounded. Such an answer was significantly related to how quickly and successfully the dog adapted to the new conditions.

How the dog adapted after the amputation and how quickly it happened

Adaptation was defined as good if the dog returned to normal or near normal activity. Adaptation was satisfactory when the dog was less active, but its activity was acceptable to the owner. On the other hand, if the dog's activity was unacceptable to the owner, the patient's compliance after the amputation procedure was defined as insufficient.

• Most dog owners were very satisfied with the functioning and adaptation of their amputees (this is similar to what was seen in the North American study).
• 42 out of 44 dogs adapted satisfactorily to walking on three legs and adapted much faster than most owners expected
• 41 dogs adapted very well to the use of three legs.
• Of the three dogs that did not adapt as well as expected, one owner replied that the dog showed an acceptable level of adaptation because although he was unable to walk as far as he did before he was amputated, he was still able to walk for half an hour without exhaustion.
• Two owners said their dogs recovered poorly from cancer amputation. They never fully adapted to walking on three legs and were put to sleep due to metastasis in the third and twelfth months after surgery.
• Most dogs adapted within a month of surgery, and 9 adapted within a week of surgery.
• One common finding was that most dogs had difficulty walking on a leash and preferred to walk or trot slowly.
• Except for the 2 dogs that were euthanized, no dog took more than three months to adapt to walking on three legs.
• Regarding the speed of adjustment, no significant correlation was found between the age or size of the dog, initial objections to amputation, complications related to the amputation, or changes in the dog's behavior towards other dogs.

The owner's expectations regarding the speed of adaptation

33 owners expected their dog to take longer to walk than it actually was and only 2 respondents expected their dog to adapt faster.

Complications related to amputation

• In 39 cases there were no complications between the amputation and the time of the interview.
• In 5 dogs, complications were:
  • edema,
  • symptoms of degeneration of the other limb,
  • radiographic signs of pneumonia,
  • wound dehiscence.

The dog's behavior towards other dogs

Behavioral changes towards other dogs were found in 14 dogs after surgery. The behavioral changes observed were:

• aggression in 6 dogs,
• anxiety in 5 dogs,
• decrease in dominance in 2 dogs,
• no interest in other dogs in 1 dog.

There was no statistically significant association between these behavioral changes and the weight or gender of the dog or the amputated limb.

Behavioral changes occurred in 14 of the 44 dogs. Unlike humans, dogs may not recognize deformities, therefore the interactions between amputated dogs and normal dogs should not be altered.

This study could not determine the cause of these behavioral changes, but it is possible that three-legged dogs may have more difficulty defending themselves due to the change in functional status.

Behavioral changes such as increased fear, aggression and anxiety, and a decrease in dominance over other dogs suggest that such animals may be lower in the hierarchy.

Reaction of family and friends to amputation

The response of respondents 'families to amputation at the time of the interview was positive in 35 cases, and their friends' response was positive in 22 cases. Two family reactions to amputation were negative, and nine were negative for friends.

• When walking the dog, none of the family reactions, but 8 responses from social contact, were extremely negative.
• There was a significant relationship between the family's response and speed of adaptation, and the dog's behavior towards other dogs.
• The owners' expectations regarding the speed of the dog's adaptation had a significant influence on the positive reaction of the family.
• The reaction of friends is much more negative with older dogs. Owners were often asked about the cause of the amputation and accused of cruelty to the dog.

The results of this study showed that the positive reaction of the family had a significant positive effect on the speed of the dog's adaptation. Perhaps because the dogs adapted so quickly to the new situation, family members reacted positively to the amputation.

So it is possible that the owner's family reaction could be more positive if the dog recovers sooner than expected. However, the reaction of family members may only be a reflection of their attitude towards the dog - some people just react more positively than others, regardless of how quickly they adapt.

Communication between owner and veterinarians and the impact of this communication on decision making

31 amputations were performed in Utrecht and 13 in Amsterdam. All patients were referred to one of these specialist veterinary clinics by an attending veterinarian.

