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Osteosarcoma. Should we amputate?
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16 June 2017 - 1:05 pm
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Hi everyone 🙂

My sweet 10+ year old boy was diagnosed (based on x-rays) with osteosarcoma of the proximal humerus last October. He had been limping off and on since May 2016, and every time took him back to the vet, he acted like it was his paw - hence the diagnosis delay.  We were told he would have 2 weeks to live without amputation (due to pain), or 4 months to live with amputation and chemo. Like a lot of people, we were resistant to the amputation idea initially and after doing some research, opted for palliative radiation.  We would have gone for stereotactic except the tumor was too big to leave enough bone, they felt.  Zato finished his treatments right before Christmas and was relatively pain free. We also did monthly Zoledronate treatments, and he did great and was using his leg.  We always figured that by the time the radiation wore off, the cancer would have spread so we would know it was time to let him go.  

Fast forward to now.  The pain is returning, not bad yet, but it will be.  X-rays show that his poor leg is on the verge of fracture, so radiation is not an option anymore.  His lungs are clear though!  And there seems to be no spread anywhere they can see.  Almost 9 months later, here he is - happy, thriving, and just being Zato.   

I don't know why I am struggling with this decision of the only option we have left other than letting him go. I have read so many inspiring stories here, and so many wonderful people don't regret it one bit.  His oncologist says if we amputate it will activate the cancer that is most likely elsewhere in his body and he could have a month, he could have more, or who knows. But all the vets are also amazed that he is still here.

Can you give me some perspective?  Does anyone have a similar experience as far as how long he has been around after diagnosis?  Shoot, I would be grateful for any experience.  He does have an appt. with the surgeon on Monday for an evaluation.  He should be ok - bloodwork is good and his joints are pretty good, too.  I am so emotionally exhausted that I just can't decide what I should do.  I know I need more info, but if anyone could chime in and tell me what they think, it would mean a lot to me.

Thanks 🙂

Tracy & Zatoichiheart

Former neglect case/shelter dog, adopted in 2009.  Read my story here.

Elder statesman of Richard & Tracy's pack!  Nicknames: Little Bud, Master Ichi, The Anma.

Diagnosis of presumed osteosarcoma of the left proximal humerus on October 29, 2016 ~ Palliative Radiation & Zoledronate treatments November 2016 thru June 2017 ~ Left foreleg amputation on June 29, 2017 ~ Homeopathy with Dr. Loops starting July 2017.

The Rainbow Bridge

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16 June 2017 - 4:09 pm
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Hi Tracy, welcome. Your future posts won't need approval so post away. I apologize for moving your post before I read it all the way though, I didn't realize that wow you have been through all of the entire palliative care options with him. Simply put Zato is a walking miracle!

Look at it like this: even dogs who haven't gone through radiation therapy have micro mets in their lungs if osteosarcoma is involved. So when they go through amputation, they have the same odds as Zato when it comes to metastasis. Sometimes it happens in a month, sometimes not for years. Sometimes it happens even if the dog has had chemo, other times it doesn't happen at all and the dog didn't do chemo. Nobody can say for sure. So really, Zato's odds are just like anyone else's. Make sense?

One thing that I wonder about, which you may want to ask your vet about, is I have read reports where some oncologists believe that after a while, cancer gets smart to whatever therapies are being thrown at it. If you do the amputation and proceed with chemo afterward, would he have less chances of long term survival than a dog who had never been through treatment before amputation?

It's better to hop on three legs than to limp on four.™
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16 June 2017 - 4:26 pm
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Thanks for your reply!  That's a good question. If they feel we have already had our "good time", I would have to think long and hard before doing it, but if the clock has basically reset, he might go a long time again! I will ask the vet on Monday.  

jerry said
Hi Tracy, welcome. Your future posts won't need approval so post away. I apologize for moving your post before I read it all the way though, I didn't realize that wow you have been through all of the entire palliative care options with him. Simply put Zato is a walking miracle!

Look at it like this: even dogs who haven't gone through radiation therapy have micro mets in their lungs if osteosarcoma is involved. So when they go through amputation, they have the same odds as Zato when it comes to metastasis. Sometimes it happens in a month, sometimes not for years. Sometimes it happens even if the dog has had chemo, other times it doesn't happen at all and the dog didn't do chemo. Nobody can say for sure. So really, Zato's odds are just like anyone else's. Make sense?

One thing that I wonder about, which you may want to ask your vet about, is I have read reports where some oncologists believe that after a while, cancer gets smart to whatever therapies are being thrown at it. If you do the amputation and proceed with chemo afterward, would he have less chances of long term survival than a dog who had never been through treatment before amputation?  

Former neglect case/shelter dog, adopted in 2009.  Read my story here.

