Golfball Size Tumor On Upper Leg Joint

[Guest Tatum]

My sweet white greyhound Tatum had been limping off and on for the last two weeks. I wasn't too concerned as she was eating fine, playing with her toys, and acting normal (besides the limp). I kept checking her left leg and foot but didn't see anything until Christmas Eve. My heart sank when I saw and felt the hard tumor on her upper left leg. Because she wasn't in pain or stressed we waited until (Yesterday) Monday to see the vet. He took some radiographs and said, as he could tell, the bone looked normal - no breaks - but he confirmed that she had a tumor on that bone. He suggested several options to determine what the tumor is... the only one I would consider is the fine needle biopsy to help diagnose the tumor but from everything my husband and I've read (and it was hours of reading) we are almost certain that Tatum has Osteosarcoma. We have both agreed that if this is the case, we'd like to do holistic treatment rather than any type of invasive treatments or surgery. So we are even wondering if the fine needle procedure is necessary. Should we send the x-rays to Dr Couto? We adore Tatum and have cried and cried over this, and right now are trying to figure out what to do next. I must add here that our philosopy is that we could spend $1000 and put Tatum through amputation, and treatment to give us maybe only 6 more months with her or we can do our best with her while she is still pretty much painfree then donate to our group, help rescue another grey, and give a nice donation to Dr Couto.

 

I have read on this site that others have opted for no surgery or chemo and that is what feels the best for us, but I am looking for advice on how we should proceed now. Thanks for any help. This is a wonderful site and I appreciate all the various opinions.

 

Marilee

[duncan41]

Marilee - Welcome to GT! I am so sorry it is under these circumstances. You will get tons of advice and support here, but for now, if you will scroll thru Health and Medical and read the threads started by RedFawnMom, you will get a sense of what you are facing.

 

Don't hesitate to ask for help or support. The people on this forum are the BEST! Hugs to you, DH and Tatum.

[Guest Greytluv]

Tatum

 

 

I'm sorry to hear this. Yes, I would defiantly send the film to Dr. Couto.

[riverbosun]

You can send the films to OSU but most likely he'll advise a FNA. Amputation and chemo is a very personal and expensive decision. I chose not to get the FNA and I did not treat. I spoiled my guy rotten until the very end. Considering less invasive/aggressive treatments is also a way to treat and perhaps have more time. Osteosarcoma just plain sucks. Good Luck.

[Guest Tatum]

Greyaholic - how did you determine that your guy had Osteo? I also forgot to add that Tatum is almost 9 and she had her tail amputated last summer because an injury got infected and she was really a mess after that surgery so that has influenced our decision. Also I love the spoil rotten part!!

[Charlies_Dad]

Marilee, I am sorry it's due this that you have joined GT. There are many people here who have gone the palliative care path for their pups. Jen (Neylasmum) went this route and got 7 months with Neyla which is fantastic. She did a lot of research and I suggest you try getting in touch with her. We went the amp & chemo for out Charlie so I cannot give you a lot of advice however I do suggest you join CircleofGrey@yahoo.com which is a group formed for those who's pups have been diagnosed with Osteo and other cancers. Also you may want to look the Artemisinin group on Yahoo as well as we provide this to Charlie and it has shown some positive results.

 

Yes, sending the films to Dr. Coutu and his team will provide you with a valuable second opinion which is always important. Most often than not, an FNA is recommended to confirm 100% it's Osteo.

[sweetdogs]

I'm sorry about Tatum. The first thing you should do is get a firm diagnosis. I would do a FNA & send the results & the xrays to Dr. Couto. You need to know what you're dealing with.

 

Is Tatum on any pain meds? If it's osteo, it's painful even if she's not showing anything other than a limp. My girl had a bone tumor in her shoulder (probably osteo but the FNA came back as fibrosarcoma - didn't really matter). She was on metacam, tramadol & gabapentin for pain & pepcid & sucralfate for her tummy. I opted to do radiation & not amputate for a number of reasons & it did shrink the tumor giving us some more time. She also had a pamidronate treatment (fosamax) & although we tried artemisinin, it didn't agree with her (she would stop eating).

