Tristan's Experience With Osteosarcoma & Amputation

[Guest patterpaws]

I keep trying to think of it from the perspective of if *I* was a hound in Tristan's perspective. Would I want to go through with the procedure? Risk the pain for the chance to live another year? Sometimes I think... yes I would. Other times I think I'd want to live out a few last days in superior comfort, go to disneyland, and then sleep away peacefully knowing that my last days were happy and I wouldn't have to suffer.

 

I am spending so much time reading tonight, that I haven't been enjoying Tristan's company- this bothers me. But we went to the dog park today, he enjoyed it despite the gimp leg. Giving him lots of treats and pets. He seems really loopy after the Tramadol pill, I feel bad.

 

I keep imagining what it would be like for his leg to spontaneously break and have to put him to sleep at the vets office that he hates so much. I can't bear it.

 

Reading through all the posts dealing with life after amputation- I'm afraid I'd be constantly worrying about whether the pain meds were enough, guessing the up and down day to day while never really knowing what his quality of life really is since he can't tell me where it hurts.

 

The images of the surgical scars are so horrible, but then the videos of happily romping tripods softens the impact. But then, the comments underneath saying that happy greyhound only lived 2 months? Yet others live 2 years or more- I know they are the exceptions but it does give hope. Imagining the 2 weeks after the surgery. My husband would be the one to stay home with him, carry him out to do his business in the yard while poor Tristan is drugged up and confused from pain medication. Would Tristan be so drugged up that he wouldn't realize what was going on? It would be so stressful to watch, not knowing what he's going through. I'd have to go to work and go insane knowing what is going on at home.

 

If we don't have the surgery, and decide to put him to sleep before the possibility of a fracture, I'll have to say goodbye when he's still very much enjoying life. Its almost unthinkable but sometimes feels like the kindest option.

 

Really torn about all of this. At the moment I feel like a robot. Its 2am already and at 9am we'll have to consult with the surgeon to make a decision? What am I to do? I feel like pleading to the universe for answers but no answer will come. I'm sorry about this rambling. I've been talking the ear off of all my friends and family, these random thoughts are circling around in whirlwinds and its hard to make sense of anything right now.

Edited July 13, 2012 by patterpaws

[silverfish]

Is it worth it if we only gain another month or so with him? If I knew it would be a year, I think it would be worth it, but there are no guarantees.

 

I cannot bear the thought of only doing radiation/chemo and having him end up dying with a pathological fracture. That is just not acceptable to me, I can't imagine going through that.

 

So that leaves me to ponder, if the surgery ends up feeling like an option we don't want to go with, maybe it would be better to give him a really good week or so with pain meds, and then end things earlier to save him the suffering of deep bone pain and pathological fracture. So torn. I don't know what to do. My husband is as torn as I am, we are just going in circles and circles with trying to decide what to do.

 

Take a breath, and try to calm yourself so you can make a rational decision.

 

Look at the options. You have four:

 

1) Do nothing. Not really an option, huh?

 

2) Palliative treatment - radiation, pain relief etc. You've already considered the pathological fracture, but be aware that bone cancer pain is one of the worst, and with the best will in the world, drugs and radiation won't eliminate it. Many have gone this route and been happy with their decision, and for many it is the best option for many reasons. But your guy doesn't have any serious health problems in his spine or his other legs, does he? And he's young enough to be a good candidate for amputation.

 

3) Amputation. Yes, it's traumatic for both you and the dog, there's no doubt about it and your dog will spend anything from one to three or four days in shock from the procedure and the loss of a limb. You, however, will agonise for longer. You see, dogs are the most philosophical of creatures; all they really care about is the here and now. Once those few days are past, they get on with living life in the now, and coping with three legs.

 

4) Choose to put him down early to save you both the trauma. Really, I would say this belongs with option 2. You could attempt to guess (with the help of your vet) when he is likely to suffer a pathological fracture and try to let him go before that happens. It's a very uncertain outcome, I have to say, because they are very unpredictable - unless you feel like x-raying him every week.

 

I haven't had a dog with osteosarcoma, but I do have a tripod who smashed his hock on the track. His trainer said she has never seen a dog in so much pain as he was that day before the op ... but after the op, he was immediately calmer, because the worst of the pain had gone.

 

Yes, you might only have a month. You might even have only a week. Or you might have a year or even two - it depends on how early you've caught it (Darcy deerhound had four years, I think). If you do nothing you're guaranteed that the time will be shorter.

 

Talk to your vet, and to as many people as you can who've been through this. Then take a piece of paper and write down the pros and cons of each option. You will perhaps find that the right answer for you will leap off the page.

 

Good luck - I don't envy you the choice.

