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Caring for a Three Legged Dog or Cat

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Ampution for 9 year old german shepherd mix with localized grade 2 STS
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Grue
1
9 January 2020 - 6:08 am
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For context, we recently removed a lump from the front right elbow of my 9 year old german shepherd mix. He was not in pain as a result of the growth. In fact, we thought it was a lipoma. It turns out it was a grade 2 soft tissue sarcoma (hemangiopericytoma). The lump could not be completely removed by our vet and so we went to see a surgeon. Imaging by the surgeon shows no signs of metastasis. Complete removal is uncertain given the location on the limb and depending on how deep it is. Complete removal through amputation would be the most straight forward option according to the surgeon. Note that he does have some hip issues, bilateral lateral hip extension pain according to the chart, but doesn't have dysplasia.

My concern is that the sarcoma is not immediately life threatening. It will continue to grow and may metastasize, but may not. He has not experienced or shown any signs of pain. Amputation seems to me extreme as his life may play out naturally without any issues. It may even degrade his quality of life due to the increased weight he'll have to bear on his hips. Of course I have no experience or expertise with something like this which is why I'm here. Any opinions, advice, or recommended reading, really anything, would be helpful. Thanks.

On The Road


Member Since:
24 September 2009
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9 January 2020 - 10:45 am
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Hi Grue and family, thanks for posting. Please consider registering as a member so your future posts won't need approval.

I can understand your hesitation. When a tumor isn't as mean as say, osteosarcoma, it makes the amputation decision tougher. 

After reading your post my first thought was that it would be good to investigate electrochemotherapy or intralesional chemotherapy for your pup. Not many vets do it in the US but it's common in Europe and other countries. It's quite cost effective and does not require amputation. Although it may or may not get rid of the tumor completely, in most cases it brings it under control and allows the patient to continue with a great quality of life. Two current members, also Shepherds and Tripawds too, experienced great results. 

See our blog posts about electrochemotherapy and intralesional chemotherapy. In those interviews you'll hear from Dr. Kelly, one of the pioneers of these treatments in the US, and if you'd like us to connect you let us know. 

I hope this helps. Stay tuned for more feedback from the community.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

Oakland, CA
Member Since:
20 December 2008
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18 January 2020 - 12:16 pm
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Hey there Grue and pupper,

We have done both intralesional chemo and electrochemotherapy . In both cases the tumor was removed first as that is considered most effective with both these treatments. We did the intralesional on our boy Travis, who also had a grade 2 STS on his right elbow. They were not sure they could remove the whole tumor due to its placement but they were able to get narrow margins (so higher risk of recurrence, metastasis). You can read about the options we considered and why we chose intralesional for him here. Its going on 3 years since his treatment and we have had no sign of recurrence. Yay!

Last year our Codie Rae developed oral osteosarcoma and we treated it with electrochemotherapy . Right off the bat I'll say there are not many vets in this country who do this procedure, here is a list of vets that do but it is not up to date because it does not include the clinic we had it done at here in the SF Bay Area. It also includes a vet we saw who never even mentioned electrochemo as an option. You don't say where you are located but this will be an issue for most people. Here is a link to the post I made last year. It is more of a rant about how hard it was to get the treatment but hopefully you will get some useful info. After Codie's surgery we put her on metronomics therapy and things were going OK until a new tumor blew up in her mouth a few weeks ago. We agonized but did not want to put her through another major surgery (she was 14+ and also had severe mobility issues). So we let her go on Wednesday. Osteo is generally much more aggressive than STS so it is not really surprising that it came back. With the electrochemo we got another 9 months with Codie, which is pretty good when you are dealing with osteo. I would expect it to be much more effective with a low grade STS. Dr Kelly actually no longer does simple intralesional because she feels the electrochemo is more effective.

Bear in mind I am not a vet but I think the intralesional alone could be effective for your pup, the whole point is to kill any cancer cells left behind by the surgery. So even if they did not get the whole tumor it could be really useful and you could avoid an amputation. Is there a veterinary teaching hospital near you? I would start asking there. Or you could consult with a local oncologist. In my experience surgeons want to do surgery and are loathe to talk about other options.

Hope this helps,

Martha

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