Caring for a Three Legged Dog or Cat
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Hi, I'm hoping for a little insight from someone with oncology experience as the significance of my dogs blood work. Crush is a 10 year old 60 lb samoyed, 6 months post-amp for osteosarcoma, and has been doing really well. He goes for ~25 minutes walks everyday, and is bright and happy and seems comfortable. He has slowed down a bit compared to before his surgery, but hopping takes so much more energy than walking I don't think it's super significant- and his stamina has been increasing steadily as his fitness improves.
On Friday morning, we were walking in the park when he was attacked by another dog, who was off-leash despite clearly not being well behaved enough to warrant being loose. I took him to the emergency vet, and he has sustained a back injury- no bites luckily, although he needs two weeks of bed rest and has been fairly immobile and has lost his appetite. He's in pain but will recover.
While we were at the vet, she did blood work and and it came back as low in iron, which she tells me is indicative of metastatic cancer.
My question that has come of all this, is how serious is that? Is it an early sign, or a late sign? I haven't noticed any dark or blood spots in his stool. He does have a cough, but it's minor and he only coughs after drinking water. Sometimes just one little cough, if he drinks a lot he coughs a bit more. I never see him cough when we are exercising or doing anything else.
Does this indicate metastasis in areas other than his lungs? Could it be from the lung cancer? Does it mean his cancer is advanced, or is it an early sign? Should I supplement his iron, or is that a bad idea? His last set of chest x-rays were just before his surgery in January, and they were clear. This is the first actual medical confirmation I've hd that Crush does still have cancer, though I did know it was basically a certainty.
Hoping for someone with some insight. Thanks.
Oh no poor Crush! I'm so glad he is mostly OK and hope he continues healing. Rest is medicinal!
Stay tuned for what Dr. Pam thinks. In the meantime I'm curious, what did your vet recommend after the lab results were discussed?
I can't recall anyone here discussing anemia and metastatic cancer. A Google search comes up with oldish info on human cancer patients. (pre 2015). But even when searching the Dog Cancer Blog or Dog Cancer Answers (author of the Dog Cancer Survival Guide ), there's nothing in there on this subject. Hmmm...
No specific action recommended, it wasn't his regular vet, it was the emergency vet on call. She's from another clinic and as I explained his case history to her she was aware he likely had some lung cancer. We did the blood work since he's been prescribed some muscle relaxants and extra painkillers, and he's already on a pain regimen for his cruciate and nerve pain so we wanted to make sure his liver and such was coping well. When she called it was really more just to inform me that his blood work looked OK other than this indication of metastatic cancer, which shouldn't have been too surprising for me, honestly. She didn't recommend any specific action, she was just passing along the info. I've just been wondering and worrying since then what the implications really are, and if it means his time left is shorter than I would've hoped.
Ahhhh OK. So when you say lung cancer, you mean metastasis from his primary cancer right? Just trying to get clarification for Dr. Pam.
Were any x-rays taken? That, or a CT scan, is the only way to confirm metastatic disease in the lungs. IF his cough is related (and remember it can be due to anything like seasonal allergies), it's possible he has mets but without those diagnostics it can't be said for sure. And if there's metastasis anywhere else, again, only a CT or MRI can confirm (and that situation with mets is relatively rare). So in short what I'm trying to say is try not to let that comment get you so worried right now. I know it's hard not to, but until you talk to your regular vet try not to panic.
How is he doing otherwise today?
Yes sorry, I think that's what I mean. I'm referring to the likely spread of his osteosarcoma from his now amputated leg to his lungs or elsewhere. He's had no CT scans, I don't think there's a veterinary CT machine in town. His last set of chest X-rays was taken in January a week before his amputation. They were clear, but of course wouldn't necessarily pick up small mets.
He first coughed within a few days of those x-rays though, in January. At first I'd hear him cough once every couple weeks, it has slowly increased to every day when he drinks. It still doesn't seem to be bothering him yet though. He never had a cough before the osteosarcoma so I assume it's related, the regular vet and his mobility specialist seemed to agree but no follow up x-rays were ordered as he's doing well and knowing wouldn't change anything. And I wasn't sure I wanted to know. I'll see if there's someone I can talk to on Monday though to get more information.
