Osteo Thread

[krissn333]

Will he tolerate wearing some jammies? My Carrie, who is 12, is a bit of a fidgeter at night (just from being herself really, not for any medical reason like Sam) and I'd be up every hour or so re-covering her if she didn't have her jammies. They are light fabric and just fit her like a cape with velcro around the chest. They're enough to keep her covered up and comfy

[KF_in_Georgia]

I can put a t-shirt on him tonight and see how that goes.

 

But he loves being under the covers--head and all.

[winnie]

I'm sorry to hear that Sam has been so restless. If it helps, it did take Faye Oops about a week to get used to the gabapentin. She was initially on 300mg 2x/day which was too high a dose for her. Others do fine on that dosage and even higher ones. a lot just depends on the dog. We now have her on 500mg split into 200mg, 100mg and 200mg doses. We also have her on 100mg Tramadol 3x/day. It also helped when we took her off the piroxicam. That was a total accident since we had scheduled her to cross the bridge and ran out of it a few days beforehand. I think the combo of getting used to the gabapentin and dropping the piroxicam is what made the difference for her. That first week on the gabapentin was AWFUL though.

 

I hope that Sam sleeps better tonight. If not, I can totally understand if you go ahead with his appointment on Tuesday. Cancer is so tough. Even though we postponed Faye Oops appointment to cross the bridge, we know that our time with her is still limited. It could be tomorrow, next week or next month. There really is no "right" time with this disease.

[KF_in_Georgia]

I hope that Sam sleeps better tonight. If not, I can totally understand if you go ahead with his appointment on Tuesday. Cancer is so tough. Even though we postponed Faye Oops appointment to cross the bridge, we know that our time with her is still limited. It could be tomorrow, next week or next month. There really is no "right" time with this disease.

 

At present, I'm planning to ask the vet to examine Sam to see if he thinks we've got the pain managed successfully. If Sam's in pain, then I think we're screwed: I don't think he can function on a higher dose of pain meds. Lung cancer isn't known to be particularly painful in early stages--and Sam just coughs occasionally (not in any distress) and isn't coughing up blood or anything like that. But we're figuring there's a primary cancer lurking, and I want to make sure he's not being made uncomfortable by that.

 

If the vet thinks we have the pain managed, we'll go on for a while.

[krissn333]

Any chance you can start an NSAID for him to help? I think you mentioned Meloxicam? We've had good luck with Deramaxx here. When Pinky was restless, the Deramaxx really took the edge off.

[KF_in_Georgia]

Any chance you can start an NSAID for him to help? I think you mentioned Meloxicam? We've had good luck with Deramaxx here. When Pinky was restless, the Deramaxx really took the edge off.

 

He's on meloxicam (for his back), and it's been successful.

 

There's a long washout period for NSAIDs, and that would mean having to go at least a couple of days (maybe more) with no NSAIDs before he could start a new one. Also, I think I remember reading that meloxicam often is used for people with cancer. I don't think we'll be changing his NSAID.

[krissn333]

Oh, I didn't mean to suggest you switch...just from your daily log above I couldn't tell if he took the Meloxicam regularly or just as needed.

[KF_in_Georgia]

Yeah, the x-rays on the 14th showed a slightly herniated disk at L5. On the 15th, I started giving meloxicam every morning.

 

He's being all cuddly tonight (temperatures have gotten much colder today). I'm probably going to go to bed soon. I'm about cross-eyed on this freelancing job.

[krissn333]

for a restful night for all of you

[GreytHurleyDawg]

Prayers for Sam....he needs better answers than what you have so far! Good to hear he isn't too disturbed to zoom about!

 

Kristin, hugs to you and Ace.....I suppose there could not be a worse time for this to happen but at least they are going through this 'together' in a way. Pinky's path report sounds good to me (I work in a lab but I stay away from the pathology part)...our comment said the same 11.5% but specified for amp only. Then it said the 12-14 months for amp + chemo. It seems like a sentence or two fell off yours. Have FUN at the party if you go....my husband suggested a shirt that says: I ALWAYS WIN THE THREE-LEGGED RACE! He still wants to market shirts for this cause.

 

Clark's foster mom: I am sorry it sounds quite bleak right now and hope it will still turn around.

