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Yeah, FWIW, I can certainly understand your hesitation if his pain is seemingly somewhat under control. A lot of unknowns with the cementoplasty and has only been done on a low number of dogs, right? And even less with dogs who have jad the radiation treatment first ???
This may be a totally irrelevant question and I'm just curious, , what were the sizes of the dogs who have had this successfully? And how do they define success???
Were all the dogs battling osteosarcoma and trying to avoid amputation because that was completely off the table??
Does this surgery guarantee no risk of fracture or is that "guarantee along the same lines as the radiation......reduces the risk, but doesn't eliminate it entirely??
Oh geez.....I cannot believe I am asking you more questions!! In no way trying to mufdy the waters, okay? Not expressing an "opinion ", just curious about some thngs.
Guess I'm just trying to mirror back your hesitation and adding a few bonus questions along the way😉
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!
Here is a video this morning of things looking like they sometimes do and not as good as in the other video.
Oh, yeah, that's definitely a more pronounced limp than the other video. He gets the cementoplasty next week?
Those are all good questions, Sally! I don’t think that video worked. Ugh. How could I get it right once then mess it up?! Not sure how to delete it.
So, the size ranges of dogs in the study varied but it was mainly large/giant breeds since they disproportionately get this cancer. If I recall, the study done in Europe only had something like 12 dogs and none of them were allowed to be on any either treatment (including chemo and radiation). Some of the dogs were euthanized before the study ended (at 6 months) due to lung mets. One fractured….not clear why but they concluded it was still a smaller percent than the number of dogs that normally fracture without it. Several switched over to do chemo, radiation or amputation so left the study and the only 2 dogs left in the study were doing well at the 6 month mark. The results showed a 50-68 percent reduction in pain and they concluded less risk of fracture. Obviously, not a large study sample. So, to answer the fracture question, they can’t guarantee no risk of fracture and, theoretically, the procedure could actually result in fracture because you are going in and messing around with the area and have to go in through healthy bone to inject the product. The vet I spoke with in NC though told me the product has been getting used a lot in Europe since this study came out. As far as the US, it’s just the 6 dogs she has done the procedure on and the one that the UF vet recently did. The dog that was featured in the tripawds podcast is still doing well.
The problem is he keeps looking worse then a little better and, when he’s looking worse, I feel more certain I should try it and, when he is having a better day, I start to have doubts! I’m going to get the pre-op testing done and hopefully talk with the Dr. some more, come up with any questions, and go from there.
Oh, the video did work!
Yes, heading to Gainesville Tues afternoon. I drop him off early morning for pre-op testing on Wed. then, if all that goes well, the actual procedure would be on Thurs. and he’d be able to come home on Fri.
So, to answer the fracture question, they can’t guarantee no risk of fracture and, theoretically, the procedure could actually result in fracture because you are going in and messing around with the area and have to go in through healthy bone to inject the product.
Maybe I shouldn't ask this knowing your tendency to over think, but what is the plan if a fracture occurs during the cementoplasty?
Well, since I do overthink, I had considered that. I don’t think they will do the procedure if his bone has gotten that fragile since last xray. She also said the dog she recently did had a much worse case and he is doing well. Assuming his chest xrays were still clear (which they would need to be to do the cementoplasty anyway) then I would probably see if they could scan him to make sure they don’t see it anywhere else and, if not, then amputate.
It hasn’t been a good day for Honor. The limp never let up. He wasn’t even up to going for his short walk down the street tonight and only made it out to the yard where he layed down. I sat out there with him because I have to keep him on leash. We were sitting with our backs to the woods and I stood up at one point trying to motivate him with some chicken to go back inside. No luck but then I noticed there was a bear laying in back of the fence about 12 ft from us. It was stretching and rolling around on the grass. It was super cute, actually, but I couldn’t enjoy watching because I was trying to make sure Honor didn’t turn and see it. So here’s how I know Honor is not feeling well. He usually smells bears from a mile away and he didn’t even notice there was one right behind us. Once it moved on, I was finally able to get Honor up and inside. Just hoping things are better and not worse tomorrow. Nothing really happened to explain why it’s so much worse today.
