Fungal Bone Infection Or Osteo

[TwiggysMom]

Twiggy started limping on Saturday, didn't seem to be due to any specific incident.

 

Since she was still limping yesterday, I brought her in. There wasn't any really obvious swelling, but if you stared at it hard, you could convince yourself there might be a little swollen (vet's opinion too). There was no reaction to palpation or manipulation of the joint. We went home with some rimadyl and limited activity.

 

Today, she was limping more despite the meds, and when I got home from work I could tell there was a slightly enlarged area at/above her wrist. Took her in and got xrays.

 

My vet says it isn't a classic osteo presentation, but it could just be very early. She says it also looks like it could be a fungal bone infection. The xray shows a darkish area above her wrist and some bone thinning. Her recommendation for next step is a referral for a bone biopsy.

 

I'm planning to have OSU review the xrays and will submit a consult form tomorrow.

 

Any experience with fungal bone infections? It seems like Valley Fever is the most likely to mimic osteo, but the furthest SW Twiggy has been was the farm in OK. Does that seem a likely diagnosis?

 

I'm trying not to panic, but I feel like I'm burning time - I wish I could find out what this is and treat it tonight!

[BootsyCollins]

Osu will be able to give you guidance per next steps, so hang in there. They likely will recommend against a biopsy in favor of a fine needle aspirate. Good luck.

[EllenEveBaz]

No experience here -- just sending hugs.

[robinw]

OSU will help you. My experience with Phoenix taught me that greyhounds often present osteo differently than other dogs and many vets aren't aware of that. Phene didn't exhibit swelling or limping, yet OSU diagnosed him with osteo after I insisted my vet forward his x-rays there. I'm not trying to scare you, I'm just urging you to send the x-rays to OSU so they can rule out it out.

Edited August 10, 2011 by robinw

[RedFawnMom]

I'm sorry you're going through this. I know how scary it is to not have an answer. Lucy was diagnosed with osteo in late January, but before we had the FNA done, one of the radiologists suspected her abnormal X-rays were showing an infection in the bone, not cancer. Unfortunately, he was wrong. It sounds like you're on top of this, whatever it is, which is great. Just don't let anyone tell you to "wait and see" - we got that advice from a couple of vets. Luckily, I am not a wait and see type of person. OSU will give you good advice.

[TwiggysMom]

Thanks for the advice and support.

 

The point about FNA vs bone biopsy is a good one. I am leery of a bone biopsy as I've heard they are excruciating and can damage a bone already compromised by cancer. Would a FNA show whether this is infection or cancer? If so, would you just schedule that right away rather than wait for a consult reply from OSU?

 

Another question - my vet just took the "side view" of both the bad and good leg. Is this likely to be enough for OSU to go on? If they would also need the "top view" (sorry, I don't know the official term for these views) should I have my vet do that before sending anything to OSU? I know the OSU team is always so busy, and I'd hate to both waste their time and wait in the consult queue just to have to start over again.

[robinw]

If OSU needs different or more x-rays, they'll let you know. They will email you and be very specific with what they need and what you can do. You won't go to the back of the queue.

Edited August 10, 2011 by robinw

[Batmom]

Histoplasmosis is a fungal infection that can cause bone lesions resembling cancer. Usually there will be some lung involvement; the pattern there is pretty distinctive.

 

Sending hugs and best wishes for you and your pup.

[Charlies_Dad]

Wendy,

 

Not to panic you but your description of the x-ray sounds distinctly like Charlie's. The vet who took the x-ray was an orthopaedic surgeon and he then had another surgeon (oncologist) and radiologist look it over. Their thoughts were it that it was Osteo but it did not show the 'classic' signs, e.g. starburst pattern, moth-eaten etc. so they said the only way to tell was a FNA. I had them send the rads to OSUand the same day got the same answer, only a FNA will confirm and even then it's not 100%. Could you tell whether there was any thinning of the bone or perhaps some rough edges where the shadow was? I believe Charlie's had ever so small rough edges and it looked like something had bitten little pieces of bone off but it was very very small and that was why they thought more likely Osteo. They were right unfortunately.