 

If you're not going to amputate, the most important thing is pain management & being ready to let her go when you can't control it anymore. But first things first, get a confirmed diagnosis. And welcome to you & Tatum.

[Guest ChasesMum]

So sorry about sweet Tatum...but welcome all the same. I lost both my 2 to cancer...

 

imho tumors on the long bones can be less painful than lesions in the joint... for George his was a lesion in the shoulder joint and was extremley painful. there was no palliative option, it was amp or pts.

 

for my parents husky, his was upperleg/scapula but not in the joint until the end and he rarely showed any pain and had a good 6 mos at least with no treatment.

[packmom]

I would consult with OSU always. One thing to consider, though. Pain control is very hard if it's osteo and will very quickly become impossible. Sooner than you would think. As others have said. We've gone both ways and there really is no right answer for everyone. It's all about what's right for your dog. We've dealt with several different kinds of cancer and bone cancer causes the most indecision!

[joejoesmom]

I am so sorry that you and Tatum are facing this. Although given the location and the fact that Tatum is a greyhound (both pointing towards osteo), there are a couple of less horrible things it could be. Did Tatum ever visit the Arizona or California area? If so, it could be Valley Fever. There are a couple of cancers that are not quite as bad as osteo but these are rare in a greyhound. A definitive diagnosis usually requires a fine needle aspirate (guided by ultrasound). There have been a few rare occasions that Dr. Couto has determined that the apparent lesion was not cancer. In any case, I would definitely send the x-rays and whatever test results you have to him at OSU. I will follow this with my standard info on contacting them. However, the GHWP (greyhound health and wellness program) is closed until January 5 for the holidays. I don't know if Dr. Couto is checking emails but I know his two greyhound vets (Drs. Marin and Zaldivar) are not. So it might be best to send an email directly to Dr. Couto. Alternatively, you could call OSU's main number and ask to speak to an oncologist (they are listed below). I'm sure they have one or two that are working over the holidays but they might not be able to handle anything but their "in-canine" patients.

 

If it is osteo, no decision you can make would be wrong -- this is a horrible disease and the outcome is typically not good. If caught before there are visible lung metastases, there is a 15 percent chance that he would make it two years or more after amp and chemo. Otherwise, realistically with amp and chemo you are probably looking at 6 to 12 mostly pain-free months (mean time is 14 months -- including those who make it long term). Withoug amp and chemo you are often looking at weeks. It would be very important to keep ahead of the pain using a combination of pain killers. There are a few who have made it past 6 months without amp.

 

The cost for amp around here (including 4 to 5 days in the hospital) is $3500 to $4000. Chemo administration (with free drugs from OSU) can range from $500 to $2000.

 

The cost for pain management is relatively small. However, if you opt for all the potential palliative treatments (radiation, fosamax, or others) the cost can approach the cost of amp/chemo.

 

If you choose pain management, be sure to talk to your vet about the following drugs: an NSAID (such as deramaxx, rimadyl, or metacam), tramadol, and gabapentin. All except the mentioned NSAIDs are available at human pharmacies as generics (relatively inexpensive). If you can't afford a canine NSAID, you can substitute a human NSAID (like meloxicam) but getting the appropriate dose is more difficult (if not impossible without compounding charges). Many vets do not mention gabapentin -- it has been shown to be very helpful in treating pain from osteo (it is typically used to treat "nerve" pain).

 

I hope this info helps you. I am so sorry that you are facing this.

 

Jane

 

Here is info on how to contact Dr. Couto and his team. The email or phone consult is free, however a few people have been told they must sign up for the website ($50) and submit the request that way. Dr. Couto tells me that this is not true. However, if you are a member of their website, please submit your request that way because it will automate things and make record keeping for them easier. Certain chemo drugs are free; you would need to pay to have them administered.

