Amputation: Are Three Legs Better Than Four?

Unfortunately,  this isn’t a yes or no answer because there are so many factors and  considerations involved in making an amputation decision.  While the  decision to amputate a greyhound's leg can be fraught with moral,  ethical, and emotional considerations, it is sometimes necessary to  ensure an animal's welfare…but not every hound is a candidate for such  drastic measures.

Like all  animals, greyhounds are susceptible to injuries and illnesses that  require veterinary intervention.  Rarely will the matter of amputation  ever come into conversation, but there are times that it will.

In  greyhounds, there are two primary reasons for leg amputation to be  considered: traumatic injury such as fractures, dislocations, and severe  soft tissue damage that cannot be repaired or that repairs have been  unsuccessful due to complications, and cancers such as osteosarcoma.

There  is also the high incidence of hounds with previously broken or injured  legs, that have been repaired, being broken again in being allowed to  run off lead in open spaces.

We  were recently posed the question by a distraught owner whose arthritic  teenage greyhound had been diagnosed with bone cancer in a front leg.   The vet had told them that the only options were to amputate or  euthanise, and they wanted us to know if amputation was the best option.   

Our honest answer was, no, it wasn’t.  

This  may sound heartless, but having supported hounds through amputations in  the past, the idea of putting a hound of his age through a traumatic  and painful surgery and recovery would have been borderline cruelty.   Given the other legs were arthritic and unlikely to support the  additional pressure and balance needed to walk again.  There is also the  additional fact that osteosarcoma is an aggressive cancer that can  quickly metastasise into the lungs and abdomen…so even amputating the  leg wouldn’t have saved him from the cancer.

When  it comes to sharing our lives with our hounds, in situations like  these, their quality of life should be of paramount importance.  While  we all want as much time as possible with our canine companions, we  believe in quality, not quantity.  We wouldn’t want to put our hounds  through any unnecessary trauma in the hopes of getting a few more months  that, likely, would have been filled with pain and distress.

If  your hound is diagnosed with bone cancer, before even considering  whether to accept an amputation decision, you want to have x-rays done  of the lungs, abdomen and full blood panels done.  
Osteosarcoma  is an aggressive cancer and develops very quickly.  It can also  metastasises elsewhere in the body just as fast.  This means that by the  time your hound is showing symptoms…there is a high chance that it has  already taken hold somewhere else, usually the lungs, meaning that an  amputation would not be curative.

Unfortunately,  even if x-rays come back clear, there is still a big risk in pursing  amputation.  X-rays are not always effective in identifying  micro-metastasis in the lungs which means they can go unnoticed.  You  are then running the gamble in putting your hound through amputation,  as, from what we’ve seen and heard in the past, your hound won’t live  more than a few months.

In this  case, your vet may offer palliative care.  This will basically just  involve strong pain killers but given how painful bone cancer is, and  how quickly it progresses, it’s unlikely to even touch the sides…and all  it takes is for them to be playing a play in the garden, or going for a  walk, for their moth-eaten bone to break without warning.   Realistically, the kindest thing is to make that truly awful decision we  all dread making.

Many of the  people we have spoken to in the past that have amputated a bone cancer  leg have come to regret it, massively.  They wish they had just enjoyed  what time they had with them rather than causing them so much pain in  their final months.

But, in  saying this, there are countless hounds around the world who have  survived it and gone on to live full and happy lives.  There are  Facebook groups dedicated to three-legged sighthounds.

This  is the gamble.  There is a chance it will work, but there’s a bigger  chance that it won’t.  You absolutely want to take on board the  recommendations from your vet and make a plan that is appropriate for  your hound based on the specifics of your own situation and their test  results rather than listening to people on the internet……. they say,  while writing about the subject!

