Amputation In Cats and Dogs - Lap Of Love

 AMPUTATION

  

Amputation...It's a word that fills most of us with a sense of horror.  We immediately think of ourselves missing an arm, a hand, a leg, or an eye.  We've watched the drama on television when someone wakes up minus a body part and starts screaming.   We think of people learning to walk again and are saddened by their ordeal.

I'm a little different.  When I hear the word "amputation" I smile.  I remember Trois Jambes (also called Jambie or Mr.  Moo), the tiny kitten whose life was saved by an amputation and who hopped his way into my family's hearts. 

Not long after I graduated from veterinary school, a Good Samaritan brought in a tiny black and white kitten who had been hit by a car.  They gave the receptionist $20 and asked if we could put him to sleep.  My boss, a gruff but kind man, told me he wouldn't mind at all if I worked to save the kitten.  It would be good practice.  The little guy's rear leg was shattered and infected.  He was in shock.  We decided to amputate.  It was my first amputation surgery, and I was scared to death that he would die (that was actually highly likely considering the condition he was in).  

 

He survived the surgery, and I took him home to watch him overnight.  My parents caught sight of him and fell instantly in love.  He lived with us until he passed away at the age of 3 from bladder issues brought on by the accident.  

Mr. Moo was an acrobat.  He would do "floor exercises" running at top speed to each corner of our large area rug.  During the Olympics, we would laugh and say he was a gymnast.  The only time you could tell he had a missing leg was when he walked.  He looked so pitiful hopping along.  And then he'd take off running and scale a piece of furniture like he had six legs instead of three.  Jambie taught me that missing a leg didn't make him feel awkward or embarrassed.  He could still turn into an octopus if we tried to give him a pill.  He didn't mourn over his loss.  He lived his life just as he pleased with almost no limitations.  

Years later, I found myself doing shelter work, and often the difference between life or death for a pet was an amputation.  We couldn't always afford to send injured animals to a specialist for surgery.  And some were injured so badly that the only option was an amputation.  I was always amazed at how quickly they would recover.  Most had not been using the injured leg anyway, so they only had to realize there was no more pain.   I had trouble getting them to comply with cage rest - they wanted to run and play as soon as they felt better (which was usually within a day or two).   I saw many cats with severely injured eyes who were purring and rubbing their cheeks on my hands hours after surgery.  

Amputation is an excellent treatment option for many diseases.  It isn't anything to be afraid of.  Your pet only wants to be free of pain and spend more time with you.  If your vet recommends amputation, please give it full consideration.  It may take a little getting used to for both of you - but if it gives you and your pet more quality time together then it's worth it!  

Read Dr. B's Blog about Nikki: http://lapoflove.blogspot.com/2011/10/dr-cherie-buisson-and-story-of-nikki.html

Dr. Mary Gardner's 2 cents:  Two years ago I found a cat in the islands while I was on vacation.  Her name is Mingo (we found her by a FlaMINGO pond). She was missing a back foot - we don't know how or why but you can tell it was present at birth and somehow was lost. Locals told us that many birds of prey will pick up kittens and maybe her foot came off in the clutches of a bird. Who knows.  

 

But I will tell you that Mingo could care less about having a peg leg.  I tried my best to take a full body shot of her so you can see it - but she is too wiggly!   She runs faster than all my other cats and even jumps up on all the counters!  She does try to scratch her ear with the foot and all she does is scratch the air. It's so funny.  The point is I have had many clients that have had a cat/dog that needed even a toe or a foot amputated and they were resistant about it.  Pets really have an amazing feature of simply not caring about amputation!  

Dr. Mary Gardner

Posted by:

Dr. Cherie Buisson 
(Click here for Dr. B's full bio)

drb@lapoflove.com

Dr. Buisson services all towns in and around Pinellas County including St. Petersburg, Pinellas Park, Seminole, Largo, Clearwater, Dunedin, Palm Harbor, and the beaches.

Please explore our website www.lapoflove.com or contact your local Lap of Love veterinarian to ask any questions you may have about hospice and euthanasia.

Click the states below for a list of veterinarians near you:
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Feline Hyperthyroidism Cherie Buisson

What's The Skinny on Feline Hyperthyroidism?

Hyperthyroidism is a fairly common disease in older cats.  It occurs when a (usually) benign tumor forms on one or both thyroid glands in the neck region.  These tumors cause the gland to produce much more thyroid hormone than is necessary.  The bad news about hyperthyroidism is that it can be very dangerous - spikes in blood pressure and heart problems caused by too much hormone can be fatal.  The good news is, hyperthyroidism is treatable!  And if it is treated properly, it doesn't shorten your cat's life.

