Amputation For My Grey

[Guest tiffysmith]

Hi everyone. My name is Tiffany Smith and I am new to this board. I have two greyhounds, Annie and Star. Last night my greyhound Annie took a horrible spill on my kitchen floor and broke her front left leg (up near the shoulder.) I rushed her to my vet who sedated her and took an x-ray. He said that it was the worst break he had ever seen and sent us to the emergency room at U of Penn. Annie was put on IV and pain meds. Her chest was x-rayed to look for bone cancer. Nothing came up on the x-ray. This morning I spoke with the ortho specialist. They were still concerned about bone cancer due to the severity of the break. They did an aspiration today that also came back negative. They also took an biopsy that will be back on Tuesday. That will tell us definitely one way or another. I am praying that it is not cancer. If she does not have cancer we have decided to have her leg amputated. The break is so severe.

 

We are taking her to NGAP for the procedure.

 

Any advice that anyone has would be great.

 

Has anyone every had a chest x-ray and aspiration come back negative, yet have the biopsy come back positive?? I know I am only second guessing everything, I am just having such a hard time waiting for the results.

 

Thanks!

[greysmom]

No advice. just some good thoughts for your girl.

 

Be patient. You have a plan and it sounds like a sound one. The Board is slow on weekends so you may not get a lot of responses.

 

Good luck!

[joejoesmom]

Arghh, I had just written the complete response (many lines) and the computer kicked me off before I clicked to submit. So I am going to do this in two messages.

 

Tiffany, please call me. I can probably answer most if not all of your questions. My number is 614-523-0754. Call anytime. Don't worry about waking me up if you don't get this until late. I typically stay up very late.

 

My number is 614-523-0754.

 

Jane

[HopeForHounds]

Tiffany, Jane will be an excellent resource, and can give you information for OSU's Greyhound Wellness program as well.

Other than that, I pray that it is just a really bad break.

 

I'm sad that this was the reason you found the board, but welcome! You will find lots of resources and support here.

[RobinM]

And you know how to reach me if you need to!

 

Robin

[Guest azlorenz]

Praying it is just a terrible break and you don't join the osteo club.

[Guest ChasesMum]

PRAYERS FOR A FLUKE BREAK AND NO OSTEO!

[Magdalyn58]

Sending prayers from NEPA. I hope it's not osteo. I'm so sorry that you are going through this.

[GreyPoopon]

No advice, just best wishes for you and your girl.

[Guest Paige12]

Wow, what a nightmare. Keeping both of you in my prayers and thoughts tonight. Beth in Ohio

[joejoesmom]

I will first answer your primary question and then give you more information.

 

Yes it is possible to have clear lung x-rays and an inconclusive (negative) aspiration and still have bone cancer. Usually bone cancer can be diagnosed with a good deal of certainty by viewing an x-ray. Most cancers have a very distinctive pattern. A fine needle aspirate can confirm that diagnosis or be inconclusive. Since a biopsy can weaken the bone leading to breakage, it is typically not done. In your case, I am guessing that the break is so severe it is impossible to detect any cancer-like pattern in the bone fragments.

 

You might think back to her behaviour over the last few weeks or month. Have you noticed her limping or favoring a leg? Have you noticed her panting more than usual (a sign of pain)? Has she been playing or running less than normal? While none of these are conclusive, it may give a hint. She certainly could have cancer in the absence of these signs. Likewise, there are other reasons she might limp, pant or play less.

 

Even if it is cancer, you may still want to do an amputation. See the survival statistics below.

 

Osteosarcoma is by far the most common bone cancer in greyhounds; about 1 in 4 greyhounds will get this type of cancer. It is very, very painful. It will weaken the bone so the bone is prone to breaking. This cancer will spread (metastasize) to other bones and the lungs if not treated. In more than 90 percent of the cases there are small mets (matastases) that are not visible on xray. This means that it will spread even when it is treated, but there is a longer survival time with a much better quality of life. There are a couple of bone cancers that do not metastasize. This means that if the affected bones are removed, the dog is essentially cured. Unfortunately, these are not as common as osteosarcoma.

