Osteo Thread

[BauersMom]

We needed to fill out a survery form, send them a blood sample and the post-amp biopsy results. I think that was it?

 

Here's an older article about the shortages: http://www.medscape.com/viewarticle/732883

Edited November 13, 2011 by BauersMom

[TwiggysMom]

When Dr. Marin initially emailed me, she indicated that they would send doxorubicin. This is harder on the heart for some dogs, and is more expensive to administer for 2 reasons. First, you have to do EKGs before each treatment to ensure that no heart damage has occurred. Second, this drug is extremely toxic to flesh tissues. If accidental contact occurs, it can cause damage so severe as to require amputation. I was very worried about using this drug, and only trusted a board-certified oncologist to do the administration.

 

Once the time came to actually start chemo, Dr. Marin offered the choice of doxorubicin or carboplatin. Both the oncologist and I preferred to use the carboplatin. (She feels, but readily states that she has no proof, that it does a better job and that dogs do better on it). This was about 2 months ago, so availability may have changed since then.

 

To Gabe's family, I'm glad you've got a plan. It's got to feel good to have a direction. May he follow FedEx's path!

 

Johanna, same for you guys - being able to move forward is a sense of accomplishment in itself. It sounds like you are pretty nearly ready. I certainly understand your concern about surgery, and know you will be on pins and needles waiting. I'll be thinking about you and Hurley next week and looking for updates!

 

I love the photo of Faye Oops' vacation. I'm glad she was able to enjoy her trip!

 

Pinky, FedEx, Charlie, Joe, Berkeley, Faye Oops and all the others who continue to kick butt: Keep it up!

 

BTW, how did Berk handle his latest chemo, it was a week ago last Thurs, right?

Edited November 14, 2011 by TwiggysMom

[krissn333]

Doxorubicin sounds scary

[BauersMom]

Berk did great - and yep, it was last Friday! We'll do blood work this week to check his CBC. We're holding off for a month for the next/last chemo because his system really took a hit last time.

 

Interesting that you had a choice of doxy or carboplatin - Berkeley only started a few weeks before Twiggy and doxy wasn't an option!

[krissn333]

At this moment I am praying that carboplatin is an option. I think doxorubicin is what Winston had-it weakened his heart and eventually THAT is what took him

[Guest Yankeegreyhound]

Please keep Hailey in your prayers. She took a turn for the worse and we feel it may be time. She is not putting any weight on her leg. She's walking and holding it up and jumping. I had to carry her downstiars. She did go outside to potty but she's in pain. I'm going to increase her tramadol. See if that helps. But we can see the tumor - it's causing swelling in her shoulder. Our vet might stop by tomorrow and check in on her. I'll keep you all posted.

[krissn333]

Prayers headed your way. Hope she'll be comfortable soon

[NeylasMom]

Like Chris said, doxy is not available right now. It appears to be completely out of production, at least temporarily.

 

Winslow had several wonderful happy years after his amputation and chemo, far beyond the normal expectancy for a dog with osteo and the chemo probably had something to do with that. I don't think it makes much sense to focus on the potential long term side effects when chemo is what will give you your best shot at extended life if you've chosen amputation.

 

Please keep Hailey in your prayers. She took a turn for the worse and we feel it may be time. She is not putting any weight on her leg. She's walking and holding it up and jumping. I had to carry her downstiars. She did go outside to potty but she's in pain. I'm going to increase her tramadol. See if that helps. But we can see the tumor - it's causing swelling in her shoulder. Our vet might stop by tomorrow and check in on her. I'll keep you all posted.

Do you have her on other meds that you can also increase, or do you have other meds on hand that you can add in? If you decide it's not her time, please get extra meds from your vet so you can be prepared for future incidents like this. Most dogs do best on a combination of Tramadol, an NSAID, and Gabapentin. It's best to know how high you can go for each drug and at what increment you should increase them. After having gone through this, I think it's best to err on the side of going a little too high and then having to back off than going too slowly.

 

I hope she's doing a lot better tomorrow.

