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BrittaAndGregg

Osteosarcoma Amputation/Chemo Decision

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Our retired racer, Puma, has always been a very happy and healthy greyhound.   Recently, while walking down some stairs, she froze up and yelped.  After carrying her down the stairs, it became noticeable that she was limping pretty severely.  Luckily we had pain meds on hand. We took good care of her with pain meds and a heating pad, and although the limp definitely improved, we ended up taking her to the vet about a week later just to be safe.  On Friday, after taking X-Rays, our vet informed us that Puma has Osteosarcoma in her right front shoulder.  Fortunately, we did catch it quickly and there are no signs of tumor or spreading to the chest or lungs.  Despite getting a diagnosis early on the game, our vet informed us that this cancer spreads rapidly and that her life expectancy is probably only three to five more months unless we choose to amputate the leg and begin chemo.  We are having a very difficult time deciding whether to just accept the cancer, begin palliative care and keep her on four legs until it is time to euthanize in a month or two.  Or do we go forward with the amputation and chemo in the hope that is extends her life for another year +.  Any advice, recommendations or assistance would be greatly appreciated. 

Edited by BrittaAndGregg
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I'm so sorry for your diagnosis.  Many here have been exactly where you are now.  It is always a highly personal decision and there really isn't a right or wrong answer. 

There are many resources to help you, including your vet and oncologist.  There have been many exciting new vaccine trials recently, so make sure you get the most up-to-date info you can.

On Facebook, there is a group called "Greyhounds with Osteo"where you will find many in your situation.  In the web look up the Greyhound Health Initiative and their informative pages.  They have on staff and available for consults Dr Guillerma Couto who is a world renowned greyhound medical expert, specializing in osteo.

Search here in the forum for the most recent threads entitled "Osteo Thread" followed by a number(I'll try and bring the latest one to the front page here).  The first post in each thread has lots of links and info that can help you make your decision (though some will be outdated).

Some general things to think and discuss:

Your dog needs to be generally "healthy" otherwise, to absorb the stress and strain on the other three legs - ie, no severe arthritis or degenerative myopathy or spinal issues.  This is especially true for front leg amps as it takes way more energy to do everything with only one front leg.  They also need to be comfortable with strange people and at the vet office as they will be spending a LOT of time there the first 3-4 months between surgery, recovery, and chemo.

The first two weeks following surgery are the hardest as the dog recovers and learns to deal with life as a tripod.  This happens astonishingly quickly from our point of view, but it's a process.  Someone needs to be with them pretty much 24/7 until your sure they can be safe by themself.

If you have a lot of stairs in your home that will be something to consider.  Most tripods end up being able to do them after much trial and error - supervised of course.

The cost of the procedure(s) and  hemo is an issue.  Even with insurance it can be *very* expensive.

Amputation is NOT curative.  Osteo is still, at this point, a terminal diagnosis.  So.  While amputation and chemo will buy you some time, there's no guarantee of how much.  It could be days.  It could be years.  Or anything in between.

Palliative care is a perfectly acceptable choice.  Provided you remember that the goal is to keep your dog happy and pain free.  There's no need to be especially conservative with pain medication because of side effects.  

So you can see there's just lots of things to consider and only you can make the right choice for your family.   Good luck!


Chris - Mom to: Lilly, Felicity (DeLand), and Andi (Braska Pandora)

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Angels: Libby (Everlast), Dorie (Dog Gone Holly), Dude (TNJ VooDoo), Copper (Kid's Copper), Cash (GSI Payncash), Toni (LPH Cry Baby), Whiskey (KT's Phys Ed), Atom

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Super Bowl Sunday so responses may be a little slow here today.  I'm sorry you have to deal with this like so many others here have.  There is a series of Osteosarcoma threads that will let you see what others have dealt with and the decisions they've made. Here is the most recent one, and it is a running post although it seems to have slowed down recently.  

There are 8 other related posts of 50 pages each  - so probably close to 1000 individual posts in each one with lots of good info. Also be sure to read the posts from Beachbum1 about Taylor. Taylor had an amputation and was one of the longest living hounds with osteo that we know of. He did well for a very long time before succumbing to this disease. There is no right or wrong decision here. Only the decision that is right for you and your hound. 