 

Not knowing enough about bone fungal infections, I only hope that is what it is because the other is not something I would wish on anyone.

[robinw]

it did not show the 'classic' signs, e.g. starburst pattern, moth-eaten etc. so they said the only way to tell was a FNA. I had them send the rads to OSUand the same day got the same answer, only a FNA will confirm and even then it's not 100%. Could you tell whether there was any thinning of the bone or perhaps some rough edges where the shadow was? I believe Charlie's had ever so small rough edges and it looked like something had bitten little pieces of bone off but it was very very small and that was why they thought more likely Osteo. They were right unfortunately.

Same with Phoenix's x-rays. They looked essentially normal except for a few spots that my vet was unsure about, but didn't particularily concern him. He offered to have the x-rays looked at by a radiologist, but we sent them straight to OSU instead. OSU will give you peace of mind. I never did an FNA. I asked Dr. Couto how confident they were about the diagnosis, and he replied that it was strongly consistant with osteo. That was good enough for me.

 

Additionally, my other greyhound bridge angel, Loca, was diagnosed with chrondrosarcoma, another form of bone cancer, by a local radiologist. We sent the x-rays to OSU, where it was determined that everything was normal, and that what they thought was a lesion was actually normal clavicle superimposed on her lung. She was fine! I added this so that you know that OSU can alwo bring good news as well as bad.

[NeylasMom]

If OSU needs different or more x-rays, they'll let you know. They will email you and be very specific with what they need and what you can do. You won't go to the back of the queue.

I wouldn't delay sending what you have off to OSU. You need to use their online submission form - instructions and a link are in the first post of the current osteo thread.

 

Unfortunately it is more likely that what you are dealing with is osteo, not a fungal infection. I really hope that's not the case, but the odds are unfortunately against you. My oncologist astounded me by continuing to say that it could be a few other things when I refused to do the FNA (because they wouldn't do it without anesthetizing Neyla and I had received confirmation of osteo from Dr. Couto so didn't see the point). They continued to say this even 5 months in because there was no progression on Neyla's x-rays. It seems there's a problem with even specialized oncologists not understanding how common this is in the breed, and also that it may not progress much for some time before the very accelerated progression we see at the end, where most people actually catch and dx it.

 

Like others I don't want to be discouraging, but I do think it's in your best interest to get the x-rays off to OSU immediately.

 

Keeping my fingers crossed that it's not osteo.

[TwiggysMom]

Hi everyone, thank you for all your support and input! I’m sorry I disappeared for the day (had to go work for the kibble monies!)

 

I did send the xrays off to OSU at 9:30 this morning (attached to the consult form), and bonus! my vet did take the top view too, she just didn’t show it to me yesterday. Obviously, I’m still waiting for them to evaluate things.

 

I do know of a couple greyhounds who started out similarly to this, and it did indeed turn out to be bone infection – one of them is now 15 years old and was diagnosed 5 or 6 years ago (so I’m clinging to that tiny wisp of hope).

 

If OSU says definitely osteo and doesn’t recommend FNA, I’ll take their word for it. Originally, my plan was to go directly to OSU as fast as possible for amp if that was the diagnosis. However, I’ve had also some recommendations for pamidronate treatments as long as the osteo is caught early enough. I’m hearing that prognosis and survival times are similar for that versus amp (6-18 months survival times). Anyone have advice and/or experience on this as an alternative? Possibly in conjunction with chemo/radiation?

