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Sarcoma + mets in lungs (pre-amp); Qs and advice?
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Virginia
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16 March 2014 - 9:36 pm
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Hi, all -- I'm relatively new and just learned a day after initial front leg sarcoma diagnosis that Lexie, 13, does have mets in her lungs. Not sure of type, size, pattern or stage yet, but after being almost symptom-free she went downhill dramatically within 24 hours.

I was hoping for a clean X-ray so I could move quickly on the amputation, but now I'm not so sure -- and I may not be able to get in to see an oncologist until Thursday (but calling around to try to find one who has a cancellation). 

[Lexie's symptoms, presentation, initial diagnosis timeline info is here, btw, including other health issues.]

 

Update: After distress and Sat. night trip to emergency vet (rapid heartbeat, shaking, throwing up) where they did the chest X-ray she was given subcu fluids and IV pain meds, and I was sent home with Gabapentin 100mg, Sucralfate (to coat GI tract given all the meds she's on), in addition to her 50mg Tramadol 2-3x/day.

After some touch and go she seems to have stabilized, thankfully, and is walking on her own (though not thrilled with stairs, or with me trying to carry her), eating and drinking a bit, and will go outside for 2 or 3 minutes to pee.

Questions for others with dogs who also had mets pre-amp and/or anyone who may have decided to forgo amp:

Q1. How old was your dog, and how did you made your decision to go ahead and amp even with mets present? (I do plan to read the older dog thread, btw)

Q2. What stage and type of cancer and mets?

Q3. Did you do chemo or radiation immediately after amp, or have other meds pre- and post-amp for mets?

Q4. How long between diagnosis of mets present and amp?

Q5. For anyone who decided not to amputate due to advanced stage or other factors...did you take other steps to try to manage/shrink mets and have some additional time, quality of life, etc.? Any advice?

Q6. Given the mets, any questions or treatments I should ask the oncology vet in particular (besides the obvious ones) -- or anything else I should be thinking about?

 

Sorry for the long list...any insights, advice, thoughts on any or all would be appreciated. Thanks so much for being here. This is an amazingly supportive and helpful community.

 

 

 

 

Deb and Angel Lexie* Spirited 13 y.o. mix 3/15/14 Aggressive front leg tumor likely soft tissue sarcoma 3/16: X ray showed multiple lung mets; amp not recommended 3/18: Onco visit 3/20: Comfortable with Tramadol, Gabapentin, Yunnan Baiyo + misc meds 3/21: Began Cytoxan metronomic oral chemo 3/26: 5 days of palliative radiation 4/2: Radiation shrank tumors but painful infection developed 4/8: Onco agreed amputation now best option 4/9: Club Tripawd! 4/10: Great first few days, hit post-op wall ~day 5 Post amp Rx: visitors, seeing other dogs, physical therapy May: Palladia with side effects; lung scan showed more mets; started K9 Immunity+ & Leukeran July: Added Chinese herbs Aug: New tumor; Palladia again. Amazing last weeks before joining Bridge Party at age 14 in Sept. 2014. Rock on, my girl! Hindsight: Wish I amputated upon diagnosis, even with mets  Advice: Start PT as soon as your vet clears it, especially hydrotherapy if available in your area. :-) See Lexie pics here.  

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16 March 2014 - 9:50 pm
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Hi, so sorry you are going through this with your sweet Lexie, and so sorry you have to be here. But you are right, this is a great support group here and help is always here as well. I, unfortunately, cannot answer any of these questions for you, my set of circumstances will my sweet Angel Polly were a bit different with her particular type cancer. There are many others here, though that will chime in to help you out. Just want to support you and Lexie, as you start to deal with your situation.

Keep us posted on her, and keeping you in my thoughts....

Bonnie & Angel Polly

Virginia
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16 March 2014 - 10:03 pm
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I just wanted to applaud yo for being an incredible adovate formyour Lexie! Yo are dong an excellent jobin researching the best plan of treatment formher.

Iposted on yor other thread.....jist wanted to surround you with some more hugsz,! Others will be chimng in...if not tonight, certanly by tmorrow.

Yoj jave listed some qgreat questions...very specific, very clear.

Sounds like her pain meds are ample t keep her comfy...maybe a little whacky too!!