 

Joe-joe's mom, thanks for the info about suramin + doxo. I noticed Charlie takes Palladia after Chemo ended...I will be looking into all that as soon as I can. There is a semi-holistic vet very closeby to us and I wonder if they can provide some of the supplements and natural herbs, etc that I will need. I also wonder if insurance will deem these to be worthwhile. Does anyone have a good timeline to follow in terms of followup treatment with artemenisin, etc? Is it all for after chemo is finished or is it best to get started now?

 

So, chemo does get rougher as it goes along? We had pickiness with food and maybe some lethargy from the first one. How will that get worse? I am having trouble figuring out how chemo works...does it build up or does it treat immediately and then it treats more next time? Should we worry very much about cleaning his poop? Petra eats poop and Jim left one of Hurley's piles outside even though I told him to bag them up. Sheesh. Husbands. As you can see, I could go on and on.

 

Time to take him out for last turnout.....good night!! Stitches can come out in about 2 days! Yay...he can run then! (P.s. he has been off leash a few times in the yard and has trotted a bit!)

Edited November 29, 2011 by GreytHurleyDawg

[greysmom]

Our vet said to use gloves to pick up Dude's poop and to dispose of right away. I would really try to not let her eat any.

[Charlies_Dad]

Does anyone have a good timeline to follow in terms of followup treatment with artemenisin, etc? Is it all for after chemo is finished or is it best to get started now?

 

So, chemo does get rougher as it goes along? We had pickiness with food and maybe some lethargy from the first one. How will that get worse? I am having trouble figuring out how chemo works...does it build up or does it treat immediately and then it treats more next time? Should we worry very much about cleaning his poop? Petra eats poop and Jim left one of Hurley's piles outside even though I told him to bag them up. Sheesh. Husbands. As you can see, I could go on and on.

 

 

We only started Artemisinin after chemo if I recall correctly. Palladia was also after the intravenous chemo.

 

As for your question about chemo, I'm no expert but we did notice Charlie be more lethargic after round 3 but he never experienced any other symptoms and his WBC never dropped too low that we had to delay a round. Poop cleaning we were told to do with plastic gloves but we pick it up with a plastic bag anyways so doesn't that do the same? I would certainly try to make sure your other pups do not eat it. As for husbands....well I am one and I always make sure to pickup as we have two who enjoy the nasty side.

[winnie]

Checking-in for any news on Sam.

 

Today was my first day back at work since November 17. We kept Faye Oops and Celeste on the main level with baby gates. She still doesn't do that great on stairs. I didn't want to risk having her fall while we were at work. She definitely has some uncomfortable moments, but she is still using all 4 legs, eating and sleeping. It breaks my heart to see her in any amount of pain, but this dog is just so damn determined to live. She amazes me. DH and I made peace with the fact that we're going to have to help her cross the bridge. We're mentally prepared - just waiting for Faye Oops to tell us when she has had enough - and enjoying every moment we have left with her.

[joejoesmom]

Prayers for Sam....he needs better answers than what you have so far! Good to hear he isn't too disturbed to zoom about!

 

Kristin, hugs to you and Ace.....I suppose there could not be a worse time for this to happen but at least they are going through this 'together' in a way. Pinky's path report sounds good to me (I work in a lab but I stay away from the pathology part)...our comment said the same 11.5% but specified for amp only. Then it said the 12-14 months for amp + chemo. It seems like a sentence or two fell off yours. Have FUN at the party if you go....my husband suggested a shirt that says: I ALWAYS WIN THE THREE-LEGGED RACE! He still wants to market shirts for this cause.

 

Clark's foster mom: I am sorry it sounds quite bleak right now and hope it will still turn around.

 

Joe-joe's mom, thanks for the info about suramin + doxo. I noticed Charlie takes Palladia after Chemo ended...I will be looking into all that as soon as I can. There is a semi-holistic vet very closeby to us and I wonder if they can provide some of the supplements and natural herbs, etc that I will need. I also wonder if insurance will deem these to be worthwhile. Does anyone have a good timeline to follow in terms of followup treatment with artemenisin, etc? Is it all for after chemo is finished or is it best to get started now?

 

So, chemo does get rougher as it goes along? We had pickiness with food and maybe some lethargy from the first one. How will that get worse? I am having trouble figuring out how chemo works...does it build up or does it treat immediately and then it treats more next time? Should we worry very much about cleaning his poop? Petra eats poop and Jim left one of Hurley's piles outside even though I told him to bag them up. Sheesh. Husbands. As you can see, I could go on and on.

