Caring for a Three Legged Dog or Cat
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mck025 asked:
So my question is, if it's a good (humane?) gamble to go ahead with
amputation and chemo with a clear xray, and our xray was clear except
for one small spot, would it be reasonable to proceed that way and
despite the CT results? Or does any sign of lung mets mean very little
time?
I dealt with different kind of cancers in my tri-pug but I know several here have had long and happy runs after lung mets were diagnosed. There is one spectacular story about Reno who has lived with lung mets for three years. Admin guy gave you some links above (post #12) for info on treatment options for lung mets.
Based on what I have learned here it is more humane in my opinion to lose the very very painful leg and give the pup a pain free life for what ever time you have. If his lungs were full of mets visible on an xray the decision might be different, but that is not where you are right now.
As far as chemo goes- most dogs tolerate chemo very well- way better than people. There are good meds available to help with nausea if that is an issue. And- if you decide the side effects are not tolerable you can always stop treatment.
One other thing on the stats from my experience. My pug Maggie had mast cell cancer- a high grade tumor in her left hind leg with lymph node involvement. With amputation and chemo her prognosis was 6 to 9 months. We did the amp and the chemo and hoped for the best. She lived almost 4 years and passed from a second, unrelated cancer. Maggie definitely beat the odds- but it shows that it is possible. It taught me to stay positive and optimistic until there is a reason not to be.
Once you make your decision about how to go forward do so with confidence. You might even want to write down your thinking so you can refer to it later. I made a decision not to treat Maggie's second cancer, a melanoma tumor in her mouth. There were lots of factors I considered and felt it best for her not to have more surgery and aggressive treatments. She passed three months after diagnosis. Do I question my choices sometimes? Of course I do!! I think it is part of human nature- the 'what ifs'. But whenever I have those thoughts I think back to my original reasoning- all the factors that contributed to my decision, and I know I did the right thing. The truth is we can never know what would have happened if we had made another decision, all we can do is make the decisions we think are best at the time.
Karen and the pugapalooza
I know this is very stressful, but again, you have to take a step back to be able to put some thought into your decisions. You are not going to find a magic bullet. Cancer is a bad disease. If it's OSA, it's a highly aggressive one. If it's a soft tissue sarcoma, it can go in many directions and just settling on a diagnosis can be difficult. No one can tell you with any accuracy what an individual dog's outcome will be with any treatment plan. Taking a day or two to sort through your options is not going to change his.
Your dog ( what's his name?) is almost 12 years old. He's into his senior years, cancer or not, they are never with us long enough. Your dog doesn't care what decisions you make. He cares about right now. If he is happy & comfortable now....he's happy. Your anxiety is undeniably going to affect his world negatively.
When you are seeking the advice of professionals, they are giving you information based on the Standard of Care for a diagnosis. They don't know your dog as you do, they don't share your life. If they did, they would not be able to objectively provide care, whatever you decide it will be. Anytime you seek care in an academic setting, while you may have more options, they aren't necessarily better. What's right for you will take a more thorough vetting. Dwelling on the decisions already made & acted upon is wasted time. Every experience, positive or negative, teaches us something.
Try to make one decision at a time. If relieving his pain with amputation, even if it's for a short time, is something you can live with, than focus on that. Save the chemo decisions for later. Chemo is not mandatory. There are many dogs here on both ends of the treatment spectrum. Many dogs here have outlived their prognosis with & without chemo, and sadly, the same is true in the reverse. You have to consider your individual situation and it's overall impact on everyone's quality of life.
I did not choose to do chemo on my dog. She had her leg amputated in August, when she was likely well over 12. She's had a fantastic almost 8 months now & never had a bad day related to her cancer or amputation. Statistically, this wasn't supposed to happen. I will never regret taking her to the park instead of the oncologist. I don't know what tomorrow has in store, but in retrospect, I would change nothing.
Try to be grateful your dog has reached his senior years, appreciate every moment you have with him....someday these memories will be your comfort...don't allow your anxiety to diminish this irreplaceable time. You have to make peace with his mortality...cancer or not.....only then will you be able to savor your life together. Your choices for him are obviously being made out of love and that's all you can ask of yourself.
Cynthia
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There are no wrong decisions here. I look at amputation as a way to control pain, and you might get 3 good months or over a year with lung mets but there is no way to know. It is true that amputating the leg does tend to make lung mets grow faster but you may be able to slow this down with metronomic chemo.
If you are okay spending the money for even a few pain-free months and your dog is otherwise in good health I would say go for it. I would not do the biopsy ahead of time, especially since the FNA showed sarcoma cells.
If you choose not to amputate there are other methods of pain control such as gabapentin and Tramadol that may help but most dogs will still experience some deep bone pain which is why amputation is the best and fastest way to take the pain away.
Pam
Thank you all for your posts. My dog's name is Percy, which is actually short for Persevere. I'm hoping that his name will give him some help in this!