 

One of the issues that might factor against amp for Twiggy is that I live in a tall, skinny townhouse with lots of turning, tiled stairs. This could be tough on a tripod, especially at first. I do have one small room on the first floor next to the garage that I could transform into our main living quarters, but there’s no plumbing down there, so would be a little inconvenient. I am perfectly capable of carrying Twiggy up/down stairs, too, so I could make it work. On the other hand, doing pamidronate and sparing the limb would always leave me worried about a pathologic fracture especially since Twiggy is a very active/playful girl. In fact, the limping got worse on Sunday because she just HAD to do her trademark crazy spinning zoomies for several minutes on the hardwood floors. At the time, I was happy to see her doing them because I thought it meant the minor limping from the day before was better .

 

A friend who has been through this a couple times with her own hounds (and is the former pres of the adoption group I volunteer for) mentioned that Twiggy is at a bit of an odd age for osteo (6.5 yrs). Of course it can hit at any age, but usually doesn’t it tend to strike early (young dogs) or late (seniors)? Again, clinging to wisps of hope… I know it probably is osteo.

 

Here are the rads in case anyone is interested:

Side View Bad Leg:

 

Top View Bad Leg:

 

Good Leg:

[BauersMom]

I'm very sorry you're going through this. A few quick answers -

 

The osteo thread in this forum has a bunch of good info on different treatments. If you go back to some of my posts from the previous (now closed) osteo thread, I asked very similar questions about going the non-surgical route (I'll see if I can dig them up for you). The info in the osteo threads is SO helpful.

 

Second - I don't think there really is a typical age for osteo, and I'd say a nearly 7 year old isn't all that uncommon an age to see it, either.

 

We are three weeks post-amp and honestly, I'm not sure how I would make it work with tiled stairs. Of course, I'm sure some folks have figured out the stairs thing and an amp but in our case, Berkeley gets freaked when carried and he's nearly 75 lbs so it really wasn't an option for us. Just something to consider if it comes to that.

Edited August 11, 2011 by BauersMom

[NeylasMom]

It definitely looks to me like there's a pretty large area where bone has been eaten away. Now what it's due to, I don't know. 6.5 is young for osteo, but it's not impossible. It doesn't sound like you live in an area where VF is possible and while there are other fungal infections that infect bone, like someone else said, they typically present with lung problems as well. But hopefully you will have an answer (that it's not osteo) from OSU very soon.

 

As far as the pamidronate goes, I have never heard that prognosis time given. I think 6 months is probably on the long end, but really it all depends at what stage the cancer is when diagnosed and how quickly it progresses for that dog. There is some speculation that pamidronate helps to rebuild bone, but you really need to consider it palliative care only, which means that your dog's prognosis is only as long as the pamidronate (and other pain meds) overcome the pain, or until the leg breaks. With a dog that's very active, there is a risk of a fracture if the bone deterioration is continuing while the pain is well managed. Of course, you can monitor progression via periodic x-rays and make decisions accordingly, but knowing that it's sort of a crapshoot. I think any radiologist will tell you that some dogs have so little bone left its unfathomable they're walking (I think Kristin's Sutra was almost to that point when she decided to let him go and she's one of the few on here who have used pamidronate) while others have almost no visible deterioration or even symptoms and one day the leg just breaks.

 

It's one of the things that's very tough about osteo, so much of it is really just a crapshoot and there is no clear right answer.

 

I will say that I think pamidronate does provide better pain relief than meds alone. I would consider it again in the future. Unfortunately it didn't work out so well for Neyla - it did give her good pain relief, but she also suffered the kidney side effects some patients do so we couldn't repeat the treatment and then had other issues to deal with. But, she had an episode of acute kidney failure back when she was younger that she somehow recovered from and I think my oncologist was an idiot to recommend the treatment to me without making it clear that we would likely encounter side effects. Side rant. The other thing to consider is that it is expensive (I paid about $600-700 for a treatment, including necessary tests beforehand, but I'm in DC) and needs to be repeated every 3-4 weeks. It also requires staying several hours at the vets each time.

