Amputation of the fingers may be indicated due to neoplasia, osteomyelitis, or trauma. In many of these scenarios, amputation of the affected finger (s) may be the easiest, most effective, and cost-effective method of restoring the patient to good health. Although this procedure is performed routinely, some aspects of this simple surgery can be more complicated.

What if I need to delete the number 3 or 4?

Since numbers 3 and 4 are responsible for increased weight bearing, it has long been feared that amputating either of these numbers could lead to long-term lameness or an unacceptable outcome. A retrospective study concluded that dogs with a 3, 4 or both digit amputation did not appear to have a worse outcome than dogs with other digit amputations.¹ Previous reports describing an increased incidence of persistent lameness after amputation of fingers 3 and 4 were often associated with resection of the finger in the mid to distal region of P1 or P2. Removal of the remaining bone resolved the lameness in the 3 reported cases.² Many practitioners prefer to amputate by disarticulation at the level of the metacarpo-metatarsophalangeal joint. Amputation at other sites is still acceptable, but more proximal metacarpo / metatarsophalangeal amputation may be warranted for numbers 3 and 4.

What if I have to amputate more than one digit?

Amputation of more than one finger (partial amputation of the foot) may give good results for the patient (Figure 1). In a small series of 11 dogs treated with partial foot amputation, lameness resolved in 8 dogs after a median of 37 days.³ The mild lameness that persisted in the remaining 3 dogs did not seem to impact their quality of life, and all owners were satisfied with the result. Another study found similar results, with both dogs in this study regaining full function after partial foot amputation.¹ In fact, they also discovered that it is possible to remove all the fingers and still have a functional and painless foot if the metacarpal / tarsal pad is preserved.

What if I don’t have enough skin to fill a paw defect?

Another complication associated with foot surgery is a lack of skin necessary to close a defect on the paw. This is common in cases of heavy mass removal or shear injuries. In these scenarios, a technique called phalangeal net is used to transpose the skin of a sacrificed finger to the defect of the paw (Figure 2). Although a relatively more complex procedure, this unique flap allows the closure of defects that would otherwise be impossible.

What about common complications?

Short-term lameness is to be expected immediately after surgery for uncomplicated finger amputation; however, other complications are also common. One study found that almost 40% of dogs had short-term complications, other than lameness, after amputation of a finger.¹ These complications included dehiscence with and without infection, wound discharge, and delayed healing attributed to dog licking.

Homeowners should be made aware of the potential for short-term complications; however, the long term results are generally excellent. Minimization of complications can be achieved through meticulous surgical technique (in particular, tension-free closure and precise apposition) and owner compliance with the use of the electronic collar or the management of bandages. Applying a light, soft, padded bandage for 1 to 2 weeks after the operation is common and can help protect the incision from environmental contaminants, licking and spreading of the fingers at the start of placement. charged. Stopping the bandage may be necessary if pododermatitis or bandage management becomes a problem.

Conclusion

Although short-term complications are relatively common after amputation of a finger, this surgery is generally well tolerated by dogs with good long-term results. Nonetheless, clients should be made aware of potential complications in order to ensure a positive experience for both client and patient.

Kassidy Burgess, BS, is a fourth year veterinary student at Midwestern University in Arizona. She has a strong passion for small animal surgery and hopes to complete a surgical residency in the future. In her spare time, Kassidy enjoys road trips and exploring the great outdoors.

Stephanie Rasoir, DVM, DACVS-SA, is an ACVS Certified Veterinarian and Assistant Professor of Small Animal Surgery at Midwestern University in Arizona. She enjoys hiking, traveling, making friends, family, and teaching veterinary medicine students.

The references

1. Kaufman KL, Mann FA. Short and long term results after finger amputation in dogs: 33 cases (1999-2011). J Am Vet Med Assoc. 2013; 242 (9): 1249-1254. doi: 10.2460 / javma.242.9.1249
2. Muir P, Pead MJ. Chronic lameness after finger amputation in three dogs. Veterinarian Rec. 1998; 143 (16): 449-450. doi: 10.1136 / vr.143.16.449
3. Liptak JM, Dernell WS, Rizzo SA, Withrow SJ. Partial amputation of the foot in 11 dogs. J Am Anim Hosp Assoc. 2005; 41 (1): 47-55. doi: 10.5326 / 0410047