• Only 13 owners felt they had been well informed by the referring veterinarian, and of these only 4 felt they were well informed about the functional consequences of amputation for their dog.
• 35 owners felt they were well informed by the specialist, and 42 considered the specialist's reason for amputation was satisfactory.
• 40 owners who were well informed by a specialist replied that they would amputate another dog if needed.
• A significant difference was seen in the overall satisfaction of owners with the way they and their dog were treated by the referring physician and specialist - 28 of 37 respondents were satisfied with the referring veterinarian, compared with 41 of 44 who were satisfied with the referring doctor.

The dog owner's satisfaction with the attending veterinarian and specialist depended in part on explaining why the limb was amputated.

Overall, satisfaction with the specialist was higher than with the referring physician. The decision to amputate a limb is best made by an informed owner, and this study shows that owners were more satisfied when amputation was considered well in advance.

The question is whether the owner would make a similar decision in the future

• 37 out of 43 owners indicated that they would have made the same decision if a similar problem had arisen.
• None of the respondents regretted their decision to perform an amputation.

Cat amputation and owner assessment

A similar survey has been conducted in the UK among owners of cats that have lost a limb to help better understand how a cat is coping after losing a part of its body.

More than 230 amputated cats participated in the study, and the responses received provided information on symptoms, causes, quality of life, behavioral changes and pain observed in cats following partial or complete limb amputation.

Some of the results were as expected:

• 80% of cats are domestic short-haired cats (this corresponds to the breed distribution in Great Britain);
• Two-thirds of amputated cats were male - possibly because males travel farther than females and are therefore more prone to accidents;
• 2/3 of the cats were under 4 years old - possibly because younger cats are less experienced and therefore more vulnerable;
• The main causes of amputation were the same in both females and males:
  • trauma, such as a broken bone,
  • nerve damage,
  • damage to the skin and muscles.
• For both limbs and tails, the main causes of amputation were the same, although tail amputations were more often caused by nerve damage.
• Few of the owners have witnessed the incident that caused the cat's injuries, but in most cases it was thought to have been caused by road accidents.
• Cats lost their left leg as easily as they lost their right leg.
• Cats were twice as likely to have a hind leg amputated as a front leg. This may be due to several factors:
  • Hind limb amputation is generally believed to be more effective, so foreleg amputation may not be offered as often. The explanation for this is similar to that of dogs: the front legs have a greater load than the hind legs.
  • Cats that have a front leg injury are more likely to have chest damage, which can reduce their chances of survival.
  • It is also possible that the hind legs are also injured more often.

As you can see, young male short-haired cats were over-represented in this study. Broken bone was the most common cause of amputation, and the hind limb was almost twice as likely to be amputated as the forelimb.

• About 90% of owners believed their cats had regained their normal quality of life following amputation. Even though 10% of cats still do not achieve this, it is very encouraging. In fact, most owners are very pleased that the amputation did not significantly affect their cat's quality of life.
• In nearly all aspects of their lives, cats were no different after amputation, with the only differences observed by owners being less activity and slower walking. Some owners have reported that their cat gets tired more easily. These observations likely reflect the increased effort of only walking on three legs, but also show that most cats' quality of life appears to be excellent.
• When asked if they would have made the same decision if they knew what they know now, 94% of owners would say yes.
• Nearly 90% of the owners knew their cat had received painkiller to return home after amputation surgery. However, 36% of caregivers felt their cat still felt pain after returning home. Interestingly, the results of the survey showed that if the owner thought the cat was suffering, it took the patient over a month to recover from surgery, while cats that did not feel pain recovered much faster (within 2 weeks).

Another retrospective study in Malaysia assessed the quality of life of amputated cats based on owners' perceptions.

The clinical data of 43 cats were included in the survey conducted during the telephone interview, including symptoms, causes of limb amputation and postoperative medications.

The owners were asked questions about the cat's behavior, activity, movement, speed, play, mood, body and coat condition, appetite, care and attitude towards people and other animals.

• The most common cause of limb amputation in treated cats was osteomyelitis (58%).
• The domestic shorthair cat was the only breed to be treated.
• Limb amputation was much more common in males than in females; in non-castrated cats, and was also more common in the hind limbs compared to the forelimbs.
• The results of the study revealed that all cats showed no signs of pain at home.
• About 97% of owners reported that their cats had returned to routine activities and had a good quality of life, and 87% of respondents would recommend a limb amputation if another cat had a similar situation.

Prognosis of dog and cat amputation

Prognosis after surgery

Amputation is an irreversible procedure, so it is not done lightly.

A key factor in deciding whether to amputate is to choose the cases in which amputation is the best option. If successful, most postoperative patients do well and adjust easily to life without a missing body part.

To reduce post-operative pain and minimize the risk of neuropathic pain, it is important to use an effective painkiller before surgery.

In some cases, amputation can save lives, e.g. a patient with a complex fracture where euthanasia is the only other option, or a patient with aggressive osteosarcoma where removal of the primary tumor reduces the risk of its further spread.

The prognosis depends largely on the cause of the operation:

• When an amputation is intended to remove a tumor, the prognosis depends on the nature of the tumor.
  •  In the case of amputation as a standalone treatment for osteosarcoma, the average survival time is 3-6 months.
  • With the simultaneous use of cisplatin, this period ranged from 260 to 400 days (38-62% of patients live a year), and carboplatin on average 321 days (35% of patients survive a year).
• The prognosis for dogs treated surgically with amputation is considered very good.
  • Most dogs recover to a high level of activity and endurance. After a four-week recovery period, there are no recommended lifestyle restrictions.
  • After forelimb amputation, gait should be significantly corrected, so if your pet is older, it may take more time to learn how to navigate the procedure.
  • If inflammation or degeneration of the joints is present in the other limbs, the pet's movement may be difficult and painful.
• Although amputation is a radical operation, mortality and morbidity are low.

Summary

Animal leg amputation is one of the most drastic decisions an owner can make and, therefore, one of the treatment options he rejects most. Caregivers view this procedure as too extreme and are concerned that the animal will not adapt to only walking on three legs.

However, the truth is that dogs and cats can function exceptionally well after amputation. In fact, most of them are just as mobile after surgery as before, especially if the animal suffered from prolonged pain and discomfort.

In many cases, amputation of the affected limb provides immediate pain relief as post-operative pain pales in comparison to cancerous or traumatic pain.

There is, of course, a period of adjustment - amputees must recover, and it can take days or even weeks to learn to walk and balance.

Very often the diseased limb was non-functional for some time and the animals had to adapt to using only three legs. In such cases, it can be quite easy to switch from four legs to three.

Unfortunately - some patients (especially obese, giant breed dogs, or animals that have problems with the functioning of other limbs) may find it much more difficult to adapt and may not be suitable candidates for amputation. In these cases, pain control, rehabilitation, adapted environments, and ultimately humane euthanasia are sometimes the only options.

Experience shows that the biggest problem with the concept of amputation lies in the owner's head. We often think about how we would react if we lost an arm or a leg.

However, animals don't think that way. They just want to feel free and live without pain and suffering. Dogs and cats do not experience the same psychological problems associated with amputation as humans.

After a short adaptation period, most of them are doing really well.

So maybe it is worth to tame our emotions for a moment and listen to what the doctor wants to tell us? It does not oblige us to anything yet, but in fact it broadens our horizons and gives us room for any deliberations.

The help from support groups for owners of amputees is also invaluable. These people have experienced your pain and know exactly what you are afraid of. Talk to them, make inquiries, search for information, but under no circumstances compare your animal with a human. It won't work here.

Sources used >>