Caring for a Three Legged Dog or Cat
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Approximately six weeks ago, a week before Christmas, our almost 12-year-old Shiba mix Rusty missed a step and slid down our flight of stairs on his stomach. He bounced back up from the slide as if nothing had happened but soon after he began showing worrisome symptoms. Over the weeks what started out as soft tissue inflammation from the fall has turned into a diagnosis of mast cell tumor in his left forelimb.
The diagnosis process with Rusty has been painfully slow. The waiting game is so difficult to handle as I see his symptoms progressively get worse each week. First, we did leg x-rays which looked good, and we were sent on our merry way with carprofen. One week of carprofen and his symptoms had not improved, and he was showing digestion issues with the carprofen. Our vet at this point thought cancer and recommended a biopsy. His bloodwork results were delayed due to bad weather, which in turn delayed his biopsy. His biopsy results took over two weeks and at this point we only know it’s an intramuscular MCT (likely low grade – I say likely because that’s what the vet thought but he didn’t have the full pathology report yet). It's apparently rare that they occur deep in tissue.
We live in rural central ND, so our vet has sent our records to a vet clinic in Fargo. The clinic has a vet that has an interest in cancer patients but isn’t necessarily an oncologist. We are awaiting a call from them to discuss if they will be able to help or if we should go directly to U of M to an oncologist. All while Rusty’s mobility and breathing continues to decline.
Within a few days of the fall Rusty’s armpit got very bruised and his upper limb and shoulder were swollen with a fluid pocket behind the armpit. After the biopsy his swelling got worse, even more so within the past week. The leg is more than double its original size and is swollen down to the paw now. The bruising has not improved any and he now has saggy fluid pockets down his chest/abdomen. We tried Benadryl (3 pills, 3 times a day) at the recommendation of our primary vet to keep his histamines in check but he had a bad reaction where he couldn’t even stand or sit without falling so, we stopped. We started him on a lower dose after a few good days and he had another bad episode just the other night, so we stopped again. At this point we don’t know if it’s the medicine or just his MCT getting worse so we are waiting to see if it reoccurs while he’s not on it.
We are hoping the clinic in Fargo will be able to give us some options, but I expect it’ll be something along the lines of bringing him in for additional diagnostic. Ultrasounds and FNA biopsies to determine if it’s spread. Depending on those results, he’ll either be a good candidate for amputation of the leg or he won’t. We’ve decided amputation is not an option if it has spread. With how poorly his biopsy incision healed we just don’t want to put him through that pain of recovery without a good prognosis.
Our other options would be chemo and/or palliative care. I worry because he’s already shown sensitivities to pain killers and possibly antihistamines. I fear if we can’t get his inflammation down his mobility and breathing issues are just going to continue to slide and further diagnostic work may not buy us anything more than extending his misery. He does still have an appetite, is usually excited for treats, and alert to our voice but seeing him unable to barely walk, breath so harshly, and just have a difficult time getting comfortable breaks my heart.
Sorry for the long post... any words of wisdom would be greatly appreciated. His 12th birthday and half of his life with us are to happen in 2022. We adopted him July 2016, when he was 6 years old. Pictures of the lovable fluffy butt can be found at this reddit post I made last year after a DNA test:
Turns out Rusty really is part Shiba Inu, part Border Collie, and 100% fluffy butt. Results on last slide!
byu/Obiza47 inDoggyDNA
Hi Rusty and furmily! Sorry you had to join us, but we are so glad you did. I'm totally in love with him, he is adorable!
As you are discovering, mast cell cancer is a tricky beast. There are so many ways that treatment can go so try not to jump to any conclusions until you talk to the experts. Once you have all the information on the table you will be able to make an educated decision that you can feel good about, or at least more comforted knowing you left no stone unturned.
If going to Fargo is a burden on you guys, you might want to consider Dr. Venable's new virtual oncology consulting service. She works with family vets to come up with a treatment plan for pet cancers. It's a great option for folks in rural locations.
Right now, I'm thinking that part of his mobility decline is related to uncontrolled pain. Benadryl can make dogs reallllly sleepy, so it makes sense that he got wonky on it. But he may be in some kind of pain that is not being treated as aggressively as it can be. Everything you described are pain signals . Not saying it definitely is, but under these circumstances it seems likely in my non-vet opinion. Have you talked to your vet about his symptoms?
