Osteo Thread

[NeylasMom]

Thank you Judy!!!!!!! The auction is raising over $10,000 for OSU so far!

That is amazing! Have you guys all seen the mystery package Judy donated in honor of Neyla. If not, go check it out and bit on it!

 

Judy, I am so honored that you thought to donate it.

[Charlies_Dad]

It's a small donation to the auction, but made with you all in mind.

 

http://www.2houndsdesign.com/cgi-bin/2hounds.pl?category=GBA&item=1320595065

 

Judy

 

Judy, thank you from us all. Someday we will find a cure.

 

 

Dr. Less called this afternoon - FNA confirmed a sarcoma. She is scheduled for surgery Monday November 7th. He would have done it next week, but, he has to be out of town later in the week. He didn't want to do her surgery and then take off and be unreachable. I thanked him for that. She will likely spend the night at the ER because they don't have overnight staff in their clinic. I think I'd much rather she be looked after all night, even though she'll have surgery Monday morning and then be transported to the ER that night for overnight observation.

 

We spoke about Amicar and he sent a script to my pharmacy for me to pick up. We discussed post surgical pain meds and I think we're going to go with the patch...at least for a couple of days. I talked to him about deramaxx and gabapentin, we'll probably use that once she is home and I know she is eating (and thus will take the meds without me having to stress her by pilling her).

 

I feel like I'm on a rollercoaster that is slowly being pulled to the top of the big hill....

 

Crossing our fingers all goes well even though it is a week away. I agree that 24hr supervision is critical.

 

 

Berk's red cell count went from 150k last week to 78k this week so no chemo today. We'll try again next week.

 

That sucks!

 

 

That stinks, but at least he's in good company. Twiggy was supposed to have chemo today too, but the machine said neutrophils were 1,800 and the manual count was 2,100. Onco said she was borderline and didn't want to do it today. We'll be trying again next week too.

 

That doubly sucks!

 

I hope the count goes back up for Berk and Twiggy!

 

Charlie is rear amp and has had very little trouble last year in winter albeit he does not walk on sidewalks nor roads. His backyard is plowed for him to ensure he doesn't have to walk/run in deep snow and his berm works great in the winter however there has been some times in the late winter when snow is melting off the roof that I had to get out there and break-up some ice.

[krissn333]

I usually snow blow an area for the iggies to potty in, so I'll just make the area bigger this year for Pinky. Odds are she'll still venture into the deeper snow-they all love romping around:

[krissn333]

I just love my big girl...she's so quirky but she's so sweet. If you rub under her chin she streeeeetches her neck out and closes her eyes with enjoyment. She also likes when you rub her chest between her front legs...she does the neck stretch for that too

[krissn333]

As the time draws nearer to surgery, I'm getting more nervous. My mom and I are planning out how to arrange things at the house to accommodate her, but she's such a creature of habit. She likes "her" corner in the living room (which of course is the corner farthest away from the door)...I have no idea how much she is going to care about things like that when she gets home. She may surprise me and take it all in stride, but I want to be prepared for whatever she needs.

 

I have an air mattress and I fully expect I'll be sleeping on it in the living room with her for a while, just so I'll be close to her on the floor.

 

Is there anything in terms of food or OTC items that I should make sure that I have on hand in case it's needed?

[greysmom]

For Dude, he wanted to get back to his completely normal routine, MUCH faster than I thought he should. Our bedroom is upstairs - I say "our" but it was really his! - and he wanted to get back up there after only a week or so. He never really lost hs appetite until chemo, but you should have some potatoes and hamburger on hand, and maybe some tempting add-ins if she has a picky spell.

 

If she's a rear leg amp you should look into this

WebMaster Harness

 

Some people have said it doesn't really fit a front leg amp well, but you could try it.

 

It really helped us help Dude get around the few times that he needed it and was invaluable for the stairs. It has a handle on the top so you can carry them like suitcase! He never needed help going potty so we never used the sling the surgeon sent home.

 

Get plenty of sleep now!

 

Good luck to you!

[TwiggysMom]

I think part may depend on how long she is in the hospital before she comes home. If it is only 2-3 days, she will still be pretty out of it and won't want to do much. She may not care about going all the way across to her corner. OTOH, she may surprise you.

