HELP - My best friend has osteosarcoma

[chivas]

Yeah, the sling goes under their belly and you help them walk - they cannot walk with it without your help, let me see if I can find a picture of one.
dog harnesses adns slings and mobility support to help a dog walk

I used something similar to the belly sling

[Xena's Daddy]

Chivas, thanks for the info!! That looks like a good product, it should work well, as long as I'm around to help her with it. I may give it a try..........
MK

P.S. Was breed was Zeke? 17 years??? Wow!! That's a good run!

[jlaack]

My vet doesn't really know what to do. He said that there really is nothing to do and he said that if we wanted some oral morphine, he would supply that in Lucas' last days. God, this is like hospice care.

This is one reason why it is helpful to use an oncologist even if your not treating. They have so much more knowledge about this than regular vets that you are likely to get more accurate answers to your questions. Regarding the oral morphine, I'd highly recommend having some on hand even if you never use it and perhaps even some ace (sedative). If your dog has a nasty fracture you still need to get the dog to the vet (unless the vet is coming to your house). For this purpose make sure you are not getting the extended release morphine. For the extended release morphine if the tablet is crushed or broken and not taken whole it can cause a morphine overdose. It can be difficult to give a pill to animal in pain and it is very difficult to transport a dog in pain. We were going through the limb spare and had a complication arise. After that I insisted that I had a small supply to get my dog through a minimum of two days if needed.

limb-sparing IS removing the tumor.......in a sense. With OS, the tumor is not a growth ON the bone, but rather the bone itself changing shape, growing un-regulated in an outwardly fashion. So basically, you do not 'remove' the tumor, you 'grind' down the bone & either use a bone graph or an implant of some kind, since the remaining bone is brittle & will not support the dog at all.

The limb spare does remove the tumor but the tumor is cut out. Then either an implant (typically of bone, sometimes manmade) is placed in the space left and the entire leg is plated in addition to the ankle being fused to minimize the impact on the plate. There are many variations on accomplishing this but even for a small tumor the amount of bone removed is substantial. At this juncture this would definitely not be the route to go and I would say any vet that would consider performing this procedure at this time is inethical (ditto for amputation). While the visible tumor is growing rapidly the likelihood of what the cancer is doing on the inside that you can't see is probably more of a medical concern for your dog. I'm not trying to scare you, but it is the impact on the internal organs that often is the end for dogs with OS, not the initial tumor unless there is a fracture or pain cannot be managed.

I just saw the post for a sling. I will also recommend a harness. The dog can easily wear it 24/7 and you can use it to lift your dog too. This piece of equipment was invaluable to us (still is). It is called the WebMaster Harness, Ruff Wear Dog Boots, Dog Coats, Dog Bowls, Dog Packs, Dog Toys, Dog Beds, and other Dog Gear For Dogs On The Go..

[Xena's Daddy]

Originally Posted by jlaack

Regarding the oral morphine, I'd highly recommend having some on hand even if you never use it and perhaps even some ace (sedative).
The limb spare does remove the tumor but the tumor is cut out. Then either an implant (typically of bone, sometimes manmade) is placed in the space left and the entire leg is plated in addition to the ankle being fused to minimize the impact on the plate.

Jlaak,
Thanks for the info on the harness. I have some thinking to do........

As far as the tumor discussion, I think we're both saying the same thing, just from a different perspective. You obviously have more experience with this than myself, as my dog has not undergone that procedure. But as far as I understand it, the 'tumor' IS the bone in a sense.........not really bone, as you have stated, but rather made out of what the bone is changing into in that area. (Not Really bone, but a more honeycombed brittle substance) Which is why (As far as I know) there is a 'hole' left over from the procedure. For if was was truly just a 'growth' on the bone, there would be no recess created from it's removal, no??


I am just trying to understand this thing a little better, as I was very interested in this option when everything first started happening with my girl. Let me know if I got anything wrong.

Thanks!
MK

[chivas]

Zeke was a mixed breed chow and whippet. The fastest, blackest, skinniest little mutt you have ever seen. And never a lb over 33lbs his entire life. Oh, what a huge hole that 33lbs has left in our lives.

