There are numerous reasons why owners may be presented with the difficult decision of having to amputate their dog’s or cat’s leg. Such cases may include:
- Bone cancer particularly osteosarcoma
- Other types of cancer affecting the bones/joints/soft tissues of the leg that can not be managed in any other
- Trauma of the limb that makes repair impossible. This may include severe bone fractures (although with advances in orthopaedic surgery these are fairly rare now), severe soft tissue injuries resulting in irreversible damage to muscles and/or blood supply and nerve damage resulting in the limb becoming totally non functional
- Intractably painful limbs due to other conditions such as infections and severe arthritis
In dogs, the commonest reason amputation is carried out is for treatment of osteosarcoma. In cats, it is due to severe limb trauma usually following a road traffic accident. In this article, I will concentrate on dogs. Osteosarcoma is a very aggressive form of bone cancer that presents with severe progressive lameness. Sometimes, affected dogs present with a fractured leg that occurs because the bone has been weakened by the cancer and just doing something normal like getting up can result in the bone breaking. This is called a pathological fracture. Larger breeds of dog are most commonly affected with osteosarcoma with Greyhounds, Rottweilers, Great Danes and Irish Wolfhounds particularly commonly affected. The average survival time for a dog with osteosarcoma is 6 months with surgery alone and 12 months with amputation and follow up chemotherapy. You do not cure dogs with osteosarcoma by amputation because by the time the cancer becomes apparent in the bone, it has already spread elsewhere in the body. The big advantage of amputation is that it is the most effective way of eliminating the pain associated with osteosarcoma. Amputation and follow up chemotherapy is still the most common treatment option that is undertaken. More advanced limb salvage procedures are carried out in some specialist centres and now there are pioneering procedures using prosthetic limbs in dogs. It is unclear whether these offer any real advantages over amputation and each case needs to be considered on an individual basis. The decision to amputate a dog’s leg who is suffering from bone cancer poses an owner a whole host of dilemmas:
- Do I put my dog through such a big operation? Will they cope on three legs?
- Is it reasonable to put my dog through such a big operation when survival time can be relatively very short?
- What are the risks of the operation?
- How long will it take my dog to be back to normal after surgery?
Most of these questions are difficult to answer and the decisions made by owners depend on the advice offered by their veterinary team and their personal beliefs. However there are some generalities that we can consider:
- Although a major operation, amputation of limbs in dogs is a relatively simple surgical procedure. There are risks of serious haemorrhage but a suitably experienced surgeon should be able to avoid this. The general anaesthetic risks depend on each individual case but provided there is no pre-existing diseases such as heart and lung disease, these risks are usually fairly low
- I have never seen a dog not cope on three legs that I have operated on. An eminent orthopaedic surgeon once said that dogs are born with 3 legs and a spare! Each case must be judged on an individual basis and if there are serious pre-existing diseases affected the other legs then amputation may not be suitable. But provided the other 3 legs are sound, dogs will cope. I have even amputated a limb from significantly obese dogs. They have required intensive post op care, rehabilitation and dietary control but have all done well.
- Dogs do not have the emotional issues that human amputees endure. I can only imagine how incredibly hard it must be for people to deal with loosing a limb but for dogs this does not exist.
Despite all the above, it is a difficult and emotional decision for owners to make. We hope therefore that this support group can help.