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Prepping for forelimb amputation, Tripawd style

Posted in Pre-op | 5 Comments »

When we decided to rid the world of my bad leg, we realized that we had very little time to get emotionally prepared and stock up on important essentials. All the pups and kitties in the Tripawds community have been sharing their tips and tricks for years, so I want to share the pre-op prep that we followed and now recommend. The first ones are more hefty, but I included all the basics, too.


#1: BE MORE DOG

The first thing humans think about when faced with debilitating or life-threatening diseases is the desire to undo the damage or the chance to wish it never happened. Something to do with “mortality salience”, where they apparently obsess about their fears of death. Let’s be honest with each other, though. Humans don’t have time machines or guaranteed preventative, painless, free, fast treatments for most fatal conditions. As dogs, the Tripawd community and I have a better solution: be more like us!

In January, I learned that I had cancer, and in July learned that I’d be an amputee. Yeah, that sucked, but I couldn’t be distracted by that nonsense when my schedule was already jam packed with puppy breakfast time, potties, ponies, cuddles with Mommy and Daddy, going for rides, keeping squeaky toys from Phineas, puppy dinner time, and bedtime kisses. Besides, the bad leg put a total damper on my outdoor adventures!

And sure, you may be thinking, “but Loki, your post-op prognosis is excellent! My dog won’t even be cured after this!” To that, I say… look at your dog’s itinerary. Did they establish retirement and estate plans? Or is every day just so booked with fun and love that they don’t have time to worry about the future? I bet it’s the latter. So while we need you to be the responsible adults through this undeniably serious process, we also ask you to take things as they come, embrace your time with us, and be more dog.


#2: FIND A VET YOU TRUST AND ASK THEM  EVERYTHING (EXCEPT WHAT THEY WOULD DO IN YOUR SHOES)

When we’re struggling after surgery, we’ll need your confidence that this was the right decision. Every situation is different, and only you know what’s best for us and our family. Through education about options, risks, benefits, and expected outcomes, you’ll be able to figure that out. 


#3. JOIN THE TRIPAWDS COMMUNITY.

Not only does the site well adorable clothes, but it offers a community full of resources. There’s a 24/7 phone hotline. There are grants for financial assistance. There are ebooks, videos, forums, and blogs loaded with the collective guidance and experience from professionals and families who have been there. Mommy and Daddy say they’d have been super overwhelmed without Tripawds. Plus, you can help your dog (or cat, really) start a blog of their own!


#4. GET PREPARED FOR POST-OP PAIN

Whether or not your pup is in pain before surgery, I can say firsthand that he’s gonna need some help afterward! This surgery is worth it, but man does it hurt! Prepare yourself for whining, panting, and sometimes yelping at all hours of the day. Some of this can be mitigated by trying to keep your pup as comfy as possible, but if you get into a prepared and positive mindset, you’ll be able to cope (and help us cope) with a bad moment here and there.

I highly recommend a reusable cold pack like my TheraPearls, which Mommy and Daddy can mold to my figure.  For meds, I suggest gabapentin beforehand and post-op to minimize the risk of phantom limb syndrome and to help with general surgical pain. I also take carprofen, an NSAID, which my vet wanted me to stop taking for 48 hours before surgery. Mommy and Daddy worked with the vet to figure out what I’d need and how often, which is often unique to each dog (see #2 above). We picked up some plain Tylenol and Prilosec at the vet’s recommendation, too. With time and treatment, it will all get better!


#5: GET A GRIP… LITERALLY

We really don’t need the spare leg, but we’ve all become complacent by walking around on all four. The Tripawd transformation is a bit of a shock, and your pup will need to learn how to walk again. Firm surfaces with traction make this a whole lot easier! Mommy and Daddy got me the most affordable industrial carpet runners from Home Depot, and other Tripawds have used yoga mats to line their most traveled walkways. If you already have carpets, all the better!

I already had Ruffwear’s GripTrex booties, but I know other pups have bought them just for Tripawd life. We all walk funny with them for a minute at first, but they make a huge difference in helping us keep steady outside (or where carpets aren’t an option).


