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Amputation Insight?


giadog

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Hello, all. Gia was just diagnosed with osteo. I'm absolutely sick. We're definitely considering amputation because she's a good physical candidate... youngish (only 9), well muscled, and the cancer hasn't metastasized at all. Mentally, I definitely think she'd handle it. She' pretty much our bombproof HBIC, so I think she'll take it in stride. But I'd like to hear any insight you all have... if you've done it, what it was like, was it worth it, the time it gave you, etc.

 

We're meeting with an oncologist tomorrow morning at 9:30, so I'm trying to move quickly if we do go ahead with it.

 

Thanks in advance.

colleen

 

 

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No advice but wanted to say I'm sorry to hear of the diagnosis. Assuming you go forward, she sounds like a good candidate. Seek out Charlies_Dad as he has had great success with his boy. He's definitely a really good example!

Doe's Bruciebaby Doe's Bumper

Derek

Follow my Ironman journeys and life with dogs, cats and busy kids: A long road

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As mentioned, the osteo thread is a great resource, but it's also a lot to comb through. However, bigorangedog chronicled her amputation experience in a blog and the link to it is in the first post in the thread so you may find that helpful. There are a lot of people in that thread who have dogs who have had an amp who are doing well, Charlie is one of the one's that was back when the original osteo thread started but there are quite a few going through or just finishing up chemo now. So lot's of support if you need it (and video of recent amps playing if you need a little pick me up as you go through the process).

 

It can be a tough road whichever route you go, but I will say that even in the time since Neyla was diagnosed, it seems like the new pain management and chemo protocols are helping dogs who are diagnosed to survive much longer. I also think that's in large part a function of people identifying the cancer earlier, which can only help.

 

The only technical thing I will say, because I didn't choose amputation myself and can't speak to that is that it's great news that the lung x-rays don't show mets, but it doesn't technically mean there aren't mets not visible on x-ray or somewhere else in the body. Of course, that's why you follow up with chemo, to get rid of any of those microscopic mets if they exist and it's possible they don't. Just a technicality, but if you're like me and what as much detailed info as possible to make your decision, it might matter to you.

 

Regardless of the route you choose, I hope you and Gia have lots and lots of pain free time left together. And again, I'm sorry you're facing this. I will never forget the feeling I had when I got the confirmation of Neyla's dx. Like I had been kicked in the gut so hard I couldn't breathe. If you need a couple of days to adjust to the diagnosis and deal with your own emotions before making a decision, that is totally okay. Hang in there.

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Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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I'm so sorry....sending all my thoughts and prayers.....

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Robin, EZ (Tribal Track), JJ (What a Story), Dustin (E's Full House) and our beautiful Jack (Mana Black Jack) and Lily (Chip's Little Miss Lily) both at the Bridge
The WFUBCC honors our beautiful friends at the bridge. Godspeed sweet angels.

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Guest greyhoundgirl1

So sorry, I will keep you and Gia in my prayers. I hate this cancer thing. We need a cure so no one else needs to go through all this heart ache. Try to hang in there. We're all behind you.

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I'm so sorry to hear that dx. :cry1 It's just heartbreaking. Highly recommend the Circle of Grey support group in addition to the osteo thread on GT. Many prayers for much more quality time with your precious Gia... :hope

Jeanne with Remington & Scooter the cat
....and Beloved Bridge Angels Sandee, Shari, Wells, Derby, Phoenix, Jerry Lee and Finnian.....
If tears could build a stairway, and memories a lane, I'd walk right up to heaven
and bring you home again.

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Things to consider if looking at amputation - cost is a big one. Amputation and the follow up chemo (even if you get it for free from OSU) will run anywhere from $5000-10,000 easily - depending on the cost of x-rays, bloodwork, complications, etc.

 

After amputation care is not trivial in some cases. Can you stay home with them during the first week? How will you handle helping them around, if needed? Stuff like that should be considered.

 

Another is logistics within your lifestyle. Berkeley can no longer do stairs (though MANY tripods do well with stairs, Berkeley does not)... so we've had to move our bedroom to the first floor. Thankfully, we have a first floor bedroom that was an office. We also have a ramp out to the yard. Can you manage a tripod for the next year, hopefully two/three years?

 

The other thing to consider and realize is that amputation may not give you much more time over going the pain management route. It's a crap shoot, though like Jen said, there are dogs that make it a lot longer post-amp and diagnosis.

 

Good luck with your decision. :( It took me a good week to really think it all through, it's a lot to take in.

With Buster Bloof (UCME Razorback 89B-51359) and Gingersnap Ginny (92D-59450). Missing Pepper, Berkeley, Ivy, Princess and Bauer at the bridge.

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I have done amputation twice, and I have not done amputation once. Three very different cases. We didn't do chemo with either amp, but if I had to do it all over again, I would have gone with both amputation and chemo in those two cases. In the case where I didn't do amp, I still wouldn't.

