Osteo Thread

[greysmom]

Zoolady - please contact the OSU program regarding their free IV chemo program, if you choose to go that route. They also might have some more information about your specific location of osteo.

 

Hugs to everyone..............

[GreytHurleyDawg]

So much to say and I'll probably forget a topic or two!

 

I'm sorry about Shimmie!

 

As for Ben, those are many good questions and all questions that need to be decided after you meet the oncologist (or during that)...it is amazing how a good oncologist is the link to the next step. I realize how lucky I am since our onco is 5 minutes away...at our 24 hour e-vet. For your personal sanity, I would ask if you have a closer oncologist than the one you have? Granted, you only have to see this doctor about every 3 to 4 weeks but I still would search for something closer. hopefully, you are getting exactly what you need from this one if you are not able or willing to go elsewhere. Also, did you send the xrays and all info to OSU yet for a second opinion?? This was crucial in Hurley's diagnosis and for many other hounds here. Forgive me if I just missed that. The reaction you get from your onco will also clue you in to your future plan for your greyhound. Most educated people appreciate the recommendations from a research hospital like the one at OSU. You just follow the directions in post #1. But there are always vets who do not appreciate this information and the fact that you are seeking their recommendation. Mine has gone to conventions to see Dr. Coutu so I feel VERY good about her. Best of luck during your decision making.....it is a difficult and stressful time but not something to ignore. We have all been there and are HERE for you!! (I reread this and I sound like I consider you a new member here but you actually have done this all before. Rather than edit the whole thing, I hope that osteo treatment has improved since your last visit here and that your options are greyter now....hugs for you and your family!!)

 

Hurley will be getting repeat thoracic xrays before his next chemo as well. Of course, it has to be done but I also felt a little stomach butterfly when I read that. But, one day at a time....we will deal with it if mets are found and we will celebrate a little if he is clear!

 

We had some good news in the bill department! Our VPI insurance had a comment on many of their payments that said: further benefits will be considered upon receipt of the pathology report. With all the craziness going on, I got the path report and never thought to send it in because it came after the surgery and wasn't even performed until after the amputation. I finally sent it in and got the same amount that I initially got for the amputation: I only got 1/3rd of the total at first and then I got the second 1/3rd yesterday!!! I also got a little bit for two other appointments as well. That made my day with all the post Christmas bills, our possibly needing a different car and then a small trip to NYC next month!

 

The snow came pretty hard today....fortunately Hurley can run through the fluffy stuff with no problems!! I will always gladly shovel a path for him!!

Edited January 13, 2012 by GreytHurleyDawg

[NeylasMom]

For anyone else with VPI doing only palliative care, they say that bone cancer requires a biopsy or pathology for diagnosis, but obviously I wasn't going to do a biopsy of Neyla's leg so I spoke to them, explained the risk of fracture as my reason for not pursuing the biopsy and was then able to submit a letter from the radiation oncologist we did a consult with earlier on that stated he felt confident in his diagnosis of bone cancer, along with her other vet records and they considered it osteo from that point on and reimbursed accordingly. I was actually very pleased with VPI throughout Neyla's entire illness.

[Batmom]

Lily left us tonight. What originally started as osteo took a spin for the worse. Will post an update in Remembrance when I can. I know you all do, but please hug your hounds tonight. No regrets.

 

I'm so sorry for your loss.

 

Godspeed, sweetheart.

[Guest snakes]

I am just going to add a few answers based on our experience with FedX taking the palliative care route:

 

 

 

"I'm concerned about how the appointments happen. Do I stay or drop him off. Time is important because it's an hour drive to get there."

 

With fedX's one radiation treatment I waited in the waiting room as it only took about 40min.

His pamidronate treatments last at least 3 hours, i usually take my other grey with em and take a nice long walk somewhere nearby and now that we are going to a location clsoer to my parents we go visit them and then the office calls us when he is 30min from finishing.

 

"How much additional time for the blood work?"

Don't forget about costs.....time is usually very quick, they usually run them in house and you have results within minutes.

 

Any typical side effects for greyhounds?

