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Prognosis Question
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Forum Posts: 9
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14 February 2018
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16 February 2018 - 3:56 pm
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Our 10 year old boxer was initially diagnosed with osteosarcoma in his lower right leg on Feb 5th. We went in for a surgical consult today (2/16) where we also had them check another small lump that just popped up on the fleshy upper part of his right leg. It turns out it has metastasized to the skin. Chest x-rays and blood work look good at this time. We started chemo and biophosphates immediately today and are still considering amputation. Has anyone had experience with this? Our vet thinks at this point that we are looking at about 6 months or less. I was looking for other points of view on whether the amputation would still be the best bet for keeping his pain managed for as long as we have left. Thank you.

The Rainbow Bridge

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16 February 2018 - 4:21 pm
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Hi there! Thanks for joining. What’s your dog’s name? Sorry about the diagnosis. Our fairy vet mother Dr. Pam will probably chime in soon, but in the meantime here are my non-vet questions and thoughts for what they’re worth:

It turns out it has metastasized to the skin.

I’m unclear on this. What exactly metastasized. Did the vets confirm the tumor type? Were the lymph nodes examined?

We started chemo and biophosphates immediately today

What type of chemo? Was radiation therapy offered? 

Our vet thinks at this point that we are looking at about 6 months or less. 

This is the standard prognosis for osteosarcoma with amputation alone and no chemo. The thing is, nobody can say for certain how long our animals will live with cancer. Some live months, some years. Even with chemo, there are no guarantees. What I can tell you is that in all the time we’ve existed as a community, only a small percentage of people (less than say 5%) have said they regret amputating, even when their dog or cat only lived a short time afterward. Overall people are happy to get more quality, pain-free time with their animal before the disease runs its course.

The most important thing is to manage the animal’s pain and amputation is usually the best way to do it. Unless the patient has serious existing conditions that would prevent him or her from adapting to life as a Tripawd, there’s no reason why they can’t do well. How did your surgeon feel about your dog being a candidate?

I know I have more questions than answers, sorry! It’s good to get a clearer picture of your dog’s situation so we can better help you.

It's better to hop on three legs than to limp on four.™
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16 February 2018 - 4:42 pm
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Thank you for your response. His name is Roger. 🙂

I’m probably not explaining this well, still trying to wrap my head around it. She said that the original tumor in the leg had metastasized to a skin sarcoma in the same leg. The lymph nodes feel normal at this point but I don’t know if she aspirated any of them. The chemo is carboplatin and we did discuss radiation therapy but were leaning towards amputation. The ortho vet cleared him for the surgery but I just wasn’t sure how drastically this metastasis affected the prognosis and if an amputation would be “using up” too much of his good time left. It doesn’t seem like this is a very common way for it to metastasize.

Michigan
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16 February 2018 - 9:28 pm
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When our Murphy had his surgery he had already been limping for about 5 months (he was originally misdiagnosed).  They thought it was osteosarcoma, but the pathology came back as histiocytic sarcoma.  The lymph node they removed was also positive, showing that it had already spread.  We were told that if we were lucky, we might get 12-18 months after chemo.  Histiocytic sarcoma is a fairly aggressive cancer that can often be found in the liver, spleen or the skin, it’s not as commonly found in the bone.

Many people choose not to do chemo, which is fine … we did do it.  He had 6 doses of CCNU, which is an oral chemo and is recommended for his type of cancer.  Murphy did well through all of that.  Then we waited … and he did well, for a really long time!  

Murphy far outlived his prognosis – he lived for over 4 years!  He actually passed due to a hemangiosarcoma – he never had any metastasis from his bone cancer, his lungs always remained clear.  

Not everyone is as lucky as we were, but some are.  Roger doesn’t know that he has a “prognosis,” he just knows that he’s in pain.  If you go ahead with surgery, he’ll have to recover, which can be difficult for a couple of weeks (usually 2-3 weeks for most dogs), but after that most dogs do very well.  They are happy to be free of that painful leg.  They think about today, not about tomorrow or next week.  And they know that whatever decision you make, you make it from a place of love.

Donna

Donna, Glenn & Murphy  http://murphyh......pawds.com/

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  

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17 February 2018 - 9:48 am
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I would still do amputation for pain control, especially if the lungs are clear.  Usually the amputation is performed first and then chemo so he may require increased healing time since his body may be immunosuppressed from the chemo but that is not a deal breaker.

Pam

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17 February 2018 - 10:05 am
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The prognosis question is tricky…our vet has always been reluctant to discuss that topic. 

Wendel started limping in January 2017, but due to a misdiagnosis and some inconclusive biopsies, he was not diagnosed with osteosarcoma until August 2017 (we opted to amputate in August prior to diagnosis because Wendel was in a large amount of pain, and it was due to a biopsy on the amputated limb that led us to a definitive diagnosis).  Wendel was only 1.5 years old at the time of amputation, and that played in his favour…he had a fast and uncomplicated recovery.  We opted not to pursue chemo, as we live in a northern region and we would have a 20 hour round trip drive for chemo.  Wendel was diagnosed with lung mets 6 months post amputation…but he is not showing any symptoms and with meloxicam added for pain management he is back to his happy and mischievous self.  Not sure how much longer we have with him, but the amputation is definitely making the best of the time that we do have left with him…we have no regrets with our decision to amputate. 

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