 

I second the recommendation to join Circle of Grey.

 

Please feel free to PM me if you want my number. I am happy to be a sounding board, if needed.

Meri & the Dorg
with Little Lee from Eetaly (Raider Retire), Freya FooFoo (Writers Block), Brodie (never raced), and "foster" JJ (Rossmore Judith). Missing Bravo, Chickie, Nico, Meri Carol, Lucky II, Ringo, Mylie, Bull, Geordie, Shae-Leigh, Stretch, Dustin, Cooper, Lucky, and Heidi.

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I am sorry to read this diagnosis. I wish you and your girl the best outcome.

Irene Ullmann w/Flying Odin and Mama Mia in Lower Delaware
Angels Brandy, John E, American Idol, Paul, Fuzzy and Shine
Handcrafted Greyhound and Custom Clocks http://www.houndtime.com
Zoom Doggies-Racing Coats for Racing Greyhounds

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Colleen, first and foremost I am very sorry to read of Gia's diagnosis. As Derek (Trihounds) and Jen (NeylasMom) have mentioned, Charlie is my boy and he is now 19mths post dx and amp which unfortunately is the exception. Based on statistics, the average lifespan after amp and chemo is 12 months and I believe Jane (Joejoesmom) has been quoting OSU seeing 14mths. So that does mean unfortunately there will be some that leave us much too early and some who fight the battle and live many months longer. One also has to consider 12 months in a dog's life is much longer than ours and as everyone says, they live in the moment and if they can get 352 days of those moments with a terminal illness, that's pretty good. Jen mentioned the Osteo thread of which there have been 4 and they have great information in there (a lot of reading) and you will find great support.

 

One needs to look at various reasons for their own decision and I can only write about ours. First and foremost, just like you when we heard the dx (I was out of the country with the vet on the phone), I made the decision immediately, no questions, no second thinking at all. I knew we were in for a battle but I thought he was only 7 years old, full of life and otherwise healthy and selfishly I was not close to saying goodbye. He raced for the full five years (213 races) and had been with us for two years on the road in our RV. We finally built a house designed for Greyhounds (single story, minimal stairs and a big fenced in backyard. We wanted him to enjoy it as we had only moved in 3 months prior to his dx. So we immediately had his amp done after a second opinion by OSU (dx Wednesday, second opinion Thursday, amp Friday). I saw him for a few minutes before his amp after flying back home. The amp was performed at a very good animal hospital about an hour away as we basically did not trust anyone else to do this major operation and we did not regret it one bit even after the bill. We paid just over $5000 for the amp and 4.5 days 24/7 care so that is why it cost more than some. I believe if you are able and willing, bringing home your pup a day or two earlier will reduce the bill. OSU prices are less and if you can drive to them, it's worth it. As already mentioned, after your pup comes home, they will need assistance so I took a week off work and worked from home the second week plus DW stays at home so it worked well for us. Due to leaving Charlie at the hospital longer, he was in decent shape when he came home and lucky for us, Derek generously lent us his Ruffware(sp?) harness which we are forever grateful for. We also purchased a ramp for our truck as well. The first week we were a lot more stressed than Charlie was. The only issue we had was either the Tramadol or the patch was causing panting and some restlessness (not uncommon) but it still made us very stressed and worried. It shocked us how well Charlie got around outside abeit we helped him the first week. Something we also did when he came home was cover all the wood and tile floors with area rugs so he would not slip, this is highly recommended. Something else we were lucky with is that Charlie is a chow hound and really never stopped eating which some other pups experience.

 

After the staples were removed, we started chemo a week or so later if I recall correctly. It was no big deal, very easy for Charlie overall. He did turn up his nose at bananas which is one of his favourite foods. We did 5 rounds of Doxyrubicin at our local vet who is fantastic with Charlie. The chemo drugs you can get free from OSU but they are not expensive to be honest, it's all the blood work and vets time that adds to the bill. I believe we spent $3-4,000 for everything. After chemo we chose a at home chemo protocol, Palladia, along with many holistic approaches that DW researched extensively. You can find what we feed Charlie and all his supplements and herbal treatments at http://pinneyandpnut.blogspot.com/search/label/Dog%20Health if you are interested.

 

The one other thing you need to carry with you on this journey is positive thinking. You must stay positive for Gia as she will do everything to fight this disease so you need to as well. Also you need to get angry and stay angry. This is a fight, don't hide from it, don't let it push you around. Feel free to contact me if you have ANY questions at 613-525-5551 or kyle241_2000@yahoo.com. We are all here for you and please give Gia a hug from me.

Edited by Charlies_Dad

Kyle with Stewie ('Super C Ledoux, Super C Sampson x Sing It Blondie) and forever missing my three angels, Jack ('Roy Jack', Greys Flambeau x Miss Cobblepot) and Charlie ('CTR Midas Touch', Leo's Midas x Hallo Argentina) and Shelby ('Shari's Hooty', Flying Viper x Shari Carusi) running free across the bridge.

