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1st appt for osteo and head is spinning- have ?s would love advice
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Forum Posts: 9
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4 September 2018 - 8:09 pm
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Hello.  I am new to the site and since confirmed diagnosis today of osteoscarcoma from scans and I have been researching and seeking out advice.   Paul is a newly turned 8 year old black greyhound who started limping.  I thought it was arthritis and never even thought Cancer.   Besides the limping he is acting normal and blood work is good.  He is a very sensitive dog.  That is the one thing that concerns me but he is also stubborn which I know he has fight.    I feel like amputation may be his best chance but it is scary for us.   I see all these pictures of greyhounds doing great on the 3 legs and gives me hope.    We also have 2 other dogs-  an almost 2 year old chocolate lab and a great pyrenees.  If you have other big dogs-  how do they react?   I am worried also of them knocking him down.

Here are our 2 options for treatment…The ‘curative-intent’ treatment is the best chance for long term control and pain relief from this cancer. This involves amputation of affected limb followed by chemotherapy. The gold standard chemotherapy is carboplatin given every 3 weeks for 4-6 treatments. Recheck chest x-rays are recommended at the time of 4th treatment then every 3 months thereafter. 

In palliative therapy, radiation therapy may offer relief of bone pain. This involves 1-4 treatments (1 x/week) of traditional radiation therapy or alternatively 1 fraction of Cyberknife radiation therapy. About 50-75% of dogs experience pain relief. CyberKnife is a specialized form of Stereotactic Radiation Therapy. It is sometimes called radiosurgery, as CyberKnife is a non-invasive way to deliver radiation therapy with similar precision as a surgical procedure. We are currently combining the radiation therapy with an injection of pamidronate or zoledronate, which is a bisphosphonate drug destroys the cell that is causing bone breakdown within the tumor. This drug is administered every 2-4 weeks as an IV infusion. Finally we recommend chemotherapy with the above treatments.

Then the clinical trials… these are options….Clinical Trial Options: 
(1) Current osteosarcoma trial: Dogs will undergo preliminary staging tests including initial consultation, physical examination, lab work, thoracic radiographs. All eligible dogs will undergo amputation of the affected limb followed by carboplatin chemotherapy every 3 weeks for up to 4 doses. Dogs will also receive immunotherapy (no placebo). The initial immunotherapy treatment series will be administered every 2 weeks. Boosters and recheck chest x-rays will occur every 3 months thereafter until removal from the study. Preliminary staging tests, amputation, carboplatin treatments, immunotherapy treatments and follow-up visits after completion must be performed at HopeVS. Dogs will remain in the study until osteosarcoma metastasis is documented.
This study is partially funded by the Sponsor to help offset the costs. Owners are responsible for the costs initial consult visit, tests required for enrollment eligibility screening, amputation surgery, lab work and chest x-rays in excess of those covered by the study, and treatment of any adverse events.

(2) We are now enrolling dogs with osteosarcoma who have undergone amputation and chemotherapy in a study of the Canine Osteosarcoma Vaccine, Live Listeria Vector (COV-LLV), a conditionally licensed product. For participation, your dog must meet the eligibility requirements and have completed amputation and chemotherapy protocol. All dogs enrolled in the study will be treated with the vaccine (no placebo). The study has partial funding to pay for bloodwork, examinations, etc. The majority of the cost for screening and treatment and any adverse events is covered by the owner.

Has anyone done any of the 2 above?

I am so stressed out about this decision.   I am so scared of not doing and him suffering in pain and then I am scared of doing and him being additional pain because of the amputation.    Did you all go through these emotions?  

I am so glad there is a site because I am someone that likes to see and hear all options.   It is a tough decision but I know I need to make it fast.   

Also my greyhound could not get all xrays so if we amputate they have to do chest xray before.   He gets so worked up with people trying to lift him and move him etc.   I am wondering with all the post treatment if that will stress him out more. 

The Rainbow Bridge



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4 September 2018 - 10:19 pm
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Hi Paul and family, welcome. You have come to the right place. I’m sorry you had to be here though, it’s such a tough situation for sure, but we hope we can make it easier.

You’ve done your homework! That’s terrific. Yes, there are many members here whose dogs have had the exact type of treatments you mention and many have gone through clinical trials like the Canine Osteosarcoma Vaccine.  In fact we have a story about Bowie, a greyhound, who recently completed her COV immuno therapy and is doing great! Clinical trials are so awesome. Here is an interview we did with Colorado State University’s oncology team about why clinical trials matter to everyone

Sounds like you’re working with a great clinic. Which one is it?