 

Time to take him out for last turnout.....good night!! Stitches can come out in about 2 days! Yay...he can run then! (P.s. he has been off leash a few times in the yard and has trotted a bit!)

 

Love the "I always win the three-legged race!". Would it be okay with you if I made a shirt or vest for Joe with this logo? If your husband does make up some T-shirts, we would love a donation of one or two for the OSU conference fundraiser (occurs during the OSU greyhound conference in May -- all proceeds go to the OSU GHWP.)

 

Palladia is very expensive. I doubt it would be covered by insurance as it is only officially approved to treat mast cell cancer.

 

Joe was a bit picky and somewhat nauseous throughout the entire IV chemo period (he got the chemo every 2 weeks). After the 3rd chemo he developed some diarrhea which was cleared up by metronidazole (Flagyl). He did receive cerenia for 4 days after each chemo and was on famotidine throughout. He also received ondansetron and reglan from time to time for nausea. I was told by OSU that Joe had more side effects than typical.

 

OSU gets artemisinin from Holley Pharmaceuticals. They didn't give it to Joe until the IV chemo was completely finished. I think we waited until two weeks after the last IV chemo but I'm not sure. I believe I remember OSU saying NOT to use it during IV chemo. IIRC, this is because they don't know if it will impact the effectiveness of the IV chemo.

 

Joe's Palladia protocol is a bit different than Charlie's. This is what he gets:

 

15 mg famotidine twice a day (30 minutes before each meal)

Palladia on Monday, Wednesday and Friday with the evening meal (actually it is best given with whatever meal for which you can be most consistent with the timing)

Cytoxan (cyclophosphamide) on Tuesday, Thursday and Saturday with the evening meal

Artemisinin every day before bedtime (must be given at least 2 hours away from any foods containing iron)

 

He also gets metronidazole occasionally for diarrhea (this is a side effect he gets with the Palladia) -- it seems that it is about one episode every 2 to 3 months

 

Not for the cancer but for other reasons, he takes

 

a glucosamine and chondroitin supplement

Petzlife gel for his teeth

CET enzymatic toothpaste

 

I included the above three just so folks would know that OSU said it would be okay to use these in conjunction with the Palladia metronomic protocol.

[TwiggysMom]

my husband suggested a shirt that says: I ALWAYS WIN THE THREE-LEGGED RACE! He still wants to market shirts for this cause.

 

So, chemo does get rougher as it goes along? We had pickiness with food and maybe some lethargy from the first one. How will that get worse? I am having trouble figuring out how chemo works...does it build up or does it treat immediately and then it treats more next time? Should we worry very much about cleaning his poop? Petra eats poop and Jim left one of Hurley's piles outside even though I told him to bag them up. Sheesh. Husbands. As you can see, I could go on and on.

 

I love the Three-Legged Race shirt idea! Twiggy could use one that says "Still faster than 4-legged greyhounds!"

 

As for how they progress through chemo, I hope I didn't scare you with my comment in your other thread! Many dogs sail through chemo with little to no effects other than what you have already noticed with Hurley. Twiggy has been pretty much like that, too. Her first treatment has absolutely no effect on her behavior at all. The 2nd one made her fairly lethargic, a little nauseated, and a bit picky about her food.

 

She also has at times what I'm calling "chemo poop". I'm not sure if anyone else had experienced this, but at times she has oddly colored (sort of rusty) loose (almost "sticky" for lack of a better term) stool. The other thing that is weird about her "chemo poop" is that if she goes multiple times on a walk, it will be the first one that is weird like that, then progressive ones become more normal and firmer. (Of course that is totally opposite of what usually happens with multiple poops in a short time frame).

 

Twiggy's 3rd chemo was delayed by 1 week because her neutrophils were borderline. It probably would have been fine to go ahead and treat her, but played it safe just in case.

 

This latest round has been going better for Twiggy, a little lethargic for the first day and a half, but no loss of appetite, and returning to normal very quickly (and no chemo poop yet!). She hasn't yet needed metronidazole, or any antacids. She does get Cerenia for 4 days after each treatment, but really hasn't needed it much this time around (I actually forgot to give yesterday dose!)

 

I've heard that sometimes a particular round of chemo will suddenly have more side effects than previous ones, and that often once that happens, the remainder of the treatments go smoothly. Twiggy's oncologist thinks that if the first one goes smoothly, the rest usually do.