Gus an coinnich sinn a'rithist my boys and little girl.

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Joe was diagnosed on Monday, July 26, 2010. He had his amputation on Wednesday, July 28, 2010 -- just 2 days later. He had some complications and was in the hospital for a full week. During that week and for the two weeks after, I questioned whether I made the right decision for him. After those first two weeks home, it was clear to me that I had. He has had a wonderful 18 months. Sadly, he now has another primary osteo tumor in a different leg -- the left rear (the right front was amputated). He is being treated with radiation and we will likely follow that up with pamidronate if and when it makes sense. I am still not sure about doing additional chemo. The radiation appears to be controlling his pain pretty well at this point.

 

Would I do it all over again? Absolutely. Was it expensive? Yes.

 

As Jen (Neylasmom) said: It is highly likely that there are microscopic metastases in his body. This is why they follow up amputation with chemo.

 

The median time of survival for amputation with chemo is about 14 months. It is 2 to 3 months with only pain management (no chemo). They have been doing radiation and chemo on non-amputees more in the last year or so. OSU just gave me a median time of survival with radiation alone of 4 to 8 months, with radiation and chemo it is 6 to 9 months. They didn't have a statistic to quote if you add pamidronate (Fosamax) infusions to the mix.

 

Unfortunately, there is no way of knowing what time Gia will have. It does seem to me that most dogs who undergo amputation survive at least 6 months. Of course there are a few I can think of that didn't last this long, just as there are a few I can think of who had over 2 years.

 

I did want to mention that Joe's experience with chemo was not bad. Most dogs have very few side affects. Joe needed stomach meds following the chemo treatments. He had a few bouts of diarrhea. He ate well throughout (I did have to tempt him some with good stuff). He had a total of 2 days during the 8 weeks when he didn't want to eat.

 

The first week that Joe was home was difficult. He would cry at times. He didn't really need much help getting up or going out, but it hurt me so much to see him in pain. He had a urinary tract infection (he had to be catheterized in the hospital because of his complications -- a UTI is not really a common thing after amputation) when he came home. He had accidents in the house; mainly because of the effort it took to get up as often has he needed to because of the UTI.

 

I would plan on keeping Gia on the main floor of your house -- no more than a few steps to go out if possible. Plan on staying with her 24/7 for the first week if at all possible. Set up a bed for you next to her. Staying with her for the second week would be preferred but not essential. If you don't stay with her the second week, have someone who can come at lunch time and take her out.

 

Buy rubber/vinyl backed carpet runners to create a path through areas of your house with hard surface flooring. A home store will sell this by the foot so just measure your space and they will cut it to order. You don't have to cover all surfaces, just create a slip-free path.

 

If you have an SUV or Truck, get a ramp. Most dogs can get into a minivan or even a car with a little bit of help. You may also be able to use the ramp on your steps to get outside. Just make sure it is secure and doesn't slip.

 

If you are doing this alone, have the vet write all the prescriptions for you before you bring her home. Call different pharmacies to get the best prices. Around here, I could get the tramadol for $4 from Kroger. The deramaxx came from the vet (you might be able to use meloxicam instead -- another $4 generic). If it is not on the $4 generic program, Costco is usually cheapest. Hopefully you have a pharmacy that will match prices so you can get it all from one place. Get the prescriptions filled before you come home. Also, if you are alone, go grocery shopping and buy a bunch of pre-made food. Getting a few rotisserie chickens will feed both you and Gia. Get peanut butter, cream cheese, and liverwurst (braunsweiger) to hide pills in. You never know what will work. Sometimes hot dogs, cheese whiz (in a can), or american cheese you can roll around the pill will be preferred. Get some tempting food additives (steak, hamburger, liver, chicken) to entice her to eat. Arrange for someone to help you get her inside and settled.

 

While she is in the hospital, make some of her favorite special food to take in for them to entice her. Prepare your house for her arrival. Most of all, get some sleep to prepare yourself.

 

If you must leave her for the first couple of weeks, be sure to put her in a crate or in an area she can't try to jump up on furniture or go up and down stairs.

 

Depending on front or rear leg, find something to reduce licking of the incision. For a front leg amputation, you can use a T-shirt with her remaining front leg through one of the arms. Tighten the T-shirt at the neck and at the lower back by gathering it and using a rubber band. You can safety pin some sanitary pads at the incision area to catch any seepage. For a rear leg amputee you can buy some small boxer briefs. Put the tail through the fly and the leg through one of the legs. Tighten with a rubber band and pin a sanitary pad as needed. You can also use a muzzle with a stool cup installed. Be sure to file the ends of the zip ties so they are round and have no sharp edges (you use zip ties to attach the stool cup). You can also use duct tape to tape the end of a muzzle to make a make-shift stool cup. Be sure to leave holes so the dog can drink. I personally don't like leaving a muzzle with stool cup on a dog when I am not awake and with them. I worry about them vomiting and then aspirating vomit (of course, I am the queen of worriers and have never heard of this happening).