Pamidronate makes FedX very thirty and he pees a ton for about 24hrs after treatment.

 

"Can treatment be stopped if the dog is reacting badly or once you start you must go back until finished?"

 

You can always stop any treatment if the side effects are too bad.

 

"The cost estimates need to be told to us too."

 

Make sure this is not only for initial visits but the follow-ups as well and get printouts. I had big problems with this when we started treatment...

 

I always ask about the potential benefits of any tests, since we are doing palliative care a lot of the tests they "recommend" really are not worthwhile, we only check the kidneys which are affected and determine the pamidronate use. I opted out of a followup CBC, the initial biopsy, and a few follow up xrays as it won't change my course of treatment for him.

[Zoolady]

First I want to say I am so sorry about Lily. It always hurts so much when we lose a piece of our heart.

 

Thank you everyone for more of your thoughts and advice for Ben. I thought I learned a lot when Wonder passed but it seems to be a whole new world when you're considering treating and hoping for remission. Dr. Moore said it wouldn't go away but can be slowed down.

 

The good news is that even though the first visit for this was only January 7, Ben has met the insurance deductible and they are sending me 90% of the rest minus exam fees. Anything he needs from now on except exam fees will only cost us 10 percent and the animal hospital's office does all the paperwork.

 

So far we haven't heard from OSU but we don't doubt the diagnosis.

 

I called my vet to see if they do chemo and was told no. I asked if there was anyone nearer than Coral Springs and they were going to check. When they called back I was told my regular vet could do the chemo and an emergency vet in Deerfield could also do it. I'm thinking, no, we need an oncologist to be there that would recognize whatever might come up. I don't think we should trust the treatment to someone that would probably just have to call the oncologist. I need to word questions better.

 

I called for a consultation appointment and was told the first available was the 25th. I left a voice mail with for the nurse asking to be squeezed in Tuesday when Scott could go. She told me they could squeeze us in if we needed to. They won't be back in the office until Tuesday so I won't know until then. They only work Tuesday through Friday.

 

Today sucked. A coworker friend's dog died during a routine dental (posted in Off Topic). My dermatologist called and I have to go in for a second Moh's procedure on my nose in another place for basal skin cancer. I sort of expected it and had it on my nose before so am not upset. Kind of been there done that. The only difference is he wants me on antibiotic for a week because of my artificial hip. Got a feeling this one may go deeper.

 

Outside of the above, everything is great. You'd never know Ben had anything. He is still acting his old self. Can't wait for tomorrow morning because that is when he can jump on the bed and cuddle. He either gets right next to me with his head on my shoulder or pillow. Whichever is closer to me.

[TwiggysMom]

I'm sorry to hear about Shimmie, Ben, and Luli's diagnoses.

 

Lily's loss is so sad. What a wonderful girl who just had too much happen to her in such a short time. Rest well, Lily.

 

Twiggy had her last of 6 carbo treatments yesterday, and had a rough time of it. When I picked her up they told me she had 2 bad diarrhea episodes while she was there. (She had totally perfect stool the night before about midnight, so there wasn't any warning). They said I should start metronidazole that night.

 

Then, when I left the specialty center, she had what appeared to be bloody urine (as in mostly blood). I brought her back in, but her oncologist didn't seem to quite believe me and said it wasn't an emergency. If she continued to have blood in her urine I should get it tested. Her oncologist also said that she was really concentrated earlier in the day (per bloodwork), and that she might just be dehydrated. I thought they were supposed to give her iv fluids with her treatments - I guess they didn't do that this time, or the oncologist wouldn't have said Twiggy's problem was just dehydration.

 

Twiggy had a little squirt of diarrhea when we got home, which had bright red blood in it.

 

I had to get into work for a little while, and she didn't have any accidents when I got home 4.5 hours later to take her to our regular vet.

