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How rehabilitation can help our 3 legged friends – Looking after the amputee

Dog’s have a special ability to get on with living, no matter what life throws at them, whether it’s cancer, osteoarthritis (OA), or losing a limb. This is a lesson that we as humans could benefit from learning from dogs, making the most of the life you have, despite what has happened. Now, that is not to say dog’s do not have any mental health problems, for example, those of you have had anything to do with a paralysed dog will know, if they don’t get up and walking within a few months, they can appear depressed at times, which is where carts and wheel chairs come in to perk them up whilst they continue their rehab. This also does not, by any means, mean that dog’s do not feel as much pain. They 100% do, but are generally very stoic and the fact they just get on with life sometimes can be to their detriment with diseases like OA. Mentally they may want to do everything they used to, but their body can’t keep up any longer. So that’s where we have to step in and restrict them at times.


A dog’s ability to carry on loving life after a serious injury is no more prevalent than in amputee’s, sometimes called tripods (or as we prefer, TriPAWds!). It’s commonly thought that dogs (and cats) cope absolutely fine on 3 legs, and it’s easy to see why, based on the previous paragraph. So whilst mentally they do cope, physically they could really benefit from some help, starting from as soon as the leg is removed to improve their strength and coordination on 3 legs, to long term management of the increased load on their joints and soft tissues. This blog is going to go into how rehab can and should be used to make sure that our 3 legged friends have the best quality of life possible. Some of the things discussed here can also be applied to double amputees.

Immediately post-surgery

Surgeries for amputation can be part of emergency care in cases of road traffic accidents, but they can be planned as well, in the cases of cancers, like osteosarcomas. If the surgery is planned, there may be an indication for pre-operative rehabilitation too, however this would depend on the individual and their pain level.

Ideally, rehabilitation should be started immediately post-op in order to begin a graduated strengthening programme and begin to manage any compensatory areas of discomfort that may have already started to develop (a lot of cases will have been walking on 3 legs well before the surgery). They should be assisted in getting up and down, as well as walking in the early post-op period by using a sling or towel under their abdomen and a properly fitted harness (unfortunately, not all harnesses fit 3 legged dogs properly). A dry treadmill could be started relatively soon too to allow for the patient to get used to walking on 3 legs with the benefit of a therapist on hand to aid them.


Managing the home environment and compensatory issues

In the early stages, your tripawd should avoid going up and down stairs, and getting on and off furniture as they will not be stable enough on 3 legs to do this safely. Reducing the frequency of these sorts of activities long term would be ideal but as they get stronger, some of these activities could potentially be re-started, although should be done with assistance (harness and possibly a sling). Slippery floors are difficult for 4 legged patients never mind those with only 3, so some sort of grip should be applied to the surfaces in the form of rubber backed mats or rugs, or grip tape.

Other high impact activities like chasing after balls should be stopped and safer alternatives to playing with a ball should be adopted for the rest of their lives. This is to reduce the impact and injury risk for these patients which is crucial in their management. Dogs can walk on 3 legs, but walking on 2 is extremely difficult, if not impossible for some patients so effort should be made to avoid further injuries. Unfortunately, amputee patients are at greater risk of developing further musculoskeletal injuries like osteoarthritis (OA) and cranial cruciate ligament disease due to having increased weight on their remaining limbs and their backs. Conditions like OA can be managed with rehabilitation to keep the patient comfortable, but if an amputee suffers something like a cruciate rupture, surgery is likely going to be necessary to stabilised the joint and will require intensive rehab and assistance afterwards.

3 legged dogs won’t just suffer from joint diseases like those mentioned above, they will also become tight and sore through their muscles as they adopt new postures and movement patterns to adjust to living on 3 legs. Rehabilitation can be very beneficial here too. The sorts of therapies that can be used in the management of these conditions include massage, stretching, heat therapies, electrotherapies like laser and PEMF, and an exercise plan.



Improving strength, coordination, and movement

As already mentioned, the rehabilitation for tripawds should include an exercise programme to improve their ability to function on 3 legs. These sorts of exercises include resistance-based activities to improve strength, things like balance discs help to improve stability, and as mentioned treadmill walking can be used to improve their movement patterns. Hydrotherapy can be extremely useful here too; swimming provides the chance for the patient to exercise in a weightless environment and the treadmill can help to improve the way they walk but with the support of the water.


Prosthetics

Prosthetics are used routinely with human patients, usually requiring a period of acclimatisation before fitting. Currently, most prosthetics in canine amputees are used when a partial limb amputation is performed. However, some companies are producing prosthetic limbs for dogs that have had full limb amputations, although the degree to which these prosthetics help in achieving a better gait and reduce complications associated with amputation is still to be seen.

Whilst prosthetics can be costly, for dogs that have had a partial limb amputation, they can be very beneficial. A consultation with a qualified prosthetist should be sought if you believe your dog could benefit from one.

Wheelchairs/carts can be used for double amputees or 3 legged dogs that have become very weak and deconditioned due to other conditions.


Photo credit: Ortho Pets Europe


So, whether you are a recent or long term tripawd owner, or are looking to rescue one, hopefully this blog will help you understand a bit more about what else you can do to manage them. Contact your local veterinary physiotherapist for more information about what you can do!


All the best,

Matt


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