Osteo Thread Part V I I

[Guest fastcasper]

Call me wishy washy. I am going to do 1 round of Doxo and see how Casper tolerates it. If he is fine, then I will do 2 rounds and either stop treatments or switch over to oral Cytoxan (depending on his x-ray results). It's been a hard week of thinking and my brain hurts. I guess I had a dream about it and I need to say we tried everything. Again, Jay, thanks for your insight and others. I am super nervous for Casper. He had a good week, I have him on Artemin and cordyceps, so at least he wasn't completely untreated this week.

 

Kim and Casper

[Charlies_Dad]

Kim, we are all pulling for Casper and will be here for you both. Going one round is not a big deal, see how he tolerates it. Then make the switch if you need to. I understand exactly how you are feeling, to exact to be a matter of fact and my heart goes out to you. I hope that Casper tolerates the Dox well and please keep us updated.

[Guest fastcasper]

Thank you. I will keep posted what happens to my baby boy! Fingers crossed for Casper!

 

Kim and Casper

[Guest Taras]

How do you know its time to say goodbye.. Im really having a hard time with this. The good days still out number the bad. And sometimes i think its time and then he (Treetop) will get up and trot across the room and play bow and i go ok nope not yet. Watching this beast of a disease grow on his side has been hard. We have kept it a bay since june but it no longer responds to any thing. I hate this , i hate this. I know we all say you'll know when but i hope my heart and brain will agree . He has had a good life and been loved more then words can say. Sorry for the rambling. I just had to get out of my head.

[45MPHK9]

I'm sorry that you're faced with this awful decision, Tara. Osteo is a cruel disease. I wish you peace.

Edited November 28, 2013 by 45MPHK9

[greysmom]

It's OK to ramble. This is the. hardest. decision. ever.

 

{{{{{hugs}}}}} for you and Treetop.

[Charlies_Dad]

Tara, I am sorry. It is not an easy decision and it is sometimes difficult to know the 'right time'. It's a deeply personal decision and you know Treetop best. If his good days still outnumber his bad and if his pain in controllable by meds then perhaps it's not time but the facts are this disease takes no prisoners and is a battle you can't win. You can delay it and give your pup as much quality time as possible but in the end it up to us to help our pups on their final journey. I am sorry you are having to contemplate this now with Treetop. Our thoughts are with you.

[TwiggysMom]

Tara, I am so very sorry that it is at the point where it is difficult to evaluate the good vs. bad time. You and he have fought this very well. Only you can know when it the time comes. I hope he is able to give you a good signal, and that you can arrive at a peaceful decision, whenever that may be.

 

Kim, when is Casper scheduled for his doxo? I hope he does well with it! I think the first round of a new chemo usually goes pretty well (especially with Cerenia on board prior and after), so I am hoping for good results with little to no side effects from this!

 

I am stunned to be able to say that Twiggy will have her 6th gotcha day this Sunday. I wasn't guaranteed a 4th with her, so this is truly special and unexpected.

[KF_in_Georgia]

Tara, my Sam had arthritis and a number of other issues--not osteo. He was taking gabapentin and methocarbamol and tramadol and a host of other meds, and he was maxed out on the pain killers.

 

He still loved going for walks (although he had back-end issues). He still loved cuddles. And he loved his food and his toys and his naps.

 

But he had one night where he panted all night long. He didn't cry out in pain or anything, but he just couldn't sleep--despite all the meds--and that's what did it for me.

 

Yes, he might have had better days left. But he most assuredly would have had nights as bad--or worse--so I took him to the vet that next morning and we let him go.

 

That was in August, and I've missed him like crazy. But I don't wonder if I acted too quickly. I'm glad I didn't wait until he no longer enjoyed his food and cuddles. I've wished he could have stayed longer--for my sake. But for his sake--once I was no longer able to make the bad times be less bad--it was time.

[jaym1]

But he had one night where he panted all night long. He didn't cry out in pain or anything, but he just couldn't sleep--despite all the meds--and that's what did it for me.

 

that's what did if for tempo. i'm sure he still would have had some good times left, but terrible times were clearly coming. after two nights when he was up panting the whole time, i decided to let him go. because i did it a little early, rather than a little too late, his last day was beautiful. we went to the park and the sun was shining and i fed him two giant meals of his favorite food, then he went and visited his friends at the animal hostpital.

 

i still look back at the last day with a lot of sadness. but i can only imagine how much worse it would have been had that last day NOT been a good day. the vet was crying when he died, but tempo never noticed. it's very difficult, but it's the best for all involved if you can let them go a little early.

[a_daerr]

My 5-year-old, Henry, was just diagnosed today.

