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Help with Amputation Decision

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12:04 pm
12 April 2009


Leah

Member

posts 4

1

My sweet, gentle Olivia (Pit Bull mix, age unknown, but at least 10 years and probably older) has been diagnosed with a tumor "highly suspicious of osteosarcoma" in her right proximal ulna (elbow).  Her lungs and abdomen are clean as of a month ago.

The tumor was initially discovered in an x-ray that looked abnormal, yet did not scream osteo.  So, we did a biopsy which came back clean – - completely clean.  Our vet, at Tufts (LOVE Tufts), really felt it was cancer so we did a nuclear scan and her elbow lit up!  That very day, we did a second biopsy which came back as cancer.  Olivia has a pronounced limp, but it is not terrible, and varies in severity from day-to-day.  She does steal herself before going up and down stairs and doesn't follow me all over the house like she used to.  She is particularly stoic, even by doggy standards, so it is hard to get a read on her pain (we are using Rimadyl and Tramadol right now).  Also, she might still be in pain from the biopsies.  She does seem a bit depressed, which could be pain or boredom (she hasn't been able to walk with her canine buddies for a few months now).

I feel really confident in the care we are getting.  Everyone at Tufts (surgeon, oncologist, internist) is steering us, gently, toward amputation.  (To their credit, they are also clearly outlining the pros and cons of all treatment options.)  The amputation is scheduled for Thursday.  Right now I also plan to do chemo and work with an integrative vet on nutrition and acupuncture.

My question is whether anyone out there has similar experiences – - atypical tumor, in the elbow, and, most importantly, a dog who does not appear to be in excruciating pain.  This is really hard, to decide to remove a limb on a dag who is getting around alright.  I feel like if she were barely able to use the leg, it would be a lot easier to do this.  But, in so many wasy, she seems almost fine.  She even runs, yes runs, back into the house on a brisk day.  I have thought about palliative radiation, but understand amputation is the gold standard.  Help!  This is the worst decision I have ever had to make.  Any thoughts or stories would be appreciated.

Thank you for this website, for keeping Jerry alive to help his canine pals on earth, it has already been a great help (and allowed me to release uncontrollable sobs when I first read it.  I needed to cry.).

Leah – devoted pawrent to sweet, loving Olivia

12:49 pm
12 April 2009


hugapitbull

My heart lives at Rainbow Bridge

Moderator
Moderator

posts 3167

2

I know what a difficult decision this is to make, and I know how torn I was when faced with it.  The vet we are currently using for treatment is not the vet who diagnosed the osteosarcoma.  The diagnosing vet gave us options, but did not encourage us to pursue them.  The treating vet, very much encouraged amputation.  Why?  Because it is the only way to stop the pain.  The pain may not seem to be severe now, but as the disease progresses so does the pain.  I made the decision to amputate because I did not want to see Trouble drugged on pain killers for whatever time she had left.

The morning I dropped her off for the amputation, I drove to work wondering and praying I'd made the right decision. When we picked her up 2 days later, she was happy and able to get around on her own.  She needed a little assistance for about 3 days and from then on she is good to go.  Knowing what I know now, I'd make the decision again in a heartbeat.  For now she is cancer free and pain free.  As with any cancer, it can return but we will live each day to the fullest until that point.

I am a big advocate for the surgery, I feel like it gave us the time we've already had pain free.

Make decisions with your heart, based solely on the quality of life for Olivia.  One of Jerry's famous lines is 'there is no wrong decision'.  The point being not every circumstance is the same.

Shanna & Spirit Trouble

Trouble gained her wings 3/16/2011, a 27 1/2 month cancer survivor, tail wagging

RIP sweetheart, you are my heart and soul.  Run free at Rainbow Bridge.

We honor our fellow November Five members who will always remain forever in my heart

 Nova – the lone survivor, live proud and long

 Spirits Max, Cherry, & Tika – who made half the journey with us and greeted Trouble at the Bridge

http://k9cancer.org – a canine cancer support community

 

2:29 pm
12 April 2009


jerry

The Rainbow Bridge

Team Tripawds
Team Tripawds

posts 6961

3

Leah, thanks so much for joining us here, we're so sorry about Olivia. But kudos to you for being such a great pawrent, you are definitely doing everything in your power to make a good decision that's right for you and your girl.

