Alex Limping & Big Wrist

[LakeshoreGreys]

Just got off the phone with the vet. She said that his creatinine and kidney values were up, but that she wants to go ahead with some pain relief and the ketoconazole anyway. Looking at the kidney values (don't have a number because I returned her call and she didn't have them in front of her) she was surprised he isn't having drinking/peeing issues. She says the ketoconazole won't hurt him, even if he winds up not having blasto.

 

DH doesn't believe it's blasto and doesn't want to start the anti-fungal med (ketoconazole). I'm not so sure it's blasto either, because he doesn't have any of the other more common symptoms.

 

Not sure what to do, but I do have all afternoon to mull it over before DH comes home.

 

I hate this.

[Burpdog]

Remember the greys up your way that had blasto (I think that was it). Also, you might overnight a sample to protatek to make sure it's not VF.

[JJNg]

Sorry you're having to go through this. While blasto usually comes with other signs, it doesn't always, and I've heard of some cases where there was only 1 bone lesion. Blasto is somewhat regional, and if it's something that is seen in your area, it's certainly still a possibility.

 

However, I probably don't have to point out that given the breed and location, osteosarcoma is probably the more likely diagnosis. Can't tell for sure, but from the photo, it looks like the bony swelling is at the distal radius, which is one of the common sites for bone cancer.

 

What is the plan your vet is suggesting? It sounds like just starting the pain meds and ketoconazole while waiting for the results of the test for blasto? Whether or not to get more aggressive with pursuing a diagnosis depends on what you would do if it ends up being osteo. If you would opt for palliative care and pain management only, then I wouldn't necessarily suggest doing anything different.

 

However, if you would want to treat more aggressively, with amputation and chemo, then I'd probably be more proactive in getting a diagnosis asap. I would consider getting a 2nd opinion on the x-rays, either through OSU or an internal medicine specialist or oncologist locally. With the elevated kidney values, this may be a good idea anyway. I'm assuming your vet is familiar with greyhound values? Did they check a urine specific gravity (concentration)? You might also want to consider doing a biopsy or aspirate of the mass which may help distinguish osteo vs blasto.

[Guest Stripeyfan]

I have no advice, but sending lots of good thoughts.

[lovinggreysslp]

We had a grey with blasto a couple years ago. First symptoms were elevated body temperature and very slight cough. Vet treated with antibiotics. A week later, he was not better but now had a swollen wrist. Vet treated with more antibiotics. A week later, he suddenly started a different kind of cough, very violent. Rushed him to the vet, did x-rays and found blasto. I so wish we had started the anti fungal treatments earlier. Even with the best emergency care our local University vet school provided, the antifungals were too late to help him. I tell you this story because while I hope it's not blasto, if it is, getting the antifungals started sooner rather than later is very important. You can send a urine sample to a specific lab for blasto testing. At the time, our vet was not aware if this.

[GeorgeofNE]

I'm so sorry.

 

Cancer was actually the first thing I thought when I saw his pictures on the banner. Any other kind of dog, I would have wondered a lot more.

 

Hoping for better news soon!

[Guest ericcd]

The other day, I thought Alex's wrist looked a bit swollen, but then decided it was my imagination.

 

Today, he was limping. He usually tears up the stairs, but took them very slowly and gingerly tonight.

 

Just looked at his wrist, and it's BIG. And hard. It's not swollen like you can compress it...it's solid.

 

Going to call the vet first thing and get an xray. If you can, please keep fingers crossed that it's nothing serious! He turns 9 next month.

[Guest ericcd]

We have three greys the oldest being 10. I decided to look at the forum because our vet believes our oldest has osteosarcoma. So when I got onto the forum yesterday I was surprised to see pictures of my greys leg. The picture of Alex is exactly what my Court's looks like. We are meeting with an oncologist on Monday hoping that our vets diagnosis was wrong. We had made three trips to the vets before they x-rayed a second time and saw the mass on his leg. He's such a good boy and would hate for him to have suffer anymore than he has to. The pain pills he is on seem to be working well. Despite trouble with the stairs he seems to be getting alone fine. Here's hoping he is okay.

 

PS: Sorry for messing up my original posting.

[Guest Shermanator]

Yes, I forgot to mention that, sorry. They xrayed the leg and his chest. Chest didn't show anything too interesting. Leg didn't show any fractures, but did show what could either be a tumor or she said a fungal infection can show up the same way. From what I've read, if it were blasto, you'd notice more stuff on the chest xray.

 

 

Remember the greys up your way that had blasto (I think that was it). Also, you might overnight a sample to protatek to make sure it's not VF.

 

 

Oh, no I am so sorry. That is exactly what Sherman's wrist looked like when he was diagnosed with osteo. I hate to say it. I really hope its not cancer.

