Amp- W/o Fna Or Biopsy?

[Guest HeatherDemps]

As I mentioned in a different post- Dempsey's needle aspirate did not give a diagnostic sample. Vets are confident it is likely cancer, but of course won't say 100% for sure w/o confirmation.... we will be talking further with the vet hospital and are likely going to move forward with amputation w/o putting Dempsey through further testing. Has anyone else done this here? Anyone done it and been WRONG? I'm having little moments of panic of "what if" but I know the reality is that it's some type of cancer, likely osteo. Could just use a little reassurance though I guess. Dempsey is now putting less weight on that leg when standing- although he is still walking out (thank goodness for pain meds!).

 

Any thoughts?

[HopeForHounds]

I would have your vet send the x-rays to Dr Couto at OSU. He will give you sound advice. greyosu@osu.edu

 

[Guest HeatherDemps]

The first set of x-rays were already sent to him... he suggested repeating the x-rays, which we did, they show the bone lesion as being quarter sized....

[Guest MorganKonaAlex]

For Morgan, his leg broke landing at the base of the stairs 36 hours after starting to limp. The Vet was sure it was OSA and the leg was not repairable anyway.

 

For Alex, I did do the core bone biopsy and would not do that again. It was way too painful. I would make the decision without conclusive biopsy results if I had to do it over again.

[iluvgreys]

I think I asked this question before, but is there any chance your boy was exposed to Valley Fever or any of the other fungal diseases? If so, I'd rule that out with a test first. I think it's about $125 for a panel, and is just a blood test, not a biopsy.

[Guest HeatherDemps]

Isn't Valley Fever out west primarily? We are in Illinois (not that he couldn't get something here though). He isn't showing any other signs of these diseases, no coughing, no fever, no lack of appetite/depression, etc. No signs of infection. We will probably be going down again next week for a second chest x-ray and some blood work then move him over to surgery the next day, so I can ask about the blood work to rule out the fungal diseases.

 

 

I think I asked this question before, but is there any chance your boy was exposed to Valley Fever or any of the other fungal diseases? If so, I'd rule that out with a test first. I think it's about $125 for a panel, and is just a blood test, not a biopsy.

 

[Guest JohnnyBell]

My bridge girl Sophie had an xray which had a lesion on the bone most likely osteo.A bone biopsy was done, which didn't show osteo but it wasn't totally ruled out.She had a chance of not having osteo so we went ahead with the amputation to give her a chance.The decision was so hard to do.After the amputation was done the bone was tested and indeed it was osteosarcoma.Had I known it was osteo from the getgo I would have done pain managment and not amputated.My 2 cents.Good Luck!!!

[Batmom]

If you wanted to check on the possibility of fungal diseases, you'd want to do that sooner rather than later -- the bloodwork takes awhile. The two most likely to occur in the midwest are blastomycosis and histoplasmosis. IIRC one of those is more likely to produce bone lesions than the other, but I've forgotten which.

 

ETA: There are also various types of bone degradation that can occur, especially in older dogs, that are not cancerous.

[Greytlady94]

The first set of x-rays were already sent to him... he suggested repeating the x-rays, which we did, they show the bone lesion as being quarter sized....

 

Were the second set of x-rays also sent to Dr. Couto?

[Guest HeatherDemps]

No, but I'll be talking to the oncologist again tonight so I'll see if she can forward them on to him as well.

 

The first set of x-rays were already sent to him... he suggested repeating the x-rays, which we did, they show the bone lesion as being quarter sized....

 

Were the second set of x-rays also sent to Dr. Couto?

 

[ahicks51]

Dr. Stack is a vet in Yuma, AZ with a lot of experience with greyhounds. I saved this off the greyhound email list as it reflects her experience with her own dog.

 

Date: Sun, 2 Dec 2007 13:37:12 -0700

From: Don and Suzanne Stack <yumadons@GMAIL.COM>

Subject: MEDICAL: Tips from osteo survivor

 

<< Anyone out there have a long term cancer survivor, a year or more?

Could you please forward what treatments, feeding, medicines you did

that you feel might have helped your dog become a survivor. >>

 

 

My greyhound, Aussie, now 9 years old, is > 4 years post amputation

(Oct 23, 2003). His protocol:

 

Took x-rays just a few days after noticed him limping. Saw what looked

like osteo at proximal humerus (left shoulder). Did not waste precious

time with a biopsy - amputated the very next day.

 

Started chemo exactly 1 week post-amputation - the day we got biopsy

results back from the lab (we sent in the amputated limb for biopsy).

 

Aussie had 6 carboplatin chemo treatments. No problems except a low

WBC delayed the 6th chemo by 1 week.

 

He's taken 3.75 mg meloxicam (generic Metacam) ever since amputation

because he's got a bad arthritic hock in backleg on same side.

 

1 year post-amputation, I started him on 10 mg tamoxifen once daily.

Tamoxifen is the anti-estrogen drug that breast cancer survivors take

for the rest of their lives. Anecdotally, tamoxifen may be an

anti-angiogenesis drug (a drug that stops new blood vessels from

branching out from tumors). Tamoxifen can have some problems in girl

dogs but is OK for boys. Not approved nor or you likely to be able to

find out much of anything about it. I just started Aus on it because a

friend's boy osteo grey was started on it by Dr. Ogilvie (ex CSU

oncology guru). I figured if it's good enough for Dr. Ogilvie, it's

good enough for me.

 

Aus eats the same food as the rest of my dogs, "Enhance Hunter's Edge"

by ARKAT. We feed it because it's relatively cheap (we have lots of

big dogs) and does a greyt job keeping weight on my greyhounds with

once daily feeding. Relatively high in protein, fat, and calories.

