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Osteo Question


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My boy Stolie was diagnosed late last September for Osteo and had an amputation Oct 2 and Chemo following. He seems to be in pain these past few months - takes a long time to recover from exertion - and we have him on metacam, gabapentin and tramadol. Despite all this, he continues to be physically strong and mentally he is playful and affectionate (thou he is really grumpy to our new whippet puppy). Over the past several months we have gotten ourselves to the point where we decided we are going to treat for pain and not pursue any other measures.

 

The last chest x-ray he had was in May and he was clear. Our oncologist wants us to continue to come in for x-rays every 3-6 months. Has anyone else done this? I'm curious why we would do this as it isn't going to change how we are going to treat Stolie.

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If he's in pain, it's possible the cancer has spread. An x-ray could tell you. Otherwise, the first time you know it may be when Stolie breaks a leg.

 

And if he appears to be in pain, then the pain meds you have him on may not be adequate--especially if the cancer has returned.

 

But it's possible the pain could be something else--spine out of alignment because he has to walk differently now. The vet may be able to tell you more after x-rays.

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This sounds pretty standard to me... for the first year post-amp, Henry went back in for chest x-rays first every 3 months, then every six months. Now, we're coming up on two years post-amp, and he only has to go in annually. Even though it won't necessarily change your course of treatment in your case, the chest rads will determine whether or not the cancer has hit an unmanageable spread. At that point, it would be more compassionate to have him PTS instead of him passing through a slow, debilitating, drawn out process. Especially if the lungs develop masses and start filling up with fluid, the dog can slowly drown to death. For some dogs, osteo can get really awful near the end. Sending hopes and prayers that's NOT the case for your Stolie boy.

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I would pursue continued imaging. Being educated may help further medical protocols. I wouldn't just do chest rads--sadly we are seeing Osteo strike in second limbs and spine. To snap lateral limb and spine rads is quick and may be hugely benefical.

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Sounds really routine and what nearly all of us go through. Talk to your vet about increasing his pain medication - remembering that you don't need to be conservative or worry overmuch about side effects. You want him to be comfortable. When the max doses can no longer control his pain, then you need to be ready.

 

Xrays are for information. Even xrays that are normal (or don't indicate anything's wrong) can tell you something about how to move forward.

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