 

Where do you live, and where did the pup come from?

In AZ we are at high risk for our pups to get 'Valley Fever.' It is a fungal infections from inhaling dust particles, and I know of several pups who have it. It can get into the bone, and mimic cancer lesions on the bone. (My Echo has VF, it settled into her leg, so she limps at times.) She has been on the medication for almost 2 years, its a hard one to treat.

 

Anyway, with Sherman's wrist so swollen, my vet (who was once the track vet at Phx Greyhound Park, so he knows these dogs inside out) said it was cancer, the bone lesion he had did not mimic VF. However, with Patton, when I first took him to the vet when he starting limping, his x-ray showed the lesions, but the vet wanted to test for VF first. Unfortunately, it was osteo.

 

I believe VF testing is a blood sample. (But I do not know 100%.) Every 6 mos, we have to take Echo in to have her 'titer' tested - lower the titer means she's beating the VF.

 

It sucks, I am sorry.

[LakeshoreGreys]

What is the plan your vet is suggesting? It sounds like just starting the pain meds and ketoconazole while waiting for the results of the test for blasto? Whether or not to get more aggressive with pursuing a diagnosis depends on what you would do if it ends up being osteo. If you would opt for palliative care and pain management only, then I wouldn't necessarily suggest doing anything different.

 

However, if you would want to treat more aggressively, with amputation and chemo, then I'd probably be more proactive in getting a diagnosis asap. I would consider getting a 2nd opinion on the x-rays, either through OSU or an internal medicine specialist or oncologist locally. With the elevated kidney values, this may be a good idea anyway. I'm assuming your vet is familiar with greyhound values? Did they check a urine specific gravity (concentration)? You might also want to consider doing a biopsy or aspirate of the mass which may help distinguish osteo vs blasto.

 

You are right, the plan so far is to start him on pain meds and ketoconazole and wait for results. I was pleasantly surprised to find the keto was not as pricey as I thought - $26 for 35 tablets. I don't believe she did any other tests on the urine other than sending it out for the blasto test. She is familiar with greyhounds, especially ours. In fact, she requested that the next time we come in, we do so for simple vaccines or something as we haven't been there since we put Joe down in December from an osteo fracture in his front leg.

 

I did ask for the xrays to be emailed, but she said that we'd need specialty equipment to view them (is this true?) I made noises about sending them off and she said that if it comes back as negative for blasto, they'd need to re-do them anyway and at that point she'd set us up with a specialist.

 

 

We had a grey with blasto a couple years ago. First symptoms were elevated body temperature and very slight cough. Vet treated with antibiotics. A week later, he was not better but now had a swollen wrist. Vet treated with more antibiotics. A week later, he suddenly started a different kind of cough, very violent. Rushed him to the vet, did x-rays and found blasto. I so wish we had started the anti fungal treatments earlier. Even with the best emergency care our local University vet school provided, the antifungals were too late to help him. I tell you this story because while I hope it's not blasto, if it is, getting the antifungals started sooner rather than later is very important. You can send a urine sample to a specific lab for blasto testing. At the time, our vet was not aware if this.

 

Wow! So that gives me a little hope that it's blasto. I kinda figured no considering he really has no other symptoms, but it looks like yours had very slight symptoms too. She did the urine sample and sent it in for blasto testing. I guess that's kind of a new way to test.

 

 

We have three greys the oldest being 10. I decided to look at the forum because our vet believes our oldest has osteosarcoma. So when I got onto the forum yesterday I was surprised to see pictures of my greys leg. The picture of Alex is exactly what my Court's looks like. We are meeting with an oncologist on Monday hoping that our vets diagnosis was wrong. We had made three trips to the vets before they x-rayed a second time and saw the mass on his leg. He's such a good boy and would hate for him to have suffer anymore than he has to. The pain pills he is on seem to be working well. Despite trouble with the stairs he seems to be getting alone fine. Here's hoping he is okay.

 

PS: Sorry for messing up my original posting.

 

Sorry to hear about Count. Glad that you're able to keep him comfortable. Hope the appointment on Monday goes well - fingers crossed.

 

 

Oh, no I am so sorry. That is exactly what Sherman's wrist looked like when he was diagnosed with osteo. I hate to say it. I really hope its not cancer.

 

Where do you live, and where did the pup come from?

In AZ we are at high risk for our pups to get 'Valley Fever.' It is a fungal infections from inhaling dust particles, and I know of several pups who have it. It can get into the bone, and mimic cancer lesions on the bone. (My Echo has VF, it settled into her leg, so she limps at times.) She has been on the medication for almost 2 years, its a hard one to treat.

