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Caring for a Three Legged Dog or Cat

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Member Since:
15 July 2016
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19 July 2016 - 4:43 pm
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Hi,

First -- I realize that none of you have met Milo and can't make decisions for us, but I still like to hear opinions and experiences.  I like data points!

Here's our backstory & timeline.  It's the timeline I'm fretting over:

  • Milo is an Australian Labradoodle, ~75-80 pounds, turning 10 in September, no health issues until now.
  • July 2 (Sat night) he sprinted after something and came back limping.
  • July 5 (Tues) visited vet in hopes of getting drugs for him.
  • July 7 (Thurs) sedated and x-rays were taken.
  • July 8 - 13 we were out of the country and Milo was being spoiled by his favorite neighbor
  • July 13 (Weds) finally got radiology report that it is a tumor
  • July 14 (Thurs) scheduled appt with oncologist and learned of a clinical trial at Tufts
  • July 18 (Mon) met with oncologist.  Decided to shoot for the trial.  Did slew of tests to see if he qualifies for the trial (clear lungs, clear liver and spleen, cytology, blood.)
  • July 19 (Tues - today) Tests look good, but cytology and blood not complete.  All work must be complete and organization funding the trial must approve after all work is complete.  At this rate, it looks like if he is accepted, the amputation won't be until next Tuesday, July 26. 

I realize we are very lucky to even have a chance at a clinical trial.  It's being done at Tufts in Massachusetts, an incredible location.  The trial is amputation followed by 4 rounds of carboplatin for all dogs, and then some randomized set of dogs get rapamycin immunotherapy after the chemo.  Some dogs just get chemo.  It's $1000 credit toward the amputation (if we finish the protocol), chemo covered, and immunotherpy covered if we get selected for that.  Complications from chemo are ours to cover, but complications from immunotherapy are theirs.  One of the requirements is that no additional supplements or side treatments are being done to bias the study.  The two reasons amputation wouldn't happen until Tues is partially due to scheduling -- they can't schedule the surgeon until he's officially in the trial which requires all tests and higher level approval.  The other reason is that they'd prefer to not do a Friday in case there are complications going into the weekend.

The alternative is that we could get the amputation done Thurs or Fri, would probably skip chemo due to costs, and follow our own regimen of unproved Artemissin and K9 Immunity and whatever.   

So.... given the choice of clinical trial with the amputation delayed 4-5 days and no supplements allowed, but free carboplatin and possibly rapamycin at a very highly regarded research university.... or quicker amputation, no chemo, but more control in diet and supplements.... what would you choose? 

Do the 4-5 more days matter at this point?  I figure he already has ostesarcoma cancer cells all over his body -- we just can't detect them yet.  Does chemo really buy them anything?  Commute-wise, local vet is 20 minutes, and Tufts is 55 minutes, but Milo loves riding in a car.  Do most dogs come home the day of the surgery?  Or stay?  My two college age sons are 6' plus, work out of town Sunday night through Friday night, but would be home Friday-Sunday night to help move the big gimp -- if that's a thing.

I talked to my regular vet today, the onco yesterday, his asst today, the clinical trial technician today, and meet the clinical trial onco on Thursday.  But I'm still interested in points of view from those sitting on my side of the fence.  Thanks for any insights.

Regards,

-Jenifer

Here he is breaking the "no furniture" rule.  His legs were shaved for the tests yesterday.  You can see the tumor in his left leg.

Milo breaking the furniture rules.  Tumor can be seen on his left leg.Image Enlarger

And a close up of the tumor.

Close up of tumor after yesterdayImage Enlarger

Michigan
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19 July 2016 - 6:35 pm
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You're right, no one can make the decision for you.

Murphy had his surgery and treatment at Michigan State University, which is 1.5 hrs away from us.  When he had his chemo he needed blood work the following week, so our regular vet did that for us to save us the drive.  They've always worked well with him, faxing every report to him to make sure that he was kept up to date on everything that was going on.  When Murphy had his surgery, he actually had already been limping for about 5 months due to a misdiagnosis.  You're right about microscopic cells already floating around his body - that's the theory anyways.  That's why they recommend chemo - to kill off any cells that might be there.

