Osteo Thread Part 8

[4My2Greys]

I'm sorry to hear that Diamond's cancer has spread like it has, but glad that you still have more time to spend with her. Enjoy and treasure each moment given

[Rickiesmom]

I have a question about Artemisinin. I understand that some people give it every day, and some people do week-on, week-off, and I think somewhere I read that it is better to pulse it, though I don't know where I saw that or what the rationale is.

If those of you who have given it to your osteo hounds would chime in with what you did and why, I would be very appreciative as it will help clarify my thinking.

Jaynie will have her final Carbo treatment next week (yay) and I would like to go into the consult with the oncologist with as much information as possible.

Also . . .

I got hold of the histology report and it's mostly incomprehensible to me. I spent a lot of time googling terminology, but couldn't really put it all together. I gather the mitotic index is low (good) but the necrotic tissue is a bad sign.

If anyone here can translate it into layperson's terms including the significance of what it says, that would also be so helpful:

"Three decalcified sections of bone tissue were examined, which contain portions of a lytic mass within the medullary cavity, which is associated with areas of periosteal reactive woven bone proliferation. The neoplasm consists of short plump spindloid to polyhedral cells, present in disorganized indistinct fascicles, bundles and sheets. These are frequently associated with numerous islands of osteoid. The cells have oval nuclei with vesicular chromatin and small to medium-sized nucleoli and small to moderate amounts of wispy eocinophilic cytoplasm. There is mild to moderate anisocytosis and anisokaryosis. Mitoses average 3 per high-power field. Regions of the tumour are sometimes necrotic. Focally severe areas of medullary fibroplasia are also present."

 

Thank you so much!

[greysmom]

Only guesses about the report. Seems to just confirm osteo?

 

As far as Artemisinin, the body builds up a tolerance to it very quickly and it becomes less effective over time, which is the reason for pulsing and/or not giving it every day. I think.

[Rickiesmom]

Thanks Greysmom. I guess I should have added that the report did confirm osteo explicitly, I was just trying to understand the detail, especially as it might pertain to any prognostic factors.

 

Good to understand the reason for pulsing, thank you for that too.

[krissn333]

Hoping for lots of good time left for Diamond

 

I lost three to osteo in a 12 month period. It's awful.

[nessa]

Hello!

I have a question and feeling very desperate! Can Rymidal cause kidney problems and if so, what should we give her? She started on Rymidal during/ after her radiation. Her creatinine ( sp?) was high all along at 2.4 ish. But her levels were slightly higher since the day we adopted her. She did not tolerate Tramadol the one time we gave it to her!!!

 

She clearly has more leg pain now, we are adding Gabapentin, but on her blood work, her creatinine was 14??? Is that even possible?? We are going to retest it. She is not eating well at all, and does not feel good obviously but will go on a walk, pee, poop, drink....

 

thanks in advance

[nessa]

never mind.

[Rickiesmom]

Don't be discouraged - most people who would answer here posted to your other thread, and some of us who didn't post probably refrained because we agreed with what had been said and had nothing to add.

 

I opted for palliative care for my first osteo hound, who, fortunately, tolerated all pain meds, in spite of which, she wasn't with me long after diagnosis. It is an extremely painful cancer. I was told it may be the most painful cancer there is - the bone is exploding from the inside, and the pain is unrelenting.

 

I hope you find a combination of pain meds that will allow you to get ahead, and stay ahead of that pain, so you are able to give your girl a little more good quality time.

[4My2Greys]

Hello!

I have a question and feeling very desperate! Can Rymidal cause kidney problems and if so, what should we give her? She started on Rymidal during/ after her radiation. Her creatinine ( sp?) was high all along at 2.4 ish. But her levels were slightly higher since the day we adopted her. She did not tolerate Tramadol the one time we gave it to her!!!

 

She clearly has more leg pain now, we are adding Gabapentin, but on her blood work, her creatinine was 14??? Is that even possible?? We are going to retest it. She is not eating well at all, and does not feel good obviously but will go on a walk, pee, poop, drink....

 

thanks in advance

What drug regimen (drugs and dosages) is she on right now? Could the creatinine of 14 be the BUN/Creatinine ratio result? Nadir's creatinine was 2.4 and ratio was 15 prior to passing from a combination of advanced renal disease and clotting problems.

[tbhounds]

Hello!

I have a question and feeling very desperate! Can Rymidal cause kidney problems and if so, what should we give her? She started on Rymidal during/ after her radiation. Her creatinine ( sp?) was high all along at 2.4 ish. But her levels were slightly higher since the day we adopted her. She did not tolerate Tramadol the one time we gave it to her!!!

 

She clearly has more leg pain now, we are adding Gabapentin, but on her blood work, her creatinine was 14??? Is that even possible?? We are going to retest it. She is not eating well at all, and does not feel good obviously but will go on a walk, pee, poop, drink....

 

thanks in advance

Double check that creatinine level. As for pain control if your hound truly can not tolerate Tramadol you might what to see how she does on Tylenol with codeine. Also what dose of gabapentin have to been prescribed??

[nessa]

We are rechecking the creatinine level Monday. She is on 100mg gabapentin x1 daily which from reading here, is very low. I gave her 2 doses today?! She gets 50mg of Rymidal 2x daily.

 

 

I did not know you could give tylenol with codeine to dogs ??

 

Interesting about the ratio of BUN/creatinine. I will ask the vet.

[greysmom]

100 mg of gabapentin is very low for pain control. An average size greyhound can get up to 300 mg 3 times a day. Also, it's now recommended to give it every 6 hours instead of every 8, depending on tolerance and pain control, as greyhounds seem to metabolize it faster than other breeds.

