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Please help with hard decisions in an 8 year old, overweight cane corso
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8 August 2017 - 12:31 pm
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I wish I wasn't posting here, but here I am. 

I have a beautiful 8 year old female Cane Corso mastiff we affectionately call Clouders.  Clouders has had a rough few years. In 2014, she tore her right ACL/CCL and underwent TPLO shortly thereafter. About a year later, her left knee went, and we had to do it all over again. No regrets. Our bionic doggy was almost as active as before. A bit arthritic, but that's to be expected for a giant breed of her age post-op. 

About 6 months after TPLO #2, her left knee started looking bad. Swelling, hot, drainage tract, the whole 9 yards. We determined she had an infection and x-rays showed that one of her TPLO screws was trying to escape. We had it removed and she was good as new. 

Well, with 3 knee surgeries, lots and lots of downtime, and arthritic changes, she obviously wasn't quite as active as she used to be. Her 60 minute walks slowly became 30 minutes, then 15 minutes, then some days when her arthritis flared up, she wasn't having it at all. We took it in stride, but she started gaining weight despite our efforts to reduce her food intake. She's very food motivated - and not shy about telling me she wants food. She makes these ridiculous moans and what we affectionately call her "inside voice" bark. 

Fast forward a year or so and she went from normal dog to having a right hind leg that was 3x its regular size over the course of 3-4 days. It was incredible how fast it grew. I suspected the worst, but hoped it was just the remaining TPLO plate rejecting, or maybe a meniscus injury. Nope. Osteosarcoma. Aggressive. Her radiology shows a massive peristeal reaction - in an unsual location (mid femur, just above the hock), but apparently clear lungs, liver and kidneys, no signs of lymph involvement. 

I've read everything I could get my hands on, so I know the standard of care, the expected survival, etc. etc. But there's no book in the world to help you decide the right decision. I need help. 

Here's where I'm at. I have a tenacious, rambunctious, FOOD MOTIVATED monster. She's slowly gained more and more weight and is currently about 25 lbs overweight. Probably more, if I'm being honest with myself. And since the OSA, her appetite has gone through the roof. She argues with me. Vocally. She takes my hand and drags me into the kitchen to argue some more. She's so hungry. 

We took her to one oncologist. Then another. The second I liked much better. He recommended we amputate and take her to a vet school about 3 hours away that's doing trials. I'm waiting for a call back from them. But here's the rub. She's fat. Her healthy hind leg is the one with the TPLO post-removal. She has fairly advanced arthritic changes in that knee and minor in her forelegs. Her spine is showing moderate degenerative changes. She's fat and her appetite is only getting bigger. She doesn't show pain, still mostly weight bearing on her bad leg even. She wants to walk, but gets tired pretty quickly. Did I mention she's hungry? She's super hungry. She wants to play sometimes, but she gets bored more quickly than usual. She's happy most of the time, but for a couple hours a day she just looks so down - probably because I won't give her more food. It's heart breaking. 

I'm willing to do the amputation, rent a van and drive her 3 hours to the vet school for treatment for the next few months. I have a wonderful workplace that will accommodate my needs. Issue 2 - she hates car rides. She refuses to sit even for a second. When I moved across country when she was a pup, she stood the entire 8 hours, wobbling around like a sack of potatoes. I'm considering drugging her for the drives. 

What I don't know is if it's worth it - if it's humane to HER. I would go to the moon and back for her, but it's not about me.

If she loses a limb, she will absolutely have to lose at least 15 of her extra pounds - probably more for best results. I'm not sure if I'll be able to coax her into doing underwater PT, she's terrified of water even though we tried to condition her from a young age. The tumor has, for whatever reason, perhaps the fever, made her appetite uncontrollable. She whines for food all day, all night. She moans at me for anything, even her kibble which she ordinarily hates. How do I explain to her that she's obese and can't have any more food? In the last 2-3 years, we've tried every diet - raw, home cooked, grain free, high carb, low carb, low fat, high fat. You name it. She only eats one bowl (3.5-4 cups) a day, but kept gaining. Did I mention she's still hungry? Her thyroid is fine, she just wants food. 

I'm also terrified she won't get up after surgery. After her second TPLO, she was only about 10-15 lbs overweight and we had a very difficult time getting her to stand. Her ortho was mystified. She wouldn't get up whatsoever for the first 3 days (she was up and running within 10 hours of her first TPLO). It was about 2 weeks before she could squat to defecate at all. Now she's even heavier (I know, I know, my fault.. ) - will she be able to stand up again? 

I'm a small human, only 100lbs, and my parents, who have been helping me take care of my monster are in their 60s and can't lift her if something happens either. What will happen if she falls or can't stand when none of us are strong enough to lift 156 lbs of fat dog. 

I love her so much, she's my spirit animal. I would do absolutely anything for her. But I feel like I'm pushing for treatment for ME. Because I can't bear the thought of living without her. But will she be happy? I don't think she'll care about losing a leg, she was pretty blase about her knees when they gave out. But she'll have to be on a very, very strict diet or her forelegs could give out. Food is her greatest love, no doubt. Forced to choose between me and a piece of lamb, I think I'd lose. Our trusted kennel does underwater treadmill, but she'll be terrified.

