amputation – The Journey of Ellie the Great Pyrenees Mix

Smooth Sailing… kind of.

Today marks 6 weeks plus 1 day since Ellie had her amputation!! I’ve officially stopped coddling her and have been trying to catch up on everything I left by the wayside (not overwhelming at all…*cough cough*), but she’s still my number 1! We have had to go to the vet every week ( and sometimes twice ugh) since her surgery for clinical trial blood draws and/or her carboplatin treatment and/or PT. this upcoming Tuesday will be the last one for 3 whole weeks!! I’m so excited! Don’t get me wrong, everyone at CSU has been amazing- but you know you’ve been there too much when you and the front desk staff (of which there are several) knows each other by name.

In PT we have graduated up to more advanced stretches and exercises, most of them are centered around helping Ellie learn how to balance on 3 legs in a safe controlled manner- I keep meaning to take a little video of her doing them, but keep forgetting. the therapist also has me working on her incision site. mostly by lightly rubbing and rolling the skin on either side of the incision. We are trying to break down as much of that fascia/scar tissue as possible. Sometimes if it’s left as is it can pull or pinch which can aggravate nerves and cause pain. Only in the last week or so has Ellie started laying on her incision side (I freaked out when she did it the first time! I was so excited!) and she seems to enjoy me rubbing on the incision, she always lays back and starts to close her eyes, so it must feel good.

first time she’s laid on her incision side!

Not everything has been quite on the up and up, though. Last week even with being completely off all pain meds Ellie was still “dribbling” urine pretty much all day, and then started having very bad accidents two nights in a row (probably just dribbling all night) I told the vet about it and we did a urinalysis- nothing remarkable came back, no blood in the urine, her white blood cells were barely elevated as of Thursday morning the 27th. Unfortunately I didn’t get these results until late Friday afternoon. I was getting really concerned because she had started going from a dead sleep to jumping up yelping and looking around to see what “bit” her, it seemed to be happening more and more not less and less. The vet explained that even without obvious signs from the urinalysis is could still be a UTI, but it also could be spay incontinence which is really common is dogs Ellie’s age and up. At first I was convinced it couldn’t be spay incontinence, because it was just too big of a coincidence that it started right when she also started going on all these medications, the vet gently replied that it might have been happening before but I am only noticing it now and it was intensified with the medications- fair point. So the next step was getting a sterile sample of urine for them to do a culture on to see if it was in fact a UTI and if so what bacteria it was so we could use the most effective antibiotic to help clear it up. Cool… those cultures take about a week to get back…and she can’t be on any antibiotics because it could give the culture a false negative. So there I was on a Friday evening with a obviously uncomfortable dog who was involuntarily peeing all over the house. The vet ended up offering to prescribe Clavacillin which is the antibiotic that covers far and above most UTIs, if she was showing signs of improvement within 48 hours then we have our answer, if she wasn’t we could still do the culture, but might have varied results or could look into something like Prion or estrogen replacement for spay incontinence. At first I was happy, I had convinced myself it was a UTI and this would help. Then I dug into her symptoms a little more, and it started to look less and less like a UTI and more and more like spay incontinence- she didn’t strain to urinate (when she would do it outside), she wasn’t in pain urinating, no blood in the urine. I started second guessing and actually set up an appointment with my regular vet to get a 2nd opinion, but then ended up cancelling it and giving the antibiotic a shot. It made me anxious because I’m very aware of how the overuse of antibiotics is creating all these resistant bacteria and I would hate to add to the issue even if it was on a small scale. Anyway- all of this to say that the antibiotics totally worked as of Sunday night (It’s Wednesday evening as I write this) she hasn’t had any accidents inside at all. She is also back on a very small dose of gabapentin (100mg 2x a day) I don’t know if the pain is from healing incision or maybe the UTI or something else entirely, but the gabapentin has helped stay on top of it- I’ll probably start going down to once a day and see how she does her in the next few days. I think I’ll also have to steam clean all my carpets/floors this weekend!

“I’m not the drama, but my mom sure is!” -Ellie probably

So after all that drama things are going great- Ellie has her 2nd carboplatin treatment this upcoming Tuesday along with another PT appointment. She has started playing around and mostly has her endurance back though we really haven’t pushed that too hard yet, but with the weather getting nice I’m excited to get outdoors more

So there’s the update! I leave you with my nearly 100 pound dog in her “stroller”, my neighbors think I’m insane, haha! If you have a big dog I highly suggest looking into Burley Bark Ranger- it’s literally the biggest one I could find, and has been a dream to use- definitely not cheap, but its not made cheap either and if you can catch it on sale I think it’s worth it (I was able to get it 25% off)!

I wasn’t zipping the back, and her little tail hanging out was killing me- so adorable.

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My dog is back

Tomorrow marks 1 month since Ellie’s surgery to amputate her front leg. It both feels like it happened yesterday and happened ages ago. This past week things have gone so good! It took Ellie a couple days to get back to normal after having to be sedated for a skin biopsy, but even with sedation and the carboplatin she had no vomiting or diarrhea which was a big sigh of relief for me. She was definitely tired, but we’ll have to see if that was due to the sedation or the carboplatin. Next time she goes in for carboplatin it’s just that no sedation so we’ll see then.

After she recouped from that she’s been an all star! As of yesterday she is off of all pain meds. This past week I did a day of 200mg x3, then a couple days 200mg x2, couple days of 100mg in morning 200 mg at night, then 100-200mg once a day, and now none! Highly suggest asking for 100mg capsules it’s so nice having the freedom to really taper them off. I know I have read on here that some vets cut them off at 8 days/14 days etc. Maybe there are scenarios where that is needed per other conditions or issues with your dog, but for reference Ellie was on carprofen/gabapentin for 2 weeks before her surgery and 10 days after, they did do a hard cut off on the carprofen, but I was given liberty with the gabapentin to give as needed, she really needed a full dose (300-400mg x3) till 3 weeks after the surgery and then slowly weaned off over this past week. My vet was so easy about it and gave me 120- 100mg gabapentin capsules refill… so they were not at all worried about her having it for a longer time. Just wanted to share, in case you also feel your puppers needs some extra, it really is the worse to see your dog in obvious pain….it’s already hard enough as is in my opinion!

I’m sure it’s a combination of both, but between Ellie being on less gabapentin which causes a sedation effect, and just feeling better in general she has become more and more like her old self. My favorite is her starting to wake me up again by coming up to the bed and laying her head on my bed and doing her impatient huffing (it’s not a bark… I can only describe it as adorable breathing?? haha) It’s impossible to not smile at this, and I didn’t realize how much I missed it till she did it! I mean c’mon…. look at that face!

In addition she hung out with us outside all weekend while we were doing different chores like she used to. She would go lay down when she needed a break, but she kept checking in and being a good supervisor to make sure we were being productive… but also was totally game if we needed a break to play, haha.

We are still working on endurance- we are probably up to .5 miles a day walks. With the weather getting so nice I might start doing our usual 1.5-2 mile walk and just bring the trailer to load her up as needed, or jump on my e-bike and bike around to other shorter walks. We have a really pretty bike path that follows the river that goes through town, that might be a great stretch.

The only negative I have at this time, is I do think she is still having either phantom pain or maybe some incision tenderness. maybe once a day or every other day she will be laying down and let out a small yelp and jump up looking around at what got her. I do think the warm compress helps alleviate that (maybe- I don’t have definitive proof), and I haven’t been great about doing that the last couple days so I’ll stay more strict on it. I have our next PT appointment this Thursday to ask them about it. I know the therapist told me about massaging the incision, because that scar tissue can pinch/irritate nerves, she didn’t want me to do it just yet since that was right when Ellie got her sutures out, but as the incision healed to start. I have a little bit, but am unsure how much/how hard to go at this point. I look forward to chatting about this with them… and maybe getting some new exercises! Ellie has become a master of her current ones!

when you are the goodest girl and know you shouldn’t get up, but also really want to chew on something, haha!

As you can see above Ellie is the perfect patient, and I think she really enjoys the warm compress. thanks to your guys input my massage and stretching technique has gotten a lot better and she doesn’t mind it one bit anymore. I can’t tell if I’ve improved anything there, but I’m confident I haven’t hurt anything…that’s another thing I’m looking forward to come Thursday!

That’s all I have for now! Cheers to an all positive (well 98% positive) post!

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1st Carboplatin Appointment

Yesterday, April 12th, Ellie had her first dose of Carboplatin. It was a big day as she also had to go in for the clinical trial side of things for an 8-hour serial blood draw and a skin biopsy to measure the effects of the Vismodegib. Thankfully this is the last one for 6 weeks.

The vet informed me that she is a total lightweight when it comes to sedation (I 100% agree after the trazadone incident) and that she will probably feel loopy for up to 24 hours.

Poor thing was so so so drunk! when we got home she wanted nothing to do with any food, wanted nothing to do with me, wanted nothing to do with the world… she was over it… but did take a few laps of chicken broth so I called that a amazing success. I was informed she didn’t go potty all day, and she wouldn’t for me either so I got some towels under her backend while she snoozed since this is exactly how she was when she came back from her surgery the first time. It’s amazing how quick we adjust to our new normal, since I had been through this before I wasn’t anxious or worried and I had an internal timeline of how long things usually took for her.

Later in the evening she perked up a little bit. We went out a few times and she really wanted to poop, but not much was coming out- what did come was awfully loose. At 11PM I went ahead and gave her 80mg of Cerenia in case she did indeed have diarrhea and/or to help her appetite, she ate up a little bit of chicken and rice and we went to bed.

This morning she is still tired, but she ate her normal kibble w/water, and went outside to pee, so all good things. I was so relieved to see her appetite back, I wasn’t surprised that it was gone after the sedation, but I was worried if the carboplatin would make her not feel great. I’m cautiously optimistic.

In preparation for her maybe not having a great appetite I made a whole chicken and some rice to offer as a replacement. Whenever I make a chicken I also make a bunch of broth in my pressure cooker. Since I make it in the pressure cooker once the broth is done all the bones crumble under a little bit of pressure (versus splintering), so for years I’ve saved all the leftovers from the broth (sans onions and garlic) and would make dog treats. I used to just stuff kongs with it and then freeze them, but now with the pupsicle I can make perfect little molds of them. one chicken makes around 20 of these treats to feed whenever.

I know it’s not the most appetizing, but Ellie sure loves them! These treats have been so helpful for when I need Ellie to be still or a little distracted so I can to cold and hot heat compresses, stretches, massages (usually she just falls asleep to the massages, haha).

That’s about all I got for now, it’s been blissfully boring 🙂

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Bit of a Rollercoaster Week

Ellie had her first physical therapy appointment this past Tuesday. Oncology had a peek at her and removed her sutures. YAY!

In her PT they did TENS (Transcutaneous electrical nerve stimulation) cervical paraspinals around her neck, as well as PEMF (Pulsed electromagnetic field) therapy. This combined with massage is a nice little spa day for Ellie which is very much appreciated as she’s building up all these new muscles. They also worked with her on some new stretches and exercises that I’ve been sent home with.

I had a really nice chat with Ellie’s oncologist on the upcoming chemotherapy and she also got the test results back on the tumor and it was confirmed osteosarcoma. This was oddly a punch in the gut. Obviously I was planning on it, and I thought I was prepared, but I guess it was the last of my diehard silver lining hopes getting obliterated that it was a lesser cancer or something completely different where even if she had to go through chemotherapy her projected lifespan would be measured in years instead of months. I try not to think about that, but it hit home again.

Since Tuesday it’s been a bit of a rollercoaster- I started tapering off the Ellie’s Gabapentin, from 300mg 3x a day to 300 mg 2x a day and then stopping. It’s not going great there- she was obviously uncomfortable the first evening that she didn’t have any so I gave her 300mg, and again later this morning she was uncomfortable with me around her incision as I was doing warm compress and actually whimpered when she was standing afterward, not sure what that was at whether it be the incision, neck pain, hip pain, leg pain? It doesn’t help that she also itched and nibbled at the lower part of her incision, no bleeding or broken skin it just looks like a new bruise at the bottom, and was obviously tender, so I went ahead and popped on the ole t-shirt again and gave her 300mg gabapentin. I’m really hoping that’s the issue.

you can see the redness (and this was before she got at it again making it worse)…that is if you can get past the cuteness overload :p

My brain won’t let me stop at that though, as I’m struggling with the exercises/massages I was sent home to do. She’s an absolute star at her neck side bends and balancing on uneven ground. But she pretty much refuses to army crawl, and seems really really uncomfortable when I work on her back end. We are supposed to be doing hip stretches and finger rolls twice a day. Her face gets tight, and she pulls her leg back in on the stretches, and looks away or moves her body away a little while doing the finger rolls. It freaks me out, because I’m not a physical therapist, I don’t think I was stretching too far, but maybe I am going way too far? Or is it a hurt so good situation? same with the finger rolls- anyone who uses a foam roller knows how painful breaking up the myofascial can be, but man does it feel better when you are through… with that said I’m worried I went too hard there too and maybe now she’s bruised on her back from my grubby fingers. Bleh! It’s really unfair that dogs can sniff out LITERAL CANCER, but not tell us dumb dumbs if we have gone too far.

This is mostly just a vent, and to be transparent with where my head is at with all of this. I have an email to the PT to get some clarification and hoping they might be able to give me some hands on advice when Ellie goes in Tuesday for her first chemotherapy (cheers to going to a university where all the things are in one place!). Oh yeah- no wonder I’m emotionally exhausted, just when you start to get over the anxiety of the amputation (and that’s only if things have all gone right), you get to prepare yourself for the chemotherapy and have another bout of monitoring to see how she’s handling it. I know it’s usually fine, but I refuse to not be prepared for as many outcomes as possible.

Wow this is a downer of a blog post isn’t it? It hasn’t been all bad, actually very little of it is has been bad. Case in point, I had to order something on amazon and since I was there I couldn’t help myself and got Ellie a life vest. How freaking cute is she?!? She was a good swimmer before all this, so I’m really excited to take her to the lake this summer and still enjoy the water 🙂 🙂 😀

She has been getting better and better at her balance, getting up and down, and her endurance. We are still at very short walks- probably going about a block round trip, but it’s definitely progress. We’ve also started learning some new tricks to keep the brain engaged! The current one is “Touch” she got to touch my hand really quick, and we are starting to work on her ringing a bell 😀 . Lastly she has easily figured out how to get her chew on- which is good because I went a little crazy and got an assortment of collagen sticks (I guess they are a longer lasting version of a bully stick), cow tails, a pig femur, and cow hooves! That combined with her Yak bars she going to be downright spoiled, and I’m here for it!!

12 days post op

The past few days have been delightfully boring. We got the go ahead from our vet to start decreasing Ellie’s pain medication so we have stopped the Carprofen since Friday (but I have a few extra to give if needed) and lowered her Gabapentin from 400mg 3X/day to 300mg 3x/day. I did drop her down to 2x a day, but Ellie isn’t quite ready for that, so we will keep her at 3x a day through the weekend and then reevaluate. Her incision is looking so good- I have been taking pictures of it daily and I think I will have to make a animation with all of them stitched together to see the change, haha. the bruising that she had on her belly has completely cleared up, she does have fluid underneath the skin, but it’s not a seroma. The vet said that’s probably due in part to the heat therapy, but that it will clear up as she continues to heal… which is being aided by the heat therapy so if it’s not inflamed or sensitive to the touch keep going the course. Ellie is so big that I have to do the heating pad in 2 parts. So for the lower section I give her a pupsicle, which usually gets us through the first 10 minutes, and then I have her lay back and I move it to the top section. She can’t really have a treat in this position so it has become our time to have scratch/massage sessions. It’s been very bonding, and I’m super grateful she’s so patient about it and has come to enjoy it, often times she just falls asleep.

heat therapy and itches time!

I’ve been trying to get her out of the house at least every other day for a mini outing to keep her spirits up (and when the weather allows it’s supposed to snow…again…on Monday :(). She is usually pretty tuckered out by the time we even get to the end of my driveway, so it’s either going for a car ride, or breaking out the burley!

biggest dog trailer I could find…still not quite big enough 😀

I got this Burley Dog Trailer last year when I bought myself an electric bike. It’s literally the biggest trailer I could find, and one of the few that’s rated for dogs Ellie’s weight, but it’s still not quite big enough for her size. As you can see I have to have the front ‘window’ up for her to sit comfortably, and it’s not really long enough for her to lay down unless she curls up- So I’m not going to be doing any long road trips in it, but it’s fantastic on the bike, very easy to push/pull regardless of it’s in stroller mode or bike trailer mode, and really well made. I’m really glad I already had it before this endeavor for a few reasons.

1. It was not cheap- I don’t think there’s anyway I could justify the price after all the vet bills.

2. Ellie was already comfortable getting into it with 4 legs, so getting into it with 3 was really no biggie.

I think the longest road on this recovery is going to be Ellie getting her endurance back. Having the trailer will allow us to really let her go at her own pace without missing out on activities just because she can’t quite keep up just yet.

Yesterday we went on a little walk and got to see our favorite neighbors- it was definitely a highlight for Ellie! But it was a lot too- even though she road in the trailer for about 75% of the 3-4 blocks she slept pretty much the rest of the afternoon. So I’ll just have to be wary of that. I’m really excited to have PT coming up, so I can learn more about how to walk that fine line of getting enough exercise to improve without getting hurt.

Another random task that I’ve been doing since Ellie’s surgery was sneaking water into her whenever possible. I saw all the warnings about making sure your dog was getting enough fluids, but I only recently found out just how much they need. I have been putting water into Ellie’s food for a long while (I don’t soak it, just put it one right before I give it to her so it’s still crunchy) and I thought that was sufficient, but I recently listened to a podcast about dogs quality of life and the vet stated that dogs need a minimum of 10cc per lb of weight, so Ellie at 97 pounds needs nearly 4 cups of water a day. I measured and figured out I was giving a cup per meal, so 2 cups a day. I tried adding 2 cups per meal, but it’s way too much at once so I started staggering it so she gets a cup of water at her morning meal, then a cup of water with just a touch of chicken broth a couple of times throughout the day and then a cup in her evening meal. Just trying to be proactive about it- if she did get dehydrated it would be a lot harder to get her to take it if she’s already not feeling good. I don’t really notice any difference, but it definitely can’t hurt!

With that I want to say thank you to everyone who is keeping up with Ellie’s recovery and all your kind words! I will continue to share our journey as we find our new normal 🙂