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6 Year Old American Bulldog Potential Osteosarcoma
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Sam - Los Angeles
1
12 April 2024 - 2:02 pm
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My wife and I are parents to a 6 year old American Bulldog, Nova, and a 3 year old English Mastiff, Archie. We live in the Los Angeles area and our lives revolve around our dogs so all of this has been incredibly difficult for us and a total shock.

I apologize in advance for the lengthy description and history but just wanted to give as much info as I could in case there is someone out there in the universe that can provide us with any insight. 

Nova had an on and off limp starting in December of 2023. We visited her regular vet on December 30, 2023 at which time he conducted x-rays of her hind legs and concluded that she had signs of arthritis and advised us to provide her with weekly shots of Adequan. 

Last week we noticed that she was careful with not putting too much weight on her front left leg and thus had a follow up with a different vet (not an oncologist) on Wednesday, April 10. 

To our absolute devastation we were told that she almost certainly has osteosarcoma.

We visited a soft tissue surgeon on the following day, April 11, and were told that our options were (1) pain management only, in which case life expectancy was anywhere between 1 to 3 months (although they were not certain of this as they are not certain how far along she is), (2) amputation followed by chemo, in which case life expectancy was closer to 12 months, and (3) a far more complicated leg preservation surgery which sounded quite risky (40% chance of complications), which would potentially give her 9 months but with great difficulty. 

On the same day we conducted a bone cytology (with a fine needle as opposed to an actual biopsy needle which we were told is much more painful), and an ultrasound of her belly area. 

The bone cytology was to confirm the cancer (there is a tiny possibility that this is fungal so we'd like to eliminate this outcome). We are awaiting the results now. The ultrasound did not show any spread thus far but we'd like to confirm this with a CT scan prior to proceeding with a surgery. Her blood work came back as normal.

We have an oncologist appointment for Wednesday, April 17, by which time we should have results from the bone test and hopefully a CT scan result. 

She is on gabapentin and codeine now to help with post-testing recovery.

If faced with the inevitable, we are almost certainly following the amputation and chemo path to allow her the chance to fight this horrid disease. We'd also consider any and all clinical or other treatments if even remotely accretive. The soft tissue surgeon thought that she was a good candidate for amputation b. She is quite young (turning 7 on June 19) and it kills us that her little life could be cut so short. 

If helpful for background, she is a rescue that we took in about 5 years ago. She has had ACL surgery on her back left leg (prior to coming to us through the rescue organization). 

Also, if helpful, here's a bit about her diet - for the past year, she has been eating fresh food only (cooked turkey, pasta and vegetables) and she takes the following supplemental on a daily basis (again for the past year): (i) 8-in-1 Zesty Paws Multivitamins, (ii) LubriSyn HA+MSM Joint Health Liquid, (iii) Omega-III Liquid Supplement, (iv) Desuqin, (v) Curcumin Phytosome, (vi) PetLabs Pro-Biotic Chews, (vii) Rejensa, and (viii) bone meal for dogs. 

Livermore, CA




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18 October 2009
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12 April 2024 - 2:45 pm
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Hello Sam and Nova, welcome.

First I would recommend that you register as a member- it's free and that way your posts will show up without having to wait for approval (after the first one) and you can take advantage of all this site has to offer.

I'm sorry you have had to find us but this is the best place to be when setting out on this journey.  All of us that have been on the cancer journey can relate to the shock and devastation you feel when you get the diagnosis...and then they recommend amputation.

It's good that Nova's vet feels that she is a good candidate for amputation- that is an important factor when making the decision.

It's good that she is on pain meds, if it is OSA it is very painful.  Our dogs tend to be very stoic so even if she isn't showing pain signs without pain meds there is most likely pain.

I searched on Bulldog and got this result: Another American Bulldog Named Nova who Lost a Front Leg.  Nova is over a year past her amputation and still going strong.

Do you have any specific questions or concerns that we can help you with?

 

Karen and the Spirit Pug Girls and Boy

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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12 April 2024
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12 April 2024 - 3:53 pm
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Thank you for the quick response! I just registered.