Are you able to have Milo on a grain-free diet?  That's something that our oncologist said was important since grain turns into sugar and sugar feeds cancer.  I think that if I had the opportunity to have some of the costs covered by a study, I would probably go that route.  I don't think that the couple of days would make a difference.  Costs can add up quickly.  Are you able to drop out if you need to?  Like if there are adverse affects.  Like some others have said, when doing chemo you have the option of stopping if Milo isn't tolerating it well, so would that same thing hold true if he is in the study?

Most hospitals keep them overnight after surgery.  Murphy was able to hop out to the car on his own the next day.  The first 2 weeks or so are the hardest.  Make sure that you keep up on the pain meds - give them around the clock for adequate coverage.

Donna

Donna, Glenn & Murphy 

Murphy had his right front leg amputated due to histiocytic sarcoma at 7 years old. He survived 4 years, 2 months & 1 week, only to be taken by hemangiosarcoma at 11 1/2 years 6/12/17  
Read about Murphy's Life on Three Legs

Donna.png

Virginia







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19 July 2016 - 6:46 pm
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Milo is flat out adorable!! And might as well throw the "no furniture" rule out the window! It's almost impossible to say "no" to any dog once they become a trilawd...especially one as cute as Milo! 🙂

Every decision is an individual one. EVERY dog is an individual. Everyone's finances, time costraints, etc, are all individual.

In my unrofessional opinion, so many of these decisions we are faced with are pretty much a crap shoot! Some dogs who do NO chemo get far more extended time than expected.....some far less. Some dogs who DO chemo get far more time than expected.....some far less.

Sometimes it just boils down to which decision would you second guess the most if you didn't try "it"...whatever "it" maybe. Some dogs hate going to the vet and some hate car rides and that can be a factor. Some love car rides and have no problem going to the vet! So knowing your dog certainly factors I to the equation. And sometimes, your "gut feeling", your "inner voice" will guide you as much as any "statistics".

I can answer a couple of questiions a little more directly though. Generally, most dogs spend one night at the surgeon's 24 hr clinic. Some dogs may need to stay an extra night or two. On occasion some come home the same day. Most of us here opt for an overnight stay (at 24 hr staffed) if at all possible. It is MAJOR surgery.

As far as waiting a few extra days, that shouldn't be a problem at all. Of course, I am no vet and you must consult with a vet. I can tell you that many, many of us here first had our dogs for misdiagnosed for several months with a sprain, or arthritis, pulled muscle, etc. Quite often rest and Rimadyl would give the appearance that it was "better"...until the limp came back. So for Milo to go from diagnosis to surgery in just a matter of weeks is a lot faster than many of us!

Just know we are all here for you and want to help in any way we can. Recovery is no picnic for a couple of weeks,so stay connected. We can all tell you this though, once you see Milo's sparkle come back and he's rid of that painful leg, you will be so happy for your boy!

Take some deep breaths, eat lots of chocolate. You'll make a decision out of love and that will benthe right decision!

Lots of love!

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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19 July 2016 - 8:53 pm
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Donna,

We started changing Milo's diet the day he was diagnosed.  I lost my dad to cancer 17 years ago, but during his battle I learned a lot about diet and cancer.  I also have a daughter who is Type 1 diabetic so we also know the carbs-to-sugar path too well.   

Milo is now fully transitioned to a home-cooked, no grain, low carb diet.  And he loves it!  He gobbles it up.  He gets excited and hobbles into the kitchen when he hears me get his dish. He still pees and poos regularly.  Of course, being a tad neurotic, as many of us here seem to be, I worry about the change. He's not active due to his leg, so getting the right calories is a challenge. Assessing his energy level is a challenge. But I'll just keep an eye on him and continue paying too much attention to poop.     

Thank you for sharing your experience with Murphy.  It's these personal experiences that give me perspective.

Peace,

Jenifer 

Minneapolis, MN
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19 July 2016 - 9:39 pm
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Hard decision, but the chance for Tufts expertise would be pretty compelling to me!  There are no guarantees, but what Sally says is true - many have a longer wait than 4 or 5 days from diagnosis to amputation.  Time is important of course - but this is not a really long period of time!

Milo is so adorable.  Very best thoughts - either choice is certainly a sound one.

