Caring for a Three Legged Dog or Cat

The beginning - Our beloved Daisy Duke was diagnosed with osteosarcoma at the end of February 2012 - we were devastated and terrified. We have been very fortunate not to have many experiences with cancer in our lives so we thought this diagnosis was a death sentence. Over the following days and weeks, we educated ourselves as much as possible so that we could be good advocates for our little girl. When the first oncologist said she had doubts about Daisy's ability to cope as a 3-legged dog, we got another one who believed in her as much as we did. Despite having had two TPLO surgeries over the years, at almost 12 she was a lean, keen, rabbit-chasing machine It took us no time at all to decide on surgery and follow-up chemo.

Surgery & recovery - she pulled through surgery without a hitch - she had a scapulectomy so there is no stump left to get injured. We are fortunate that her surgeon is based at a 24 x 7 clinic so she spent 2 nights there with round the clock care. We had a fabulous nurse who advised us not to visit with her during recovery as it would just upset her when we had to leave. So she took a video do her and we also watched her from around the corner. It seemed harsh at the time but allowed her to get though the first 48 hours with minimal stress. We brought her home on March 9 and the first few days were good. I think that was due to the residual from the injectable pain meds but when they wore off the trouble started. The next week was hell as we tried to get her pain under control with a combination of Piroxicam, tramadol and gabapentin. We knew it was finally getting better when a week later she tried to roll on her back for tummy rubs. We stared 4 doses of carboplatin on March 21 and other than a couple of low white blood cell counts, she really didn't have any side effects from the chemo.

Metronomic protocol and the next 8 months - we started the metronomic protocol on June 30 a combination of cyclophosphamide and Piroxicam. After a couple of months she started urinating in the house and acting really agitated. We had blood work done, urinalysis and even ultrasound on her abdomen to see if they could find any bladder issues. Other than a mild urinary tract infection no cystitis, tumours, etc. but our oncologist recommended stopping metronomic just in case. Her mood seemed better after that but she was still anxious and urinating in the house. Finally additional bloodwork was done and they discovered her thyroid levels were through the roof. To this day, I'm still upset that no one had checked/thought of that right away given that she was on thyro-tabs. Her dosage had not been adjusted after amputation and led to a buildup which caused the excessive drinking/urination and anxiety. I think that is one of the downsides of having multiple health care providers - sometimes they don't each have complete records which can lead to misses. With thyroid levels down she returned to her old self and was enjoying life. In October we got her a front wheel cart from Eddie's Wheels so we could get her some more exercise and she took to it right away. She would zoom around the trails at our local park so fast that Steve and I had to jog to keep up with her. We celebrated her one- year Ampuversary on March 7th having just had the latest clear chest rads on February 16.

Lung mets and hypertrophic osteopathy (HO) - early in the morning of April 19th I heard her coughing and then vomit. I got up, turned on the light and to my horror saw a froth, bloody puddle on her dog bed. We bundled her up an and took her to the emergency (the same clinic where she had her surgery and chemo). As her chest X-rays 60 days before had been clean, they checked for other causes - poisoning, etc. After finding nothing remarkable in the blood or urine, they decided to do X-rays and found a suspicious looking mass in her lungs. They recommended a CT scan which we did the following Tuesday and the news was devastating - a huge mass in her accessory lung lobe and enlarged lymph nodes near her heart. How could this be? We just had chest rads in February! HOW COULD THIS BE?!?! Our oncologist said that if we wanted to be aggressive we could do a lobectomy followed by chemo (Navilbene). This was a big decision - should we do another major surgery? Would she come through. Even with the surgery - prognosis was poor given the hugely enlarged lymph nodes near her heart. Median survival was only 90 days! This couldn't be - 90 days?!? We sought a second opinion and when the other oncologist had the CT scan reviewed by different radiologist - devastating news - he saw 3, not 1 lung mets. Unusual metastasis for OSA but given the calcification the radiologist was sure it was OSA mets. The 2nd oncologist recommended Palladia so we started right away. Wen we went back the following week for bloodwork/urinalysis, we told the oncologist that her front wrist looked swollen. She looked concerned and told us about hypertrophic osteopathy (HO) which xrays subsequently confirmed. We felt like we were punched in the stomach - the news was getting worse. She only received 4 doses of Palladia because she started having bloody diarrhea and the HO was significantly decreasing her mobility.

Saying goodbye, guilt & grief - we talked to the oncologist about pamidronate which has been used with success in humans to alleviate pain associated with HO. So Monday we went in for the infusion. She was shocked at how swollen her leg had gotten in just a week and told us that it might be time to say goodbye. We refused and went forward with the pamidronate infusion. When we went to pick her up we were delighted to hear that while receiving her treatment, she had eaten 2 handfuls of dry kibble. She had refused to eat dry kibble at home for the last 5 weeks - it had to be good sign. We went home and sat in the backyard in the sun for a couple of hours. It was a good day. I had high hopes when I woke up,the next morning but she was not herself. She was able to stand to urinate so I think the pamidronate had a positive effect but once inside she started coughing up little blood clots and was drooling. This was not our happy little dog anymore. We made the decision early yesterday and made arrangement with the vet to come to our house so she could be in a stress-free environment at the end. We spend the day hanging out (even got some time outside in the sun). It all happened so fast and then she was gone and her body was driven away. I wanted to scream and run after her to get my baby girl back. I scoffed at the surgeon who gave me the 90 day timeframe less than a month earlier. What I would have done for 90 days . As I sit here crying I wonder what I could have done better or, different? Did they miss something in earlier X-rays? Why did this have to happen? I know none of those can be answered but right now I'm in so much pain that I can't help but think them. I'm hoping that the pain will subside a little each day and look forward to getting my baby's ashes back soon so I can have her close or me once again.