I am awaiting her biopsy results now. I guess I didn't have any specifics other than putting this out there for now so I can post future updates and ask questions as they come up... I'm sure we'll have a lot as we navigate through this challenging journey. 

Is there a way to upload pictures of her? It would help visualize our princess pup

The Rainbow Bridge



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25 April 2007
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13 April 2024 - 4:47 pm
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Hi Sam and Nova, welcome to the club nopawdy wants to join!

If you're in L.A. you have tons of great vet care and resources, you are so lucky to be there if you have to deal with this poopicondisease. It always comes as such a shock, especially when you've gone to such great lengths to make sure your dog is in the best health, gets the best diet, etc. Cancers like this don't discriminate, unfortunately. 

Please do post as much as you'd like and ask any questions, we are here to help.

As for pictures, yes, here's how adding images to the Forums works. Holler with any questions.

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12 April 2024
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13 April 2024 - 11:18 pm
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Thank you Jerry for your thoughts and this incredible community. I am so grateful to have stumbled upon this page. 

We are eagerly awaiting the oncologist appointment this coming Wednesday - we have asked for a CT scan to confirm that the disease hasn't yet visibly spread to her organs (fingers crossed). 

We are seeing Gabrielle Carter of the VCA of West Los Angeles. 

She's been very needy since the bone cytology of two days ago which clearly caused her some significant pain. She is on 1200 mgs of gaba per day (split into 3 doses) and 135 mgs of codeine per day (split into 3 doses). 

Should I be considering anything else on the pain management front? Has anyone experimental with C

Her bone cytology report did come in last night but I honestly cannot understand much of... and I'm hoping to get more clarity from the oncologist Wednesday. I've pasted it below in case anyone understands the lingo and can help me understand any aspect of it... the last lines seem to suggest further testing although I have no idea really...

Here it is:

"CLINICAL INFORMATION: 6-year-old. Canine. Bulldog. SF. Presenting for evaluation of LTL lameness. Lameness was first noted in
December 2023, owners noticed patient started limping after coming back in from a walk. SOURCE: 11 slides: Bone aspirate.
Description: Eleven digital smears are examined. The best smears are of moderate nucleated cellularity and have a large amount of
blood. The background is purple. Rare amorphous pink material is present (osteoid verses collagen). The majority of cells are spindle
cells. They are present individually and rarely in aggregates. They have a moderate nuclear to cytoplasmic and mild to moderate
anisocytosis and anisokaryosis. They have an oval, slightly eccentric nucleus, coarsely stippled chromatin, 1-2 small nucleoli, and
moderate amount of blue cytoplasm occasionally small vacuoles. Occasional osteoclasts are admixed. Few spindle aggregates contain
mildly increased numbers of neutrophils and macrophages. No microorganisms are seen. Microscopic findings: Mesenchymal
proliferation with mild to moderate atypia. Mild mixed inflammation. Comment: The findings of mild to moderate spindloid atypia
(occasional malignant features) with an osteoblastic appearance is concerning for osteosarcoma. However, there is some mild
inflammation present and this could also reflect a reparative bone process (could be seen with previous fracture, non-apparent
infection, or less likely another type of poorly exfoliative infiltrative neoplasia). Correlate to imaging. Tissue biopsy with histopathology
should be able to help more definitively characterize the cellular atypia prior to radical surgery."

Livermore, CA




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6
14 April 2024 - 1:57 pm
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Hi Sam,

I can't comment on the cytology report- lots of big words!  Best to leave that part to the pros at your appointment on Wednesday.

One question I would ask is: is the bone in the leg so damaged that no matter what the cause amputation would be recommended?  That would be important to me to determine if further invasive testing in needed.  Biopsies can be very painful as you were told so if the end result (amputation) would be the same then I would question why further tests were needed pre surgery.

On the pain meds- are you alternating dosing or giving both together?  If you are not already you might try giving the codine and gaba at different times to get better coverage.  Of course always check with your vet to let them know what you are seeing.