Amp is scheduled for Monday. After I get past the initial shock, I'll be anxious to read through this thread.

[jaym1]

unbelievable. the number of participants in this thread whose dogs go on to get osteo is shocking and beyond my ability to understand, if statistics are to be believed.

 

im really sorry to hear this. let me know if you need any advice.

[greysmom]

I'm so sorry you're having to join this Club Alicia. Is Henry a front leg or a rear leg amp?

 

 

{{{{{hugs}}}}}

[TwiggysMom]

Alicia, again I am so sorry you and Henry are going through this. I know you were so well-prepared, but it's different when you're actually faced with the reality of it all.

 

There are links to the original and 2nd Osteo Threads on page 1 here, but not to the rest, so let me try to link them here (I'm sorry I don't know how to give links nice short names), in case you want to peruse them.

 

Part III:

http://forum.greytalk.com/index.php/topic/274810-osteo-thread

 

Part IV:

http://forum.greytalk.com/index.php/topic/279977-osteo-thread

 

Part V:

http://forum.greytalk.com/index.php/topic/286427-osteo-thread-v

 

Part VI:

http://forum.greytalk.com/index.php/topic/292972-osteo-thread-part-vi

 

Beyond all the normal amp-prep advice, I have one weird tip - if it won't be too stressful, give him a bath first. I still think a very likely reason that Twiggy got her infection is because she walked in the hospital with it already on her body. If I'd just bathed her, she might have avoided an additional 5-day hospital stay and a very painful infection.

 

You can use the time while he is in the hospital to set up a good safe recovery area for him and you to stay in, stock up on easy-to-prepare (or pre-prepared) meals for you, make sure you've got enough food on hand for him for a while, and some good stuff for giving pills in - there's so many pills! Set up a schedule for the pills, and cross-check the medication instructions on the bottle versus the discharge papers, I found several discrepancies between the two and had to call to clarify.

 

Be prepared for him to not seem at all like himself when you first see him, and for the first couple weeks - it WILL get better! Also, be prepared for the bruising. As bad as it looks initially, it will get worse before it gets better.

 

Also, he should be getting a little better every day, not worse. If you feel he is backtracking, make sure to investigate. I called when Twiggy was clearly in increasing pain and was told that she shouldn't be feeling worse, but it was OK to up her pain meds a little. I'm mad at myself for not pushing beyond that advice - when bandage change day came, we saw that the reason for her increasing pain symptoms was the bad infection she'd developed.

 

All my best to you and Henry, I hope he is staying comfy this weekend - I know he is happier to be at home with you, rather than staying the hospital!

 

It looks like my links work, but have all of my search terms highlighted, so they may be a pain to look through. If anyone can do a better job with the links, please do!

Edited November 30, 2013 by TwiggysMom

[Guest fastcasper]

Hi everyone,

Just checking in and updating you on Casper. He went for his round of Doxo. He had a reaction upon administering the drug. They gave him Benadryl and a pain med. That seemed to do the trick but he was totally wigged out for the rest of the day and night. He was feeling better in the morning, but was tired from the day before. He struggled with eating. On Thanksgiving day he wanted to go for a walk and we went farther than I thought we would but I didn't push it too much. He also was chasing Wynnie in the yard and being chased. He is much better and his eating is returning to normal. I told the doctor that if he was going to have another bad day and a half after the next round, then I rather not do round number two. He days are numbered and we can't afford for him to waste them. He gets his blood checked this week and then is scheduled for Dec. 10th for his (possible) second round and I think we are stopping Doxo after that. I don't want to risk weakening his heart muscles. We will stop if the mets did not recess and if they did , we will switch to an oral protocol.

 

I had a grey with cancer in her throat and the chemo controlled it for about 7 months and then we stopped the treatments when the tumor had gotten bigger. She had some great days and I watched her like a hawk for her to give me a sign that it was time. That came when she did something very out of character for her and I knew that was the sign. Her last day was spent taking a short walk, laying by a roaring fire, and eating practically a whole jar of peanut butter. The vet came to the house and she passed on her favorite part of the couch. I share this because I hope Treetop gives you a sign, but I especially hope you know it's a sign for him to go. It was very hard to say good bye, but I also was relieved in a way because I had the final say not the cancer! She left this world with all her dignity in tact and that is very important to me for my greys. I think greyhound are one of the most beautiful dogs(ever!) and they deserve to go to the bridge with dignity.

[MrAlexTheDog]

i'm peeking in to see how everyone is doing. i'm happy about the good news that i've read so far, and saddened by the not-so-good news and the additions of those who are now affected by it. know that i think of you all.