 

 

Greyhound Health and Wellness Program

 

Ohio State University College of Veterinary Medicine

 

601 Vernon Tharp Street

 

Columbus, Ohio 43210

 

Phone: (614) 247-6757 or (614) 247-8490

 

Email: greyosu@osu.edu

 

Website: http://www.vet.ohio-state.edu/GHWP.htm (registration and fee now required to get full access to this site)

 

 

This email goes to the team. If Dr. Couto is traveling, you may get a quicker answer from one of his team members. Drs. Marin and Zaldivar typically respond to greyhound owners. The consult is free but if you can afford to support the program please do so. You can sign up for full access to the website ($99 per calendar year) or donate through the giving page on the website. If you decide to donate, you can double your money by giving through the Greyhound Project. They will match the funds that you donate.

 

Just go to this website and scroll down to the appropriate donation button:

 

 

http://www.adopt-a-greyhound.org/donate.shtml.

 

 

The Team:

 

 

Dr. Couto, Department Head, Greyhound Medicine, Oncology and Hematology

 

Dr. Lili Marin, Greyhound Health and Oncology

 

Dr. Sara Zaldivar, Greyhound Health and Oncology

 

Dr. William Kisselberth, Oncology

 

Dr. Cheryl London, Oncology

 

Dr. Cristina Iazbik, Blood Bank Director and Hematologist

 

Dr. Bridget Urie, Oncology Resident

 

Dr. Matt Sherger, Oncology Resident

 

Dr. Joelle Fenger, Oncology Resident

 

Dr. Roberta Portela, Oncology Resident

 

Dawn Hudson, Vet Tech

 

Ashley DeFelice, Vet Tech

 

Stacey Gallant, Vet Tech

 

 

Drs Marin and Zaldivar are originally from Spanish speaking countries. If you have trouble understanding them over the phone, you might ask for one of the other vets or vet techs to “translate”.

 

 

Dr. Couto's direct email is:

 

couto.1@osu.edu

 

His phone number is also 614-247-6757. If he is in town, he typically returns emails in the early hours of the morning.

 

 

You should know that (in my humble opinion) they need more staff. Unfortunately finances do not permit it at this time. They do 20 to 30 greyhound consults a day along with all of their "in canine" patients. Depending on their workload there may be a wait for the consultation. If you are contacting them on an emergency basis, please let them know.

 

If you want to make an appointment to be seen in person/canine, you can call the main number to set up a date/time. The main number for the veterinary hospital is 614-292-3551.

 

 

If you decide to visit OSU please contact me. I may be able to put you up in a local home, provide moral support, or just help with logistics:

 

 

Finewhipador-drool@yahoo.com

 

 

 

[Guest Tatum]

Thanks for all the information JoeJoesMom,

Tatum raced in RI & FL and was never out west - so that elimates Valley Fever. I will ask about the pain meds you suggest. She isn't crying or whimpering so we don't think she is in much (if any) pain yet. Am I wrong to assume that is the case?

[3vagreys]

I am so sorry that you and Tatum are facing this. Although given the location and the fact that Tatum is a greyhound (both pointing towards osteo), there are a couple of less horrible things it could be. Did Tatum ever visit the Arizona or California area? If so, it could be Valley Fever. There are a couple of cancers that are not quite as bad as osteo but these are rare in a greyhound. A definitive diagnosis usually requires a fine needle aspirate (guided by ultrasound). There have been a few rare occasions that Dr. Couto has determined that the apparent lesion was not cancer. In any case, I would definitely send the x-rays and whatever test results you have to him at OSU. I will follow this with my standard info on contacting them. However, the GHWP (greyhound health and wellness program) is closed until January 5 for the holidays. I don't know if Dr. Couto is checking emails but I know his two greyhound vets (Drs. Marin and Zaldivar) are not. So it might be best to send an email directly to Dr. Couto. Alternatively, you could call OSU's main number and ask to speak to an oncologist (they are listed below). I'm sure they have one or two that are working over the holidays but they might not be able to handle anything but their "in-canine" patients.

