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- [Sue] Today, guys, I wanna talk about amputation in dogs.
There's so much fear, and honestly misconceptions,
about how their dog will do.
Where you're just told that maybe you have to remove
your dog's leg, and you're thinking,
are you kidding me, doc?
This is what you need to know.
The majority of dogs do well,
and I'm gonna break it down for you in this new video.
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So one of the reasons I wanna do this video on amputation
is as a cancer specialist, we're recommending amputation
for dogs with osteosarcoma, which is the most common
primary bone cancer that we see in dogs.
I lecture all over the country to veterinary professionals,
and when I do this lecture on osteosarcoma,
I end up spending so much time on the amputation,
because I listen to what pet-owners have told me
about how difficult the decision is, and how agonizing.
And I have had owners that didn't want to do amputation,
and told me they would euthanize their dogs
rather than amputate, and then we did things
like radiation instead of amputation.
Five or nine months later, they went ahead
and did amputation, and I was shocked,
because I really thought when the leg broke
in both of these cases, that I'd walk in the room,
and the owners were gonna euthanize the dog.
And they're like, no, we'll do amputation,
and they were so happy that they did.
During my residency, when I was being trained,
we would just go in the room and recommend amputation,
and I don't think I really appreciated
until years of being in practice, and talking to pet-owners,
and listening to them, how difficult the decision is.
(inspirational music)
- [Female Vet] This way, Minkus, this way!
Come on buddy, come on!
Minkus, come on, this way, this way,
come on, let's go.
- [Sue] So dogs that we're seeing osteosarcoma
are usually seven to nine years of age,
they're usually large and giant breed dogs,
so those are the dogs that are at risk for osteosarcoma.
These are dogs that you would think,
oh, you can't remove a leg, but often we can.
And often, most of these dogs have preexisting arthritis
'cause they're of middle to older age.
I've had dogs where they have to have one hind leg removed,
and the leg that's going to remain has had a torn cruciate,
and has been repaired with a TPLO,
and our surgeon will do an evaluation, and it will be okay.
Not every dog is gonna be a candidate,
but most dogs that many owners,
and even general practitioners often think
are not going to be candidates, often will get cleared,
and can be candidates for amputation.
If you're watching this video, you're probably thinking
about doing amputation, and you're wondering,
do we need to do any other diagnostics, yes we do.
Briefly, you're always gonna wanna do full blood work,
so a CBC, a chemistry panel, one of the things
that we're looking for that you're gonna ask
your veterinarian, or your oncologist, or your surgeon about
is the alk phos elevated, or the ALP,
that is a predictive test, we always run a baseline urine,
and you definitely wanna do some sort of imaging
of the lungs to make sure that there is no spread
to the lungs before you remove the leg.
So typically, that's gonna be three-view chest radiographs,
potentially you could do a CT scan as well,
but in practice, most of the cases
we're doing three-view chest radiographs or x-rays.
The other thing that you would potentially do
is have your vet aspirate the draining lymph node.
The other thing about amputation is
it is not a curative procedure,
because for osteosarcoma, there's such a high spread rate.
And that's usually where I get involved in these cases,
after amputation, typically about 10 to 14 days
after that incision is nice and healed,
we're gonna start chemotherapy.
And I'll be honest, guys, chemotherapy in some ways
is the easiest part of this whole osteosarcoma process,
in the sense that getting through the amputation
is often the most difficult part
for the family to get through.
One of the things that I think is really important
is to be prepared...
That your dog's gonna have a really big shave job
on the day that they come home from surgery.
So for the front leg, when they're removing,
they're removing at the scapula,
so your dog's chest is gonna be shaved, very big shave job.
And a lot of owners don't wanna see
those very large incisions, so usually what I recommend
to clients is to bring an old t-shirt,
and we'll put that t-shirt on,
so you don't have to see the incision.
We are gonna ask you to check the incision daily
for redness and discharge, and things like that,
but sometimes it's nice, a t-shirt can be a good thing.
So ask your vet or your surgeon
if you can bring a t-shirt and cover it up.
The other great resource for three-legged dogs,
so three legs is often called a tripod,
so there's a great site called Tripawds,
T-R-I-P-A-W-D-S, and we'll throw a link below in the video.
And this is a great community of three-legged pet-owners,
dogs and cats, and not all of them have had cancer.
Sometimes we'll have dogs that have had trauma,
like hit by a car, but it is really just a great resource.
Owners can really share their experiences,
so don't take it from me, but talk to pet-owners as well.
And the other thing is you're on YouTube, guys,
and we're gonna include videos here,
but you'll see other videos of three-legged dogs
still doing all the things that they do.
So I've had dogs when I was in upstate New York
that are still sheep-herding, and dogs that can still swim,
and still go on walks, and still have
a great quality of life.
There still will be a recovery period,
and there still will be an adaptation period for your dogs.