Lots of dogs don't show horrible pain when they are first diagnosed. Many will hide the pain from their pack until their leg shatters from the cancer eating away at the bone. That's how strong and stoic we are! I did a 12 mile hike just a few weeks before my surgery. My pawrents were stunned when they learned that I did the hike with a huge tumor in my scapula.

As you know, the pain from bone cancer is horrible, beyond belief for humans, and something that no human would tolerate for very long. If you decide to move forward with the amp, it is best to do it sooner than later.

You are so fortunate that you discovered the cancer while she is still healthy and able to get around well. That is a big plus to have on your side.

Another plus is that the tumor is located down lower on her leg. From what we understand, the lower it is, the greater the chance that "clean margins" around the tumor can be obtained, and a longer metastasis-free period can happen.

You are in great hands at Tufts, and we are completely confident that if you do go forward with the surgery, you can give Olivia the kind of quality of life that she deserves. While there are risks with the surgery, and all dogs are different in their recuperation time, we're betting that you will be amazed at how quickly she bounces back.

We hope this helps somewhat. All of us here understand how hard this is, but remember, it's harder for you than it is for her. Try to follow her lead, and think more Dog. Never fear, never worry, life life one day at a time and everything will be OK.

Keep us posted and let us know what happens Ok? We'll be thinking about you.

"It's better to hop on three legs than to limp on four."
Read my news blog lately?

Help with Tripawd Research!
What do you want to see in a new Tripawds Canine Amputation and Cancer Care Survey?

3:18 pm
12 April 2009


Carina

Member

posts 132

4

My question is whether anyone out there has similar experiences – - atypical tumor, in the elbow, and, most importantly, a dog who does not appear to be in excruciating pain.

Raises hand and waves. Yes, left elbow, 8 yr old Rottweiler. Background: Despite being diagnosed with bilateral elbow dysplasia at about a year old, he became asymptomatic (no limping) except for feet that turned out when standing at rest, and has had a very active life and great agility career. Timeline:

Aug 2008, turned up limping at a trial. Rest didn't ease the limp, so in Sept he had xrays showing fractured coronoid process and "joint mice" which are bone chips, basically.

Oct 23, ortho surgery to remove the bone chips, knowing that it only had maybe 50:50 chance of being successful. After consideration, took chance. It was not successful….had him in physical therapy, etc etc, but he didn't improve.

Jan 2009 he got worse. Back to vet, re-xrayed, saw a little bitty spot, needle biopsy to check for fungal infection and cancer. Biopsay came back negative for both. He got much worse, very quickly, and a decision had to be made. Still thinking it was an ortho issue, I made an appointment for Feb 9 (soonest I could) for an ortho consult hoping he would be a candidate for a TATE elbow prosthesis. Exhaustive research, second/third opinions and calling all over the country led me to believe this was probably the best option.

By the time we got to MSU, he was three legged and on Fentanyl patches. By that time he was wearing his tracking harness so I could help him get up, down, and around, when I thought he needed it. He never vocalised, whined, flinched, nothing, this whole time. Just was three legged and starting to act "depressed." It was awful because he is such a high drive, exuberant dog, to see him like this and I felt so helpless.  Dr DeJardin manipulated his leg and poked around and Cooper just stood rock solid still, no reaction except a low growl (which was more comment than threat.)

They xrayed and the tiny spot from 3 1/2 weeks prior was now a blurry grey mass almost obscuring the elbow and the bone was eaten away. They said cancer, but not osteo (they thought, hemaniosarcoma or synovial cell sarcoma, I think that's right) and also saw one spot on his left lung. After the amp the path report came back with a long complicated report but basically, osteosarcoma, clear lymph nodes (yay)….it's an atypical location for the tumor as you know, and given all the ortho stuff, this confounded the diagnosis.

This is not my first osteo dog and it took me about one nanosecond to decide on amputation. He was amputated on the 13th and was up and walking from day one.  Is he "cured"? No he is not. He is way low in energy, sleeps a lot and is starting to go off his food. I had his chest re-xrayed 3 weeks ago and ultrasound; the spot on his lung is unchanged so perhaps it's not cancer, and his organs looked good except for a little ambiguous something on his spleen. Bloodwork is all normal, heart and lungs sound good, no masses (I just had him and my other two dogs at the vet yesterday for the annual heartworm blood test and requested a blood panel and exam on Cooper.)