 

Twiggy was hopping all the way across the hospital by day 2 after surgery. I didn't bring her home for 5 days, but that is because I did the surgery at OSU, not locally.

 

It sounds like you've got at-home help, so that is fantastic! Still, as Chris said, try to get some good sleep now! (I worked like crazy to get everything ready at home the weekend before driving all night to OSU, but was able to sleep while in Columbus). I guarantee you won't sleep well when Pinky gets back home for the first couple weeks. I too slept on an air mattress for the first month - I was in my downstairs room that doesn't have any plumbing, that was fun!

 

Even with people to help out at home, have the house stocked with groceries, also get some irresistible canned dog food - this will be good for giving meds in. Plan to make a med chart to schedule which pills are given when, there will be a lot, and they will be on odd timing. The first week or two it will seem like you are giving at least one pill every 2-3 hours.

 

Have plastic wrap, too. You will need to keep her bandage dry in case it rains (wrap before going out, unwrap as soon as you get back in - only need to do this if it is rainy or snowy). Basic first aid supplies you probably already have, and may not need. I ended up having to buy a lot of additional stuff to deal with Twiggy's infection - you probably won't encounter that. I've never heard anyone else recommend this, but it is my own idea that I didn't think of beforehand: along with washing everything else she will come in contact with, wash HER! It is very possible that the pseudomonas infection she contracted was on her fur to begin with. Maybe a bath would have prevented that.

 

Also, find a dog-friendly taxi company in your area. I never imagined I'd need one, but when Twiggy had to go to the e-vet for her infection, my car wouldn't start! That had never happened before, of course it did in an emergency. Fortunately, a neighbor was willing to take us. Buy I now know a cab company that could have taken us.

 

I spent lots of $$ and time fashioning a "bite-not" style collar and after the fact realized that a small towel and vet wrap would have accomplished the same thing I also made a nice soft, padded sling to help with walking and stairs - for Twiggy it was just a nuisance. I quit even trying to use it after about 5 minutes. This will definitely vary depending on the dog. I know a sling or harness has been invaluable for some.

 

Small women's short-sleeved t-shirts work well to cover the amp area if a front-amp. (sorry I don't remember). Just sew one sleeve shut.

 

As usual, I've written a novel, and as usual, I'm sure I've focused way too much on some things that won't even apply, and completely forgotten some things that were really helpful. I'll come back and add on if I remember anything.

 

I'll keep checking in and will be thinking of you! (feel free to pm me, too, if you want).

[Charlies_Dad]

I believe Wendy has summed things up well. You will likely be surprised how quickly Pinky will want to get back to her routine as she is young and will likely have decent energy after surgery. Depending on how long she stays at the hospital (I believe you stated 1.5 days or something?), the first 2-3 at home may be very trying for you. The best thing is to stay calm, have plenty of pain meds available, know what you can and cannot increase in case of a pain spike. Make sure Pinky has easy access to going outdoors (move furniture around if you have to, etc.). It makes it a lot easier when you are escorting her out if you don't have things close by. We removed our coffee table from our sunroom altogether for Charlie and we moved our dining room tables plus chairs away from the door leading to the deck. This gave us ample space and nothing for Charlie to manoeuvre around. Whatever bedding you are going to have, cover it will towels or blankets as the wound will likely seep and it's easier to clean that then a whole bed. Sometimes you may need to use a cold compress around the wound area to help reduce bruising and we used a frozen bag of peas, Charlie seemed to like it when we did this. Also know that a fall is going to happen at some point, just try to eliminate the chances as much as possible while she is healing as you don't want the stitches to rip out. That means covering slippery surfaces, etc. Just some additional thoughts:

 

- Keep a muzzle close by as sometimes your pup can react differently while on pain meds or in pain

- Get a lot of rest beforehand if you can as the nights will likely be long for the first 2-3 days

- Make/buy food in advance for you and Pinky. It's easier if you don't have to think about cooking for a short period.