#6. KEEP US COMFY AND SAFE

I suggest getting a really firm but supportive bed for your pup. Partly because we deserve it, and partly because we have a hard time moving around on really plush bedding after surgery. Many Tripawds suggest Big Barker beds, and I concur! They are a bit of an investment, but they are guaranteed to keep their 7inch foamy thickness for at least 10 years, and are cozy yet firm enough to appease fluffy bed nesters like myself. They’re even comfortable enough for you to share with your pup! Mommy and Daddy put one of my favorite thin blankets on top so I’d feel right at home (and yes, it is an NSYNC blanket, so what?), and they added a Big Barker waterproof liner in case of accidents or ooziness.

You’ll also want some sort of sling to help us move around post-op. Not all dogs totally need it, but some of us are too nervous, uncomfortable, or confused to stand up, walk, or get positioned for potties after surgery. For the long-term, a solid harness (see Ruffwear) is a good idea, but a basic sling is better while sutures or staples are still in. Many Tripawds DIY this part by cutting a canvas grocery bag to fit (http://tripawds.com/2017/01/25/diy-tripawd-dog-sling/), but if you’re handy like Daddy and want something fashionable, you can make an ultra cute sling like mine!


#7. KNOW THE INS AND OUTS (OF YOUR PUP’S GI TRACT)

A lot of us new Tripawds end up having issues eating, drinking, and going potties after surgery. Between the meds (opiates are very constipating), the pain, and just feeling off, we usually don’t jump right back into our normal routines. Mommy and Daddy got me special food, like canned versions of my kibble and broth (with no poisonous spices) to help me stay hydrated. They got canned plain pumpkin to keep me pooping, and peanut butter to make my pills taste better. They even got plain chicken and rice to help minimize the acid reflux symptoms that I get from buprenorphine.

Elevated food and water bowls help us keep our balance, too.

Inevitably, all that mushy, wet food is going to come back out! Supposedly a lot of pups have accidents after surgery, and you should be prepared for that with cleaning products, spare towels, and old blankets. I personally like going outside so much that I demanded a special area that would be easy to reach and inviting… we have foxtails, hills, and rocky ground in our yard that I didn’t want to learn how to hop on! Daddy’s working on a permanent outdoor area for me, but in the meantine this outdoor fake grass is just fine!

The other output you should prepare for is incisional drainage. I personally didn’t have much, but we prepped for the worst. Ask your vet (#2… ahem) what they expect in terms of dressing changes, if, and how, you should clean the incison. Some forelimb amputees like using adult pull-ups sop up drainage and protect the site (head and remaining leg in the leg holes, chest in the waist hole), since they’re easier to put on than new dressings. We got these ones:


I personally didn’t like them, but I didn’t like the proper dressing either. I figure maybe igt will work better for other, less picky pooches.


#8: GIVE IN TO CANINE CHIC

In the times before cancer, Daddy used to think I looked silly in clothes. Fortunately for Mommy, we learned that dog shirts can help keep dressings in place, prevent us from licking, absorb some drainage, and improve morale by letting us show off our sassy sides! Here’s a sample from my collection!

Truth be told, the shirt I’ve worn most often is my SurgiSox by DogLeggs. It’s basically a giant compression sleeve designed for forelimb amputees! You have to wait until the bad leg is gone, but I think everyone should have one on hand so that the remaining leg’s opening can be cut, and the shirt can be worn right away. These things do everything a normal shirt does, plus they’re breathable and help minimize swelling! Mommy and Daddy say that the SurgiSox have helped keep the cone of shame away! Plus, they make me look like a sleek young marathoner or something!


TL;DR? Overwhelmed? Surgery’s today and you couldn’t prepare? Remember, Mommy and Daddy got all this stuff together in less than a week! And if you really don’t have any prep time at all… follow #1, #2, and #3. A little perspective shift and education about Tripawdisation will take you so far!

Here I am on my last pre-op ride, looking ahead to a brighter future!

Keep on smiling and f**k cancer

Posted in Diagnosis, Pre-op | 1 Comment »

Okay, so everyone has their flaws, right? Some dogs eat poop, some chew furniture, some chase cats… well, I’m a diehard paw licker.  Always have been. So when my front right leg started to hurt really bad, I couldn’t figure out what to do about it, so I just started licking… and then, since I was licking the bad paw (couldn’t reach the ouchy spot), I started licking the other legs! It made sense at the time, I swear. Pretty quickly, my paws were all red and I was limping worse than ever before. I couldn’t even go for walks on soft dirt without my booties.