I'm glad Lexie is feelng better tonight. I kow this is such a scarey time, but I also know Lexie's not worried about any ole' stupid diagnosis! She's just happy beng with you!

Hangin there, okay? Lexie ounds like a real little spit-fire and has no intentin of going anywhere anytme son!

Sending love and hugs!

Sally and Happy Hannah

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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17 March 2014 - 3:10 am
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Good morning,

Tuck, like Polly, did not have the same challenges with mets as your gorgeous Lexie.

Tuck however was not an ideal candidate for the amp.....nine years old....big chested 100 pound lab who needed a front leg amp and had mild arthritis in his hip...

After consultation with the surgeon, Tuck had his surgery almost six months ago and is doing great!

Good Luck with all your decisions regarding Lexie's care.  This community will support you no matter what your decision because we all know that it was made by someone who loves Lexie!

Many hugs

Linda and Tucker

 

The Rainbow Bridge

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17 March 2014 - 9:46 am
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Hey there, see my response to your other post in Presentation & Diagnosis.

Here is another members' story about amputation after mets were discovered:

X-rays vs. CT Scans for Canine Bone Cancer Staging

It's better to hop on three legs than to limp on four.™
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Virginia
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17 March 2014 - 11:06 am
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You silly goose...just got your PM...very kind of YOU to write while YOU are cealng with so much!

Guess what? , We're in Virginia too! I kow you're dealing with ice, sleet and snow most likely too. Where in Virginia? Are you going to the "specialists" on Broad Street i Richmond?

Keeping you in our thoughts....really...everyone here is!! Stay connected, we re ALL here for you and your adorable Lexie!! Update when you can.

Sending love and surrounding your Lexie with all sorts of healing energy from the Tripawd Universe!!

Sally and Happy Hannah

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!

Virginia
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17 March 2014 - 11:19 am
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I don't have any experience with mets pre-amp, but wanted to send lots of positive thoughts your way. Looks like Virginia is making its mark here crying. I was driving yesterday and saw a Tripawd out on a walk, and I saw another one while I was out running not too long ago. If the "specialist" on Broad St is where you went, its probably the same one we went to. Glad you found us here, its a community like no other! We're here for both you and Lexie!!

{{Hugs}}

Mom to Tripawd Angels Jake (2001-2014) and Rosco (2012-2015) and Tripawd Tanner. “Whatever happens tomorrow, we had today; and I'll always remember it”  

      

Virginia
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17 March 2014 - 8:11 pm
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jerry said
Hey there, see my response to your other post in Presentation & Diagnosis.

Here is another members' story about amputation after mets were discovered:

X-rays vs. CT Scans for Canine Bone Cancer Staging

Thanks so much, Jerry. *Very* helpful and good food for thought. And thanks Bonnie, Linda, Sally, Elizabeth, and anyone else I'm missing who was kind enough to reply. What an amazing group here...I'm bowled over by the knowledge, support, and people. Update to follow below...

 

Deb and Angel Lexie* Spirited 13 y.o. mix 3/15/14 Aggressive front leg tumor likely soft tissue sarcoma 3/16: X ray showed multiple lung mets; amp not recommended 3/18: Onco visit 3/20: Comfortable with Tramadol, Gabapentin, Yunnan Baiyo + misc meds 3/21: Began Cytoxan metronomic oral chemo 3/26: 5 days of palliative radiation 4/2: Radiation shrank tumors but painful infection developed 4/8: Onco agreed amputation now best option 4/9: Club Tripawd! 4/10: Great first few days, hit post-op wall ~day 5 Post amp Rx: visitors, seeing other dogs, physical therapy May: Palladia with side effects; lung scan showed more mets; started K9 Immunity+ & Leukeran July: Added Chinese herbs Aug: New tumor; Palladia again. Amazing last weeks before joining Bridge Party at age 14 in Sept. 2014. Rock on, my girl! Hindsight: Wish I amputated upon diagnosis, even with mets  Advice: Start PT as soon as your vet clears it, especially hydrotherapy if available in your area. :-) See Lexie pics here.  

Virginia
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17 March 2014 - 8:34 pm
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UPDATE...

I talked to Lexie's Internal Medicine specialist, who saw her scans from the weekend and reviewed her blood work. Unfortunately she raised some caution flags about amputation given Lexie's Cushing's disease and a few other things.