 

we've not seriously looked at adopting another grey yet, but we talk a lot about it at times. we'll get another -- of that i am sure (we might even pursue a grey puppy!). in the meantime i find myself browsing through all the pictures of katie that i took from the day we got her in november, 2004, to her final day with us two months ago. i'm really glad that i took them, and only regret that i didn't take more. sadie has handled being an only dog much better than i thought, but she could use a companion.

[a_daerr]

I'm so sorry you're having to join this Club Alicia. Is Henry a front leg or a rear leg amp?

 

{{{{{hugs}}}}}

Right rear, tibia.

 

Anybody know where I can/should purchase one of those nanny cams so I can monitor him during the day? I'm going to take some time and set up our living room as Henry's personal 'recovery zone.' I'd like to be able to check in on him, like Tempo's dad did.

 

Also, up until the aspirate, he was acting normal. Good appetite, playing, trying to run in the yard. Now he seems in much more pain. Not acting himself, barely moves from his bed. He isn't eating much, so I've been making special food to entice him- scrambled eggs, chicken and rice, canned food, etc. Is the biopsy painful? Could it just be the meds?

 

Also, the vet didn't mention how long he'd be hospitalized following his amp. I'll speak to them tomorrow, but I'm curious. How long until he'll get to come home?

 

P.S. Wendy, I'm going to take your advice and give him a bath tomorrow. He'll like that.

[jaym1]

i just used my open laptop along with ustream. skype works, too. positioned correctly, its perfect for monitoring.

 

for a rear leg amp with no complications i'd say two or three days post-op. if i recall correctly, tempo was in for four, including his surgery.

[a_daerr]

Okay, that's reassuring. I would be a nervous wreck if they tried to send him home the same day or something.

 

Another question to those who have gone through this. How did your other pets respond? Truman, who usually gets into trouble and prefers "his" space has been doing this a lot.

 

 

 

Also, my cat, who is not cuddly or clingy, and hardly ever ventures downstairs, was camped out by my sewing table with me for hours today. This is very out of character for him. In the first picture, you can see him lying on the pillow next to the dogs. Although he does like to snuggle with Truman in our bed, this is the first time he's been downstairs hanging out with both dogs.

 

 

 

Do they sense or smell that something is wrong with Henry? Are they picking up on my anxiety and grief? Or is this likely a huge coincidence, and I'm just reading way too far into it? I'd be curious to hear your stories and experiences with other household pets during a battle with cancer.

[Victor]

Sorry to hear about Henry. Our Lana had her right hind leg amputated in July due to osteo of the right distal femur. She had a needle aspiration beforehand too, and it did seem to cause her pain afterwards. Lana was in the hospital for three days (two nights). I second Wendy's recommendation to give Henry a bath before surgery if you can, since it may be a while before he can have another bath. We bathed Lana and were glad we did, although she still ended up contracting a staph infection.

 

Our other greyhound, Duke, never used to lay next to Lana, but he does it quite often now. They say dogs can tell when people have cancer, so I wouldn't be surprised if they can tell when other dogs have cancer.

 

I assume you've talked to Wendy or someone else about getting Henry on Amicar starting the day of surgery? I highly recommend starting him on gabapentin, too. It'll help control the postoperative pain (along with whatever other painkillers they give Henry) and reduce the likelihood of phantom pain in the future. You might also ask your surgeon/anesthesiologist about doing an epidural block. There are some studies that suggest this can help reduce the likelihood of phantom pain, too.

 

I hope Henry's surgery goes well! Let us know if you have any questions about postoperative care. The first 2-3 weeks are definitely the hardest.

 

--

 

Update on Lana: she saw her oncologist the day before Thanksgiving. Her chest x-rays showed that the largest met had actually decreased in size a little, while the second largest had increased in size. We're going to start Lana on cytoxan as soon as it arrives (hopefully Monday).

Edited December 1, 2013 by Victor

[jaym1]

rocko never noticed anything was amiss. it was actually pretty infuriating at times, because i occasionally felt like he was taking advantage of tempo's slow readjustment, but really he was just doing what dogs do.

 

as to the surgery: i recall them saying i could take tempo home surprisingly fast. maybe it was on the second day, but i wanted them to keep him in. the insurance made that possible.

[4My2Greys]

 

 

 

Part IV:

 

 

 

Beyond all the normal amp-prep advice, I have one weird tip - if it won't be too stressful, give him a bath first. I still think a very likely reason that Twiggy got her infection is because she walked in the hospital with it already on her body. If I'd just bathed her, she might have avoided an additional 5-day hospital stay and a very painful infection.