 

I asked Twiggy's oncologist about whether I need to be extra concerned about cleaning up after her while she's on chemo, and the doctor told me that Carbo is pretty much just excreted in the urine, and is most concentrated for the first 72 hours, so it's good to try to keep them from peeing in an area where other pets (or children!) will be playing, and to be careful cleaning up any indoor messes. I still would be careful around the poop as well, and I sure wouldn't want to let Petra eat any, but it doesn't sound like it is processed that way. Doxorubicin is a different story, apparently. That is excreted pretty much everywhere - urine, poop, saliva, vomit... so you have to be much more careful with that one.

 

I'm also trying to figure out what to do after iv chemo. I found Palladia at a Vet-VIPPS certified online pharmacy for $27/dose (for a 50-55lb dog). That's about $350/month, and Palladia requires regular monitoring via bloodwork, so that would add at least another $200/month for me. My main issues with it, though, are that it is as yet unproven for this use, has some potentially dangerous side effects, and would keep her immune system permanently lowered (which would mean she couldn't do some of her favorite things, like playing at the dog park). So, I may just go the artemisinin only route or arte/cytoxan/piroxicam, or something.

[BauersMom]

Yeah, we're in the "what to do after chemo" stage now too.

 

At this point, I think I will just go with whatever the onco vet recommends for him. His numbers got really low at one point, so I wouldn't want to put him at a higher risk of issues for unknown or unproven benefits...but at the same time, I want to do everything we can within reason. It's tough.

[KF_in_Georgia]

Home from the vet with Sam.

 

Sam's weight is up about a pound and a half. (Nothing wrong with the boy's appetite.)

 

Putting a shirt on Sam last night worked wonders. He's been waking me up so I can put the covers on him. When he's wearing a shirt, he thinks he's covered. (And it's not about the temperature. Even in the summer he wants to be under a sheet.) I know he was restless some last night, but after he wandered around, he just came back and laid down next to me--without waking me up! (It's amazing how wonderful six hours of uninterrupted sleep can make you feel!) But I know he got up and wandered around: he had a couple of light blankets over him to start with last night, and he shed them on the other side of the room.

 

Sam, taking a blanket for a walk...

 

Sam's having some pain in his spine. Considering his arthritis--not to mention the falls he took this weekend--I'm not surprised. We're stepping up the methocarbamol (from 2xDay to 3xDay); he's occasionally had three in a day without any problems. We'll give this a couple of days, then look at increasing the gabapentin if we need to. And no valium from now on.

 

Sam has been coughing more frequently, but not harder or longer coughing spells or anything like that. The vet said his lungs don't sound worse.

 

So, as with Faye Oops, getting Sam's meds adjusted made a huge difference--that, and a t-shirt.

[krissn333]

I'm so happy that the tshirt worked! To be honest I teared up a little bit just seeing that news...I know this has been tough on all of you and you'll all be in better health if you get some good rest!

 

Ace frequently takes blankets for a walk too

[KF_in_Georgia]

I'm so happy that the tshirt worked! To be honest I teared up a little bit just seeing that news...I know this has been tough on all of you and you'll all be in better health if you get some good rest!

 

Ace frequently takes blankets for a walk too

 

Even the vet said, "You're looking more rested today." I had seen him a week ago, when I'd just been through three near-sleepless nights and I was desperate for some meds to get Sam to sleep.

[TwiggysMom]

Awww, yay for Sam (and YOU!)

 

I love his blanket-walking! Twiggy has been known to take her blanket for walkies, too

[winnie]

I'm so glad to hear about Sam. The lack of sleep for us humans make this emotional roller coaster that is cancer 10x worse. When Faye Oops wasn't sleeping, I was a complete wreck - both physically and emotionally. I hope that Sam starts sleeping better with his T-shirt on so that you can finally get some rest too.

[JJNg]

I found Palladia at a Vet-VIPPS certified online pharmacy for $27/dose (for a 50-55lb dog). That's about $350/month, and Palladia requires regular monitoring via bloodwork, so that would add at least another $200/month for me. My main issues with it, though, are that it is as yet unproven for this use, has some potentially dangerous side effects, and would keep her immune system permanently lowered (which would mean she couldn't do some of her favorite things, like playing at the dog park).

Palladia isn't typically considered to be immunosuppressive. While it could technically be considered a form of chemo, it's really in a different class that tends to have fewer side effects. Palladia (and other tyrosine kinase inhibitors, TKIs) specifically targets receptors that are found on cancer cells, so they don't affect as many normal cells as traditional chemo does.

