Osteo Thread

[BauersMom]

 

You should absolutely not feel guilty for making a decision that is in his best interest. Not for a second. Amp is not a good choice for everyone, so don't feel like you're the only person who has ever decided against it. I think that if I were in your shoes, I would lean the same way. It would be a very difficult thing for everyone to go through if after the surgery and recovery (and chemo, too, I assume) he wasn't comfortably mobile as a tripod. I mean, the goal of going the amp route is that your pup has more time to enjoy life...not just more time for the sake of more time. And that's a gamble for everyone who chooses amp - even with a dog who seems like a perfect candidate, you never really know if they'll adjust and be happy and comfortable until it's done. If you have doubts about that, I think it's important to pay attention to them. And I think I remember reading that he doesn't like going to the vet - is that right? If so, that would be something else to keep in mind. Chemo requires many visits to the vet (we have been to Angell 14 times so far, though that's probably not the norm) and I don't think I could have gone through that with a dog who didn't like the vet. The last couple of times we went, Lucy started to not want to go in, and let me tell you, it took all my strength not to break down and sob while I had to basically drag her into the building. Ugh. (I actually think she was afraid of the floors there after slipping once when my husband took her, and not really afraid of the vet, but I didn't realize that at first and felt like the worst dog mom ever.)

 

Anyway, you'll make your decisions out of love for him and that means that whatever you decide will be the right choice. That's all any of us can do.

 

 

Thank you, Jess.

 

Yes - he hates the vet. He once pooped in the waiting room. Not like he had to go, like he just stood there as he pooped himself because he was so nervous. So yeah, that's part of the decision making here. (those doors at Angell can be pretty scary - I don't blame Lucy for that!)

 

Right now, he has full use of the leg and is on a lower dose of pain meds (50 mg deramaxx, 50 mg tramadol, once a day). Do folks generally wait until the pain meds are no longer working to explore things like pamidronate, radiation, etc? Or is there value in starting some of those thing early?

 

I have an email into Dr. Marin at OSU, also, but don't expect to hear anything until after the weekend.

[NeylasMom]

I had hoped to respond this weekend, but was only able to access GT on my phone, which makes typing difficult.

 

To answer the questions about radiation/pamidronate, I think it's a delicate balance. I think the pain relief you can get from those things is greater than what you can achieve from meds alone (this is my theory, fyi), but I'm not sure there would be much point in doing them (they are expensive treatments that do require time at the vet's) when you are getting good relief from a low dose of meds.

 

If you're in the same boat we were, where you've found the cancer early, you may be able to get months of good quality of life on that same dose of meds. Neyla had 5 months virtually pain free on minimum doses of Deramaxx and Tramadol along with her herbal supplements. We only decided to try the pamidronate when her pain started to progress in October. The flip side of that is that you do have to consider that if you do those treatments when the cancer has progressed a good bit and the bone has been eaten away and is weaker (ie. more likely to fracture) as a result, that eliminating pain could increase activity level and therefore the chance for a break.

 

Pamidronate does have the suspected added benefit of improving bone density/regrowth, which radiation does not, but the medication and fluids before and after are administered over about a 4 hour time period, during which time your dog is at the vet. Radiation on the other hand requires anesthesia and the current standard treatment is 2 courses 2 days in a row so that's 2 days in a row of anesthesia and vet visits. There's also hte risk of kidney damage with the pamidronate treatments, which we ran into.

 

It's a lot to weigh.

 

For what it's worth, I think you're making hte best decision for you guys. It sounds to me like amputation would be a poor choice. I'm not sure it's really feasible for a front leg amp to do stairs to start with, and with the potential for a compromised leg on top of that, plus the vet issues, I wouldn't do it. And while removal of the limb does remove the source of the pain, the recovery from surgery is no joke so it's not like amputation is the "best" choice and you're choosing something less than ideal. It's a very personal decision for each person and each dog.

 

Jess, I'm so happy to hear htat Lucy is doing so well.

 

And I cannot believe that Charlie is coming up on his 1 year anniversary!! I hope there is going to be a huge party and lots of pics for those of us who can't be there in person to still celebrate!

[BauersMom]

So DH is not in agreement with the pain management approach. He thinks I'm not giving Berkeley enough credit about how he'll deal with the amp and he doesn't want to do "nothing".

 

Does OSU offer marriage counseling?

 

And Pepper came up lame in the yard today, so yeah, that wasn't really what I needed either.