 

Karen and the Spirit Pug Girls and Boy

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

The Rainbow Bridge



Member Since:
25 April 2007
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7
14 April 2024 - 4:27 pm
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Ohh yeah I won't even pretend to interpret that path report, but thanks for including it. Lots of folks find that level of detail very helpful. It just makes my head hurt so I let the vet explain stuff like that 🙂

Her pain control sounds about right for her size, and 3 times daily is ideal. However Like Karen suggested, alternating between the two could be helpful. Also, the codeine could be making her more dysphoric than painful. You definitely want to mention her behavior to your vet, so they can work on a good strategy for her surgery recovery. Amantadine is typically used when pain is not brought under control easily with the two meds she's received. I would ask about it, if you think her behavior is more related to dysphoria from the opioid itself than pain.

VCA West L.A. is awesome! We actually did some oncology interviews there several years ago. Nova is in great hands there.

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12 April 2024
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14 April 2024 - 6:06 pm
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Thank you both. I started alternating between the two today as Karen suggested.

She was also given Meloxicam but she's progressively less vocal so attempting to keep her on gapa and codeine for now. 

She refuses my help (i.e., picking her up) to go up and down steps. I figured the steps weren't good for her but she's a strong headed little girl. 

What concerns us a lot is her absolute discomfort with the vet. She growls and bites (she came to us as a rescue and we believe she had a history of abuse in her prior home) and thus has to be muzzled which no owner loves doing. We are hoping that we can find a place that allows us to stay with her during chemo sessions. I also worry about her 24 hours in clinical care without us after the operation as I'm not sure she would allow staff to walk her or feed her or even get close. Not sure there's much we can do on that issue. 

I'm just curious if we've ever heard of cases of remission with OSA - my research seems to suggest that it's almost unheard of ... with almost all cases a matter of several to 12 or so months with some limited dogs reaching 2 year mark. When things get a little grim I do keep remining myself of what you keep stating Jerry, which is that dogs "live in the now" and I need to match Nova's thinking when it comes to this issue... 

thanks again for all of your responses thus far. they are greatly comforting to us.  

The Rainbow Bridge



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25 April 2007
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15 April 2024 - 10:45 am
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You are so welcome. I hope her pain control works better for her today.

It's OK that she refuses the help, and that attitude will go far during recovery. Where your help will be necessary is on stairs and slippery surfaces, so that's when a good harness like the Ruffwear Flagline comes in handy. With the handle on top, a dog doesn't have a lot of choice when you assist from that angle on their back. In time she may learn that it's easier if she lets you help while she's wearing it.

As for the discomfort with the vet. Try not to think of muzzling as a bad thing. Some dogs just need it, and they are actually calmer if you have the right kind of muzzle for her (tough breed to fit but usually a bigger basket muzzle does the truck). Don't use a grooming muzzle, which keeps her mouth shut, prevents panting, and ultimately causes more stress.

Also consider that chemo is totally optional, you don't have to do it if it will cause her more stress. That is where gauging her quality of life comes in. You have to weigh her happiness against what being at the vet to get chemo will do to her overall quality of life. Some places will let you sit in while chemo is administered, but I'm not sure about VCA WLA.

Regarding the remission ... we have seen a few dogs like Dexter live as long as 7 years. Not many, but it happens. And the thing is, it happens with or without chemo. Some dogs will outlive the prognosis with chemo, some will outlive the prognosis without having gone through chemo. It often seems like the chance for longevity with chemo is a crapshoot. With the new immunotherapy vaccines out there, we are definitely seeing more dogs go longer, but again, no guarantees or predictability. So always remember, everything after amputation is optional. Get rid of the pain and take it from there. See how she does overnight at the clinic, then make your decisions about what's next. 

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12 April 2024
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17 April 2024 - 10:16 am
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Thank you again for everyone's time yesterday on the monthly Zoom call. It was so helpful and gave us so many avenues and matters to consider. 

We are seeing Nova's oncologist today (her first visit to the oncologist). 

We plan to inquire about the various immunotherapies out there. I will also inquire about Zoledronate as I had heard that can help with bone density issues - not sure if you've come across that elsewhere. 

