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Help with decision about older dog
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Member Since:
11 March 2013
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11 March 2013 - 11:39 pm
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Hello,

I need some help with perspective on Beamer, my 10-year-old Shepherd/Dingo (~60 lbs.) mix, who was diagnosed with osteosarcoma in her front right paw today by the docs at Colorado State University Animal Cancer Center.

I got her from my local Humane Society shelter at 12 weeks of age back in my college days, and she's been my constant companion ever since.  She's had hind quarters issues before (mild lameness, diagnosed as knee issues, but a year of glucosamine/chondroitin got rid of all apparent symptoms), so I was worried about her rear end not being able to take the added stress when she's minus one front paw.

The oncological surgeon we're seeing at CSU took x-rays of her hind quarters and thoracic cavity today, and sees no metastasis in the lungs, and some arthritis in both hips and one knee, but says that she sees no instability in her hind quarters that would make her a bad candidate for amputation.  She thinks that the physical evidence indicates that Beamer is a good candidate for amputation.

So I did some Googling tonight, and found this site, and I see a good number of older dogs with arthritis (Nova, Cooper, Trouble, et al), and I've read so much about how dogs are so much less affected by amputation than we humans are...  But my problem is that it seems like attitude is such a large component to how successful the dog copes post-amputation.  You see, Beamer is not exactly a "glass is half full" kind of dog...

She's always been a bit high-strung and anxious, especially around "strange" people.  We have an 18 month old son who is a little terror running around the house and poor Beamer is not exactly thrilled about being fallen on or chased.  It makes me very sad to say it, but sometimes I wonder if there's any joy left in her life.  What does she truly enjoy doing?  I don't know if there is anything joyful in her life any more.  Between my work schedule, my son, and just keeping the house together, we never go on walks or play anymore-- of course, with the new lump on her paw, she isn't really very interested in being very active lately.

I'm worried that between her slightly advanced age, her arthritic hips and arthritic knee, having to go in to the veterinary hospital (which is 1.5 hours away, something she definitely doesn't appreciate...), her lack of positive attitude (for which I do take full responsibility), that if I treat this cancer the way the doctor suggests, I'm just selfishly prolonging the worst years of her life.

Also, my wife doesn't quite have the same attachment to Beamer, being that she married into the dog (we just celebrated our 6-year wedding anniversary), so she doesn't understand my willingness to spend $6000+ for an additional ~year of her life.  I've tried to make a case, and I think she will ultimately leave it up to me, but I know I will feel bad no matter which way I choose.

So here's the bottom line:  I love my dog with all my heart, and all I really want is for her to be happy, and I have the recommendation of a doctor who is among the best cancer vets in the country, but I'm still stuck.  If I amputate her leg and do the chemo and everything, I've calculated roughly that I will have spent about $6000 just to add a year to the life of a geriatric dog who, for all I know, just wants to die in peace.  But if I don't amputate her leg, then I have to euthanize her, or even worse, just let her cancer metasasize and/or her leg become more and more painful and eventually fracture until she dies or I'm forced to put her down.  How am I supposed to reconcile any of that?

Is there anyone here who's experienced anything like this?  I'm specifically asking about amputation/chemo in 1) an older dog, 2) with a "less than positive" life enjoyment outlook, 3) with arthritis in at least one of his remaining legs.  Can anyone give me some perspective on this?  I'm really having a hard time here...

Thanks for listening!

krun15
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12 March 2013 - 8:35 am
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Welcome to Tripawds, your future posts will not require moderation.

I'm at work right now so don't have much time, I wanted to get your post moderated so maybe some other members can chime in.  I'll check back later.

 

Karen

NC
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12 March 2013 - 9:55 am
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I can't address the lifelong attitude issue because Kermit (he'll be 11 in April) has always been a bundle of goofball, except when he was in such pain.

HOWEVER, it's likely that that tumor has been in your dog for quite some time before you saw any outward symptoms, so I'd guess her lack of lust for life & walks could very well be that she's been in pain for longer than you were aware. 

But I CAN say that Kermit has "significant" arthritis in all 3 of his remaining legs, especially his remaining front elbow and one rear hock where he was hit by a car as a puppy.  The vets & I initially agreed that he was not a good candidate at all.  But when radiation didn't give him any relief from the tumor pain & he was clearly in agony, we decided that arthritis pain is a lot easier to manage and went ahead & amputated.

