Osteo Thread Part 9

[Remolacha]

[FiveRoooooers]

You've been hit with a double whammy but you already have the best of the best on board for Sherlock's care. Comfort and costs are definitely huge components to the decision process and whatever you decide for you and Sherlock will be the right one because you've made it for the love of your boy. We've had OS show up in two of my campers and neither would have been an ideal candidate for treatment other than pain meds, and that's what we did - until the meds weren't working and it was time to gift my sweeties with their wings. Love on your boy extra hard because as you already know, every day is a gift. We are here for you. 

[greysmom]

Just know we've all been where you are now, in some form, so we understand the difficulties and worries.

If you choose palliative care, it's important to remember what the goal is - as pain free as possible in the moment.  So normal rules of pain management get superceded by the reality that osteo is an incredibly painful disease.  It's also a terminal disease, so you don't have to worry about long term side effects or outcomes.  Lots of vets have trouble making this switch - it's not in their nature to ignore warnings! - but it's OK to remind them you're not being conservative when it comes to pain management.  Start low, but add as much as your dog needs until you can't keep it under control anymore.  Then it's time to say goodbye.

Most of us have good results for pain management with a combination of an nsaid your dog tolerates well, the drug gabapentin for nerve pain, and an opiate pain reliever like codeine sulfate.  Avoid other opiates like fentanyl patches or morphine as they can cause bad reactions with greyhounds.  Many also have good results with Palladia infusions for pain relief.  

I'm so sorry you and Sherlock are having to go through this.  Good luck!

[mjmcmurray]

Thank you all, appreciate the support. I’m a little overwhelmed with the decisions to be made, to be honest. I did make an appointment with an oncologist for next week (earliest available) and Dr. C said an FNA would be good to confirm that it’s not metastasis from his SCC, which might change treatment options. I made an appointment to do that this week but his vet was pretty confident, and seems to think an FNA might not be conclusive? Either way, want to do my due diligence before committing to one route. 

[greysmom]

FNAs are difficult because everything depends on placing the needle in exactly the right place in the lesion so you get a good quality sample to send to the lab.  In small lesions the distance between an osteo diagnosis and a clear one can be just millimeters.  It's up to you whether you feel your treatment plan will change depending on uncertain results.  They are a fairly straightforward procedure to do, and if your dog is calm at the vet, he may be able to get it done with a mild sedative and a local instead of full anesthesia.  Something to discuss with your vet.

The question for you I think is what would the changes be if it's SCC vs osteo??  You've decided not to do amputation, which in SCC can be curative, but is only for pain management in osteo.   This also is something to have an in depth conversation with your vet oncologist about. 

You have some time since you've chosen palliative care.  Get Sherlock's pain meds on board, then take a deep breath.  Get as much information as you need to help make your decision.  There are a lot of links in the first post of this thread.  Many will be out of date by now since cancer treatments have changed greatly in the last 5 years, but they should give you some direction and different points of view.

[mjmcmurray]

That’s helpful, thank you, and I’m definitely working my way through the resources in this thread! 
 

The new pain meds already seem to be making him feel better, at least, now to get him through our oncology consults in the next week. 

 

[gracegirl]

Big hugs for Sherlock and his people. It’s a devastating disease and I hate it so much. 
 

Question for those who have been through chemo with carboplatin. ‘My looking for more information on 4 vs 5 vs 6 sounds. Tessie did well with her first round at a moderate dose, so for her second round we are going to increase the dose. The plan right now is for four doses, but the oncologist is open to another dose or two. 
 

She says a lot has to do with where you went to school. Some schools teach four, other more. She said because dog how aggressive and terminal this is, there’s not enough data to say that (for example) five is the magic number. She also said a lot comes down to costs. 
 

We have excellent insurance so cost isn’t a factor. If she continues to tolerate chemo well, should we go for five or even six rounds? I’m asking here first before I reach out to Dr C, but will likely send this question over to him eventually. 
 

In other completely unrelated news, I could some extra positive thoughts. We raise service dogs for a local non-profit and our current pupper, Revna, has to go back for “finishing school” on Saturday. We adore her and I’m so sad to see her go. 💔 She’s Tessie’s favorite of the three we have raised. #blackdogclub

 

[1Moregrey]

Good thoughts sent your way. 
 