 

To assist your dog in the first 1-2 weeks: For a front leg amputee, I would use a sling or even a folded up towel. I would be concerned that a harness would put pressure on the incision. If you have a number of steps to go down, you can attach a strap at the middle of the sling and put velcro on the end of the strap and on the upper side of the sling. This strap goes around the front leg and velcros to the top of the sling. This prevents the sling from sliding towards the rear legs when going down steps. This is helpful if you have enough steps that your dog gets ahead of you when going down. For a rear leg amputee a harness works very well. Most people seem to like the harness from Ruffwear. My Joe didn't want to have me use either of these, he said he was perfectly fine going down the 3 steps on his own. Of course he was in the hospital for a full week after his amp.

 

Well I have written a very disjointed, stream of consciousness book here. I hope you can follow it and that it is some help to you.

 

I also highly recommend bigorangedog's blog and the OSU Greyhound Health and Wellness Site. The have an article on bone cancer.

 

Jane

 

p.s. make sure your surgeon follows the OSU greyhound amputation protocol. It is somewhat different than an amputation protocol for other breeds. At the minimum, the vet needs to use Amicar (aminocaproic acid) for 5 days following the amp. You also need to ensure that they have a vet on staff, physically in the building, 24/7. Most deaths that occur within a week after amputation occur when the dog is not monitored 24/7. Amicar is not a drug that is typically used by veterinarians. It is only used with greyhounds. You may need to have the vet write a prescription and then you find a human pharmacy that carries it. There is more info on the OSU website about why Amicar is necessary. It is in an article about post surgery bleeding in greyhounds.

 

edited to add: Joe was 7 and 3 months when he had his amp. Typical cost at OSU for an amputation plus 3 day stay is about $3000 to $3500. Joe's was $6000 because he had to be in the highest level of ICU for 3 of his 7 days in the hospital. Chemo administration at OSU is inexpensive. Including bloodwork and administration of 4 chemo doses it was less than $1000 -- I think it was about $600 actually.

Edited by joejoesmom
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We're going through this right now with Pinky. She's due for her 4th chemo on Thursday morning.

 

She had her left rear leg amputated on November 7th and woke up from surgery at noon that day. She spent the night at our emergency center for observation because the vet that did the surgery did not have overnight staff. She went back to our surgeon the next morning and came home that afternoon at 2pm.

 

I chose amputation for her because she is 8 years old and very muscular and otherwise healthy. She's done very well and continues to do well. It was the right choice to make for her.

 

Money is a consideration, and you really never know how long they will need to stay in the hospital after their amputation. Pinky was really the best-case scenario coming home 26 hours after she woke up from surgery. Her surgery cost $2,000 straight out of the gate...her overnight stay at the ER was about $190 on top of that (which was CHEAP!!). We did a couple of bandage changes before her staples came out (she was kept wrapped up until her staples were removed, that doesn't seem to be a very common thing, but it's our vet's standard procedure), so those were about $25 each time (actually I did a couple myself but of course I still had to buy the supplies).

 

Beyond that, the other costs come in periodically. We get the chemo drugs from OSU, but we pay for bloodwork and administration. Her chemo days cost us around $240 each time, then two weeks later we do a $45 CBC to see how we're doing. The totals DO add up, but, it's definitely been easier to just be sure I have XX number of dollars per month ready to use for her visits rather than having to shell out $2,000 in one sitting, you know?

 

She's not on any daily medications. But when we finish her chemo, we'll likely adopt some sort of metronomic protocol which will involve daily meds. We are also looking into acupuncture and massage for her, since she now gets around differently.

 

I do keep hard-boiled eggs and carrots handy in the fridge. Her second chemo had to be postponed because her neutrophil count was too low. Since then I've been giving her hard-boiled eggs and carrots with her meals and *knock on wood* we haven't had to postpone any others. I'm not sure if she's just doing well or if the eggs and carrots are actually contributing to that success, but, either way they can't hurt :dunno

 

I was fortunate in that I happened to be working from home the week after Pinky's surgery, so I had free time off with her. I am new at my job, so I really don't have much vacation time built up. The following week, my mom stayed at my house with her during the day. I have 6 dogs and segregating her from them is not an option because she gets nervous being away from her pack, so I just wanted to be sure that she was doing okay throughout the day. By the time Thursday of that week rolled around, mom was able to just kind of check in on them and she was fine. The big thing was that I wanted to be sure she could get on and off the couches without issues, and that she could move around in the living room without a problem. She did really well, so after that I felt okay leaving her for longer periods of time.