 

I got samples of urine and stool to bring in, and they were hard to tell apart . The urine looked like strong-brewed tea, and the stool was liquid with blood. Our regular vet said she could see bacteria in the urine, as well as blood, some of which spun down with the sample (I'm not quite sure what that means). She also said that she thought she saw some broken down red blood cells (myeglobin - the kind of rbc in the muscle - I'm not sure of the spelling), and that it could be dangerous since that stresses the kidneys (so does the carboplatin). She recommended that I bring Twiggy to the e-vet to stay overnight for iv fluids (which she should have gotten earlier in the day and may have been the cause of this whole thing grrr).

 

Outside the vet's office, she peed again, but this time it was miraculously all nice bright yellow completely normal looking urine!! I ran back in with her and asked them if this changed anything. Keep in mind the "tea" sample was from just an hour earlier, so something dramatically changed in a short period of time. Her vet was excited, too, and said let's just do sub-q fluids and I could take her home to watch her. If things went bad again, I could always take her in to the e-vet. We also started her on a course of Clavamox.

 

 

Fortunately she has stayed pretty stable overnight, though very tired and pretty under the weather; but that is expected after these late doses of chemo. They seem to cumulatively take a toll.

 

I was pretty scared for her but very glad to avoid a hospital stay. She gets so nervous there now. (She never did before starting chemo, but now she can't stand the place).

 

I love our regular vet. She stayed late to see Twiggy, made phone calls on our behalf, and called me this morning to check in on her. Twiggy's oncologist - nada.

 

Thankfully, no more iv chemo for her, We just have to figure out what to do next.

[krissn333]

Sorry to hear that Twiggy has had a tough time. Hopefully the only way she goes from here is up

[BauersMom]

Oh wow, how scary! The late chemos were tough on Berkeley too - but certainly nothing like that. Glad to hear she's doing better.

[Zoolady]

Is it typical that they all have problems and get icky towards the end of chemo and whatever chosen treatments they've had?

 

Do you think Ben would have problems with chemo too at ten years old?

[TwiggysMom]

Is it typical that they all have problems and get icky towards the end of chemo and whatever chosen treatments they've had?

 

Do you think Ben would have problems with chemo too at ten years old?

 

I don't really know the answer to this, but I do know that some dogs need to have their doses lowered or spaced further apart (or both) as treatment goes on. Ideally, a dog will tolerate 6 doses of iv chemo at some pre-prescribed dosage spaced 3 weeks apart.

 

However, my understanding is that 4 doses are considered effective, and if that is all a dog tolerates well, you've still done well.

 

Some dogs sail through chemo with hardly a side effect, and I don't think it depends on age or overall health. There doesn't seem to be a predictability to how well any particular dog will do. Twiggy has been doing awesome through chemo, had full doses and only delayed two treatments (#s 3 & 6) by 1 week each. This was her 6th treatment, so she has received the full optimal dose.

 

I think the biggest problem is that they didn't flush her system this time with iv fluids after the chemo. They were supposed to, but it seems like they didn't. (I haven't asked them this point-blank, but the oncologist hinted that this was the case.)

 

So, I wouldn't let Twiggy's latest reaction alter your course of action. She is OK, I'm just keeping an eye on her. Like we all do. As long as you're watching Ben, I'm sure he'll be fine. And as said before, you can alter or discontinue treatment at any time if he isn't tolerating it.

Edited January 14, 2012 by TwiggysMom

[BauersMom]

Ditto to what Wendy said.

 

Berkeley needed his dose both lowered and spaced out further to 4 weeks. He rebounded each time after chemo, it just took him longer. The 4 doses that most dogs get was enough for Berkeley to get 6.

 

There's no real way to predict the reaction. The only thing you can do is monitor closely and make adjustments as needed.

[GreytHurleyDawg]

I missed adding my condolences to Lily's family...it sounded very quick and I know that is the fear many of us have. I am happy that there are no regrets.

 

I also missed mentioning Luli's diagnosis...it has been too busy of a week here on this thread.

 

In response to:

I called my vet to see if they do chemo and was told no. I asked if there was anyone nearer than Coral Springs and they were going to check. When they called back I was told my regular vet could do the chemo and an emergency vet in Deerfield could also do it. I'm thinking, no, we need an oncologist to be there that would recognize whatever might come up. I don't think we should trust the treatment to someone that would probably just have to call the oncologist. I need to word questions better.

