Osteo Thread

[Guest kellygreyhound]

I'm pretty new here as my girl just had her amputation Monday of last week. She had no symptoms of lameness or fatigue or anything prior to breaking her leg and discovering that she had osteosarcoma--I think that made my decision about amputation easier since there really wasn't any time for debate. BUT today I'm posting because I just took Kelly back to the animal hospital because she has an incisional infection AND developed a fever overnight The vets are planning to make a small incision to clean, drain, etc. the fluid, dead tissue, etc. from around her incision and then put in a drain (I believe the vet said something about a torpedo-type drain?)--Kell will stay the night, maybe two. Have any of you experienced an incisional infection? Just looking for some positive outlook going forward, because since this infection my girl has been feeling so gawd awful and miserable and the first few days she was home post-amp, she was actually improving pretty impressively

[MP_the4pack]

My Diamond had an infection of the incision site. She was put on a general antibiotic while we waited for the culture to come back. It came back pseudomonas, which was resistant to the antibiotic she was on.

We switched antibiotics and she recovered quickly after that.

Her chemo was held off for 2 weeks while the infection healed.

 

She was never bad enough to stay at the hospital.

Edited February 29, 2012 by MP_the4pack

[dmswartzfager]

There's been a few cases of infection along the incision posted, and the outcome has been positive in all cases, if I recall correctly.

 

It sucks to have a setback but you just have to stay positive and take it one day at a time. It sounds like you caught it early, so they can jump right on it and have her feeling better that much faster.

[KF_in_Georgia]

I'm pretty new here as my girl just had her amputation Monday of last week. She had no symptoms of lameness or fatigue or anything prior to breaking her leg and discovering that she had osteosarcoma--I think that made my decision about amputation easier since there really wasn't any time for debate. BUT today I'm posting because I just took Kelly back to the animal hospital because she has an incisional infection AND developed a fever overnight The vets are planning to make a small incision to clean, drain, etc. the fluid, dead tissue, etc. from around her incision and then put in a drain (I believe the vet said something about a torpedo-type drain?)--Kell will stay the night, maybe two. Have any of you experienced an incisional infection? Just looking for some positive outlook going forward, because since this infection my girl has been feeling so gawd awful and miserable and the first few days she was home post-amp, she was actually improving pretty impressively

 

See this post here. Twiggy had a post-amp infection that sent her to the hospital for five days, but she's done well since then.

[Batmom]

The thought that he might wag his tail when we pull out the leash for "that," car ride makes me want to just curl up and die.

 

Another way to look at that is, if he is wagging his tail, perhaps you have spared him the worst.

 

Only you can say when that point might be.

 

Sending hugs for both of you.

 

 

[joejoesmom]

Valerie, for what it's worth I do understand. Living with the constant ups and downs of pain management with a terminal cancer is incredibly difficult and at least for me involved a lot of second guessing, worrying, questioning whether it was time, etc. The two pieces of advice I will give to you based on my experience are to not hold back on increasing meds if you think he's in pain, and two, if you are running out of room to increase before you reach max doses, really think about what your next steps might be.

 

I made the mistake of thinking that doubling Neyla's Deramaxx dosage would give her significant pain relief toward the end. We were already at the limit of what she could tolerate of Tramadol and Gabapentin. It turns out that at that point, the cancer was basically exploding and I was very wrong, the Deramaxx barely made a dent. That left me with very few choices - basically let her go immediately, or try a stronger medication like a Fentanyl patch or an opiate like Codeine. I wasn't mentally prepared for those choices so I tried Tylenol w/codeine. If I could do it over again, I would have let her go. It was only the difference of a few days, but it was a few days where she wasn't doing the 3 things we had identified as signs I should let her go - her appetite waned, she couldn't play, she even only half-heartedly attempted to open a present I had wrapped for her, she could no longer climb onto the furniture to snuggle with me. But at that point, I had scheduled when the vet would come and I couldn't bring myself to call the vet and tell her to come immediately and cut short my time to say goodbye even though I had been trying to prepare myself for that moment for months. Basically, I failed her.

 

I don't think I've ever shared all of this. I'm not sharing it to pressure you into letting Gabe go. I guess I'm just saying it's not cut and dry. It's incredibly difficult to make the call because even though you want more than nothing else in the world to do what's best for your dog, you also want more than nothing else in the world to not have to say goodbye. And unfortunately osteo's course can change so dramatically so suddenly that you can't always prepare yourself for what's coming.

 

Gabe has hit some rough patches and bounced back and that's a part of osteo, breakthrough pain that you can address so I really hope that's all this is. And I hope that I haven't totally depressed or upset you or if I have, if it's any consolation know that I've depressed myself at least as much.