However he goes for short daily walks, plays sometimes, goes to the beach, wades around in the water, putters around in the park peeing on things, is alert, and not hurting.

Wow, there must be something therapeutic about being able to ramble on about his story! Anyway my bottom line: I would never hesitate to do an amputation again. Chances are the pain from the tumor will shortly become unmanageable and there is no medication strong enough. If Olivia is limping, she is hurting. And being a stoic girl, she is probably hurting badly. I think you are probably getting the best advice from your vet team, and I applaud your decision. I tell you, I just couldn't wait for Cooper's nasty old leg to come off, once I knew what the deal was! I'd been warned that the sight of him might be "upsetting" afterwards but phhhhtttt. I thought he looked beautiful with the painful leg gone.

One piece of advice (I don't know if somewhat copious drainage is more common with front leg amps) – if the vets put in a drain, you may see a lot of watery/bloody discharge. This is OK. As in, drips wherever Olvia walks, little puddles when she's lying down, drippage down onto her forechest where she can't clean herself. Old towels and sheets, and clean rags with antibiotic dish washing liquid or soap to keep her clean, and to protect her dog bed or wherever she's going to lay down and sleep.

I've probably rambled long enough LOL….here are pics of Cooper from 2 days post amp to recently. Somewhere I have a video of him running in a local park at six weeks post amp to the Flight of the Bumblebee. :D Best of luck to Olivia, and her mama too!

5:42 pm
12 April 2009


Leah

Member

posts 4

5

Thanks Jerry, Carina and Shanna & Trouble,

Your words (and pics) mean a lot.  I feel a bit less alone, having now heard from other tripawd pawrents personally.  I DO need to do this surgery.  I just don't want to have to.  I am preparing myself for a difficult road ahead for the next few weeks.  But I will take to heart the advice I keep reading here – - I will be her strong pack leader, and try to take this all more like a dog and less like a darn human!

Any prayers, good vibes and positive thoughts are graciously appreciated for Olivia's surgery and recuperation period.

8:28 pm
12 April 2009


Java mom

Member

posts 3

6

I just made the difficult decision to amputate the front right leg of my 13 year old Rottweiler Java.   She had the surgery just this past Thursday. I viisted her at the hospital on Friday and she wanted nothing to do with me, she would not even let me pet her. 

We have been together just the two of us for the last 12 years so her reaction shook me to my core. Never has she been anything but excited to see me.  I absolutely thought I made the wrong decision. On Friday the vet was very concerned as she was extremely depressed, not eating or drinking. By Saturday she was eating and drinking a little, so they authorized her release only under strict instructions that she would have to return to the hospital for more IV fluids if she did not drink on her own.

Yesterday was extremely hard on us physically and emotionally. Java was eating and drinking but she could not navigate at all on the three legs. Even with my assistance she was falling on her face and just not functioning. I absolutley thought that I made the wrong decision. Java feel on the ice this past December. She was limping and on prednisone and when that didn't help further tests were run and she was diagnosed with osteosarcoma. She was not a candidate for amputation because she has marked joint degeneration in the back and back legs and a repaired ACL in the back leg.   The cancer is in her front right leg. Although Java is 13 she is very active. Thus, unfortunately after 5 weeks of radiation, 3 chemo sessions and weekly accupuncture and chiropractic care, Java slipped and fractured her leg at the cancer site. This is the news that I learned just this past Thursday.

The option was amputation or . .. . ..  Since Java's blood work was clear and her lungs are clear, I wanted to give her the opportunity to live and tried the amputation. I was beside myself last night and logged in for the first time and chatted with Jerrie. He provided much needed support and provided other stories of other large breed (Java is 62 pounds) older dogs who have successfully handled amputaton.  It is now 10:30 pm CDT on Sunday, 3 days after her surgery and I cannot believe the diference. She is still a little wobbly (she is still on the Fentyl patch) but Java is getting along quite nicely on her own. I still assist her with the sling, and she still is falling every now and then, but she is showing progress. Just yesterday she didn't even want to try to walk.

