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Experience with limb-sparing surgery vs amputation?
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baileysaunt
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9 March 2017 - 1:57 am
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Hi Everyone! I am new to this forum - My sister and her fiancé were out hiking this past Saturday with their 5-year-old Rottweiler, Bailey, and when they threw a ball for her to chase, she cried out in pain. They took her to the ER vet thinking that she tore a ligament in her front R leg, only to find out that her X-ray was "highly suggestive" of osteosarcoma. We met with the oncologist on Monday who recommended amputation/chemo as her first choice but when asked about limb-sparing surgery, she said she would be a good candidate (the tumor is localized to the anterior part of her distal ulna and not completely through the bone; also no mets were seen on the chest x-ray). We are meeting with a surgeon tomorrow who does limb-sparing surgery but we were told that it comes with a high risk for complications and 80% of dogs who get limb-sparing experience some sort of infection. I just wanted to see if anyone opted to do limb-sparing over amputation and what their experience was like? Obviously we want what's best for Bailey and would love for her to keep her leg if possible but will do whatever needs to be done to keep her healthy, happy, and here with us for as long as possible. Thanks in advance for the feedback! Any help is greatly appreciated 🙂

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9 March 2017 - 7:22 am
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baileysaunt said
we were told that it comes with a high risk for complications...

Yes, limb sparing often results in complications. Of course, every case is different. And sometimes it is the only option. But too many times we have heard from members over the years who put their dogs through multiple painful expensive surgeries only to end up eventually amputating the leg anyway.

We've published various articles on the subject, and members have started quite a few related topics over the years...

Tripawds Blog Posts mentioning 'Limb Sparing'

Discussion Forum Search results for 'limb sparing'

While you wait for comments from others, use the Advanced Search above to refine your forum search results with specific phrases, and you're sure to find lots of helpful feedback. You can also search all blogs here. Or, consider downloading the Tripawds e-books for fast answers to common concerns and feel free to call the toll-free Tripawds Helpline anytime!

Also: The Tripawds e-books have a section about limb sparing surgeries. Here's a brief excerpt from that:

While not every dog is a candidate for limb sparing, at Colorado State University’s James L. Voss Veterinary Teaching Hospital, out of 300 surgeries, about 85% of patients have experienced good to excellent function.

According to the canine bone cancer support group Bone Cancer Dogs “ ...the average survival after limb sparing and chemotherapy is 50% or better at 1 year, which is equal to the survival of dogs receiving amputation and chemotherapy.”

However, according to Dr. Demian Dressler, in up to 28 percent of cases, tumors will regrow in the remaining
bone. Tumors may also recur in other areas of the body.

What type of limb-sparing surgery was recommended? Did the vet mention bisophosphonates as an alternative therapy?

PS: Please consider registering to take full advantage of this site. For starters, your forum posts will not require moderation and you can subscribe to be notified of replies to your forum topics.

"Dogs are born with three legs and a spare."
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9 March 2017 - 3:06 pm
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Our dog had a different form of cancer, so we opted for limb saving.

It was a nightmare for weeks. They cut out the cancer, took skin from other parts of her body.

It got infected and the new skin on her elbow died. She has lots of scars and we had to amputate anyway.

Where they took the skin wouldn't heal and we had to give her shots twice a day for 10 days along with meds for pain.

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12 March 2017 - 4:30 am
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Thanks for the responses! The surgeon who does limb sparing actually recommended against it, due to the risks and complications associated with the surgery. She's currently scheduled for amputation this Wednesday but the surgeon recommended we talk with a radiologist in the same practice who performs cyberknife radiation before surgery. She said this may be an option for her so we have a consultation with him on Monday morning. The original oncologist also recommended pamidronate; is this the bisphosphonate you are referring to? We'll certainly look into that as an option after surgery.

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12 March 2017 - 10:44 am
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bjwashbu1 said
Our dog had a different form of cancer, so we opted for limb saving.

Wow. I'm so glad you chimed in and even sorrier that you guys dealt with so much. May I interview you for a blog post? We don't have too many folks through the years, it would be helpful. 

It's better to hop on three legs than to limp on four.™
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The Rainbow Bridge

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12 March 2017 - 10:47 am
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baileysaunt said
Thanks for the responses! The surgeon who does limb sparing actually recommended against it, 

Thank you for registering as a member, your future posts won't need approval so post away.

Yes, Admin is referring to Pamidronate, which is one type of bisphosphonate. I was just at a vet conference and the vets there mentioned that Zoledronate is seeing very good results currently, at least for pain relief combined with radiation therapy. 

It sounds like you have some really great care, that's awesome. I'm sorry you have to go through the amputation journey but rest assured your vets seem great. You wouldn't happen to be in NY would you? Just curious, as there's a clinic there that does cyberknife. And yep, it can't hurt to get an opinion about that. We have friend with a Dane who isn't a candidate for surgery and she's getting radiation therapy with chemo, and doing very well last I heard. So maybe it's an option. Keep us posted.

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14 March 2017 - 8:22 pm
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Thanks for the info on zoledronate; I will do my research on that as well. The hope is to get her into a clinical trial this summer at Penn that has had good outcomes for dogs with osteosarcoma. We are located right outside Philadelphia. The cyberknife is at HOPE in Malvern. The radiologist actually also recommended against it, as the risk for fracture is still 40% and should she fracture it, she would most likely have to get it amputated anyway. She is scheduled for amputation tomorrow morning. Just hoping and praying she does well!

Virginia
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14 March 2017 - 9:05 pm
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Jerry...wasn't Shilo in a clinical trial at Penn? Seems like she responded pretty well. Shiloh the Science Dog. TJ's sibling.

