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Keep getting bad news!
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1 August 2017 - 9:46 am
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We have been fighting some sort of infection for over a year with our sweet, sweet Maddy.  She is a rescue, and we do not know her exact age, but she is about 7ish years old, mix of lab, shepherd, boxer.   She has had 2 toes amputated on the same paw, both with bone infections, but no bacteria present.  The last amputation was about 8 weeks ago, and yet she still limps.  So today we went to see a specialist, who gave us some more bad news.  Whatever was in her toes, is now in the area above her toes, not the wrist.  This is where the pain is coming from.  SO, our first line of defense is to see if we can get some other staining done on the amputated toe, to see what other bacteria it could be. Doc said that with her being from the south, it could be something that the labs up here would not test for.  Then we try to treat whatever it is.  Mind you , she just finished 6 weeks of an antibiotic, which did nothing to help.  The other option, if this treatment does not work, is amputation of her front leg.  I am devastated by this last option!!! I know we need to wait and see if the first line of treatment works, but I am torn between amputating, or putting her down.  How do I know this will take care of the issue?  Is she too old for amputation? What is the cost of a surgery like this? Both toes were about $1600 total.  What will her quality of life be?  Has she been through too much already, and how much more should I put her through?  Any advice, words of wisdom would be greatly appreciated!

Here and Now

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1 August 2017 - 10:04 am
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So sorry to hear about the Maddy's challenges and the decisions you face. You are not alone, everyone here understands what you are going through.

While it will be best to have a final determination about what is causing the bone deterioration, in the vast majority of cases dogs bounce back quickly and cope much better than their people do. You will find answers to all your concerns in the Tripawds Blogs, Jerry's Required Reading List, FAQs, and Tripawds e-books

"7ish" is not old. You will find many success stories about senior Tripawds in the Size and Age Matters Forum. There are numerous surveys and topics regarding average costs of amputation. Of course, every dog is different.

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. Start here for help finding the many helpful Tripawds Resources and feel free to call the toll-free Tripawds Helpline anytime!

Please keep us posted, your future forum posts will not require moderation.

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2 August 2017 - 11:33 am
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So sorry to hear about the bad news you keep getting. Its hard to make these type of descisions , here you will find answers to almost all of the questions you have or at the very least direction to the answers you seek. 

One year ago today our girl Mya lost her leg to osreosarcoma, she was up and hoping around on three legs the very next day. 5 rounds of chemotherapy went well but in the end the cancer had spread to her lungs and she left us in April of this year. In her case the bone cancer had advanced very quickly and we had no choice but to amputate. On the bright side her pain was gone... she was happy again , bossing Macleod around like the diva she was and the kisses... (Mrs. Kisses) lived for the moment as all our animals do. We have learned to be more dog like and to view life from the now. 

Just yesterday we had to let our boy Macleod go free from this earth. We know now that he is pain free and running around with Mya again. In his case the Osteo came on slowly  ( slowly as cancer goes...) and when it was discovered there was already signs of metastases in his lungs so the amputation option was not an really an option. We decided to try a holistic approach, we changed his food to a raw freeze-dried diet ( Orijen ) brand. He loved it... as well we started him on a Cell Care and Immuno Boost (liquid tincher drops) purchesed from the holistic vet. And we gave him vitamin D droos ( infant dose ) that we got from a local pharmacy. We gave both of them CBD ( a cannabinoid product) and Artemisinin (a chinese herb made from sweet worm wood, said to attack iron rich sells. Apparently, cancer hordes iron). Going into this second run at cancer we weren't sure of Macleod's time with us but wanted to give him every chance at a quality of life. We believe these other medications helped because when we ran out a few times of one or another there was an obvious decline in their health. 

So research all you can and come back here with questions. We are all behind you in your fight. 

Many hugs and tail wags coming your way... Terry, Allison, *Macleod, *Mya.