[jlaack]

As far as the tumor discussion, I think we're both saying the same thing, just from a different perspective. You obviously have more experience with this than myself, as my dog has not undergone that procedure. But as far as I understand it, the 'tumor' IS the bone in a sense.........not really bone, as you have stated, but rather made out of what the bone is changing into in that area. (Not Really bone, but a more honeycombed brittle substance) Which is why (As far as I know) there is a 'hole' left over from the procedure. For if was was truly just a 'growth' on the bone, there would be no recess created from it's removal, no??

Yes this description is more accurate, especially once the cancer has progressed. But to remove the tumor the bone is also being removed, not just the area affected by cancer. To get clean margins a significant amount of healthy bone surrounding the mass also has to be removed. If the tumor is removed without the clean margins no progress was made. Which is why it would be inethical to try to remove the tumor at this stage. I thougth about posting one of my dogs post op xrays in my photos but the xray has my personal information on it and I'm afraid the mods will not approve. Anyhow, my dogs tumor was very small but there was a lot of bone removed in comparison to area that actually was the tumor.

I realize how much information there is surrounding OS. I am still routinely asking questions of our dogs team of oncologists and learning new things constantly there is no harm in reaching a better understanding of something or gaining more knowledge. Granted I am working on gathering information to maybe write a book on this topic for owners, but still the more I know the more it helps me in terms of being a better owner for my dog with this disease.

[Xena's Daddy]

Originally Posted by jlaack

the more I know the more it helps me in terms of being a better owner for my dog with this disease.

Well said!!

P.S. Regarding the X-rays, have you ever tried to 'photo-shop' them? You know, 'crop' out your info & 'save as' a different file name? (To keep the originals intact) I'm curious to see them, I'm sure all of us are.

Regards,
MK

[jlaack]

Regarding the X-rays, have you ever tried to 'photo-shop' them?

No, that didn't even cross my mind. Anyhow, I erased my personal information that I know isn't allowed on this site and posted the xray of our third revision in my gallery. My dogs tumor was initially maybe 1-1 1/2" in diameter (I'd have to dig to find the exact measurements) but as you can see they had to remove a substaintial amount of the radius to get the clean margins. While this view doesn't show the implant the clearest the gap is actually filled by a piece of the ulna because the procedure we had was an ulnar transplant, which removed a piece of healthy bone from the ulna and replaced the cancerous bone on the radius. The entire plate holds it all together while the fractures we created through this procedure are healing.

[lucasmom]

Hi Mike (Xena's Dad) and all...thank you for all of your responses to my post. I so appreciate being able to share with all of you. It is such a consolation to know that you are not alone during this very difficult time. As Mike requested, I did post some pictures of Lucas so you could see my "love dog"!! He is the most wonderful, kind, and gentle dog I have ever had. It makes me sick to think that our time together is coming to an end because the this dreaded OS.

I wish that there was more that I could do. There are no oncologists in our area. The closest is at Cornell University. I did call there and they only want to see you if you are considering chemo and surgery. I don't think that I could bear seeing Lucas suffer any more. I feel like he would no sooner be recovered from surgery and then he would die. I just want to spoil him and love him in his last days. I made him 70 little meatballs yesterday that I hide his pills in three time per day. He knows the word, "meatball" now.

I got really scared yesterday because he couldn't get up after lying down and his hips looked like they were giving out. I had to help him get up and his back looked like it was sagging. Could the cancer have metastisized to his hips?? Anyone have any ideas? I was upset the entire evening after seeing him not be able to get himself up off the floor.

Thanks for everything and for your support and friendship. Laurie P.S. Mike I looked at Xena's pictures and she is absolutely gorgeous. What a beautiful girl she is!

[jlaack]

The closest is at Cornell University. I did call there and they only want to see you if you are considering chemo and surgery.