[Guest patterpaws]

Thank you silverfish, I will do that. You (and everyone here!) are so kind. I don't know what I'd do without you all.

[4My2Greys]

Thinking of you, your husband and Tristan this morning.

[NeylasMom]

 

If we don't have the surgery, and decide to put him to sleep before the possibility of a fracture, I'll have to say goodbye when he's still very much enjoying life. Its almost unthinkable but sometimes feels like the kindest option.

 

It is the only way to ensure your dog doesn't endure any future pain and it is imo an incredibly selfless choice. I think any other choice we make when it comes to osteo does have an element of selfishness in it. I can say that because I didn't choose it. It really comes down to what your philosophies are on these types of situations. I found it very enlightening to read a section of Dr. Dressler's book on cancer in dogs (really great book with info on various types of cancer, including osteo and traditional as well as holistic treatment options) where he basically says there are 3 different "types" of people when it comes to these life decisions. Some people aren't willing to risk any discomfort for their pet and prefer to just let them go, the opposite group is quite comfortable with a "hospice" situation and the other is somewhere in the middle. As always, everyone thinks their viewpoint is the right one, but it really comes down to what you are comfortable with.

 

I know there are a lot of people who in my shoes would have just let Neyla go, but had I done that, I would have missed out on many months of seriously good quality of life with her. And frankly, I couldn't handle it. I needed time to come to grips with the diagnosis and the fact taht I was going to lose her. I don't regret my decision although knowing what I know how, I would have done some things differently in the last few weeks.

 

If you choose not to do the amputation, which imo is a perfectly reasonable choice, there are some things you can do to prepare for a possible fracture if you decide to continue with palliative care. There have been some discussions about it in this forum - having meds on hand that you can administer to relieve pain until you can get him to the vet, having a plan in place in case you'd need help getting him in the car, etc. There are also things you can do to lower the risk of a fracture, including monitoring tumor progression and restricting certain activities.

 

I know it's a lot to think about, and I think you are already at the vet, but my main piece of advice, don't rush into anything. If you need to, give yourself a few more days to weigh your options, and while it's helpful to take everyone's input here into consideration, in the end, you do what's best for you and your dog. Let us know how the visit goes.

[vjgrey]

My heart just aches for you, because I remember SO well what it felt like to be at that agonizing first step. The problem for me was that I wanted to FIX my sweet boy, and there just wasn't any way to fix him. There are no "good" options when it comes to this ugly disease.

[carronstar]

My heart just hurts for you. As others have said, there is no good outcome to this disease. I will say that I am in the palliative camp. While I am in awe of those who have had such good outcomes with amputation, until the average increase in lifespan increases, it is not the right choice for me. I know that when it was confirmed that my girl did have osteo, I let my vet know right then when we would let her go. Then I concentrated on making every day as wonderful as I could for her.

 

I do firmly believe that there is no "right" decision. Only the decision that is right for your hound and your family.

 

I am holding Tristan, you and your husband in my thoughts and prayers.

[joejoesmom]

I'm having so many second doubts. Pouring over the threads here, and scientific studies, and articles and youtube videos and talking to friends and family. I'm so torn. I don't know if we will go ahead with the surgery tomorrow. I want above all else to minimize Tristan's suffering yet also do what I can to extend his life in a high quality fashion. I'm facing such an ethical dilemma- is it right to put an animal through such a procedure, when there's no guarantee of how long he'd survive afterwards, and at what quality of life? On the one hand, he's such a fighter and right now he's so full of life besides his limp. Who am I to cut his life short? On the other hand, his system is so delicate (he gets diarrhea at the drop of a hat), I can imagine his system reacting poorly to such a traumatic procedure. Is it worth it if we only gain another month or so with him? If I knew it would be a year, I think it would be worth it, but there are no guarantees.

 

I cannot bear the thought of only doing radiation/chemo and having him end up dying with a pathological fracture. That is just not acceptable to me, I can't imagine going through that.

 

So that leaves me to ponder, if the surgery ends up feeling like an option we don't want to go with, maybe it would be better to give him a really good week or so with pain meds, and then end things earlier to save him the suffering of deep bone pain and pathological fracture. So torn. I don't know what to do. My husband is as torn as I am, we are just going in circles and circles with trying to decide what to do.

 

While there are certainly no guarantees, OSU states that the median time of survival for a greyhound undergoing amputation and chemo is 14 months. This means that 1/2 make it less than 14 months and 1/2 make it more than 14 months. I only mention this because of your statement "If I knew it would be a year, I think it would be worth it, but there are no guarantees. ".