 

Anyway, with Sherman's wrist so swollen, my vet (who was once the track vet at Phx Greyhound Park, so he knows these dogs inside out) said it was cancer, the bone lesion he had did not mimic VF. However, with Patton, when I first took him to the vet when he starting limping, his x-ray showed the lesions, but the vet wanted to test for VF first. Unfortunately, it was osteo.

 

I believe VF testing is a blood sample. (But I do not know 100%.) Every 6 mos, we have to take Echo in to have her 'titer' tested - lower the titer means she's beating the VF.

 

It sucks, I am sorry.

 

We live in Wisconsin. His racing name is Streakin Diablo. Went over to Greyhound Data to check where he raced, but I forgot my password and are waiting for them to email it to me. He came into the adoption group when he had just turned 3.

 

 

-----

 

One question that keeps popping in my head is how long do we have if it is indeed osteo, especially if we choose not to amputate? Our others that had osteo were so far gone when they were diagnosed that we had to put them down immediately. The first, the mass was closing off his trachea, and the other had a broken front leg and lung mets.

 

The meds seem to be helping his pain as he is not limping, but the mass looks the same today.

 

Thanks for all of the comments. It definitely makes me feel less "alone" in this.

[Guest bethac]

On greyhound-data ... Streakin Diablo had 31 races at Geneva Lakes. I believe that track is closed - probably up your way in WI.

 

Sending more prayers and positive thoughts for you.

 

Keep us posted on Alex.

[LakeshoreGreys]

Yup, that track was in Delavan, Wisconsin.

 

Thanks for looking that up!

[Batmom]

Have never had a problem emailing x-rays.

 

Sending gentle scritchies to your pup, and hugs for yourself.

[Charlies_Dad]

 

One question that keeps popping in my head is how long do we have if it is indeed osteo, especially if we choose not to amputate? Our others that had osteo were so far gone when they were diagnosed that we had to put them down immediately. The first, the mass was closing off his trachea, and the other had a broken front leg and lung mets.

 

The meds seem to be helping his pain as he is not limping, but the mass looks the same today.

 

Thanks for all of the comments. It definitely makes me feel less "alone" in this.

 

Depending on the pup, Osteo can be very aggressive or a slow onset. If it's the former, the pain will spike quickly and meds will only do so much. The slow onset tends to occur in older pups 10-13 however nothing is for sure with this horrid disease. I hope it's not Osteo, I really do but as someone else said, the location and the breed the probability is high that it is. Not sure what your vet is stating they will need a special machine. If your vet takes digital x-rays, she can e-mail them and I would definitely get a second opinion from OSU.

 

Both you and your pup are in our thoughts.

[Guest d0ggiem0mma]

There is absolutely no reason your vet can't send the radiographs to OSU. They can send them via e-mail directly to Dr. Couto or they can deliver them via the digital radiograph server. Tell her to call Dr. Couto or the referral coordinator at OSU for more detailed instructions if she needs them!

[NeylasMom]

There is absolutely no reason your vet can't send the radiographs to OSU. They can send them via e-mail directly to Dr. Couto or they can deliver them via the digital radiograph server. Tell her to call Dr. Couto or the referral coordinator at OSU for more detailed instructions if she needs them!

I agree. I would go ahead with this regardless of everything else. It never hurts to have the second opinion and I believe Dr. Couto will be able to give you a more definitive answer. I have no idea if blasto is common in your region. If it is, then I believe it's still a possibility, but like many others my first thought was osteo and unfortunately with the age and breed, it's the likely dx. I really really hope that's not what it is.

 

To answer your question about how much time you'd have if it is, my oncologist said 2 months is the expected time post dx if you choose only palliative care with pain meds. You could potentially increase that time using palliative radiation or IV pamidronate treatments, and of course you can increase it if you choose amputation and chemo. Of course, those are all mean times, but I think 2 months is realistic unless you've caught it very early, but the swelling would seem to indicate otherwise.

 

Hoping hoping hoping that fungal test comes back positive and the anti-fungals clear everything up.

[Guest snakes]

Weird to say but i almost hope it is Blasto for you and your pup because at least then you can treat it fairly easily!

It does look similar to FedX's wrist, but blasto never even came up in any conversations here.

I am going the palliative route and already we are at just over two months with no significant change in pain levels (i hope i didn't just curse us)....my really hopefull dream goal is to make it to his birthday in Sept.

[gryhndsr4us]

Wow Sara, just seeing this. Sure hope Alex is doing better. Saying prayers for something treatable. Give your pups hugs from us.

[Guest bethac]

Any updates on Alex? Thinking of you and sending more prayers.

[LakeshoreGreys]

Nothing new here. He's been on the painkillers which seem to work fine and on the anti-fungal treatment too. Wrist still looks the same. I guess we just wait for test results at this point, which could be another 2 weeks.

