Osteo Thread Part 8

[tbhounds]

Signs to look for are redness, blistering and pain at the affected site.

[Rickiesmom]

Thank you.

[greytpups]

Update on Jaynie and a question:

 

She has been doing super-well - healed, happy, playing, running.

 

She is a little lame on the back left leg - same side as her front leg amp. I am going to give it until the start of the week, hoping it's just a strain.

 

I seem to recall that if the osteo returns to bone vs. lungs, it's in the diagonally opposite leg, is that right? I.e., it would most likely be in the other back leg.

 

Her lungs were re-xrayed a little over a week ago and appeared clear. Thank you!

 

Edited to add a photo - the collar she is wearing was made by a friend specially for her:

 

Beautiful collar for a very beautiful girl

[BauersMom]

I seem to recall that if the osteo returns to bone vs. lungs, it's in the diagonally opposite leg, is that right? I.e., it would most likely be in the other back leg.

I don't believe so. Osteo will pretty much show up wherever it wants. Berkeley had it in his other front leg (he was a front amp).

[45MPHK9]

Thinking good thoughts for Jaynie.

[MP_the4pack]

Diamond did get it in her opposite leg after her amp. But her lungs were clear.

 

I also know of two other dogs that had it in another leg once they had an amp. So, what Bauer'sMom says.

[Rickiesmom]

Jaynie's lameness, which started late last week, has not improved (I put her on Gabapentin and Tramadol over the weekend). On Monday we saw our regular vet, who did not believe it was another bone lesion, and thought it looked more neurological. Yesterday we went back to the specialty hospital and saw her surgeon and a neurologist.

They took x-rays and did not find anything sinister in the leg or pelvis, though I know that doesn't totally rule anything out. Their feeling is that the problem is in the lower spine. Said they could do a CT scan but an MRI would produce more definitive results. An MRI appointment will be booked for this weekend. The neurologist wants me to keep her on Gabapentin but only add Tramadol if she really needs it - given she is also getting chemo drugs and is kidney-compromised, my sense is that they are trying to keep the load on her kidneys as light as possible. She is managing pretty well, and in good spirits with good appetite.

I would be interested in your thoughts regarding how to proceed with the MRI:

Her last chemo treatment was on Thursday, May 29 (Carboplatin). As I understand it, this means the nadir will be sometime between this weekend and early next week. Also, she has been sedated, albeit lightly (Propofol) twice in the last week - for her biopsy last Wednesday (negative) and yesterday for her x-rays. The hospital did take blood yesterday to get her numbers prior to MRI sedation, but that will have been before the nadir. I wish I'd thought of that when I was there, although they did ask me when her last treatment was.

Bearing in mind she has compromised kidneys, I am wondering if I should proceed with the MRI this weekend, or delay a week and rest her during that time, and then do at least a CBC (?and maybe a renal panel) just prior to.

I will also contact her oncologist today for his thoughts, but would welcome yours, as multiple opinions and suggestions are so useful as input to asking more questions and determining a course of action.

Thank you for your help!

[a_daerr]

Are you worried that she won't handle the sedation of the MRI because her counts will be low?

[Rickiesmom]

Yes, though I don't know for sure it has any bearing, and also just so much sedation (and in the case of the MRI longer duration) within a short period.

[a_daerr]

I see what you're saying...

 

I'll give you my reasoning, which of course, is that of an un-expert person. I think I'd be more concerned about her renal values than the WBC, because the kidneys are responsible for flushing out the anesthetic after the procedure is over. WBC deals more with fighting infection, which isn't a huge deal for an MRI because they're not doing anything invasive or opening her up. I'd opt for pre-anesthesia bloodwork to check all her other levels, then have a conversation with the veterinary anesthetist. Maybe they could do the MRI with just a light sedative (ace, valium, or something) instead of general anesthesia.

[Rickiesmom]

Jaynie got a lot lamer on Wednesday night, and was not better in the morning, and in fact went downhill quite quickly (barely able to walk, hunched and clearly in pain). Her back legs were cold (they did warm up at the hospital).

 

Took her back to the specialty hospital, where they did a CT scan, followed by an MRI of the affected area (lumbar sacral junction).

 

MRI imagery has been sent to a radiologist for interpretation which should come back today. Neurologist thinks it looks more like a disc problem than a metastasis, but this needs confirmation.