Chemotherapy is another decision that may seem tough, but if you were to ask Paul what he would want, what might he say? For dogs that hate the vet clinic, it may not be the best choice. But if you think he can tolerate the visits, then it will give him an extra chance at a longer lifespan.

Whatever you do, know that there are no right or wrong choices. All that matters is that you move quickly to help alleviate the pain Paul is in (believe me, osteo is the worst pain there is when it comes to cancer), and whether that means amputation or just palliative care, we will support you no matter what. Amputation isn’t for everyone but for the vast majority of dogs, it gives them a great quality of life. And believe it or not, many do beat those osteosarcoma odds! Yeah they are depressing but we’ve seen dogs go much longer than anyone expected, whether or not they also did chemo.

I hope this helps! Keep us posted on how things are going.

It's better to hop on three legs than to limp on four.™
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Minneapolis, MN
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4 September 2018 - 10:50 pm
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Hello – I am so glad you have arrived and posted.  Welcome.

Paul being a grey, white coat syndrome is certainly something to consider as you weigh these options.  As Jerry mentioned, chemo  treatments will involve vet visits, but not so will palliative radiation and, if I’m not mistaken, that will also require sedation.  Because stereotactic was a not offered here in MN, we were looking at 18 to 22 daily sessions plus CT scans all under General Anesthesia as Pofi’s best option for long remission post amp with his cancer.  In the end, for various reasons, we did not do it.  But another NST dog recently did and there is a great blog on Buster’s experience with it.  I’ll find it for you.

Again, glad you decided to join us.

heart

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His Daddy and I miss him terribly along with his canine sister, Mia, and two feline siblings, Lucia and Cliff.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation

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5 September 2018 - 8:18 am
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Thank you for responding.   I will definitely ask more questions about aftercare and what is involved.   I know putting Greyhounds under is scary.   I always bring a sheet with me about their bloodwork and anesthesia for them.   Luckily this place has a board certified anesthesiologist on staff so I feel better.   The place is HOPE Veterinary Specialists in Malvern, PA.   They are one of the best in the area so I know I am in good hands.   

I think we are going to move forward with amputation.   Paul is still fairly young and all his other tests are good otherwise and to see him still be goofy through this you would not know he has cancer brewing.   I just feel like this will give him his best chance and I do not want to wonder if it could of helped and I do not want him to suffer through pain.    At least after it is done he will be monitored from here on out. 



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5 September 2018 - 9:57 am
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Hi Paul and family 🐾🌺

I am so sorry you have to join us but so pleased your family researched options to a fine degree!

My baby girl Eurydice was a huge Great Dane who lost her front leg to osteo.

There was no doubt in my mind about amputation once I got the full picture of how excruciatingly painful osteo is.

Of course, like all others, I wished with all my heart there was another option to stop the pain but sadly palliative care is not able to control 100% of the pain, as the surgeon and oncologist explained to me when we were discussing options.

We did not pursue radiation because it requires general anaesthesia each time and also it doesn’t eliminate the risk of a pathological fracture occurring, in which case amputation is the only way as this type of fracture never heals. 

I also did not want to leave the primary tumour in place, doing its nasty works even if on a more subdued state.

I figured once the primary tumour is removed it cannot spread any more cancerous cells around and that is that.

Of course, to try and tackle micro cells which are too small to show on xrays and CT scans the option was to pursue carboplatin treatments which we did, six sessions with no side effects shown and no anaesthesia involved.

We also did metronomics and 3 courses of doxorubicin.

As for anaesthesia, it is high risk for Greys and also for Danes so I tried to keep that to a minimum.

Nevertheless, I wanted to assess what the exact situation was before amputation and elected to have a CT scan performed just before surgery so we used the same anesthesia for both procedures.

I repeated the CT scan at 6 months after amputation as this is the “classical” time for lung mets to develop, if they do.

Sadly, I never got the opportunity to test any of the vaccines that are available in the States (YAY for you guys!) but if they were available here, I would not have hesitated for one second!

There are many of us who are doing the vaccine trials so I am sure you will have lost of feedback from them.

Amputation is a brutal option per se but please rest assured our babies do recover from it and adapt marvellously well.

Paul has a wonderful pain free life ahead of him and we are all here to help and guide you along the way.

