Caring for a Three Legged Dog or Cat
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My dog Daisy, a 45 lb mixed breed dog, was diagnosed with lymphoma in early March. We began chemo the same week she was diagnosed, 2 weeks later we noticed a bump on her leg that was growing rapidly and she was subsequently diagnosed with osteosarcoma. We were all surprised with this diagnosis due to the location of the bump and the fact that she did not seem to be in pain, but a second test confirmed the diagnosis. Our oncologist advised to focus on treating the lymphoma first since Daisy did not appear to be in pain and it would not be possible to operate while undergoing chemo due to white blood cell counts being too low.
Daisy has started to shift her weight off of the leg in the past couple of weeks and she is now taking 3 different types of pain medications to manage the pain. Her energy levels are good, and she continues to eat well. She had another round of chemo yesterday and we are considering amputation at the end of next week which should give her sufficient time to build up her blood cell counts. We are concerned that left untreated Daisy could break her leg.
I am so scared to make a wrong decision for Daisy, and also worried that maybe amputation is too much considering that she also has lymphoma. Has anyone dealt with a similar situation and have any advice?
Hi Liz and Daisy, welcome. Gosh as if one cancer diagnosis wasn't bad enough, I'm so sorry you are dealing with this!
Yes there is definitely a fracture risk there when it comes to osteosarcoma. I don't blame you for hesitating on the amputation. What does your oncologist suggest?
You might want to mention this new treatment for limb sparing: cementoplasty.
Tripawd Talk: Cementoplasty for Osteosarcoma Dogs and Cats
It's a minimally invasive procedure that is giving dogs a chance at a longer life with their leg, even while the osteosarcoma tumor is still present. Currently there's only one vet in the US doing the procedure (she's in North Carolina). Soon we will publish our second tripawd talk interview about it, and it features that vet, and her patient, a dog who is still doing great nearly a year past the date he received the treatment. Stay tuned. But definitely bring it up with your oncologist, it seems like it might be a good option depending on where the tumor is.
Hi and welcome.
I'm sorry you are dealing with two cancers!
My Pug Maggie had two cancers also- she lost a rear leg to mast cell cancer and later developed oral melanoma. Our situation was different though- the melanoma diagnosis came a few years after the amputation. But the first cancer and treatments led to some other health issues which limited our ability to treat the second cancer.
I would want to know what the prognosis is for the lymphoma before I made a decision about amputation. I don't know much about lymphoma- how the chemo works, what the recurrence is, etc.
How is she handling the chemo now? Would you consider doing chemo for the OSA after amputation? Would that conflict with treatment for lymphoma?
Sorry- probably not very helpful, lots of questions.
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
Thank you for the information on Cementoplasty - we will look into it.
Lymphoma is a very aggressive cancer- with treatment prognosis is 1 year for most dogs. We started Daisy on the CHOP protocol which is the good standard and is a 19 week treatment plan. She was not tolerating the drugs well and ended up hospitalized for several days so the oncologist recommended that we switch her to Tenovea which is a newer treatment - she receives a dose every 3 weeks for a total of 6 doses and has already received 3. She has tolerated the Tenovea well but is still not in remission although the oncologist believes it is under control for now.
The oncologist has told us it is very rare to have these 2 forms of cancer at the same time and therefore there is no suggested or right path forward. With amputation prognosis is maybe one year. If we don’t amputate and Daisy breaks her leg then we will have to amputate anyway, or it would be time to say goodbye.
Sorry for all the information that probably isn’t relevant for most, but hard to answer your questions without all this background. I have learned more about cancer treatment in the last two months then I ever thought I would need to know.
Hey you bet. I hope that it's an option for her.
No need for sorry, this is super helpful information. We have had many members' pets get diagnosed with a second cancer, but usually not the way this has happened to your girl. I see why your oncologist said what she said, it makes sense considering all that's happening in Daisy's body.
Please keep us posted OK? We are here for you no matter what path you take.
Oh gosh, such a rotten dilemma. You've gotten great insight from Jerry and Karen, and some good questions to ponder. Sometimes when there is no clear cut path forward, you just have to go with uour go with what you think Daisy would want. DEFINITELY no right or wrong decision. You have been thrown a curve ball making which path to take so hard and so confusing.
Couple quick questions, does she tolerate car rides and going to the Vet okay? Not stressed? If I'm reading this right, if amputation is next week, she still has three more lymphoma chemo every three weeks after that? Woild ask Onco if that would interfere at all with the surgery ittself, the pain meds needed during recovery, etc.
Give Daisy some extra smooches for us. She sounds like sich a trooper.
We are here ro help in anyway we possibly can.