By the way, I read the interview on here regarding histotripsy. Do we know if that continued on? The website link for the clinical trials is now defunct. I was curious if the therapy ever took flight elsewhere. 

Lastly (for now!), I am curious to speak with surgeons that have succeeded with cementoplasty - just so that we think through all of our options, particularly if Nova turns out to be less than a stellar candidate for amputation (we will obtain the VCA's second opinion I hope this week - the initial opinion from a different vet was a bit mixed given Nova's ACL surgery in one hind leg and less than perfect structure in the other hind leg).

As always, grateful for any and all feedback from everyone.

The Rainbow Bridge



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25 April 2007
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17 April 2024 - 12:51 pm
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You are so welcome, it was nice getting to know you and seeing Nova and Archie!

Yes, Zoledronate has been used for many years. It's a bisphosphonate that is given as an infusion, usually during radiation therapy.

By the way, I read the interview on here regarding histotripsy. Do we know if that continued on? The website link for the clinical trials is now defunct. I was curious if the therapy ever took flight elsewhere. 

Yikes thanks for letting us know. I'll reach out to Dr. Tuohy to get the status.

Lastly (for now!), I am curious to speak with surgeons that have succeeded with cementoplasty 

So Dr. Stewart is the North Carolina vet we interviewed, but I'll reach out to BioceraVet to find out if we can get a list of vets who are using it.

Keep us posted on the visit!

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12 April 2024
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17 April 2024 - 6:55 pm
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We met with Nova's oncologist and potential surgeon team today. 

The visit solidified OSA as the disease. 

Our next step is to elect amputation versus radiation, followed by chemo. 

The oncologist was concerned about Nova's hind legs. She has had ACL surgery on one and the other shows signs of a "partial cranial cruciate ligament tear" (from the report). She also shows signs of arthritis. She didn't lead us to one versus the other but did say that Nova was likely to struggle more than others and therefor require more of our assistance - the oncologist seemed focused on her size (85lbs) which I've read, based on some of the posts here, should be considered through the context that vets see less of the larger breeds (particularly in urban areas) than the smaller breeds. 

The surgeon shared a similar sentiment but the focus seemed to more on the increased level of involvement it would require of us with helping her get up etc. 

They effectively left it to us to determine but did note that radiation could eventually result in a break which would thereafter require amputation. Perhaps that is where the cementoplasty could play a role? Not sure.

We're a little lost following today's visit. Our gut tells us amputation but that's because it seems to give her the best chance at living a longer and more pain free life although there is no certainty as to whether she'll adjust all that well.

We'll need to breathe and think again with a more clear head. 

She did get a delicious and freshly cooked steak dinner to celebrate her bravery thus far (she did OK at the vet with acepromazine, a muzzle and a cone).  

The Rainbow Bridge



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25 April 2007
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17 April 2024 - 7:17 pm
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Darn, I'm sorry you didn't get clearer direction on what to do next. It's so hard when there are other factors at play. Arthritis is pretty common but yeah the cruciate situation is concerning. We have found over the years that Tripawds tend to be more susceptible to cruciate tears and resulting surgeries, so that is definitely something to consider.

In these cases, even a second or third opinion from an orthopedic specialist surgeon at a different practice is worth investigating. If you'd like recommendations to any in your region let me know and I'll dig around.

Meanwhile, spoil that girl rotten! That is awesome she did so well! Our Wyatt was even WORSE on Ace, or Trazadone, so that she did well on it is HUGE.

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12 April 2024
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17 April 2024 - 8:32 pm
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Thanks, Jerry. We are just so torn about how to proceed. 

The information out there on cementoplasty seems promising. It would greatly help to know if BioceraVet has vets/surgeons that they'd recommend who have some experience with the procedure as that could actually be a potential path for Nova. I really appreciate you offering to reach out to them. I'm sure they will respond to you. 

Perhaps cementoplasty along with radiation or chemo and careful pain management is what we're left with given the condition of her other legs. 

Again... a bit lost today and trying to find our footing once more. 

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12 April 2024
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17 April 2024 - 10:10 pm
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One other question I have is whether we can perform radiation once cementoplasty is effectuated. Probably a question for Biocera. 

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