Hugs and cuddles 😘🐮💫✨🌟🌹

 

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 :-) 

Schofield, WI
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5 September 2018 - 6:19 pm
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Welcome and sorry your diagnosis brought you here.  Wow you have really done your homework…..no wonder your head is spinning….so many more options than when our Max was being treated.  My advice is go with your heart.  I had to chunk it all down in my mind and I realized I wanted that cancer gone.  I had to give my boy the chance of beating this.  So we proceeded with amp and Max was back to his happy self within a short time.  If I had the chance all factors considered I’d probably also look into the clinical trials.  But it all comes down to you knowing your dog the best and knowing what he’s willing to tolerate.  Our Max hated going to the vets but we did proceed with chemo knowing it was possibly going to help him.  It isn’t a very long visit maybe two hours tops each time.  Search your heart and make your decision with love and you can’t go wrong.  As for your other dogs (we had two also) they seemed to sense Max was down and out and kept their distance till he recovered.  Amazing really dogs are so intuitive.  Good luck and keep us posted on your beautiful Paul!  We’ll be standing by ready to help you if you need us.  Sending hugs!

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5 September 2018 - 6:49 pm
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You have come to the right place. We were here just a little over 2 years ago feeling the same way lost and desperate not knowing which way to turn. Then we looked at our pup although over 10 1/2 years old loving life and we knew we had to give him a chance of life – we did not know what the future held but we wanted to try for him – not for us but for him. Today we lost our boy but it was under his own terms he was ready. 2 years ago he was not – he lived life to the full on 3 legs we were just amazed. He went on his daily walks actually they were runs – he wrestled with his buddies he lived life to the full. The only advice I can give is do the research then listen to your heart and your dog. Always know that this site and the people you will meet on here will support you whatever your decision. 



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5 September 2018 - 6:55 pm
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Welcome and thank you for posting.  I am sorry the ugly C brought you here to us.  You have really done research. Amputation doesn’t cure but does take the pain away.   Osteo is a very painful disease.  It took me 2 biopsies and neither were conclusive and I knew by then Sassy was in pain. The amputation took that away.

We did 4 treatments with Chemo after the amputation. We were too far away from a teaching hospital that had studies going on to do one of those.  You know how your baby reacts and you know him. 

We also had one other dog and he never bothered Sassy.  We did keep them separated the first night she was home but after that they were together.  The Chemo we did keep them separated when they pottied most people don’t but the most toxic time after chemo is 2-3 days when it is excreted through the kidneys.  Just being extra careful.  We never had any problems.

You have been given lots of great advice.  We are here and we do not judge.  Everything is a personal decision.

hugs

Michelle & Angel Sassy

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Sassy is a proud member of the Winter Warriors. Live long, & strong Winter Warriors.
sassysugarbear.tripawds.com
07/26/2006 - Sassy earned her wings 08/20/2013

05/04/2006 -  Bosch, Sassy's pal, earned his wings 03/29/19  fought cancer for 4 months.

"You aren't doing it TO her, you are doing it FOR her. Give her a chance at life."

Here and Now


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5 September 2018 - 7:32 pm
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samlee said
Today we lost our boy…  

We are so sorry to hear about you losing Mikey! heart We was lucky to have you.

Thanks for chiming in here. Your future forum posts will not require moderation.

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5 September 2018 - 10:04 pm
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So sorry to hear about Paul’s diagnosis. I surely understand how you’re feeling right now. Our dog, Murphy, had amputation of his right hind leg one week ago for sarcoma. If you proceed with amputation, you truly will be amazed at what Paul can accomplish. Murphy is hopping around pretty nicely after 7 days!

As for how your other dogs will react, we have found that our other golden, Molson, treats Murphy exactly the same. He doesn’t seem fazed at all by it and we haven’t had to keep them apart at all.

I wish you luck in your tough decision. It sounds like you are very well informed and a great advocate for Paul. Keep us posted

Valheart

Virginia




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5 September 2018 - 10:19 pm
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You’ve  done an excellent  job  on research and you’ve  gotten excellent  support from everyone .  You m kmow your Paul so well.  It is important to know how each dog reacts to Vet trips, carrirdes, etc.  Too much stress with lots of Vet trips certainly  has to be considered  in every decision. 

As Linda said, keep things chunked down and take one step st a time.   Make uour decision  about amputation or not, then everything  else  will fall in place.  You’re  doing a great job and you are clearly  strong get than you think!