On top of that, I noticed a new growth on L's other front leg (crying inside as I type this). Our vet said I should definitely talk to an oncologist given all of L's issues. She said the osteosarcoma seems especially invasive. She was shocked by how much the main tumor had grown in a matter of days, and I do understand her concern.

The good news: I found a NoVa oncologist with a cancellation for Tuesday 3/18. We'll see what he thinks. If he does think that the benefits of amputation outweigh the risks after he sees Lexie's charts, blood work, labs, and scans, that's what we'll do. If not, we'll try palliative radiation and anything else he thinks will help.

On the trying to stay positive front... Lexie seems to be doing well with her meds and wants to eat more (she's a little mad at me since she's not supposed to eat for an hour after one of her meds, and she wants food again...a big turnaround from this weekend). She even went out in the back yard in our late-season Virginia snow today, and she's always loved the snow.

Trying to push down the worry between the mets, the growth of the original tumor, plus the one on the opposite leg now... Just trying to breathe and be dog-like and keep doing research and reading all the positive outcomes here and just enjoy time with Lexie, and grateful I can see an oncologist Tuesday instead of later in the week.

Thanks again to all for your support. Will update when I know more.

Deb and Lexie

Deb and Angel Lexie* Spirited 13 y.o. mix 3/15/14 Aggressive front leg tumor likely soft tissue sarcoma 3/16: X ray showed multiple lung mets; amp not recommended 3/18: Onco visit 3/20: Comfortable with Tramadol, Gabapentin, Yunnan Baiyo + misc meds 3/21: Began Cytoxan metronomic oral chemo 3/26: 5 days of palliative radiation 4/2: Radiation shrank tumors but painful infection developed 4/8: Onco agreed amputation now best option 4/9: Club Tripawd! 4/10: Great first few days, hit post-op wall ~day 5 Post amp Rx: visitors, seeing other dogs, physical therapy May: Palladia with side effects; lung scan showed more mets; started K9 Immunity+ & Leukeran July: Added Chinese herbs Aug: New tumor; Palladia again. Amazing last weeks before joining Bridge Party at age 14 in Sept. 2014. Rock on, my girl! Hindsight: Wish I amputated upon diagnosis, even with mets  Advice: Start PT as soon as your vet clears it, especially hydrotherapy if available in your area. :-) See Lexie pics here.  

Virginia
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17 March 2014 - 8:52 pm
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Deb and Lexie!!

First of all, A STANDING OVATION to you Deb!! You have the most amazing attitude durng this gut wrenching time!! And that kind of attitude is essential to Lexie's well-being right now! And clearly she's responding positively to it!!

So glad you got the appt. Tuesday. I love that you recognize that you DO have options regardless of proceedkng with the amputation or not!

And what's more important than anyole' stupid diagnsis.....Lexie feels good today!! She's eating, her pain is managed and she loves the snow!! All good signs!!
Please knowyou can come here and freakout withnus! We all do that here and we all feel better after we do!! We cry, vent, scream, breakdown.....and then we are able to do a better job of "beng more dog" Lexie is showng you how to do that just perfectly!!

Sendingyou so much love and snowballs full of support!!

Sally and Happy Hannah

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!

The Rainbow Bridge

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18 March 2014 - 10:33 am
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Ohhh I'm glad you got into an onco doc today. Yep, there's so much to consider here, it's not as simple as many other situations. I hope there is some good news from them. Keep in mind that if you can't do amputation you may want to talk to your vets about using bisphosphonates for pain relief. Here's a forum post that talks about it:

http://tripawds.....an-option/

Keep us posted OK?

It's better to hop on three legs than to limp on four.™
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Virginia
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19 March 2014 - 1:36 am
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UPDATE 3/18:

Well, the visit didn’t start off on the right paw, and unfortunately we didn't get good news.

The first part is on me. When I got the appointment with the oncologist who had a cancellation, their patient coordinator said she would call my vet’s office to get Lexie’s records. I had to call Lexie's practice for something else anyway, and offered to do that myself. I was trying to be helpful and save them a step since I’m on a first name frequent visitor/frequent caller basis with Lexie's vets and their great staff, and Lexie is well known and loved there.

