The Scar

I took a lot of pictures of Harry’s incision during his initial healing period, so I could compare it day-to-day and look for progress, or problems (no, you’re neurotic). While I was sorting through these, today, it occurred to me that they might be helpful for others who are wondering what to expect or wanting to compare their kitty’s progress. So, this is just a photo-log of healing progress for that purpose.

Heads up, the early pictures may be upsetting for some (it was scary as heck for me to look at in person, until I got used to it).

Also, there was a period after the initial swelling went down when Harry spent most of his time lying ON his incision so it was tricky to get good shots and some are from wrinkly angles.

Day 1: ūüė¶

Day 2:

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Day 3:

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Day 5:

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Day 7:

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Day 10: Starting to get stubbly and most of the swelling was gone

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Day 14: Last Day with Stitches!

Day 21 : Gross scabbies (the whole thing looked like that scabbed bit, the day after his stitches came out, and gradually bits fell off – or, I suspect, got licked off, blech. I still used t-shirts off and on to keep him from going at the scar too much as the vet said it was okay for him to lick now, but not to let him get too aggressive with it)…but! stitch free!

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Day 25: Pretty much all better! Soft to touch, and not at all bothersome to him. Actually, he started really enjoying getting a bit of a rub on that side. I suspect the regrowing hair is still somewhat itchy and that those new muscles he’s building get sore and enjoy the massage.

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Now all that’s left is for him to get his fuzz back properly! It’s growing in much faster in some areas than others, as you can sort of see in this last picture, but it’s not worth stressing over. He’s still very handsome.

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The Unforgivable Curses

Just a quick update to say that five-six days after amputation was decidedly too soon for us to go off pain killers. It turns out that this is such an individual thing, there is sadly nobody to blame, but by Friday evening Harry was yowling and twitching and biting at me in a “hey, that hurts, knock it off!” sort of way. I still don’t know if it’s nerve/phantom limb pain or incision-site pain (Turns out there are actually three types of pain associated with amputation, as described in this interesting article: Post Surgery Pain in Tripawd Dogs and Cats).¬†¬†It did come on quite suddenly, but it lasted until the Metacam kicked in (nearly an hour) as well…so your guess is as good as mine. Either way, it was unbearable to witness.

So, it was off to the vet, through a blizzard, in the dark – to fetch some replacement Gabapentin (after dosing him, immediately, with the Metacam I still had to hand). This takes a few days to kick in, unfortunately, so it’s only today that he is back to seeming mostly comfortable. He squawked and shivered off and on yesterday and I just had to comfort him and wait it out (cannot express how hard that sucked). But, he is now doing swimmingly once again.

Here he is showing intense interest in an intensely interesting scene from Buffy the Vampire Slayer РSeason 3, Episode 10: Amends (and who can blame him?):

 

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Seen and Unforeseen

I cannot believe how well Harry is doing. This time last week he had four legs. He was limping terribly and I was worrying madly about the pain he was in, the upcoming procedure, and whether or not I was doing the right thing. I was told that he would heal up faster than I expected, but I didn’t really buy it.

We are five days in and he’s much like his usual self now, except for getting tired a lot more quickly and looking funny. He’s eating regularly, using the litter box properly (in all ways – it took almost four days for #2, in case you’re facing the same thing and wondering), getting up on the bed when he wants, and purring during pets.

He is already coming off of his pain medications (he’ll have his last Gabapentin with dinner and his final Metacam tomorrow evening. The Tramadol was done yesterday morning) and tonight will be the first night I wont have to get up at weird hours to dose him. I’m still supposed to be keeping an eye out for signs of pain, in case he needs something more, but at the moment it’s looking good.

He’s even tried to make a break for it:

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Work is tough. Yesterday was my first day leaving him and it was painful¬†to go. I’ve been reminded¬†quickly enough; however, that Harry is truly Cat and as such is pretty good at being on his own, even with a major injury. He spends most of his time sleeping or resting right now and I don’t believe that changes when I’m away.

Just in case, I’ve been leaving him like this:

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The humiliation should keep him subdued. He doesn’t wear his cone when I’m home, but I’m afraid he’ll be able to get around the t-shirt when I’m not there to thwart his efforts (efforts he has not actually made. yet) so he must suffer the indignity for now. His back, right paw is wrapped in vet wrap to keep him from scratching up from that direction, in this photo but this, I’ve officially learned, is useless. Both yesterday and today he was out of it by the time I popped home at lunch to check in. I suspect he was out of it minutes after I left. I have no solution for this risk at the moment, aside from hopeful thoughts. Maybe a belt…

Anyway, mostly I’m feeling relief, a renewed appreciation for the time I have with my pal, and certainty, now, that it was the right choice to amputate. We’re on our way.

 

Day 2 Update

img_0971Harry is doing remarkably well. He’s still very sleepy (still on very regular meds, although I will be spacing out his Tramadol more, starting today), but he is using his litter box as needed (all number 1s thus far, but I was told to expect the other stuff to take several days), eating regularly and starting to get around.

Today he made¬†a little exploration of the room I have him confined¬†to for now – which is my bedroom, with everything jump-upable or hide-under-able removed so he doesn’t hurt his wound and so I can get to him to medicate. He checked out the closet and did a slow, wobbly lap before retiring to his cage. He doesn’t seem hugely ¬†bothered by the lack of leg at the moment, although he’s still figuring out balance and has been confused when¬†trying to use the missing leg to kick the sand in his litter box. He used to stand outside the box and put one arm in to cover his business. Now he stands outside and twitches his shoulder (not his actual shoulder, which was removed, but the general area) a slight bit or stands there thinking for a moment, before just giving up and walking away.