 

Jane, the same thing happened when the vet came to our house for Neyla. After a couple of pretty rough days, she got right up and greeted her with her tail wagging away. This from my dog who once was so terrified of people that she'd run and hide in our bedroom. It killed me, not just because you are constantly questioning whether the time is right, but because it felt like such a betrayal.

 

Oh Jen, this made me cry so much. It made me cry because of the pain you went through and are still going through. This is clear from your statement "Basically, I failed her". It hit me so hard because I feel the same way about my Twister girl. Yet when I read your post, I thought "There is absolutely no way Jen failed to do the right thing for Neyla. How can I tell her that?" I realize that there is no way to convince you, just like my friends have never been successful in convincing me about Twister. I will just remind you of your own words: "it's not cut and dry. It's incredibly difficult to make the call because even though you want more than nothing else in the world to do what's best for your dog, you also want more than nothing else in the world to not have to say goodbye. And unfortunately osteo's course can change so dramatically so suddenly that you can't always prepare yourself for what's coming." AND "when the vet came to our house for Neyla, ..... she got right up and greeted her with her tail wagging away."

 

Twister had been acting depressed and not wanting to eat. I had just changed her to a lower protein food so I figured that was the problem. Then she had a TIA. I took her to the vet immediately and she was diagnosed with lymphoma. The ultrasound showed it in her lymph nodes but didn't show any masses in her organs. Despite her age of almost 15 years (Twister was a whippet mix, not a greyhound) and the fact that she had some urinary incontinence, I decided to do chemo for her lymphoma. Just 3 weeks into the protocol, she needed to be hospitalized overnight for IV fluids. A couple of weeks later, she needed IV fluids again and the bloodwork came back showing early stage kidney failure. I switched her to a much less aggressive chemo and began subcutaneous fluids. She was much perkier but still not playful. I spent the time cuddling with her. She had no control of her urine (I put rubber sheets on the bed so we could still sleep together. I was so intent on getting those precious cuddle times that I was pushing nearly a liter of fluid a day into her little 40 pound body. Sure she would eat and seem content, but only because I was forcing all this fluid into her. Eventually, even the subQ fluids weren't hydrating her so the vet told me that she was suffering. That made me arrange for the at home euthanasia. So thinking back to those 3 1/2 months after she was diagnosed with lymphoma, I put my little girl through a month of chemotherapy that made her very nauseous and depressed. I then put needles in her twice a day. I kept her around even though she had no control of her urine and we would wake up with her lying on a wet blanket. And that was still not enough clues that it was time to let her go. It took her refusing to eat anything, even her absolute favorite AND a vet telling me it was time for me to let her go. I so regret that I put my own need to have her with me that I didn't do what was best for her. I was in total denial and somehow convinced myself that this 15 year old dog, with lymphoma and kidney failure would somehow overcome it all and live at least another year. I think I will regret not letting her die with dignity to my last breath.

 

Tears are streaming down my cheeks. I don't know if any of this makes sense and I am beyond trying to make it clearer. Jen, just know that you are not alone in your regret.

 

Jane

[Batmom]

I think it is fair to learn from experiences, but I don't think it is fair to yourself to carry a load of guilt. Nobody *plans* for their beloved to suffer. You make decisions you can with the information you have. So far none of us can see the future nor know that *this* dog will be the one to respond -- or not -- to this pain control medication or chemo series.

 

It is especially hard when there are good days mixed with bad. When you have a bad day or two, you don't know in advance whether it will be only that one or two, or all the rest.

 

I tend to fall on the side of avoiding bad days but it's sure not a perfect science.

 

My heart goes out to anyone who will face such a decision.

[robinw]

I will never forget what the vet said when we sent Phoenix to the bridge, also due to osteo. She said that greyhounds are so stoic that we could be absolutely sure that they are in much more pain than they let on.

[KF_in_Georgia]

For Sam, I've realized that sleeping is more indicative of how he feels than eating is. If I can't control his pain enough for him to sleep well, then I'll need to make some decisions.

[giadog]

I'm so sorry Gabe is struggling right now... I'm hoping and wishing that it's a temporary breakthrough. And I'm so, so sorry for everyone who's had to make, and question, and relive the horrible decisions that come with this disease.

 

Gia is still working on adjusting...she's had a couple nights of 'off' sleeping, and I'm not sure exactly if it's pain, or anxiousness, or just boredom that are causing them. Other than that, she seems to be doing ok, just a bit restless still. Her first chemo is on Wednesday, as long as her blood counts agree! It looks like we're going to be moving back into our house this weekend, which I'm THRILLED about, but also a bit worried because there are a lot of stairs to get to the yard. I suppose we could just let her potty on the deck, but I know she's going to want to investigate the backyard after all this time!