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5 August 2017 - 1:47 pm
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Thank you!  The pathologist is going to do some more staining on the toe we just had amputated.  It isn't cancer, thank goodness.  But it has to be some sort of infection.  I am hoping to hear back on Tuesday with the good news that whatever it is can be treated.  I am sure I will definitely have questions if the time comes that we need to decide whether to amputate or not.

Wyoming, NY
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5 August 2017 - 3:05 pm
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I am so sorry that you are going through this. There is nothing worse than an undetermined diagnosis. The good thing is that you are now in the hands of a specialist, this person should have easier access to more resources and a bigger network of colleagues to go to for their expertise to come up with an answer. 

I agree that "7ish" is not too old. My Jesse, a 60# shepherd mix, is 9 and when I discussed with the Dr what his life expectancy could be if the cancer was gone was told that with his current health, this cancer was robbing him of 1/4 of his life. That is significant.

Please let us know how it goes for you on Tuesday. We are all pulling for you.

Elizabeth & Jesse ❤

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10 August 2017 - 8:03 am
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So we heard back from the pathologist, and they didn't find anything, no bacteria in the sample.  But the sample is now 3 months old.  The specialist gave us 2 options: biopsy tissue and maybe bone and use another lab.  He said we still might not find the cause, even with the biopsy.  OR amputate.

I have read that bone biopsies are very painful.  I don't want to put her through that kind of pain, and not find anything.  She has had 2 toes amputated, so I don't know if a bone biopsy would have the same pain or worse?  Could a bone biopsy cause her bone to break? This infection is in her dew claw and in one of her metacarpel bones. If we don't find anything, we amputate.  Meaning we did the biopsy for nothing.

So I need some serious opinions here!!! What would you do in this situation?  Do we go for the biopsy and possible find the cause of whatever is eating away at her bone? Then we treat it and save her leg.  OR do we just go straight to amputation? Either way she will be in pain, but she is in pain now.  

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10 August 2017 - 8:48 am
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Oh wow, that is a really, really tough call. I can tell you that with my guy Clyde, I opted not to have a bone biopsy before amputation when the vet suspected osteosarcoma. The vet tested for valley fever, and that was negative. He told me that the next step was bone biopsy. Well, like you I had read how painful that procedure is and that it is not always definitive. I felt that for Clyde, the best step was to skip biopsy and go straight to amputation. There were some other factors involved - I was on leave for my own issue, and getting the amputation done immediately meant that I would be home with him for the first two weeks of recovery. So we went with amputation, and the biopsy after amputation confirmed his diagnosis. 

If you do the biopsy and they can confirm infection, what are the chances that it can be effectively treated without amputation? It kind of sounds like a stubborn infection and that you may end up amputating anyway as it moves up her leg, but that's just my interpretation of what you wrote. 

Canada
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10 August 2017 - 9:34 am
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You & and Maddy are going through some hellish times right now, Stewie & and I feel very deeply for you.

I don't know much about bone biopsies and even less about bone infections. But I do know that when we were faced with losing Stewie within two months because of his pain, or amputation to get rid of that pain (100%), we knew we had to amputate. We also realize that by doing this, we may not buy Stewie much time, the Osteosarcoma is already in his blood stream, but at least the time he has with us, (it could be a few months or hopefully a few years!) will be full of love and not pain. 

Making decisions like this for ourselves would be difficult enough, but having to make those decisions for a loved one is even more difficult! I have pondered your situation and I too find it difficult to offer my opinion... I think that in your position, I would biopsy first... there is always a chance that there is an infection and that infection can be cured. 

The chioce to amputate was easier, due to the eventual outcome, than it was to actually deal with the amputation itself. I thought I was ready for the challenge, but my doubts and fears were huge and I was constantly questioning our decision. Should we have biopsies first? should we have waited? Is this the right decision for our massive dog? And the list goes on... Thankfully, (if there is any thanks to be given to a diagnosis of Osteosarcoma), we didn't have any choice... we saw the X-ray and the shattered bone, that was the tumour and once we had done our research, the decision had to be made.

i don't know that any of us can give you the right answer. I get the feeling though that Maddy is in excellent hands and if you follow your heart, you can never make a wrong decision. 
All the very best and lots of sloppy kisses to Maddy.