 

My mixed breed Corey is on Palladia (for a form of intestinal cancer), and our oncologist has never mentioned having to restrict his activity and exposure due to immunosuppression. Maybe your vet is just being super cautious? And while there are definitely some potential side effects, most dogs seem to tolerate Palladia very well, especially since many oncologists are now using it at a slightly lower dose than what's on the label. Corey has been on Palladia for over a year now, and he's had no side effects other than an occasional day of diarrhea that may or may not be related. His bloodwork has been just about perfect at every recheck.

 

IMO, the expense and the lack of proven efficacy against osteosarcoma would be the biggest factors to consider. I do feel that the TKI class of drugs seems to show a lot of promise in cancer treatment, and they may turn out to be beneficial for a number of cancers besides the mast cell tumors that it's FDA approved for.

[krissn333]

Friday would have been angel Sutra's 14th birthday. I still believe if the osteo hadn't gotten to him, he would still be here with us. Ever my miracle dog

 

Pinky's chemo consult is tomorrow morning...

[TwiggysMom]

Palladia isn't typically considered to be immunosuppressive. While it could technically be considered a form of chemo, it's really in a different class that tends to have fewer side effects. Palladia (and other tyrosine kinase inhibitors, TKIs) specifically targets receptors that are found on cancer cells, so they don't affect as many normal cells as traditional chemo does.

 

My mixed breed Corey is on Palladia (for a form of intestinal cancer), and our oncologist has never mentioned having to restrict his activity and exposure due to immunosuppression. Maybe your vet is just being super cautious? And while there are definitely some potential side effects, most dogs seem to tolerate Palladia very well, especially since many oncologists are now using it at a slightly lower dose than what's on the label. Corey has been on Palladia for over a year now, and he's had no side effects other than an occasional day of diarrhea that may or may not be related. His bloodwork has been just about perfect at every recheck.

 

IMO, the expense and the lack of proven efficacy against osteosarcoma would be the biggest factors to consider. I do feel that the TKI class of drugs seems to show a lot of promise in cancer treatment, and they may turn out to be beneficial for a number of cancers besides the mast cell tumors that it's FDA approved for.

 

Thank you for this clarification. I have to admit that I assumed (we know what that means...) that because Palladia needed to be monitored by bloodwork, that it lowered the immune system. I read the package insert, and it made me really uncomfortable; of course, the package insert of just about any prescription out there is pretty scary. I am still concerned about reports of death shortly following episodes of bloody stool. It will be winter, and I won't be able to see whether she has blood in her stool or not. Maybe you can clarify this for me - I've read that if a dog experiences bloody stool from Palladia, absolutely no more Palladia can be administered, and it may already be too late for the dog. Even if those reports are totally wrong, the package insert did report some deaths that seemed likely to be from the drug. The risks of side effects versus no known chance of improving her quality of life are what I'm mostly struggling with. I'm glad to hear about Corey and other dogs who are tolerating the Palladia well. I know several on it who are doing well, but at least two of them have had to take a "holiday" from it due to side effects and/or blood test results.

 

Of course I want Twiggy around longer (forever would be nice). I put her through amp and am putting her through iv chemo; but I don't want to extend her life from 10 months to 14 months (hypothetically) if it means her spending all of that time feeling relatively crappy. Somehow, metronomic protocols seem harsher than iv chemo - with iv chemo she feels off for a day or so and then is back to herself; having low-dose chemo (Palladia or otherwise) constantly going in to her seems like it would be worse.

 

I've said it before, and I'll say it again, the post-amp, post-iv chemo is the hard part. Everything up to now seemed so obvious given Twiggy's particular circumstances. Aarrrrgh!

 

Friday would have been angel Sutra's 14th birthday. I still believe if the osteo hadn't gotten to him, he would still be here with us. Ever my miracle dog

 

Pinky's chemo consult is tomorrow morning...

 

Happy Bridge Birthday to Sutra! He's still here with you in your heart; not the same, but still...

 

Good luck with the chemo consult tomorrow! I had 2 pages of questions for the onco when I went for Twiggy's. Thankfully, she was very tolerant of me and my questions!

[krissn333]

Is there anything in particular I should be sure to ask him about? I'm still thinking we'll go with the carboplatin. We'll discuss her lupus and the possible implications that might entail. Anything else I should ask about?