- Have someone to call at your vets 7/24 in case something happens or you have questions

- Make a list of when to give pills, there are a lot of them and frequent so it's easy to forget one

- Have something to help Pinky walk or go potty, either a sling or harness for the first couple days

- Pinky will be sensitive the first few days and you may get a GSOD, panting, pacing, etc. - all normal, try not to panic

- Watch for infections (redness/swelling) in around the suture site

[krissn333]

Thanks everyone for sharing your experiences. While I've never rehabbed a dog after an amputation, I have worked with lots of broken leg pups and used to do a lot of the medical stuff for our kennel, so, I feel like I have a good working knowledge of the medicine behind it all and what to expect to have to deal with as far as sutures, etc...I really have a feeling that Pinky will be a bit sedate for a few days, but by the weekend I imagine she'll be pretty much her normal self, attitude-wise. She is a chow hound, but wasn't too hungry the day of her FNA when she had some morphine on board, so I'm glad that I know to expect that from her and I won't worry when she isn't interested in eating a big meal. She LOVES peanut butter so I'll be sure that we have a fresh jar for her to snack on to at least have something in her tummy.

 

I've got a big notepad for writing out her meds schedule, but I'll likely put it all into my iPhone...that way it will beep at me when she's due for something. My house is already a pharmacy with Ace taking chemo drugs and prednisone, Pinky on her vitamins for her lupus, and my Rosie kitty on thyroid meds. I have tons of "little old lady pill containers"

 

She continues to do well - she is her sassy self...pigging out on her food and begging for treats. Takes her Deramaxx every morning with her breakfast. When she hears me pick up the bottle she comes running because that means she's getting a "treat"!

[Guest carla7]

Hello everyone....

 

I am so sorry to hear about all the recent diagnoses.........and also very sorry to hear about Dude.

 

For those that were asking about palliative care, I just wanted to add that so far Pamidronate has been like a miracle drug for Persephone. She initially had 2 rounds of radiation and 2 rounds of Pamidronate so far. I am convinced that it is the Pamidronate which is making such a big difference in her. I haven't even used any pain medications with her since her last tx which was about 3 weeks ago. She has been really playful with her "babies", taking walks everyday and is not showing any signs of pain or limping at all.

 

In fact, she has really been kind of rambunctious and I have to keep trying to keep her from overdoing it.

We are also going to resume the artemisinin (I am waiting since her last radiation was approx 6 weeks ago and I read somewhere to wait 2 months post radiation before resuming it). So that's where we are at so far......she is getting lots of love, treats, and walks!

Carla

[Guest Yankeegreyhound]

Can someone please talk to my Hailey and tell her that she has osteo and ask her to please stop running around and jumping like a maniac. She's giving her Mommy a mild heart attack each and every time.

 

Thank you.

[Guest snakes]

Can someone please talk to my Hailey and tell her that she has osteo and ask her to please stop running around and jumping like a maniac. She's giving her Mommy a mild heart attack each and every time.

 

Thank you.

 

 

Hailey!! stop scaring your family!!

P.s.- if you slow down you might get more treats!

[krissn333]

So, I called the vet's office today and asked for a copy of the pathology report from Pinky's FNA. I'm going to send it to OSU right now, but, if someone can translate I'd appreciate it. Kind of freaks me out a little and makes me wonder if they're suggesting it's NOT cancer... ??

Cytology Report

 

Description: Direct smears were well made. They were moderately cellular with large numbers of RBC and platelets in the background. Bone marrow hematopoietic cells were not noted. There were frequent well differentiated osteoblasts and osteoclasts noted. There were frequent small clusters of well differentiated to mildly reactive spindle shaped cells. There were rare clusters of moderately pleomorphic spindle cells. These cells had moderate anisocytosis and anisokaryosis. The N:C ratio was high to moderate. The cyto plasm was often pale basophilic to grey and tapered to indistinct cell borders. The nuclei were round to oval with fine chromatin and often, small, prominent 1-4 round to oval to linear small nucleoli. Rare binucleated cells were noted with mild intracellular anisokaryosis. No definitive etiologic agents were observed.