 

That being said, it is a very major surgery. The first 2 weeks are really tough. Most greys return to their previous personality in the 3 to 6 week timeframe. If other wise healthy from an ortho/neuro standpoint, greys get along just fine on 3 legs, and the pain is gone. My Joe actually caught a squirrel as a tripod.

 

Money is certainly an issue. Depending on prices in your area, the total bill for surgery, chemo, bloodwork, etc. will typically be from $5000 to $10,000.

 

I agree with NeylasMom, there is a bit of selfishness in the choice to amputate or do palliative care instead of just letting your dog have a good few days and putting him to sleep before the pain gets too bad. Dogs live in the moment, they don't think about how much time they have left. Thus it could certainly be argued that keeping them alive is for us.

 

However, I lean towards the side of keeping them alive if they can have a good quality of life. Is this for my benefit? Yes, in part it is. But Joe got 20 months with his amputation. All but 1 month was an excellent quality of life. He was a happy boy. Would I do it again? Yes, definitely. Would I have felt this way if I only got 2-4 months? Probably not.

 

It seems to me that most people end up being "happy" with whatever decision they make. There really is no wrong or right answer.

 

Jane

 

edited to add other statistics that OSU quoted me:

 

Palliative care (tramadol/gabapentin/NSAID but no chemo/radiation): 6 to 12 weeks

Amputation (no chemo): 6 months

Amputation followed by chemo: 14 months

 

At that time (two years ago), they felt they didn't have enough information to say what adding radiation and/or pamidronate and/or chemo to the traditional pain meds would do to the median time of survival for palliative care. They just said that it should increase the survival time. When Joe developed a second primary tumor (somewhat rare) in his distal femur, we did radiation, which drastically improved his pain level for at least 7 weeks. Because Joe was already a tripod, he had to use the rear leg with the tumor. This, of course, shortened the time he had. He lasted 10 weeks during which we did radiation and some chemo.

 

I should also say that Joe tolerated the carboplatin (given for the second tumor) better than the doxorubicin.

Edited July 13, 2012 by joejoesmom

[Charlies_Dad]

I agree with Jane. There are no guarantees and yes you will second guess yourself no matter the path you choose. I had no second thoughts with our Charlie as he was a good amp candidate and we have the finances to afford it. What time do you buy yourself and your pup? Usually pain free months however there are some exceptions to this. How many months, well Maggie May is on her way towards 40-48mths, I don't remember which and she is a poster child for beating this disease. She is one of the lucky few no doubt. However one good year is a long time for a pup so it really comes down to finances IMHO as we got 21 mths for Charlie and while that is great, he still broke our hearts when he left. Would we do it again, yes if the same criteria was before us, no doubt but each pup is different. Did Charlie enjoy his months, you bet ya! He ran, he played, he tore stuffies from our other boy's mouth, he ran after squirrels, he did everything every pup with 4 legs does.

 

Good thoughts for you both, no matter your decision.

 

Just remember. Second thoughts will always be there no matter your choice. This is human nature.

[MP_the4pack]

I had 6 months. Would I have wanted a year, you betcha. And I'm so envious of Jane having Joe around for 20 months. Would I have done anything different with Diamond if I knew it was only 6 months. No.

 

I never needed to fret day to day if her leg was going to break while I wasn't there. And once the pain of surgery is gone, so is the pain of disease. As long as they can physically handle being a tripod (no severe arthritis or LS or OS in another leg).

She was happy for 6 months. She even chased deer thru the woods (at Jane's house!). It was only the last few days that she wasn't happy and in pain. (when she developed OS in her hind leg). She never had lung mets.

 

But as several have already said........no choice you make is wrong. Even if whatever choice you made turned out not quite what you wanted. It is still not wrong, because you're doing it out of love. Good luck. It's a hard decision and I hope it's a long time before I have to make it again.

[Guest FastDogsOwnMe]

I know my husband would never let me do an amp because of the cost and he isn't a dog guy, and I think I wouldn't anyway. But if you can afford it, it's a worthy option. Many dogs live for months or even years. I am so sorry you're faced with this. Your hound is just beautiful.

[MachosMom]

I don't have any words of wisdom. Going through this myself with my baby boy. We have opted to manage the pain and give him the best time we can while we have him. Some days I second guess it, some days I think I am not doing enough. Some days I wonder why I am keeping him through this. Then he smiles at me and I get the feeling that I am doing what is right for us. I have an awesome support group with some of the people from my adoption group - one who went through this a couple years ago.

Even with that, I have days where I am down right angry, or sad, or depressed. Sometimes all of the above.

 

Anyway, just wanted to tell you that you're not alone, and whatever you decide we are all here for you.

[silverfish]

 

Just remember. Second thoughts will always be there no matter your choice. This is human nature.