 

I don't have any stairs to worry about at my house, so that wasn't something I had to consider...actually made my decision much easier. There are tripods here that do stairs - Twiggy comes to mind. Hopefully Wendy will pop in here. You might be able to find her thread with the videos of Twiggy using the stairs though.

 

When my angel Sutra was diagnosed, I did not choose chemo for him. I opted for palliative care that included Deramaxx, tramadol, and pamidronate infusions. He passed away 3 days shy of his 6 month anniversary of diagnosis.

 

Go with your gut. If your gut says she can do it, go for it. As others have said, it IS a total crapshoot. You could do amp and chemo and only get a few months, you could get YEARS. You can opt for palliative care and get a few weeks or several months, or over a year, or longer. With Pinky, I just decided I wanted to try to do everything that I could for her to try to win this fight.

 

Come visit us in the osteo thread. It's a lot of stuff to wade through, but you can just read that on your own time. There's a lot of support there :) Best of luck, whatever you decide. We're here :grouphug

Kristin in Moline, IL USA with Ozzie (MRL Crusin Clem), Clarice (Clarice McBones), Latte and Sage the IGs, and the kitties: Violet and Rose
Lovingly Remembered: Sutra (Fliowa Sutra) 12/02/97-10/12/10, Pinky (Pick Me) 04/20/03-11/19/12, Fritz (Fritz Fire) 02/05/01 - 05/20/13, Ace (Fantastic Ace) 02/05/01 - 07/05/13, and Carrie (Takin the Crumbs) 05/08/99 - 09/04/13.

A cure for cancer can't come soon enough.--

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I'm so sorry that you and Gia are having to join this club. Cancer just sucks and there's no other way to put it.

 

Dude broke his leg running in the yard with no prior limping or signs of anything wrong. Our decision to amputate was immediate as we knew he would do just fine as a tripod - he was a supremely optimistic and positive dog, so his mental state did enter in to our decision. We never had a cause to think we'd done the wrong thing as Dude adapted well, tolerated his aftercare and chemo like a champ, and went on to his maintenance protocol easily.

 

We didn't have the luxury of taking time to decide, but please do if you can. It's a BIG commitment monetarily. We spent close to $15,000 in total and were lucky we had a windfall to spare.

 

The biggest advice I can give is to find an oncologist that you trust and who will collaborate with OSU. They really do set the standard for care as far as greyhounds are concerned. Research the OSU site, Circle of Grey and all it's informative links, and don't be shy about jumping onto the Osteo thread here for information and support. Everyone there has experienced cancer and knows what you're going through.

 

Hugs to you!

Chris - Mom to: Felicity (DeLand), and Andi (Braska Pandora)

52592535884_69debcd9b4.jpgsiggy by Chris Harper, on Flickr

Angels: Libby (Everlast), Dorie (Dog Gone Holly), Dude (TNJ VooDoo), Copper (Kid's Copper), Cash (GSI Payncash), Toni (LPH Cry Baby), Whiskey (KT's Phys Ed), Atom, Lilly

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I'm so sorry you receivd this diagnosis.

Edited by JillysFullHouse

Judy, mom to Darth Vader, Bandita, And Angel

Forever in our hearts, DeeYoGee, Dani, Emmy, Andy, Heart, Saint, Valentino, Arrow, Gee, Bebe, Jilly Bean, Bullitt, Pistol, Junior, Sammie, Joey, Gizmo, Do Bee

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I'm so sorry about Gia's diagnosis. It is such an overwhelming thing to hear.

 

I'll be another one to say "go with your gut", but also, go into your decision knowing what you're in for. I can't speak much to the palliative care route, as I haven't done it, but you need to look no further than Snakes' Fed Ex to see how amazing a dog can do going that route.

 

Twiggy is 2 days shy of her 6-month amp anniversary. As Kristin indicated, Twiggy's physical abilities have not been hindered in the least. She still runs up and down stairs, spins, twirls, and was clocked at 37 mph during a fun run just 2 months post-amp!

 

As Chris mentioned, an oncologist who is willing to consult with OSU is important. The first oncologist we used seemed to have a chip on her shoulder about OSU in general and Dr. Couto in particular. I got tired of feeling like I was fighting her on standards of care, and that (along with some other things) caused me to seek out a second oncologist, who I feel much more comfortable with. Twiggy finished her 6 rounds of iv chemo; and a week ago, started her metronomic protocol.

 

Things to be prepared for if you go the amp route: She may get along much better and with less help that you expect. Lots of pups are jumping on furniture and hopping along unassisted as soon as they leave the hospital. That isn't to say they won't have lots of bruising, swelling, panting, and episodes of forgetting they no longer have 4 legs. You do need to be by their side at all times for probably at least 5 days post-release. Also, there will be screaming - Twiggy screamed nearly every time she stood up for almost a week. I think it was a combination of surprise, fear, and pain.