He's doing ok today, he wouldn't eat breakfast this morning and slept for a long time, he's woken up now and he ate, and seems restless, whining and wanting to get up and move around. He is obviously still uncomfortable though, his posture is off with his back a bit hunched and his head low.
I tried giving him a bone to chew on to settle him, and he was keen but kept yelping as he chewed it so I took it away, I think he was moving his head around too much. It'll be hard to keep him still for two weeks. It's disappointing for him to lose two weeks to feeling crappy too, especially if his time left is limited. It seems meaningful to lose all those days to sitting around being bored and uncomfortable.
Ahh OK, thanks for sharing.
It's a tough decision about whether or not to take x-rays. We opted out of doing them as well, for a while anyhow. When we did them we learned Jerry had mets. It's hard to say how long he had been living with them.
Yeah I'd talk to your vet about the cough. We were prescribed Robitussin DM for Jerry's, which helped a little. Prednisone may also help and allow him to be more comfortable. Let us know what your vet says OK?
And just to add in my non Vet opinion....Crush is dealing with a cruciate issue, was just attacked by another dog, and Crush has a back injury. No wonder he's a bit "off"! I know when dogs fight, every muscle tenses up and tightens with soreness for many days.The way his back hunches, the way he holds his head sounds like residue from the attack.
If you've ever had a really stiff neck, you know how painful it is to just have the tiniest bit of movement in it. So to hold his head in a position to try and eat probably is painful. Did they suggest any massaging, or anti-inflammatories, or even muscle relaxers?
Just some randomes thoughts I wanted to throw out there.
FWIW my Hapoy Hannah never even developed a cough, so try not to focus on that. I don't know anything about low iron as far as indicating metasis, etc., It may be that it jist I dictates something needs to be added to his Crush's diet. Dr Pam is theVet....Im certainly not👍
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!
Yes, I've thrown my back out before so I can definitely understand why he's so sore. The vet prescribed methocarbomol (muscle relaxants) and trammadol for pain. She also said we could try icing it if he will tolerate it. No massaging for now, he is still too sensitive in that area. So for the back, it should just be a matter of keeping up with those things and keeping him quiet for the next couple weeks.
I was able to get some general info from my bf now that he's off work, he is an MD of humans but hasn't practised in a long time. He said that in humans cancer can be iron hungry, so it could mean tumour growth has accelerated since his last blood test in February. He didn't really recommend supplementing it for now, as that can further feed growth. If he becomes very anemic, it may need to be supplemented for palliative care to prevent other serious iron deficiency issues. But obviously he says he knows nothing about dogs and to take his information with a grain of salt. I'd still like to hear from a vet who might have some experience in this area. I guess I'm kinda just hoping for a clearer idea of where we stand now and if it means his time left is short. Maybe someone who's seen a few case studies and knows how these things typically progress.
I'll call the regular vet tomorrow as well to get some more info on just how low it was and find out if they recommend doing anything.
The vet doesn't recommend doing anything about the iron right now, and can't give more detailed prognosis info without doing scans, which we may need to do.
I'm still wondering about a little more info from a vet with osteosarcoma experience though, if she is able. His iron is 27, the vet says the normal range is 55-35. I just want to know how concerned I need to be.
Ok glad you were able to talk to the vet. Their response makes total sense. Hopefully Dr. Pam can chime in with some feedback when she is able. It's a great question and a valid concern.
Sorry I was out of town for a few days; did they actually test his iron because that is not typical. More likely your dog either had minor anemia (look at the PCV or hematocrit number) or a small red cell size which MAY indicate iron deficiency anemia but is actually pretty rare in dogs. Can you post the CBC results here?
Pam
I spoke to her on the phone a little more earlier today and she did say hematocrit, and iron and red blood cells so I think you're right that they didn't specifically test iron but were looking at a red blood cell count. She also said his organ function and white blood cells all looked good. I don't have any actual results myself though- if you'd find that helpful I could ask for them.
Probably not needed since everyone told you not to worry; just make sure to recheck it at some point.
Pam
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