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His canine sister also succumbed to cancer on March 1, 2019 - we lavished her with our love in the interim, but life was never quite the same without her only real canine friend. Cliff kitty had to leave us, too, suddenly, in August 2019. Lucia kitty grieved all these losses, but helped us welcome two new Lurchers into our home and our lives, Shae and Barley.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation



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20 July 2016 - 5:44 am
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Hi Jennifer and Miloheart

What a gorgeous boy, love your cute little face heart plus I have a gut feeling from now on there will be no rules reg furniture big-blink

Re your questions, no, I don't think 4 or 5 days makes a difference, as others said often dogs are misdiagnosed and therefore have their amputation weeks if not months after symptoms are visible. 

You are right in saying cancerous micro cells are already present in the body at the time of diagnosis, we were told by our onco team that there is a 90% plus chance of that being the case. 

Regarding chemo, nobody really knows what the outcome will be as each dog is different but in our case we opted to go for chemo as we felt this will give our girl a better chance of surviving longer, as chemo targets those microcells and delays the progression of the disease.

Eurydice is going for her 4th session today and up to now has been as good as gold, no side effects whatsoever, she only takes cerenia pills for nausea for 3 days after chemo plus one the morning she has it done. 

Concerning recovery from the surgery, a lot of dogs come home the next day and others are back the same day. 

Eurydice stayed at the hospital for 3 days but she was ok to have come back two days after op.

I just felt it was better for her to be looked after by professionals one day longer as she weighed 170 pounds before op (152 pounds now) and I was scared I wouldnt be able to help her hopping around so soon after major surgery ...

If you have hardwood floors please make sure you put carpets down for traction . In our case, we have rubber underlay under the carpets to make absolute sure Eurydice doesn't slip. If Milo slips whilst getting used to life on 3 that can be a real confidence killer ...

We also got a ruff wear harness which has proven to be an invaluable help with getting Eurydice out of the car.

Big bear hug and cuddles to gorgeous Milo heart

Eurydice 77kg/170lb Great Dane limping end of April 2016, amputation (right front leg/osteosarcoma) 4 May 2016 6 courses of carboplatin followed by metronomic therapy, lung mets found 30 Nov 2016. 3 courses of doxorubicin, PET scan 26 Jan 2017 showed more mets so stopped chemo. Holistic route April 2017. Lung X-ray 5 May 2017 showed several tennis ball size mets, started cortisone and diuretics. Miss Cow earned her XXL silver wings 12 June 2017, 13 months and 1 week after amputation and 6 1/2 months after lung mets, she was the goofiest dawg ever and is now happily flying from cloud to cloud woof woofing away :-) 

Livermore, CA




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20 July 2016 - 11:57 am
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Maybe you can look at if from a different angle.

If cost was not a factor what would you choose for Milo?  Would you do chemo or go a more holistic route?  Many people chose to skip chemo for various reasons.  If you would like to do chemo then maybe the Tuft's study is a good option for Milo. 

When I have faced multiple options I have found it helpful to rule out things I would not consider doing.  For example- radiation was a possible option to treat Tripug Maggie's mast cell tumor.  She did not do well with anesthetic, in fact we almost lost her during a surgery, and she would have had to be put under numerous times.  Ruling out radiation helped make the options seem a bit less onerous.

The other big factor is car rides and vet visits.  You said Milo does fine in the car- does he tolerate the vet visits?  Those are sometimes factors in choosing treatment options. 

Waiting a bit longer for surgery means being extra vigalent so he doesn't suffer a fracture.

As far a the hospital stay- Maggie spent a night after her amputation.  Quad pug Obie spent one night after each of his knee surgeries.  My current Tripawd Elly was in the hospital for several days according to her records (I adopted her as a Tripawd) but she had been hit by a car.  From what I've seen here most pups spend at least one night at the hospital.  Some do come home the same day but it is pretty hard to deal with them coming off the surgery meds.  It can be done but be sure the vets let you know what to expect and have an emergency phone number and place to go if needed.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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24 July 2016 - 11:37 am
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Hi,

Checking in.  Amputation is Tuesday (2 days).  Today is for some shopping & prepping -- ordering a Ruffwear Harness, and buying some carpet at Home Depot that can be cut as an area rug and runners.  Our whole first floor is cord and hardwood with no carpets -- very slippery!