 

I called for a consultation appointment and was told the first available was the 25th. I left a voice mail with for the nurse asking to be squeezed in Tuesday when Scott could go. She told me they could squeeze us in if we needed to. They won't be back in the office until Tuesday so I won't know until then. They only work Tuesday through Friday.,

 

It sucks how veterinary oncology is quite laidback. We found ourselves in the same bind upon Hurley's diagnosis: we saw the Dr. on the last day of her work week and she was returning late the following week because of a conference. So, we were left to stew from Wed to Tues. I knew in our case that I had to convince my husband that we had to act and come to a treatment agreement by the day she came back...fortunately, she was available by email (usually answered by the following day) and I was not ashamed to use that. We skipped a day despite the long time and saw her again the next Wed. We made all the plans at that appt and have never looked back. Coming to terms and feeling right about your decision is a gift. I hope you get the Tuesday appt!!!!!! Be prepared, as much as you need to be.

 

On to Twiggy, OMG what an awful day, especially considering it was supposed to be a celebratory day....no more chemo! I would be terrified if there was blood from either urine or stool. I hope she is clear now!! Please update when you know more. I can't (frankly) believe your oncologist took quick and lazy measures with your dear Twiggy. She does not sound very caring. I don't think it sounds like she is using good medical practice either. What did your regular vet say about her? As for the blood comment, *I* believe, based on my lab knowledge from doing urinalyses on human urine, that blood that stays intact throughout the spin (centrifugal) is possibly from the bloodstream....it is no accident that the dipstick is positive for blood....and it is more of a problem then. Blood that shows on the dip but lyses (dies off) during the spin is less of an issue. Fresh blood in the urine/stool has to be coming from somewhere. I hope you find your answer or that it stops completely and it can be chalked up to dehydration. I wouldn't make a very good doctor because I am too roundabout in my speech patterns. Well, I would be your average doctor. Anyway, I hope for a good update on Twiggy!!!!

 

I have no updates for Hurley, he and Woodie and Petra are all currently fast asleep and dreaming of dinnertime....I have raw food planned for that!!

[KF_in_Georgia]

I think the biggest problem is that they didn't flush her system this time with iv fluids after the chemo. They were supposed to, but it seems like they didn't. (I haven't asked them this point-blank, but the oncologist hinted that this was the case.)

 

Is this the same oncologist that has such a low opinion of OSU? She's not doing much to impress with her own knowledge and treatment.

[Charlies_Dad]

I am sorry to all those who have recently joined, Tallulah and Ben. It really sucks that we can't beat this disease. Perhaps someday.

 

Wendy, sorry to read about Twiggy, wow, that was scary! We never had that kind of reaction from the Chemo with Charlie but the last one did knock him down somewhat (and for Charlie, that is saying something). I hope she's better today and continues on the mend.

 

I see Berk and Pinky are up for x-rays, soon. Hope these go well, I'll keep my fingers crossed.

[Zoolady]

Thank you all for more information. It is extremely helpful.

 

We took our cat, Jynx, in for his rabies shot yesterday. We found out our vet is a friend of the oncologist so she will call her Monday and ask that we be squeezed in Tuesday.

[TwiggysMom]

I think the biggest problem is that they didn't flush her system this time with iv fluids after the chemo. They were supposed to, but it seems like they didn't. (I haven't asked them this point-blank, but the oncologist hinted that this was the case.)

 

Is this the same oncologist that has such a low opinion of OSU? She's not doing much to impress with her own knowledge and treatment.

 

Why, yes, it is! I'm getting to the point that I think I may ask OSU what their best recommendation for metronomic protocol is and have it supervised by our regular vet, who I love, is next door to us, and has great hours.

 

Interestingly, the onco had great things to say about my regular vet. My regular vet "sort of" defended the onco by saying that she literally is dealing with life and death all the time so the "smaller things" don't seem like such a bit deal to her. I'm not sure I'm willing to give that much leeway. Plus the fact that they doubled the cost of a bunch of line items on our latest bill.