Symptoms of hyperthyroidism can include: weight loss, ravenous appetite (although I have seen many cats lose their appetite due to nausea), nausea, vomiting, diarrhea, fever, excessive vocalization (howling), restlessness, behavior changes, blindness (associated with high blood pressure and retinal detachment), and poor coat quality.  Sometimes the increase in appetite can be amazing - I've had patients get caught jumping INTO AN OVEN to steal food or stealing things like vegetables from babies sitting on the floor!  These poor cats are typically hungry all the time and lose significant amounts of weight.

Hyperthyroidism (or HT4) can be diagnosed with simple blood tests.  A total thyroid hormone (T4) test is the screening test used.  If the thyroid hormone is in the normal range but above a certain level, another test called a Free T4 is recommended to confirm hyperthyroidism.  I have a sibling pair of 13 year old cats that I diagnosed with HT4 within the same year.  My boy, Sinner, had a T4 level of 8.3 (normal is up to 4.0 at our lab).  His sister, Saint, had a T4 level of 2.7 (above 2.5 is a concern in older cats), so I ran a Free T4.  Sure enough, it was elevated.  Both are receiving treatment and doing well.

There is an exciting new treatment for HT4.  Hills recently released Prescription Diet y/d.  This is a diet that is low in iodine.  The thyroid gland requires iodine to produce thyroid hormone.  Hills has had spectacular results with cats who eat this diet exclusively.  Unfortunately, my two mischievous monkeys found ways to steal their housemates' food, so it wasn't an option for us.  http://www.hillsvet.com/pd-feline-yd-dry.pdf

Methimazole is a drug that treats hyperthyroidism.  It is required every day to keep thyroid levels normal.  Frequent bloodwork is needed to make sure the drug isn't causing bone marrow problems and is controlling the thyroid.  This is the option I chose for my two cats.  They each take methimazole twice daily in Pill Pockets Duck flavored treats  http://www.greenies.com/en_US/Products/felinepillpockets.aspx.  Methimazole can also be made into a liquid, treat, or even a gel that you rub on the cat's ear (for those naughty beastables who don't take oral medication well). 

If it is available in your area, radiation therapy is an excellent option for HT4.  I131 therapy is offered at many specialty practices.  Your kitty will need to stay in the hospital for a few days after the treatment.  This is curative for HT4 in the majority of cases.

Surgery is another option for HT4.  The affected thyroid gland is removed.  However, it is important to note that if only one gland is removed, the other often begins producing too much thyroid hormone within a year.  Another risk is that the parathyroid gland (responsible for calcium regulation) sits on top of the thyroid glands.  The surgeon must be careful not to damage or accidentally remove these glands.  If both thyroid glands are removed, then your cat will need to be on a supplement for life.

HT4 can be dangerous, but with regular screening it is easy to catch early and treat. It is one of those diseases that makes taking your older cat to the vet once or twice yearly well worth it.  In feline practice, we recommend a full  bloodwork screening yearly and a mid-year examination  with weight check.  If your kitty's weight has dropped unexpectedly, bloodwork for thyroid problems is recommended.  Cats 7 years of age and older are at risk for HT4.  And your kitty doesn't have to be skinny to have a problem.....even fat cats can lose dramatic amounts of weight and still appear hefty.  If your cat is 7 or older and hasn't been to the vet in awhile, please take them in and have them screened.  You could ensure a longer, happier life for them!

Photos:  Sinner and Saint sporting their summer cuts!  

Posted by:

Dr. Cherie Buisson  (Click here for Dr. B's full bio)

drb@lapoflove.com

Dr. Buisson services all towns in and around Pinellas County including St. Petersburg, Pinellas Park, Seminole, Largo, Clearwater, Dunedin, Palm Harbor, and the beaches.

Please explore our website www.lapoflove.com or contact your local Lap of Love veterinarian to ask any questions you may have about hospice and euthanasia.

Click the states below for a list of veterinarians near you:
North Carolina
Florida
Tennessee

Does Euthanasia Hurt My Dog or Cat

Answering Some Common Questions About
Veterinary Euthanasia

Veterinarians are often asked “Will euthanasia or the medications used hurt my pet?”  We understand that the stress of deciding when to put your pet to sleep is overwhelming – but to add on the thought that it hurts – can really put pet owners into a state of confusion.  Dr. Cherie Buisson offers some answers.

Euthanasia is a Greek word meaning "the good death".  It is a gift that we are able to give our pets - to suffer ourselves so they can be released from suffering.  Naturally, people have a fear of euthanizing their pet and agonize over whether they are doing the right thing.  Two of the more common questions we are often asked are "will it hurt?" and "how long does it take?"