I am very positive with her and tell her how strong she is and how she can do anything. It kills me to see her like this, but with the fracture she was in so much pain and wasn't walking anyhow, at least now she is pain free. My next step is to order her a cart from Eddie's Wheels. Does anyone have experience with this organization? 

Java loves the park and to walk and with her age and arthrtis problems, I think the wheel cart will really help her live the last year or so of her life to the fullest. Anyhow, my advice is that the amputation is probably the best course of action, be prepared for the worst but give it time. I can honestly state that every day gets better. She tinkled on her own just a few hours ago when yesterday she acted like she would never walk again because she wouldn't even balance on 3 legs. 

I truely believe that dogs pick up a lot from your emotions, so I also think it is extremely helpful to them for you to be strong, positive and encouraging to them!  Thanks for letting me express what I have been going through the last 2 days and I wish you the best of luck!

8:40 pm
12 April 2009


Java mom

Member

posts 3

7

I should also say that Java is very stoic and also is on Rimadyl and Tremdol. She probably had this fracture for a while now but I noticed more and more she wasn't putting any weight on the limb. When I brought her in for her scheduled chemo treatment (after 5 radiation treatments, 2 bone building treatments, weekly accupuncture and chiropractic care and adequan injections) I voiced concern that even after radiation she is not using the leg, seems to be uncomfortable despite teh Tremedol and I wanted to do an X-ray.  The x-ray this past Thursday confirmed the fracture. Unfortunately, if your dog is active, it takes very little to fracture the leg at the cancer site. Thus, even if you choose radiation and chemo and forego amputation, in a short time you may be faced with the news that your dog has fractured his leg at the cancer site.  At that point all they can do is amputation or control the pain for a few weeks but the pain will become unbearable. Unforutnately, the osteosarcoma eats the bone from the inside out.  If you asked me yesterday I would have said that I absoltely made the wrong decision and I should have never authroized an amputation on a 13 year old dog with arthritis and joint disease. But now, only 24 hours later, I do not regret my decision in the least.  She is doing such much better as every hour passes. Now I feel that I wish I made the decision of amputation when I first learned of her diagnosis at the end of January! 

9:50 pm
12 April 2009


jerry

The Rainbow Bridge

Team Tripawds
Team Tripawds

posts 6961

8

Oh Java's Mom, we are so glad to hear that things are much better for you two!!!! Thanks for the update. Isn't it amazing what a difference even just a day makes?

Thanks for taking the time to share your story with others. By being so upfront about your fears and experience in coping with the diagnosis and surgery, you are making the world a better place for other future Tripawds and their pawrents. Thank you so much.

"It's better to hop on three legs than to limp on four."
Read my news blog lately?

Help with Tripawd Research!
What do you want to see in a new Tripawds Canine Amputation and Cancer Care Survey?

3:09 pm
13 April 2009


sdbe53

Member

posts 5

9

Amputation was the best decision we made!  Mac was walking on his leg and it had not only fractured, the tumor had eaten half of his femur.  Luckily, the vets were able to get a clean margin.  He felt better almost immediately.  He had surgery on Friday and we picked him up on Sunday.  He had an adjustment period of about 24 hours where he whined and seemed uncomfortable, but then he went back to being Mac!  He was howling and barking and jumping off things (despite our best efforts to keep him quiet).  He's never looked back.  He tells us that leg had outlived its usefulness and he's glad it's gone.

I hated to have to do something so drastic to my furry baby, but he's continued good health and good nature tell me this was the right decision.  Good luck on a speedy recovery!

Stephan

MacInnis

McDuff (Mac's right paw dog)

4:50 pm
13 April 2009


Willysmom

Seattle

Member

posts 17

10

When the vets told us that Willy was in pain, we found it hard to believe. Sure he was limping, but he was also running around and playing, never crying or whining! But the xrays were pretty convincing that it was cancer. We strongly resisted the amputation because it seemed like mutilating our beautiful boy, but then we found this site! We are so very, very glad that we amputated that cancerous leg. Willy has recovered just fine (10 weeks post-amputation); he has no pain and is happily hopping on 3 legs. We even have some family members who were reluctant to come and visit, because they were afraid to see him in "this state". That whole attitude is so wrong. Dogs don't care. Dogs live in the moment and are so happy to be able to love us and play with us. We cherish every day with our boy and we are so grateful that this site gave us the courage to do what was clearly the right thing for us. You'll be able to ask questions about the process with Leah all along the way. There is so much support here. And as Jerry said: "there is no wrong decision". Good luck!

