Originally Posted by animalcraker
Am I reading correctly that you're suggesting using a local anesthetic to perform a partial leg amputation?
I said the OWNER should ASK * THEIR * VET or better yet, get a 2nd opinion from a different vet, as to whether amputation
rather than dissection would be possible, as it greatly shortens the period of sedation / anaesthetic.
Additionally, laser surgery seals blood vessels as they're cut, & thus limits blood loss - which the OP's vet also said was a serious concern.
For all i know, opting for amputation instead of dissection might make the surgery possible - or amputation plus laser might make the difference.
OTOH, none of us knows the prognosis
of this dog - for all we know, he may have only weeks of survival time, which would make tissue-sparing dissection of the tumor or even amputation, pretty pointless.
If we cannot improve the quality of his life by sparing him pain, or extend his life in a meaningful fashion so that he can still enjoy some quality of life, then any major intervention could actually be abuse.
Without that critical info, we can't say. What we have is the information the owner has provided.
I am not a vet. I am quite literally listing the very Qs that i would ask MY vet
, if my dog could avoid further suffering & *possibly* extend their life, by having fewer drugs [to spare their damaged kidneys] plus laser surgery.
I would further ask my vet just how long amputation would take, using a laser to minimize blood-loss, & what the prognosis of my dog is, in days, weeks, or months.
If 5-minutes or less under a local anaesthetic with a laser would potentially extend my dog's life AND relieve their pain, & assuming that my dog could also take post-surgery pain meds AND blue-laser healing treatments to minimize inflammation & cut healing time, why would i not do that?
There is also ketamine
- whether this would stress the dog's kidneys or liver too much, i don't know.
If this were my dog, that's another Q that i'd ask. If ketamine spared the organs & made the dog safe to operate on, & a rapid amputation with laser would then be possible, with a reasonable prognosis of fair quality of life on 3 legs --- for a while - Why not do it? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258981/
QUOTE, Recent clinical applications ...
Procedural sedation for adults and children:
The literature is strongly supportive of the safety and efficacy of ketamine for emergency department (ED) dissociative sedation, for a variety of brief painful or emotionally disturbing procedures in both children and adults, e-g.: Laceration repair, fracture reduction, abscess drainage, emergency cardio-version, amputation, chest tube insertion.
It is useful for procedures in the mentally disabled, who are often unco-operative. 
This dissociative sedation can be readily achieved by administration of a single IV or IM loading dose of ketamine followed by titration.
Intranasal ketamine is being used in a wide range of clinical doses for procedural sedation in children (0.5 - 9 mg/ kg). [44, 45] It is used for sedation or general anesthesia for pediatric procedures like cardiac catheterization, radiation therapy, radiological studies such as MRI, dressing changes, & dental work.[1, 3, 46]
Ketamine in low doses in combination with low-doses propofol provides effective & safe sedo-analgesia in pediatric emergency short surgical procedures & in adults undergoing colonoscopy & short gynecological procedures [47,48,49]
All of these, of course, assume that i can afford them:
laser-surgery, the amputation co$t, the vet's fee, post-surgery blue-laser Tx, possibly a transfusion from the vet's stock or a self-transfusion from my dog, plus follow-up care, post-surgery meds [antibiotics, pain Rx or OTC], etc. Surgery without general-anaesthesia or even a local
was done for centuries & continues to be done, but those surgeries are on humans, & so not topical. Personally
, I've twice had procedures, surgery / stitches, sans anaesthesia -
the 1st was a root-canal on an abscessed tooth, gone so far, i could time my pulse by it. I was in agony. WARNING
: painful description:
my dentist, whom i trusted & had known for years, told me the swelling was so bad, he could not ascertain the bottom, so i had to be able to feel it & TELL him when the drill got there.
It hurt like H***, but i did not move, i gave him the high-sign when the drill bottomed out, & the relief when the pressure eased was enormous. // I was 21 at the time, & that was over half my lifetime ago.
Do i think i should have died, rather than have a painful but relatively-short surgical procedure to remove an infection that could have become life-threatening?... Of course not.
The second was after an accident in the kitchen -
I was the chef in a PSU fraternity, & breaking down a pork-loin into chops. The knife hit a curved inside-joint surface & skidded, cutting so deeply into the left index finger's proximal knuckle, that both joint & ligaments were visible. // I was prepping for Homecoming weekend, & i couldn't bend my hand
, because the wound would instantly bleed in a heavy seep.
Off to the E.R. -- One of the brothers drove me there.
On arrival, they had no locals that did NOT contain pseudo-epinephrine, which i can't tolerate. The Dr on duty gave me 10 stitches, 3 internal & 7 external, when i should have had 12 - he was so upset over sticking me sans numbing agents that he fiddled & faffed over every stitch, taking twice as long or more, & he SKIPPED 2
, at the center of the wound, where the stress was greatest when i flexed my hand.
(I kept telling him to get on with it, please, i'm okay - that it would hurt less
if he just did it & got it over with, but he couldn't seem to steel himself.)
As a result of his tender sensibilities, the scar is wider than it should have been, & i had to wear a home-made aluminum splint for 10-days to keep the stitches from cutting thru my skin if i inadvertently flexed that knuckle - I had only 9 usable fingers, & one rigid useless stick with a metal splint & lots of vet-wrap, securing it.
Do i think i should NOT have gotten stitches? - Of course not.
Do i think that i should have stayed at home, & quit my job, to nurse my own hand full-time, vs get fully-sentient stitches & deal with the pain when using my hand? - of course not.
I needed to be employed; i needed my wages. Leaving it open to continue bleeding, or to get infected, would be asinine; joint infections are bu**ers to knock down, & readily spread to become body-wide sepsis.
So in both instances, painful treatment w/o anaesthesia certainly beat no Tx at all. Euthanasia
We don't euthanize humans who are suffering; in some cases, IMO & IME as a caregiver, we merely prolong their pain.
Euthanasia, when the person is compos mentis
, is terminal or suffers untreatable pain, & that person desires it, could be an incredible kindness - again, IMO.
The closest we approach it is assisted suicide, & that's legal only in a few nations / states. // Our pets can be legally killed with minimal pain, to spare them & ourselves further suffering; because they cannot kill themselves, we extend this last gift to them.
whether the OP's dog is in serious pain now, we don't know; whether their dog's pain will ramp-up quickly & wreck any remaining quality of life, we don't know.
Whether the dog might live in relative comfort for a few more months, once free of that tumor, we don't know - only a vet who's seen the dog, & the owner who's heard that vet's diagnostic opinion, knows if there is a chance for a bit more time, or if it is best to resign oneself, & stop all suffering by euthanizing the dog.
Everyone dies; how one dies, or when, may or may not be a decision we get to make. But we can make choices for our pets - which choices we make are entirely personal.
I had a client who opted to euthanize her lean, whipcord-tough 18-MO 45# dog, rather than amputate his foreleg - the one with bone-cancer eating the wrist.
I thought it was not a good choice - he was young, otherwise healthy, a narrow-framed dog who could easily & happily live as a tripod.
But he was HER dog - not mine.
is there any update? -- How's he doing, & how are U coping?
all my best,