Caring for a Three Legged Dog or Cat
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Hi all, I have a husky mix about 9.5 years old. We're in Alaska and she's some kind of sled dog type, likely has greyhound in her as she has the soft coat and has always been slow to heal cuts (which is relevant).
In April she started limping on her left front and couldn't isolate a painful area nor did x-rays show anything but she had a lump on the elbow. We aspirated it and it was a sarcoma so in the absence of anything else thought was it was causing a soft tissue type pain and it was removed first week of May. It turned out to be a nerve sheath tumor and they got clean margins. The limp didn't go away but wasn't expected to get worse and it wasn't terrible so figured she would have a mechanical lameness the rest of her life and didn't worry about it. She's a pretty smart dog and will self limit, plus PT was always an option if needed. About 10 days after the surgery she opened up the lowest two stitches in the incision scratching it with a hind leg and was put on antibiotics for a week. Otherwise uncomplicated- happy, alert, eating, wanting to run. Usual maniac self.
A couple weeks after that, month or so after surgery (mid June), she became much more painful and developed an all around hitch/ gait problems.lethargy and general miserableness. I'd been increasing her exercise and the thought was she'd overdone it on the limpy leg and hurt her neck or back. OK. She was put on meds (meloxicam, gabapentin, robaxin) and told to rest. She got no better though. Coat started to look rough and she started to have yeast infection on skin and periodic upset stomach. Took her off the NSAID as a result of the stomach upset. No change.
Mid July she became acutely painful in her back and leg. Back has slowly resolved over time mostly. Leg- new (2nd) x-rays showed a weird shadow on the humerous in the elbow where the lump was removed. This is in the same spot she had surgery and the slow healing incision. Vet sent the x-rays out of state to 2 different radiologists who also just saw a "weird thing" on the distal humerus, could be fungal , cancer or bacterial or fracture. Follow up three weeks later (3rd xrays) showed large lesion. Sent to local specialist, they did biopsy, which came back yesterday as "well differentiated reactive bone trabeculae with distinct bordering edges of dense fibrous tissue and some associated acute hemorrhage. Can be associated with a number of underlying processes". Dog is now on Tramadol and non weight bearing on that leg but also just seems sick: lethargic, loose stools, rough coat etc. She is still super happy to go for walks (or hops) but she is a sled dog. She is back on an antibiotic as of last night and I'm supposed to wait a month per specialist and repeat x-rays. I'm not sure we have a month.
Specialist ruled out fungal infection as we are in Alaska, but as I noted above she has a very noticeable yeast infection on paws, lips, urethra etc which is particularly bad in that paw. We have x-rayed her head to toe twice and found nothing else btw.
My question is where to go from here?
- What are the odds of a dog having two unrelated cancers in the same exact spot on one leg with no cancer anywhere else?
- Should I be asking they reconsider fungal? she is in and out of the local lake a lot and it is frequented by water fowl. I did a literature search and indeed fungal infections are rare in Alaska.
- I'm happy to do the amputation if it's bone cancer. But no one is quite comfortable with amputation yet given the results and chance it is an infection.
- I'm NOT willing to put her through a bunch more invasive tests unless there is a very good reason. She hates it and hates the vet and, as a husky, is very dramatic and gets incredibly worked up. The biopsy she had last week was very painful for her. The vets are kind and gentle with her but she's Not A Good Patient. I, however, can do anything to her: shots, dressing changes etc are no problem at home.
- She lives to go outside and run around, she is definitely depressed now so long term, if we amputate, she'd need to be able to get around and go for walks etc or she'd go insane.
- I have all the records and am happy to send them out for a second opinion.
Any advice appreciated! This one is kind of stumping everyone but I know the dog best and am alarmed at her apathy and general affect right now.
Hello and welcome, your future posts will not have to wait for approval.
Is your girl's name Sadie?
I don't have experience with NSTs but a few people here have dealt with them. From what I've read they can lurk and are hard to diagnose. I'm wondering if all the symptoms are related to the previous NST?
Pofi's Story might be helpful to you.
I'm expecting a delivery soon so I have to run (have to coral the dogs!) but I wanted to get your post approved so others can help.
Karen and the Spirit Pug Girls
Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.
1999 to 2010
The nerve sheath tumor was purely soft tissue,non-aggressive and was sort of attached to the callous on her elbow. It was gumball sized and we did pathology which showed clean margins. The bony lesion is on the humerus. So not the exact same spot internally, sorry that was misleading, but they are within a few cm of each other. The bony lesion did not show up until 6-8 weeks after the sarcoma was removed. I tend to think it must be related but maybe not.