It's been 2 weeks today & he's back to playing ball, chasing my poor kitty, and hopping up & down onto/off the furniture.  He had osteosarcoma AND lymphoma, so if we get a year I'd be THRILLED beyond belief, but even if we don't get anywhere near that, I see my former goofball coming back and know that whatever time he has left will be worth it.

I can't imagine how much harder the decision would be if you couldn't tell if your dog was ready to go... but at least try to think about how she might have been feeling 3 or 4 or 5 months or so ago and consider if her outlook then was any better & if it might have been clouded lately by brewing pain.

Twin Cities, Minnesota
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12 March 2013 - 11:51 am
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I was in similar shoes six days ago. My dog Sampson is a large breed (akita x) who has arthritis (troublesome) and mild dysplasia in his hips. He also is hypothyroid, has an autoimmune disorder that made him lose his hair and be prone to skin issues, and has invasive lipomas (one in his hamstring which add to our back leg issues). He is almost 13.

For me, it would be a no brainer...as I have had him since I was 23 years old. DH, otoh, is a little more..."old school" in his thinking. And, we have four cats (one of whom also has a chronic, terminal illness that set us back a  couple grand already this year) and another dog. So...lots of vet bills, even in a good year. I had to take that into account.

At his diagnosis, the lysis was so advanced in the front leg, that the vet basically said...amputate now, or put him down (or wait until he has a traumatic fracture, which, honestly, could have happened at any second). We chose amputation (about $750), and no chemo (although there were studies at the U we could have gotten in to). We are considering metronomics .

Bone cancer is horribly horribly horribly painful. Meds don't really touch the pain.

Everyone's decision is different, there is no right or wrong answer. But with OSA, the only way to really get rid of the pain is to amputate, or let them go (esp. if they are shoing signs of discomfort, b/c by then they are REALLY in pain).

For me, and even my very practical husband, in the end, amputation was an easy choice. But that is our decsion--you have to decide what is right for you.

"Let us think the unthinkable, let us do the undoable, let us prepare to grapple with the ineffable itself, and see if we may not eff it after all."
-Douglas Adams, Dirk Gently's Holistic Detective Agency

"May I recommend serenity to you? A life that is burdened with expectations is a heavy life. Its fruit is sorrow and disappointment. Learn to be one with the joy of the moment."
-Douglas Adams, The Long Dark Tea-Time of the Soul

New Haven, CT
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12 March 2013 - 12:42 pm
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I think I'm going to parallel what mmrocker13 has to say: amputate or be ready to end her pain soon by euthanasia.  I say this so bluntly b/c you asked for our opinion.  I also say this, mostly, because of how you paint your dog's quality of life and age.  If she were younger and/or with more zest and/or with a quality of life everyone enjoys, I'd push you to amputate for sure and then look into chemo options.  I guess for me the diff between amputate w/o chemo and freeing her to the Bridge, would be if you think you and your family want to go through the recovery, the costs, and the travel time all in the end to give your pup painfree months.  All those issues, for the simple sake of her life, are too important to ignore.  If your pack cannot help her through recovery, amputation may be too cruel...  It's noted that OSA in older pups moves less quickly, so it's possible that amputation alone *may* give her the months everyone wants/hopes!  The same can't really said for a pup diagnosed with OSA at age 2 or 3...

It's a tough call.  Everyone has been there in some way.  For us, amputating was a no-brainer.  Jackson has a great life and so much life ahead of him.  The tough part came down to chemo, weighing the time, money, 'likely outcome', etc.  In the end, everyone here has had to make a tough decision.  Whatever it is, please make it in the best interest of your pup.  Just by being here and posting such a thorough question tells me you have her interests high on the list.  Whatever you decide, make sure you can sleep well with your decision.  It's tough.  So tough.  Let us know!

~ Katy

ACL tear in right hind leg 12/5/12 and scheduled ACL repair surgery 12/21/12. Pre-op xrays revealed osteosarcoma. Amputation 12/28/12.  Chemo (carboplatin) started Jan 10, 2013 and ended on April 5, for a total of 5 doses. He handled carbo like a champ!  No side effects.  We started metronomic therapy at his third chemo and have been also doing some holistic treatments.  He's a lively, playful 10 year old huskie-boarder collie and a very proud member of the Winter Warriors!  Our love. Our funny little guy!