[vjgrey]

He perked up a bit after the pamindronate and was catching stuffies DH tossed to him last night. :wub: He hasn't done that in months.

 

Today is slightly rockier, although that may be because we're weaning him off Deramaxx to switch to Previcox. His oncologist recommended that he be off Deramaxx for two days before we start the new med.

[Charlies_Dad]

Good thoughts for Gabe and Sam. My thoughts are always with you all and your pups as you fight this battle.

[NeylasMom]

He perked up a bit after the pamindronate and was catching stuffies DH tossed to him last night. :wub: He hasn't done that in months.

 

Today is slightly rockier, although that may be because we're weaning him off Deramaxx to switch to Previcox. His oncologist recommended that he be off Deramaxx for two days before we start the new med.

Yeah, that's why we didn't make that switch although we considered it for the same reasons. In the end, I didn't think she'd be comfortable weaned off and we couldn't switch cold turkey because of the kidney issue. Can you increase his other meds during the transition?

[vjgrey]

He perked up a bit after the pamindronate and was catching stuffies DH tossed to him last night. :wub: He hasn't done that in months.

 

Today is slightly rockier, although that may be because we're weaning him off Deramaxx to switch to Previcox. His oncologist recommended that he be off Deramaxx for two days before we start the new med.

Yeah, that's why we didn't make that switch although we considered it for the same reasons. In the end, I didn't think she'd be comfortable weaned off and we couldn't switch cold turkey because of the kidney issue. Can you increase his other meds during the transition?

 

Yeah, I've given him slightly more Tramadol, which seems to be making him really sleepy, but at least he's resting.

[NeylasMom]

Valerie, for what it's worth I do understand. Living with the constant ups and downs of pain management with a terminal cancer is incredibly difficult and at least for me involved a lot of second guessing, worrying, questioning whether it was time, etc. The two pieces of advice I will give to you based on my experience are to not hold back on increasing meds if you think he's in pain, and two, if you are running out of room to increase before you reach max doses, really think about what your next steps might be.

 

I made the mistake of thinking that doubling Neyla's Deramaxx dosage would give her significant pain relief toward the end. We were already at the limit of what she could tolerate of Tramadol and Gabapentin. It turns out that at that point, the cancer was basically exploding and I was very wrong, the Deramaxx barely made a dent. That left me with very few choices - basically let her go immediately, or try a stronger medication like a Fentanyl patch or an opiate like Codeine. I wasn't mentally prepared for those choices so I tried Tylenol w/codeine. If I could do it over again, I would have let her go. It was only the difference of a few days, but it was a few days where she wasn't doing the 3 things we had identified as signs I should let her go - her appetite waned, she couldn't play, she even only half-heartedly attempted to open a present I had wrapped for her, she could no longer climb onto the furniture to snuggle with me. But at that point, I had scheduled when the vet would come and I couldn't bring myself to call the vet and tell her to come immediately and cut short my time to say goodbye even though I had been trying to prepare myself for that moment for months. Basically, I failed her.

 

I don't think I've ever shared all of this. I'm not sharing it to pressure you into letting Gabe go. I guess I'm just saying it's not cut and dry. It's incredibly difficult to make the call because even though you want more than nothing else in the world to do what's best for your dog, you also want more than nothing else in the world to not have to say goodbye. And unfortunately osteo's course can change so dramatically so suddenly that you can't always prepare yourself for what's coming.

 

Gabe has hit some rough patches and bounced back and that's a part of osteo, breakthrough pain that you can address so I really hope that's all this is. And I hope that I haven't totally depressed or upset you or if I have, if it's any consolation know that I've depressed myself at least as much.

 

Jane, the same thing happened when the vet came to our house for Neyla. After a couple of pretty rough days, she got right up and greeted her with her tail wagging away. This from my dog who once was so terrified of people that she'd run and hide in our bedroom. It killed me, not just because you are constantly questioning whether the time is right, but because it felt like such a betrayal.

 

Oh Jen, this made me cry so much. It made me cry because of the pain you went through and are still going through. This is clear from your statement "Basically, I failed her". It hit me so hard because I feel the same way about my Twister girl. Yet when I read your post, I thought "There is absolutely no way Jen failed to do the right thing for Neyla. How can I tell her that?" I realize that there is no way to convince you, just like my friends have never been successful in convincing me about Twister. I will just remind you of your own words: "it's not cut and dry. It's incredibly difficult to make the call because even though you want more than nothing else in the world to do what's best for your dog, you also want more than nothing else in the world to not have to say goodbye. And unfortunately osteo's course can change so dramatically so suddenly that you can't always prepare yourself for what's coming." AND "when the vet came to our house for Neyla, ..... she got right up and greeted her with her tail wagging away."

 

Twister had been acting depressed and not wanting to eat. I had just changed her to a lower protein food so I figured that was the problem. Then she had a TIA. I took her to the vet immediately and she was diagnosed with lymphoma. The ultrasound showed it in her lymph nodes but didn't show any masses in her organs. Despite her age of almost 15 years (Twister was a whippet mix, not a greyhound) and the fact that she had some urinary incontinence, I decided to do chemo for her lymphoma. Just 3 weeks into the protocol, she needed to be hospitalized overnight for IV fluids. A couple of weeks later, she needed IV fluids again and the bloodwork came back showing early stage kidney failure. I switched her to a much less aggressive chemo and began subcutaneous fluids. She was much perkier but still not playful. I spent the time cuddling with her. She had no control of her urine (I put rubber sheets on the bed so we could still sleep together. I was so intent on getting those precious cuddle times that I was pushing nearly a liter of fluid a day into her little 40 pound body. Sure she would eat and seem content, but only because I was forcing all this fluid into her. Eventually, even the subQ fluids weren't hydrating her so the vet told me that she was suffering. That made me arrange for the at home euthanasia. So thinking back to those 3 1/2 months after she was diagnosed with lymphoma, I put my little girl through a month of chemotherapy that made her very nauseous and depressed. I then put needles in her twice a day. I kept her around even though she had no control of her urine and we would wake up with her lying on a wet blanket. And that was still not enough clues that it was time to let her go. It took her refusing to eat anything, even her absolute favorite AND a vet telling me it was time for me to let her go. I so regret that I put my own need to have her with me that I didn't do what was best for her. I was in total denial and somehow convinced myself that this 15 year old dog, with lymphoma and kidney failure would somehow overcome it all and live at least another year. I think I will regret not letting her die with dignity to my last breath.

 

Tears are streaming down my cheeks. I don't know if any of this makes sense and I am beyond trying to make it clearer. Jen, just know that you are not alone in your regret.

 

Jane

Thank you for this Jane. Your circumstances with Twister at the end were very similar to ours. We do were dealing with kidney issues, my bed was lined with incontinence pads so Neyla could sleep with me, etc. etc. Most of the time I don't give myself a hard time for most of it, but I know there were times when I trusted the vets over my own gut, or in those last days when I could have made better choices. She was my first dog, and my heart dog so it was horrifically difficult and I did the best I could, but while I don't let it eat at me most days, I still know in my heart I could have done better for her. I hope it will help me do better next time, that's all I can do at this point.

 

 

But day-um I am really bringing the bar down lately. Sorry, I think emotions are running high lately as a dear friend's greyhound was just diagnosed with osteo as well. Neyla's birthday is also on the 11th and I am hoping that I can FINALLY write her remembrance thread.

 

He perked up a bit after the pamindronate and was catching stuffies DH tossed to him last night. :wub: He hasn't done that in months.

 

Today is slightly rockier, although that may be because we're weaning him off Deramaxx to switch to Previcox. His oncologist recommended that he be off Deramaxx for two days before we start the new med.

Yeah, that's why we didn't make that switch although we considered it for the same reasons. In the end, I didn't think she'd be comfortable weaned off and we couldn't switch cold turkey because of the kidney issue. Can you increase his other meds during the transition?

 

Yeah, I've given him slightly more Tramadol, which seems to be making him really sleepy, but at least he's resting.

Glad to hear it.

[45MPHK9]

I need to speak to our oncologist about how high we can go on his meds. He's currently on 900mg Gabapentin (300 x 3), 200mg Amantadine, 100 mg Deramaxx (changing that this week, though), and we're upping him to 300mg of Tramadol (100 x 3).

 

This amount of medicine was our limit with Bee Wiseman. She was at 900mg Gabapenin, 300mg Tramadol, and 100mg of Deramaxx. She was still limping, even with all of that pain medicine. We agreed, with the help of our vet, that it was time. She was in pain. She was hurting everyday.

 

We have never had a moment of regret about letting her go when we did.

 

Valerie, I don't envy the position you are in right now. Hug Gabe for us.

[dmswartzfager]

Symbra was feeling feisty today - she met me at the door when I got home and was playing with a stuffie and trying to figure out how to play bow and sphinx with just the one rear leg. I took the toy from her and she jumped for it. She was a little unsteady with that, so I let her have her toy and get her bearings.