From Super Stu🐾 & his pack,

Petra, Paul, Spike🐾 Chester🐾 & Miss Lily🐾❤️

Stewie adopted his Pack in 2015. He has 3 feline siblings, Mr. Spike🐾 Chester Molester🐾 & Miss Lily🐾He was diagnosed with OSC on July 5th 2017 and had his left front leg amputated on July 10th 2017. He is our Tripawds Super Hero!🐾❤️                                         http://stewie20.....pawds.com/

The Rainbow Bridge

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10 August 2017 - 9:54 am
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First, how is her pain being managed? If you notice she is in pain, she needs more medication. If your vet isn't providing it, then please ask or turn to a new vet if they don't have any recommendations for stronger medication until this is resolved. I'm sorry, I know that's not what you want to hear right now.

Have you asked the vet, will her leg need to come off regardless of the test results? Is it beyond repair? If the leg is so damaged that it's beyond repair, why wait to amputate? 

Yes, a bone biopsy could break the bone when the procedure is being done, if the tumor has destroyed the bone beyond repair. It's a risk. Most times a needle aspirate should be enough to diagnose. I'm sorry it wasn't the first time for you guys.

In situations like this I recommend turning to a larger institution for at least looking at the biopsy sample. A veterinary teaching hospital can look at her case and all the tests that have been done and come up with some recommendations. You may not even need to visit the actual campus. Where exactly are you? We can help point you in the right direction.

Another option is to have a new fine needle aspirate biopsy sent to the incredible folks at Texas A&M Diagnostic Lab. They are probably THE best lab in the nation when it comes to odd cases like this. Your vet needs to reach out to them to get hooked up. 

I hope this helps.

It's better to hop on three legs than to limp on four.™
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10 August 2017 - 10:36 am
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This has to be so exhausting emotionally and physically!!     Not to mention frustrating beyond words!   Try and take a couple of DEEP BREATHS.....B R E A T H E......B R E A T H E.........

teach16711 said

I have read that bone biopsies are very painful.  I don't want to put her through that kind of pain, and not find anything.  She has had 2 toes amputated, so I don't know if a bone biopsy would have the same pain or worse?  Could a bone biopsy cause her bone to break? This infection is in her dew claw and in one of her metacarpel bones. If we don't find anything, we amputate.  Meaning we did the biopsy for nothing.

It seems to me you have a "sense" of which way to go based on your comments.  Yes, the bone biopsy IS painful and so very, very often INCONCLUSIVE.  Many here who have gone through it said they would not do it again.   Not everyone,  but the majority.   Absolutely no right or wrong!   The often "inconclusive" part is what's frustrating to so many.  

It also seems, based on whst you are saying, the "infection" is spreading and it hasn't been stopped at all by aggressive antibiotic treatment....and the pain is getting worse!    So even IF a bone biopsy shows it is an infection, it appears that amputation is the only recourse anyway.....am I reading that right? 

  Good feedback from Jerry.  Maybe some of those options will make you feel more comfortable if you do proceed with amp.  And, as Petra suggested, you can still do a bone biopsy and it may possibly get results. Or, as Clyde's Mom suggested, skip the biopsy for all the reasons outlined.   You get the point...NO CLEAR ANSWER!  

Should yoh proceed with amputation....it's ine surgery....pain is gone...and you're done!!   Sure, recovery is no picnic for a couple of weeks, but we are all right by your side to help support you.  Maddy will have some good pain meds to help her!  Sounds like she's already adapting to three legs by not using that painful leg much.   Should you go that route, you will be AMAZED at how happy she is ro have the pain gone and avle ro get on with a quality life of spoiling a d love and more spoiling!!

Update when you can...and we would love to see pictures!!

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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10 August 2017 - 3:55 pm
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I am in Meriden, CT.  We know for sure that it is not cancer, so no tumor.  Something is eating away at her bone, osteolysis.  So any biopsy done is to determine what sort of infection is in her bones.  My feeling is that the infection was already in her foot, and not even looked at due to the swelling of her toes prior to amputation.  