Twin Cities, Minnesota
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12 March 2013 - 1:49 pm
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fetchon3 said
All those issues, for the simple sake of her life, are too important to ignore.  If your pack cannot help her through recovery, amputation may be too cruel...  It's noted that OSA in older pups moves less quickly, so it's possible that amputation alone *may* give her the months everyone wants/hopes!  The same can't really said for a pup diagnosed with OSA at age 2 or 3...

~ Katy

The age thing is one of the reasons it made our choice relatively simple--Given Sam's age and size and breed, seeing 14 or 15, while not IMPOSSIBLE, was highly unlikely. But at almost 13, he was still enjoying life (albeit in his low-key, yet slightly neurotic way).

Doing chemo would be very pricey, and stressful given his temperment. Even the study--while less expensive would have been VERY stressful for him, for a variety of reasons. Chemo would net us (likely scenario) 6-12 months at most.

No chemo and amp alone, we could go 2-6 months (most likely odds)...and low-stress. And it was cheap. Even the metronomic protocol would be relatively inexpensive should we go that way (we are already on piroxicam).

So for the extra thousands of dollars, and a stress-inducing experience, our chance of a gain would be small. Again, it made it easy. Lung mets or more other bony tunors also woudl have made it easy (relatively speaking, I mean).

In a way, I am very glad I didn't have to make this decsion at 6 or 7 or even 9 or 10.

"Let us think the unthinkable, let us do the undoable, let us prepare to grapple with the ineffable itself, and see if we may not eff it after all."
-Douglas Adams, Dirk Gently's Holistic Detective Agency

"May I recommend serenity to you? A life that is burdened with expectations is a heavy life. Its fruit is sorrow and disappointment. Learn to be one with the joy of the moment."
-Douglas Adams, The Long Dark Tea-Time of the Soul

Virginia







Member Since:
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12 March 2013 - 1:54 pm
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I also welcome you to the team no one wishes had to exist - and thank goodness it does.

 

For me the decision was a very difficult one as my Happy Hannah is a senior by  Bull Mastiff's standards and overweight by anyone's standards!  The decision was made by Hannah when the pain started getting worse and I had to increase her pain meds and I knew I would be losing her sooner rther than later.

The amputation is three weeks ago and fallen into the "statistics" of some take longer to recover than others AND she is recovering AND getting her sparkle and joy back --slowly but surely.  I'm paraphrasing Jerry but he says' "Statisticly(sp)  nine out of ten statistics are wrong!!

You appear to have made a great' wellthought-out assessment of your situation, possible recovery challenges, Beamer's Attitude, etc. Happy Hannah's energy level and joy of life was very evident for a laid back dog prior to surgery and that was also an important part of my decision.

 

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!

Virginia







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12 March 2013 - 2:09 pm
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Sorry, the tablet keeps crashing.  As mentioned eaelier, perhaps some of Beamer's "not enjoying life" is due to the bone cancer pain or he may just be feeling his age.  Getting old is not for sissys and it's no fun!!      Hannah just has myself and my other dogs to handle her recovery and it has not been easy.  For me, there has been a lot of missed time from work and many, many sleepless nights by her side on the floor

 

Whatever the outcome, you will make the right decision.  Keep on searching this site and you will find many situations like Kermit and many other dogs with mo hallenges or a lot of challenges  I don't know how long Hannah's leg will hold out but I have slings ready and as long as she has the sparkle, the joy and the "I,m not through wagging my tail yet "attitude' we'll keep on hopping along.

Again, I applaud you for the depth you have given your situation.  YOUR assessment is based on YOUR knowledge of all the dynamics of your household.  In the meantime you .ove up on Beamer like he's never been loved before.  Spoil him---chicken, ice cream (just a little) and tons of hand clapping for every step he takes.      The very best to you and Beamer has a great Dad as his champion

 

Sending you support',   Sally and Happy Hannah

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!

My heart lives at Rainbow Bridge
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12 March 2013 - 5:19 pm
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Trouble was 10 when she had her amputation.  The real question is how much time will I have, and unfortunately, no one knows the answer to this question.  Vets can give you statistics, and yes there are many here who follow the statistics. But then there are the Trouble's, and Nova's that just beat the odds for who knows what reason. Trouble's arthritis didn't develop (or maybe become an issue) until the last 6 - 9 months.  I hesitated to treat the arthritis aggressively because I had some insanity going on in my head that told me it may shorten her life. What was I thinking.  She was 12 years old by then, had beaten cancer, and I was worried about giving her something that could reduce her lifespan?  Really?!