It remains hard to watch him struggle, and to see the huge gash in his side (although I’m getting used to it) but I’m still really impressed with how far he’s come in such a short time, the tough little monster.¬†Fingers crossed he stays on track!

I can’t post videos on this blog, but you can click HERE¬†to watch how Harry’s mobility is progressing, on youtube ūüôā

Flesh, Blood, and Bone

The big day was traumatic (as are a couple of the pictures below, so be prepared). Harry was checked in first thing in the morning, with some confusion over whether he would come home the same day or not – usually, they don’t.

THE PROCEDURE

Harry was sedated, almost immediately, because he is highly anxious and hates the vet. Some blood tests were run to check organ function before he was put fully under for the surgery. One of these showed significantly elevated blood sugar and the vet requested permission to do a urine test for diabetes. Fortunately, that came back negative and everything else was in good shape for the operation. At this point, the vet had a word with me about Harry’s stress levels – which were responsible for the high blood sugar, and manifesting in non-stop growling and intermittent hissing – and suggested that if everything went smoothly with the amputation he would be better able to rest and heal at home that night. I was eager to get him home so I consented, even though I was worried about early recovery.

Still, everything went very well. ¬†Harry had his right forelimb¬†removed at the shoulder and was patched back up without complication. I went to get him in the afternoon. The poor beast was in his cage with a cone of shame on, and I didn’t get a good look at him in hospital. I was sort of glad that I’d be able to have my horrified reaction in private.

MEDICATION

Harry would be coming off his surgery meds for the rest of the night and I was told to continue his daily Metacam (which is an anti-inflammatory) dose, and add Gabapentin (which is for nerve pain and reduction of phantom limb issues) three times per day. I was immediately concerned that this was not enough pain management considering my cat had just had a limb chopped off, and was told I could try to continue using the Tramadol (an opiate for moderate to severe pain) they’d given me for the cancer as needed if I wanted, but that the two meds should be enough. To be fair, it was an assistant rather than the vet who did our discharge and Harry is difficult to get Tramadol into, but this still didn’t seem quite right. ¬†A bit of research, Harry’s behaviour when I got home, and a call to the after-hours on-call vet assured me that I was right to question.

Harry came home and weaved drunkenly out of his cage, looking like this:

Of course my heart shattered for him. Poor little soul. He barely knew where he was, however, apart from seeming more comfortable – not growling, etc. And, happily, he was eager to eat right away.

If you’re preparing for a similar operation with your pet, expect him to look devastating, and expect him to flop around a bit – especially if he is still stoned when you bring him home. It is brutally¬†upsetting, but if you’re on top of pain management and keeping his wound clean I think you can trust that he is healing.

After eating (his first dose of Gabapentin in his food), Harry started fussing. He yowled and grumbled and rolled around on the floor. He wasn’t aggressive. He still purred when I pet him. But he wasn’t comfortable. I didn’t know whether this was pain or the disorientation of coming off his surgery meds, so I called the on-call vet to ask. At this point she said to give him his Tramadol dose and see if that helped. It absolutely did. Harry was still fussy as he came off the meds. The rest of the night was not a picnic and I recommend preparing for some loopiness and confusion, but he wasn’t nearly as vocal or fidgety.

I’m not an expert, but it’s clear in Harry’s¬†case that the opiate is an important factor in keeping him comfortable to begin with. Other tripod Mamas I have spoken to via an excellent support forum I found (which I will talk about later) confirmed that in Canada it is heard of¬†to give only Metacam and Gabapentin following surgery, but that that should not be considered enough for something so major. Elsewhere, most personal accounts I’ve read involve those two (or just the Gabapentin) AND a major painkiller.

GETTING THROUGH THE NIGHT

The night was still rough. I was told to keep Harry in his cage, with his shame cone on while I slept (or tried to). I put his cage close to the bed, where he could see me and I him. He tossed and turned, and threw in the odd meowl. His collar was clearly making it hard for him to get comfortable and it looked like the hard plastic edge was digging into his incision when he was in certain positions. So, when I took him out to re-medicate at 2am (Gabapentin), I switched his collar for the onesie I mentioned in a previous post.

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This made a big difference. So far he hasn’t shown any interest in his stitches, but the shirt will serve the same purpose as the collar if he does. I also moved the cage onto my bed, by my head, after noting that he was calmer when I was on the floor with him (if you do this, make sure your bed is against a wall and the cage is on that side. The last thing you want is your injured baby toppling cradle-and-all to the floor). This also seemed to help. He wasn’t sleeping yet, but was able to lie comfortably and stare into space calmly. He continued to fidget a bit, but not nearly as much.

By this point, I should also mention, Harry was already able to hop/wobble about a bit when out of his cage. Although he got tired quickly, he wasn’t faceplanting. He did, however, try to curl up in his litter box to sleep…which I decided was unsanitary.

At¬†4am, when I pulled him out to do his next dose of Tramadol, he actually used the litter box – even though he got worn out halfway through peeing and sat in it, I still think he’s a champ. He flopped out on the rug for a bit then and I cleaned him up. Moments later, he hoisted himself up onto his remaining feet, wobbled over to the bed and jumped up (!). I had taken¬†my box spring and mattress off the frame so he wouldn’t hide underneath, which made this a bit easier, but he’s still a trooper to be getting around like that a mere twelve hours post-op.

He’s adjusted his placement a few times, but has been on the bed ever since. Even better, he finally started to sleep around sunrise. Phew. I’ve brought him food and drugs in bed, and placed a cold pack on his wounded side to combat swelling (vet suggested):

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He’s not quite happy, but he’s resting and healing; and that’s all I can ask for, one day in.