 

How true that is - thanks for that. It applies to any terminal illness or any life-or-death situation in our dogs, across the board. Whichever option you choose, you'll still wake at night sweating about it. As you say, it's human nature.

 

I also agree that if you decide with all the facts in front of you, and decide both with your head and your heart, there is no wrong decision.

[Guest patterpaws]

Well, we met with the surgeon and he was SUCH a wonderful guy. Extremely knowledgeable and very caring. He's owned a greyhound before and seems to know all about their particular needs. He was even familiar with all of the work being done at Ohio State and their research, he immediately knew all their names and all the particular drugs they recommend! This is in direct contrast to our previous vet, who didn't seem to know what she was talking about at all, I think she was a newb fresh out of vet school (she greeted us with "Oh a greyhound! I've never seen one of those here before!... talked about going to a bar the night before and ordering a "greyhound" mixed drink (not that its bad, just gave me that "cheerleader party girl" vibe)... she misinterpretted his blood panel thyroid readings.... wanted to schedule his surgery at her clinic despite having no vets onsite 24/7 and acted extremely defensive when I tried to tell her about Ohio State, etc) In contrast, this surgeon seemed like a complete expert who has gone out of his way to study greyhounds in depth and had lots of experience with them. (I'm guessing because he had one before, he has a special interest in them)

 

He alleviated some of my fears about the amputation process, though I'm still not 100% confident. He explained how the healing only involves soft tissue, which is why the recuperation process is much faster than one would expect. He assured me that they are highly concerned with pain management and will work with me to assure Tristan has the right medication. Though, it is still a major surgery and definitely scary to think about. He claimed that its healed in 2 weeks, but I know that the process in reality is longer than that. Like Jane said, 3 to 6 weeks is probably a more realistic estimate?

 

He also explained the cancer in a way I found helpful... I already knew a lot of this but found some of his metaphors very illustrative. Most likely, the cancer has already spread microscopically. The amputation isn't going to get rid of it, its just going to provide pain relief. With amputation, you remove the painful "mothership" tumor. When the mothership is removed, all the little baby satellites go on red-alert and have the possibility of going haywire and growing/spreading rapidly. For this reason its extremely important to have chemo done right away, preferably the same day that he will go home. He said if we go through with amputation today, he wouldn't be able to get chemo until next week, which would increase the likelihood that the cancer takes hold rapidly. He advised waiting until next week- we made an appointment to consult with oncology next Tuesday and if we decide to go forward, have surgery on Wednesday. So we will have the weekend to mull things over. I can also talk with oncology after they've had time to examine the xrays and blood panel, to get their best guess about how long he might have left... even tho I know that nobody can really predict the future accurately. I agree with carronstar, that the odds are not really to my liking yet.

 

Thank you for all those research statistics, Jane. Its amazing that Joe caught a squirrel! I'm so glad you got 20 months with him, that is amazing! If only all hounds got at least 20 months. And Diamond chasing a deer! Ah, that is so wonderful, it sounds like she was really happy in those last months.

 

I'm sorry for dumping all of my agonizing last night- I was really upset and terribly confused, especially since the vet I had been talking to didn't seem to know what she was doing. I was left in the dark to research everything on my own, and was having to trust someone I didn't feel comfortable with. I feel much better today after finding a surgeon I feel confident in. Still have a lot to consider and don't know what to do, but at least I know that I'll be supported by competent vets either direction.

 

Its hard, because no matter what decision, I can think of both the aspects that are selfish and the aspects that would benefit Tristan. So every time I decide on a direction to go, doubts creep in and I start thinking of all (just as valid) reasons to do the opposite. I also have friends/family who very very strongly feel a certain direction is right (most are very very against the amputation, they react in horror that I'd even consider it) so I know I'm going to be judged for any direction I go in, too. I truly believe each and every one of you made a good decision tho, because there are very valid reasons for each direction.

 

I've also been pondering mortality lately. Our western culture, as a whole, doesn't do well with death at all. We fight it so much, and live in denial about it. I'm having a lot of flashbacks to when my grandfather was dying in hospice, and all the books I read at the time to come to terms with death. For Tristan, if there was no medicine, he would probably die fairly soon. So any medical procedures are extending his life artificially and taking a risk that he's in more pain than he can handle since he can't really communicate things to me. I can guess, but I can never really know for sure.

 

I'm also having a lot of flashbacks to other pets I've had who have passed on. I had a rat with a tumor who I had put down before it got too painful, and sometimes I wonder if it was too early, since she was still eating and having good times inbetween her rough patches, but I wanted to spare her a painful end. There was a bunny who I opted for palliative treatment when he had cancer, and I feel like I kept him alive for too long when he was in pain. Most others I feel at peace with, I feel like things happened at about the right time for what they were going through. I really hope I don't have regrets with Tristan. Hindsight is always 20/20

 

Hearing that the people who did go forward with amputation don't have regrets is a very strong point too, although I have talked to a few who did regret it so I know it goes both ways.

