There are a number of reasons which may necessitate the removal of an animal’s leg. The two most common of these are severe trauma, for example after a road traffic accident, or as management of a leg cancer. As a general rule, dogs cope far better with amputation than people imagine they will. Humans of course only have two legs, so losing one leg means a reduction to only one. Dogs have four legs so losing one still leaves them with three.
Owners often assume that dogs experience the same emotions as we do, this may not be true. However, we do know that dogs are supremely good at adapting to new situations. Vets with the most experience of managing dogs who have undergone amputation consistently report that these animals do not show any signs of an emotional disturbance. Most dogs that have a leg amputated do so for relief of a severe, often life-threatening, illness. Almost invariably these patients have an extremely painful condition affecting the leg that is to be removed. In many cases the patient is immediately happier and more relaxed after amputation.
It is extraordinary how quickly most animals become mobile after amputation of a leg. Patients that have no other mobility issues, for example osteoarthritis, should be able to go for a lead walk within 24 hours of the operation. Young dogs, dogs of slim build and dogs with a weeks-long history of lameness affecting the amputated limb can be expected to start walking on three legs after only 12 hours.
Following amputation dogs will usually stay in the hospital for a few days after surgery. The veterinary team will need to examine the patient regularly to ensure the wound is healing properly and to provide appropriate pain relief. During this time the patient will make their early adjustments to being three-legged. Within three days of surgery most dogs would be able to jog for 5-10 metres.
For two weeks after surgery the dog’s exercise will need to be significantly restricted to allow the surgical wound to heal. During this time, patients should be allowed to potter about a garden or have lead exercise for a maximum of 5-10 minutes at a time for toilet purposes. The dog will begin to adjust and to train their muscles for moving in a different way.
Once your dog returns home after amputation they will have a large shaved area with a line, or lines of stitches or staples where the operation was performed. Often there is substantial bruising under the skin where blood may have trickled during surgery. This is not painful, like a normal bruise.
Surgery of course would be painful if appropriate pain-relief was not administered. Your vet will probably prescribe strong pain-killers, such as morphine, in combination with non-steroidal anti-inflammatory pain-killers. These drugs will normally be given before surgery to stop pain developing and then are continued after surgery. Typically the strong pain-killer is given for one to three days while the non-steroidal anti-inflammatory pain-killer is given for one to two weeks and therefore is continued at home once the patient has been discharged from the hospital. In some institutions additional pain relief is also provided using a local anaesthetic in the surgery site before surgery and for one to three days afterwards. This adds even further to the comfort for the patient.
Patients whose pain relief strategy is well thought-out and well-managed are very comfortable throughout.
Phantom limb pain is a debilitating condition affecting some human amputees. They experience an extremely uncomfortable pain, which their brain tells them affects the leg or arm that is no longer present. Importantly phantom leg pain has never been reported in animals. Clearly we could not rely on animals telling us that they are experiencing phantom leg pain for a diagnosis to be made, but if dogs were in pain after the operation they would show some signs of this.
Owners should not expect to have to perform any significant wound management. You should check the wound every day to look for signs of inflammation or soreness. These include redness, swelling, heat, discharge and pain. This is because there is a risk of post-operative bleeding or infection with any operation and prompt recognition of the signs of either of these can mean that the consequences for the patient can be minimised.
If you are concerned about the appearance of your dog’s wound you should make contact with your veterinary team. It is better to ask and to find that there was nothing to worry about than to leave something and then learn you should have acted sooner.
As dogs adapt to life as an amputee they become more able to cope with slipping or stumbling. However, in order to make matters easier for them in the early days, it would be wise to make the flooring as grippy as possible. Laminate and tiled floors are problematic in the first few weeks after surgery. It is beneficial for patients to have rugs or mats placed in the areas where they are most likely to turn or stand up from rest.
Some dogs can be allowed unrestricted activity as early as two weeks after surgery. This decision is really governed by the normal activity level of the dog. For more active dogs, owners will have to take a greater responsibility to ensure that dogs do not over-exercise. For dogs with greater athletic expectations, adequate time must be allowed for muscles and tendons to adjust.
For a greyhound who would be used to sprinting at exercise, an additional four weeks of gradually increasing lead-controlled exercise would be advisable before allowing unrestricted periods off lead. For a dog with greater stamina such as a border collie, who lives to chase balls and who could run without stopping for 45 minutes or more before amputation, it would be fine to allow periods of unrestricted off-lead exercise six weeks after surgery. However it is advisable to limit the duration of these periods off lead at first.
In the first week of off-lead exercise, limit the time off lead to five minutes at a time. These periods can be increased in five minute increments each week for approximately eight weeks. This way, three months after surgery, the dog would be galloping as normal at exercise with the least risk of self-injury during the recovery period.
There is no doubt that once a patient has undergone amputation, the remaining limb on the other side of the body has to do the work of two. Your dog will adjust the way it stands and moves and this does result in a degree of redistribution of weight-bearing. Muscle or tendon injuries are exceptionally rare in amputees, so long as there is not another complicating disease process which makes them happen.
There are some patients who are simply not good candidates for amputation. There is no official statement establishing which breeds of dog do well and which do not but it is generally accepted by specialist surgeons and oncologists that very short-legged breeds and very broad-chested breeds of dog do not cope well with life as an amputee.
Osteoarthritis is frequently listed as a reason for not performing amputation but there are exceptionally good medications for arthritis and in the view of this author, arthritis alone does not constitute a valid reason for choosing not to perform amputation, particularly since the conditions we are treating by amputation are typically intractably painful and this pain can be cured by a single surgical procedure.
In order for a dog to cope well after amputation they do need to be able to adapt to life on three legs. Dogs with spinal problems are usually unable to do this. If affected patients undergo limb amputation, it can precipitate a worsening of the neck or back problems resulting in a failure to ever really thrive after amputation.
Other people may influence your decision on whether to choose amputation for your pet. Sadly, there are some people in the world who share their opinions without considering that they may be unwelcome. Some owners of amputees can feel that there is a social stigma associated with keeping an amputee dog. Clearly if you know that your dog is happy, you can rest confident in the knowledge that the individual in question has an uninformed opinion and that their sharing it with you is simply rude. However, this can affect different people in different ways and it is a point that might seem a little abstract but that is worth giving some consideration to before deciding to definitely proceed with an amputation procedure.
It is sadly true that cancer is one of the primary reasons for considering amputation. Many cancers of the limb bones do spread (metastasis) prior to the diagnosis of the lameness in the first place. This means that even with a certain cure of the primary cancer in the leg, there is a very high likelihood of cancer still developing at other sites, most frequently the lungs. Surgery must not therefore be regarded as a cancer cure.