Elder statesman of Richard & Tracy's pack!  Nicknames: Little Bud, Master Ichi, The Anma.

Diagnosis of presumed osteosarcoma of the left proximal humerus on October 29, 2016 ~ Palliative Radiation & Zoledronate treatments November 2016 thru June 2017 ~ Left foreleg amputation on June 29, 2017 ~ Homeopathy with Dr. Loops starting July 2017.

Virginia
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17 June 2017 - 9:24 am
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Your pup is one amazingly spunky pup, that's for sure!! And can't wait to see more pictures! He is soooo darn cute in his Avatar!

As Jerry said, there are NO guarantees either way! We have a Dobie here named NITRO who is celebrating his THREE YEAR AMPUVERSARY! Another hero, MURPHY, just crossed over after FOUR YEARS! And yes, their are dogs who get far less time. Obviously the surgery itself, like any xurgery has a risk too.

The one thing we know is the amputation removes the painful leg and gives them a chznce at extended quality time for more loving and spoiling. As Jerry said, their is a theory that the piece of crap disease still lurks is some microscopic form. As you can see though, some dogs blow that theory out of the water. I'm kind of surprised the Onco put it in the terms she did. I don't know, just hadn't really heard it put like that in such "definite" terms.

As far as pursuing the chemo, that's another "some dogs appear to get extended time with chemo; some dogs appear to get little time". And some dogs appear to get great extended time without chemo, znd some appear to get little time. It truly is a crap shoot!!

Whatever decision you and Zato make will be the right decision for Zato. Any decision made out of love is ALWAYS the right decision. We are here for you and with you!

Lots of hugs

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

PS. Are you in the Virginia area? I noticed your post about Fetch A Cure.

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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18 June 2017 - 8:11 am
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Thank you Sally for your kind reply!  We are in VA, about 2 hours from Richmond.  Fetch A Cure is in the same building as the Advanced Radiation Treatment Center, and I can't say enough good things about all of those folks!

As I'm sure you know, this whole thing is very hard to cope with, but I am feeling stronger this morning.  I am hoping that tomorrow we will get some good news, as he is getting more painful and that poor shoulder has nothing left.  They said the tumor may be the only thing holding it together :(.  BUT otherwise, he is a happy boy and after spending a lot of time thinking and just being with him, I feel like he has the can-do spirit to keep going.  Right now, if the surgery happens, we are leaning more towards contacting Dr. Loops than chemo, but everything is open for discussion.  He has been taking supplements these last few months and we changed his diet to baked chicken with broccoli and carrots.  His new nickname is Carrot Nose :).

I will post what we find out tomorrow.  In the meantime, prayers and good thoughts for Zato are greatly appreciated!  I will post more pictures when I figure out how...his avatar is from his younger days. Now he is my white-faced little old man :).

Tracy and Zatoichi heart

Former neglect case/shelter dog, adopted in 2009.  Read my story here.

Elder statesman of Richard & Tracy's pack!  Nicknames: Little Bud, Master Ichi, The Anma.

Diagnosis of presumed osteosarcoma of the left proximal humerus on October 29, 2016 ~ Palliative Radiation & Zoledronate treatments November 2016 thru June 2017 ~ Left foreleg amputation on June 29, 2017 ~ Homeopathy with Dr. Loops starting July 2017.

The Rainbow Bridge

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18 June 2017 - 11:02 am
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Hey Tracy, here's a link that discusses adding images to the Forums. If you'd like help just let us know OK? We can't wait to see them.

P.S. What are the origins of Zatoichi's name? I love it.

It's better to hop on three legs than to limp on four.™
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18 June 2017 - 11:51 am
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Thank you so much! I will post some soon. His name in the shelter was Zato, and we love these movies from the '60s and '70s about a travelling swordsman named Zatoichi, so that's how he got his name!rasberry

Tracy & Zatoichi heart

Former neglect case/shelter dog, adopted in 2009.  Read my story here.

Elder statesman of Richard & Tracy's pack!  Nicknames: Little Bud, Master Ichi, The Anma.

Diagnosis of presumed osteosarcoma of the left proximal humerus on October 29, 2016 ~ Palliative Radiation & Zoledronate treatments November 2016 thru June 2017 ~ Left foreleg amputation on June 29, 2017 ~ Homeopathy with Dr. Loops starting July 2017.

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19 June 2017 - 3:02 pm
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My two cents: 

When Rocky was diagnosed with OSA, I was very worried about his leg breaking. It's my understanding a pathological fracture is excruciating for the dog. I didn't want Rocky to go through that. His lungs were clear and he was in good health otherwise, so I decided to be proactive and get rid of the leg before it could become a bigger problem. It's been four months and five days since Rocky became a Tripawd and he's (*knocks on wood*) doing very well so far. 