 

The cost does intimidate me, but I do have some money saved up so its not a barrier. I'm not rich and I'd love to use the money for other things, like a car or buying a house someday, or keeping it as a nest egg in case someone else needs help. But....really, my main reasons for saving money are so I can have it in case my family, pets (who are my family) or friends need help. So I don't want to let my money concerns influence the decision.

 

Its so helpful to know that I'm not alone in this. You all understand so well. Here I am writing another essay! Thank you again for each and every comment here, I am taking each one to heart and truly appreciate you all! <3

Edited July 13, 2012 by patterpaws

[Guest patterpaws]

Oh another thing he said was that from the xray, there are already signs of micro-fractures in Tristan's leg. Which I guess just goes to show how serious it already is even tho my good boy seems perfectly normal aside from a limp. <

 

Here's a pic of him yesterday at the dogpark (he romped around and enjoyed himself a while but sat down when his leg started bothering him, so we didn't stay too long)

 

Here we are at the vet this morning (sorry its kinda blurry)

[MachosMom]

Awww Tristan! You are a cutie patootie!

 

Please don't feel bad about any rants or agonizing or anything. And don't feel like you have to please other people when making your decision. You do what's best for you and Tristan. NO ONE else can make that decision for you!

 

I am very glad that the guy you spoke with today was way more knowledgeable! I can understand the misgivings about the other one!!!

 

Whatever you decide, or if you just need to vent or cry, don't hold back. Don't forget to celebrate the good moments you have as well

[JJNg]

I feel for you during this difficult time of decision making. I'm sure no one here minds you posting your thoughts, and sharing that process may be helpful for others going through the same situation.

 

Just a couple thoughts... There is no right or wrong choice. You need to do what you feel is best for your family and Tristan. Don't let other's opinions and fear of judgment sway you from what you feel is best.

 

Your comment about the surgeon wanting to start chemo the time of discharge from surgery caught my attention as that doesn't seem to be the norm. Most of the time, they want the dog to be healed from surgery before starting chemo, as it can delay healing. I believe most oncologists choose to start chemo at the time of suture removal, about 10-14 days after surgery. Either way, I think it's good that you have a week to make sure you are certain about your decision and aren't rushing into this.

 

Best wishes for you and your beautiful boy!

[krissn333]

The only time that Pinky was "out of it" was the day of her surgery and overnight-they kept having to sedate her so she would lay down. She kept getting up in her kennel and getting mad it wasn't tall enough and would spin around and tangle her IV line.

 

When I picked her up the next afternoon, she walked to the waiting room herself. The next few days she learned how to GET UP on her own-I did help her get up out of bed, etc, but she walked in her own with me supporting her.

 

She came home with a pain patch on and that managed her pain well...can't really recall if I also gave her oral meds during that time...I think maybe some tramadol. She whined a little but never screamed or anything. The big thing is to just keep to a meds schedule so you don't ever give the pain a chance to really break through. I learned after a day or so that if she was panting or whining, it was because she needed to go to the bathroom and wanted me to get the hint and help her get out of bed

 

It is highly unusual and not part of OSU's protocol to start chemo earlier than 10-14 days after surgery. The body is really trying to heal from a big surgery-chemo treatment too early can limit the healing process. I'd urge you to have the surgeon speak to OSU directly first.

 

Pinky did receive a platelet infusion the day of her surgery...she was bleeding a little more than our surgeon cared for a couple hours after her surgery, so she got some platelets and that helped IMMENSELY.

 

Take your time to make a decision. No one here can TELL you what to do.

 

I'll take some pics of Pinky tonight if I can and post them over in the osteo thread...she doesn't really have a scar, per se...she just has an area where her black brindle fur meets her whitish fur and skin on her underside A little boy at a meet and greet was FASCINATED by her "undercarriage."

