Osteo Thread V

[greysmom]

For those of you who have made the decision to put your dog down rather than surgery - how did you know that was the right choice? We talked to our primary vet for Kyle today she was only 50/50 on doing the surgery and really I felt like that was just to ease what she was saying to us. Kyle's 11 (although so is Jenny and she just had surgery). Not sure how to make this decision and not question it.

 

When our 10 1/2 year-old was diagnosed last year, I immediately knew that he wasn't a candidate for amputation. Mainly because he'd had a wobbly hind end for several years, and I didn't think he could support his weight. My DH was initially all for the surgery, and I had to talk him out of it. Which made me feel absolutely awful, but I knew my dog, and I knew amputation wasn't right for him.

 

Two days later, he was diagnosed with a second primary tumor in one of his back legs.

 

We managed his pain for four wonderful months with a good mix of meds (including gabapentin, which made a huge difference), pamidronate and radiation treatments.

 

FedEx, another GT hound, made it close to two years (I think?) with just palliative care.

 

Thanks Greyaholic! Our vet is saying pain management is likely not an option since he has been in some serious pain for a couple days and hasn't been able to stand up on his own or walk down stairs/ramp.

 

You have quite a ways to go if he's only taking 200mg of tramadol. Gabapentin is a must to add in - I seriously think it's a miracle drug! - and an NSAID (rimadyl, piroxicam, deramaxx). Many GP vets are way too conservative with pain meds for a dog with cancer.

 

I don't think you ever stop second guessing yourself, no matter what decision you make. You can only consider what information you have and how well you know your dog and make the best decision for HIM. Remember, the amputation is only to control pain. The cancer will still be there, and may crop up again the week after his amp, or he could get many months. It's just a horrible crap shoot either way. And in multiple dog homes you also need to consider how this will impact the rest of the pack. Do you have time (and money) to treat and care for two dogs with osteo, and still give your remaining dog enough time and attention? Can your home manage two tripods? There's so much to take into account, but still, at the end, it should all be about what's best for Kyle.

 

Good luck. {{{{{hugs}}}}}

[RaineysMom]

For those of you who have made the decision to put your dog down rather than surgery - how did you know that was the right choice? We talked to our primary vet for Kyle today she was only 50/50 on doing the surgery and really I felt like that was just to ease what she was saying to us. Kyle's 11 (although so is Jenny and she just had surgery). Not sure how to make this decision and not question it.

 

When our 10 1/2 year-old was diagnosed last year, I immediately knew that he wasn't a candidate for amputation. Mainly because he'd had a wobbly hind end for several years, and I didn't think he could support his weight. My DH was initially all for the surgery, and I had to talk him out of it. Which made me feel absolutely awful, but I knew my dog, and I knew amputation wasn't right for him.

 

Two days later, he was diagnosed with a second primary tumor in one of his back legs.

 

We managed his pain for four wonderful months with a good mix of meds (including gabapentin, which made a huge difference), pamidronate and radiation treatments.

 

FedEx, another GT hound, made it close to two years (I think?) with just palliative care.

 

Thanks Greyaholic! Our vet is saying pain management is likely not an option since he has been in some serious pain for a couple days and hasn't been able to stand up on his own or walk down stairs/ramp.

 

You have quite a ways to go if he's only taking 200mg of tramadol. Gabapentin is a must to add in - I seriously think it's a miracle drug! - and an NSAID (rimadyl, piroxicam, deramaxx). Many GP vets are way too conservative with pain meds for a dog with cancer.

 

I don't think you ever stop second guessing yourself, no matter what decision you make. You can only consider what information you have and how well you know your dog and make the best decision for HIM. Remember, the amputation is only to control pain. The cancer will still be there, and may crop up again the week after his amp, or he could get many months. It's just a horrible crap shoot either way. And in multiple dog homes you also need to consider how this will impact the rest of the pack. Do you have time (and money) to treat and care for two dogs with osteo, and still give your remaining dog enough time and attention? Can your home manage two tripods? There's so much to take into account, but still, at the end, it should all be about what's best for Kyle.

 

Good luck. {{{{{hugs}}}}}

 

absolutely WAY too low for pain management. I originally took our regular vets recommendation of no more than 1.5 (75 mg total) of Tramadol 3 x day and came here for advice -- and was told it was WAY too low and to get Gabapentin in there too -- and the folks here were right! When we went to the oncologist, she immediately put him on 3 Tramadol's (150 mg) 3 x day and 300 mg Gabepentin 3 x day (plus he was getting Rimadyl 75 mg 2 x day too). He got 3 radiation treatments and then started chemo -- we got an extra 2 months with him post-diagnosis. He started to not eat well (and he was a total food hound) so we knew the cancer must have spread elsewhere.

 

PLEASE have your vet put him on the above meds and see if you can control the pain!