 

Here are some statistics on typical survival times with various treatment options for OS (osteosarcoma) with no visible tumors in the lungs:

 

Amputation, then chemotherapy: 50-60 percent are still living at one year post-amputation. This period has the same or almost the same quality of life as before the cancer. Removal of the cancerous bone eliminates the horrible pain from bone cancer. 10-20 percent are still living at 2 years post amputation. I personally know of a few who have lived 3 years or more. One of my friends has a greyhound that is more than 3 years post amp and is still going strong. However, 40 to 50 percent do not make it to the 1 year point. Try to remember that to a greyhound, one year is 1/12th to 1/14th of their normal life. In other words, a year to us is really 7 years to a greyhound. This treatment is fairly expensive. At Ohio State University, the amputation is typically $3000 to $3500, inclusive of surgery, a 4 day hospital stay, and medications while in the hospital. Administration of the chemo at OSU is relatively inexpensive. The 5 treatments, inclusive of blood work and a lung xray usually totals about $500. I have heard quotes as high as $2500 from other parts of the country.

 

Amputation, but no chemotherapy -- I'm not sure on this one. I would guess 3 to 4 months. Removing the leg eliminates the pain from the bone cancer. However any lung mets that were too small to see on the x-ray would grow. Eventually this would impact her breathing and other functions. It is also possible that there are undetected mets in her other bones (spine, other leg, etc.). In this case, the pain would become uncontrollable.

 

No treatment, except for pain management -- 2 to 3 months after initial diagnosis. In your case, if she has bone cancer you would either need to amputate immediately or put her to sleep immediately.

 

Unlike in humans, chemotherapy in dogs is generally very well tolerated. Most greyhounds have few side affects. Typical side affects are some lethargy and queasiness for a day or two after the chemo treatment. This often doesn't start until midway through the course of treatment. Ohio State University will provide certain chemotherapy drugs at no charge to retired racing greyhounds. However you would still need to pay for the administration.

 

Typical chemotherapy for OS is 5 separate administrations of an IV chemotherapy agent given 2 weeks apart. After that it is often suggested to provide some herbal supplementation (such as artemisinin) and perhaps the oral cancer drug, Palladia.

 

You may be asking how do I know all this. No I am not a veterinarian or a vet tech. I live near the Ohio State University Veterinary Hospital. This hospital is home to Dr. Guillermo Couto, widely regarded as one of the best greyhound experts in the world. He is the section chair for oncology (cancer), hematology (blood), and greyhound medicine. He runs a greyhound clinic and supervises three veterinarians who are almost totally dedicated to greyhound medicine. He also has a staff of roughly 12 oncologists. I help people who choose to come to OSU from far away. A group of local greyhound owners can provide reservation assistance, moral support, or even have owners and their dogs as guests in their home. So I have sat in on a lot of osteo consults and been there with owners as they wait for the amputation surgery to be completed. Unfortunately, this past week, my own greyhound has had to undergo amputation due to osteo. He is still in the hospital.

 

Dr. Couto's team will provide free phone or email consultations. They may be able to take a look at your x-rays and tell if it is cancer, perhaps not with the severity of the break.

 

If you decide on amputation, I suggest that your vet contact OSU for information on the surgical and post-care protocol Dr. Couto has developed. This includes administration of Amicar for all Greyhound amputations. Greyhounds have a tendency to bleed significantly. Amicar increases the bonding strength of blood clots, significantly reducing post-op bruising and guarding against death from bleeding out. It also includes a cocktail of fentanyl, ketamine, and lidocaine post-op to help keep the greyhound relax. Greyhounds tend to get quite nervous in a hospital environment. Keeping them calm helps promote healing.

 

I am not sure, but I believe NGAP does not agree completely with Dr. Couto's protocols. It is possible that you may hear different strategies from them.

 

I am happy to help you in any way that I can. Please feel free to call me or email me at:

 

finewhipador-drool@yahoo.com

 

Jane

Edited August 1, 2010 by joejoesmom

[Guest bigorangedog]

Hi there. Sorry you're going through this.

 

Yes - it is VERY possible, and in fact not uncommon, that the first sign of osteosarcoma is a terrible break. This happened to my vet's greyhound last year, actually. No other signs of bone cancer, including the needle aspirate.

 

I have done amputations with 2 of my dogs in the last year, so if I can help in any way please let me know. Check out the link in my signature here to my blog post on "What to Expect with a Leg Amputation."

 

Best wishes for you and your pup.

[MandysMom]

I have no advice, just prayers for your Annie.