Higs
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!
PS...Might want to try posting g thos ro our volunteer Vet in
Ask A Vet thread. Not sure of she'll jave a y insight on Daisy's double whammy, but worth a try. She's so knowledgable.
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!
All the information is relevant. Although I haven't heard of another case like yours yet- someone will come along and this will be helpful for them.
I would lean on the opinion of the oncologist as far as if Daisy can get into remission if her treatment is interrupted by amputation. If she is handling the new chemo pretty well then maybe she wouldn't have to miss any treatments.
Unless you can get her some type of limb sparing treatment I think you have to make a decision quickly on amputation. Even though she wasn't limping before she was probably hiding her pain- dogs are good at that.
Such a tough decision.
Based on the information you provided maybe you can look at it like it's one cancer. You can't stop the lymphoma treatment since she isn't in remission. You have to make a decision on amputation soon because the leg is at risk of fracture. If the leg fractures when her white cell counts are low then surgery may not be an option. So at this point it's all in on treatment/amputation or you move to palliative care.
Just suggesting another way to think about things.
We all tend to second guess ourselves- but the truth is you will never know what would have happened if you chose another path. I've learned that over the years and it has helped me make hard decisions and move forward.
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
Thank you for all the feedback and support. This has been so difficult to go through with so many twists and turns. Sometimes I feel so sad and angry that this is happening- I love Daisy so much and I wish she wasn’t going through this. I try to focus on making every day good for her and keeping her comfortable.
To answer your questions, Daisy does well in the car, but she does not like to go to the vet - probably because they are always poking her with needles. We give her trazadone in advance of her visits to calm her nerves.
The plan is that if we time the surgery for next week she would not need to delay any of her lymphoma treatments. My understanding is that we would finish up the next 3 Tenovea treatments and then potentially move on to some other chemo drugs to treat the osteosarcoma which can still metastasize after the amputation.
It is true that if she happened to break her leg after one of her chemo treatments that they would not be able to operate due to the white blood cell counts and that would be a very bad situation. The tumor on her leg is bigger than a golf ball but smaller than a tennis ball and is growing roughly one centimeter per week. We are asking for more imaging to see if we can understand the breakage risk better. We are also going to speak to her doctors on Friday to talk through more of our questions.
I think I had mentioned before that she is walking on her leg but that is with the help of a significant amount of pain medications- codeine, gabapentin and a form of ibuprofen. We added in the codeine a couple of weeks ago when she had stopped putting weight on her leg.
I will keep you updated as we get more of our questions answered. Thanks again for all of your support!
Liz and Daisy
We spoke with Daisy’s oncology surgeon today and decided to move forward with the amputation. Daisy appears to be in more pain the past couple of days and considering all the pain medication that she is taking, the pain is probably significant at this point. We will also be at a good point in her lymphoma treatment to take the opportunity to do the amputation. The Dr believes that she is a good candidate and will do really well.
We take her in on Wednesday for updated imaging, and assuming no surprises she will have surgery on Thursday.
It is so clear how mich you loce Daiay and how you will do whatecer ot takes to give her QUALITY. While it is hard to see her in pain, the fact that it continues ro increase is definite sign that you are taking the best path forward with amputation.
You've gotten as much reassurance as you possibly can from the medical professionals that Daisy is a good candidate, in spite of that crap solve whammy she's dealing with.
I know you'll ve on pins and needles until Thirsday's surgery. Just remember sweet Daisy is blissfully unaware of any of the stress ypu are dealing with. She's living in the now, in the present, and has no worries about the tomorrows. That's called Be More Dog .
We are here vy your side every step of the way. YOU ARE NOT ALONE! Recovery of no picnic at first, but it doesn't last furever.
Hugs
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!
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!
Aww poor Daisy, I'm so sorry you had to make this call under these circumstances. I think you've made a sound decision based on a very complicated situation. Working together with your oncologist, I have no doubt that the surgery and follow-up will be 100% all about her quality of life and making the most of every minute. We are here to support you, please let us know how we can help.
Daisy got updated scans yesterday (after 6 weeks) and they showed no signs of metastasis. She had surgery today and the dr called to update this evening - she is already up and walking unassisted! I am so happy and relieved. We expect that she will be able to come home tomorrow. I can’t wait to see her 🙂
YAAAAY FOR DAISY! Surgery is done and she's on the road to recovery!!👏👏 Up and walking already? WOW!!! Daisy is "high as a kite" and feeling no pain. So tonight you can rest easy and sleep well! You have gone through a lot of mental and physical exhaustion getting to this point.
Let us know jow the home goes, okay?
Hugs
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!
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!
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