Pre-op tests done. I can pick him up at 12:30. I’m having an anxiety attack over the chest xray though. When the student working with him called to let me know when he could be picked up, I asked her if she could just tell me if it was good or bad news on the chest xray and she said the Dr would have to go over the results with me when I got there….which, of course, makes me feel like it is going to be bad news.
Try not to stress too much. I'm sure it's protocol for the vet to have to review the results with you. Would you want to potentially get wrong information from a student who didn't interpret the xray correctly? It's only an hour away. You can hang on. Let us know what the vet says. Hopefully it's good news.
It’s even worse than feared. 7 lung nodules and a small hairline micro fracture. Now I have to decide by 5 pm whether to still have the procedure done tomorrow or not and, as you can imagine, I am not thinking clearly.
Pros: could reduce pain and prevent more fracturing at least giving him better quality of life for as long as he can manage with the lung mets
cons: Right now, it’s not a displaced fracture. She said it wasn’t a fracture where they would say amputation needed to be done for example as far as level of severity. There is however a small risk the procedure could cause a displaced fracture which would basically mean the end of his life. Also infection risks, wearing a cone after surgery (which he hates….trying to find out for how long)
i am sure there are more pros and cons but I just can’t think straight
First of all, I'm sorry it's not better news. I know you want only the best for Honor.
Did the vet quantify the risk of fracture better than "small"? I feel like "small risk" means a very different degree to different people. Or did she provide any info on how easy it would be for Honor to make the fracture worse if he tries to run or jump or even just stumbles and lands awkwardly on that paw/leg?
I know the lung mets mean the cancer is spreading. Did they talk about a long term prognosis with this new information? And how your options may affect that? I think that's what I would want to focus on - what will give Honor the most quality time.
I’m so sorry to read this. So sorry for you. And so sorry for Honor. Obviously it hits home with me and breaks my heart for that reason alone.
First, i totally agree with Mischief. Focus on his qualify of life. I know that you’re going to do what is best for Honor, but if it were me, i doubt that I’d move forward with the procedure. I just don’t think that I’d want to put Ophelia through the recovery or the anxiety of it knowing what you now know.
Please ask your vet about the Losartan-Palladia combo treatment that has had a lot of success with dogs with metastasized osteosarcoma. It was developed at CSU. I just recently had Ophelia’s oncologist tell me how she was working at CSU when they were doing the testing and that they were getting results in over 50% of the dogs in the study. It’s not going to cure him. But it is possible that it could contain the metastasis and extend his life.
I am so sorry.
Thank you both. After many hours of stressing and consulting, I decided to go ahead with the procedure. My preference was to take a couple days to maybe make this decision with a clearer state of mind, but the only surgeon that does this is booked this week then out the next 2 weeks (of course).
The problem is if he fractures when I get him back home and it is a super painful displaced fracture, that’s it. I would no longer have my backup plan of amputating. I might not even be able to say goodbye to him at home. Maybe I could have 2-6 months more with him with the lung mets but his leg could end my time with him literally any day. I was able to connect with one lady who’s dog had the procedure and asked her would she still have done it even of she found out her dog had lung mets prior. She thought she would have. She said her dog has arthritis so things still aren’t perfect but they were significantly improved from how things were prior to the procedure.
Michael, the chemo treatment for the lungs is another big question. I had actually had to delay Honor’s chemo appt because it was scheduled for Fri and we won’t be home. They had booked me in on Monday with a different Dr. Now, the issue is if I keep that appt this Dr will come up with his new treatment plan. If I want to use the same Dr, I can’t get in until Thurs. I think they are all good there but I did touch base with his regular oncologist by phone and she said they all have very different treatment preferences when it comes to lung mets based on their own clinical experiences. I mentioned palladia to her and she didn’t seem to have a good opinion and mentioned some ones I haven’t heard of yet. One more decision to have to make. I figure I just need to make it through tomorrow first.
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