The bad news is that Milo didn't make the clinical trial -- well, there is a slight chance he'll sneak in, but we're not counting on it.  Milo had to pass a few tests to be accepted. 

  • Clear lungs.  Check.
  • Clear liver and spleen with abdominal ultrasound.  Check.
  • Cytology to show sarcoma.  Check.
  • CBC blood work.  Passed the tricky ones, but failed on his ALT.  It seems Metacam adversely effects the liver in 7% of dogs.  Milo is one of those 7%.  He was on Metacam and Tramadol for the pain.  We moved him to just Tramadol and he's doing great.  If his liver recovers by Tuesday morning, they'll spend Tuesday dotting i's and crossing t's to get him into the clinical trial and doing the amputation on Wed.  If his ALT is still too high, they'll do the amputation Tuesday and no trial.  We could wait another week to see if the ALT comes down, but then he'll have to repeat all the other tests and who knows how they'd go.  So we're going now

One of my concerns is his right shoulder.  He had injured it earlier this year, but x-rays show it's fine.  Maybe strained?  Or cartilage?  Even though his front left leg hurts like the dickens, he is still using the leg which worried the Tufts team a bit.  They put on a velpeau sling (tied his bad leg up), and he spent an hour as a pseudo-tripawd.  He handled it well.  Of course, there is a chance the shoulder will fail and we'll have to say our goodbyes too soon, but we've decided the number one thing is get rid of the painful leg and if we don't,  we have to say our goodbyes soon anyway.

So it's off to Tufts early Tuesday morning, and they'll keep him for 2 nights.

Meanwhile, we are so lucky to have so many awesome vets helping out.  The Tufts team spent almost 4 hours with him on Thursday, including 2 hours explaining things to me, then one of them called me at 9PM that night to further review options since he failed the blood test.  The local oncologist has called me twice this week to check in.  He calls Tufts, then calls me.  My local vet has also called me after hours to check in, too, and discuss treatments and drugs.  

Thanks for this resource.  Hopefully things go well, and we do recognize if it doesn't, it's not because we were heartless or careless.  All decisions have been made with the goal of eliminating his pain.  We've made a list of his 5 favorite things and in life and recognize that when he's no longer interested in any of them, it's time.  Fortunately, 4 of the 5 are no different with 3 or 4 legs

Regards,

-Jenifer



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24 July 2016 - 12:03 pm
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Hi Jennifer and Miloheart

I really appreciate the way you place Milo's interests first, you are the BEST Mom heart

And, as you say, you do everything you can and if you don't succeed, at least you've got the consolation of knowing you tried everything possible. That is how I look at Eurydice and myself.

Love that you have a fantastic team around you, vets, onco etc all seem to be highly professional and committed which is totally great !

I really hope his blood test will be ok so he can be part of the clinical test but agree you shouldn't repeat all the tests, I am assuming he was under anaesthesia for the ultrasound?

As for his right shoulder and given the team you've got looking after him, I am sure you'll get more info in due course and possibly some rehab? 

Keeping fingers, paws and tails crossed for Milo and sending you and him a big hug and cuddles heart

Eurydice 77kg/170lb Great Dane limping end of April 2016, amputation (right front leg/osteosarcoma) 4 May 2016 6 courses of carboplatin followed by metronomic therapy, lung mets found 30 Nov 2016. 3 courses of doxorubicin, PET scan 26 Jan 2017 showed more mets so stopped chemo. Holistic route April 2017. Lung X-ray 5 May 2017 showed several tennis ball size mets, started cortisone and diuretics. Miss Cow earned her XXL silver wings 12 June 2017, 13 months and 1 week after amputation and 6 1/2 months after lung mets, she was the goofiest dawg ever and is now happily flying from cloud to cloud woof woofing away :-) 



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24 July 2016 - 3:04 pm
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I agree it sounds like you have a great team and are doing a fantastic job of finding what is best for Milo.

I wanted to say something about ALT, which I have checked monthly. Recently the level was very high and my doctor was not at all excited about it. He said they'd check it again in a month when it was back to it's normal range. He said a high number can indicate muscle damage or even a bad mushroom.

Here's hoping Milo's levels are down by Tuesday.