One of my biggest regrets is not doing more sooner for the arthritis.  It likely wouldn't have bought her a lot of time, but it may have bought her some.

With the cancer and treatment, you have to just jump in there and do what you think is best for the two of you.  If the arthritis is already causing mobility issues, then I would consider that as well.  If you have a vet you trust with your heart, let them guide you. 

You will make the decision that is right for you and Beamer.  Just have faith, and keep us posted.

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.
The November Five - Spirits Max, Cherry, Tika, Trouble & Nova. 11/2008 - 3/2013 An era ends as Queen Nova crossed the Bridge.

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12 March 2013 - 5:47 pm
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I'm so sorry you have to make this decision.  I adopted Willow after her amputation, so her amputation wasn't my decision to make, but I have had to make other difficult decisions with beloved dogs in the past.  Even though I made the decision out of love and in the best interest of my dog, I have always wondered after the fact if my decision was the right one.  So, maybe there isn't a "correct" decision. 

 

If she is in pain that will alter her outlook and how she behaves.  If she isn't on meds, maybe you can get her on some pain meds and see how she does for a few days.  That may help you with your decision. 

 

People here will tell you how great dogs do on 3 legs, and that's true.  They will also tell you that it's a major surgery, that the recovery can be rough, and that it is a huge commitment on the owner's part to help their pet through the recovery.   There are no guarantees, there are never guarantees in life.  There is no way to know what Beamer's recovery will be like and how long she will live after amputation.  Will you be upset with yourself if you don't try the ampuation and see how she does?  Or, maybe even worse, will you be upset with your wife because you feel pressure from her to not choose amputation?  It wouldn't be healthy for your marriage if you end up blaming your wife.  If you choose amputation, are you prepared to help Beamer though her recovery?   You love Beamer so much, so make your decision based on your love for her.  And whatever you decide, you can be sure that Beamer knows that you love her. 

 

Carol

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13 March 2013 - 9:37 am
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Wow...  Thanks everyone for all of the replies.  I was waiting for my first post to be moderated, and I thought I would get an email when I got replies, but I checked on it today to see if it was moderated yet and saw all of this...

 

For the folks asking about Beamer's attitude and whether or not it could have been affected by her OSA, I believe strongly that the answer is no.  My son was born in September of 2011, and she was very much affected by the new addition to the pack.  She's gotten a lot less attention from me and my wife ever since then, and I think she resents being shooed away from the baby (which we do both for his sake and hers, as if he falls on her, she would not be very happy).  Of course, we also move the baby away from Beamer when she's minding her own business, and he's getting to the age where we can tell him "be nice to the doggie" and he understands what we mean.  In the past 18 months, her attitude, which was before more happy and bright (the reason she got her name), became either anxious and high-strung, or sullen and distant, depending on the day.

 

I absolutely do not think that she's had this OSA (or any cancer) for 18 months.  Considering that as of a month ago, she had no noticeable lump on her paw, and today her right wrist is over 2cm bigger than her left (in diameter), I'm fairly sure that the OSA is a new development.  Within the last few months for sure.

 

She is on pain meds (Rimadyl, Tramadol, and Gabapentin) as well as Fluoxitine (Prozac) for her anxiety (which doesn't really seem to be helping yet but she's only been on it for a week), vitamin E for her crusty/cracked nose, and glucosamine/chondroitin for her arthritis.  She seems comfortable, and doesn't show any obvious signs of pain anywhere, although I know that dogs will often hide pain very well.

 

I do appreciate the blunt advice.  Over the past 48 hours I have really come to peace with the fact that Beamer is likely not long for this world.  By yesterday morning, I had pretty much made up my mind to treat her with palliative intent, and not to do the amputation and probably not the chemo either.  I've spoken briefly with the oncology vet about it, and she seems to think that it's a perfectly valid direction to go in (but of course, every vet is going to say something like "only you can decide what is truly right for your dog"...  I just wish someone or something else would just make this decision for me!).  I haven't yet fully committed to any decision, but I'm not in a hurry at this point to do anything because I'm definitely leaning towards palliative.

