New Osteo Diagnosis (Probable)

[Guest SusanP]

This is our first osteo hound. I am going to start going through the osteo thread here, but there is a lot to read and so little time. Our Zena is 11 1/2, with failing kidneys. She began limping badly a week ago, with pain in her left, front shoulder- radial nerve. She's on meloxicam and gabapentin and still limps, but seems not really to be feeling pain at the momen--The limp seems to be more due to paralysis. Due to her age and condition, we are not considering amputation, but the vet suggested a supplement (I'll get the name as soon as DH picks it up). We also know that the pain meds she's on are almost certain to make her kidneys fail faster.

 

The only thing is, we are not 100% sure it's cancer, though the vet feels pretty sure based on appearance and location of the spot in the xrays. Is there anything I'm forgetting that we should be doing? We don't want to put her through a bone biopsy or any procedures that will stress her at this point. If I remember right, Dr. Cuoto's group works with osteosarcoma in greyhounds. Is there info that would help in these circumstances? The vet said she could treat for the unlikely possibility of bacterial/fungal infection if I want, but it would cause more problems for her digestive tract/kidneys and it would take a very long time for any results. She felt it wouldn't be of much value.

 

Our inclination is to try the supplements, keep her on her pain meds, and make sure she doesn't suffer. Is there anything else I need to be aware of?

[macoduck]

http://www.coutovetconsultants.com/for-ownersadopters/ Your vet can send all reports and xrays for review. The fee was $120 and well worth it. He may have better suggestions for pain management.

[Guest SusanP]

Ah, I see that Dr. Cuoto's group has disbanded, and now that I've had a little time to process Zena's diagnosis, I think we will keep her comfortable as long as we can and then let her go. She limps but seems willing to romp and bow on the leg, and the vet says it's not likely to break anytime soon, positioned in the shoulder as it is. The gabapentin and Meloxicam are helping her feel fine for now. So I guess I've answered my own question. Meds and lots of spoiling until the inevitable.

 

Zena will join her Labrador sister, Mabel, who passed away just a couple of weeks ago from what was either cancer or severe arthritis in her only hind hip. (Mabel had been a stray found at around age 6, and xrays also revealed she lost her other hind leg due to extreme trauma). It's been a very upsetting time with both our girls in trouble within weeks of each other. I guess sometimes life goes that way.

Oh, thanks, Macoduck! Can Dr. Cuoto read the xrays better than most vets? This is what I was wondering about doing. It's nice to be sure....

[macoduck]

Dr Couto left OSU but he is still in business at the link I posted.

 

For you and Zena

Edited January 5, 2015 by macoduck

[Guest normaandburrell]

Prayers for you and Zena. I think you are doing the best for her by keeping her as comfortable as possible.

[greysmom]

Dr Couto has more experience reading xrays in greyhounds. And, one way or another, you will likely have a way to move forward. He will likely advise adding tramadol or another pain med to what you are already doing. Possibly the supplement is Artemisinin? It is supposed to help actually shrink the cancer. There is also some evidence that the nsaid "piroxicam" helps specifically with cancer pain and swelling, as well.

 

Just keepin mind that osteo can be hideously painful, and is really a terminal diagnosis. If that *is* what she has, there's not much reason to be conservative in pain management. You want to keep her pain free, if possible. Also discuss with your vet how high you can go with the pain meds. When doing palliative care, it's also a good diea to have a plan in place in case of a catastophic break happening. It's not as likely in a shoulder, but it can still happen.

[EffieGrey]

We are going through palliative care right now with our 13 year old greyhound who also has osteo in the shoulder. We've gotten 5 months past diagnosis with her, although the last month has been tough and she is going downhill. If you can afford it, the radiation therapy gave us the best pain management, and combined with monthly pamidronate treatments gave her about 4 months of truly happy, pain free life. Zena should also be on tramadol at this point (unless her kidneys prevent it?) and we've recently added Amantadine to Effie's lineup due to breakthrough pain. We did two radiation therapy rounds at two treatments each round. One round was at the very beginning and one was recently due to her pain worsening. We will be trying out zoledronate this weekend for her, it's supposed to be stronger than pamidronate. Our vet is a fantastic oncologist who specializes in palliative care, so I know Effie is getting the cutting edge treatment.

 

Best of luck, this is truly a horrible disease and every hound diagnosed breaks my heart. Dr. Couto did consult with us when first diagnosed and our regular practice vet wasn't positive, and confirmed the osteosarcoma diagnosis. He is excellent at reading the x-rays.

[Cully]

Edited January 6, 2015 by Cully

[galgrey]

I'm so sorry to hear this about your sweet Zena.

[Charlies_Dad]

I am sorry to read this. Dr. Couto recently consulted from afar with our non-Grey who has Hemangio and he was fantastic. Worth every penny and I think we emailed back and forth a dozen times all within a 2-3 day span.

 

Good thoughts for Zena and you.

[Guest SusanP]

Thanks, Everyone. You've given me a lot to think about. Whatever we do, we'll be careful not to let her suffer. Our sweet girl. We'v had her only just over a year.

 

How are xrays sent to Dr. Cuoto, via mail?

Edited January 6, 2015 by SusanP

[macoduck]

SusanP, do you know if your vet had a digital xray machine? If so, they can just email him the images once you've paid for the service and let him know that they will be coming. If they have an old xray machine they can give you the sheets of film to mail to Dr Couto.

Also send any lab results.

[Guest SusanP]

Thanks for the info, Macoduck, and thanks to everyone else, too. We'll do the best we can for our girl.

[Charlies_Dad]

Dr. C. will want to see digital films and blood panel if possible.