lilythetigerdog Posted March 7, 2013 Share Posted March 7, 2013 I just got off the phone with my vet and we spoke at length about Lily’s meds and I shared all of the information I have from here and from my own research. Almost everything I read tells me that 2x/day – 50mg of Tramadol is too low. He told me that he often does not prescribe such a low dose as a starter but he said that we discovered Lily’s osteo at a very early stage. Lily’s cancer went mis-diagnosed as a cruciate tear twice and then was only evident when we x-rayed her good leg and compared magnified images of her two femurs side by side. There is no distortion of the bone or “starburst” pattern in her marrow. He feels that the Tramadol 2x/day plus the Metacam 1x/day is enough, but said to increase the Tramadol if I want to and he will prescribe anything I need. I’m also concerned that I won’t recognize her pain – there has been no yelping, crying, and her limp has been sporadic at best. He told me I could bring Lily over to the office any time I like and as often as I like and he will watch her walk (for free) and will make suggestions/write prescriptions as we need to. He also gave me the name of his college who is familiar with Lily’s file and said that if I can’t reach him, she will be able to give me whatever we need. He is also familiar with Dr. Coutu and the work they do at OSU and said he would consult with them if I wanted him to. I’m not at that point yet (although I have become a member and been all over that site), but after all of this support from you all and my vet, I am definitely feeling a little more confident. I’m also worried about her life expectancy. Like everyone else has said, he confirmed that her life span could be shorter or longer. Fortunately, in his opinion she likely has months rather than weeks or days given how early we detected the cancer. I hope he’s right. DH and I went home at lunch and Lily was jumping in circles in the living room, so I suspect the Tramadol is working. Quote Image removed. Not within the GreyTalk signature guidelines of <15 KB file size limit. Your image was 17.51 KB (17,929 bytes) file size. Link to comment Share on other sites More sharing options...
lilythetigerdog Posted March 7, 2013 Share Posted March 7, 2013 Carrie there is absolutely no reason that Lily is not a candidate for amp/chemo. I am suspecting the vet just believes it is not of benefit in the long run. She is otherwise healthy and has no limb problems. Amputation alone will absolutely not buy you more time. I know how confusing this is. there is so much information to absorb. Whatever decision you make is the right one, trust me. I know how much you love her and no has her interests at heart more than you do. There is no guilt attached to whatever choice you make. You know my number. Call it anytime. As for palliative care, I did it with three of mine, there is no way in hell they EVER suffered the "worst kind of pain". Their lives were of varying lengths after diagnosis but their days were good. That was the deal we made. True. Amputation is indeed an option, but not one that the vet feels will give her any more time. We have decided to manage the pain as best we can. And I will definitely call. A lot. Quote Image removed. Not within the GreyTalk signature guidelines of <15 KB file size limit. Your image was 17.51 KB (17,929 bytes) file size. Link to comment Share on other sites More sharing options...
joejoesmom Posted March 7, 2013 Share Posted March 7, 2013 (edited) True. Amputation is indeed an option, but not one that the vet feels will give her any more time. We have decided to manage the pain as best we can. And I will definitely call. A lot. First, I am absolutely NOT telling you that you should amputate. However I disagree with your vet that amputation will not give her any more time. The statistics that most oncologists quote are: Pain management: median time of survival of 1 to 2 months Amputation alone, without chemo: 3 to 6 months Amputation with chemo: 12 to 14 months Some general purpose vets (and even orthopedic surgeons) are not familiar with the increased longevity that is now possible with chemo, radiation and pamidronate. While amputation alone doesn't significantly increase life expectancy; amputation combined with other treatments has resulted in a significantly longer median survival. I am not trying to change your mind -- I just want to be sure that you have accurate information when making your decision. Jane edited to add: OSU will send you free chemo drugs. You will still need to pay to have them administered. Amputation and chemo are quite expensive, even with the free drugs. Edited March 7, 2013 by joejoesmom Quote Link to comment Share on other sites More sharing options...
