Osteo Thread Part Vi

[Victor]

I'm glad to hear that Lana is home!

 

Right now, sleeping is what she really needs to do. (But eat a little more, OK Lana?) This is going to be a tough road for all of you for at least the first week, and it still won't be quite back to normal for several more weeks after that.

 

If she doesn't start at least drinking a bit of water, you may want to try to syringe a bit over her tongue to stimulate her to drink some. Since she isn't on iv fluids any more, you do want to be sure she is staying hydrated.

Thanks, Wendy! I guess you're right; sleep is what she really needs right now. I just wish she'd show a little more interest in food or drink. She was this way after her fine needle aspiration, too. I think it's her way of showing her displeasure. If she doesn't drink tomorrow we'll try a syringe.

 

Here's a photo of Lana smelling—but not touching—some delicious beef soup:

 

[krissn333]

Wow, that's quite a position! Hope that swelling goes down. Don't forget to massage it a bit. It pools sometimes and becomes more uncomfortable. Feels kind of like Stretch Armstrong but it'll get better.

 

Glad she's home

[Guest bozicj]

Wanted to share a little hiccup that I encountered in getting the free chemo from OSU. Since Python is getting her treatment as part of a research study at the University of Minnesota we're not able to get the free chemo

 

This isn't because of the research study. Because the university pharmacy is licensed as a "pharmacy" versus a "dispensary" (most vet offices are dispensaries, I guess) there are laws that prevent it (because of what a pharmacy is allowed to accept from another facility; they're not allowed to accept a compound that will then be changed to be given via IV unless they get it directly from the manufacturer BUT since OSU has their own agreements with the manufacturer which dictate what their terms are to get the chemo)

 

So, we'd have to get it drop shipped from the manufacturer for the U to be able to accept it BUT that's not possible to do and comply with OSU's agreement to get it in the first place... le sigh! It's good that pharmacies are so heavily regulated, but sometimes it sucks...like now.

[Victor]

2 days 16 hours post amputation

 

Lana slept through the night without incident. This morning we gave her a little skim milk to get her to drink something. (She loves milk, and she seems to tolerate it okay.) After the milk, she seemed to be comfortable on her bed, so we took a minute to get some things from the kitchen. A moment later we suddenly noticed Lana standing in the dining room! She had gotten up and hopped out all by herself! We quickly grabbed the sling to support her, but she seemed to be standing okay without it.

 

We figured she was hungry, so we opened a jar of baby food and she gobbled it down. By then her leg was swelling up again, so we took her back to her bed to lie down. We gave her some strips of pan-fried beef, which she kindly ate for us. When I asked Duke if he wanted to go out, Lana started getting up so I took her out to the yard to go potty (#1). Now she's resting comfortably, and Duke is keeping her company:

 

 

Lana has her Fentanyl patch and gabapentin (200mg twice a day) for pain. We also have Rimadyl in case she needs it, but so far she seems to be doing okay without. In addition to the pain meds, she's taking the antibiotic Clavamox (500mg twice a day), aminocaproic acid (500mg three times a day), and fluoxetine for anxiety (20mg twice a day). Thank goodness we took Wendy's advice and made up a medication checklist!

Edited July 13, 2013 by Victor

[Victor]

Wanted to share a little hiccup that I encountered in getting the free chemo from OSU. Since Python is getting her treatment as part of a research study at the University of Minnesota we're not able to get the free chemo

 

This isn't because of the research study. Because the university pharmacy is licensed as a "pharmacy" versus a "dispensary" (most vet offices are dispensaries, I guess) there are laws that prevent it (because of what a pharmacy is allowed to accept from another facility; they're not allowed to accept a compound that will then be changed to be given via IV unless they get it directly from the manufacturer BUT since OSU has their own agreements with the manufacturer which dictate what their terms are to get the chemo)

 

So, we'd have to get it drop shipped from the manufacturer for the U to be able to accept it BUT that's not possible to do and comply with OSU's agreement to get it in the first place... le sigh! It's good that pharmacies are so heavily regulated, but sometimes it sucks...like now.

Sorry to hear this, Jeni! Do the chemo drugs have to be shipped to the University of Minnesota pharmacy? Could they be shipped directly to your oncologist at the University of Minnesota instead?

[Guest bozicj]

Sorry to hear this, Jeni! Do the chemo drugs have to be shipped to the University of Minnesota pharmacy? Could they be shipped directly to your oncologist at the University of Minnesota instead?

Unfortunately they can't do that either since the oncologist can only administer drugs they get from the vet pharmacy.

[TwiggysMom]

Shoot, I'm sorry to hear the the OSU chemo won't work with UM administering it. I never knew about those restrictions. What study is Python in? Hopefully, there are also some financial benefits to participating - maybe that will make up somewhat for not being able to take advantage of OSU's chemo.

 

How is Python doing otherwise? Has her crying settled down some?

 

Victor, I'm glad to hear Lana has started eating some for you. You guys have quite the recovery room for her! She looks quite comfy with her leg propped up and her head on an extra pillow. How nice of Duke to keep her company!