Zatoichi has already beaten the initial odds. It sounds like he's doing well other than the leg weakening. I would definitely consider amputation to eliminate the possibility of the fracture and give him a chance to continue bucking the odds. 

Best of luck to you and Zatoichi with whichever course of action you decide. 

David and Rocky. 

David and Rocky

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19 June 2017 - 6:48 pm
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Thank you, David & Rocky!  We really appreciate your input. Today Zato saw a surgeon and he said that he is a great candidate for amputation, so we are scheduled for next Monday!  I agree with you, the thought of a fracture is just not something we would want him to have to endure.  

He is definitely doing well otherwise. He has a lot of spirit and we're really hoping this will give us more good time together. Did Rocky do chemo?

Tracy & Zatoichi heart

Former neglect case/shelter dog, adopted in 2009.  Read my story here.

Elder statesman of Richard & Tracy's pack!  Nicknames: Little Bud, Master Ichi, The Anma.

Diagnosis of presumed osteosarcoma of the left proximal humerus on October 29, 2016 ~ Palliative Radiation & Zoledronate treatments November 2016 thru June 2017 ~ Left foreleg amputation on June 29, 2017 ~ Homeopathy with Dr. Loops starting July 2017.

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20 June 2017 - 8:38 am
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Rocky is 5/6 of the way through his chemo, so just one more treatment to go! I don't think there's anything conclusive one way or the other about chemo and OSA, but I wanted to feel like I did everything I could to give Rocky his best shot at beating this thing. He's handled it well, although his WBC has been a bit low the last couple of times. 

Good luck Monday. The first couple of weeks post-op can be rough, but it's remarkable how well they bounce back. 

David and Rocky

David and Rocky

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20 June 2017 - 8:46 am
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Thank you so much! Go Rocky!

Tracy & Zatoichiheart

Former neglect case/shelter dog, adopted in 2009.  Read my story here.

Elder statesman of Richard & Tracy's pack!  Nicknames: Little Bud, Master Ichi, The Anma.

Diagnosis of presumed osteosarcoma of the left proximal humerus on October 29, 2016 ~ Palliative Radiation & Zoledronate treatments November 2016 thru June 2017 ~ Left foreleg amputation on June 29, 2017 ~ Homeopathy with Dr. Loops starting July 2017.

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21 June 2017 - 2:52 pm
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Just reading through your post and all of the replies and am so glad you chose the amp surgery. I'd hate to see him endure a fracture. Certainly would be worse than the recovery from the surgery! He's done so well already so far in this crazy journey I'm sure he will do great after surgery!! Kylie bounced back quickly! It was more work to keep her quiet and rested because she just felt SO good with that diseased nasty leg gone!  It was like a relief to her. We did 6 rounds of chemo, alternating with 2 different drugs and she tolerated it well for the most part & her quality of life was amazing! We are over 9 months post amputation now and you wouldn't know she only has 3 legs!

I wish you the very best for the weeks ahead! They may be tough at times & a little emotional, but well worth it for a chance to have your best buddy around a little longer! heart

Chris & Kylie xo

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21 June 2017 - 4:00 pm
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Thank you, Chris & Kylie!  I'm so glad Kylie is doing so well.  The closer we get to the surgery, the more I am feeling really good about it.  I think it will be a relief for him, too! I am struggling to keep him from bouncing now, so I'm sure he will be wide open when the pain is gone!

Tracy & Zatoichi heart

Former neglect case/shelter dog, adopted in 2009.  Read my story here.

Elder statesman of Richard & Tracy's pack!  Nicknames: Little Bud, Master Ichi, The Anma.

Diagnosis of presumed osteosarcoma of the left proximal humerus on October 29, 2016 ~ Palliative Radiation & Zoledronate treatments November 2016 thru June 2017 ~ Left foreleg amputation on June 29, 2017 ~ Homeopathy with Dr. Loops starting July 2017.

Virginia
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22 June 2017 - 11:53 am
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Stay connected....we're with you the whole way!

Where in Va are you doing the surgery?

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 June 2017 - 4:36 pm
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Midlothian! VA Vet Surgical Associates.

Thank you :):)

Tracy & Zatoichiheart

Former neglect case/shelter dog, adopted in 2009.  Read my story here.

Elder statesman of Richard & Tracy's pack!  Nicknames: Little Bud, Master Ichi, The Anma.

Diagnosis of presumed osteosarcoma of the left proximal humerus on October 29, 2016 ~ Palliative Radiation & Zoledronate treatments November 2016 thru June 2017 ~ Left foreleg amputation on June 29, 2017 ~ Homeopathy with Dr. Loops starting July 2017.

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