Right now, there is no pain management.  We were given tramadol prior to her last toe amputation.  We were able to get the meds at CVS. But I don't think it worked.   She does use her leg, and also hops on 3.  She runs around, but that doesn't last long of course because her foot hurts.  Besides this, she is a spunky dog.  She wants to play and run and go for walks. 

I think that if she did have cancer, amputation would be the definite route.  Her leg is not beyond repair.  If we can determine the cause, the specialist said we can treat it and save her leg.  BUT there is always that possibility that we don't find the cause of the osteolysis, even with a biopsy.  If that happens, we will have no choice but to amputate.  Those that have amputated, how long did you need to stay home with your pup?  I am a teacher going back to work in 2 weeks, so I won't exactly be able to take time off already.  

I am also thinking if the pain of a biopsy would be anything to what she experienced with the toe amputations.  She handled those like a champ! I was a mess though!!! 

I was just hoping for some opinions on which option others would consider.  How do I upload a picture?

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10 August 2017 - 6:01 pm
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teach16711 said
How do I upload a picture?  

Here are detailed instructions for adding photos to forum posts. If you don't already share photos online somewhere, you can start a free Tripawds blog any time and upload them there. Need further help? Post in the Tech Support forum and we'll be happy to help!

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10 August 2017 - 10:39 pm
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I completely understand how you feel.  We have been through a similar situation.  We have an 18 month old golden retriever (Wendel) who had his front leg amputated last Thursday.

In January Wendel started limping.  We brought him in for x-rays and we were referred to a specialist and he was diagnosed with OCD.  Wendel has surgery in April and we were told that these surgeries are almost always successful.  However, during the surgery the specialist noted that this was an odd presentation of OCD, he sent the joint fluid off to pathology and the results were inconclusive.

The recovery from surgery was rough.  Wendel did not show any signs of improvement, and we noticed that he was in more pain and has muscle wasting.  We returned for x-rays in June and the lesion on his bone was worse, and the integrity of the bone was poor.  The surgeon suggested a biopsy, but stated that the bone may be beyond repair even after we determined the cause.  We agreed to the biopsy, however the surgeon was out of town until August so we would have to wait.

In July we returned to our vet, as Wendel was continuing to deteriorate.  Another set of x-rays confirmed that the lesion was worse and the bone had further deteriorated.  Chest x-rays did not indicate any sign of cancer.  The vet performed a bone aspirate with inconclusive results. Despite not knowing the cause of the lesion we proceeded with amputation.  We wanted Wendel to be pain free and did not want to wait until August 15th for the biopsy.  We also worried about subjecting him to a painful procedure, and risk having inconclusive results.  Logically we thought that amputation would likely be the end result.  We are now awaiting the biopsy results from the amputated limb, but Wendel is happy and pain free.  We do not regret our decision. 

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11 August 2017 - 6:42 am
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This is our Maddy.... We have decided to do the biopsy after talking with her regular vet.  She told us the pain from the biopsy will not be as bad as the pain from the amputations, as the incisions will be much smaller.  I hope we are making the right choice!!

Canada
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11 August 2017 - 8:34 am
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Good luck Maddy! You're gorgeous! 

As far as healing time for Stewie... He was confined to a small area for two weeks. He was totally mobile from day one, bit until the stictches came out, he was under strict supervision. At four weeks post surgery, he is pretty independent, but we still close off the stairs when we are not around.

Best wishes to you and Maddy, from Super Stu! & his pack,

petra, Paul, Spike🐾 Chester🐾 & Miss Lily🐾❤️

Stewie adopted his Pack in 2015. He has 3 feline siblings, Mr. Spike🐾 Chester Molester🐾 & Miss Lily🐾He was diagnosed with OSC on July 5th 2017 and had his left front leg amputated on July 10th 2017. He is our Tripawds Super Hero!🐾❤️                                         http://stewie20.....pawds.com/

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