[joejoesmom]

Well, we met with the surgeon and he was SUCH a wonderful guy. Extremely knowledgeable and very caring. He's owned a greyhound before and seems to know all about their particular needs. He was even familiar with all of the work being done at Ohio State and their research, he immediately knew all their names and all the particular drugs they recommend! This is in direct contrast to our previous vet, who didn't seem to know what she was talking about at all, I think she was a newb fresh out of vet school (she greeted us with "Oh a greyhound! I've never seen one of those here before!... talked about going to a bar the night before and ordering a "greyhound" mixed drink (not that its bad, just gave me that "cheerleader party girl" vibe)... she misinterpretted his blood panel thyroid readings.... wanted to schedule his surgery at her clinic despite having no vets onsite 24/7 and acted extremely defensive when I tried to tell her about Ohio State, etc) In contrast, this surgeon seemed like a complete expert who has gone out of his way to study greyhounds in depth and had lots of experience with them. (I'm guessing because he had one before, he has a special interest in them)

 

He alleviated some of my fears about the amputation process, though I'm still not 100% confident. He explained how the healing only involves soft tissue, which is why the recuperation process is much faster than one would expect. He assured me that they are highly concerned with pain management and will work with me to assure Tristan has the right medication. Though, it is still a major surgery and definitely scary to think about. He claimed that its healed in 2 weeks, but I know that the process in reality is longer than that. Like Jane said, 3 to 6 weeks is probably a more realistic estimate?

 

He also explained the cancer in a way I found helpful... I already knew a lot of this but found some of his metaphors very illustrative. Most likely, the cancer has already spread microscopically. The amputation isn't going to get rid of it, its just going to provide pain relief. With amputation, you remove the painful "mothership" tumor. When the mothership is removed, all the little baby satellites go on red-alert and have the possibility of going haywire and growing/spreading rapidly. For this reason its extremely important to have chemo done right away, preferably the same day that he will go home. He said if we go through with amputation today, he wouldn't be able to get chemo until next week, which would increase the likelihood that the cancer takes hold rapidly. He advised waiting until next week- we made an appointment to consult with oncology next Tuesday and if we decide to go forward, have surgery on Wednesday. So we will have the weekend to mull things over. I can also talk with oncology after they've had time to examine the xrays and blood panel, to get their best guess about how long he might have left... even tho I know that nobody can really predict the future accurately. I agree with carronstar, that the odds are not really to my liking yet.

 

Thank you for all those research statistics, Jane. Its amazing that Joe caught a squirrel! I'm so glad you got 20 months with him, that is amazing! If only all hounds got at least 20 months. And Diamond chasing a deer! Ah, that is so wonderful, it sounds like she was really happy in those last months.

 

I'm sorry for dumping all of my agonizing last night- I was really upset and terribly confused, especially since the vet I had been talking to didn't seem to know what she was doing. I was left in the dark to research everything on my own, and was having to trust someone I didn't feel comfortable with. I feel much better today after finding a surgeon I feel confident in. Still have a lot to consider and don't know what to do, but at least I know that I'll be supported by competent vets either direction.

 

Its hard, because no matter what decision, I can think of both the aspects that are selfish and the aspects that would benefit Tristan. So every time I decide on a direction to go, doubts creep in and I start thinking of all (just as valid) reasons to do the opposite. I also have friends/family who very very strongly feel a certain direction is right (most are very very against the amputation, they react in horror that I'd even consider it) so I know I'm going to be judged for any direction I go in, too. I truly believe each and every one of you made a good decision tho, because there are very valid reasons for each direction.

 

I've also been pondering mortality lately. Our western culture, as a whole, doesn't do well with death at all. We fight it so much, and live in denial about it. I'm having a lot of flashbacks to when my grandfather was dying in hospice, and all the books I read at the time to come to terms with death. For Tristan, if there was no medicine, he would probably die fairly soon. So any medical procedures are extending his life artificially and taking a risk that he's in more pain than he can handle since he can't really communicate things to me. I can guess, but I can never really know for sure.

 

I'm also having a lot of flashbacks to other pets I've had who have passed on. I had a rat with a tumor who I had put down before it got too painful, and sometimes I wonder if it was too early, since she was still eating and having good times inbetween her rough patches, but I wanted to spare her a painful end. There was a bunny who I opted for palliative treatment when he had cancer, and I feel like I kept him alive for too long when he was in pain. Most others I feel at peace with, I feel like things happened at about the right time for what they were going through. I really hope I don't have regrets with Tristan. Hindsight is always 20/20

 

Hearing that the people who did go forward with amputation don't have regrets is a very strong point too, although I have talked to a few who did regret it so I know it goes both ways.

 

The cost does intimidate me, but I do have some money saved up so its not a barrier. I'm not rich and I'd love to use the money for other things, like a car or buying a house someday, or keeping it as a nest egg in case someone else needs help. But....really, my main reasons for saving money are so I can have it in case my family, pets (who are my family) or friends need help. So I don't want to let my money concerns influence the decision.