 

I think if you are the type of person who would consider amputation and think it's a good option for Twiggy (ie. she'd do well on 3 legs, could handle the vet stays, chemo, etc.) then I would talk to others who have been through it to see if you can work around the "logistical" problems.

 

If you decide it's not for you, or wouldn't work in your current circumstances, I do think both pamidronate and radiation are worth exploring as pain management tools. There's a bone cancer yahoo group (non-breed specific) where a number of people have used them together so you might be able to get some additional information there. I also recommend fish oil and artemisinin as primary "holistic" options to start. Lots of information on that in the osteo thread.

 

Anyway, really getting ahead of ourselves here I'd say but I know it helps to be informed of your options so you can make a decision about treatment asap if it does turn out to be osteo. Again, really really hoping not. I will be keeping my fingers crossed for you guys.

[krissn333]

REALLY hoping it's not osteo, but, if it is, whatever you decide, please join in the osteo thread. There are many of us that have gone the amp route and many who have done palliative care.

 

What Jen said about my Sutra is true...the night I let him go, his xrays were almost completely transparent The vet couldn't believe he was still walking, let alone RUNNING, on that leg. We did 3 pamidronate infusions before his kidney numbers crept higher than the vet was comfortable with (IMO the numbers weren't alarming or anything). We managed his pain with Deramaxx mainly. We used tramadol once in a while but it made him restless rather than helping his pain. As I mentioned, he was still using the leg, so we didn't even get to the point where we needed the gabapentin either.

 

As Jen said, the pamidronate should be considered a palliative treatment option, not a curative one.

 

Best of luck with whatever you're facing. If it's osteo, you're definitely not alone. We all seem to walk the path with each other and personally I'm finding that when another is lost to osteo, I feel the loss right along with them, and when one is doing well, I feel the gratitude and joy right along with them too. It's really not a club you want to join, but, if you do join, you'll be in good company.

[Charlies_Dad]

There is definitely something suspicious with Twiggy's x-ray. I have to agree with Jen, there is a good size of bone that appears to be eaten away unfortunately. As for your statement about age, Osteo spares no pup no matter the age. Lucy who had amp & chemo I believe was only 4 when diagnosed and she is doing well (check the Osteo thread). I recall reading the average age is 7 which shocked me when I saw it as I had incorrectly assumed it was more common in older dogs but alas that is not to be.

 

I am definitely no expert on pamidronate treatments but when we looked at all options I understood then that life span was not that long. Again I have to agree with Jen but one never knows, any pup can surprise you and live much longer than the average. I believe FedEx is having these treatments again if I am recalling correctly. His mom posted a few times in the previous Osteo thread and I think goes by the name of 'Snakes', not entirely sure but you could ask her if you look through #2 of the Osteo thread (I'll try to find her as well).

 

As for amputation, lifespan is not as good as it should be. The average lifespan of amp alone is only 4-5 months but with chemo it's 12, still not great but it is the average so it means some lucky pups will survive a lot longer and live pain free. I know Arthur up in MA is now 30mths post dx and doing very well but there are many that do not even make the 12 months. Like Jen says, it's a crapshoot. IF it's Osteo and IF you choose amp & chemo, I believe you could address your floors with some runners. You will be very surprised at these pups and how they get around. The 'positives' about amputation in my opinion is: it relieves the pain and one doesn't have to fear a fractured leg. I could not deal with either of these personally.

 

Let's cross our fingers and hope OSU comes back with 'good news' and says it's not Osteo. They may also ask for a FNA to be certain so you should prepare if you have not already on what you will do about that. It takes 3-5 days to get results back and it is not always conclusive. We'll be thinking of you both today.

[robinw]

I don't have the experience or expertise to be able to interpret the x-rays. Don't panic unless you receive bad news from OSU.

[Guest snakes]

As someone mentioned I am doing pamidronate treatments with FedX. he was diagnosed in Jan at 6years old, we started pamidronate 3 months later when his pain was getting worse (his xrays looked similar to Twiggy's).