Apparently, I wasn’t detailed enough in what I needed them to send. The onco doc had gotten the internal med vet and ER vet notes -- but not the actual scans, radiology report, or needle biopsy specs.

Lessons learned, which hopefully will help some Tripawd readers down the road:

-Regarding records: Ask your contact at Specialist B’s office to contact vet A’s office directly to tell them exactly what the oncologist needs to see, and in what format (for example, emails with PDFs of the Xrays and scans; faxes of the notes).

-By noon the day before the oncology vet appointment, call your vet(s) and ask when they sent the records to the oncologist’s office, and confirm what and how they were sent.

-That afternoon, call the oncology vet’s office to confirm that everything needed was received. Trust but verify.

So, back to Ms. Lexie…

The oncologist isn’t positive that it’s osteo; said her tumors could possibly be due to malignant melanoma, nerve sheath oma, or another bad oma. That was a bit surprising to us since the internal med vet seemed to think osteo was indicated given the ‘moth-eaten’ appearance of the recent leg X-Ray at the tumor site.

In addition to the left front leg's original big beauties (all of Lexie is beautiful to me, and my girl doesn’t do things half way), he confirmed what I suspected…a new tumor has formed on her right front leg. 

He also felt her lymph node and said that was suspect as well. So, needle biopsy on lymph node, another needle biopsy on a different part of the original big beauty tumor, Rimadyl for inflammation relief and comfort, and some Asian holistic med capsules to help stop the recent bleeding from the purple beauties that show up so well on her pretty white lower legs.  

The good news: Thankfully, the meds are really helping. Evidence, Exhibit A: We went on a three-block walk before the appointment…and she would have gone longer if I had let her. Exhibit B: Five minutes after we got home, we heard a noise at the front door. In a flash, there was Lexie, running two steps behind Milo when The Evil Mailman Who Must Be Stopped had the audacity to come to our door, yet again, and put mail through the slot.

I've never been so happy to see them attack the mail in my life!  

Thanks again for all the support and good thoughts and well wishes and for the helpful links, Jerry -- I'll definitely check out the bisphosphonates and anything else you and others recommend for pain management, mets, tumor management, etc. I’ve learned so much by reading your posts and some of the other threads.

I’ll update again when we get the official news. Meanwhile, I’m trying to follow the lead of all who have traveled before us and shared your wisdom to try our best to enjoy our time together and ‘Be More Dog.’ Cheers to that!

Deb and Angel Lexie* Spirited 13 y.o. mix 3/15/14 Aggressive front leg tumor likely soft tissue sarcoma 3/16: X ray showed multiple lung mets; amp not recommended 3/18: Onco visit 3/20: Comfortable with Tramadol, Gabapentin, Yunnan Baiyo + misc meds 3/21: Began Cytoxan metronomic oral chemo 3/26: 5 days of palliative radiation 4/2: Radiation shrank tumors but painful infection developed 4/8: Onco agreed amputation now best option 4/9: Club Tripawd! 4/10: Great first few days, hit post-op wall ~day 5 Post amp Rx: visitors, seeing other dogs, physical therapy May: Palladia with side effects; lung scan showed more mets; started K9 Immunity+ & Leukeran July: Added Chinese herbs Aug: New tumor; Palladia again. Amazing last weeks before joining Bridge Party at age 14 in Sept. 2014. Rock on, my girl! Hindsight: Wish I amputated upon diagnosis, even with mets  Advice: Start PT as soon as your vet clears it, especially hydrotherapy if available in your area. :-) See Lexie pics here.  

Virginia
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19 March 2014 - 2:52 am
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P.S. One of the reasons I love communities like these is because people you meet remind you of things about your dog and yourself that you may have forgotten -- or in some cases, you learn something new. A shout-out to Elizabeth who reminded me that Lexie is one tough cookie.

She is indeed.

Sometimes I forget that because her other chronic conditions and earlier issues have been so well-managed and well-treated. I'll list everything in reverse order:

Growth on her other front leg; suspect lymph node; lung mets; some form of sarcoma tumors; Cushing's disease; pancreatitis; a slipped disc from playing too hard, which left her back legs partially paralyzed for several weeks; horrible allergies and after all the usual elimination drills, the lovely shaved stomach pin-prick skin test results led us to the conclusion that "she's allergic to pretty much everything you have in your back yard at your new house." 