Willy–diagnosed with osteosarcoma January 5, 2009 (amputation January 27, 2009) left us just after his 11th birthday on December 2, 2009 to join all the other brave tripawds. We'll always love you!

11:28 am
18 April 2009


jerry

The Rainbow Bridge

Team Tripawds
Team Tripawds

posts 6961

11

Hi Leah, just checking in to find out how things are going with Olivia. We are thinking of you.

"It's better to hop on three legs than to limp on four."
Read my news blog lately?

Help with Tripawd Research!
What do you want to see in a new Tripawds Canine Amputation and Cancer Care Survey?

9:52 am
18 July 2009


dixiedog

Phoenix, AZ

Member

posts 25

12

How did it go Leah? We seem to be in the same boat, kinda…

I'm debating amputation for my australian kelpie mix, Dixie. She's about 57lbs and we guess 4-5 years old (she's a rescue). In about 6 mos, she grew a tumor vaguely smaller than a softball on her front left elbow. About a month ago she developed the slightest, almost unnoticable limp so we decided to have it removed about 10 days ago. We got the biopsy results back and turns out she has a grade I soft-tissue sarcoma (only 5-10% chance of metastisizing). The vet recommends we amputate the leg to “increase her chances of a disease-free life.”

For now, we've decided to let her recover from her elbow surgery and take her on some four-legged doggie adventures—longer hikes/runs, camping. Like Jerry, she LOVES being in the wilderness. We are thinking October is a good time to do the amputation surgery, with a chest xray before to make sure it hasn't spread.

But I wonder, “Are we being too aggressive?” Dixie was getting around great, running and jumping. I never noticed a change her in behavior. The cancer has such a low chance of spreading. I've read a lot about canine osteosarcoma—all the pain those dogs have—and how they recover quickly because it's a relief to have the leg gone. Since Dixie uses her left leg with no problem, I'm concerned she'll have a harder time recovering.

I guess I just need some reassurance due to her current pain-free situation… Thanks!!

emily & adam & dixie—diagnosed 7/16/09 with a soft tissue sarcoma on her front left elbow. Amputation 8/25/09. Recovering well!

9:33 am
19 July 2009


jerry

The Rainbow Bridge

Team Tripawds
Team Tripawds

posts 6961

13

Hi Dixiedog, thanks for joining us here! You sound like such a great pawrent, Dixie is getting some terrific care thanks to you.

Most times, it seems the best route to go is to try the least invasive surgeries first, and see how things go. My friend Calpurnia was in a similar situation with a grade 2 soft tissue sarcoma, check out the blog post we wrote about her a while ago. You can Private Message her Mom, TC here too for some extra advice from someone whose been there.

It's a tough call when you're not dealing with something as nasty as osteosarcoma. Whatever you decide, only you know what's best for her. See how she does in the next few weeks and be open to hearing what she's saying to you through her actions.Keep us posted OK? Good luck!

"It's better to hop on three legs than to limp on four."
Read my news blog lately?

Help with Tripawd Research!
What do you want to see in a new Tripawds Canine Amputation and Cancer Care Survey?

10:42 am
19 July 2009


dixiedog

Phoenix, AZ

Member

posts 25

14

Thanks for that link! That sounds very similar to our situation. Dixie's tumor is also a "nuisance tumor." Because of the location and how deeply attached it was to the ligaments, they were not able to remove all of it. Even this past surgery was much more invasive than any other surgeries she's had. Knowing that other people/dogs have been in similar situations and have come out well on the other end makes me feel a lot better!

Thanks for the great website! I'll keep you posted.

emily & adam & dixie—diagnosed 7/16/09 with a soft tissue sarcoma on her front left elbow. Amputation 8/25/09. Recovering well!

12:10 pm
19 July 2009


admin

Here and Now

Team Tripawds
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posts 7410

15

dixiedog said:

Thanks for the great website!


No, thank you! This site is only as helpful as it is thanks to the continued support from members like you.

"Dogs are born with three legs and a spare."
— Jerry G. Dawg (10/98-10/08)
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