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Book Review
Without Regret:
Handbook for Owners of Canine Amputees
by Susan Neal

Review by: Kate Connick, Dec. 2002

I have never lived with a 3-legged dog, nor have I faced the prospect of having to subject one of my pets to amputation. And so it was with particular fascination that I read Susan Neal's Without Regret: A Handbook for Owners of Canine Amputees. This recently-published book is truly one of a kind, as it covers a subject that few of us give much thought to unless circumstances force us.

Neil comprehensively explores the topic of canine amputees in an effort to provide the layperson with a useful and inspirational reference guide. The author estimates that more than 30,000 dogs undergo amputation annually, a figure that I must admit I find somewhat suspect. Where are all these dogs? Nonetheless, even if that figure is inflated, I have no doubt that numerous people can benefit from reading a book of this nature.

The author discusses common reasons for amputation, dividing them into cancerous and non-cancerous categories. Bone cancer (most often, osteosarcoma) is the number one cancer leading to amputation. Neil's discussion of cancer is extremely readable and easy for anyone to understand. Auto-related accidents, not surprisingly, lead the pack in terms of non-cancerous events necessitating amputation. Other causes include abuse/neglect, birth defects, animal attacks, and gunshot wounds. She stresses that amputation is a life-saving manuever that dogs adjust to readily.

The author strongly and sensibly hammers home the idea that amputation can suddenly present itself in any dog's life but that most (non cancer related) amputations are preventable through proper restraint and supervision. Sometimes she comes on a bit too strong in wanting to assign blame. For example, in discussing congenital defects she remarks, "One can only hope that the dogs used in that breeding would never be bred to each other again and that the entire breeding line and program would be seriously reevaluated." Ironically, this well-intentioned remark is found in the chapter where she discusses terminology. She confuses congenital disorders with genetic disorders, and they are not the same thing. A congenital defect is one that the animal is born with, but it is not necessarily hereditary, so there is no logical need to remove the parent of such an animal from a breeding program.

Again, with all good intentions, the author presents information which I believe may be misleading. She discusses "data provided by canine amputee owners during 1997-1998" and attempts to make sweeping generalizations about amputee demographics based on this information. Nowhere does she detail how that data was obtained, and the reader has no reason to believe that it is a representative sample. While the author admits that no central organization systematically maintains records about canine amputees, she draws up tables and attempts to extrapolate conclusions based on what appears to be a very limited sample of amputees.

The pseudo-scientific approach is off-putting to this reader. Without a representative sample (or even a description of how she obtained her data), her generalizations about amputees are meaningless. She would have done better to adopt the informal and more personal mood of Susan Cope Becker's book about deaf dogs. That author freely admits that much of her information is anecdotal, and she uses the anecdotes to develop a warmth that is understated in this book.

In fact, my greatest criticism of this book (one that other readers may disagree with entirely) is that the author sacrifices much-needed sentimentality in an effort to present a more informational handbook. It is, in fact, an informational book. I have no complaint there. Anyone could have written the book, in fact, but anyone didn't. The owner of a canine amputee wrote it, and yet the author never shares with the reader the soul-bearing emotions that went into her own heart-wrenching experience and decision-making. It's that unique perspective that the author has that makes her so special as an author, and yet she held back.

The author's bullmastiff had been diagnosed with bone cancer at age two and given a five-month prognosis. She went ahead with amputation, and the dog experienced a complete remission and was alive and well six years later as the book went to print. That's all we really know. I craved a chapter about the author's own, very personal struggle. Instead, I read, "Dog owners faced with the prospects of owning an amputee... will be seized by an emotional roller coaster that will become the most difficult aspect of their ordeal to understand and with which to come to terms." Accurate? I don't doubt it. But very clinical. The author dropped the ball in not sharing her pain and triumph in a more personal way. That would have lifted the book from flatly factual to gut-level inspirational. As a reader, I wanted to be moved as much as educated.

That is, perhaps, a nit-pick, because the book is filled with a wealth of information that ranges from patient criteria for amputation, to the surgical aftermath itself, to practical tips for making life a bit easier for the amputee (for example, no-skid bathroom mats placed at strategic locations are a big help). The author discusses pain management, and she even sensitively discusses when to say goodbye. The chapter about the history of amputation is riveting. Throughout, the book is intelligently written yet very readable.