I took the advice to slow down and think about this and I am surprised that I am pretty comfortable with my decision. It was hard to think about this without thinking about losing Percy, but when I was finally able to sort of put that aside and think about things logically (what steps will relieve his pain and give him the best chance of having the freedom to play and be happy) it was (still not easy, but) clearer what I should do. I decided Saturday morning to go with amputation and we have an appointment scheduled for Monday. I never would have thought that I would be ok with amputating my dog's leg -- I am surprised that I am at peace with this decision, but Percy is perfectly happy right now and I think this is the best choice of the choices we have right now. I was told the biopsy would take a few days which will give me time to research and think about chemo.
This weekend I took Percy for long walks, a trip to the farmer's market, out to the park, and then out to the beach today for some fun before Monday.
Karen,
Thanks for the suggestion of writing down my reasoning. I think I will do that.
-- AJ
Good luck tomorrow. I hope Percy (and you) have a successful surgery and uneventful recovery. It sounds like the two of you spent a nice weekend together.
Cynthia
Is metronomic chemo more effective than regular (carboplatin) chemo for lung mets? Dr. Pam mentioned metronomic chemo above and I've read several stories at this website of dogs who have started metronomic chemo after detecting lung mets. Should I not try regular chemo at all and just go directly to metronomic chemo, or can regular chemo potentially help shrink/prevent-more lung mets?
I am happy for you that you are at peace with the decision you have made. I wasn't truly ok with the decision to amputate until the day we picked Trouble up from surgery. When I saw she was ok, then I was too.
And you are right about the chemo, you have a little time to make that decision. If you are leaning toward conventional chemo, it is generally recommended you start treatment within two weeks. I'm not sure about metronomics , we didn't go that route.
Wishing you peace tomorrow, an uneventful surgery and a speedy recovery for Percy.
Shanna & Spirit Trouble ~ Trouble gained her wings 3/16/2011, a 27 1/2 month cancer survivor, tail wagging. RIP sweetheart, you are my heart and soul. Run free at Rainbow Bridge.
The November Five - Spirits Max, Cherry, Tika, Trouble & Nova. 11/2008 - 3/2013 An era ends as Queen Nova crossed the Bridge.
mck025 said:
Should I not try regular chemo at all and just go directly to metronomic chemo...
That is a totally personal decision, as avery dog is different. But more importantly, don't start shoulding on yourself!
We chose not to do IV chemo with Jerry because we chose to focus on quality of life instead of quantitiy since he was given only a few months to live and the drive for chemo treatments would have been 5+ hours each way, every few weeks.
We started Jerry's metronomics after we discovered the mets because we could administer it on the road as we continued our travels with him. Metronomics is a very low dose oral chemotherapy. Carboplatin, Doxyrubin and other IV chemos are much more potent drugs. They are presumably then, more effective, but also have greater chances for adverse side effects.
If you haven't already, be sure to watch our video interview with oncologist Mona Rosenberg discussing metronomics, chemotherapy and immunity supplements.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Traditional chemo like carboplatin is given to decrease micrometastasis (spread to the lungs or other bones). Once the cancer is in these organs the chemo often does not help much. Metronomic chemo helps to reduce new blood vessel formation so can keep mets small and delay their spread so this would be the preferred treatment for a dog with lung mets. This is a new field and different oncologists use different drugs but the standard is to use an NSAID like piroxicam or meloxicam with a chemo drug such as Cytoxan.
Pam
Percy's doing well after his surgery on Monday. He was up trying to walk on three legs that first night, and is now able to get around pretty well -- a little wobbly still, but he gets impatient if I try to use the towel sling. I am amazed how he has adapted -- I wish I had his attitude! He's been quieter than usual the last few days, but he is gradually becoming his old self again.
The biopsy came back as hemangiosarcoma, which I was told has a worse prognosis than osteosarcoma. So we are preparing to fight this as best as we can.
I am thrilled Percy is doing well with his recovery, but not so thrilled with the diagnosis. I don't know much about that type of cancer, but am sending good thoughts for the both of you. You can be assured, you aren't in this fight alone. The support you find here is the best you can get.
Shanna & Spirit Trouble ~ Trouble gained her wings 3/16/2011, a 27 1/2 month cancer survivor, tail wagging. RIP sweetheart, you are my heart and soul. Run free at Rainbow Bridge.
The November Five - Spirits Max, Cherry, Tika, Trouble & Nova. 11/2008 - 3/2013 An era ends as Queen Nova crossed the Bridge.
Champ has hemangiosarcoma as well. I am sorry that was Percy's diagnosis. It definitely is a nastier cancer. We are doing everything we can to fight it though. He did show a small nodule in one lung this past xray (3 weeks ago?)
We are doing metronomic chemo every day and K9 Immunity Plus. I was very disappointed in my visit to the holistic vet as she really didn't offer anything new to fight the cancer with. We are on a low carb, no grain diet to keep from feeding the cancer.
No one knows how long… and I've come to terms with that. We are living each day to the fullest… and that's all we can really do.
Best of luck with Percy.
Joy & Champ
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