The bony lesion is apparently odd because it has very smooth edges- everyone keeps commenting on them. I do have digital xrays if it would help. One specialist is sure she can see it on all three sets of x-rays and thinks it originated in the marrow and grew outward, the other ortho specialist does not believe it is visible on the first x-ray. They both seem good and are colleagues so I will let them argue that one out!
She is looking brighter after 24 hours of antibiotics I think, maybe? Hard to say. She is currently sitting by the car whining and hoping I take her to the park for a run!
Hey there I'm in the Tripawds Chat room right now if you want to talk. back in a sec...
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
So.....I'm not qualified to answer this:
What are the odds of a dog having two unrelated cancers in the same exact spot on one leg with no cancer anywhere else?
But here's what I can offer:
You are an awesome advocate for her. It does sound like she is not getting enough pain management right now based on what you're describing:
Dog is now on Tramadol and non weight bearing on that leg but also just seems sick: lethargic, loose stools, rough coat etc.
Personally, and I'm not a vet so take this for what it's worth, but based on what I know about Tramadol, it's likely not enough pain control for her right now. If she can get back on the Gabapentin and Galliprant, a NSAID alternative, that would probably be very beneficial. Talk to your vet.
As for waiting a month, if she were my dog I would not wait it out if additional pain meds are not helping. What I would consider is sending her file to Colorado State University. Their Lucy Oncology Center's oncology consulting service will be happy to look at her case and give you their opinion.
It's wonderful that you are in Alaska and able to get such great vet care for her. You must be in Anchorage? We just came down from the North Country, it is soooo beautiful there.
Oh and if you're worried about a three-legged sled dog, fear not. Calpurnia's story will put any doubts to rest.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
I just got Galliprant which we will start tomorrow am. She came off meloxicam last week and letting her tummy recover a bit. Hopefully it helps! They are really cognizant of her pain but right now I'm more worried about long term decisions.
btw- she was on gabapentin for two months (300mg gabapentin + robaxin 2-3x a day and meloxicam). It didn't help and it makes her SO loopy and disoriented, even at the lowest dose. I'm pretty sure she hurt her back falling down the stairs high on the gabapentin. the tramadol is better for her.
She's getting around ok and she's still happy but her super power does appear to be metabolizing drugs, that's for sure.
Hi there sweetie 🌸
Could you publish the X-rays here?
Bone cancer is very specific, generally can be identified with X-rays alone and it grows outwards from the inside of the bone.
The progression of the bone being eaten away is quite fast too.
When my vet told me he suspected bone cancer I went on the net to see photos of xrays and when my baby's xray was done the next morning and the vet shown it to me I could see what it was.
Him, the surgeon and the oncologist I saw subsequently all agreed it was bone cancer and sadly they were right.
What I am saying, not being a vet, is if there are xrays done at different times and if it is osteosarcoma there must be an evolution shown.
I would definitely check the oncology consulting service link Renee published.
Making sure drugs are correct for your pup is also crucial at this point.
We are all by your side, please keep updating us.
Sending you 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 :-)
Hi, Pofi's Mom here.
Can you tell if there seems to be muscle atrophy in the triceps or other muscles of that leg? Comparing the left front to the right font leg?
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 canine sister also succumbed to cancer on March 1, 2019 - we lavished her with our love in the interim, but life was never quite the same without her only real canine friend. Cliff kitty had to leave us, too, suddenly, in August 2019. Lucia kitty grieved all these losses, but helped us welcome two new Lurchers into our home and our lives, Shae and Barley.
If there is a lesion on the xray then that is probably the source of her pain. A nerve sheath tumor should not invade the bone but perhaps the first biopsy was wrong? Distal humerus is not a typical site for OSA but could be a site for a metastatic lesion so I would do chest and abdominal xrays and if you can't find anything else I would consider amputation for pain relief.
Fungal infection is very unlikely in Alaska.
Pam
Hi. Pam pointed out that a nerve sheath tumor should not invade the bone and I think that it typically does not. Pofi's did however, wrap itself around a rib: part of the reason it was Grade 3 of 3, remote metastases. Not common, and maybe not what is being seen in this x-ray. But the rib had to be removed - the surgeon thought from MRI she could remove just part of the rib but decided that was not possible during the op and removed whole thing.
Pofi also had multiple other bumps and lumps that seemed to spring up or grow during the entire pre-diagnosis and post-diagnosis course of his illness with an NST. They were red herrings - we kept thinking it was this nail bed infection, this lump in a toe. This lump near a foot pad on the back leg (same side). And when his cancer was back post amp, the first sign seems to have been a lump that he had had for years on remaining front leg was suddenly growing and he was licking it incessantly. Just like the toe that started the journey of missed diagnosis 18 months earlier. We removed it, it was not cancerous (again, like toe removal and other lump removal), but while we suspended Palladia for treatment, the cells from bad margins roared back to life and took root in his spine.