 

 

Wendy, I wonder though if the infection Twiggy fought is one of the reasons for her long survival time. I think someone mentioned it in one of the threads. It is believed that by having to fight the infection the body's amped up immune system also fights the cancer better.

Alicia I found something you might find interesting on this.

 

http://www.iwfoundation.org/articles_detail.html?item_id=42&year=2009

 

Over 100 years ago, an orthopedic surgeon at Memorial Sloane Kettering, names William Coley, injected a concoction of live bacteria into his human patients with osteosarcoma 1 . He documented some complete remissions in people that were known to have aggressive disease using this early form of immune therapy. More recently other investigators have used different strategies to activate the immune system in dogs with osteosarcoma to try to achieve the same effect 2-4 . Interestingly in these studies, the use of immune therapy prolonged overall survival in a number of dogs with osteosarcoma, after amputation. Finally, it is known that dogs that develop bacterial infections at the surgical site after amputation tend to have longer survival times than dogs that do not develop infections at the surgical site, again suggesting that activation of the immune system (in this case by the natural bacterial infection) may help in preventing the tumor from recurring 5 .

 

Taken together, these findings suggest that osteosarcoma might be a cancer that is amenable to immune therapy. To enhance the success of immune therapy and to reduce the chance of adverse side effects, it is necessary to identify a particular marker that is uniquely expressed by the cancer cells. The immune system can then be trained to recognize cells that express this marker and then kill them. Osteosarcoma cells express a marker known as Her2/neu (the same marker found in some women with breast cancer) 6-9 . Training the immune system to recognize and kill cells that express Her2/neu represents a promising strategy to treat osteosarcoma in dogs.

[Charlies_Dad]

Alicia, yes other animals know when another is sick so that could be the reason or he could be reading your emotions.

 

As for hospital time, a lot of that has to do with you and your pup. Some pups don't handle vets well so it's better they come home as early as possible however be prepared that this means more work and stress for you. Charlie was in for 5 days (Fri-Tues) at a 24/7 hospital with full-time staff 24hrs so was well looked after. It cost most as it was about $1000/day however when he came home, he was very calm and easy going. I preferred this as both Lynn and I were stressed out enough and knew we would not do well if something were to happen a day or two after major surgery.

[krissn333]

Pinky came home 24 hours after she woke up from surgery, but, that's not the norm.

 

She was crabby at the vet's office and wanted to be up and moving around much more than she was able to there hooked up to an IV, so, Dr. Less had told me the morning after her surgery that if she was doing well moving around and would eat for them, he would send her home with me that afternoon.

 

Be prepared for him to try to do things before you are ready. Less than 24 hours after she came home, Pinky was getting up on the couch. It was her favorite spot and where she was most comfortable.

 

I set up the airbed in the living room and lived out there for a week. After that week, I had to go back to work, so my mom came up and stayed with her during the day for a week, then started coming just at lunch time to check in on her.

 

As for how my other dogs acted...I kept the littles in an ex-pen because I was worried they'd step on her. But the three other greyhounds were fine. Everyone inspected her when we got home and that was it. I started out trying to take her out alone, but, she would get out in the yard and look around for the rest of them, so, I put them all out with her and no one was too rough.

[greysmom]

We had three other greys in our tiny house when Dude had his amp, so I actually *wanted* him to stay in the hospital an extra day or two. Just so he was really up and able to move around well. I think he was there four days after his surgery (he was there three days prior as he had broken his leg on a weekend and we had to wait for surgery time).

 

Dude had spent considerable time as a tripod a couple years before when a toe amp went wrong. He spent three months in a splint and basically tripodded the entire time, so we knew already he would be fine with only three legs. The first thing he did when we brought him home was RUN around the yard (I almost passed out!) and do a big poop. Then he went in, everybody had a good sniff, and they all laid down and were fine.

 

We set up an xpen in the living room so he would get stepped on, but took it down within a day. We did have to block off the stairs to the second floor as he tried to do them right away and that wasn't going to happen, at least on his own. He was too heavy for us to carry so he had to wait until his stitches were out. He then taught himself how to do stairs three-legged, and never looked back.

 

You WILL need help the first two weeks. Just having someone else there while you take a shower, or run out for groceries (see if you can get delivery where you are), or even just take a stress-free nap can be invaluable help.

 

This journey is one of the hardest you will ever have to take. And in some ways, one of the most rewarding. The dogs don't know they're supposed to be sick and never getting better. They have such joy in their life, and make you feel that way too. Many of us have remarked that our tripods often show us something "extra" about their personality following an amputation. They seem to be *more* of themselves, or bigger somehow. I hope you have many good days and weeks and months with your special Henry!