 

We went for a short walk a little later - here she is, three weeks to the day after her amputation:

[Zoolady]

Update on Ben: He was able to have his chemo yesterday and is doing great. The bone stuff next week. We will be doing chemo every four weeks instead of three.

 

My heart is heavy for all that are sharing and have shared this monster. Hugs to everyone.

[vjgrey]

Symbra was feeling feisty today - she met me at the door when I got home and was playing with a stuffie and trying to figure out how to play bow and sphinx with just the one rear leg. I took the toy from her and she jumped for it. She was a little unsteady with that, so I let her have her toy and get her bearings.

 

We went for a short walk a little later - here she is, three weeks to the day after her amputation:

 

This really made me smile. She looks great! It always amazes me how well they get around as tripods.

[joejoesmom]

Thank you for this Jane. Your circumstances with Twister at the end were very similar to ours. We do were dealing with kidney issues, my bed was lined with incontinence pads so Neyla could sleep with me, etc. etc. Most of the time I don't give myself a hard time for most of it, but I know there were times when I trusted the vets over my own gut, or in those last days when I could have made better choices. She was my first dog, and my heart dog so it was horrifically difficult and I did the best I could, but while I don't let it eat at me most days, I still know in my heart I could have done better for her. I hope it will help me do better next time, that's all I can do at this point.

 

Jen, Twister was also my first dog as an adult and she was also my heartdog. Like you, most of the time I don't let it eat at me. But Twister's sister is now 15 1/2. Joe has another primary osteo tumor. So I will likely lose all three of the only dogs I've ever owned as an adult within a year's span. I just hope I learn from Twister and like you, I hope it will help me do better next time.

 

Jane

[krissn333]

Jen, I still haven't been able to do Sutra's remembrance thread. I just keep hoping to find the strength, but at this very moment, just typing about it has me crying

 

I have another friend whose girl was just diagnosed. Front right shoulder, same as Fine Point. Fine Point's family is still missing her terribly, and her greyhound sister Wonder is really having a hard time.

[vjgrey]

Does anyone know how long it takes Previcox to "kick in?" Gabe is having a hellish morning. He couldn't get up on his own and needed a lot of help to walk. This is is first day on the new med, having been off Deramaxx since Wednesday. We've been giving him extra Tramadol, but it's clearly not enough.

 

He absolutely can't continue on like this. It's not fair to him. Desperately hoping that the new med works miracles.

Edited March 2, 2012 by vjgrey

[Guest snakes]

Does anyone know how long it takes Previcox to "kick in?" Gabe is having a hellish morning. He couldn't get up on his own and needed a lot of help to walk. This is is first day on the new med, having been off Deramaxx since Wednesday. We've been giving him extra Tramadol, but it's clearly not enough.

 

He absolutely can't continue on like this. It's not fair to him. Desperately hoping that the new med works miracles.

 

No experience with Previcox but the info sheet says "improvement can be seen within days". In my experience with humans there is often a mild relief somewhat immediately but full relief is about 48hrs after the first dose.

 

http://www.fda.gov/downloads/AnimalVeterinary/Products/ApprovedAnimalDrugProducts/DrugLabels/UCM050402.pdf

[NeylasMom]

 

Jen, Twister was also my first dog as an adult and she was also my heartdog. Like you, most of the time I don't let it eat at me. But Twister's sister is now 15 1/2. Joe has another primary osteo tumor. So I will likely lose all three of the only dogs I've ever owned as an adult within a year's span. I just hope I learn from Twister and like you, I hope it will help me do better next time.

 

Jane

I hope that turns out to not be the case, it's tough enough to lose one, let alone more than one in short succession.

 

Does anyone know how long it takes Previcox to "kick in?" Gabe is having a hellish morning. He couldn't get up on his own and needed a lot of help to walk. This is is first day on the new med, having been off Deramaxx since Wednesday. We've been giving him extra Tramadol, but it's clearly not enough.

 

He absolutely can't continue on like this. It's not fair to him. Desperately hoping that the new med works miracles.

that it kicks in soon. I don't know much about Previcox so no help there except that if it's similar to other NSAIDs I would think you would see some relief relatively quickly. Can you bump up his Gabapentin too to give it a little more time to kick in? You can always back down again in a day or two.

[vjgrey]

He's had extra Tramadol and Gabapentin, and he's still limping but is much more himself. While I was finishing up some work, he stole a bag of dehydrated chicken out of the cabinet, chewed a hole in it and ate all of it. And the oncologist wonders why he's gaining weight.