I saw immediate improvement and have continued the treatments each time seeing immediate improvement. It is expensive. Here the cost (After initial consultation) is alternating $350 and $400, it alternates due to blood tests to check the kidneys every other treatment. I now get that test done at my vets a few days prior so that if the values are high i don't waste the time bringing him in (and it is half the price).

Due to money issues we did three treatments at every 3 weeks (they like to do 6), and now are at every 6 weeks with his 5th (of total) coming up in a week or so. He is doing great, back to his normal walking, he even tried to run and play in the past week (i limit that since i don't want to see a sudden fracture if i can avoid it).

I am not considering chemo, we did one dose of palliative radiation before the pamidronate and the pain got worse, hence why i went with pamidronate. I didn't go the amp route due to a few issues of money, he has a mast cell tumor on a hind leg, and the fact we live up two flights of stairs and he is 80lbs now!

We are now at 6.5month survival time!

I won't say he is pain free (his worst pain is when he first gets up from sleeping, but he can walk well, and is happy as ever.

I want to add that gabapentin was our other wonder drug! It helps a lot. We are also doing herbal remedies and artemisinin.

[joejoesmom]

My boy Joe had just turned 7 when OSU diagnosed him with osteo. I elected amputation and chemo. Since I live near OSU I was also able to get him into a Palladia study (requires monthly visits to OSU initially, now every other month to OSU and the other months I go to my normal vet). He is one year post-amp and doing great. However, it could also have been just 6 months -- there is no way of predicting.

 

If amputation is an option for Twiggy and you can afford it and the follow on treatments, I think putting carpet treads on your stairs will likely work (I assume 4-legged Twiggy is able to use these stairs without problems). It is amazing how well they do. They sell treads that you tack on to your stair step. In your case, you could use glue or a double side tape -- just as long as it is secure. You might also be able to use stair runners if you can adhere it to the stairs some way. You would need to live on the first floor little room for the first 2 to 4 weeks.

 

If it is osteo and you decide to amputate at OSU, there is a network of local greyhound owners who could put you up in their home and give you moral support. Just let me know if you would like to do this. At the minimum, we can recommend a hotel and help you with logistics.

 

Jane

[tbhounds]

Did your vet discuss the possiblity that this may be a bone cyst you are dealing with??

[TwiggysMom]

This is long and not really informative, just so you’re forewarned…

 

So, I spent a large part of my day today reading all of Osteo part deux, and catching up on part 3. I haven’t heard anything from OSU yet, I sure wish they could get back to me. The suspense is making me nuts.

 

To TBHounds, no – I hadn’t heard any suggestion of a bone cyst as yet. I need to run off to research that later

 

However, I’ve pretty well convinced myself it is osteo; and based on others’ experiences as well as thinking long and hard about Twiggy, me, and our various capabilities, I think I’ve returned to the idea that if it is what we fear it is, I’ll take her to OSU for amp and follow up with chemo. This is based purely on our circumstances; I know it wouldn’t be right in many situations, but I think it is for us.

 

My reasons for this include:

1) Twiggy is young, otherwise very healthy and fit, very active/playful, not afraid of vet's offices, lets me carry her if necessary, and fearless about stairs/hard, slippery floors. My fear with palliative treatments is that I would always have to keep her at a significant enough level of pain to keep her from wanting to play so that she doesn’t break her leg. What kind of life is that for a dog who loves to play?

 

2) I am fortunate that I’m physically capable of carrying, moving, etc. her as much as necessary, and that I’ve got enough cash stashed away to cover the costs (was going to use it to fix my house, but I’d rather fix my dog – at least for as long as I can). It is also “good” timing, if there can be such a thing. The weather is good, and I just finished my quarter-end projects at work, so I can take some time off and work from home off and on for a while. (Besides, in addition to working thousands of additional hours for free, I have forfeited the vast majority of my time off at work for the past 10 years, so they kind of owe me). I also live next door my regular vet's office (and I've been going there for 15-20 years), so follow-up treatments and chemo administration appointments will be very convenient. I'm also a good planner and will be able to come up with ways to make this work.

 

3) The reasons for not doing amp/chemo would mostly be that it would be hard for me because there is no one to assist, I work full time, and it would be inconvenient for several weeks or months. That just doesn't cut it as an excuse as far as I'm concerned.

 

Jane, great minds think alike – I have had carpet runners on my stairs in the past specifically to help fosters who are just learning. And I did exactly like you said and used double-stick carpet tape. I recently removed them because before putting them down I had a “brilliant” idea to coat the tile with non-slip grit in clear non-yellowing polyurethane to help with traction. Unfortunately “non-yellowing” wasn’t so much, and I had a huge mess to remove that from two full flights of stairs lol. Also, Thank You so much for the offer to help with connections for a trip to OSU. I’ll contact you if we end up with osteo.

 

I feel bad because I have to hand off my current foster to a new foster home on Saturday because of this. Essie is a 1.5 year old non-registered greyhound who was taken from a tragic situation where the person caring for her was hospitalized for over 2 weeks and his trailer was condemned, and all the animals were fending for themselves. Aside from being one or the cutest, tiniest (46 lbs), most fun greyhounds you could ever meet, Essie is a crazy, untrained puppy-head, with some issues, and she is such a bulldozer – she keeps jumping on and body slamming Twiggy, and I’m afraid she’ll get hurt.

 

Finally, I have to say how moved I am by all of your warmth, compassion and support. I’ve gotten familiar with many of your experiences through the osteo thread, and well, I’m just blown away. Jen, your organization of information is wonderful. The fact that so many of you stay active on the thread and continue providing support even after your own hounds have passed is amazing.

[BauersMom]

You're already way ahead of where I was when I was waiting for the OSU read on the x-rays! Took me a week after the diagnosis to figure out what to do.

 

It's good to have a decision made, though - so if it is osteo (of course, I'm hoping it's not though) you can focus on the future and not be stuck in that "what the @*#&$# am I going to do?!" phase that royally sucks.

 

There's really no right decision with anything in the osteo world, all you can do is look at your situation and do what you think is right. You've obviously given it a lot of thought.

 

Keep us posted!

[NeylasMom]

Thank you Wendy. I'm glad you found the info in the osteo thread useful! It's really just a culmination of lots of information shared by everyone in the first thread, I just put it all in one place.

 

I truly hope that you are not dealing with osteo, but either way, I applaud you for how carefully you've thought this out and prepared yourself. It sounds to me like you've got a clear plan for what to do if needed, which is really the best thing you could be doing for Twiggy while you wait.

 

I know the waiting sucks too. Hopefully you will get some answers soon.

[Charlies_Dad]

Wendy, have you tried calling OSU? I know they are always busy but sometimes a call will get your answer a little quicker. We're still thinking of you both and hope it's not Osteo but you have thought it out and that is good because that is the hard part.

[joejoesmom]

This is long and not really informative, just so you're forewarned…

 

So, I spent a large part of my day today reading all of Osteo part deux, and catching up on part 3. I haven't heard anything from OSU yet, I sure wish they could get back to me. The suspense is making me nuts.

 

To TBHounds, no – I hadn't heard any suggestion of a bone cyst as yet. I need to run off to research that later

 

However, I've pretty well convinced myself it is osteo; and based on others' experiences as well as thinking long and hard about Twiggy, me, and our various capabilities, I think I've returned to the idea that if it is what we fear it is, I'll take her to OSU for amp and follow up with chemo. This is based purely on our circumstances; I know it wouldn't be right in many situations, but I think it is for us.