Mommy and Daddy were really concerned, so they brought me to the vet. She thought that maybe my allergies were to blame, but after a few weeks of various treatments, everyone decided they weren’t. She also thought I was maybe just out of shape, so I spent a few months in puppy PT.

Next trip, we found out that my vet was moving away, and I started to see a new doctor. He listened when Daddy said that I seemed to be licking and limping on the right front paw more than the others. The xray he took came out negative, so he suspected I had strained the paw and gave me carprofen. That helped, but not completely. Winter came and went, and I tried to put on a happy face.

When my old lady sister, Roxbury, went to the vet in January, 2017, I went along for the ride because Mommy and Daddy didn’t feel quite right about my visible discomfort and weird behavior. By then, I was antsy and unenthusiastic about life, and had started gnawing on the bad paw… it really hurt, and I was depressed nobody seemed to have a better solution!

A full assessment of the paw, including aspiration for cytology, all came back negative. We all agreed that something was wrong, but nobody knew what. The vet thought maybe I had been having anxiety about my crazy little brother, who Mommy and Daddy rescued against my better judgment around the same time my leg started hurting. The vet agreed to another xray anyway, just to be certain. After all, Phineas is insane but I tolerate him pretty darned well.

As it turned out, the xray was negative again, BUT while the vet tech was in the back room with me, he couldn’t help getting investigative. He pushed all over my paw, and then started to push on my leg. Suddenly, he pushed on the bad spot and I screamed! Not only did it hurt horribly, but he finally understood! We rushed back to Mommy, Daddy, and the vet to show them for sure that I wasn’t stressed about my brother after all (annoying as he is!). The vet did cytology on the bad spot, and soon enough he returned to announce that I had CANCER! We were all shocked! Within days, I went for a biopsy. During surgery, the vet was able to remove a 2.5″ tumor that had been hiding, wrapped around my medial nerve near the carpal joint. He felt hopeful, but was also guarded about my options until pathology results came back. I was just happy to get a little reprieve from the pain.

In the meantime, Mommy met Amber, a Tripawd Hero who visits her job as a therapy dog. Amber and her mom introduced us to Tripawds and told us that, if I did need amputation, I’d still have a great chance for a great quality of life. Yay Tripawds!

A few days later, we learned that good margins of resection and a diagnosis of a grade 2 hemangiopericytoma led our vet to believe that additional treatment didn’t seem necessary. We all hoped for a surgical cure, but after surgery I continued to lick, gnaw, and limp due to surgery-related neuropathy that didn’t seem very responsive to medication.

Repeat cytology in April showed no cancer cells, so we were forced to accept that I’d probably be that way forever. Amputation due to neuropathy wasn’t an option, although I gladly would have given the bad leg away! We were all begrudgingly starting to adjust to our new normal when, on July 1st, the old pain started up along with a visible lump right under my carpal pad. When Mommy walked by, I held up my leg to show her. She took my paw in her hand and asked, “what are you trying to tell me?” She started to massage my leg, and then she noticed the lump (as seen below in this not well posed picture). Distressed, Mommy and Daddy got me an appointment with the vet as quickly as possible.

The morning of July 3rd, cytology found the same cancer cells as before, indicating that the hemangiopericytoma had returned. Given that this type of soft tissue sarcoma generally recurs more entrenched and locally aggressive, Mommy and Daddy were hesitant to attempt another resection without chemo and/or radiation. They were wondering if maybe I would be better off without the stupid bad leg after all. I mean, look, I didn’t even use it!

The vet referred us to an excellent radiation oncologist for more info, and he called Mommy and Daddy that same afternoon. The oncologist expressed similar concerns, worrying about the additional neuropathy or functional loss a necessary pre-treatment debulking could cause. He also felt that, given one recurrence, even if I endured the debulking, 14-16 sessions of radiation, and maybe chemo, the cancer could still return. In his words, “if a radiation oncologist is recommending no radiation, that should say something”. He also said that, given the location and type of cancer I had, an amputation would offer a 95% chance of cure. So all that said, my mommy and daddy scheduled me for July 10th to finally cut the bad leg off once and for all!

To quote Climbers Against Cancer’s founding badass, John Ellison, “Keep on smiling [and] fuck cancer.” …tripawd life has got to be better than this, right?

Loki's Tripawd Journey is brought to you by Tripawds.
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