[krissn333]

You're right, Jen. I guess I'm feeling like things are going a little too well right now, I am almost waiting for the other shoe to drop We're past the surgery hurdle and now we're looking to the chemo so I have a whole new set of things I'm worrying about. Yes, I'm a freakshow

[joejoesmom]

You're right, Jen. I guess I'm feeling like things are going a little too well right now, I am almost waiting for the other shoe to drop We're past the surgery hurdle and now we're looking to the chemo so I have a whole new set of things I'm worrying about. Yes, I'm a freakshow

 

No, you're just normal.

[Charlies_Dad]

At this moment I am praying that carboplatin is an option. I think doxorubicin is what Winston had-it weakened his heart and eventually THAT is what took him

 

Carboplatin or Doxorubicin are your options and it's a coin toss as to which is better/worse. Charlie was given Doxy and as Jen stated, we did not care about the long-term effects as remember you are fighting for your pups life here and now. Osteo is so aggressive, you want to stamp out any possible cancer cells if you can. We also looked at larger doses but after lengthy reading and discussions realized that would be only doing it for ourselves not Charlie. Not to mention most vets would not agree to give more to a pup. Don't worry too much about the chemo, it's an easy procedure. Just do everything you can to keep Pinky's WBC up and her healthy. You want to get through all the protocol.

 

 

Please keep Hailey in your prayers. She took a turn for the worse and we feel it may be time. She is not putting any weight on her leg. She's walking and holding it up and jumping. I had to carry her downstiars. She did go outside to potty but she's in pain. I'm going to increase her tramadol. See if that helps. But we can see the tumor - it's causing swelling in her shoulder. Our vet might stop by tomorrow and check in on her. I'll keep you all posted.

 

I'm sorry to read Hailey is doing worse. Do you have her on Gabapentin as well? It will not help with the swelling but has done wonders for pain. We'll keep you both in our thoughts.

[winnie]

Please keep Hailey in your prayers. She took a turn for the worse and we feel it may be time. She is not putting any weight on her leg. She's walking and holding it up and jumping. I had to carry her downstiars. She did go outside to potty but she's in pain. I'm going to increase her tramadol. See if that helps. But we can see the tumor - it's causing swelling in her shoulder. Our vet might stop by tomorrow and check in on her. I'll keep you all posted.

 

Hugs to you and Hailey. I'm afraid to say that Faye Oops has taken a turn for the worse too. I have a call into the vet now to ask some questions about what we can do. We thought her restlessness Saturday night was due to being away from home, but she was restless again last night. We now have her on Tramadol 3x per day. She didn't want to eat her cookie this morning. I hate this disease. Please keep us posted on Hailey.

 

ETA... When our vet calls back, I'm going to ask her about Gabapentin. We don't have Faye Oops on it now - just Tramadol and Piroxicam. I came here to write down all the various drug names so I can be prepared to ask her about our options.

Edited November 14, 2011 by winnie

[Guest Yankeegreyhound]

Thank you all for your prayers for Hailey. She is NOT ready yet.

 

I thought she was but then I realized I can do more for her. I upped her doses. She was only on 50mg of tramadol 2x a day and 1/2 a deramaxx in the pm and 1/4 in the am. I started her on 100mg of tramadol and we'll do that 2x a day, maybe 3 (if my mother in law can give her the afternoon dose) and 1/2 a deramaxx 2x a day. I asked my vet about the gabetrin (sp?) and she feels it's the same as tramadol. I'm sure she'll give it to me if I ask her for it but right now, we'll just see how the extra tramadol does.

 

I had my son say goodbye to Hailey this morning in case she wasn't there when he came back. I guess it was premature but I didn't want to take any chances. It was a bad move on my part but it's done. When I went to take him to school, Hailey came running to the door. She wanted to come with us. I was tempted but we get to the bus stop early so DS can play. I know Hailey would be uncomfortable waiting there with all the kids. But, when we walked out the door, she ran over to the couch and was watching us out the window. Then, when I left for work, same thing, came running to the door. This time, for her cookie. She's still eating, she's still asking for cookies, she's still wagging her tail. It just kills me to watch her drag that leg. And I hate that I can see that tumor getting bigger. She's not crying or whimpering or anything but I know she's in pain and I wish I could make it go away.