 

You would expect the initial surgery and recovery period to be very time-consuming and expensive (which they are); but it does not end there. Vet visits at least every 3 weeks, and monthly costs of roughly 2 thousand dollars. Eventually, those will subside a bit. At 6 months, we should be approaching a phase where the vet visits can drop back to once a month, and costs should level out to about $1,500/month. After another 6 months, the costs may lower even a little bit more for the rest of her life (which will hopefully be a long one). The iv chemo lowers their immune systems, and infections are common (particularly UTIs), that adds up to extra vet visits and meds. Also, if their bloodcounts are off, you will have to postpone their chemo (read extra bloodwork and time off of work). I have yet to find a veterinary oncologist that has hours outside standard business hours, so all your visits will mean time off of work.

 

I really expected the initial treatment to be the major cost factor, but that is very far from the truth. Fortunately, I had saved up money to fix up my house, that money is now going to Twiggy's medical bills, so it hasn't been too painful financially.

 

I would choose to go this route again for Twiggy. She was not even 7 years old when diagnosed, was in great shape, a high-energy playful girl who has to be home by herself all day while I work, and I was just too afraid of her experiencing a pathological fracture while I was gone to not go the amp route with her. With a different dog and a different situation, I could easily make a different decision.

 

Also, I have LOTS of stairs, but I also have a downstairs room that we stayed in during her initial recovery. If we had to go up lots of stairs just to get into my house (like a walk-up apartment), I don't know if I could have done it with a front-leg amp. I just don't know how I would have carried her without pulling on her stitches. A back leg amp would have been a different story.

 

I'm sorry that my thoughts have not been the best organized. I'm just typing as things come to mind. Please consider joining us in the Osteo thread, and feel free to pm or email me if you'd like.

 

Wendy

Wendy with Twiggy, fosterless while Twiggy's fighting the good fight, and Donnie & Aiden the kitties

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Wendy, our vet is open until 7pm M-Th and until 6 on Fridays. They also have Saturday morning hours...is it uncommon for oncologists to have Saturday hours? Ours is with a large clinic, so he adheres to their hours.

Kristin in Moline, IL USA with Ozzie (MRL Crusin Clem), Clarice (Clarice McBones), Latte and Sage the IGs, and the kitties: Violet and Rose
Lovingly Remembered: Sutra (Fliowa Sutra) 12/02/97-10/12/10, Pinky (Pick Me) 04/20/03-11/19/12, Fritz (Fritz Fire) 02/05/01 - 05/20/13, Ace (Fantastic Ace) 02/05/01 - 07/05/13, and Carrie (Takin the Crumbs) 05/08/99 - 09/04/13.

A cure for cancer can't come soon enough.--

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Thanks for the input, everyone. Based on some of the advice, I've got some ups and some downs.... on the plus side, DH and I work basically opposite schedules, so he'll be home during the day and I'll be home at night. On the downside, he's scheduled to have knee surgery on Tuesday, so I'm not sure how much help he'll be able to be. Hopefully his recovery won't be so extensive that he can't help Gia with hers. Cost is frightening; we're still recovering financially from Moe Moe and Apu's stay in the e-vet after the fire, but we have $2500 of insurance coverage for Gia, so hopefully her surgery will be without incident and the insurance will at least cover a majority of the up-front costs. We'll be getting a decent insurance settlement from our house fire, so I can scrimp on getting stuff back for the house and put more towards Gia. The good news about being in our rental house is that it's a single story, where our real house is a raised ranch, so to get outside at all she'd have to tackle a lot of stairs. We'll be in this house for at least a few more weeks.

 

 

Mostly, I'm scared of her being in so much pain afterwards... I come a bit unhinged when one of my pups is suffering. I've sent a e-mail consultation request to OSU, and we're set up to meet the oncologist tomorrow. I'm fully ready to get this moving as fast as possible, but I also want to be able to read as much as I can in the meantime to prepare myself even a bit for what comes after. I don't know this oncologist myself, but he came with the highest recommendation from my vet, whom I trust implicitely. One thing I'm not worried about yet is her appetite, I HIGHLY doubt anything could put Gia off food for more than an evening!

 

 

And charlies_dad, I promise, there's going to be NO problem staying angry. ;)

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Wendy, our vet is open until 7pm M-Th and until 6 on Fridays. They also have Saturday morning hours...is it uncommon for oncologists to have Saturday hours? Ours is with a large clinic, so he adheres to their hours.

 

Oh man, go and prove me wrong, why dont'cha? lol!

 

In Chicago, all the specialty clinics are associated with emergency 24-hour treatment centers, but the specialists only have hours from roughly 7:30 or 8:30 am to 3:30pm, no evenings, no weekends, and not necessarily even 5 days a week :( . Furnetics (the specialty clinic associated with U of I) only has oncologists 1 day every 2 weeks - that's why I ruled them out pretty quickly, I didn't want to be driving 3-4 hours down to Champaign every time we got off schedule or needed an extra visit for some reason.