[krissn333]

When I had to decide what to do with Sutra, the vets we saw were very helpful in helping me determine if Sutra would do well as a tripod. Since the tumor was in his shoulder, I decided he would have a hard time keeping his balance. Had the tumor been in a rear leg, I probably would have gone for it. He was 12 years old and not horribly strong in the hind end, but, he would have adapted. He'd had an issue with his knees when I first got him, but he was weak from another illness that he was recuperating from.

 

Your vet should be able to help you evaluate if he will do well as a tripod, but remember that you know how he does around the house, so, it's ultimately your opinion that will influence your decision.

[BauersMom]

The oncologist we saw felt confident that he would be OK as a tripod. But - she'd only been with him for an hour.

 

If it was his bad back leg, I would have lopped it off at the time of diagnosis. Of course it had to be in a "good" leg.

 

We're going to have to come to some sort of agreement and it's very hard because it's obviously an emotional subject. Sucks.

 

Here's a shot of him the other day:

[krissn333]

That pic makes me smile

 

It's a very tough choice and to be honest, no matter what you choose, it's a crapshoot. We did palliative care with Deramaxx, tramadol, and pamidronate infusions, coupled with chiropractic (his neck had strain from the different way he walked to accommodate the osteo leg) and got 6 months. Some go the same route and only get a couple of weeks. Some choose the amp and get a long time, some only get a few months.

 

Are you prepared to go through chemo if you decide on the amp? From what I understand, if you don't do chemo it's almost not worth doing the amp-good results are fewer and far between without it.

 

Also, as I said, you know him best. The vet may think he's a good candidate, but she only saw him for an hour.

 

I must have missed where you mentioned what's wrong with the non-osteo leg? What makes that his bad leg?

[BauersMom]

It's an old track injury of some sort. We did x-rays, MRI, ortho consults, neuro consults and no one could figure out why he wouldn't use it much. He was 2 at that time and he has gotten a lot better - went from not using it at all like half the time to maybe now favoring it a bit and only not using it in certain situations like the stairs... He also has a corn on that foot now too that he's developed within the last two years or so.

 

Yeah, and we'd have to look at chemo if we do the amp which then gets into the whole dragging the poor dog to the vet thing.

 

The DH is still reeling from losing Princess in March, so I'm sure that's playing into his wanting to do "everything possible" here. Hard to think about losing a dog only months after another.

Edited July 12, 2011 by BauersMom

[NeylasMom]

I don't see how a vet could recommend removing a limb when you already have another non-weight bearing (even if only in certain circumstances) limb. How will he manage to do get around, let alone do stairs on 2 legs? Not to mention the pain from the additional load on a corn toe. She must have been basing her opinion only on what she saw in the exam room and not on the history you provided?

[KF_in_Georgia]

Has Berkeley had chest x-rays? If there's any chance that the cancer has spread to the lungs...

 

I'm so sorry you guys are facing this decision.

[BauersMom]

I don't see how a vet could recommend removing a limb when you already have another non-weight bearing (even if only in certain circumstances) limb. How will he manage to do get around, let alone do stairs on 2 legs? Not to mention the pain from the additional load on a corn toe. She must have been basing her opinion only on what she saw in the exam room and not on the history you provided?

 

I dunno. She said he was in good shape overall and that would play in his favor. I did explain his current limitations but of course when she was evaluating him, he looked fine, so I'm sure she was basing it on that.

 

Yes, chest x-rays are clear.

 

This whole thing really bites.

[KF_in_Georgia]

I don't see how a vet could recommend removing a limb when you already have another non-weight bearing (even if only in certain circumstances) limb. How will he manage to do get around, let alone do stairs on 2 legs? Not to mention the pain from the additional load on a corn toe. She must have been basing her opinion only on what she saw in the exam room and not on the history you provided?

 

I dunno. She said he was in good shape overall and that would play in his favor. I did explain his current limitations but of course when she was evaluating him, he looked fine, so I'm sure she was basing it on that.

 

Yes, chest x-rays are clear.

 

This whole thing really bites.

 

Maybe you can get some video of him doing his regular stuff: stairs, walking, etc. Perhaps if the vet looks at that video and sees Berkeley move... I can understand that it's hard for DH to face losing another dog so soon.

[NeylasMom]

 

This whole thing really bites.

It sure does, I know.

 

I'm really sorry DH is not feeling the same way as you. Totally understandable that he's having a hard time dealing with this, but I know it must make it more difficult for you. The sad truth about osteo is that it sucks no matter what. I did it all alone, which meant I got to make all the choices, but that meant I had to make all of the choices.

 

Have you thought about any holistic supplements? A high dose of fish oil would be a good place to start (work up to double the recommended dose) and you might also look into artemisinin, chinese herbs (if you have a vet who can prescribe them although I have some leftover I could send to get you started), or other anti-cancer supplements. There are quite a lot you can try, but I think those are the big powerhouses (purely my opinion). I also think maitake extract is promising.