All of that doesn't even count my naivete as an unexpected first-time solo dog parent in 2002, when I soon realized that naming her Houdini or Flash would have been very appropriate. She managed to escape to have an adventure in the mud, in the woods, in the water, or in the neighborhood every three months or so until I finally wised up.

I read everything I could about how to thwart four-legged escape artists and took all appropriate measures, including warnings to anyone visiting our house for the first time -- plus a door sign for parties, and for delivery men.

Her 'Lexcapades,' as I referred to them after she returned home safe after 10 or 15 minutes (and a couple of times up to an hour or two), would now give me 100% gray hair as an older, wiser dog owner. In hindsight, we're incredibly lucky that all of her adventure-seeking resulted in safe and happy reunions.

The fact that Lexie has been on this Earth for 13+ years, and with me for 12, is something I need to be grateful for.

Now if we could just find a magic ray gun to shrink the tumors and manage the mets given her other challenges. After years of allergy shots, my girl *hates* needles and even plain syringes, so anything we decide to try should be in pill form, or a better yet, a capsule or something else...and ideally involve zero to minimal of those bad pointy things. 

Thanks in advance to anyone who has thoughts or suggestions on what might be helpful given what I've noted. I'll search around in the other forums, too.

Elizabeth, thanks for starting the ball of yarn that led me all the way back to the early days. Those Lexcapades definitely made me smile... 

  

Deb and Angel Lexie* Spirited 13 y.o. mix 3/15/14 Aggressive front leg tumor likely soft tissue sarcoma 3/16: X ray showed multiple lung mets; amp not recommended 3/18: Onco visit 3/20: Comfortable with Tramadol, Gabapentin, Yunnan Baiyo + misc meds 3/21: Began Cytoxan metronomic oral chemo 3/26: 5 days of palliative radiation 4/2: Radiation shrank tumors but painful infection developed 4/8: Onco agreed amputation now best option 4/9: Club Tripawd! 4/10: Great first few days, hit post-op wall ~day 5 Post amp Rx: visitors, seeing other dogs, physical therapy May: Palladia with side effects; lung scan showed more mets; started K9 Immunity+ & Leukeran July: Added Chinese herbs Aug: New tumor; Palladia again. Amazing last weeks before joining Bridge Party at age 14 in Sept. 2014. Rock on, my girl! Hindsight: Wish I amputated upon diagnosis, even with mets  Advice: Start PT as soon as your vet clears it, especially hydrotherapy if available in your area. :-) See Lexie pics here.  

Virginia
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19 March 2014 - 3:08 am
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Cannot believe it's 5:00a.m. and Happy Hannah decided she needed some attention and woke me up with some fussing...the kind of fussng that says, "Give me a treat...not lookng for a tummy rub...I want a treat!"

So now that she's fast asleep...and I'm not...I cut on the computer and here's Deb!! Lexcapde stories are fascinating!!

Really, really glad to hear the meds have kicked in for Madame Lexi and she's feelng like a Sprng Chicken!

Your "lessons learned" are

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!

Virginia
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19 March 2014 - 3:21 am
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Oops! Hit reply by mistake...

One of my biggest frustratuons with going to the specialist was so mich "lack of communication" and cnstant tests! I would take Happy Hannah tonher refular vet for whatever "test" it was tey wanted...and it would never be exactly right. Sometimes I think they just wanted all the tests to be done bythem for a much higher fee than he charged! Sorry, but that's how it felt!

I know thisis sooooooo fristratng right now. I also know no one t could a better advocate for Lexi than you!! My goodness, yor devotion and determjnationare stellar examples of the nbreakable bond you two have! Love IS power! Lexi IS one tough cookie!! You WILL...and ARE ...gettkng a plan together and that will bring trmendous relief.

I'm so sorry you are having to go through this. It does seem like you are headed towards a solution and that's good!

What an astoundingly brave and courageous girl your Lexi is!! Takes after her Mom!

Okay, gonna try and get a little more "shut-eye". I'm realy glad Happ,y Hannah woke me up...clearly she knew her new friend was on line!
I'm a little groggy so I haven't quite digested all the specifics in yor post. I DO know you have options though!! I'm just thrilled that she's feeling better!! That is the best news of all!

Sending love...lots and lots of it!

Sally and Happy Hannah

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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