 

So, we will take it one day at a time.

[NeylasMom]

Gabapentin is absolutely not the same as Tramadol. Tramadol works like an opiate to manage pain, Gabapentin is a neurological drug and addresses that part of the pain (there is supposedly a neurological pain component to bone cancer), and NSAIDs are anti-inflammatories that work on different pathways as well. That's why most dogs do best on a combination of the 3 types of drugs (although some dogs don't tolerate high doses of Tramadol well).

 

I've posted this article many times and it's in the initial post of this thread, but sharing it again so you can read it or potentially share it with your vet. While the title indicates it's about the use of radiation, there is good information on bone cancer pain and general palliative care.

 

 

I've also said this many times but I'll say it again since there are a couple of pups having a bit of a hard time now - many vets don't realize how high you can go with these drugs when you're managing cancer pain. For Neyla, at 56 lbs, we were up to 125 mg Tramadol 3x/day, 50 mg Deramaxx daily, and 300 mg Gabapentin 3x/day. Obviously each pup is different and you'll have to evaluate what side effects there are and whether they're worth it to you. At the doses I just listed, Neyla did not demonstrate any side effects. When we went above 300 mg Gabapentin she got woozy or dizzy so although the vet said we could go up to as much as 100 mg 3x/day we never went back to that high of a dose.

 

Last thing I'll say, of all of these drugs, the NSAIDs carry the highest risk of more damaging side effects (liver issues or possibly kidney issues versus dizziness, sedation, etc.) so that's the drug I would increase more as a last resort although you do have to weigh what works best for your pup. For Neyla, I would say the Deramaxx helped her the most, then the Gabapentin, then the Tramadol although that's not the order we implemented them.

Edited November 14, 2011 by NeylasMom

[Guest snakes]

I would encourage everyone who is not using Gabapentin to use it. It works differently than tramadol in that it blocks the neurological pain signals.

It has worked WONDERS and MIRACLES for FedX. I hardly even give him tramadol anymore. I mainly use gabapentin and an NSAID. It has very little side effects, too high a dose will just make them lethargic/dizzy and you can back ti off.

I have FedX on 200mg twice a day and he does great, at one point when his pain was worse it was 200mg three times a day.

It is very cheap when you get a script and buy it from a human pharmacy, i think i pay about $15 for 400 capsules.

Edited November 14, 2011 by snakes

[Guest Yankeegreyhound]

Gabapentin is absolutely not the same as Tramadol. Tramadol works like an opiate to manage pain, Gabapentin is a neurological drug and addresses that part of the pain (there is supposedly a neurological pain component to bone cancer), and NSAIDs are anti-inflammatories that work on different pathways as well. That's why most dogs do best on a combination of the 3 types of drugs (although some dogs don't tolerate high doses of Tramadol well).

 

I've posted this article many times and it's in the initial post of this thread, but sharing it again so you can read it or potentially share it with your vet. While the title indicates it's about the use of radiation, there is good information on bone cancer pain and general palliative care.

 

 

I've also said this many times but I'll say it again since there are a couple of pups having a bit of a hard time now - many vets don't realize how high you can go with these drugs when you're managing cancer pain. For Neyla, at 56 lbs, we were up to 125 mg Tramadol 3x/day, 50 mg Deramaxx daily, and 300 mg Gabapentin 3x/day. Obviously each pup is different and you'll have to evaluate what side effects there are and whether they're worth it to you. At the doses I just listed, Neyla did not demonstrate any side effects. When we went above 300 mg Gabapentin she got woozy or dizzy so although the vet said we could go up to as much as 100 mg 3x/day we never went back to that high of a dose.