 

I'm glad not every one has to make as big an adjustment to their schedules as I do! :)

 

Edited to add that I should point out that because I'm in Chicago, my costs may be quite a bit higher than others'. I took Twiggy to OSU for her amp, everything there, including 5 days hospital stay was less than $2000, so I started out really cost effective! Also, she had a second hospital stay for an infection back here in Chicago, that added a lot to her overall costs. My experience has overall probably been toward the high end dollar-wise (I'm also using Palladia as part of her metronomic protocol, that is $27/dose - it's the "cutting edge" med, but not everyone uses it. Also, you might be able to get in on a clinical trial that covers the cost of the drug, that would really help cost-wise).

Edited by TwiggysMom

Wendy with Twiggy, fosterless while Twiggy's fighting the good fight, and Donnie & Aiden the kitties

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Guest MorganKonaAlex

You would expect the initial surgery and recovery period to be very time-consuming and expensive (which they are); but it does not end there. Vet visits at least every 3 weeks, and monthly costs of roughly 2 thousand dollars. Eventually, those will subside a bit. At 6 months, we should be approaching a phase where the vet visits can drop back to once a month, and costs should level out to about $1,500/month. After another 6 months, the costs may lower even a little bit more for the rest of her life (which will hopefully be a long one). The iv chemo lowers their immune systems, and infections are common (particularly UTIs), that adds up to extra vet visits and meds. Also, if their bloodcounts are off, you will have to postpone their chemo (read extra bloodwork and time off of work).

A lot of these costs are protocol specific. Morgan had 4 rounds of carboplatin and no further treatment. I choose not to do routine check-ups/xrays after that. After chemo ended, there weren't any additional costs. We didn't change his food or supplements.

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You would expect the initial surgery and recovery period to be very time-consuming and expensive (which they are); but it does not end there. Vet visits at least every 3 weeks, and monthly costs of roughly 2 thousand dollars. Eventually, those will subside a bit. At 6 months, we should be approaching a phase where the vet visits can drop back to once a month, and costs should level out to about $1,500/month. After another 6 months, the costs may lower even a little bit more for the rest of her life (which will hopefully be a long one). The iv chemo lowers their immune systems, and infections are common (particularly UTIs), that adds up to extra vet visits and meds. Also, if their bloodcounts are off, you will have to postpone their chemo (read extra bloodwork and time off of work).

A lot of these costs are protocol specific. Morgan had 4 rounds of carboplatin and no further treatment. I choose not to do routine check-ups/xrays after that. After chemo ended, there weren't any additional costs. We didn't change his food or supplements.

 

Good point - there's lots of different ways to handle this, and Morgan had a survival period that pretty much any of us would be thrilled with!

Wendy with Twiggy, fosterless while Twiggy's fighting the good fight, and Donnie & Aiden the kitties

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Wow, those hours would really make it tough...makes me REALLY thankful for our clinic, they're so awesome! But it does sound like our place is the exception, not the rule, unfortunately. Their awesome hours are one of the many reasons that I transferred everyone's primary care to this clinic too.

Kristin in Moline, IL USA with Ozzie (MRL Crusin Clem), Clarice (Clarice McBones), Latte and Sage the IGs, and the kitties: Violet and Rose
Lovingly Remembered: Sutra (Fliowa Sutra) 12/02/97-10/12/10, Pinky (Pick Me) 04/20/03-11/19/12, Fritz (Fritz Fire) 02/05/01 - 05/20/13, Ace (Fantastic Ace) 02/05/01 - 07/05/13, and Carrie (Takin the Crumbs) 05/08/99 - 09/04/13.

A cure for cancer can't come soon enough.--

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Thanks for the input, everyone. Based on some of the advice, I've got some ups and some downs.... on the plus side, DH and I work basically opposite schedules, so he'll be home during the day and I'll be home at night. On the downside, he's scheduled to have knee surgery on Tuesday, so I'm not sure how much help he'll be able to be. Hopefully his recovery won't be so extensive that he can't help Gia with hers. Cost is frightening; we're still recovering financially from Moe Moe and Apu's stay in the e-vet after the fire, but we have $2500 of insurance coverage for Gia, so hopefully her surgery will be without incident and the insurance will at least cover a majority of the up-front costs. We'll be getting a decent insurance settlement from our house fire, so I can scrimp on getting stuff back for the house and put more towards Gia. The good news about being in our rental house is that it's a single story, where our real house is a raised ranch, so to get outside at all she'd have to tackle a lot of stairs. We'll be in this house for at least a few more weeks.

 

 

Mostly, I'm scared of her being in so much pain afterwards... I come a bit unhinged when one of my pups is suffering. I've sent a e-mail consultation request to OSU, and we're set up to meet the oncologist tomorrow. I'm fully ready to get this moving as fast as possible, but I also want to be able to read as much as I can in the meantime to prepare myself even a bit for what comes after. I don't know this oncologist myself, but he came with the highest recommendation from my vet, whom I trust implicitely. One thing I'm not worried about yet is her appetite, I HIGHLY doubt anything could put Gia off food for more than an evening!