Zoolady Posted March 7, 2013 Share Posted March 7, 2013 Ben's renewal prescriptions at higher amounts was not as smooth as could have been but accomplished. I called the oncologist to renew the Tramadol and Gabapentin. He wasn't willing to give more Tramadol but for $4 for 100, I asked him to fill it. I told him how we saw Ben's regular vet Saturday by opportunity and what she recommended. He was not willing to give more Gabapentin than originally prescribed because "he hadn't seen Ben since January 29." I certainly didn't offer to bring him in and make that long car trip. For what? I don't think so. He said if I wanted more "I could get it from Ben's regular vet" which I did. She was more than willing to call in a prescription for 180 pills. So we're okay for now. Scott was home sick today and said Ben slept most of the day. He unstacked a few beds as Ben was having trouble with the height. Tomorrow he will be up to six a day of the Gabapentin. Tramadol is already at six. Slept a lot today but is still eating and the tail is still going. Not always at the door to greet but most of the time still. Quote Alice (missing 12/7/05), Wonder and Ben And our beloved Bridge Kids... Inky, Maui, Murphy, Ragamuffin, Della and Natalie Link to comment Share on other sites More sharing options...
greysmom Posted March 7, 2013 Author Share Posted March 7, 2013 There might be some slight sedation at the time the gabapentin is increased, but this should decrease as he becomes accustomed to the dosage. And, in the end, keeping him quiet is probably better than being *too* active. Quote Chris - Mom to: Felicity (DeLand), and Andi (Braska Pandora) siggy 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 Link to comment Share on other sites More sharing options...
Zoolady Posted March 7, 2013 Share Posted March 7, 2013 There might be some slight sedation at the time the gabapentin is increased, but this should decrease as he becomes accustomed to the dosage. And, in the end, keeping him quiet is probably better than being *too* active.Makes sense. Thank you. Ben's handling it much better than I am. Sometimes it just gets to me knowing what is probably weeks away. Thank God they live in the moment. That's probably why they have humans....to do the worrying and stressing and wondering. Quote Alice (missing 12/7/05), Wonder and Ben And our beloved Bridge Kids... Inky, Maui, Murphy, Ragamuffin, Della and Natalie Link to comment Share on other sites More sharing options...
greysmom Posted March 8, 2013 Author Share Posted March 8, 2013 Makes sense. Thank you. Ben's handling it much better than I am. Sometimes it just gets to me knowing what is probably weeks away. Thank God they live in the moment. That's probably why they have humans....to do the worrying and stressing and wondering. I always think it's the opposite! We have hounds to teach us to NOT worry and stress and wonder! Just be in the moment and enjoy life while it's happening. Quote Chris - Mom to: Felicity (DeLand), and Andi (Braska Pandora) siggy 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 Link to comment Share on other sites More sharing options...
NeylasMom Posted March 8, 2013 Share Posted March 8, 2013 True. Amputation is indeed an option, but not one that the vet feels will give her any more time. We have decided to manage the pain as best we can. And I will definitely call. A lot. There's just no way to know that, but statistically speaking the opposite is more likely to be true. I highly recommend you do a consult with an oncologist and learn about your options. Even if you choose palliative care only, there are good options outside of pain medication, namely radiation and IV pamidronate. Your vet won't be able to offer those to you. I sound like a broken record, but if you had cancer, would you just continue to see your PCP? Once you know your options and decide on a course of action, you can work mainly with your regular vet and have the onco and your vet consult if you'd prefer, but for now, get an expert's opinion on your options. Quote 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." Link to comment Share on other sites More sharing options...