 

She may be dead tomorrow, and I'm okay with that if that's the way it goes.  She's had a good life, and I truly believe that she's on her way out.  I don't see death as a bad thing, it's just a part of life.  I will miss her terribly when she's gone, but I'm way too practical to let that get in the way of her well-being.  It's kind of funny, in a dark way, that I could be considering letting her die to benefit her "well-being", but I think that's really the truth.  I believe that if she could speak, the existing level of stress in her life, combined with the stress we would be adding with 3-hour trips to the cancer center every 2-3 weeks for 9 months, would be at the point where she would probably just rather say goodbye than live an extra 1-2 years of old age.

 

That's where I'm at today anyway...  New perspectives are welcome.  Thanks.

Twin Cities, Minnesota
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13 March 2013 - 9:55 am
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One thing I would add, if you are considering palliative care...most vets (and probably doctors and people who've had it) would agree that when it comes to bone cancer, the best drugs still don't take the pain away--certainly not if the individual taking them is staying reasonably coherent.

So, and I sound like a bossy, pushy, proselytizing harpy, I'm sure...but if you want palliative care, consider amputation, at least. Or don't let her linger. YOU may "not be in a hurry at this point to do anything", but it is probably very, very painful for her. And, beside that...esp. if they tumor is large and visible, that bone could shatter at any time. That, for me, was the worst thought. I couldn't have handled that--and it would have been horribly ugly for the dog.

And while he didn't say it in these exact words, more or less, our vet boiled it down to "whether you choose chemo or radiation or any of that or not later, make your decision now to take the leg off, or put him down. B/c if you DON'T, the alternative could be heartbreaking and traumatic."

It's a tough place to be in, absolutely. And I can't tell you which option is right for your family--but putting off a choice IS a choice, and in the end, there is a very real chance that it's one without a happy--or even peaceful--ending.

 

"Let us think the unthinkable, let us do the undoable, let us prepare to grapple with the ineffable itself, and see if we may not eff it after all."
-Douglas Adams, Dirk Gently's Holistic Detective Agency

"May I recommend serenity to you? A life that is burdened with expectations is a heavy life. Its fruit is sorrow and disappointment. Learn to be one with the joy of the moment."
-Douglas Adams, The Long Dark Tea-Time of the Soul

NC
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26 February 2013
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13 March 2013 - 9:57 am
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Sorry you have to arrive in this place at the end of her life- sometimes the end is SO hard. :(

If you truly believe that letting her go is the right thing to do, and from your description I'd have to agree, I don't see any benefit to prolonging her life until she's in too much pain to function. Please, please, please keep a very close eye out for any decline in her comfort level and don't let her get to the point where she's just existing.

As much as it makes it easier to think "tomorrow she might be dead & I'm ok with that", it's probably not going to happen; you're probably going to have to make the awful choice and the dreadful drive to the vet to euthanize her to prevent her suffering. Just be sure the decision is made with her ease in mind above yours.

 

NC
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26 February 2013
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13 March 2013 - 10:02 am
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I have to agree with mmrocker above- if she shatters that bone, which can be absurdly easy to do when it's severely compromised by the tumor, the result is catastrophic and you do NOT want to have to go through that. Sorry to be so graphic, but this will likely not be a quiet, "the dog started limping badly" kind of break.

 

On The Road


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13 March 2013 - 10:36 am
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Jon, I apologize for being late to this discussion, I just now saw your post. After reading through your situation, I'd say that in your heart you know what the best decision is for Beamer. Amputation isn't right for every dog or every pack, and it's a tough decision that deserves careful consideration as you're giving it. Not all dogs are cut out for the recovery process or life afterward, and since you've lived with her for so long only you know how she might do.

Palliative care is always an option and you aren't the first person here to decide on it. We are here to support you no matter what you decide, so as you go through this journey remember you can come here to talk. A few references I wanted to point out:

Colorado State has an excellent hospice program through their Argus Institute. I'm not sure you live within the service area but it can't hurt to ask. It's free and an excellent choice for end of life care without pain. Another great resource you might want to read is Just One More Day, in which the author chose palliative care for his dog with osteo.

This is such a hard part in the journey we take with our pack, I'm so sorry you are going through this.

Tripawds Founders Jim and Rene
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