Pam - I know this is not established science. But it was our experience and I can't be convinced his licking and gnawing at other lumps was not somehow related to the undifferentiated pain he suffered from that hidden NST in the brachial plexus and radiating outward.
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 canine sister also succumbed to cancer on March 1, 2019 - we lavished her with our love in the interim, but life was never quite the same without her only real canine friend. Cliff kitty had to leave us, too, suddenly, in August 2019. Lucia kitty grieved all these losses, but helped us welcome two new Lurchers into our home and our lives, Shae and Barley.
Hi all, thanks for the input. I let her go on Friday. I had a vet visit scheduled Tuesday (tomorrow) to make a final decision on amputation. She seemed to be doing much better on the antibiotics so I was hopeful. But Friday morning at 4am she woke me up in pain and we couldn't get it under control, even at the vets with injectable meds. We re x-rayed and the bone lesion was unchanged, no fracture, just an un-explainable increase in pain. Her back end looked bad too, she was staggering a bit, and there was concern about that.
So many vets looked at her and the x-rays (good, compassionate vets, I can't tell you how many times they called to check in on her) and we still had no idea what we were dealing with and therefore had no idea what the prognosis would have been post-amputation. We didn't even know if it was cancer. Given that and her pain levels, her long-standing panic about vets and dislike of being handled in general, I just got this very strong feeling it was time and I had to let her go. She had a great last day, was able to hang out at the lake with her best dog friends and play a bit and was not in much pain. We'll probably never know what happened to make her worse but that's been the way this has gone from the beginning. In retrospect I should have asked them to biopsy it after she died so we finally knew but I was too upset at the time to really think straight.
So, not the ending I wanted but she's not in pain anymore and that's good.
Ohhh I'm so sorry. I cannot imagine how hard that was for you, and the not knowing...oh my gosh.
You followed your gut, that's what counts. Amputation isn't always the right course of action, and you made this choice with all the love in your heart for your very special girl. She knew that, and she likely left this world with a huge sense of relief and gratitude that she did not suffer. No creature could ever ask for more.
Please know that we are keeping you close in our hearts, and sending special messages to our Tripawd heroes in heaven to make sure they greet your girl with a big pawty. I'm very sorry.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Thanks. It was hard. She was very much her own dog and did not appreciate people making decisions for her so I think she was probably pretty mad that I thwarted her plan to die in the kitchen guarding the dog treat cupboard.
To clear up a couple questions: She definitely had a nerve sheath tumor, it was removed intact and sent to pathology. She was lame for 1.5 month(ish) before it was removed and had no bony lesion at that time. She became much more lame 6 weeks after removal at which point we could see a tiny maybe/ maybe not lesion on x-ray. Three weeks after that the lesion was very big but the all three vets said it didn't look like osteosarcoma so we biopsied. The biopsy was inconclusive despite the surgeon getting three good samples. The lesion didn't change much after that but the joint became very swollen and filled with fluid. She also had digestive upsets and her coat became rough and started to fall out, which was improved by the antibiotics to some degree. She had no lesions elsewhere, we -x-rayed her head to toe twice. If you look up the % incidence of NST and then of the non-osteosarcoma bone cancers and multiply them together to obtain the odds of the same dog developing both - it's mathematically unlikely. Not to mention at the exact same time in the same precise area on her body with no tumors elsewhere. So sadly we just could not get a handle on this in time to save her, or maybe we couldn't have anyway if it was a bad infection. She never did heal well from cuts and scrapes, the bit of greyhound in her.
I am so very sorry. With an NST, it there could have already been another one lurking somewhere and in many locations they will not show on an x-ray - maybe the one you removed was a satellite. Not that it matters, really. I am glad she felt a bit better for a while with the antibiotics so you had some more time together.
Sending wishes to you for comfort - you did all you could and what was best for your girl. Pofi being a sled dog/sighthound mix, I feel like I know how special and unique your girl was. I would love to see a picture of her - did she look anything like Po? Take care.
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 canine sister also succumbed to cancer on March 1, 2019 - we lavished her with our love in the interim, but life was never quite the same without her only real canine friend. Cliff kitty had to leave us, too, suddenly, in August 2019. Lucia kitty grieved all these losses, but helped us welcome two new Lurchers into our home and our lives, Shae and Barley.
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