 

Jaynie stayed in the hospital overnight on fluids and IV pain meds. Saw her this morning and she is definitely more comfortable. An action plan depends on the radiologist report.

 

We really need to find a way to manage this medically, as I cannot see putting a tripod with metastatic disease through any sort of back surgery.

 

Because of her kidneys she can't have NSAIDs and the fact that she's currently on chemo discourages though may not preclude steroids. I don't think the DM shots are applicable here, but something like oral Pred / Medrol may be, depending on what the oncologist says.

 

I have no idea how she injured her back, and she has been doing so incredibly well, this injury is very frightening and completely unexpected.

 

Any thoughts on non-surgical treatment and maintenance while we wait for the radiology report would be most welcome. Thank you!

[Guest Greyt_dog_lover]

I have not followed your journey completely, have you tried acupuncture? For my girl who we chose the pain management route we had weekly acupuncture and it worked wonders! I cannot say enough good things about it. You will just need to be sure the acupuncturist knows all the medical conditions because if there is active growths or other bad things, the acupuncture could accelerate the growth.

[Victor]

I'm sorry to hear Jaynie's having pain in her back. I don't have any advice, but I hope her doctors can offer some good options.

 

Thinking good thoughts for you and her,

Victor

[Rickiesmom]

MRI shows a bulge at the lumbar sacral junction. She continues on pain meds, rest, and may start on a low dose of steroids. Hopefully the combination does the trick. Now that we know what the problem is she can also go to the rehab clinic I use, which is excellent and will help her I am sure.

[greysmom]

Bumping to the first page.

[4My2Greys]

Mary, how is Jaynie doing? Are the pain meds helping her back?

[Guest SabrinaInDE]

It's been a while since I've posted here, but today I got the news I had been expecting but dreading - my beloved heart dog Max has osteo. Max is 12. I don't feel that amputation is really an option. He's old, arthritic, and has a severe fear of the vet. Our plan right now is to hopefully manage his pain for a little while until we have to let him go. Right now he is on Rimadyl, Gabapentin, and Tramadol. This is my first experience with osteo. For those who have been through it (or are going through it), what are your thoughts on Pamidronate? Do you think it's worth putting him through the process at the vet (he's very fearful at the vet; shakes and hyperventilates the entire time, even if it's hours!).

 

Also, thoughts on when it's time to say goodbye. How did you know when the pain got to be too much?

 

Just FYI, it's in his left shoulder. The x-rays of his lungs are clear. He has a pronounced limp, but we just added the Rimadyl today and increased the dosage of Gabapentin and Tramadol, so I'm hoping that helps.

 

[45MPHK9]

For those who have been through it (or are going through it), what are your thoughts on Pamidronate? Do you think it's worth putting him through the process at the vet (he's very fearful at the vet; shakes and hyperventilates the entire time, even if it's hours!).

 

So sorry to see that Max has been diagnosed with osteo. When Bee Wiseman was diagnosed, we agreed that we'd take no heroic measures to deal with her cancer. We agreed that there would be no amp, no herbs, no chemo, no radiation. We weren't willing to have her spend time at the vet for treatments that could not cure her of cancer. We gave her a combination of Tramadol, Deramaxx, and Gabapentin for eight weeks, and then we let her go. Those drugs weren't controlling the limp, and we knew she had to be in awful pain. We also feared a catastrophic fracture. We were at peace on the day we released her from the pain. The weeks after she died were hell, though.

 

I'm sorry for what you and Max are facing. Osteo is a cruel disease.

[krissn333]

We did pamidronate with Sutra and found it to be very beneficial, but, Sutra LOVED the vet's office. With a dog who hates the vet that much, I am not sure that I would pursue something like pamidronate. They have to be there for a few hours and it's unlikely the treatment would be very beneficial to him if he can't relax....

[Rickiesmom]

It's been up and down. Pain meds seemed to help for a couple of days, then last Wednesday night she was in bad shape at her last outing. Became worse through the next morning (I had to carry her from the where she was lying in the kitchen out to the car) so I took her back to the hospital, where she was put on IV pain meds. Their MRI machine is very small, so they did a CT scan to try to localize the problem, and then an MRI of that area. Radiologist said it looked like a disc bulge but he couldn't tell for sure, and felt that it wasn't pronounced enough to account for her symptoms. Could not rule out a tumour. It's right at the lumbar-sacral junction, where L7 meets the first sacral vertebra.