 

If it is osteo, no decision you can make would be wrong -- this is a horrible disease and the outcome is typically not good. If caught before there are visible lung metastases, there is a 15 percent chance that he would make it two years or more after amp and chemo. Otherwise, realistically with amp and chemo you are probably looking at 6 to 12 mostly pain-free months (mean time is 14 months -- including those who make it long term). Withoug amp and chemo you are often looking at weeks. It would be very important to keep ahead of the pain using a combination of pain killers. There are a few who have made it past 6 months without amp.

 

The cost for amp around here (including 4 to 5 days in the hospital) is $3500 to $4000. Chemo administration (with free drugs from OSU) can range from $500 to $2000.

 

The cost for pain management is relatively small. However, if you opt for all the potential palliative treatments (radiation, fosamax, or others) the cost can approach the cost of amp/chemo.

 

If you choose pain management, be sure to talk to your vet about the following drugs: an NSAID (such as deramaxx, rimadyl, or metacam), tramadol, and gabapentin. All except the mentioned NSAIDs are available at human pharmacies as generics (relatively inexpensive). If you can't afford a canine NSAID, you can substitute a human NSAID (like meloxicam) but getting the appropriate dose is more difficult (if not impossible without compounding charges). Many vets do not mention gabapentin -- it has been shown to be very helpful in treating pain from osteo (it is typically used to treat "nerve" pain).

 

I hope this info helps you. I am so sorry that you are facing this.

 

Jane

 

Here is info on how to contact Dr. Couto and his team. The email or phone consult is free, however a few people have been told they must sign up for the website ($50) and submit the request that way. Dr. Couto tells me that this is not true. However, if you are a member of their website, please submit your request that way because it will automate things and make record keeping for them easier. Certain chemo drugs are free; you would need to pay to have them administered.

 

 

Greyhound Health and Wellness Program

 

Ohio State University College of Veterinary Medicine

 

601 Vernon Tharp Street

 

Columbus, Ohio 43210

 

Phone: (614) 247-6757 or (614) 247-8490

 

Email: greyosu@osu.edu

 

Website: http://www.vet.ohio-state.edu/GHWP.htm (registration and fee now required to get full access to this site)

 

 

This email goes to the team. If Dr. Couto is traveling, you may get a quicker answer from one of his team members. Drs. Marin and Zaldivar typically respond to greyhound owners. The consult is free but if you can afford to support the program please do so. You can sign up for full access to the website ($99 per calendar year) or donate through the giving page on the website. If you decide to donate, you can double your money by giving through the Greyhound Project. They will match the funds that you donate.

 

Just go to this website and scroll down to the appropriate donation button:

 

 

http://www.adopt-a-greyhound.org/donate.shtml.

 

 

The Team:

 

 

Dr. Couto, Department Head, Greyhound Medicine, Oncology and Hematology

 

Dr. Lili Marin, Greyhound Health and Oncology

 

Dr. Sara Zaldivar, Greyhound Health and Oncology

 

Dr. William Kisselberth, Oncology

 

Dr. Cheryl London, Oncology

 

Dr. Cristina Iazbik, Blood Bank Director and Hematologist

 

Dr. Bridget Urie, Oncology Resident

 

Dr. Matt Sherger, Oncology Resident

 

Dr. Joelle Fenger, Oncology Resident

 

Dr. Roberta Portela, Oncology Resident

 

Dawn Hudson, Vet Tech

 

Ashley DeFelice, Vet Tech

 

Stacey Gallant, Vet Tech

 

 

Drs Marin and Zaldivar are originally from Spanish speaking countries. If you have trouble understanding them over the phone, you might ask for one of the other vets or vet techs to “translate”.

 

 

Dr. Couto's direct email is:

 

couto.1@osu.edu

 

His phone number is also 614-247-6757. If he is in town, he typically returns emails in the early hours of the morning.

 

 

You should know that (in my humble opinion) they need more staff. Unfortunately finances do not permit it at this time. They do 20 to 30 greyhound consults a day along with all of their "in canine" patients. Depending on their workload there may be a wait for the consultation. If you are contacting them on an emergency basis, please let them know.