 

My reasons for this include:

1) Twiggy is young, otherwise very healthy and fit, very active/playful, not afraid of vet's offices, lets me carry her if necessary, and fearless about stairs/hard, slippery floors. My fear with palliative treatments is that I would always have to keep her at a significant enough level of pain to keep her from wanting to play so that she doesn't break her leg. What kind of life is that for a dog who loves to play?

 

2) I am fortunate that I'm physically capable of carrying, moving, etc. her as much as necessary, and that I've got enough cash stashed away to cover the costs (was going to use it to fix my house, but I'd rather fix my dog – at least for as long as I can). It is also "good" timing, if there can be such a thing. The weather is good, and I just finished my quarter-end projects at work, so I can take some time off and work from home off and on for a while. (Besides, in addition to working thousands of additional hours for free, I have forfeited the vast majority of my time off at work for the past 10 years, so they kind of owe me). I also live next door my regular vet's office (and I've been going there for 15-20 years), so follow-up treatments and chemo administration appointments will be very convenient. I'm also a good planner and will be able to come up with ways to make this work.

 

3) The reasons for not doing amp/chemo would mostly be that it would be hard for me because there is no one to assist, I work full time, and it would be inconvenient for several weeks or months. That just doesn't cut it as an excuse as far as I'm concerned.

 

Jane, great minds think alike – I have had carpet runners on my stairs in the past specifically to help fosters who are just learning. And I did exactly like you said and used double-stick carpet tape. I recently removed them because before putting them down I had a "brilliant" idea to coat the tile with non-slip grit in clear non-yellowing polyurethane to help with traction. Unfortunately "non-yellowing" wasn't so much, and I had a huge mess to remove that from two full flights of stairs lol. Also, Thank You so much for the offer to help with connections for a trip to OSU. I'll contact you if we end up with osteo.

 

I feel bad because I have to hand off my current foster to a new foster home on Saturday because of this. Essie is a 1.5 year old non-registered greyhound who was taken from a tragic situation where the person caring for her was hospitalized for over 2 weeks and his trailer was condemned, and all the animals were fending for themselves. Aside from being one or the cutest, tiniest (46 lbs), most fun greyhounds you could ever meet, Essie is a crazy, untrained puppy-head, with some issues, and she is such a bulldozer – she keeps jumping on and body slamming Twiggy, and I'm afraid she'll get hurt.

 

Finally, I have to say how moved I am by all of your warmth, compassion and support. I've gotten familiar with many of your experiences through the osteo thread, and well, I'm just blown away. Jen, your organization of information is wonderful. The fact that so many of you stay active on the thread and continue providing support even after your own hounds have passed is amazing.

 

 

Very well thought out. Some comments:

 

1) My reasoning for Joe exactly. Although if I decided not to do amputation, I would probably work hard to alleviate the pain as much as possible and just be aware of the potential for fracture. Get x-rays to monitor, Crate or otherwise contain when I am not at home etc.

 

3) I also live alone so had no one to assist. It really wasn't that big of a deal. You need to stock up on food and be sure to get Twiggy's meds before you bring her home. You will be homebound for at least the first week. Usually by 2 weeks, it is safe to leave for work, etc.

 

I also had to have my group find a new foster home for my current foster at the time. I actually didn't even need to ask. When I told the president about Joe, she said "Well of course we need to find a new foster home for Jack, it'll just take me a day to arrange it." And Jack was a perfectly well mannered boy. It just would have been too much for me to handle.

 

I sure hope it is not osteo, but if it is, you've got a plan.

 

Jane

 

Wendy, have you tried calling OSU? I know they are always busy but sometimes a call will get your answer a little quicker. We're still thinking of you both and hope it's not Osteo but you have thought it out and that is good because that is the hard part.

 

 

The phone number for the hospital is 614-292-3551. Ask to speak to Dr. Marin. She is in charge of the Greyhound Health and Wellness Program and is a cancer researcher. FYI, Dr. Couto is in today but will be out next week.

 

Jane