 

Thanks for thinking of us! Will post again with test results or if something changes before then.

[LakeshoreGreys]

Weird to say but i almost hope it is Blasto for you and your pup because at least then you can treat it fairly easily!

It does look similar to FedX's wrist, but blasto never even came up in any conversations here.

I am going the palliative route and already we are at just over two months with no significant change in pain levels (i hope i didn't just curse us)....my really hopefull dream goal is to make it to his birthday in Sept.

 

The vet made that comment too...that they usually don't "hope" for blasto, but in this case.

 

Hope you and FedX reach that goal!!

[LakeshoreGreys]

He didn't want his breakfast yesterday. Thought it was because of his medication (ketoconazole) so DH picked it out. When I got up a 3 hours later (no, I'm not a complete sloth...he gets up for work and feeds them breakfast at 4a!) the bowl was still sitting there full with his Rimadyl laying on top. Took the pill over to him on his bed and he ate it, then came into the kitchen and ate breakfast. No feeding issues for lunch or dinner, and he got his dose of ketoconazole wrapped in little balls of bread so he swallowed them whole.

 

Today, no breakfast again. Dave did get the ketoconazole in him with our pill shoooter thingie. He wouldn't take his Rimadyl from my hand at all. At lunchtime, I got desperate and mixed in some turkey gravy and then after a few initial sniffs he gobbled it up.

 

Gonna call the vet and see if we should discontinue the ketoconazole. We noticed he has been really gassy too - not so much in the afternoon, but definitely at night, which coincides with his ketoconazole dosing.

 

This dog is not known for ignoring his food bowl, so it makes me nervous. Something is affecting his appetite.

[Guest mcsheltie]

Ketoconazole really messes with their appetite. It isn't unusual. You'll just have to find something that he will eat for the duration. Canned cat food, tripe... something smelly. Chicken nuggets maybe? Sounds like he likes bread, feed him slices of that.

 

If he needs the medication you will just have work around it.

[Guest Shermanator]

 

One question that keeps popping in my head is how long do we have if it is indeed osteo, especially if we choose not to amputate? Our others that had osteo were so far gone when they were diagnosed that we had to put them down immediately. The first, the mass was closing off his trachea, and the other had a broken front leg and lung mets.

 

The meds seem to be helping his pain as he is not limping, but the mass looks the same today.

 

Thanks for all of the comments. It definitely makes me feel less "alone" in this.

 

I am sorry to say, we lost Sherman after 2 1/2 weeks after diagnosis. But, Sherman was my stoic boy, and I had first noticed he was having some problems @ 1 mo prior. Because his limping was so sporadic, we couldn't nail down a pattern. Patton we lost after 5 days, but I have no idea how he managed not to alert us he was in pain, which never prompted us to have him checked. He was my screamer, but when is real pain, he never made a sound.

 

He didn't want his breakfast yesterday. Thought it was because of his medication (ketoconazole) so DH picked it out. When I got up a 3 hours later (no, I'm not a complete sloth...he gets up for work and feeds them breakfast at 4a!) the bowl was still sitting there full with his Rimadyl laying on top. Took the pill over to him on his bed and he ate it, then came into the kitchen and ate breakfast. No feeding issues for lunch or dinner, and he got his dose of ketoconazole wrapped in little balls of bread so he swallowed them whole.

 

Today, no breakfast again. Dave did get the ketoconazole in him with our pill shoooter thingie. He wouldn't take his Rimadyl from my hand at all. At lunchtime, I got desperate and mixed in some turkey gravy and then after a few initial sniffs he gobbled it up.

 

Gonna call the vet and see if we should discontinue the ketoconazole. We noticed he has been really gassy too - not so much in the afternoon, but definitely at night, which coincides with his ketoconazole dosing.

 

This dog is not known for ignoring his food bowl, so it makes me nervous. Something is affecting his appetite.

 

 

It could be the meds. While Sherman continued to eat, he was losing weight. Patton's appetite was never affected until his final days. Because we noticed Sherman's weight loss, we started supplementing his kibble with wet food. (In my house, that was doggie crack.) I made sure I smashed it around the kibble, so instead of inhaling the wet food, he's have to chew up some kibble, too. However, in Sherman's and Patton's final days, when we knew we would have to let them go, it was nothing but burgers, sticks, you name it, they had it.

 

I hope Alex's loss of appetite is from the meds.

I so hate this.

[LakeshoreGreys]

Just got a call back from the vet. She says it's likely the ketoconazole causing his appetite change.

 

The good news: We can take him off of it. The tests came back negative for blastomycosis.

 

The bad news: The tests came back negative for blastomycosis. He has osteo.