 

Its so helpful to know that I'm not alone in this. You all understand so well. Here I am writing another essay! Thank you again for each and every comment here, I am taking each one to heart and truly appreciate you all! <3

 

I am so glad you feel comfortable with the surgeon you saw. I want to clarify something I said. I said that they seem to return to their normal personality in 3 to 6 weeks. That doesn't mean it takes that long to physically heal from the surgery. For the most part, that is done in two weeks, barring infection. I just meant that it can take 3 to 6 weeks to be as playful as they were before the cancer struck and to return to "normal". After just 10 to 14 days, I could tell that Joe was in less pain than before the amputation.

 

I also wanted to mention that OSU typically does the first IV chemo 14 days after the day of amputation. I'm not saying that your surgeon is wrong. I am just saying that there are different opinions as to how long to wait for the surgery site to heal before the chemo. I do know that all oncologists want to start the chemo as soon as is feasible.

 

As to having doubts and second guessing yourself. This is totally normal. As I said before though, when asked months or years later if they were happy with the decision they made, the majority say yes. This seems to apply whether they chose amputation or palliative care.

 

I guess you could say that I was lucky in a way. I have had a number of people stay with me while they visit OSU with very sick dogs. I sat in on a pretty large number of osteo consultations. I heard the options many times. This caused me to think about what I would do if it were one of my dogs. I came up with different scenarios: If my dog were under 10 years old and otherwise healthy, I would likely do the amputation. If my dog was older than 12, I would likely not do an amputation. I know these ages are pretty arbitrary. If my dog was very fearful of vets, I may not do amputation. If my old dog was "full of life", I might do the amputation. So Joe had just turned 7, was very healthy, absolutely loved going to OSU (he donated blood every 6 to 8 weeks so loved going to OSU to visit his Aunt Cristina) -- everything that I had previously thought would be a "no-brainer" to me to do the amputation. All of this did not stop me from questioning if I was doing the right thing for him. While I was waiting for the surgery I remember asking everyone I knew at OSU if I was doing the right thing. For the first few weeks after the surgery, there were times I was sure I did the wrong thing. Yet once he healed and became my funny, goofy JoeJoe, I knew I made the right decision for us. Yes it cost a lot of money. Yes my family thought I was absolutely bonkers for "doing this to him". Even some of my close dog friends said "Joe is so lucky to have you, most people wouldn't spend this kind of money for such a poor prognosis". I couldn't help but take this to mean that they didn't agree with me. Yet when I talked with greyhound people who had decided to amputate, most told me that they were content with their decision.

 

I don't know if any of this helps you. You have such a tough decision to make. I hope and pray that someday osteo will be eradicated.

 

Jane

[silverfish]

Take your time to make a decision. No one here can TELL you what to do.

 

 

And if no-one here (with all the collective knowledge about osteosarcoma and amputation vs palliative treatment) can tell you what to do, what makes your friends and relatives think they know any better?

 

The decision is yours. Not Aunty Lou's or cousin John's. Not your neighbour's or your best friend's. He is your dog and your responsibility, not theirs. If it were the other way round, my guess is that they would resent your telling them what they should do with their dog (or their cat, or their child). Please don't let other people's opinions sway you - that way DOES lie madness in the form of guilt trips. You will not be happy with a decision that you allow someone else to push you into.

 

Tristan is a beautiful soul. You're absolutely right that we in the West have a problem dealing with death. Culturally, we try to push it under the carpet for as long as possible which is why when it comes and taps us on the shoulder, we are never ready and often go into shock - whether it's on our own behalf or our dependents'. Do what is right for you and Tristan, and don't worry about what other people think.

[Guest patterpaws]

Spent a really good day with Mr. T today. Took him out to the dog park and over to see the Space Needle. (we call him "Needle" as one of his many many nicknames, and we've always wanted to show him the Space Needle, even tho I'm sure he doesn't care, ha. We moved pretty recently so hadn't gotten the chance to yet.)

 

He's still limping even with the Tramadol, and panting heavily/seeming uncomfortable in between doses, so I need to up the dose I think. Just realized the vet didn't even give us enough pills to make it through the weekend, even at his current dose (this is the vet I didn't like, so its just another reason to not like her!) We'll have to find an emergency vet thats open tomorrow, to see if they can give us enough to last the weekend.

 

Seeing the photos of the tripod dogs romping and having fun, so full of life, even seeing Pinky's charming little stump with no scar!-- I would love that for Tristan. I imagine all of the good times we could have after amputation. I'm convinced that after the recuperation period, they can live a very fulfilling life.

 

Thank you for the descriptions of Pinky and Joe's recuperation! Hearing about your different thought scenarios helps too, Jane. There really are a lot of things to take into consideration, its wonderful that you had thought about the possibilities ahead of time. Also, if we do go through with it, I'll be sure to ask them about starting chemo later than the surgeon was describing.