 

Pinky's being a picky eater

 

This morning she refused kibble, cookies, canned food, cottage cheese, ground beef, her mix of macaroni, beef, and egg, hardboiled eggs, and egg nog.

 

She drools when I bring the peanut butter with her meds on it though

 

I'm worried we're headed downhill

 

:( crap, Krissy! :( sending prayers it's just a fluke :(

[vjgrey]

Pinky's being a picky eater

 

This morning she refused kibble, cookies, canned food, cottage cheese, ground beef, her mix of macaroni, beef, and egg, hardboiled eggs, and egg nog.

 

She drools when I bring the peanut butter with her meds on it though

 

I'm worried we're headed downhill

 

Maybe she'd eat something smelly? Canned chicken? Tuna in water? I know there's also yeast supplement that has worked great for a few ill/picky pups. Nutritional yeast, I think? Tastes like cheese, apparently.

[Charlies_Dad]

 

Thanks Greyaholic! Our vet is saying pain management is likely not an option since he has been in some serious pain for a couple days and hasn't been able to stand up on his own or walk down stairs/ramp.

 

As others have written, you still do have a long way to go before you 'max' the pain meds. The issue for you though is if Kyle is experiencing severe pain as your vet is stating, you either need to ramp up the pain meds significantly or have surgery as soon as possible. I know it's not an easy decision and there are no 'right' decisions. You are dealing with a life threatening illness that unfortunately one cannot beat but can buy time and if you're lucky enough perhaps enough time that your pup passes from something else other than Osteo. We're here to support you no matter your decision.

 

 

 

 

Pinky's being a picky eater

 

This morning she refused kibble, cookies, canned food, cottage cheese, ground beef, her mix of macaroni, beef, and egg, hardboiled eggs, and egg nog.

 

She drools when I bring the peanut butter with her meds on it though

 

I'm worried we're headed downhill

 

More good thoughts for Pinky! Come on girl, try to eat something for your Mom.

[tbhounds]

name='krissn333' timestamp='1353083886' post='5375940']

Pinky's being a picky eater

 

This morning she refused kibble, cookies, canned food, cottage cheese, ground beef, her mix of macaroni, beef, and egg, hardboiled eggs, and egg nog.

 

She drools when I bring the peanut butter with her meds on it though

 

I'm worried we're headed downhill

[/b]

I know you mentioned that Pinky is still taking pred--that may be tearing her tummy up. You might want to consider starting Carafate 3 times daily and a dialy Prilosec.

[krissn333]

She did happily eat some ground beef, and a good amount of it, after a bit. I almost feel like she feels like I do when I wake up in the morning and haven't brushed my teeth yet...mouth feels icky and sticky.

 

I spoke with Dr. Bahns today and she mentioned she'd just been at a conference where they talked about moist heat applied to the neck, shoulders, and back for 10 minutes every hour, along with massage. We're going to try that too. I've been concentrating on the limbs themselves. Her front legs are pretty good except her feet get a little bit big sometimes. The hock is slightly larger than it should be, but the edema is gone.

[krissn333]

We talked today about mixing kibble with peanut butter, so I decided to try it-she liked it

[krissn333]

She LOOOOOVES the massage...she went right to sleep!

[MachosMom]

Just checking in on everyone and sending my prayers to all.

[4My2Greys]

We talked today about mixing kibble with peanut butter, so I decided to try it-she liked it

 

Pinky knows something good when she has it. There's nothing better than a big spoon of peanut butter in a bowl of cereal

[krissn333]

We decided to try sucralfate to help her gurgly tummy...

 

Her attitude is very good, and she's been pretty energetic. Just got it in her so we'll wait a bit and then try to get some food into her.

[vjgrey]

She LOOOOOVES the massage...she went right to sleep!

 

:beatheart You and Pinky are so lucky to have each other.

[Guest snakes]

 

FedEx, another GT hound, made it close to two years (I think?) with just palliative care.

 

He did indeed, 1 year 10months. We did do pamidronate treatments in the first year which helped dramatically. The pain meds at the worst times were 300mg gabapentin 3x/day; 50mg tramadol three times a day; 75mg carprofen once a day (occasionally twice with swelling).

 

In my experience the gabapentin made the biggest difference.

Please don't hesitate to give higher doses of pain meds, I often thought it was better to have to taper down the meds rather than see them suffer in pain.

[Guest snakes]

I have artemisinin (Holley Pharamcueticals) that NeylasMom gave to me. They are 100mg capsules, the two bottles total 120 capsules. Expire 8/2013.

 

Anyone who wants them they are free, i'll send them to you.

 

I'd love to see them get used instead of thrown away, just PM me.

 

I do have 3 bottles of 50mg that expired 10/2012 if anyone wants them as well.

[TwiggysMom]

jenbush, I am so sorry you are having to go through this with both Jenny and Kyle, I can't imagine. I do think that if you want to pursue pain management for Kyle, you do have a lot of options for getting him much more comfortable than he has been. You have such a difficult decision here. For what it's worth, you have my support in whatever decision you make. to all of you.