 

 

And charlies_dad, I promise, there's going to be NO problem staying angry. ;)

First, I just realized that I forgot to say how sorry I am that you are facing this. I know it is very difficult.

 

OSU no longer accepts email consultation requests. You must submit a form through their website:

 

https://greyhound.os...ltationservice/

 

 

If your husband's knee surgery is a simple arthroscopic procedure, like trimming a meniscus, he will be up and around in hours to a few days. I had a meniscus tear trimmed this way and I walked out of the surgery center with no problem and was better than before the surgery in just a few days.

 

It is really amazing how well a dog does after amputation. The first week is horrible. Yes there is pain, but a lot of the whining and screaming is due to confusion over the missing leg. Whining and such can also be due to a negative reaction to the painkillers. My Joe was a little slower with his recovery. He only screamed a couple of times during his entire recovery, but he did whine and act distressed for 2 weeks. He was getting around fine after two weeks at home but wasn't quite himself. He didn't appear to be in much pain, but he didn't really want to play. Most greys seem to be ready to play by their 4th week, but Joe didn't until his 6th week. However, after this initial period, they don't have any pain. They return to their normal selves.

 

My expenses have been considerably less than Twiggy's mom. It really depends on the prevailing rates in your part of the country. I will try to list below the tests, etc. that Joe needed. This way you can check with your vets to see what their prices are:

 

Pre surgery bloodwork

Surgery (anesthesia, surgeon, meds, IV etc.)

Three to five days in hospital (usually first 2 to 3 days in an ICU unit) along with meds (IV painkillers, amicar, etc.)

Wound checks after surgery (around here this is usually free (included in surgery price)

Suture/staple removal (usually free)

Medicines for home (an NSAID such as Deramaxx, Rimadyl, etc. for about 2 weeks; tramadol ($4 at Kroger), famotidine (about $10 a month)

 

All the above at OSU is between $3000 and $4000

 

IV Chemo Phase (4 to 6 treatments total) -- about $800 for the entire course (4 treatments) at OSU:

 

Oncology exam for chemo admin ($70)

CBC ($30 at OSU)

chemo drugs (free to all greyhounds -- submit request to OSU)

chemo administration (I think this was about $55 at OSU)

Cerenia for 3 days following chemo ($9 at OSU)

Famotidine ($10 for a months supply) -- given throughout entire chemo period

Possibly Metronidazole ($8 for 30 tablets at local pharmacy), Reglan ($4 for a month), sucralfate (don't remember but cheap), ondansetron (about $2 per day) -- the first drug is to manage diarrhea and the others are for stomach upset. You probably won't need all of these.

 

Other tests that might be needed during chemo:

Chem Panel (or just the kidney portion of it)

Hemocult (if gastrointestinal bleeding is suspected)

 

Lung x-rays every 3 months ($120 at OSU) along with a Full Oncology Exam ($70 to $130)

 

I decided to do a metronomic protocol (this is optional) which increases the costs, mainly because of the bloodwork and the exams. Unless you decide to use Palladia ($350 a month) the drugs are reasonably priced. Cytoxan is about $50 for a 10 week supply from SBH mail order compounding pharmacy. Artemisinin is low cost (don't know the actual price). The third component is often an NSAID like piroxicam. Even if you have to have this compounded it is about $30 a month or less. So a basic metronomic protocol will cost between $50 and $75 a month. There is no one metronomic protocol. The term metronomic protocol refers to a low dose but consistently given (over a long period of time) chemotherapy. Some people will do this for 6 months to a year, some for the life of the dog, and some not at all. The goal with this is to provide a relatively nontoxic chemo in hopes of holding the growth of any remaining metastases at bay. The real cost of a metronomic protocol is that you need to have a CBC done every month. During the initial stages, you also need to have an oncology consult every month. After a while, you can do the CBC anywhere and have it sent to the oncologist. Unless there is a problem you can then see the oncologist every 3 months.

 

Joe was in a study at OSU so he received Palladia and Artemisin at no cost. I purchased the cytoxan. I paid about $130 each month for the OSU consult and CBC. There were a couple of times that I had to do a urinalysis or a chem panel. So my costs for the initial stages of the protocol was about $150 per month to $180 per month. After 6 months I was allowed to go to my low cost vet for the bloodwork ($15 total for the CBC or $45 total for a CBC and chem 10). So my total cost for 2 out of the 3 months was $15 plus cytoxan ($20) plus famotidine ($10) or $45 per month. So after the initial period, I averaged $80 to $100 a month. Of course, a metronomic protocol is optional.

 

So you can see that the prices here in central Ohio are considerably less than Wendy (Twiggy's mom) pays in Chicago.

Edited by joejoesmom
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