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Always missing my boy Hi Noon Rocket. The home of Petunia, MW Neptunia and Kate, Miss Kate.

 

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Read the osteo thread - it will take some days to get through it - it is really informative.  Contact Dr. Couto for his opinion. Find a hospital affiliated with a vet school and get an appointment with an oncologist there - they can provide options and the current trials going on. Get information on Amicar - greyhounds can break up clots too early and cause bleeding (Dr. Couto provides info on this) if you decide to move towards amputation. 

Your dog's temperament should also factor into your decision as choices like amputation and chemo will require much handling. 

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As stated above, there are a lot of variables involved in making a decision to go forward with surgery.

It's a "given" that the cancer comes back after Osteo diagnosis.  It's just a case of when, and sometimes something else sends the dog "to the Bridge".

This thread is about Taylor's journey, as listed in Remembrance.  Taylor was a Miracle Dog.  Acknowledged by all of his doctors.

Taylor, 12/11/08-3/23/17

 

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Posted 3/24/17:

A wonderful mobile vet came to the house Thursday afternoon, to help Taylor have no more pain.

 

Taylor was a miracle dog.

He was diagnosed with Osteosarcoma above his right front wrist 1/10/15.

I immediately turned his care over to an oncologist practice with a wonderful doctor.

Since it appeared to be caught early, we thought we would try to save the leg.

Started with radiation treatments, and also Carboplatin chemo.

He also received an IV every 4 weeks of Zoledronate, a bone strengthening/pain relief drug.

He tolerated all treatments well. No side effects, as expected.

 

After 1-1/2 months, he slipped and fell, and broke a small bone in the area of the cancer.

He was then basically using 3 legs, and managing just fine.

Running faster than Face in the back yard. Spinning and leaping.

 

A few weeks later, he turned in the back yard, and broke another part of the bone.

 

We decided it was then time to amputate.

Amputation was done 4/10/15, and even with Amicar to control bleeding, he still had massive amounts of swelling and edema. His body was trying to absorb the edema, but he was peeing dark red. He had to stay in the hospital for 6 nights, on IV fluids to keep the kidneys from being damaged.

 

Within 2 weeks, he was back to demanding and loving rides and walks 2-3 times a day.

Hopping in and out of the SUV with Face.

Going out and about everywhere. Seeing people. Getting hugs.

 

He was a happy boy.

 

It's a given that Osteosarcoma comes back in the lungs. Just a matter of time.

Every 3 months, he would go in for chest x-rays and blood work. All was fine.

 

This past June, the chest x-rays showed a couple of very small nodules in his lungs.

We started him on Palladia, a chemo pill, given 3 times a week.

The thought was that the chemo pills would slow down the growth of the nodules, hopefully shrink them, and keep others from forming.

No side effects from the chemo pills.

Checked his blood every 4-5 weeks.

 

Late this past December, I noticed he was slowing down walking. Not as hungry. Hard to lay down.

They did chest x-rays (looked good), blood work (looked fine), and an ultrasound of his abdomen (all clear).

Started him on 300 mg of Gabapentin for pain every 8 hours.

 

He was not feeling better.

Two weeks later, I happened to be on the floor with him, and his front left leg felt very warm, and very swollen.

X-rays of his legs the next day showed that he had a very rare condition called Hypertrophic Osteopathy.

He had a temperature of 104.3.

That condition seems to be an off-shoot of nodules in the lungs.

It's a thickening of the periosteum, which is a tissue surrounding the bones.

It is progressive. It is painful. It can't be cured.

 

He then started taking Previcox, which is an anti-inflammatory/pain medication and within 24 hours, the fever was gone and the swelling was down. He was walking better.

 

Most dogs don't survive that condition more than 4-6 weeks.

The amount of pain medication needed would then be too much for the dog to function, especially a 3 legged dog.

 

Around 4 weeks ago, Taylor started coughing.

Chest x-rays showed that 3 nodules in his lungs were between 6-10 times larger than they were 11 weeks earlier.