Paws crossed for a smooth surgery and smooth recovery!! Update us when you can, okay? And let us know if you have any questions about recovery, okay?

We're here for you.

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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14 March 2017 - 10:49 pm
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Yes Sally, Shilo was at UPenn, Here is the Blog of Shilo the Science Dog

Shilo was (dad) Paul's second amputee due to OSA!  Here are a couple of forum posts about Shilo, one about getting into the trial at UPenn, and one about a write up on Shilo at the vet school.

Karen

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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18 March 2017 - 4:50 am
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Thinking about you guys, and hoping all went well with the surgery - was it yesterday?

Otis - 106 pound lab/Dane mix, lost his right front leg to osteosarcoma on Febuary 9, 2016.  Four rounds of carboplatin completed in April, 2016.  Lung mets August 25, 2016.  Said goodbye too soon on September 4, 2016.   Lost his adopted sister, Tess, suddenly on October 9, 2016. likely due to hemangiosarcoma.  

Wherever they are, they are together.

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22 March 2017 - 7:10 am
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Hi Everyone! Thanks for checking in and sorry it's taken so long to respond.. surgery was last Wednesday and for the first few days she did great. She was eating her food and trying to get up and moving on her own.. but since Sunday or so she seemed to have regressed significantly. She has little desire to get up to do anything, she doesn't want to go out, she doesn't want to eat her food, and she just wants to lay around all day. She's now post-op day 8; is this normal? She did have a reaction to the rimadyl - super anxious, panting, drooling, etc. so we cut back her dose starting yesterday. We're just trying to figure out if maybe the medicine is making her feel like this or if we should be concerned. Any help would be greatly appreciated! Thanks so much again!

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22 March 2017 - 8:53 am
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Probably normal.  Most dogs experience a crash between days 3 and 5 when the hospital meds wear out of their system.  Many dogs are also reluctant to eat, sometimes the meds mess with their digestive systems.  What meds is she on now?  Is she drinking water and peeing?  The good news is that many dogs start to perk up when the staples come out, generally between days 10 - 14.

Otis - 106 pound lab/Dane mix, lost his right front leg to osteosarcoma on Febuary 9, 2016.  Four rounds of carboplatin completed in April, 2016.  Lung mets August 25, 2016.  Said goodbye too soon on September 4, 2016.   Lost his adopted sister, Tess, suddenly on October 9, 2016. likely due to hemangiosarcoma.  

Wherever they are, they are together.

Virginia
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22 March 2017 - 9:05 am
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Glad to hear Bailey is done with surgery and on the way to recovery!

Two things cone to mind as far as Bailey not feeling very perky.

Has she overdone it in anyway? For now, nothing but rest and potty breaks and then back for more rest. Sometimes just the slightest misstep can tweak something so easily the first few days and weeks.

What pain meds is Bailey on now? Most dogs have Tramadol, Gabapentin, an antibiotic and, ues, an anti- inflammatory like Rimadyl. How often is she getting meds?

The restlessness and panting may br a sign of pain and the drooling may be nnausea.Although, just to make things more confusing, tramadol and the antibiotic can cause some of what you've described!

Also, the hospital meds are pretty much all out of their system by day three and there is often a bit of a crash after that. Getting the pain meds dosed correctly becomes more crucial.

Are you trying really yummy foods?? Whatever it takes to get her to eat...cheeseburgers, pizza, scrambled eggs and bacon, etc.

Drinking and peeing and pooping okay? Incision looking okay? No fever?

As always, we are not Vets and if you have any concerns give them a call.

We'll look forward to your update. Hang in there! Recovery doesn't last forever!!

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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22 March 2017 - 9:57 am
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She's on rimadyl, tramadol, gabapentin, and kelfex. I meant to say she reacted to the tramadol, not the rimadyl. It gives her pretty bad anxiety, shaky, and makes her restless. She hasn't overdone it in anyway. She doesn't really do much of anything besides when we get her up to go outside. She tires out pretty quickly when going outside and will lay down right away after she pees. She doesn't get up for anything else other than that and just lays down all day. The incision looks great.. very minimal bruising and no drainage. She doesn't seem sick and is still on an antibiotic. She'll eat eggs, chicken, etc when we make those for her but no interest in her actual food, which she was eating the first few days. Doesn't really want to drink much water either. She just looks somewhat sad and sleepy and just has no energy or desire to even try to get up. 

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22 March 2017 - 10:12 am
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She's a smart girl! Bailey knows she needs rest and is doing exactly what she needs to do. This is MAJOR SURGERY and this is very, very early in recovery.

Walking on three legs at first is very exhausting a d takes a lot of energy, especially while in pain meds. She is getting up, she is eating some...all sou ds pretty normal for this early part of the recovery.

Maybe try to get her to drink a little better. I ended up swirling some ice cream Happy Hannah's water to entice her to drink. So try some different flavors in her water to get her to drink more.

The Gabapentin can have a bit of a sedation effect in some dogs. Again, that's not a bad thing this early on.

O e thing you might try to perk her up a bit. A d this is more for you than her 🙂 Have someone she likes come over. Have them knock on the door with enthusiasm and excitedly call her name, with treats in hand! Bet you'll see her smile!

I know it's soooo hard being patient. We want our dogs and cats to get back to "normal" ASAP! It's hard to remember they just went through manor surgerh, as well as adjusting to three legs. Pretty big deal! Your Bailey will get her sparkle back! PROMISE!! It took me three weeks before I coukd FINALLY say I did this FOR my Happy Hannah and not TO her!! Hang in there! Stay connected!

Hugs!

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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