The author does best when she sticks to her topic. Chapters 9-12 meander as she attempts to discuss everything from where to purchase a dog to dental care, and as a result, those are the book's weak points. The author's shining moments come when she discusses the practical aspects of life with an amputee. She warns that other housemate dogs may be alarmed by the amputee's surgery and also by his stilted gait, for example. In discussing diet for a terminal cancer patient, I smiled when I read her advice, "Allow her to eat anything she wants... make your pet's remaining time as enjoyable as possible... give her whatever she loves - hot dogs, ice cream, spaghetti, prime rib, fried eggs." One notable omission is any mention whatsoever of "phantom pain," as that's a significant quality of life issue for human amputees. Once dogs recover from the immediate surgical procedure, do they experience phantom pain in the missing limb?

At times, the author contradicts herself, proposing on the one hand that amputees can perform all normal activities including farm work and competitive dog sports (agility, obedience, hunting trials), and on the other admitting that amputees tire easily. She argues that amputees are and should be able to compete in dog sports, but she never tells us about any dogs that actually have done such a thing. As an agility instructor, I think it would be unsafe and unkind to attempt to perform competitive agility with a 3-legged dog, and I think it's either insensitive or uninformed to suggest that this is realistic.

A few of the author's remarks border on offensive. She attempts to contrast amputees to blind and deaf dogs, concluding that, "Unlike the other major canine disabilities (deafness and blindness) there is generally no measurable diminishment of the dog's quality of life" for an amputee. I know plenty of deaf dogs and their owners who would disagree. I, myself, own a dog who is blind in one eye, and it doesn't impair him one bit. Neal continues, "Most amputees can continue to work, play, and enjoy life just as they did prior to their surgery, whereas the majority of dogs who have lost their vision or hearing can no longer engage in many of the activities they once did before their impairment." Says who? It gets worse, "(Amputees) maintain their normal moods and behaviors, whereas dogs suffering from blindness or deafness can become fearful, confused, depressed, or snappy as a result of the new stresses that their condition has imposed on them." I think that the author has an unfairly negative perception of deaf and blind dogs, and I resent her trying to denigrate them in order to validate amputees.

Also misplaced is the author's endorsement of sanctioned amputation, i.e., cropping and docking. She argues against the trend toward outlawing these practices, strongly stating, "The heritage of many breeds has suddenly been tossed out the window, dooming such breeds to the fate of mongrelization, or, at the very least, politically correct mediocrity." Ironically, this follows her discussion of the historical practice of removing three toes from large mastiff dogs, something she refers to as a "cruel amputation custom." What makes removing ears and tails a noble form of history and removing toes an offensive act?

Lastly, some of her remarks about owners of potential amputees tip-toe perilously toward being cruel value judgments. My guess is that the average person opts to euthanize rather than to amputate (and the choice is as cut and dried as that) because they genuinely believe that it is in the best interests of the dog. The author coldly offers, "Many animals who are excellent candidates for amputation are owned by individuals who cannot deal with any type of disfigurement... For some people, owning a disabled dog is an indication that there is something wrong with them, and that society will hold it against them. For others, there is an underlying prejudice against those they view as cripples." Ouch. I find those kinds of remarks unnecessarily mean. It is very possible that people focus on different things. The person she views as shallow may deem chemotherapy, pain management, surgery and surgical recovery, tiring easily, etc. important quality of life factors for their dog. It offends this reader that the author would so harshy brand people who make decisions that differ from her own.

This is a good book and a very worthwhile read. Admittedly, I'd prefer if its focus never drifted from amputation-specific issues, and if the author had adopted a more personal/sentimental approach, but my preferences are just that. I have no doubt that the information in this book would be invaluable to anyone whose dog is facing amputation. Even though amputation isn't something I've faced or am facing now, I found the book fascinating, and I applaud the author for tackling this neglected topic.

Without Regret: Handbook for Owners of Canine Amputees by Susan Neal.
Published by Doral Publishing, 2002. ISBN: 0944875858

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