 

The artemisinin group that I have a link to in the first post is an excellent resource, not just for artemisinin although I'm not a fan of the Budwig protocol, which a lot of them use (Budwig is a mix of cottage cheese and flaxseed oil, but flaxseed is counter-productive imo as they further disrupt the balance of omega 6's to 3's rather than balancing them out like fish oils do).

[BauersMom]

I've been so mentally stuck on this amp/no amp thing, I haven't looked at anything holistic, alternative, etc.

 

I will go check out the link, thanks for the suggestion.

[greysmom]

First off, you don't need a prescription to buy Artemisinin. We get ours over the internet from Holley Pharmaceuticals (holleypharm.com). It's not that expensive.

 

It's *does* suck rotten eggs. All the way around.

 

In our case there was no alternative, as Dude had already broken his back leg. Here are some things to consider and talk over with your DH:

 

Cost - It also sucks that this has to play any part in any decision, but it does. Since January we are probably well over the $10,000 mark with emergency care, hospitalization, the surgery (three actually), the after care, the IV chemo (which we got free from OSU, but you still have to pay the vet for administering), the follow-ups, the x-rays and other bloodwork, and now the pills he'll be on for the rest of his life (which aren't that expensive, considering). Dude is doing great and I wouldn't go back and change anything we did, but cost is an issue you both have to be on board about.

 

Quality of life - Most dogs do OK after amputation surgery and adapt quickly. Your guy might do fine despite his condition. If the stairs are an issue, keep him downstairs. Are you willing to re-organize your life and your house to keep him with you the unspecified amount of time you might get with amputation? How much can you commit to taking care of him, on top of your other obligations (not monetarily, but time and patience and nursing care and all the things associated with either path of treatment)? The corn is troubling, but can be dealt with if you feel his quality of life will be maintained.

 

Talk about end of life issues NOW - you NEVER know how long you will really have, amputation or not. A tumor being treated by palliative care can go from nothing to life-threatening in a couple of weeks. He could fall after amp surgery and break a different leg. The cancer could metastisize in the midst of any treatment. Are you both prepared for when the final decision will have to be made?

 

As others have addressed the palliative issues, I'll talk about the surgery. It *IS* intense. Period. Even if you have an easy surgery with no complications and no problems afterwards, it's just hard for both the dog and the rest of the family. They require a great deal of time and care in the first three to four weeks. You will come to know the staff at your vet's office very, very well. You will end up eating soup for five days in a row bcause you can't leave him to go to the store. You and your DH will take shifts taking care of him and trying to do the things you need to do to take care of your own life.

 

Your dog will be in pain. Your dog will be confused. He will have to learn to do everything from laying down to pottying all over again and will need your help until he can figure it out. He will scare the life out of you the first time he falls down, and the first time he runs, and the first time he tries to play, the first time he tries to go up the stairs, and the first time he tries to come down. He will drive you crazy being picky about his food, about refusing to take his pills, about wanting to sleep THERE when his bed is over HERE.

 

Only you can decide what is best for your dog and your family. It's hard and yes, it sucks. And no matter what decision you make, there will always be questions in your mind if you did the right thing, or if you'd done that one thing differently, would you have him longer. The fact is, you will never know. It really is a crap shoot either way. You can only make your decision based on the best possible advice and go forward from there.

 

I'm so sorry this is happening. Please know we'll be here for you whatever decision you make to support you as much as you need.

[krissn333]

Very well put!

 

Also, if you search for GT member BigOrangeDog, she has a link in her siggy to her blog about amputation...it covers preparing for surgery and gives a great rundown of "what to expect." I read it as I was trying to make my decision for Sutra. Maybe it will help some? OSU also has an article about amputation that had good information. The pictures in both are somewhat graphic, so, prepare yourself first. The first time I read the OSU article and saw a pic of a pup who'd had a front leg amp, I cried. He was still freshly shaven and it just brought me to tears.

 

It all just plain sucks...no way around it

[NeylasMom]

First off, you don't need a prescription to buy Artemisinin. We get ours over the internet from Holley Pharmaceuticals (holleypharm.com). It's not that expensive.

The parenthetical was related to the chinese herbs, not the artemisinin. I realize now this may have been confusing because artemisinin was originally a chinese herb, but the ones I was referring to are chinese herb blends that are specifically formulated for various purposes. In particular, for cancer there are Statis Breaker & Max's Formula for all types of cancer (Neyla was on Max's Formula b/c my vet felt the other would be too strong for her), ones to boost immune health (Wei Qi was the one we talked about) and then there are ones for each type of cancer. For osteo, there's one called Bone Stasis (also used for other bone issues, we actually tried it before she got cancer for a toe issue, but it gave her terrible gas). There are many others as well, there's some decent info here. I have a link I like better, but I can't find it - I'll check my work bookmarks tomorrow.