 

 

[greysmom]

It comes down to costs and how she tolerates the treatments.  I don't think there are any contra-indications against doing more - 6 vs 4 - the more the better probably, but your insurance may have a number in mind as a cut off point.  Worth checking with them.  I'm pretty sure we did 6 treatments at Dr Cs recommendation (we also got our treatments for free from his program way back then).

[ramonaghan]

6 hours ago, gracegirl said:

Big hugs for Sherlock and his people. It’s a devastating disease and I hate it so much. 
 

Question for those who have been through chemo with carboplatin. ‘My looking for more information on 4 vs 5 vs 6 sounds. Tessie did well with her first round at a moderate dose, so for her second round we are going to increase the dose. The plan right now is for four doses, but the oncologist is open to another dose or two. 
 

She says a lot has to do with where you went to school. Some schools teach four, other more. She said because dog how aggressive and terminal this is, there’s not enough data to say that (for example) five is the magic number. She also said a lot comes down to costs. 
 

We have excellent insurance so cost isn’t a factor. If she continues to tolerate chemo well, should we go for five or even six rounds? I’m asking here first before I reach out to Dr C, but will likely send this question over to him eventually. 
 

In other completely unrelated news, I could some extra positive thoughts. We raise service dogs for a local non-profit and our current pupper, Revna, has to go back for “finishing school” on Saturday. We adore her and I’m so sad to see her go. 💔 She’s Tessie’s favorite of the three we have raised. #blackdogclub

 

Healthy Paws (which I know you have too) covered all six chemo treatments for Sweep with no issues. But she had three of doxorubicin and three of carboplatin, since we started chemo before we knew for sure what cancer we were dealing with. I think our oncologist typically does 5 total for carboplatin.

Hugs for all of you as Revna starts her next chapter; I know how hard that must be. But it will be so rewarding when she's matched with someone. You're making such a positive difference in people's lives.  

[gracegirl]

Big day today. Chemo #2 and Torigen #2 were both administered today. She did great and the oncology staff love her. We go back next week for Torigen #3 (a quick appt) and the week after that for bloodwork (a super speedy appt). And then the following week (Sept 2) we have Chemo #3. That’s another big appointment as we’ll take another set of chest rads that day. It will also be her gotcha day #5. 

[EllenEveBaz]

Extra ear scritches to Sherlock and Tessie.  

[gracegirl]

Torigen injections are now behind us! As least until we decide if we need a booster in the future. She’s recovering in her Tess nest. 
 

Sept 2nd is looming as a big day. I’m super anxious for her chest rads. 
 

 

[FiveRoooooers]

[greysmom]

      

[EllenEveBaz]

We'll be waiting with you.

Love the Tess Nest.  

[gracegirl]

You guys. I think they put houndie attracting magnets in this bed. I put it away after her amp because I didn’t want her to get stuck in it. I just got it back out and she’s hardly moved since. 🤣
 

 

[ramonaghan]

  Mega Tess Nest!

[Remolacha]

She looks so comfy 

[FiveRoooooers]

Why go flat (behind her) when you can nest! 

[NeylasMom]

6 hours ago, gracegirl said:

You guys. I think they put houndie attracting magnets in this bed. I put it away after her amp because I didn’t want her to get stuck in it. I just got it back out and she’s hardly moved since. 🤣
 

 

[greysmom]

I found that Dude preferred a bed with a little elevation because it was easier to get in and out of.

Tessie looks like she agrees!!! 

 

[EllenEveBaz]

The Loch Nest Monster!  (a very cute one)  

[BatterseaBrindl]

Ahhhhhhhh……..

[gracegirl]

Has anyone changed to a lower carb food after diagnosis? We are in the process to changing Tessie to Halo Elevate Lamb. Curious what others have done. She’s getting CBD oil and turkey tail mushroom powder as well. 
 

There’s another product called I’m-Yunity that’s supposed to be good, but I’m unsure if I should add anything else. The vet said I could go ahead and add, it was the one she recommended if I’d like. Healthy Paws hasn’t been very helpful in telling me if they cover certain items in the past, either.