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This Little Piggy…- An article about toe amputation

Not many people know this but… I had both my little toes amputated at the age of thirteen. This sounds very dramatic and believe me, after two failed attempts to straighten my toes, when the doctor announced that we ‘might as well cut them off then’ it certainly seemed very dramatic to me!

They have caused few problems since and actually appear much more normal now than when the offending digits were in place. On the odd occasion that I have caught one of the stumps on the leg of a coffee table it is fair to say that the pain is fairly severe and I think this is one of the reasons I am so opposed to tail docking- I know what it’s like to knock an unpadded end of bone against things!

It also gave me a unique position of empathy when I took on the case of Izzy. Izzy is a very beautiful, very large and very scary Rottweiler. Her owner is a great client and always comes armed with a firm hand and a muzzle. All my examinations of Izzy have a background accompaniment of her emitting a constant, low, menacing grumble that always makes me thankful for muzzles!

Izzy had been booked in by a colleague to have a lump on the side of her toe removed and her owner had been warned that she would probably need the toe amputated too. When Izzy was knocked out and I embarked on the surgery my stomach sank. The mass looked very aggressive and resembled a very similar case I had in previous years that resulted in a horrible spread of cancer all through a friend’s dog and eventually euthanasia. This lump was in the same place and looked identical when I cut over it. The mass also appeared to be much more invasive than we had first thought. I decided it would be best to x- ray her chest for any signs of cancerous spread and to perform a biopsy before embarking on major surgery in case the type of tumour meant a very poor prognosis or might even require amputation of the whole leg to stop the spread.

It is always awful to get unwanted news and both Izzy’s owner and I were ecstatic to find out from the lab that the mass on her foot was similar to the one I feared but was not malignant and would be extremely unlikely to spread into her body. It was called a haemangioma- a type of tumour that invades tissues locally and arises from blood vessels. I was now faced with the task of trying to get all the abnormal tissue out.

Because these tumours are made of blood vessels they bleed massively and are very difficult to control during the surgery. The foot has a very large number of ligaments, nerves and vessels normally too and this can also make surgery in the area tricky.

I got stuck in and doggedly started tying off all the bleeders that presented themselves to me. As the surgery progressed I could see the extent of the tumour. One whole toe was affected but the mass was also started to work its way up the main vein that drains blood from the foot. I suspected that it had arisen in the vessels of the foot and was spreading along the vein and up the leg. There seemed to be a good clear junction between diseased and healthy vein and I had no choice but to tie of the vessel in order to remove the diseased section. This may sound dangerous but veins only take blood away from tissues they do not supply it. When a vein is tied off the blood gets diverted into the surrounding, smaller ones which take over the job. Tying off arteries is much more risky and, in most cases, impossible.
In the end we had to amputate up into the bone above the toe, the metatarsal, to be as sure as we could that all the tumour was removed. In a way I was happier with this because it meant that Izzy’s stump would be higher off the ground and less likely to get knocked as mine is prone to do.

The following couple of weeks were spent redressing and protecting the site of the surgery while it healed which, in turn, meant quite a lot of time for me squatting on the floor listening to that deep rumble and trying not to look at the whites of Izzy’s eyes as she craned round to offer me that sideways stare that all vets get to know- the look that lets you know you are about to get savaged! Fortunately for me, Izzy’s mum stands for no nonsense and has always been there to act as a human shield!

Luckily for Izzy, as for me, the affected toe is not one that usually causes problems with walking when removed so once all the bandages are off and the stitches are out she should be firing around the park as normal if ever so slightly lighter than she was before. Hopefully the only long- term effect of the incident will be that, like me, she no longer has a little piggy to go wee wee wee all the way home.

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