That is apalling! We had spoken with oncologists at Colorado State U., Oregon State, UW Madison before we treated our dog and weren't sure where we were going to treat (if we were even going to tx) and all of them were willing to speak with us and see our dog just to provide a consultation and more information. They were willing to assist with any level of care we wanted to provide. Colorado even provided a free consult on xrays for us just for another opinion. All said, I probably spent a good 6-7 hours on the phone and e-mail with oncologists before we made a decision at no cost even.
I routinely go to UW Madison even though everything the oncologists do is routine checkups on my dogs cancer status and they know we won't treat even if it surfaces again. The care they provide could easily be done by a regular vet but they have never questioned seeing my dog.

Could the cancer have metastisized to his hips??

Yes, the cancer can spread to other bones though this is less likely than it spreading to organs after the primary tumor. It could also be that your dog is sore in the hip area from having to compensate his movement to accomodate walking and positioning himself in a way that is more comfortable because of the tumor. If you want to rule out a tumor in that area the best thing would be to xray the hips. If knowing for sure isn't that big of a concern then I'd just keep an eye on changes (both comfort and appearance) and maybe adjust the pain medication according to your dogs needs.

I am sorry that you and all of us are going through this.

[lucasmom]

Thanks jlaack...I have lost total faith in veterinary medicine due to my bad experiences so far with Lucas. The poor dog already was recovering from a fractured radius in August and having gone to the emergency vet center on a weekend, I was told that he needed the leg either amputated or pinned (for 4K). After 24 hours in the emergency vet center, they set his leg, took X-rays, and started and IV...the bill was $1,200. My vet provided follow up care and told us that we could simply cast his leg and see what we were left with in 12 weeks because he felt that the break was clean enough to heal. Well, after another $1,000 in follow up care (sedation and X-rays every 1 - 2 weeks and a tooth that needed to be extracted), Lucas was walking and doing so well at Christmas. That was my present. I was so happy.

Unfortunately, just when I thought that all was good and that we could move on with our lives...Lucas was diagnosed with OS on 2/28/08 after he began limping. I was told that he had "3 weeks to live"..."do not treat"...it would be a "waste" of more money and he would suffer recovering in his last days. Not feeling entirely comfortable with this "death warrant", I asked that my vet send his X-rays out to a radiologist for confirmation. I did not want a biopsy. Get this....I was charged $47 for a verbal conversation between the radiologist and my vet. I was not "allowed" to speak to the radiologist and I was not provided a name of the radiologist when I asked. I was told that if I wanted her name and a written report of her impressions, I would need to pay another $60!!! I was outraged. Needless to say, I no longer go to my vet. I found a vet who treats OS in a palliative fashion with accupuncture and analgesics. To go to Cornell for a consult, just to speak to the vet, who they could not promise would not be an intern, the cost was $150. I don't mind paying that, but I wasn't even guaranteed to see a real veterinarian unless I agreed to leave him for the weekend and begin chemo. I am contemplating not even getting another dog after Lucas dies. I cannot believe how corrupt these vets are..........I am in the medical profession myself and we would never treat our patients and their families this way. It is very discouraging. So..jlaack you are very fortunate to have such great vets at your area of the country. I was wondering...you are so knowlegeable, are you a vet yourself? Please don't take offense at my negative comments about my poor veterinary experiences if you indeed are a vet yourself. Laurie

[jlaack]

So..jlaack you are very fortunate to have such great vets at your area of the country. I was wondering...you are so knowlegeable, are you a vet yourself?

NO, I am definitely not a vet. And I wouldn't be offended if you thought badly of my professional group either not at all related to veterinary medicine. There are good and bad professionals in every sector of the economy IMO.

I am VERY sorry to hear about your very negative experiences as they are disheartening to hear. I don't disbelieve these experiences at all, it is just very frustrating because I was so pleased with the oncologists in my time(s) of crisis that it is frustrating when others have an experience that is so opposite.