[Charlies_Dad]

We are also thinking of you and Annie. As you can see by Jane's response, she has basically answered all questions in relation to what happens if it is cancer. If it's not, Annie will likely do well on three legs all the rest of her life. If it is cancer and you find out later, so be it, you'll tackle that then.

[Guest tiffysmith]

The vet just called. Annie is doing well. She is eating and drinking. She just wants to be pet and lay her head in your lap. The vet thinks it is ok for us to come and see her. We are heading over to the U of Penn now.

 

Thank you all so much for your support!!

[Guest ChasesMum]

enjoy your visit!

[silverfish]

I'm so sorry to hear about Annie.

 

I can't answer about bone cancer since I have no experience with that, but I do have a tripod, who shattered his hock in his last race. He is three years post amputation and is doing very, very well. About the only thing he can't do is walk backwards. He chooses not to jump onto furniture or go up and down stairs, though he has done short flights of stairs outdoors. The op and the recovery are harrowing, but there is a bright future out there for her, especially if she doesn't have cancer.

[Guest PhillyPups]

Hi Tiffany

 

As you can see, we are in Philly, should you need a shoulder to lean on.

 

Your girl is in good hands with her vets. The important thing is you trusting the vets you choose, being accesible to them and not second guessing yourself as every decision you make will be made with love.

 

I will keep you in our prayers and thoughts and if you need a shoulder, just let me know.

 

Pat

[Guest tiffysmith]

We visited with Annie this afternoon. She is being a real trooper. She is still eating and drinking. We took her a bunch of treats that she ate and loved. I spoke with the vet. She is hopeful for Annie.

 

To have the amputation performed at U of Penn would be an additional $4,000 and Annie would be released just a few days after surgery. As of today our bill is around $2,000.

 

NGAP will perform the amputation for $1500 and keep her for a week while she is recovering.

http://www.ngap.org/greyhound-health-leg-amputation-tigger-y431.html

My link

 

I have already taken out a credit card (care credit) to afford her stay at the U of Penn. I know that NGAP has done over 2 dozen amputations with greyt success. I would love to get her to Dr. Couto in Ohio, but I do not think Annie could make the trip.

 

Thank you all so much for keeping her in your prayers. I am sure I will have a million questions after we bring her home ...

so I am "pre-thanking" you for bearing with us :-)

Edited August 1, 2010 by tiffysmith

[Guest Swifthounds]

My heart goes out to you.

 

I know Penn is the go-to place for lots of folks in the PA/NJ area, but I've not ever found them to be worth the extra cost. That said, I wouldn't go with NGAP either, but for other reasons (not cost). I have an orthopedic practice that I use (as well as several large adoption groups that use them for broken legs) whose surgeon walks on water AFAIC and also a specialty practice that does impeccable work (by board certified specialists and surgeons) and is very reasonable. PM me if you want more details.

 

Wishing you all the best.

[duncan41]

Welcome to GT and like the rest, I am very sorry you found this site under these circumstances. There is an incredible amount of information on this site and so many greyt people willing to help. IIWY, I would use Jane as a go-to resource. As she indicated, she has not only sat in on many consults, but is now going through it herself. The surgery is just step one of a very long journey. Please learn as much as you can of everything "post amp". Sending prayers for you and Annie. Please update when you can.

[joejoesmom]

My heart goes out to you.

 

I know Penn is the go-to place for lots of folks in the PA/NJ area, but I've not ever found them to be worth the extra cost. That said, I wouldn't go with NGAP either, but for other reasons (not cost). I have an orthopedic practice that I use (as well as several large adoption groups that use them for broken legs) whose surgeon walks on water AFAIC and also a specialty practice that does impeccable work (by board certified specialists and surgeons) and is very reasonable. PM me if you want more details.

 

Wishing you all the best.

Tiffany doesn't have PM abilities yet. You could either post the vets info or your email just in case she wants to follow up with this.

[Guest Swifthounds]

Thanks for that. I forgot about the number of posts needed to PM.

[MaryJane]

I just wanted to mention that joejoesma did a "great summation" on the amputation outlook.

[Guest PhillyPups]

Tiffany,

 

I know you came here new to this forum very confused and distraught and under tragic circumstances. You asked about amputation and have been given unsolicited advice on your choice of vets. I think UofP is incredible and personally have had success with surgical procedure at NGAP.

 

I am here to support your decisions for your girl.

 

There are a lot of good vets in this area, as a result of having UofP vet school here.

 

I will keep you in my prayers.