 

Kyle, thanks for the well-wishes!

 

Johanna, I didn't quote your reply because you are already way over my head ! It sounds to me like you're saying that the blood that stayed with the sample after spinning down made it a potentially more serious issue. You're right - it totally put a damper on what was going to be a celebration!

 

Fortunately, her urine has remained nice and yellow since Friday evening; however, she still has dark-rust colored liquid diarrhea. She is totally in control of it, actually wanting to go out to potty even less then her normal schedule and not having diarrhea each time we go out. But, she has been on Metro since Friday night and she is still liquid. I'll call both vets tomorrow morning unless there's been a big change.

 

On the bright side, the bounce is coming back into her step, she wanted to go for a longer walk this morning, and she is really excited about food again. She even begged me for some of her chicken in the kitchen this morning, which she rarely does.

 

Hopefully the diarrhea stops soon, and she'll be back on track again! (I have tomorrow off for Martin Luther King Jr. Day, so that is great - I can easily bring her back in for a recheck if necessary!)

[KF_in_Georgia]

...she literally is dealing with life and death all the time so the "smaller things" don't seem like such a bit deal to her. I'm not sure I'm willing to give that much leeway.

 

The smaller things aren't smaller when it's your dog. And not when the smaller things result in your dog becoming unnecessarily ill because those smaller things didn't get done.

 

Not to mention that when the results of those smaller things make your dog unnecessarily ill, they often cost you money you shouldn't have had to spend.

[GreytHurleyDawg]

Wendy, I am glad there is a good pupdate on Twiggy...I am sending more good thoughts as she has more healing to do!! At least her spirits and appetite are up! As for the onco, I totally agree that it is time to fire her...she may care enough to cover her butt but where is the truth that is needed when dealing with a beloved pet? If she was truthful, she would have said she doesn't see bleeding after chemo to be a response that could have been caused by chemo...instead she said it wasn't life or death. Well, no, it's survivable but the reason must be kept in mind...there has to be one, so why can't she be bothered to worry about it or comment on it?? Ugh! Of course, it is totally your decision and there are some things you need a real oncologist for but I'm thinking that in your area, you could do better.

 

After all that wonderful news about Hurley that I posted yesterday, he vomited up half his dinner last night!! I do think it was random, somehow, as he seemed good after that and he had an enormous appetite again today. So, we are in the hopeful phase again. Petra was not gated away from Hurley while he was eating that meal and he very suddenly ran away after she infringed on his personal eating space...then he was wobbly on the couch as he tried to spin and sit down....instead he horked up his meal onto the floor. So, I am chalking it up to nothing at all!

[krissn333]

Pinky's 1 week post-chemo bloodwork is in...neutrophils down to 2500, WBC at 3400. Hoping she stays put or rebounds before the 26th so she can have her third chemo The hard boiled eggs and carrots seemed to help (or maybe she just needed another week to rebound), but either way, she likes them and they're good for her, so, I just boiled 18 more eggs for her

 

Hope Hurley's hurling episode was just an isolated incident. Maybe too much hopping right after eating?

[krissn333]

I'm sitting waiting for Ace to return from having X-rays. Dr. Bahns got a pain response from her when she squeezed her femur. Crap. I really don't need to be in this club with two dogs at the same time.

[BauersMom]

Fingers crossed for Ace!!

[vjgrey]

I'm sitting waiting for Ace to return from having X-rays. Dr. Bahns got a pain response from her when she squeezed her femur. Crap. I really don't need to be in this club with two dogs at the same time.

 

It's not allowed. We have limits.

 

Thinking all the positive thoughts in the world for you and Ace right now.

[krissn333]

Oh. My. God.

 

 

X-rays are clear But, that means we still don't know what has happened/what's going on here. Running some bloodwork.

[Guest snakes]

Is no news good news? We have all been rather quiet lately and I hope that is because all the pups and humans are doing well!

 

FedX is still going, he has been limping a bit more lately and we increased his Novox ever so slightly, the cold weather seems to be getting to him. Hopefully another week and he'll be trotting as usual He certainly hasn't lost his love for treats and food!