 

Those herbs you cannot just buy online, you need to find a vet who practices chinese medicine. I have both bone stasis and Max's Formula leftover, though not in large quantities.

 

Also, if you search for GT member BigOrangeDog, she has a link in her siggy to her blog about amputation...it covers preparing for surgery and gives a great rundown of "what to expect."

The link to Jen's blog is in the first post in this thread.

[Charlies_Dad]

I'll add my two cents as someone who has gone the amp & chemo route. Chris (Dude's mom) has summed it very well. There surgery and overall cost of chemo, blood tests, etc. is expensive and you need to come to terms with it. We are just ahead of her at over $12k for Charlie and I don't regret one single cent. This cost includes going to an expensive animal hospital (but they are the best around here), leaving Charlie at the hospital longer than many (4.5 days), chemo and many, many blood tests (these are expensive, not the chemo) plus Palladia (very expensive!!! - at home chemo drug but not necessary). The surgery is stressful for everyone and each pup will fare differently. Charlie came through it with flying colours and didn't have any issues. We were more stressed than he was and he ate from day 1 which is not common but we also brought his food into the hospital. Most pups lose their appetite after surgery and it's quite understandable. You do need to spend some time with them, at least the first week, ideally two weeks if you can. I took one week off work and worked from home the second but I run my own business and could allow myself to. This helped immensely. It's tough but I will say for us well worth it and everyone is so surprised at how these pups fare on three legs. It's shocking to watch them run.

 

My reasons were mine and I felt that Charlie had a strong spirit and a strong body other than this damn disease. Both DW and I were onboard together on the decision because he raced for the full 5 years, made good money for his owners and now only two years into his 'retirement' his life would be cut short. Yes, dogs only live in the moment but we were not ready to say goodbye and he had only just started to experience freedom in his backyard and was having just too much fun. These were OUR reasons, they do not justify the decision for others. We have been lucky and Charlie is now 12 mths post dx/amp and doing well. Unfortunately 12 mths is the average life span after amp & chemo, not long I will grant you that but these past 12 mths with him have been fantastic and I wouldn't trade them for anything. We are closer to him now then we ever have been.

 

May you find peace in whatever decision you make. It is yours and your DH's decision. It's not easy, it's not fair and my heart aches for you both.

[BauersMom]

Thank you all.

 

I sent a bunch of links to DH this morning, including BigOrangeDog's blog, which was great.

 

I emailed the oncologist at Angell to confirm if they sent the disk with the X-rays to OSU and she's been out of the office. So now I have to see if I can get someone else to confirm that it went out. Oy vey.

[greysmom]

First off, you don't need a prescription to buy Artemisinin. We get ours over the internet from Holley Pharmaceuticals (holleypharm.com). It's not that expensive.

The parenthetical was related to the chinese herbs, not the artemisinin. I realize now this may have been confusing because artemisinin was originally a chinese herb, but the ones I was referring to are chinese herb blends that are specifically formulated for various purposes. In particular, for cancer there are Statis Breaker & Max's Formula for all types of cancer (Neyla was on Max's Formula b/c my vet felt the other would be too strong for her), ones to boost immune health (Wei Qi was the one we talked about) and then there are ones for each type of cancer. For osteo, there's one called Bone Stasis (also used for other bone issues, we actually tried it before she got cancer for a toe issue, but it gave her terrible gas). There are many others as well, there's some decent info here. I have a link I like better, but I can't find it - I'll check my work bookmarks tomorrow.

 

Those herbs you cannot just buy online, you need to find a vet who practices chinese medicine. I have both bone stasis and Max's Formula leftover, though not in large quantities.

 

Also, if you search for GT member BigOrangeDog, she has a link in her siggy to her blog about amputation...it covers preparing for surgery and gives a great rundown of "what to expect."

The link to Jen's blog is in the first post in this thread.

 

 

No problems, just to clarify. Thanks for the link too.

[MP_the4pack]

So DH is not in agreement with the pain management approach. He thinks I'm not giving Berkeley enough credit about how he'll deal with the amp and he doesn't want to do "nothing".

 

Does OSU offer marriage counseling?

 

And Pepper came up lame in the yard today, so yeah, that wasn't really what I needed either.