 

Now that I'm calmed down a little, I feel like I'm able to think about this a little more rationally. I'm reluctantly leaning more towards palliative care, with the very real possibility that we will help Tristan go the the bridge very soon. As much as I like to think of Tristan as being very healthy and in excellent shape besides his afflicted leg, I must admit that he does show signs that would affect him should he undergo amputation. He's never had a limp in any of his other legs, but his back end shakes after even a moderate amount of walking. Also he's terrified of the vet. We had to literally drag him through the door for his second appt for the xrays. His system is really delicate too, he has the most sensitive stomach of any animal I've ever had, even though he's a total glutton for treats of any kind.

 

Its going to be very difficult to decide when to help T go to the bridge, if we don't do the amputation. He's certainly enjoying life, but I can tell that he's in pain. Knowing that his leg already shows signs of micro-fractures is also is worrying. I really don't want him to leave this world with a pathological break and trip to the dreaded vet. I'm thinking of upping the pain medicine, giving him a really good week, and having a vet come for a house call ..... as soon as next weekend? Not sure.

 

Here are some pics of us at the park today:

 

 

 

 

 

One of my good friends mailed a package of dried turkey hearts for T, so I took some pics of him doing "his trick" for her (he balances a treat on his nose until I give the "okay" to eat it, though sometimes he gets impatient hehe:

 

 

 

Thank you for all the reminders to make this decision based on weighing all of the options for Tristan, and not based on what others think. I'm truly trying to reach inside my heart and make a decision out of love for Tristan and nothing more. The emotions run so strong that sometimes its hard to think clearly. Despite how much I'd like a black and white situation, it is instead many shades of grey. Tristan is a very very special hound to me. I adopted him when I was in a deep deep depression from losing my mom to suicide. He helped pull me out of that dark pit- he saved me. He was with me during some very tumultuous years when my first husband left me, too. He's always been my big goofy houndie, full of life and mischief. Despite being a huge clumsy moose, he's also a very gentle soul. He has lived peacefully with both cats and rabbits. When I first got him, if I didn't want him to go into a room, I'd just lie a piece of paper on the floor and he'd be too scared to cross it. He's been the calm, secure dog to help my friend's dog overcome terrible anxiety and fear aggression. Yet when I first adopted him, he was so terrified of everyone and everything- for the first few weeks I had him, he cowered in a corner and didn't want anyone to come near him. I worked with him patiently for months, even years, until he was miraculously trusting of life again and would greet strangers with a tail wag and run up to other dogs in the park to play- it was like he became a totally different dog! I'm going to miss him terribly. My poor hound. I sure hope there is a special place in heaven for him. I don't really believe in anything, but I sure hope there is an afterlife. Maybe my mom is out there somewhere, and she can take care of Mr T until the day comes when I join them. She never got to meet him, but I know she would have loved him.

 

 

Here are a couple videos from today, one at the dogpark and one at home.

 

In this one, I had gone to throw away a poo bag, and Tristan had lost track of me. He's looking for me and comes running to me when he finally spots me :

http://youtu.be/zpXAXApBNmw

 

 

In this video, he's doing his "trick" with some dried turkey hearts that my friend mailed to us when she heard of his diagnosis:

http://youtu.be/BLCjMVtH_yE

 

 

I know I'm writing a lot here, some of it may be tmi. I'm surprised anyone bothers to read it all, but thank you so much to those who do. I will try to celebrate the good moments too. I think today, despite my sad ramblings tonight, was really wonderful. We spent a gorgeous day with Tristan, spoiling him with tons of treats and attention. I kept fighting back tears all day but tried my best to just be in the moment and enjoy it. Thanks again for all of the love and support, its helping me more than you know.

[galgrey]

It's obvious he's a very loved hound. I'm so sorry you are facing this. The panting and limping sound like his pain is not under control. I'm sure others with more pain management experience can advise you about what to do next. Enjoy every precious day.

[robinw]

Keep writing away. So many of us have been through this and if writing helps, then we're lucky to be able to read about such a special guy. As others have said, make decisions for you and Tristan, not for your friends.

[Guest patterpaws]

Writing does help, I think. At least it makes me slow my thoughts down enough to try to express them in words. It also helps to know that there are others out there who understand.

 

Right now we're giving 75 mg Tramadol every 12 hours. We only have one dose left for tomorrow morning and then we run out, and the vets office is closed. I wanted to give him more tonight but didn't want to run out. Tomorrow we'll try to find a different vet that will give us more medicine.

 

This is in addition to 93 mg of Rimadyl every 12 hours. We have plenty of that one left.

Edited July 15, 2012 by patterpaws

[Batmom]

I'm so sorry you're going through this.

 

Keep talking and posting. Your boy is beautiful, as is the incredible love you have for him.