Kerren and Tripawd Kitty Mona

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28 July 2016 - 7:57 pm
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A quick update.  Today was the big day -- Milo is now a tripawd!

There's been a bit of drama between the last update and now.  He was rejected from the clinical trial because his ALT was too high (liver damage), but when we took him in for his amputation on Tuesday (two days ago), his ALT had dropped significantly.  He was having a bad reaction to Metacam, and we had stopped Metacam when we saw the high ALT number.  Yay!

But over the weekend, I had noticed a lump on his good leg.  Yes -- I'm just like everyone else -- there is no casual petting anymore.  Every petting includes a search for lumps!  That led to x-rays and an orthopedic poking at him, but a comparison to old x-rays showed the lump has been there for a while and is probably an old injury.  It's where a key ligament is.  Along the way, the radiologist accidentally took another set of x-rays of his lungs (usually the onco is asking for lung shots, not shots of the dog's good leg), and the new lung x-rays are still clear.

So Milo is part of an osteosarcoma clinical trial at Tufts University.  He was randomized into just the standard of care branch, and will NOT be getting the extra 4 months of immunotherapy with Rapamycin.  But standard of Care means he does get Carboplatin -- for free, and all of the supporting tests.  I'm thrilled with that.  Plus, as a scientist myself, I'm glad my baby is contributing to science.  I'm glad he'll be somebody's datapoint, as weird as that sounds.

Amputation was today.  His lymph nodes are clear.  Surgery went well.  The doctors texted me pictures.  Tufts will keep him for two days.  We could get him back tomorrow, but I recognize Tufts has the good drugs and 24 hour nurses and technicians.  While I miss him, I recognize he's probably better off there for now.  We'll pick him up on Saturday.

I'll keep people posted.

-Jenifer & Milo & family   

Schofield, WI
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28 July 2016 - 8:14 pm
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Awe love that sweet face!  So glad that you've got his recovery path all mapped out at Tufts U.  So glad to hear surgery is done and all went well.  You've done all your homework Jenifer and you are sweet Milos champion!  Let us know if you need us we'll be here right next to you!

Linda, Riley & Spirits Mighty Max & Ollie

Virginia







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28 July 2016 - 8:51 pm
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YAAAAAAAAAY FOR MILO ON SOO MA Y LEVELS!! 🙂 Mi@o jas great test results...he's in the Clinical Trial where he gets a @lt of FREE stuff....surgery is over and he's doing well...his lump is just a lump...and he's on the road to recovery!!clap

Good job Milo!!

Hugs to all!

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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29 July 2016 - 8:40 am
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Hi Jennifer and Milo,

I already congratulated you both on another thread but can't resist to scream of happiness again Yuhuuuuuuuuuuuuu clap

I am SOOOOOOO glad he is doing well and staying for a couple of days under nurse's supervision .. and he is on the trial too clap

Plus Xray and lymph nodes are clear ! 

A lot to celebrate !!!! 

I think this calls for a nice glass of special wine later, Jennifer big-grin

Sending you and your cuddly bear lots of love heart

Eurydice 77kg/170lb Great Dane limping end of April 2016, amputation (right front leg/osteosarcoma) 4 May 2016 6 courses of carboplatin followed by metronomic therapy, lung mets found 30 Nov 2016. 3 courses of doxorubicin, PET scan 26 Jan 2017 showed more mets so stopped chemo. Holistic route April 2017. Lung X-ray 5 May 2017 showed several tennis ball size mets, started cortisone and diuretics. Miss Cow earned her XXL silver wings 12 June 2017, 13 months and 1 week after amputation and 6 1/2 months after lung mets, she was the goofiest dawg ever and is now happily flying from cloud to cloud woof woofing away :-) 



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29 July 2016 - 10:20 am
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It will be great to get your Milo back tomorrow but please know that is when the hard work begins so please enjoy your day and pamper yourself. Think of it as a vacation. My kitty Mona spend her first night after the amputation at a sleep-over at the vet's home. Of course she was perfect for him and when I got her home she would either race around the bedroom or just crash and sleep. The pain meds can make our pets a little nutty.

So spend your day taking care of and celebrating yourself. Strengthen your heart today because it will melt when you see your dear Milo on Saturday. He looks like a lover.

Kerren and Tripawd Kitty Mona

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