 

We had an MRI already scheduled at the best facility around for early that Saturday AM, but Jaynie had been through so much in the previous 8 days (including 4 sedations / anaesthesias) and was so strung out from the IV pain meds when I picked her up on Friday evening, that we postponed a week. We would have had to leave at 5:30 in the morning to make it, and I was afraid the cumulative stresses might be too much for the long anaesthesia required by the MRI.

 

She has been doing OK on pain meds and strict rest / short leash walks, in fact I have been able to wean down the pain meds a bit, but it's unpredictable. Last night on our last outing she was vdry unhappy and it felt like deja vu, but she seemed better in the house later and also today.

 

So we'll go tomorrow morning for a full spine MRI and hopefully the radiologist's report will come in a day or two after that. If it is a disc bulge then we have a bit of a balancing act because she can't have NSAIDs and it isn't good to give steroids in conjunction with chemo, though I know they will try to figure out the lowest possible effective dose.

[MP_the4pack]

I hope Jayne feels better soon. Disc problems are sore.

 

 

I'm sorry to hear about Max. I chose amp for my 12 yr old. But I had Dr. Couto and the OSU team determine if at that age she was a candidate because she was a young 12. When she developed OS in another leg, I let her go on the xray table.

[Rickiesmom]

SabrinaInDE I am sorry for Max's diagnosis.

 

Angel Arlie received pamidronate and radiation - pamidronate to help strengthen the bone, and radiation for pain. She tripped about 2 months after treatment started and fractured her leg. It was a green stick fracture, so not as awful as it might have been, but bad enough nevertheless.

 

As others have said, the treatments are long, so if Max doesn't settle down well once treatment begins, it may be hard on him. If he's the type that is stressed at first but can be calmed once he's in the treatment area, it might be OK. I gave our technician my cell number, and I would wait in the car with Arlie until they were ready for her so we could just walk right through the waiting room without stopping, and that helped a lot.

[Guest SabrinaInDE]

Thank you so much for the replies. Rickiesmom, he won't calm down. A year and a half ago, he had to have an overnight stay at the e-vet and they eventually had to give him a light sedation because he would NOT settle and it was compounding his problems. Looks like pamidronate may not be the best plan.

 

I guess what we'll do is keep trying to manage his pain for a while and keep him out of the vet's office as much as possible. Our wonderful has agreed to come to our house when it is time. Overall, it seems to be the kindest thing I can do for him, though it's breaking my heart.

 

We also have a 14 year old (Leah in my signature) who has kidney disease and severe arthritis and is likely nearing the end. It's a tough time here.

[greytpups]

It's been up and down. Pain meds seemed to help for a couple of days, then last Wednesday night she was in bad shape at her last outing. Became worse through the next morning (I had to carry her from the where she was lying in the kitchen out to the car) so I took her back to the hospital, where she was put on IV pain meds. Their MRI machine is very small, so they did a CT scan to try to localize the problem, and then an MRI of that area. Radiologist said it looked like a disc bulge but he couldn't tell for sure, and felt that it wasn't pronounced enough to account for her symptoms. Could not rule out a tumour. It's right at the lumbar-sacral junction, where L7 meets the first sacral vertebra.

 

We had an MRI already scheduled at the best facility around for early that Saturday AM, but Jaynie had been through so much in the previous 8 days (including 4 sedations / anaesthesias) and was so strung out from the IV pain meds when I picked her up on Friday evening, that we postponed a week. We would have had to leave at 5:30 in the morning to make it, and I was afraid the cumulative stresses might be too much for the long anaesthesia required by the MRI.

 

She has been doing OK on pain meds and strict rest / short leash walks, in fact I have been able to wean down the pain meds a bit, but it's unpredictable. Last night on our last outing she was vdry unhappy and it felt like deja vu, but she seemed better in the house later and also today.

 

So we'll go tomorrow morning for a full spine MRI and hopefully the radiologist's report will come in a day or two after that. If it is a disc bulge then we have a bit of a balancing act because she can't have NSAIDs and it isn't good to give steroids in conjunction with chemo, though I know they will try to figure out the lowest possible effective dose.

Sending my very best wishes that the MRI locates the pain area and she recovers quickly. Give her some scritches and and for you

[greysmom]

bumping again