The chemo pills weren't as effective anymore. One nodule that had been the size of a dime was now the size of an egg. But he wasn't coughing when walking or eating. Just once in a while when laying down.

 

Earlier this week, the coughing got worse and he was having a real hard time walking and laying down, but he was eating well, and demanded those rides and walks. His breathing was very rapid. He seemed uncomfortable.

 

Tuesday evening, I noticed his left front leg was swollen in a large area.

I called the oncologist's office in the morning, and they said to bring him in.

They did one x-ray of his leg, and the doctor showed me the huge difference in the thickening of his Hypertrophic Osteopathy.

 

He was taking the maximum amount of pain medication. There was nothing else to do to help him with his pain.

It was time.

 

Taylor was my first greyhound, and he came to me 12/20/11 when he was 3 years old.

He was a BIG boy (90 pounds), and he loved his hugs.

We went everywhere together. He loved rides and loved being around people.

 

Face, another big boy at 85 pounds, joined us a year and a half later.

He loves rides and walks, too.

I would be walking, loose leashed, 180 pounds of well behaved hounds, in stores, everywhere.

 

I promised each dog, when they came to me, that I would always take care of them, and keep them happy as long as possible.

 

On Wednesday, I knew it was time for Taylor. The doctor and I knew it was coming.

He was a miracle dog.

It's VERY rare for a dog with Osteosarcoma to still be around 2 years and almost 3 months after diagnosis.

He was a tripod almost 2 years.

Never slowed him down.

Up until a few weeks ago, he could STILL run faster than Face.

 

Taylor's last day, Thursday, was a Taylor day. 2 rides. 2 walks. 2 cans of dog food. Lots of treats.

Saw lots of people he loved, and they said goodbye to him, and cried.

We've lived here for almost 3 years and have met thousands of people.

 

The vet came to the house at 2:00 PM on Thursday.

The dogs greeted her looking for TREATS!

She was so caring and gentle.

She and I sat on the floor, and I petted Taylor's head and told him what a good boy he was.

Face stayed in the room and watched (mostly upside-down).

Taylor passed quietly.

I have his ashes back today.

 

My heart feels shattered.

I had not left him alone for more than 2-3 hours for the past 2 years and almost 3 months.

He was my heart dog. My baby boy. My hug-loving boy.

I know it was time, and I wouldn't let him suffer.

 

I miss hugging him.

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this is a tough personal decision, some dogs do well and beat the odds, some don't. if you decide not to amputate and proceed with pain management(which is what i did the first time) then it's the right decision for you. don't feel guilty, some dogs do not last that long after amputation, some are lucky and as i mentioned beat the odds. it's a stressful situation for you. How good is your dog's health insurance? How much time do you have to be able to rehab the pup if amputated? Have you looked into FREE clinical trials for canine cancer. Just google it and something will come up. It's sponsored by the American Vet. something or another. I've been there twice with my GHs. The second girl was far more sensitive and pain management was not the answer for her. Life throws us some nasty curve balls- HUGS- your decision will be the correct one. 

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Whatever decision you make is the right one. As you're making it out of love.

 

I won't tell you what to do. But I'll  tell you what I did.  I went the amp route for two girls. A 12 year old and 9 year old. I  had Diamond out to OSU (from NJ) for a ton of examinations to make sure she could handle it at her age. Dr. Couto said age is just a number.  Diamond was a very healthy 12 year old.  She did fantastic and even surprised her care givers with her recovery.  She lasted a wonderful pain free 6 months before osteo hit the back leg.

Tanzi lasted 14 terrific months enjoying life to the fullest before osteo hit her back end. God I miss my Tanzi. 

It's supposed to be rare that osteo comes back in another bone but both my girls had that. 

While the first 2 weeks are very hard,  you'll question your decision, once you're past that there's no stopping them. They just won't be able to do the walking distance you once did. And be careful of stairs.  They forget they lost a limb.

Good luck.

 

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If you decide to go the amputation route, the Tripawds website has useful forums and reasonably priced guides.  I bought Three Legs and a Spare before our first amp and it was incredibly helpful, including advice on how to prepare for those first days after your dog returns home.  The books can be downloaded.