 

Comments: The glass slides were mailed labeled as Bone Marrow but the submitted history indicates that bone (not marrow) was sampled. The findings above are more consistent with a bone (cortical) sample. The cells described above did not fulfill strong cytologic criteria of malignancy. These cells may be representative of a periosteal reaction. Sarcoma cannot be definitively ruled out. Histopathology of the lesion is recommended.

 

Interpretation: Possible sarcoma

Edited November 1, 2011 by krissn333

[Batmom]

They're saying they can't tell -- it might be, it might not be.

[krissn333]

They're saying they can't tell -- it might be, it might not be.

Ugh. Now I'm freaking out.

 

She is PERFECTLY NORMAL. I've been giving her 50mg Deramaxx in the morning before I leave for work. I am almost tempted to NOT give it to her one day and see how she does.

 

I mean, I'm all for the amputation if what we're dealing with calls for it, but, if it doesn't, I hate to put her through a surgery when it's not even indicated...KWIM?

 

It's got to be something, right?

[Batmom]

Absolutely.

 

In a little more detail, what they're saying is, *something* not entirely normal is going on with that bone ("may be ... periosteal reaction"). "Periosteal" means "involing the periosteum," which is the covering of the bone. You could have a periosteal reaction from something as simple as a strained tendon/muscle -- for example, dog caught herself from falling, had a hard slip in the grass, etc., during which an attached tendon yanked hard on the surface of the bone. Not saying this is the case for your sweet girl, just that it's possible.

 

They can't rule sarcoma in *or* out because, while the cells aren't entirely normal, they aren't that weird either.

 

I'd let OSU take a look at all your data and see what they think.

Edited November 1, 2011 by Batmom

[BauersMom]

Kristin - Berkeley was not limping at all at the time of his amp. We did not do the FNA for exactly the reason you are experiencing - many times it is inconclusive.

I would go by OSUs recommendation. Since they've already seen the x-ray you should get an answer quickly.

[krissn333]

I sent in another consult form - wasn't sure I should just email Dr. Marin even though she and I have chatted back and forth a little bit about various items. I attached the xray again just so they'll have it handy when they look at the FNA interpretation rather than having to try to find it in the mounds of stuff they get every day.

 

I almost wonder if I should have her xrayed again?

 

I kind of feel like I'm being a little bit insane

[Guest Yankeegreyhound]

I sent in another consult form - wasn't sure I should just email Dr. Marin even though she and I have chatted back and forth a little bit about various items. I attached the xray again just so they'll have it handy when they look at the FNA interpretation rather than having to try to find it in the mounds of stuff they get every day.

 

I almost wonder if I should have her xrayed again?

 

I kind of feel like I'm being a little bit insane

all

 

You're not insane at all. I know, if I were in your situation and there was ANY doubt in my mind, I would want to know for sure. You have time before the scheduled surgery so I see no problem with contacting OSU again. With Sara, there was no question she had a tumor because her leg was HUGE(different type of cancer). We had a biopsy done and it came back as benign. After the biopsy, the incision site wasn't healing. We went for a second opinion. We had no choice but to amputate because benign or not, it was growing. After the amp, the vet (our new vet - the 2nd opinion vet) sent samples to be biopsied and again, came back benign. She then sent what was left to Cornell and they found the cancer deep, deep inside the tumor. Sara's is a very strange and not normal case but it took 3 biopsies to find her cancer.

[TwiggysMom]

Kristin,

 

My experience probably won't help you any, but when I sent in Twiggy's x-rays, the response was that it was "consistent with a primary bone tumor" and stated that a FNA was recommended prior to surgery (which I had them do there the day before surgery). Since you've already done a FNA with inconclusive results, OSU may not be able to give you anything definitive, either. They didn't actually conform osteo until the path report came back about a week and a half after surgery.

 

I would ask OSU if having new x-rays would be helpful, or if another FNA should be done, or whether in this case they would recommend a bone biopsy (that is much more painful, invasive, and can compromise the bone especially if osteo is present, so biopsy usually isn't recommended) the upside of biopsy is that it has a much better chance of getting a large enough sample that a definitive diagnosis can be made. At least this is my understanding, somebody please correct me if I'm wrong!

 

This has to be really tough for you, because I know how much you want it to not be osteo, but if it is, you want a diagnosis NOW!