 

Kristin, I am glad to hear that Pinky is eating again. I think the sucralfate is a great idea. I was going to suggest that, but wasn't able to post for a couple days. Is she on any nsaids? That is what caused issues for Twiggy last summer, and the sucralfate was like a miracle! More kisses to to Pinky! (and all your other pups and kitties, too!)

[krissn333]

Wendy, no NSAIDS, she's on prednisone. But, she's also on tramadol, benazepril, and Zeniquin, along with her cytoxan.

 

In order to keep her caloric intake up, we've been giving her a variety of foods, which, without the drugs involved, would probably never even phase her tummy...but the combination over time has made her tummy gurgly

[krissn333]

She ate a cookie earlier She has been turning her nose up at them lately sometimes.

 

Since we started the moist heat therapy, her resting respiration rate is the same as Ace and Fritz's...I really think that the issues we've been having might be related to a sore neck/back, and possibly also upset stomach.

 

She's just had some sucralfate and she's resting with her moist heat...then we'll get her bedtime meds into her and see if she wants to eat a bit

[greysmom]

 

I loved this when I saw it this morning!

[krissn333]

Saw it on Facebook last night-loved that!

 

Still can't get over how well Pinky is breathing...and how sheepish I feel for not considering that her neck and back might be sore DUH Mom!

[krissn333]

She ate another can of chicky

[NeylasMom]

Yes. What Valerie (vjgrey) said: Decent pain meds, and rest assured they won't make him all groggy and out of it. You may soon find that your biggest problem is keeping him from overdoing things when he feels better.

 

Most vets just don't seem to be super-experienced in heavy-duty pain management for a dog that is terminally ill. Also, drug combos that might be considered risky for long-term use are just fine for the here and now for your boy.

 

Even if the drugs do nothing but give your boy comfort for a few weeks, that's a few weeks you can have with much less pain for him.

I can't emphasize what these 2 have said enough. You may still not have a lot of time left if you choose palliative care, or you may have months. It's impossible to know without first getting him on the appropriate dose of medication. IV pamidronate and radiation may both also be good options for you depending on a variety of factors and generally I think they *can* provide better pain relief than meds alone.

 

As far as knowing what choice to make, only you can decide that. All I will say is that if you choose not to amputate and let him go (potentially) sooner, he won't know the difference. Of course if he potentially has months of good quality of life left, you don't want to let him go early and deprive both him and your family of that, but the harsh reality is again he won't know the difference so it's really a question of possibly depriving yourself more than anything else. At least that's the way I look at it, but I know everyone has a different outlook. And honestly, you don't know what will happen (the other harsh reality of dealing with this disease) - you could amputate and lose him on the table, or have the cancer show up in another leg within weeks or you could get several years. You could choose palliative care and see the pain increase faster than you can keep up with it almost immediately or you could increase meds and possibly try other treatments and get close to 2 years like FedX did. The only certain thing is that if you choose amputation, the source of the pain will have been removed once he's recovered from surgery (at least temporarily).

 

Neyla wasn't a candidate for amputation for a lot of reasons so we weren't really faced with that decision, or at least in my opinion we weren't and I'm not sure what I'd do now if I had a dog who was get osteo so really, no idea what's best for you - just trying to give you some food for thought.

 

I'm really sorry again that you're faced with this.

[TwiggysMom]

Chris, I love that cartoon! I hadn't seen it before, but it's my mental thought every time someone gives the "oh, poor 3-legged doggie" look!

 

Kristin, this is great news! Keep eating, PInky! I may have to try warm moist heat on Twiggy's left hip - she's been limping on it for many, many months, and seen umpteen doctors for it, had as many types of treatments, as well as x-rays/ct scan, but no identifiable cause. I'm sure it would feel good on her neck/shoulder, too. With how active she is, I just don't know how she does it - her neck and front leg really bear the brunt of this, but all she wants is to go, go go! What do you do for the moist heat? Just a hot, wet towel?

[greysmom]

Wendy, we found that a canine massage therapist really helped Dude stay loose and limber, and kept all his muscles in line. You might give it a shot.

[krissn333]

Wendy, I have a flannel thing full of rice that I heat up for 2.5 minutes. While she's laying down on her side, I lay it along her back from her lower neck down. She must like it because she instantly relaxes and goes to sleep.

 

I'm still having a hard time getting enough food into her, but, we'll keep trying. It's hard when her attitude is so good to even think about letting her go, but, I can't let her waste away either

[krissn333]

She has hardly eaten anything since yesterday afternoon Dr. Bahns mentioned trying Cerenia, but, she hasn't vomited, so I'm not sure that's really going to do anything.

 

This is so hard How do you know when to say when? She won't eat, but she just sat here in her bed and sang with the others, and gets up to go outside...