 

If you want to make an appointment to be seen in person/canine, you can call the main number to set up a date/time. The main number for the veterinary hospital is 614-292-3551.

 

 

If you decide to visit OSU please contact me. I may be able to put you up in a local home, provide moral support, or just help with logistics:

 

 

Finewhipador-drool@yahoo.com

 

Be aware that even though certain chemo drugs are free to greyhounds, that only applies if they have a supply. When Stampede needed chemo, they had no extra so we had to get his from the oncologist and pay for them ourselves. It was distressing because I had always counted on that.

[Guest Tatum]

UPDATE: The president of our greyhound group found out about Tatum and just called me. Very tearful conversation as Tatum was his first foster (he has now fostered 33 dogs!) He has seen several dogs with Osteo and said he approves of our decision to do palliative care until it gets too hard for her/us. What a sweet guy to call and comfort my husband and myself. Tatum is our first greyhound and we are so impressed at the love and caring of this group and greyhound owners in general. I just wanted to write this....

[GeorgeofNE]

Thanks for all the information JoeJoesMom,

Tatum raced in RI & FL and was never out west - so that elimates Valley Fever. I will ask about the pain meds you suggest. She isn't crying or whimpering so we don't think she is in much (if any) pain yet. Am I wrong to assume that is the case?

 

Yes, I'm afraid you are wrong. She's limping. You said she's been limping for two weeks. A dog who is not in pain won't limp. She needs to be on strong pain meds now. Bone cancer, sadly, is a very pain disease. I am SO sorry for you and your family, and of course Tatum.

[Guest Tatum]

Pain meds:

The vet gave us VETPROFEN 75 MG. We are giving it to her twice a day. She seems to sleep a lot now but still has a good appetite. We were charged $20 for 16 caps. Anyone know about these?

[joejoesmom]

Thanks for all the information JoeJoesMom,

Tatum raced in RI & FL and was never out west - so that elimates Valley Fever. I will ask about the pain meds you suggest. She isn't crying or whimpering so we don't think she is in much (if any) pain yet. Am I wrong to assume that is the case?

 

Yes, I'm afraid you are wrong. She's limping. You said she's been limping for two weeks. A dog who is not in pain won't limp. She needs to be on strong pain meds now. Bone cancer, sadly, is a very pain disease. I am SO sorry for you and your family, and of course Tatum.

 

I totally agree. Dogs are very stoic. Their instinct is to not show pain. So by the time you see outward signs of it, they are very painful. Other signs include: panting (although this can be caused by pain meds), lack of desire to go for walks or to play, changes in behavior (such has isolating herself or any other change from her normal).

 

The three drugs I mentioned are used in combination. It isn't an either / or. Be sure to ask your vet for a maximum dosage allowed (in advance) so you can increase it if she becomes more painful when the vet isn't available. She should also be on medicine to protect her stomach (the NSAID can be hard on the stomach). Be sure to ask the vet about this. Initially your vet will probably have you start with an over the counter medicine like famotidine (pepcid). Be sure to give pepcid before the meal (most vets recommend at least 15 minutes before eating. Give the NSAID with the meal. The tramadol and gabapentin can be given any time. If stomach upset becomes an issue even with pepcid there are a lot of low cost prescriptions available to help. There are low cost prescriptions to help if there is any diarrhea.

 

Tramadol can cause panting or restlessness. So can pain. It is important to note when tramadol is given and whether it increases or reduces panting/restlessness. If tramadol is causing any problems, other pain killers can be prescribed. FYI, tramadol is an opiate like medication.

 

Lastly, NSAIDs can cause gastrointestinal bleeding and in rare cases, kidney and liver damage. Of course, if your dog has bone cancer, it is most important to control the pain and not worry about these possible rare side effects.

 

As I said, I sure hope your little girl doesn't have cancer. It is just a terrible disease.

 

Jane

Edited December 28, 2010 by joejoesmom