Amputation As Treatment For Osteomyelitis In A Dog
A veterinarian never knows what he’s going to see from day to day.
I sure got fooled by this one. At least at first I was surprised.
A cute little puppy came in for her first examination after being adopted from the Humane Society of South Mississippi. She was reportedly limping on the left front leg and had a good appetite, but the leg hurt so bad the new owners had to take the food bowl to her to keep her nourished.
The rest of the examination was fairly unremarkable. She had some discharge in both ears, with a bad odor and some sensitivity when we touched the ears, so we performed a cytology to determine the cause.
I saved the “bad” leg for last so as to avoid concentrating on the obvious problem, possibly causing me to miss other physical abnormalities.
When I got to the left humerus (upper arm bone between the shoulder and elbow), I was immediately struck by the amount of heat produced locally. That told me there was something major going on.
My brain began to work its way back to third-year pathology class, reciting to myself the list of juvenile bone diseases that could affect the distal part of the humerus.
Of course, it was necessary to include the obvious: infection. Infection in bone is called osteomyelitis. The word comes from a combination of Greek parts: osteo from osteon, meaning “bone,” myel, from myelos, referring to the bone marrow, and itis, a suffix meaning inflammation. Osteomyelitis is almost always caused by bacteria, although there are sterile forms of inflammation and fungal forms of infection of the bone.
What I saw when I processed the radiograph (X-ray) was not what I suspected. The humerus was broken and the two fragments were overriding. The leg muscles had contracted for so long that the two parts of the bone overlapped over an inch. They even appeared to be trying to heal to each other. Nearby, there was a large area of mineralization, probably also packed with infection. The ends of the bones have become rounded, a result of the body trying to clean up the bone and infection over a period of weeks.
Saving the leg is mostly out of the question. One could easily spend $10,000.00 on surgery and antibiotics and still lose the limb.
Amputation, which will quickly resolve the problem by removing it, is the best course of therapy in this situation. We humans think of amputation as being life-changing. Pets, on the other hand, hardly seem to miss the leg. You can read about some amputation success stories by clicking here.
The new owners asked a valid question: “You have amputation success stories. What about amputation failure stories?”
“I don’t have a single one, actually. I’ve never seen a single pet who didn’t adapt quickly to loss of a limb.”
Having owned the puppy for less than a week, they are already thoroughly attached to her. Still, they needed some time to talk about options and make a final decision. The “E” word, euthanasia, came up, but I told them that was not an option. She should have a long, full life with a single surgery for amputation.
So, we say a prayer for her and hope the owners make the right choices.
We just never know what any given day will hold.