Photo Curtosy: Tampa Tribune (Dr. Dani McVety)

With Lap of Love, euthanasia is not painful and typically more peaceful than most people expect.  Why?  Because in almost all cases, we give our patients an injection of a sedative before euthanasia.  This injection is given either under the skin (like a vaccination) or in the muscle. The sedation typically does not hurt – we use teeny needles – similar to a vaccine needle.  

Before humans are given anesthesia for surgery, they are also given a sedative. And we do the same for your patients. The wonderful combination of medications we use give them a sense of relaxation and in many cases can make them unconscious (some dogs will even snore!).  

Some pets may be able to move a bit while under sedation and even have their eyes half open, but they are not aware.  It takes about half the dose of our sedation to make our patients unconscious.  It takes more to stop their body from moving without their knowledge.   (For instance, I have a friend who had anesthesia for a tooth removal.  While he was under anesthesia, he moved around and kicked one of the nurses.  He doesn't remember a thing about it.)  It is similar to when your dog cat (or even yourself) moves/twitches in their sleep.  It is just a natural reflex.

Once they are in a relaxed state, we can take our time administering the euthanasia solution. The actual administration of the solution is not painful – it does not sting or hurt.  In dogs, it is typically given in a vein and they do not feel discomfort. However, in elderly or sick patients and in cats, being able to find a good vein can be difficult.  Rather than poke and prod, the euthanasia solution may also be administered centrally (for example, into the abdomen).  This is also painless as our patient is already sedated.  

The drug used for euthanasia is an overdose of a barbiturate (a type of anesthetic) called Pentobarbital Sodium. (Many of us are asked if it is like what was used with Michael Jackson – and although not the exact drug (Proprofol) – it does work the same way).  It stops brain function – so the pet passes while they are sleeping and will not ‘know’ what is happening. 

How long does the euthanasia appointment take? The Lap of Love veterinarian is usually with you for less than an hour.  Most appointments last 30-45 minutes.  Sedation may take seconds or up to 20 minutes depending on how ill the pet is at the time.  Actual administration of euthanasia solution takes only seconds.  It can be followed by an increase in breathing, then breathing stops.  

Photo Credit - DVM News Magazine

The heart stops a few seconds to minutes later.  Our patients may hiccup, give a big stretch, have a final deep breath or make slight noises during this time.  These are all natural reflexes and is perfectly normal.  They happen with natural death as well.  If the solution is administered centrally, it may take longer.  Sometimes 15-20 minutes can pass before the heart stops completely – but the pet is sleeping the whole time and is in no discomfort or pain.  This is a great time to cuddle with your pet and tell them how much you love them.  Many owners are grateful to have a chance to hold their pet again knowing they are not in any pain.

Euthanasia is the most difficult decision we face as pet owners.  It is also the most generous – especially when your pet’s quality of life is diminished or they are suffering.  Be kind to yourself and be sure to ask questions.  This is your beloved family member, and it's good that you don't make this decision lightly.  If you truly love your pet and only want what is best for them, you will make the right decision when the time comes.  Be sure you talk with family members and your veterinarian.  No one should have to go through this alone.  We have some wonderful resources at www.lapoflove.com to help you with your decision.  And of course, our veterinarians are always willing to lend a hand/and an ear!s.

Please explore our website www.lapoflove.com or contact your local Lap of Love veterinarian to ask any questions you may have about hospice and euthanasia.

Dr. Cherie Buisson and the story of Nikki

When I woke up the morning of January 6, 2011, I had no idea that my life was about to change.....again.  There had been alot of changes in my life recently.  I had left my full-time job at SPCA Tampa Bay less than a month before to open my own business.  I was exhilarated and terrified to be self-employed for the first time.  The holidays were over, and I was trying to get back into the swing of things.  I was still working at SPCA three days a week as their relief veterinarian until they could find someone to replace me, but that day, I was doing relief work at another local shelter.  I was available by phone for the medical team at SPCA, so I assumed they simply had a question for me about a patient.  Instead, the tech sounded excited and upset.  There was a puppy that had come in with their 24-hour ambulance service.  Was there any way I could come in and tend to this puppy's mutilated ears?

I quickly made arrangements to leave the shelter early so I could get over to SPCA.  They had already administered pain medication to the puppy and would keep her as comfortable as possible until I arrived.  When I reached the shelter, the clinic was full of people.  One of the assistants disappeared into the kennel and returned with a wretched-looking puppy in her arms.  In her eyes, I saw the definition of "suffering".  She was dull-eyed and squinting, brow drawn with pain.  What was left of her ears were two rotten, dangling masses of flesh with large indentations where the rubber bands had been deliberately placed to inexpensively crop her ears.  I could smell the infection from across the room.  I examined her quickly, but I had to be thorough and document everything I saw for the animal cruelty case that was sure to come.  Every second I was keenly aware that this little baby was suffering.  Pain medication can only do so much in the face of such injury and rampant infection.