Protein 24%, fat 18%, ~585 calories/cup. Aus doesn't get any

supplements or special treatment and is very fit (we live on 2 & 1/2

acres).

 

Suzanne Stack, DVM

[sdisto]

Sorry to hear of Dempsey's situation. I will say a prayer for the both of you that it does not turn out to be OS.

 

Unfortunately, I have learned more than I care to know of OS in the last two months. Here's our story.

 

My 6 1/2 year old, Jesse, began limping after a walk in the park one Sunday in July. He was in a great deal of pain all night long, so first thing in the morning I took him in. They did an x-ray (suspecting OS) but it came back clean. The bone lines were perfect except for a small fragment, or joint mouse, which we suspected was the result of calcification due to early arthritis. We put him on an anti-inflammatory and in a day or two the pain went away. He had a couple of re-occurances, but they were further an further apart so I thought we were in the clear. Then one day I realized that he had begun limping again and it wasn't responding to the anti-inflammatory, so I made another appointment. On November 3rd, they did another x-ray. Expecting to see some sign of arthritis (remember, they had already ruled out OS) I was absolutely blind-sided by the sight of his bone - completely destroyed.

 

Since then I have discovered that OS begins eating the bone from the inside, so it doesn't actually show on an x-ray until it works it's way out. Typically, dogs hide their pain to keep them from being vulnerable so we don't usually see any early warning signs.

 

Three days later I met with the surgeon. He questioned if Jesse had ever raced in the south and may have been exposed to Valley Fever. He said that there could be a slight chance that it was an infection, which could be treatable, but that he had only ever seen that in one dog - out of hundreds! If I did chose to wait on a biopsy, it would take some time. It could also be dangerous for the bone because it greatly increases the risk of breaking it. In the end, I didn't feel like I had the time to wait for a biopsy when the chances were so incredibly slim that it could be anything else. Besides, the bone had already been destroyed so badly that I didn't feel like we had much of a chance of repairing it -even if it was an infection.

 

So here we are, nine weeks later. Jesse's right front leg was amputated the next day and he never looked back. He had some pain for the first two days due to the fact that it was major surgery, but now his is back to his old self and I for one am glad that he is rid of the pain that the leg was causing him. He just had his third of six chemo treatments today and if he wasn't missing a leg you wouldn't even know that anything was wrong with him. In fact, 5 weeks after his surgery someone at the vet's office commented that it almost looked as if he had been born without a leg because he looks so natural. Oh yeah, after surgery the biopsy came back positive for OS.

 

Whatever you decide, don't second guess yourself. Follow your heart and you can't go wrong - for yourself or for Dempsey.

 

Good Luck

[Guest HeatherDemps]

Thanks a lot everyone.

 

I think I have just been having these little moments of "what if". I did sign the release for the x-rays to be emailed to Dr. Couto and he said he'd look at them of course, but I don't think that's going to change anything. I talked with my vet tonight and she does agree that we are looking at cancer, just not sure what specific one. I guess during the examination, the oncologist could feel that it was not normal bone there (the word my vet used started w/an "L", can't remember it though!). I remember the oncologist saying that now... My vet suggested I make a list of the reasons why I made this decision and to hang onto that during the times I'm scared and second guessing. Will talk with U of I tomorrow but we are probably going to schedule the amputation for next week. They want to do new chest x-rays and bloodwork and if those come back good, we can get him right into a trial that includes the chemo.

[Aerosmom]

I'm so sorry to read this. I think the "L" word is lytic -- the lesions/moth-eaten appearance of bone cancer. I had a fine-needle aspirate done for Snickers but the results were inconclusive. I think the look of osteo is pretty distinctive and I had my local vet, Dr. Couto and a radiologist confirm it. In retrospect, I wouldn't have bothered with the FNA. There are also typical locations for osteo. I remember I kept asking could it be something else, but there really weren't any other possibilities other than the fungal infection. I remember feeling like I wanted to just do something to fight the OS and scheduled the amputation that week. The difference between Snickers's first set of x-rays and the second just a few weeks later was devastating. It's a very aggressive cancer. After the amputation, the results came back OS as we suspected. I think the oncologist told me if it looks like a duck and walks like a duck....meaning the x-rays were convincing enough on their own.

 

I hope you have joined Circle of Grey -- it's a wonderful source of info and comfort.

[Guest HeatherDemps]

Yes, thank you, lytic is the correct word. Dempseys' x-rays were two weeks apart and fortunately, I don't think there was a significant difference between the two. Unfortunately, we are noticing subtle signs that he is not using the leg as much as before, so that could have changed already I suppose. I think I've accepted it is what it is (for now) and am just ready to move forward and do what we canto fight this. I have joined Circle of Grey, and that along with GT, has been such a huge source of information and support to me.

 

Thanks again....

 

I'm so sorry to read this. I think the "L" word is lytic -- the lesions/moth-eaten appearance of bone cancer. I had a fine-needle aspirate done for Snickers but the results were inconclusive. I think the look of osteo is pretty distinctive and I had my local vet, Dr. Couto and a radiologist confirm it. In retrospect, I wouldn't have bothered with the FNA. There are also typical locations for osteo. I remember I kept asking could it be something else, but there really weren't any other possibilities other than the fungal infection. I remember feeling like I wanted to just do something to fight the OS and scheduled the amputation that week. The difference between Snickers's first set of x-rays and the second just a few weeks later was devastating. It's a very aggressive cancer. After the amputation, the results came back OS as we suspected. I think the oncologist told me if it looks like a duck and walks like a duck....meaning the x-rays were convincing enough on their own.

 

I hope you have joined Circle of Grey -- it's a wonderful source of info and comfort.