[EllenEveBaz]

Love the pic of Lana and Duke. Sending best wishes to Python and all the rest of the gang.

[Victor]

Victor, I'm glad to hear Lana has started eating some for you. You guys have quite the recovery room for her! She looks quite comfy with her leg propped up and her head on an extra pillow. How nice of Duke to keep her company!

Thanks, Wendy! Lana's really taken to eating steak.

 

Love the pic of Lana and Duke. Sending best wishes to Python and all the rest of the gang.

Thanks, EllenEveBaz!

[Guest bozicj]

Python has pretty much stopped crying constantly since her patch was removed and we have some anti-anxiety meds now too.

 

The new bad news is that she has an infection and the incision is trying to open up a bit and there might be some necrotic cells which will need to be debrided... we're on bandage number three since Wednesday because of the seepage.

 

She seems blissfully unaware of any of these complications though. More energy and mobility every day. She's eating well again and seems to be in little to no pain.

 

It's a toss-up I guess

Edited July 14, 2013 by bozicj

[MrAlexTheDog]

a picture of katie taken yesterday:

 

today was her best day yet since surgery. she wanted to go outdoors a number of times; she left her incision alone all day while not wearing a t-shirt; ate quite a bit.

[Guest FawnFan]

I'm sorry to hear of all of the new members who joined this club recently. Just read through 5 or 6 pages of updates and glad to hear everyone who had amps are doing well and are home resting comfortably.

 

And Kristen I'm so sorry to hear about Ace's passing. You certainly have been through a lot over the past year with your hounds. Sending lots of hugs to you.

[Charlies_Dad]

Beautiful pic of Katie. Looks like she is coming along nicely!

[TwiggysMom]

Python has pretty much stopped crying constantly since her patch was removed and we have some anti-anxiety meds now too.

 

The new bad news is that she has an infection and the incision is trying to open up a bit and there might be some necrotic cells which will need to be debrided... we're on bandage number three since Wednesday because of the seepage.

 

She seems blissfully unaware of any of these complications though. More energy and mobility every day. She's eating well again and seems to be in little to no pain.

 

It's a toss-up I guess

I'm glad that it was the fentanyl patch causing the crying and that it was able to be removed.

 

I specifically wanted to comment on the infection. First, it sounds like it was caught pretty early, which is great. Hopefully it will turn out to be a strain that will be easily treated with antibiotics. There is evidence that dogs who incur an infection while healing from their amp actually have longer survival times than those who heal without infection. It sounds crazy, but apparently the thought is that the infection somehow "wakes up" the dog's immune system and enables it to fight the cancer better. So, while this is a rough patch that I know you'd rather not go through, there may be some benefit to it in the long run.

 

I've mentioned this quite a few times in here, but you might not have read it - Twiggy had a terrible infection in her incision, she had to be hospitalized for 5 days to cure it. This may be a contributing factor to why she continues to do so well. The first thing Twiggy's new oncologist said to me when I told him this part of her story was: "well, you know that dogs who get infections have longer survivals, right?"

 

Steve - that is just a beautiful picture of Katie. She looks so happy to be relaxing out in the yard!

[Victor]

Lana 3 days 9 hours post amputation

Lana woke at 12:40am panting heavily. We tried to comfort her, but she just wouldn't stop panting and crying. Then she started pacing around the house. She would lie down in one spot, cry out, and then get up to look for another spot. At 2am I called the vet, who recommended an additional dose of gabapentin. This didn't help, so at 3am I took Lana to the ER. The vet checked Lana's vitals and her incision. Everything looked okay so she decided to replace Lana's Fentanyl patch; apparently the efficacy of the patch drops significantly after 3 days.

When we got home at 5am, Lana was still in pain, but it seemed to be getting better. We gave her an acetaminophine/codeine to help cover the 6-12 hour period during which the patch reaches maximum pain relief. (Lana can't have tramadol since it interacts with fluoxetine.) At 8am Lana received her usual barrage of meds and by 10am she was sleeping comfortably. Poor puppy. I feel terrible that we couldn't relieve her pain sooner.

Edited July 14, 2013 by Victor

[Guest bozicj]

I'm glad that it was the fentanyl patch causing the crying and that it was able to be removed.

 

I specifically wanted to comment on the infection. First, it sounds like it was caught pretty early, which is great. Hopefully it will turn out to be a strain that will be easily treated with antibiotics. There is evidence that dogs who incur an infection while healing from their amp actually have longer survival times than those who heal without infection. It sounds crazy, but apparently the thought is that the infection somehow "wakes up" the dog's immune system and enables it to fight the cancer better. So, while this is a rough patch that I know you'd rather not go through, there may be some benefit to it in the long run.

 

The clinical trial that she's in is exploring the same thing. They are given salmonella-IL2 at the same time as their chemo treatments. The theory is probably the same. The way our oncologist explained it is that the body is very good at fighting cancer but that cancer is really good at convincing the body it's "normal" so their hope is to induce an infection so the body fights it and the cancer as well. She has only had one dose of the salmonella at her initial biopsy (about 10 days ago) and will then get them at each of her chemo treatments.