 

Last thing I'll say, of all of these drugs, the NSAIDs carry the highest risk of more damaging side effects (liver issues or possibly kidney issues versus dizziness, sedation, etc.) so that's the drug I would increase more as a last resort although you do have to weigh what works best for your pup. For Neyla, I would say the Deramaxx helped her the most, then the Gabapentin, then the Tramadol although that's not the order we implemented them.

 

Thank you so much for all this information. I get sad and then I get angry when I can't do anything. Reading information like this helps me feel like I have some control over this. My vet started Hailey on the low dose of tramadol but said I could increase it. I guess I just panicked without thinking. I started increasing her meds last night.

 

 

I would encourage everyone who is not using Gabapentin to use it. It works differently than tramadol in that it blocks the neurological pain signals.

It has worked WONDERS and MIRACLES for FedX. I hardly even give him tramadol anymore. I mainly use gabapentin and an NSAID. It has very little side effects, too high a dose will just make them lethargic/dizzy and you can back ti off.

I have FedX on 200mg twice a day and he does great, at one point when his pain was worse it was 200mg three times a day.

It is very cheap when you get a script and buy it from a human pharmacy, i think i pay about $15 for 400 capsules.

 

Thank you again. I e-mailed my vet and hopefully will have her on the gabapentin tonight.

 

I don't know what I'd be doing right now if I didn't have all the wonderful support from this site.

[krissn333]

I have a question about "returning to normal things"...and I know that the answer is probably "everyone goes at their own pace," but, I want to ask anyway.

 

We've been sleeping in the living room on an air mattress since Pinky came home. She is now jumping up on the couch and resting quite often, and has no trouble getting comfortable. Is it too soon to move back to the bedroom? She usually sleeps in bed with me, along with Ace and Fritz (Miss Carrie prefers her bed on the floor and the little guys have little bedtime kennels that they sleep in). She has been sleeping in bed with me on the air mattress so far.

 

Any thoughts?

[winnie]

I finally got to speak to our vet on the way home from work today. She is so awesome. She called an oncologist vet friend who works at the Hope Center (specialized vet clinic here in NoVA) about the best course of action for Faye Oops. In addition to the Tramadol (100mg 2x/day) and Piroxicam (10mg 1x/day), we added the Gabapentin. We're starting at 300mg 2x/day for now. I'm hoping the Gabapentin gives us all some relief - haven't really slept in 2 days.

 

Faye Oops spirit is still good. She is using all 4 legs. She has been having trouble with stairs. She whines at the bottom, but does OK once she gets going. I don't think it's her time yet - just needed to get her comfortable again.

[BauersMom]

I have a question about "returning to normal things"...and I know that the answer is probably "everyone goes at their own pace," but, I want to ask anyway.

 

We've been sleeping in the living room on an air mattress since Pinky came home. She is now jumping up on the couch and resting quite often, and has no trouble getting comfortable. Is it too soon to move back to the bedroom? She usually sleeps in bed with me, along with Ace and Fritz (Miss Carrie prefers her bed on the floor and the little guys have little bedtime kennels that they sleep in). She has been sleeping in bed with me on the air mattress so far.

 

Any thoughts?

 

How high is your bed? Will she try to jump on it? Do you think she can get in/out of bed safely? That would be my only concern - if she tries to do too much too soon, at least while the staples are still in.

 

 

 

I finally got to speak to our vet on the way home from work today. She is so awesome. She called an oncologist vet friend who works at the Hope Center (specialized vet clinic here in NoVA) about the best course of action for Faye Oops. In addition to the Tramadol (100mg 2x/day) and Piroxicam (10mg 1x/day), we added the Gabapentin. We're starting at 300mg 2x/day for now. I'm hoping the Gabapentin gives us all some relief - haven't really slept in 2 days.

 

Faye Oops spirit is still good. She is using all 4 legs. She has been having trouble with stairs. She whines at the bottom, but does OK once she gets going. I don't think it's her time yet - just needed to get her comfortable again.

 

I hope the gabapentin does the trick. Hugs to you and Faye Oops!

[krissn333]

I hope that the gabapentin does the trick for Faye Oops. It's good that she's using all 4 legs though! Hopefully the gabapentin will give her the comfort she needs so that you can all get some rest

 

I don't think my bed is much (if any) higher than the couch. Yes, she will try to get in bed with me. This girl has almost never slept on the floor When I FIRST got her, she liked to sleep in my closet on the bed in there I'll do a height comparison before we attempt anything. I'm not suggesting we go back to the bedroom tonight, but, sooner rather than later would be preferable for my poor back (it's all knotted from sleeping funny). Crazy girl wanted to jump into the back of the Jeep tonight and got mad when I made her wait for me to pick her up

[krissn333]

Jane, hoping for a clean X-ray for Joe tomorrow. What time is your appointment? So cool to see Dr. Couto

[joejoesmom]

Joe is going in for his 15 month post amputation checkup tomorrow. He will actually be 16 months post amp on November 28. He will be getting lung x-rays. He had two little coughs a couple of nights ago. I think he just had something tickling his throat but of course I have been obsessing about it ever since. And to top it all off we are having thunderstorms with a tornado watch tonight. So I am camped out with Joe in my office with "Through a Dogs Ear" playing on the computer. His sweet thunderphobic highness does not like being in the family room (aka the TV room) during storms -- too many windows. So no Dancing with the Stars for me tonight.

 

I am actually scheduled to see Dr. Couto tomorrow. Dr. Fenger, Joe's amazing oncologist since his equally amazing oncologist Dr. Portela went to U of Illinois in Champaign, is off clinics for a few weeks. So we are seeing the big man himself.

 

By the way, if any of you need an oncologist in the Champaign Illinois area, I highly recommend Dr. Roberta Portela.

 

Jane

 

edited because I can't spell

 

Jane, hoping for a clean X-ray for Joe tomorrow. What time is your appointment? So cool to see Dr. Couto

 

Our appointment is for 10:30 eastern time tomorrow. Of course, being OSU, we will likely be there all day. That's just how things tend to go there. If Dr. Couto has an emergency come in or if someone scheduled an initial consult after me, I still may not see him. It is far more important that he see new cases, but I know he really likes Joe and would love to see him. Joe was a blood donor at OSU and everyone there just loves him.

 

Jane

Edited November 15, 2011 by joejoesmom

[winnie]

Tonight I gave Faye Oops here 100mg of Tramadol, 10mg of Piroxicam and 300mg of Gabapetin. The latter was just added to her drug cocktail. Earlier this evening she acted really drugged up, but at least was resting comfortably. Now its 10 p.m. She is whining a lot and still can't seem to get comfortable. This is how things have been the past two nights. I'm worried. I was really hoping for some immediate improvement by adding the Gabapetin. I'm planning to call into work sick tomorrow so I can observe her.

 

Also, does 300mg 2x per day sound like the right dosage on the Gabapetin.

[BauersMom]

300mg 2x/day was what Berkeley was on post-amp.

[tbhounds]

Tonight I gave Faye Oops here 100mg of Tramadol, 10mg of Piroxicam and 300mg of Gabapetin. The latter was just added to her drug cocktail. Earlier this evening she acted really drugged up, but at least was resting comfortably. Now its 10 p.m. She is whining a lot and still can't seem to get comfortable. This is how things have been the past two nights. I'm worried. I was really hoping for some immediate improvement by adding the Gabapetin. I'm planning to call into work sick tomorrow so I can observe her.

 

Also, does 300mg 2x per day sound like the right dosage on the Gabapetin.

First - hugs- it was really nice to meet you and Faye this weekend. Most often gabapentin can be started with a lower dose but, considering Faye may be in pain I can see why your vet started her on that dose. Gabapentin can be given at a lot higher dose if needed. A common side effect when first starting the drug is lethargy until the body adjusts. I wonder if the piroxicam is tearing up her tummy. It might be time to try a different NSAID like deramaxx, metacam or rinadyl.

Hope she finds some comfort tonight.