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

PS   Sam, we celebrate  the life of our amazing  Mikey with you today❤  Such a powerful  inspiration  for anyone starting  this journey, especially  “mature” pups.  And yes, Mikey lived life on his own terms and he created his own version  of “statistics “.  He proved that “their” statistics  don’t  mean much around here.

Very kind of you to post tonight.   I know it wasn’t  easy, yet I also know it was a great way to pay tribute  to sweet Mikey.  He has a great Legacy of Hope that he likes sharing. 

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!

Green Bay, WI


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6 September 2018 - 7:55 am
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Welcome Paul and family, sorry you find yourselves here, but “here” is the best place for info and support. It sounds like you have an amazing amount of information – kudos to you for that. People that know me, know my motto is “knowledge is power”. Even with having all the info, and asking all the questions, it still boils down to taking a leap of faith, and doing what your heart tells you is the best thing for your boy. Sometimes that’s a hard thing, sometimes you know immediately what to do. I agonized over taking a leg from my beautiful athletic Doberman when he was 8 1/2 years old; but we knew he was not ready to leave us yet, so we charged full-steam ahead, ready for the fight of our lives. He lived an amazing life for over 3 1/2 years as a tripawd, when old age took him from us. It was a challenging journey to say the least, but we don’t regret it for a minute.

So do your research – you have….ask questions – you are. The rest is up to your heart – and your gut. Good luck, keep us informed; we’re here for you.

Paula and Warrior Angel Nitro

Nitro 11 1/2  yr old Doberman; right front amp June 2014. Had 6 doses carboplatin, followed by metronomic therapy. Rocked it on 3 legs for over 3 years! My Warrior beat cancer, but couldn't beat old age. He crossed the Bridge peacefully on July 25, 2017, with dignity and on his terms.  Follow his blog entitled "Doberman's journey"

http://nitro.tripawds.com

"Be good, mama loves you".....run free my beautiful Warrior

Minneapolis, MN
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6 September 2018 - 9:42 am
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More stories that may be relevant or of interest.  

Fallon

Buster – radiation treatment for Nerve Sheath Tumor, but very informative on the process

Also, if you are pursuing the amp and it seems like you are, you have really confidence in the anesthesiologist and that is wonderful.  I would also talk to the surgeon about using Amicar or Aminocaproic Acid.  Greys are prone to some particular issues with surgical bleeding, clotting and bruising (and perhaps you already know this, but just in case).

My number one recommendation is always to discuss in advance the pain management plan – how many meds – what sort of schedule and what can you tweak or adjust to get max coverage for recovery.  I am an advocate of “more is best” – our team was very proactive on this front.  Gabapentin 3x daily, Rimadyl 2x daily, and Tramadol 3x daily to start – did this for two weeks prior and post surgery.  Three different modalities of pain relief that compliment each other.

Let us know what your next steps are!

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His Daddy and I miss him terribly along with his canine sister, Mia, and two feline siblings, Lucia and Cliff.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation

kbart1107
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7 September 2018 - 3:37 pm
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Hi Paul and family.  

It seems we are on the exact calendar of our osteosarcoma findings 🙁  Oddly enough, I live in Bethlehem, PA and am seeing an oncologist who’s home base is at Hope!

I know exactly the feelings you are going through. My 5 (or 6) yr old boxer (she was rescued with zero background info so I really don’t know how old she is), Lady, is absolutely her normal happy self, minus the limp and boney tumor sticking out of her left front shoulder. I’m going through the back and forths of amputation + chemo as that is what the doctor assured me is the best chance of survival/quality of life. I can’t imagine living without her and don’t want to give up on her so I feel (after much research and conversations with my boxer rescue friends) this is the best choice. It’s not an easy one by any means and I cry constantly. I knew I would have to go through a difficult time with her at some point, just not any time soon. She’s young and we’ve only been with each other for 1.5years. 

We will always wonder if it’s the “right” decision, but there’s no right or wrong. Whatever you decide is the best decision for you and Paul. 

I hope this helps at least a bit. I just find some comfort in knowing I’m not alone in this nightmare.

Cancer sucks 🙁

I’ll keep you and Paul in my thoughts. Please give him a big hug from me and Lady. <3

Here and Now


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7 September 2018 - 3:47 pm
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kbart1107 said
It seems we are on the exact calendar of our osteosarcoma findings… 

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