Jackandgrey Posted March 8, 2013 Share Posted March 8, 2013 There's just no way to know that, but statistically speaking the opposite is more likely to be true. I highly recommend you do a consult with an oncologist and learn about your options. Even if you choose palliative care only, there are good options outside of pain medication, namely radiation and IV pamidronate. Your vet won't be able to offer those to you. I sound like a broken record, but if you had cancer, would you just continue to see your PCP? Once you know your options and decide on a course of action, you can work mainly with your regular vet and have the onco and your vet consult if you'd prefer, but for now, get an expert's opinion on your options. We don't have those available to us here as you guys do there so please keep that in mind when making suggestions. We have very few specialists without travelling really great distances.Not everyone can do that. Quote Susan, Jessie and Jordy NORTHERN SKY GREYHOUND ADOPTION ASSOCIATION Jack, in my heart forever March 1999-Nov 21, 2008 My Dancing Queen Jilly with me always and forever Aug 12, 2003-Oct 15, 2010 Joshy I will love you always Aug 1, 2004-Feb 22,2013 Jonah my sweetheart May 2000 - Jan 2015 " You will never need to be alone again. I promise this. As your dog, I will sing this promise to you, and whisper it to you at night, every night, with my breath." Stanley Coren Link to comment Share on other sites More sharing options...
Batmom Posted March 8, 2013 Share Posted March 8, 2013 Can't speak for the region in question but here, most regular vets are familiar with the basic chemotherapy protocols for various cancers. They might choose to consult with one of the universities if it were an odd case, to check up on the latest and greatest, etc., but there would be no need to see an oncologist in person in most cases. Wishing Lily (and Ben, and anyone else going through this) all the best. Quote Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in IllinoisWe miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10. Link to comment Share on other sites More sharing options...
TwiggysMom Posted March 9, 2013 Share Posted March 9, 2013 Glad to hear that Ben's dosages were able to be adjusted. Hopefully you are seeing signs that he is getting more comfortable! I'm sorry to learn of Lily's diagnosis. As others have said, treatment course is a completely individual decision. And while the stats indicate that there are significantly longer median survival rates with amp/chemo, those are just stats and have no real bearing on any individual case. I know several hounds who have made it approximately 1.5 years with palliative care, and know several who have only had 4-6 months even going with amp/chemo (and of course, there is a significant recovery period involved in the surgery). If only there were some sort of guarantee, our decisions would be much easier. I hope you and Lily have a great deal more quality time together regardless of the route you take. I never posted about Twiggy's 18-month anniversary a few weeks ago. She continues to do really well, and now that the weather is starting to get a little warmer we're going for a bit longer walks again. Her 18-month check up went well - still no lung mets, and her oncologist said that whatever they saw in her distal femur in early January couldn't have been an osteo lesion or she would be in serious pain (or probably gone) by now. He was so confident it is no longer anything to worry about that he didn't even want to re-do xrays! So, we continue to celebrate and take advantage of each day! Quote Wendy with Twiggy, fosterless while Twiggy's fighting the good fight, and Donnie & Aiden the kitties Link to comment Share on other sites More sharing options...
BauersMom Posted March 9, 2013 Share Posted March 9, 2013 What wonderful news about Twiggy! Quote With Buster Bloof (UCME Razorback 89B-51359) and Gingersnap Ginny (92D-59450). Missing Pepper, Berkeley, Ivy, Princess and Bauer at the bridge. Link to comment Share on other sites More sharing options...
tbhounds Posted March 10, 2013 Share Posted March 10, 2013 What wonderful news about Twiggy! Times two!!!!!!! Quote Link to comment Share on other sites More sharing options...
4My2Greys Posted March 10, 2013 Share Posted March 10, 2013 Make that times three!!! Quote Link to comment Share on other sites More sharing options...
krissn333 Posted March 10, 2013 Share Posted March 10, 2013 Twiggy! Quote 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.-- Link to comment Share on other sites More sharing options...
Charlies_Dad Posted March 10, 2013 Share Posted March 10, 2013 Way to go Twiggy!!! Quote 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. Link to comment Share on other sites More sharing options...
joejoesmom Posted March 11, 2013 Share Posted March 11, 2013 Wendy, I am just so happy for you and Twiggy! Jane Quote Link to comment Share on other sites More sharing options...
greysmom Posted March 11, 2013 Author Share Posted March 11, 2013 Twiggy! Quote Chris - Mom to: Felicity (DeLand), and Andi (Braska Pandora) siggy 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 Link to comment Share on other sites More sharing options...
lilythetigerdog Posted March 14, 2013 Share Posted March 14, 2013 What great news about Twiggy!!! You must be so relieved!! A quick update on Lily-hound... She is doing well on her 3 doses a day of Taramadol (50mg) plus one dose of Metacam a day. Her limp is amost gone - she limps a bit if she gets up from sleeping on her bad leg, but otherwise is a prancing, zooming girl :0) I took the day off work yesterday to hang out with her. We put some seeds in the squirrel feeder and spent some time watching "wildlife" in the yard. Quote Image removed. Not within the GreyTalk signature guidelines of <15 KB file size limit. Your image was 17.51 KB (17,929 bytes) file size. Link to comment Share on other sites More sharing options...