But one of the things that continually impresses me
about dogs and cats, being a veterinarian all these years,
is how well they recover, and their resilience.
Like this dog Jerry, overnight he's standing
with his bandage wrap, ready to go.
I was actually out of town, and my intern
is Dr. Keith Sobel, sent a video and he said,
here's Jerry, you're gonna see him in two weeks
when he starts chemotherapy,
but his tail was banging so much in ICU
that he was waking up all the other animals,
so they moved him over into the doctor's office.
But here he is the day after surgery standing,
happy Labrador, and just really, really doing well.
Will your dog be on pain medications?
Absolutely, and that's why they're gonna spend
at least one night in the hospital.
I'm not gonna minimize that this is a painful procedure,
that's why they're gonna be in the hospital.
We're gonna be proactive with pain.
We wanna prevent pain, we wanna get on top of their pain,
and they're gonna go home on pain medications as well.
One of the other things that I often will have,
and you can ask your veterinarian or your surgeon,
do they have someone that you can specifically talk to.
So I have Bella, who's an owner of mine, and we still
are in touch, and she will talk to other owners who are...
'Cause she knows the struggle.
She didn't wanna amputate, so we did stereotactic radiation,
and the tumor ended up growing back, and nine months later,
she finally made the decision to amputate Bella.
And years later, Bella's mom will still get on the phone,
Joanne, and talk to owners, and help them through that.
And she looks back and said, gosh, Bella did so well,
Bella lived four-and-a-half years later.
So I told you that I'm really comfortable recommending it,
and that's years of seeing patients do really, really well,
and owners coming back to me saying, I'm really happy
I did it, my dog's quality of life is really great.
Also there's a really good study that came out in 2015
that looked at 64 dogs that had amputation,
and they wanted to know what the owner satisfaction was.
The results of this study are really, really great.
So 91% of owners of 64 dogs said there was no change
in their dog's attitude after amputation.
88% said their dogs had complete or near complete return
to pre-surgery, pre-amputation quality of life.
Almost 90%, guys, that's how satisfied these owners were.
78% said the recovery or the adaptation
was better than expected, 73% of the pet owners said
that there was no change in the recreational activities.
So these dogs were still able to swim,
go on walks, go on hikes and do things.
Like I said, I've had dogs that still sheep-herded.
Herd sheep? Sheep-herded, whatever.
But they were still able to herd sheep,
so that was a border collie when I was in upstate New York,
so that's really exciting.
Dogs that are more overweight,
they are not gonna do as well, potentially,
with an amputation, because again,
there's more weight to redistribute onto those three legs,
that really makes sense, right?
So if you have an overweight dog, they may have more issues
than if you have a nice, lean dog.
Which is another good reason why it's important
to have a lean dog, because studies show
that having leaner dogs live longer.
There's a great study that I always talk about of Labradors,
so lean Labradors live two years longer.
Think about that in people years,
that's like 10, 14 years longer.
Okay, last thing that came out of this 2015 study,
would owners do it again.
86% said they would do it again.
And the owners say to me, oh my goodness,
I'm so happy with my dog's quality of life.
But the point of this video is so many dogs are told
that they're not amputation candidates,
and then they actually are candidates.
Another dog that I wanna tell you about
is another Bella, and she was told,
because she was a Great Dane,
that she was not a candidate for surgery.
You know what, she was.
Her tumor when I met, and we're showing you pictures,
was huge, but she actually was a candidate.
Just because your dog is a Great Dane, or a certain breed,
does not mean that they are not a candidate.
This dog was maxed out on her pain medications,
and she was non-weight-bearing when she came in.
She was not putting weight on her leg.
She was already telling me and her family,
I'm gonna be okay as a three-legged dog.
So if you've been told your dog isn't,
let's get a second opinion.
See a cancer specialist, see a surgeon.
If you have watched this, and now it's time
to find a cancer specialist, we'll put a link there,
so vetspecialist.com is a great place
to find a veterinary cancer specialist.
For osteosarcoma, just so you know,
you do need chemotherapy to delay the spread,
because it's not going to...
Amputation is to remove the source of pain,
but it is a cancer that spreads.
There are some cancers that amputation will be curative,
like a low-grade cartilage cancer called chondrosarcoma,
but for osteosarcoma, usually the amputation's
the first step, and then you see me, and they get chemo,
and 80% of dogs have no side effects with chemo,
and they do super fantastic,
and now there's this cool immunotherapy.
So we're gonna have some new osteosarcoma videos coming out
in the next couple of weeks if you're watching this
when this is first published,
but I have tons of videos with osteosarcoma,
so check out the bone cancer osteosarcoma playlist.
Please like, please comment, and don't forget to subscribe.
Thank you so much, guys, kick cancer's butt.
I hope this was helpful, and I'll see you all soon.
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