 

There are also lots of other nsaids to try if she can't handle riymadil. But if her kidneys are compromised that badly, an nsaid might not be appropriate.

 

What kind of reaction did she have to the tramadol?? Most greys do tolerate it OK, but the dosage might have been too high, or needs to be increased more slowly. I have one that is very sensitive to it, too, and we give her half a dosage when she needs something for pain.

[nessa]

One tramadol ( I do not remember the dosage unfortunately) made her pant, shake and seem anxious and nervous all night. ??!! It was not good.

I will see the vet in the am and talk to him about the dose of gabapentin. She was definitely looking better today with that in her system then yesterday.

thanks

[tbhounds]

Yes-you an give dogs Tylenol w/ codeine but, it needs to be accurately dosed. Interesting that your hound reacted so terribly to 50mgs of Tramadol --you don't think that what you saw was your hound acting painful vs side affect to the medication??

Edited July 21, 2014 by tbhounds

[45MPHK9]

She is on 100mg gabapentin x1 daily which from reading here, is very low. I gave her 2 doses today?! She gets 50mg of Rymidal 2x daily.

 

From what I've read here, 100mg of Gapapentin once a day can't touch the pain of osteo. Within five weeks of diagnosis, Bee was up to 900mg of Gapapentin everyday in addition to Deramaxx and Tramadol. At eight weeks, even that combination of drugs couldn't prevent her pain.

 

I would definitely talk to your vet about increasing the amount of pain medication your dog is receiving.

[GreyWrangler]

Harry is currently on gabapentin 300mg bid and bactrim twice a day. He has had one round of carboplatin. Next round is August 1st. I forgot to ask about his heartworm med! He gets sentinel, any reason for him to not get it?

Edited July 23, 2014 by GreyWrangler

[Rickiesmom]

Jaynie's oncologist told me to continue with heartworm/flea preventatives (I am using Program + Interceptor, which is what Sentinel combines).

[NeylasMom]

I have a question about Artemisinin. I understand that some people give it every day, and some people do week-on, week-off, and I think somewhere I read that it is better to pulse it, though I don't know where I saw that or what the rationale is.

 

If those of you who have given it to your osteo hounds would chime in with what you did and why, I would be very appreciative as it will help clarify my thinking.

 

Jaynie will have her final Carbo treatment next week (yay) and I would like to go into the consult with the oncologist with as much information as possible.

 

Also . . .

 

I got hold of the histology report and it's mostly incomprehensible to me. I spent a lot of time googling terminology, but couldn't really put it all together. I gather the mitotic index is low (good) but the necrotic tissue is a bad sign.

 

If anyone here can translate it into layperson's terms including the significance of what it says, that would also be so helpful:

 

"Three decalcified sections of bone tissue were examined, which contain portions of a lytic mass within the medullary cavity, which is associated with areas of periosteal reactive woven bone proliferation. The neoplasm consists of short plump spindloid to polyhedral cells, present in disorganized indistinct fascicles, bundles and sheets. These are frequently associated with numerous islands of osteoid. The cells have oval nuclei with vesicular chromatin and small to medium-sized nucleoli and small to moderate amounts of wispy eocinophilic cytoplasm. There is mild to moderate anisocytosis and anisokaryosis. Mitoses average 3 per high-power field. Regions of the tumour are sometimes necrotic. Focally severe areas of medullary fibroplasia are also present."

 

Thank you so much!

The folks on the artemisinin group no longer feel pulsing is necessary. I would just give it daily.

[Rickiesmom]

Thank you! That is very useful to know!

[greysmom]

Just wondering if anyone here has had any experience with either fibro- or histio-sarcomas?

 

My Lilly is going to have a tumor taken off the side of her head today that might be one of those two types. The lump just appeared a week ago, and I nearly didn't ask the vet about it when we were in for another issue. Cytology report was inconclusive on the slide the vet aspirated and sent in, but it clearly showed sycle-shaped cells and cells with multiple nucleii.

 

Internet research is actully scaring me quite a bit, so I came for a reality check here.

[a_daerr]

My boy's tumor was a spindle cell, which falls under the category of fibrosarcomas. His was a little different because the cancer cells spread from the soft tissue into the bone, which is what caused the osteolytic lesions. FSAs are much more common in the face and mouth area. The most important thing with FSAs is to get clean margins. A lot of dogs go through multiple surgeries when the tumor comes back. But for us, that wasn't really a consideration, as we amped the whole leg. It wasn't 100% critical that we do chemo because FSAs aren't likely to metastasize, but due to the unusual nature of the tumor, we did pursue chemo under the oncologist's recommendation.

[Rickiesmom]

No experience, but sending good thoughts. Hopefully it will turn out to be something innocuous when the actual tumour is examined. We will be thinking about you and your girl.

[MP_the4pack]

I had experience with fibro of the spleen. My Pearl had her spleen removed but it turned out to also be in her liver. The cancer grew a centimeter a day and I lost her 3 weeks after surger.

 

I hope it's not as aggressive as my Pearls.

 

[krissn333]

Generally I believe the ones that show up in the skin are less nasty. Generally I think clean margins upon removal do the trick. Ace had something in her thigh that they aggressively removed in order to get nice clean margins. It was a sarcoma of some type. It never returned though.

[greysmom]

Thanks everyone. The sarcoma turned out to be smaller than it looked from the outside and quite easy to take out. She has a very small slit with only two stitches on the side of her head now. The surgery itself was short and sweet! Though she did have a bad anaphlactic (sp?) reaction to a post op shot, and is now spending the night under observation at the hospital.

 

We'll know what the biopsy says next week.