5-Year Old Golden Retriever Mix Needs Leg Amputation
Kayleigh looked like a normal, happy 5-year-old Golden Retriever mixed breed dog. Her bright eyes and warm tongue greeted Doc Truli as she bent to pet Kayleigh’s silky-soft ears (arguably the softest, bestest place to pet a Golden Retriever.) Kayleigh’s tail swung in a gentle, calm, Southern hospitality wag. Here was one of those dogs Doc Truli likes to call an ambassador dog.
“An ambassador dog is one of those rare, calm, thoughtful, confident dogs that can walk into any situation and make everything better. They never fight, because they never have to. No one messes with them, because they never offend anyone (people or dogs). And they act as a perfect ambassador for the nation of dog to the nation of people, or the nation of cats, or rabbits, or whatever other species they meet,” says Doc Truli. “They often foster other species’ babies, they are wonderful with kids, and most importantly, the veterinarian understands, they do not complain.”
Kayleigh’s right front leg barely touched the floor. It hung by her side with a permanent crook in the elbow. The side of her paw pressed to the floor as she knelt on her wrists to investigate underneath the bench in the examination room.
“Kayleigh uses her leg as a stabilizer,” said her dad, Tom. “She literally acts like a tripod dog.”
Car Accidents Can Paralyze a Dog
Kayleigh suffered an automobile accident 6 months before her visit to Doc Truli. She rested for a few days and otherwise acted fine, according to Tom. However, she could not move or feel her leg.
Doc Truli tested the leg for movement and feeling. Kayleigh could not feel pinching on her toes. She could not move the leg. Doc felt he atrophied supraspinatus and infraspinatus (two of the muscles covering the outer side of the shoulder-blade) and the bony scapula under Kayleigh’s golden fur.
“Kayleigh suffered brachial plexus avulsion,” said Doc. (pronounced bray-KEE-ul plex-us avulsion) Kayleigh’s armpit got stretched back during the accident and the nerves to the arm became ripped or stretched into uselessness. The gentle dog’s right front leg did not move or feel. It was paralyzed.
Brachial Plexus Avulsion
Picture this: a dog, or a person has important nerves and blood vessels in the armpit. Oodles of them. If the arm got snapped back at high velocity, there is an elastic give to the nerves and the blood vessels. (A little more in the blood vessels.) Sometimes, without ripping the arm off, the nerves get ripped or stretched, and the leg looks normal after the pull, but the nerves do not work. The area of nerves and blood vessels in the armpit are called a plexus and brachial refers to arms. (That’s why orangutans with their tremendous arms are “brachiators” because they swing by their arms through the rain forests of Borneo, or a zoo, depending on their fate.) Avulsion means something is ripped off of its moorings.
Treating Brachial Plexus Avulsion for a Dog
How Much Time is Reasonable to Allow for Improvement to be Seen?
There really is not scientifically validated treatment for a brachial plexus avulsion. We know that nerve injury can recover, depending on the severity of the damage and the ensuing necrosis that may occur after the initial injury.
“Give a nerve injury 72 hours to show improvement as long as you can keep a pet pain-free, comfortable, and support life functions like eating and drinking either at home under veterinary supervision, or in a hospitalization setting as needed,” says Doc Truli. “If your pet shows neurologic improvement in the first 72 hours after injury, then recovery is likely to progress. If not, it is unlikely.”
The Dangerous Consequence of Paralysis in a Dog
Kayleigh didn’t care that her paralyzed leg couldn’t feel or move. On the plus side, she wasn’t uncomfortable of suffering. Can you guess what the minus side is? Remember how Kayleigh put her wrist down on the floor and slid under the bench in the exam room to explore? What if she tried that on cement?
Dogs with brachial plexus avulsion, and other reasons for paralysis of a limb, need careful covering and protection so they don’t wear a hole right through their skin and down to the bone. Remember, the dog cannot feel the injury. They do not stop what they are doing. Basically, their “common sense” of self-preservation has been shut off along with the paralyzed nerves.
Paralysis, paired with an energetic young dog and the difficulty of keeping a healthy bandage on a dog’s limb, especially long-term, causes some major planning issues for a family. Kayleigh’s family bought her some neoprene and velcro dog booties and put them on her every time she went outside. She stayed healthy and sore-free for 6 months. Then Kayleigh went to the neighbor’s house for a day while her folks went out-of-town. The neighbors forgot the paw bootie one time. Once.
That afternoon, she developed an ulcerated sore on her paw. Because the nerve supply to the leg is abnormal, the healing process just would not take over the natural process as it should. The paw became infected in spite of antibiotic drug therapy and wound care and tender loving bandages. Soon the leg up to the elbow became swollen and hot and Kayleigh stopped eating. She developed sepsis (whole body infection) from the small oversight in her care.
Forelimb Amputation Saved This Golden Retriever’s Life
Doc Truli delivered the sad news,” Kayleigh needs her right front leg amputated in order to save her life.”
Like most pet parents, Kayleigh’s family worried she would not be happy as a three-legged dog. Doc advised them to check out “2-legged dog” on You-Tube to gain inspiration and confidence that three legs were certainly easier than two! The pictures that follow show Kayleigh just after surgery, while she is still under anesthesia. Her incision was about 9 inches (22 sm) long and had 45 stitches. The black bandage helped the skin stay sealed up next to the underlying muscles and also provided the comfort of compression when she awoke.
Post-Operative Care for a Canine Leg Amputation
The night of the surgery, Kayleigh slept in the hospital with a nice morphine drip to keep her comfortable. When she woke up the next day, we started her gradually on water and food so as not to upset her stomach after anesthesia. The bandage was tricky because we needed it to stay in place without slipping or tightening and hurting her.
“If a bandage slips or becomes wet or fouled, it must be removed and replaced if those are your veterinarian’s orders,” says Doc Truli. “Generally, no bandage is better than a bad bandage.”
Kayleigh was a perfect patient. Her bandage was changed after three days and the stitches were removed after 14 days. The pictures show her moving so fast, the picture is out of focus. She’s not thrilled about getting on the “lift” table scale. But once the stitches came out, she’s good to go!
We tried to avoid surgery in order to leave her body intact and to avoid possible operative or post-operative complications. IN the end, her ulcerated, infected paw demanded amputation and tipped the scales of risk toward a surgery. Kayleigh should live a full, perfect life after her year-long ordeal.
2013 Update for VirtuaVet readers from over 60 countries:
Doc Truli is Dr. Sandra Truli Springer, V.M.D. She writes VirtuaVet inspirational pet medical stories to help pets and people around the world understand the potential of medicine for enhancement of their lives, and to educate and encourage conscientious pet parents who wish for more perspective and depth in their online medical research. All VirtuaVet content is original and copyrighted 2009-2013 by Boston Brain Bank, LLC. and may not be used without written permission.