Once we had her under anesthesia, you could hear a sigh of relief from every person.  My heart rate began to drop, and I took deep breaths to release the tension.  I knew her ears had to come off.  I had seen injuries like this before.  About a year earlier, a young pup with gaping wounds where her ears had been came through our doors.  She had been healing, so surgery wasn't necessary.  I had never amputated ears before, and I was anxiously running the procedure through my mind as I gave instructions to the staff.  It didn't help that I had an audience armed with camera and video to document the entire surgery.  But these were all friends - of me, and of the little girl with the sad, sad ears.  Everyone was there because they were so worried about her.

We cleaned the surgical site as much as possible.  I removed the rubber bands, which were astonishingly small AND twisted double around each ear.  The bands were photographed with a ruler to show their size.  Up close, the ears were even worse than they had appeared.  There was very little normal tissue to be salvaged.  I just hoped there would be enough to close her wounds.

I went to work.  My only rules were that the spectators keep quiet unless they had a question.  Video had to stop immediately if I requested it.  The SPCA staff was outstanding.  They all cheered me on (very, very quietly) and helped me in any way they could.  The amputations were fairly simple.  There was just enough tissue there for me to close each wound completely.  The second ear went faster than the first, as I had learned a great deal by that time.  

When I was finished, I stayed with a hand on her little back as she woke up.  I was thinking over all that had happened and needed to happen, when I saw movement out of the corner of my eye.   Her tail was wagging.  I reached quickly to remove the tube in her throat that had helped her breathe and delivered the anesthetic.  Her eyes were trying to focus on me as her tail thumped the table.  She licked my hand, and the tears I didn't know I'd been storing up filled my eyes.  I kissed the center of her forehead and tickled her chin. 

"Nice job, girlie," I whispered to her.   As I looked at her adorable little face straight on, it dawned on me: Her ears are crooked.  A little jolt of panic shot through my chest.  I had been so worried about getting those ears off her head and being able to close the wounds that I hadn't thought to see if I gave her a matching set of new ears!  I felt terrible.  What a lousy plastic surgeon I turned out to be!  Well, I wasn't going to put her through anything else that night.  I wrapped her head in a bandage, administered more pain medication, and left - 2.5 hours after I had arrived.

Nikki was amazing!  She healed beautifully.  She held the entire staff (and anyone else who met her, news reporters included) in the palm of her paw.  She would cry pitifully, which always induced someone (or several someones) to rush to her cage.  As soon as attention was administered, she thumped her tail and played with her toys.  She stole hearts at every turn.

As the months went by, I became "the vet who fixed Nikki's ears".  I talked about her at fundraising events, on TV, and on the radio.  But nothing was as rewarding as rubbing her little ear buds and getting a kiss in return.  At the time of her spay, I thought about fixing her ears, but I just couldn't bring myself to cause her any more discomfort.  Besides, she wore her badges of honor well, despite their asymmetry.  And her new mom and dad thought she was beautiful no matter what her ears looked like.  The fact that they were healed and painless was enough.

I still see Nikki on a regular basis.  I follow her on Facebook (along with LOTS of other people), talk to her mom whenever I can, and smile as I watch her grow into a sassy adult.  This one little soul has made my life so much better.  Repairing her ears made me feel more accomplished than anything else I have done in my career.   I hope through her story that people become more aware of animal cruelty, and demand that it be stopped in their community.  When I think about the fate Nikki had in store for her: a fighting dog with no ears for an opponent to grab onto - it makes me so sad.  Because there are THOUSANDS of Nikkis out there who won't get the chance that she did.  They will fight for their lives, and eventually, they will die.  No one will kiss them as they go.  Their mangled ears and scarred bodies won't feel a gentle touch from a beloved owner.  They will die in the ring or be killed and thrown in a dumpster, because if they can't perform, they are worthless.

Congratulations to SPCA Tampa Bay for saving this life, and helping this wonderful girl find a forever family.  On October 15, I will be at the SPCA Tampa Bay 3K Petwalk at the Lap of Love Veterinary Hospice booth.  Come by and say hi.  Or, join my team and help me raise money to help more pets like Nikki get a second chance  http://3kpetwalk.kintera.org/faf/search/searchTeamPart.asp?ievent=477838&team=4254181.  SPCA does such a wonderful job and saves so many animals.  Their medical department is full of animals being rehabilitated from injuries, behavior problems, and abuse.  Their volunteers work tirelessly to socialize, exercise, and give attention to the animals already up for adoption.  If you can help them out, even a little, you could help a little fur person like Nikki get a new home and a new life.

Cherie T. Buisson, DVM

Lap of Love Veterinary Hospice andIn-Home Euthanasia

Friend of Nikki, an SPCA Rescue Dog

For More Information on Dr. B - click here