 

 

I drove from NJ to OSU just to see Dr. Couto (9hr). I knew he had seen more greyhounds for OS than anyone else. My girl was 2 weeks shy of 12 yrs old. While to me I thought she was a young 12 yr old, I wasn't sure if she could physically handle being a tripod. I let Dr. Couto and his team tell me.

 

We did go thru with the amp and chemo. While I only had 6 more months, they were pain free. And she was very happy.

 

But if you asked me to put Onyx thru that, I would have said no. She could not have handled it.

 

If for nothing else, would a visit to OSU help put either your mind or your DH's mind at ease?

 

Because of the distance. I drove there on a Wed (all by myself, with a 12 yr old SUV that was in the shop until 7:30 the night before!! ) Diamond spent the day THurs being checked over by everyone. The decision was in favor of amp and she was done Fri. They released her Monday late afternoon and we drove home Tues. All aftercare was done by her local vets. Suture removal and antibiotics. They also did the chemo with the free drugs Dr. Couto sent.

 

I'm not trying to convince you to go the amp route, I'm just trying to help get a decision that both you and DH are comfortable with.

I hope I did help. It's not easy no matter what happens. I lost 5 lbs just agonizing over the decision. And it wasn't until 3 weeks after surgery that I was convinced I did the right thing. Yes, I doubted myself for over a month.

By the way, there are people at OSU that have opened their hearts and homes to people like you and me, traveling long distances to OSU. It'll save on hotel rooms and angst.

 

I wish you the best of luck no matter what you end up doing. And whatever you do is coming from your heart because you love him.

[BauersMom]

OSU does have the new scans, so I am just waiting to hear from Dr. Marin. I do have the last week of July off from work already, so traveling to Ohio isn't totally out of the question.

 

I had asked the onco vet about the possibility of a break if we didn't amp and she said she's seen lesions smaller than Berkeley's fracture and dogs with lesions larger than his walk normally on the leg without issue. Why is everything with this damn disease a crapshoot? Argh.

[krissn333]

I know...the crapshoot part of it is the worst Sutra's entire shoulder was completely transparent on his xray the night I let him go. He had fallen, but his leg wasn't broken. He was still limping on it-using it (a lot of front leg osteo pups resort to dragging the leg after a while, or they hold it up so it won't touch the ground). But I couldn't take the chance that it would break. The doctor couldn't believe he was even able to walk without screaming, but was worried if I took him home that it might fracture while he was just standing

 

My friend didn't even know her boy had osteo...he had never limped or anything. One night he was standing next to her getting scritches when his leg broke, just as he was standing there. It's just horrible that individual experiences vary so much.

 

Crapshoot indeed I am thankful for every day that I had with Sutra and I have no regrets about the choices I made for him. We still managed to have many more good days than bad, and we had a lot of fun together. I hated that most of the time, you'd never have known he had osteo, yet I knew it was there, lurking. I believe he put on a brave face for me. Everyone always told me that I saved his life when I took him in when he had pancreatitis, but in truth it was the other way around. He took care of me.

[Guest azlorenz]

Hi my dear old friends of the 7.5 Club. I can't believe it will be a year tomorrow since we received the mind blowing news that Flash had osteo and the whirlwind that followed. I miss him every day and know that there will never be another like him in my life. Flash was diagnosed on July 14, 2010, had his amp on July 15, 2010 and his first chemo on July 27, 2010. I don't know what I would have done without Jen (NeylasMom), Kyle (CharliesDad), Jen (BigOrangeDog) and all the many others diagnosed before and after. There is comfort in numbers - knowing you aren't the only one feeling this way or going through this horrible process alone. I remember the relief I felt when he made it through surgery, when he stood up, when he finally ate, how thankful we were to have made it through the first night home (he came home a little over 24 hours after surgery), the relief after we made it through the weekend and he was still alive, the knots in our stomachs when he had his first chemo, then the follow up white cell check, the fear I felt when he had his 3-month post-amp x-ray and the feeling of being punched in the gut when the oncologist told me he had lung mets and would be gone in 6-8 weeks. That was on October 18, 2010 and we had to let our beloved Flash go to the bridge on November 27, 2010. The bond that grows post-diagnosis is as deep as the ocean. Something about fighting this dreadful disease bonds our souls. I will forever be thankful to all of you and want to commend you for continuing on and helping the newly diagnosed with answers. We have gotten back into volunteering with our local greyhound group and have adopted two wonderful girls from them. Life does go on but you never forget.

 

Here is a pic of our boy Flash on what would turn out to be one of his last long walks.

 

 

Flash aka Skiddy Newsman (7/4/2002 - 11/27/2010)

Edited July 14, 2011 by azlorenz

[krissn333]

[greysmom]