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Struggling with decision of treatment options
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Forum Posts: 2
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6 December 2017
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6 December 2017 - 3:27 pm
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Hi. I have a 6 yr old Saint Bernard, Moose, who was diagnosed last week with osterosarcoma in his right shoulder. I'm struggling with what my best options are. Not having a definitive time frame of life expectancy after treatments (I know that that's not possible), I'm not sure what I should do. I know, no one can tell me what to do here, but maybe some advice might help me make my decision.

His xray shows no visible cancer in his lungs, but he's not had a CT scan of other soft tissue. I've had two visits to two different oncologist and they didn't push me in any particular direction, which I wasn't expecting, but it's so difficult to make this decision.

Up until last night, I had decided I was just going to manage his pain and when the time came, I'd say goodbye. I was not considering amputation at all. I had been leaning towards some type of radiation treatment. Either palliative or stereotactic radiation, w/o chemo, but the radiation cost is so high and I'm struggling with knowing that I will still only get 4-5 months with Moose. I feel awful for obsessing on costs, but it's a big thing. Palliative is upwards of $3,000. Stereotactic is upwards of $8-$9,000 (including scans, etc). This does not include chemo costs.

If I do the stereotactic radiation plus chemo, maybe I get a year. But, if I do amputation and chemo, I may get a year or more. But, that's a total crap shoot since this cancer can be so aggressive.

I am putting the idea of amputation back on the table because I was naively ignoring the intense pain bone cancer causes and the possibility of the bone breaking. He's on pain meds and anti inflammatory meds and it's helping currently. Last night I read up on how giant breeds truly handle front leg amputation and I had just dismissed the idea that he'd be able to handle only one front leg. Luckily he's not over weight and on the small side for a male Saint. Although people flip out thinking he's the biggest dog they've ever seen.laughing 

I'm waiting on a quote from one of the oncologist I've talked with regarding the cost of amputation and chemo. I'm not sure what to expect cost wise. I just feel awful for even considering that.

If anyone has a story or insight they might share, I'd love to hear it. I understand that every situation is different and what one dog experiences doesn't mean another will, but I'm hoping something I read may help with my decision.

Thanks so much.

The Rainbow Bridge

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6 December 2017 - 5:14 pm
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Hi Moose's Mom, welcome. Your future posts won't need approval so post away.

We understand your struggle, it's so much to think about and the guilt of having to make this decision for our animal who can't make it for themselves, is tremendous. Totally get it. 

It sounds like you're really doing your research, which is fantastic. Have you seen our stories about other Tripawd Saints here? Like Chuck's story? His people went the palliative route, be sure to read it. Others like Patchy had their leg amputated and did really well. After speaking with numerous forward-thinking vets through the years, the general consensus is that as long as the dog is otherwise healthy, size shouldn't be the limiting factor. 

Do not ever feel guilty about considering the cost factor. It's life. And if we are stressed about paying for treatment, that will lower our dog's quality of life. They want us to be happy, not working all the time to pay off debt and feeling overwhelmed about it. Yes, palliative care with stereotactic radiation and chemo is incredibly expensive, around $15k for both according to Hazel's people. Thankfully their pet insurance company paid the bill. I'm guessing you don't have insurance on Moose? You're not alone, we didn't have it on our Jerry when he was diagnosed. 

What I hear in your voice is that you are concerned about the timeframe for the prognosis no matter what way you decide. You're not alone, we all were at first. But what most of us see as we go through this journey, is that our pets do  not concern themselves with time, dates or prognosis. Every day is the best day to them as long as they are living a happy, pain-free life with the people who love them. It's a valuable lesson that cancer teaches us. Remember that none of us, animal or human, have time stamps on our butts. Nobody can predict an expiration date so why obsess about something we cannot predict? It's out of our hands and we must learn to Be More Dog to give our pets (and ourselves) the best quality of life possible.

If you haven't already, please check out Questions to Ask Your Oncologist, and our Size and Age Matters Forum to read about the experiences of giant breed Tripawds. Our Tripawds e-books library has great info for you as well. And stay tuned, others will chime in soon.

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6 December 2017 - 6:02 pm
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Hi there and welcome to our family 🌺

I'm very sorry you find yourself here but rest assure we are all here to help and guide anyway we can.

You've already got great advice from Rene! 

I have to say I'm impressed with the depth of the research you've done. 

You've pretty much covered every main option and are aware of the down sides as well. 

For most of us, amputation was the elected  choice (unless impossible) because that is the only solution to eliminate 100% of osteo pain. 

Following amputation some of us went the chemo route (like my girl Eurydice) some of us didn't (like Jerry), some of us had long lives with chemo, some didn't and the same goes for no chemo ...

But where we all agree is in providing a pain free life for our babies regardless of how long we may have together. 

I can't really "point out" a treatment route as that is a very personal question but would say I never saw anybody here regretting having gone for amputation as that guarantees quality of life for our beloved boys and girls. 

Sure, it is a hell of a decision to make, especially when it is a giant breed loosing a front leg but they DO adapt and can have deliriously happy lives just like my own adored baby did and she was truly enormous. 

I'm sure others will chime in soon and I hope we will be able to help you make your decision.

Whichever route you may take, we ain't going anywhere so ask any questions, big or small, anytime, we're here. 

Sending you a big hug and XL cuddles to your sweetie 😘😘😘🐮💫✨🌟🌹

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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7 December 2017 - 10:24 am
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Thanks for the positive, supportive feedback.  I'm still waiting on a call from an oncologist, for a cost breakdown for amputation/chemo. In the interim I'll call the other oncologists. Hopefully I hear back today.

Thanks for the link to Chuck's story. So similar to Moose. If a big guy like Chuck can handle only one front leg, I'm sure Moose can.

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7 December 2017 - 3:22 pm
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Sure he can, seeetie pie 🌺

We'll be waiting for your updates and in the meantime give Moose an XL cuddle from us and big hug to you  😘😘🐮💫✨🌟🌹

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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11 December 2017 - 10:34 pm
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Hi moosesmom! I mainly lurk around here these days, but wanted to offer my experience. My guy is not Saint Bernard size, but is a good size fella, about 68 pounds pre amputation. As we all are, I was devastated with his preliminary diagnosis of osteosarcoma. My vet wanted to test for valley fever, and when that came back negative, it was time to decide. I could not afford chemo, leaving me with amputation or palliative care. What tipped the scales for me was the risk of fracture to his leg - he's home alone when I work, and I was just sick thinking about him breaking the leg while I was away and lying there with a broken leg until I could get home. So we went the amputation route. Luckily, he had an uneventful recovery.

But the best thing of all is that his amputation was a year and a half ago and he's still going strong. I was told 3-6 months because no chemo. So you never know - the saying around here about no one having a date stamped on their butt is so true! I know I've been very lucky, but even if I had only gotten a few more months with him, the surgery would've been worth it. He's slowed down a little, but he's now 11 and I think he would've slowed down some even if this hadn't happened. He's still happy and goofy, and loves every minute of his life. Good luck to you - whatever decision you make will be the "right" one for your and your pup.

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