Don't get me wrong, I have also had bad experiences with vets (and doctors). One oncologist in particular--I refused to let him have any direct involvement of my dogs care. He was very technically competenet but he was so technical in his manner of practicing medicine that I felt my dog might not do well being going through chemo tx with him. I spoke for my dog and insisted this person not provide care for my dog (he didn't) and this individual was also the head of the oncology department. Additionally my dog most likely lost his leg because of a veterinary error. We trusted a regular vet to recast his leg post op--big mistake. The positioning wasn't correct and afterwards our dog didn't put his leg down once until after the next surgery. The radius was shattered but we tried to correct it twice, then tried a different technique and last took the leg. I learned a valuable lesson, and after that I permitted no one but our surgeon to have anything to dog with our dogs leg until it was removed. We also have a very expensive prosthetic in our attic which I only trust to collect dust. So I guess, I do understand bad experiences. What I mostly found appalling (with your experience) is the oncologists lack of willinginess to explain things or discuss things with you. Knowledge is power and shame on them for being unwilling to share their knowledge.

I recall you posting about the 3 weeks to live estimate and that is just so incredibly ridiculous. That vet obviously doesn't have a clue what he/she is talking about. The saddest thing (IMO) is that if I had been told that by a vet after my dog was dx, I likely would have believed that my dog had about a month and there was nothing I could do. And I am sure that there are owners out there that make decisions and think things that aren't accurate simply because they trust the vets position without question. We have had times when the answer to our questions was, I don't know, or this is just a guess... Yes it can be a little scary to have that be an answer to your concern but I'd rather have the truth than an answer that may not be accurate.

Again I am sorry that the professionals you have turned to for help have been more harmful than helpful. I am also glad that you have found someone that is helping you to care for your dog. On a different note; there is a non-profit in MD, run by two vets. Here is their site: Kate Koogler Canine Cancer Fund : Help us fund cancer research for large breed dogs.. Since they are closer to your geographically they might know of an oncologist that would be open to having a conversation with you just to share information with you about your dogs dx, not information about tx.

[chivas]

I competely forgot about the Kate Koogler Cancer fund and I was one of the first members! They help fund OS research in dogs and may have some better info for you, I know the wife is a vet.

[Anne]

I too was told by my vet in December that my dog probably only had a couple of weeks of life left. The pathology result showed her cancer to be 'highly malignant'. We saw an oncologist within two days and though the pressure for surgery followed by chemo was intense I just kept saying NO, I will not go down that path. They wanted to surgically remove her mandible. My research shows that by the time osteo is diagnosed it has probably already metastasised so I couldn't see the point in putting her through the pain of such a radical surgery.

Sophie is still doing well on the metronomic drug protocol. She has strong pain relief and she shows no sign of pain. Her appetite is good and she's actually gaining weight on the cancer starving diet. She does have difficulty in eating meals sometimes so I spoon feed her. She is quite adept at eating from a spoon.

[Xena's Daddy]

Originally Posted by lucasmom

P.S. Mike I looked at Xena's pictures and she is absolutely gorgeous. What a beautiful girl she is!

Hi Laurie, And thank you!! I think she's pretty swell!
Lucas is a really nice boy too! He looks like a sweatheart!! You can tell a lot by the eyes! ;)

So yesterday I brought Xena around to see some old 'friends' of hers (ours), you know, all the places she always liked to go. She's always made such an impression on everyone she meets and always gets so happy to go visiting! She knows all of my friends by name, always has. If I say, 'Go say hi to Joe', she's goes to Joe. Not Mike, not Rick, but Joe. And if I tell her to 'go say hi to Rick', well........you get the idea. (I LOVE my girl!!)

A lot of them were all together yesterday (Which made the trip easier! LOL....), and this was the first time any of them has seen her since the Dx, so it was kind of heartwrenching for them. She actually made a grown man cry yesterday. (He held it back the best he could, but I could tell.......)

It made me realize that it's not just me who thinks she's so special. She's actually had quite an impact on a good handful of people over the last 7-years. And as bad as I feel for those who are hurt by this, it makes me feel a lot better knowing that people genuinely care about her. Just knowing that tells me that her memory will last a lifetime!!

Hope all is well.
Talk to you soon,
MK