BauersMom Posted March 15, 2013 Share Posted March 15, 2013 Our "honorary pack member" Jewell was just diagnosed with osteo in her knee. I really hate this disease. Here she is with Berkeley several years ago. Quote With Buster Bloof (UCME Razorback 89B-51359) and Gingersnap Ginny (92D-59450). Missing Pepper, Berkeley, Ivy, Princess and Bauer at the bridge. Link to comment Share on other sites More sharing options...
RaineysMom Posted March 15, 2013 Share Posted March 15, 2013 oh God not another. :( sending hugs and prayers to you. Quote Kim and Bruce - with Rick (Rick Roufus 6/30/16) and missing my sweet greyhound Angels Rainey (LG's Rainey 10/4/2000 - 3/8/2011), Anubis (RJ's Saint Nick 12/25/2001 - 9/12/12) and Zeke (Hey Who Whiz It 4/6/2009 - 7/20/2020) and Larry (PTL Laroach 2/24/2007 - 8/2/2020) -- and Chester (Lab) (8/31/1990 - 5/3/2005), Captain (Schipperke) (10/12/1992 - 6/13/2005) and Remy (GSP) (?/?/1998 - 1/6/2005) at the bridge"Always do sober what you said you'd do drunk. That will teach you to keep your mouth shut." -- Ernest Hemmingway Link to comment Share on other sites More sharing options...
krissn333 Posted March 16, 2013 Share Posted March 16, 2013 Say a little prayer for us tomorrow...Ace has been limping since Monday-left front leg. Full story is here: http://forum.greytalk.com/index.php/topic/296342-good-thoughts-for-my-peanut-puppy-please/?p=5465887&do=findComment&comment=5465887 I am trying not to worry, but as you all know, that dreaded diagnosis is always at the back of my mind, and it shows no mercy, doesn't care that it has already taken two of my babies from me Quote 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.-- Link to comment Share on other sites More sharing options...
krissn333 Posted March 16, 2013 Share Posted March 16, 2013 X-rays were ALL CLEAR So we just have quite a bit of inflammation, and she needs to go for acupuncture for her neck. We just got home and she's resting comfortably Quote 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.-- Link to comment Share on other sites More sharing options...
Guest dmt Posted March 16, 2013 Share Posted March 16, 2013 That's great news! Quote Link to comment Share on other sites More sharing options...
Zoolady Posted March 17, 2013 Share Posted March 17, 2013 Yaay Ace. Time to breathe again. Update on Ben: He seems to be losing muscle mass in his legs and some in his body. He is not using the leg on the side of the tumor and drags his foot going up and down the two plus one step to outside. His "good" leg sometimes shakes supporting him when he pees. Today we gave him 300 mg of Gabapentin this morning, going to 900 a day today. He had his normal three this afternoon. He vomited tonight around 6:30 all this yellowish orangeish liquid and about 30% of his breakfast. The odor was very bad and he has been passing some evil farts the past couple days which we have been attributing to all the meds. Tonight Scott is making him rice. He is laying in bed now with his head up, panting. I don't know if any meds were in the vomit. He just tried to stand up and manged although a little shakey, laid back down and a minute later let out a little scream. He had a leg in a bad position and couldn't move it. Scott helped him and he is laying comfortable now although still panting. I should probably call the vet Monday unless he gets worse. The hospital is open 24 hours a day and is five minutes from the house. Quote Alice (missing 12/7/05), Wonder and Ben And our beloved Bridge Kids... Inky, Maui, Murphy, Ragamuffin, Della and Natalie Link to comment Share on other sites More sharing options...
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