The  decision to amputate also largely depends on which leg it is.  A  hound’s centre of gravity is above the front legs, which is no surprise  given their deep chest.  They carry the largest percentage of their  weight and balance here, therefore making foreleg amputations less  desirable.  Many physiotherapists that we have discussed amputations  with in the past have said that they would never recommend a front leg  amputation on a greyhound.  Back legs are a different matter, they can  adjust much faster with a back leg amputation.

However,  there is an additional consideration when considering amputation and  that is pre-existing injuries…as these largely affect the back legs.

Many  hound parents aren’t notified of their racing injuries.  It doesn’t  matter how minor it may seem, whether a niggle or a full break, their  other leg may not be able to support them post-amputation.  Most  greyhounds also suffer with arthritis, even at early ages, due to racing  injuries.
We would strongly recommend seeking x-rays  and a full assessment of the opposite leg prior to amputation, as any  pre-existing injuries could heavily impact their ability to cope, cause  chronic pain and cause long term welfare issues should you proceed with  an amputation.

The last thing you want to do is agree to an amputation only for it to cause your hound ongoing issues.

If  it’s an injury (rather than cancer), all of this still stands, and  realistically all attempts should be made to fix the leg…but this is  sizeably more expensive and complicated than an amputation.  The  recovery time is also longer.  While both surgeries carry the same risk,  a lot of people can’t afford a leg repair without insurance.  

But,  if for whatever reason the repair doesn’t work, you can still go back  and amputate later, it gives you two attempts to save them.  Whereas if  you amputate and have complications, there isn’t a whole lot of options  available and it could be the end of them, especially if a nasty  infection takes hold.

Sometimes  amputation is the ONLY option.  But when this is the case, you must be  honest with yourself as to the practicalities of what is to follow.  

For  instance, do you truly believe your hound will cope with three legs?   Have they got the resilience, strength, fitness, and temperament needed  to successfully cope with the surgery, the painful recovery and  re-learning how to walk, run and play?
Is amputation  the most humane option or should other treatments be pursued?  Taking  into consideration the cost, prognosis, and potential impact on the  dog's well-being, have you got enough time to be with them as they  recover?  

They experience  psychological distress following an amputation, just as a human would,  including anxiety, depression, or changes in behaviour.   Adequate  support and rehabilitation are essential to help the dog adapt to its  new physical limitations.  

The  first days and weeks following an amputation are immensely stressful.   We’ve seen dogs become extremely defensive, aggressive, and unable to be  handled following amputation surgery, while others have handled it with  grace.  Your hound needs to be supervised at all hours to prevent them  hurting themselves either in trying to bite at their stitches or in  trying to move around.

While dogs  recover and adapt from amputation surgery, typically, very quickly, and  have minimal impact on their quality of life moving forward, it is  still an absolute roller coaster…even long after they’ve recovered.

You  need to be extremely careful with their diet and weight, to prevent  putting any extra strain on the remaining legs and joints and be more  restrictive with their exercise until you are completely confident that  they have recovered…even then you may never be comfortable letting them  run or play freely, as the risk of injury to the remaining leg (be it  front or back) could be life ending.

If  you go ahead with the amputation, as anyone who has supported a hound  through it, they’ll tell you that the first couple of weeks are literal  hell.  Especially those first days.  The surgical site is usually very  large, the swelling makes it look even worse…and the bruising.  No one  prepares you for the bruising.
You would think that  it would just sit around the surgical site, but no.  You need to be  prepared that the bruising from the surgery will cover most of their  body.  It is truly traumatic as a hound parent to see them in such a  state.
Unable to stand or walk without support,  unable to get comfortable, constantly panting, crying, not eating, and  either seeking your undivided attention and support or lashing out  defensively, angry at the world.

You  need to be strong in yourself, both emotionally and physically.  It’s  incredibly difficult to see the hound you love so much go through so  much pain, but you need to be physically able to help lift, assist, and  manoeuvre them while they recover.

The reward at the end, if they successfully come out the other side, is worth it.  

But it is an impossibly difficult and emotional decision.

We don’t envy anyone in that position, and hope that the universe never puts any of us in it again.