 

Hello everyone....

 

I am so sorry to hear about all the recent diagnoses.........and also very sorry to hear about Dude.

 

For those that were asking about palliative care, I just wanted to add that so far Pamidronate has been like a miracle drug for Persephone. She initially had 2 rounds of radiation and 2 rounds of Pamidronate so far. I am convinced that it is the Pamidronate which is making such a big difference in her. I haven't even used any pain medications with her since her last tx which was about 3 weeks ago. She has been really playful with her "babies", taking walks everyday and is not showing any signs of pain or limping at all.

 

In fact, she has really been kind of rambunctious and I have to keep trying to keep her from overdoing it.

We are also going to resume the artemisinin (I am waiting since her last radiation was approx 6 weeks ago and I read somewhere to wait 2 months post radiation before resuming it). So that's where we are at so far......she is getting lots of love, treats, and walks!

Carla

 

Carla,

 

I'm SO glad to hear how well Persephone is doing - that is great!

 

I know a number of dogs have done really well for a long time with Pamidronate, sounds like we can add Persephone to that list

[greysmom]

FNA are VERY often NOT conclusive. That's why they aren't necessarily a good diagnostic tool for osteo. If you don't get a sample from just the "right" spot, it can become confusing - as you've seen.

 

Dude had no limp, no pain behavior, no swelling, no visible tumor in his rear leg. There was nothing to make us nervous or even curious about anything. He was running in the yard and broke his leg. Could have not been cancer, but it could. The xrays taken of the break were NOT conclusive. Even the reading by OSU came back as only "suggestive" of cancer due to history and appearance. The surgeon who cut off his leg said he couldn't tel by looking at the bone. Osteo was only confirmed after a post-op biopsy results that we got a week after his surgery.

 

Sometimes you just don't know and you have to make a very huge and hard (and expensive) decision based on incomplete information. And you still are at risk of the cancer - if that's what it is - being aggressive and surgery not really giving you any extra time. The whole thing just sucks eggs.

 

Good luck to you and your girl. Don't hesitate to bug Dr Marin!

[krissn333]

Sutra's FNA was technically inconclusive, but, the description of the cells in the report highly suggested a sarcoma of some type. I had expected a similar report from Pinky's FNA. I guess having it not read out the same is what's making me question all of this. Deep down I still think that it's very likely osteo, and that we need to do the amputation. I'm just thinking that maybe we were fortunate to have caught it early. I'm hoping Dr. Marin can provide some further clarification and guidance to put me at ease a little bit.

 

If it was "just" a bone infection, the FNA would be able to tell THAT conclusively, right?

Edited November 2, 2011 by krissn333

[TwiggysMom]

Sutra's FNA was technically inconclusive, but, the description of the cells in the report highly suggested a sarcoma of some type. I had expected a similar report from Pinky's FNA. I guess having it not read out the same is what's making me question all of this. Deep down I still think that it's very likely osteo, and that we need to do the amputation. I'm just thinking that maybe we were fortunate to have caught it early. I'm hoping Dr. Marin can provide some further clarification and guidance to put me at ease a little bit.

 

If it was "just" a bone infection, the FNA would be able to tell THAT conclusively, right?

 

I don't know the answer to your question, but I had to say that I just looked up Pinky on GD, and discovered that she and Twiggy have a lot in common. They are both dark brindle Molotov granddaughters, both raced at Dairyland in the same time frame and grades (although never in the same race), and both ended their careers as a "no runner" (a friend found her last race online somewhere, and sure enough, she never exited the box!).

 

I will add that Twiggy's FNA was more like Sutra's in that they were confident it was bone cancer, just not sure which type. I was also hoping for "just" a bone infection.

[krissn333]

I was bummed that they stopped offering the ability to get races on DVD shortly after the track closed...I didn't request her races soon enough after I got her and the. The track closed

 

Pinky is so dark brindle that most people think she is black. She has some light stripes by her neck and you can see her brindling in the sunlight, but most people don't notice it. She is my beautiful special girl Interesting that she and Twiggy have so much in common

[BauersMom]

Berkeley is a Molotov grandpup too