 

So glad to read your comment, it reminded me why I'm doing this

[TwiggysMom]

The clinical trial that she's in is exploring the same thing. They are given salmonella-IL2 at the same time as their chemo treatments. The theory is probably the same. The way our oncologist explained it is that the body is very good at fighting cancer but that cancer is really good at convincing the body it's "normal" so their hope is to induce an infection so the body fights it and the cancer as well. She has only had one dose of the salmonella at her initial biopsy (about 10 days ago) and will then get them at each of her chemo treatments.

 

So glad to read your comment, it reminded me why I'm doing this

Wow, that's very interesting. I wondered whether there could be a study involving inducing infection, but it seemed that it would be hard to control something like that. Will the infection Python has interfere with their results, or will she be classified in a different group of the study?

 

I do hope that a definitive correlation between infection and survival rates can be found. When I first read about the theory (this was just before her surgery), a thought flashed through my mind hoping that Twiggy would get an infection, I was immediately horrified at myself for thinking that, and then blamed myself when she actually got one. Fortunately, she survived it (survival was questionable for a while), and now maybe it is extending her life!

 

Lana 3 days 9 hours post amputation

 

Lana looks fantastic! Her incision looks so clean and neat, and she seems to have very little bruising! How's the edema doing? It's hard to tell from the picture, but I don't really see much of that, either.

 

I'm sorry she (and consequently the rest of you) had such a rough night. Hopefully the fentanyl patch will keep her pain control pretty even. The pain should be starting to get a bit better for her over the next few days.

[Victor]

Lana looks fantastic! Her incision looks so clean and neat, and she seems to have very little bruising! How's the edema doing? It's hard to tell from the picture, but I don't really see much of that, either.

 

I'm sorry she (and consequently the rest of you) had such a rough night. Hopefully the fentanyl patch will keep her pain control pretty even. The pain should be starting to get a bit better for her over the next few days.

Thanks, Wendy! The bruising and edema are indeed much better. When Lana gets up to go out her leg still swells up, but the swelling goes down again after we massage it and/or elevate it. The new Fentanyl patch seems to be managing her pain (knock on wood). Fingers crossed we can get some sleep tonight!

[krissn333]

Lana and Python are perfect examples of how one method of pain management doesn't work for everyone...glad that everyone is more comfortable

[Guest bozicj]

Wow, that's very interesting. I wondered whether there could be a study involving inducing infection, but it seemed that it would be hard to control something like that. Will the infection Python has interfere with their results, or will she be classified in a different group of the study?

 

I do hope that a definitive correlation between infection and survival rates can be found. When I first read about the theory (this was just before her surgery), a thought flashed through my mind hoping that Twiggy would get an infection, I was immediately horrified at myself for thinking that, and then blamed myself when she actually got one. Fortunately, she survived it (survival was questionable for a while), and now maybe it is extending her life!

I'm not sure what her current infection will mean for the study. My guess would be that they just won't start her chemo until this infection is under control, and then she'll be treated normally.

[greysmom]

Dude's chemo was put off for about 8 days due to his infection. He had to go back in for surgery to debride the area and have a drain put in. Once that was resolved, we went ahead with treatment as normal.

[Guest bozicj]

Dude's chemo was put off for about 8 days due to his infection. He had to go back in for surgery to debride the area and have a drain put in. Once that was resolved, we went ahead with treatment as normal.

She had surgery and debridement yesterday (they switched her to a tie on bandage) and will want to see her every day to change it. Once there is some healthy tissue again we'll be able to stop that but there's a chance she'll have to have surgery again to properly close the incision again.

 

On the upside, she seems completely oblivious to most of this and is getting more and more back to her old self every day.

[cristar]

Boy Jeni,

I was just reading through this thread and saw your posts.

After hearing about Python's leg trouble at the picnic, I was hoping that this wasn't going

to be the outcome but it sounds like she's coming along pretty good.

Hoping things keep getting better and better for your girl.

Hugs to you sweetie.

 

Marcy

[MP_the4pack]

Diamond had an infection after her amp. They had to culture it to find the right antibiotic to use since the general antibiotic wasn't working.

 

She lived 6 months before OS claimed another leg.

 

So I'm not sure I believe in infection being a good or bad thing. But once the infection cleared up, she was right as rain and nothing could stop her. It seems the magic mark for her was 2 weeks.

[Victor]

Lana 5 days post amputation

Lana did much better last night. Although she didn't quite sleep through the night, she made it to 4am before crying out. We're not sure why she cried out, but we think she may have been changing positions, because we found her standing on her bed when we got the lights on. She was panting heavily, so we gave her some acetaminophen/codeine and alprazolam. After about an hour of reassurance, she calmed down and went back to sleep.

This morning Lana had more of an appetite than she's had these past few days. She even ate some chicken and rice, in addition to her baby food and pan-fried beef. Afterwards we took her outside and she started out on her usual morning route! She tired quickly, though, and I had to carry her back home.

The bruising and edema are much better today: