Luna, a happy ending despite an agonizing decision to amputate

Luna, an 11 year old shepherd mix, had a large mass (larger than a golf ball) between her toes in the left front leg.

WARNING – WHAT FOLLOWS IS GRAPHIC – YOU HAVE BEEN WARNED.

Actually, the mass got much smaller suddenly, after she literally chewed up half of it. That left a large open wound, which got infected, and caused a horrible smell.

Luna was limping because of the severe pain this mass caused.

Her family vet did a needle test (“fine needle aspirate”), which came back normal or as we say “inconclusive”. So there was nothing to worry about right? It was likely a benign mass after all.

Amputation was mentioned, but Luna’s loving owner could not accept the idea. She thought it was a horrible idea and Luna would be miserable. She found me through my website, reached out to me, and we had a little heart to heart. I explained my concern that this was not a benign mass at all, and that amputation was the only reasonable option.

After agonizing over this difficult decision, Luna’s owner eventually agreed to do the right thing for her beloved dog and scheduled the amputation.

But first, we needed to take chest X-rays, because the cancer I suspected typically spreads quickly to the lungs. Fortunately, no spreading was visible at that point.

 

We performed the amputation (let’s call it day 1) and surgery went smoothly. Luna went home that night – walking. Below is a summary of what happened after surgery, to give you a feel for the emotional roller-coaster Luna’s owner went through.

Day 1: surgery was performed. Luna went home and had a rough first night. Of course, Luna’s owner questioned her decision.

Day 2: I recommended adding a third pain medication.

Day 3: One of my nurses called to check in. Luna felt much better already.

Day 5: Luna’s owner wrote: “Hi Dr. Zeltzman, she seems to be doing great so far. She’s acting more like herself each day. She’s just sad she can’t get on the couch or bed.”

Day 6: The biopsy results came back. The news was not good. As expected, the mass was indeed cancerous. It’s called malignant melanoma.

In spite of the bad news, Luna’s owner was relieved that her dog was finally out of pain. She wrote: “Thanks again. We can’t thank you enough for the amazing work you did to her!”

Day 28: Four weeks after surgery, Luna’s owner wrote: “Hi Dr Zeltzman. Just wanted to thank you again for the wonderful care you gave to Luna. She is doing wonderful and living a happy pain free life. I wanted to share a picture of her because she looks so beautiful and happy!”

So what is the purpose of this blog? I’m not sharing this story to brag. And I am not here to try to convince you that amputation is a wonderful thing and a walk in the park (no pun intended) .

What I would like pet lovers to believe is that when we recommend sacrificing a leg, it’s never for fun. It’s always to help a cat or a dog feel better, once the source of the pain is removed.

The biggest obstacle is most often in the pet owner’s mind. They are often terrified that amputation is cruel. I suspect that, subconsciously, they think of themselves as an amputee, walking on one leg. Well, remember, pets walk on 3 legs after amputation and they adapt very well. And typically, they start walking a few hours after surgery!

Pets don’t even know they’re missing a leg, all they know if that they don’t feel the pain anymore.

In Luna’s owner’s own words: “She is doing wonderful and living a happy pain free life.”

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified

Lucy becomes an amputee

Lucy, a sweet 6 year old Golden, started limping in her left back leg.

Her family vet’s X-rays showed that something, most likely bone cancer, was eating her thigh bone away (femur). The blue arrow shows normal bone; the red arrow shows bone that has been either eaten away or that has created a mass.

There weren’t a whole lot of options: the best course of action was to sacrifice the leg. Before that, we ensured that her blood work was normal and that chest X-rays did not show any spreading of the (presumed) cancer to the lungs.

A few days later, I traveled to the practice to perform the amputation. Everything went well in surgery.

The very next day, Lucy started to walk around on 3 legs. She was comfortable and started to eat nicely.

A week later, the biopsy confirmed the suspicion of bone cancer (osteosarcoma). The next step was to discuss chemotherapy, which is recommended in the case of bone cancer.

With amputation alone for confirmed osteosarcoma, the average survival is 3 to 6 months. With amputation and chemotherapy, we hope for an average survival of at least one year. When we recommend treatment, our goal is more about quality of life than quantity of life (aka survival time).

Amputation is typically needed because of severe trauma or cancer – most often bone cancer. No pet owner ever opens a bottle of champagne when their pet needs a leg amputation. Yet it’s very important to understand and believe that virtually 100% of dogs and cats do great on 3 legs. My most surprising patient, Gator, was able to swim in the pool with 3 legs (and a life jacket).

To this day, I have never met a client who has told me that they regretted their decision to amputate their pet.  As long as we are on the same page, and we all decide as the pet’s best advocates, we typically get good results, regardless of the amount of time left.

In other words, we would rather have 3, 6 or 12 months of quality life, than 3 years of misery.

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified

Why you shouldn’t be afraid of a leg amputation

Lucy, a sweet 6 year old Golden, started limping in her left back leg. Her family vet’s X-rays showed that something, most likely bone cancer, was eating her thigh bone (femur) away (see red arrows).

 

 

 

 

 

 

 

 

There weren’t a whole lot of options: the best course of action was to sacrifice the leg. Before that, we ensured that her blood work was normal and that chest X-rays did not show any spreading of the (presumed) cancer to the lungs.

A few days later, I traveled to the practice to perform the amputation. Everything went well in surgery.

The very next day, Lucy started to walk around on 3 legs. She was comfortable and started to eat nicely.

A week later, the biopsy confirmed the suspicion of bone cancer (osteosarcoma). The next step was to discuss chemotherapy, which is recommended in the case of bone cancer.

With amputation alone for confirmed osteosarcoma, the average survival is 3 to 6 months. With amputation and chemotherapy, we hope for an average survival of at least one year. When we recommend treatment, our goal is more about quality of life than quantity of life (aka survival time).

Amputation is typically needed because of severe trauma or cancer – most often bone cancer. No pet owner ever opens a bottle of champagne when their pet needs a leg amputation. Yet it’s very important to understand and believe that virtually 100% of dogs and all cats do great on 3 legs. My most surprising patient, Gator, was able to swim in the pool with 3 legs (and a life jacket).

To this day, I have never met a client who has told me that they regretted their decision to amputate their pet.  As long as we are on the same page, and we all decide as the pet’s advocate, we typically get good results, regardless of the amount of time left.

In other words, we would rather have 3, 6 or 12 months of quality life, than 3 years of misery.