No affiliation, just passing along a resource that I found useful.

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Thank you to everyone who is responding. We certainly can use all the information and tips you all are able to provide.

 

Update: We reached out to Dr. Couto and he was quick to respond.  We are going to consult with him.

 

We also are meeting with the surgery team at a university hospital in Boston on Thursday.  Still have not made a decision and really looking for what questions we should be asking or what things we should be getting. 

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This info is in the osteo thread, but just to throw it in here, there are much better palliative care options now than just oral meds. Ask about both IV Pamidronate and palliative radiation in your consult if you want to consider other options. Sadly I've been through this twice. I don't know if I would choose amputation, but it wasn't an option for either of mine so we went the palliative route. It's a tough road either way, sorry you're going through this. 


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Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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Are you going to Angel or Tufts? One of my dogs had the amputation at Angel in Jamaica Plain and another one at Tufts in Grafton.  They both have great teams - check the list of trials going on because each place may be participating in different ones. 

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1 hour ago, NeylasMom said:

This info is in the osteo thread, but just to throw it in here, there are much better palliative care options now than just oral meds. Ask about both IV Pamidronate and palliative radiation in your consult if you want to consider other options. Sadly I've been through this twice. I don't know if I would choose amputation, but it wasn't an option for either of mine so we went the palliative route. It's a tough road either way, sorry you're going through this. 

Zoledronate has been used to replace Pamidronate.  It has proven to be much more effective, and takes a lot less time to administer.

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1 hour ago, Beachbum1 said:

Zoledronate has been used to replace Pamidronate.  It has proven to be much more effective, and takes a lot less time to administer.

Sorry, I meant to say Zoledronate. I used Pamidronate with Neyla way back when and Zoledronate with Zuri more recently. 


gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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I am so sorry for this sad diagnosis.  I wish you and your dog well.


Irene Ullmann w/Shine and Odin in Lower Delaware
Angels Brandy, John E, American Idol, Paul and Fuzzy
Handcrafted Greyhound and Custom Clocks http://www.houndtime.com
Zoom Doggies-Racing Coats for Racing Greyhounds

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1 hour ago, BrittaAndGregg said:

@NeylasMom why were they not approved for surgery?

It's not that they weren't approved. They both had other physical issues that I thought would make 3 legs difficult and Neyla was too anxious at the vet's to put her through that. They were also 10 & 11 so that was a factor for me. But both were diagnosed in May. I let Neyla go the day before Christmas Eve. Zuri didn't have as much time, I let him go the day after labor day. But they were happy and playful until things started to go down more quickly at the end. Zuri I think could have had a lot more time because the Zoledronate really helped him, but he developed kidney issues as a side effect, which is when it was clear we wouldn't have much more time.


gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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We lost two to osteo - a retired racing greyhound and a Spanish galgo. We chose palliative care, but it's a very personal decision and whatever you choose will be the right decision for your family. I'm very sorry regardless. 


Laura with Celeste (ICU Celeste) and Galgos Beatrix and Encarna
The Horse - Gracie (MD Grace E)
Bridge Angels Faye Oops (Santa Fe Oops), Bonny (
Bonny Drive), Darcy (D's Zipperfoot)

 

 

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Hi,  I'm sorry your GH was diagnosed with osteo.  Our miracle story is Jamey's.  Diagnosed at 8.5 years, early on in the disease, they had a hard time diagnosing it.  We amputated his front leg, he had 5 chemo treatments once healed from the surgery.  He lived another 27 months post amputation, all except the last month being a "normal" 3 legged dog.  Not everyone gets this amount of time but Jamey did.

Then our other osteo case was gone in 2 days....

Good luck with your decision.


Tin and Michael, Galgos: Lucas, Baltasar, Picasso, Hero, Oasis, Galina, Neizan, Enzo and Salvo the Galgos.
Remembering Bridge Angel Greyhounds: Tosca, Jamey, Master, Diego, and Ambi; plus Angel Galgos Jules and Marco.

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