Is it humane to deprive her of food, force her into a scary pool? Humane to force her to spend 3-5 hours in a car each way to get chemo/trial treatment every 2-3 weeks for 4-5 months? If I was even 80% sure this would give her another 1-2 years, I would say maybe. But if she dies in 3 months despite all of it, she'll have died hungry and confused. I can't bear the thought of it.

God I'm so scared to make the wrong decision. She's already 8. Her breed typically only lives 8-10. I always knew my heart would break when she died, but I never thought there was a risk she wasn't going to die happy. I'm torn between going all out and doing everything under the sun to stop this stupid cancer or just treating her pain as best I can and letting her spend her last couple months on earth fat and happy. 

How do you guys make these decisions? What do I look for? How do I ask her? 

Thank you for reading my wall of text. Clouders

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8 August 2017 - 12:46 pm
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Welcome and best wishes for with the difficult decisions you face. You've come to the right place for feedback and support. Ultimately only you and your veterinary team can make the final decisions best for Clouders, and your family.

Try to take things one step at a time. The first step is to get rid of the pain. Chemotherapy is always optional. While amputation may not get rid of the cancer, it will stop the tumor pain. You will find various Tripawds Blogs about Cane Corso dogs and other giant breeds.

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!

Above all, our best advice is to Be More Dog. And that's not just some silly saying, listen to the podcast for details and helpful tips for coping with diagnosis, recovery and ongoing care.

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

Schofield, WI
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9 August 2017 - 6:20 am
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My heart goes out to you as you try to make this very hard decision.  Admin is correct that amputation will take away the very real pain of osteosarcoma.  But with all you have going on in your case you must also choose whether or not it is right for your girl.  I think I would start by having sweet Clouders evaluated by a orthopedic specialist to see if she could handle the amp with her remaining legs.   That may give you more clarity to be able to make a decision that is best for her.  If he thinks amputation could be a go there are some tools that could help you with mobility in those early days after amp.  Many of us have used a harness on our rear legged amps right away out of surgery to help us be able to assist in them up. As far as her loosing weight can you divide her amount she is able to eat and still possibly loose some weight into like every two or three hour feedings?  Yes she wouldn't be getting very much at a time but would consistently be feeling fuller and more sated throughout the day.  Sending you hugs and prayers for the clarity you need to be able to make the best decision you can for your special girl!  I'm sure others will be here soon with other thoughts that I am missing.  

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9 August 2017 - 8:29 am
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linda8115:

Thank you so much for your kind words and thoughts. I've never understood support groups until I needed one myself! 

The second oncologist we saw does a far bit of orthopedic work. He basically told us that although she's got some arthritic changes already in her "good leg," he still recommended amputation based on the fact that dogs carry so much more of their weight on the forelimbs - and kept emphasizing the pain relief aspect of the procedure. The weakness of her remaining leg would be more an issue for post-amputation weight loss and much-needed exercise. She's got a very high pain threshold, the poor dummy still wants to run on all four legs now, much as she did when she had previously torn her ligaments. I can tell she's hiding how much she hurts, but I guess her desire to chase small woodland critters far outweighs her perception of pain. For safety's sake, I've just been letting her out onto the back deck rather than the yard for her evening security patrol. Maybe I'm being silly, but she's always been our protector and I feel like I need to let her feel useful still. 

We've always a vest harness for walks, and it has a sturdy handle positioned over her mid back that's been useful. I'll look into some other harnesses and see if there's something more effective than the belly slings we still have around from her TPLO recoveries.  

I'm leaning heavily towards full treatment now. When I came home from work last night she was alert and lively and wanted to play (and go on a leisurely sniff-n-stroll). I know dogs are pretty bad at showing their humans that they're hurt and need help, but I don't know how to interpret her overall .. normalness(?) other than that she's not ready to give up. 

Schofield, WI
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9 August 2017 - 10:29 am
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Sounds like you have done your homework and gotten the feedback from professionals you need to make your decision.  So now you have to look into your heart and figure out which choice you can make with the least regret.  I know in our case Max was only 6 1/2 and still wanting to go on with life.  There are no crystal balls to see what lies ahead.  We weren't one of the lucky ones to get a lot of extra time.  But many many do.   Maxs cancer went to his spine less than 5 months after amp.  But I know that 5 months were for the most part pain free and still loving life.  I can look back and know we tried and did our best to help him.  And it was 5 months we had to love on him and spoil him 5 months we would not have gotten without the amp.   I know for me if I hadn't tried I would've always wondered "what if".  I think your heart and love for your girl is leading you to the right decision....the one you'll have the least regret with in the long run.  Your girl has already shown she's a fighter with all she's been through.  Many have said here TPLO recovery is worse than amputation recovery.  Your girl may well surprise you!  Keep us posted, we're here to support you in whatever decision you make!  Hugs!

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