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
You are doing such a good job on tryi g to do what is best for your sweet Risty. I k ow ot has to be frustrating to not get answers faster and to have to go through hoops to get any answers at all. Youremakkng progress and will have a clear path forward soon. Hang kn there!
While I don't have any i sight I to your specific situation, I do agree with Jerry avout adding some pain management into the mix. You can speak to the Vet about Gabapentin. I k ow you are worri about sensitivity to meds, but the breathing, etc sounds like he could use a little help managing pain. And, FWIW, biopsies are often quite painful and can hurt for awhile. So, again, maybe some pain meds can help his overall attitude.
Stay connected and keep us updated. Risty is very lucky to jave sich a strong advocate♥️
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!
Thank you both for the warm welcome. We think he's a pretty adorable stinker too. I only wish he walked into our lives sooner!
Rusty hasn't actually be on any pain meds since the initial carprofen. Our vet avoided providing us any even after his biopsy incision due to the vomiting that occurred with the carprofen prior. We spoke to our local vet again on pain management as the referral vet still hasn't had the opportunity to look at his records yet. He provided us with tramadol. He wants to avoid NSAIDs and steroids to limit contributing to more stomach issues. He still seems to think the breathing issues, inflammation, and edema are all due to the histamines being released and that the MCT itself isn't growing but just the inflammation around it. It feels like the mast cell degranulation goes in cycles because the evenings are always worse.
I did get a copy of the biopsy results. It's a bit more brief than I was anticipating. The results show he's Grade II (Patnaik), Low Grade (Kiupel), and 0 mitotic per 10HPF.
You are so very welcome!
Your vet's position on pain control makes sense, thanks for the explanation. Hopefully it's the histamines and not other pain happening. As far as Tramadol, it'is like baby asprin, pretty ineffective with acute pain. It can also cause some anxiety in dogs. I'm wondering if there is anything else that he can have that won't upset his belly? The NSAID alternative Galiprant is good for reducing inflammation, and it's easy on the gut. Gabapentin is pretty benign on the GI as far as I understand it. Not that I know anything about how they would interact with MCT but it's worth asking about if you haven't already.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
We spoke to our local vet again after getting the unfortunate news that the Fargo clinic decided Rusty's case was beyond their expertise. He put in the referral to U of M and we already got a call back to say they received his records but said it could be 2-4 days before an oncologist has time to review them.
The tramadol has been helping but not enough, so we now have prednisone for inflammation, hydroxyzine for anti histamine, and famotidine for acid reducer. I know it's wishful thinking that he won't have any symptoms from that many drugs but I'm hoping nothing too terrible since I think these should really help him out and seem to be the common group of drugs for MCT comfort care.
Oh darn I'm sorry that you weren't able to get answers locally but UofM is PAWESOME! Seriously, it doesn't get any better than a vet teaching hospital. They are so smart and you will likely have far more treatment options there too. I hope you hear from them really soon. Paws crossed 🙂
Yes, those medications are really common for MCT comfort care. I hope he starts feeling better. Hang tight, you'll be able to formulate a plan in no time at all. We are sending lots of Tripawd power your way!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
The past week has been somewhat of a roller coaster. U of M was booked out for over three weeks but we were fortunate enough to be able to get into a specialty clinic with great reviews in Madison, WI this past week. It actually worked out well since I have family within 60 miles of the clinic so we didn't have to deal with hotel rooms.
One x-ray, ultrasound, and a bunch of FNA biopsies later, and we have the good news that the MCT hasn't spread to his spleen or liver and his chest x-rays looked good. The bad news is that it has spread to the local axillary lymph node. The recommendation is forelimb amputation and lymph node removal, followed by chemotherapy depending on biopsy results. The ultrasound did show lack of movement in his intestines so we were also given some more medicine for his stomach/appetite. She also tapered the prednisone and added in gabapentin.
We decided not to do the surgery at the specialty clinic. While I'm confident the board surgeon would have done a wonderful job we didn't want to risk transporting him 12 hours in a car the next day. We didn't come prepared for surgery since they initially told us they were booked out till March on surgery. Our primary vet assured us if he doesn't feel confident doing the surgery he would be able to find someone local to do it. We're hoping to get it scheduled for this upcoming week so we can start the long journey of recovery. So I guess if all goes well my next post will be on the recovery board.
Can certainly understand why you woild want to "stay local" as opposed to a 12 hr drive to the Specialty clinic.
Goodness k OWS you are truly committed to doi g everything you can to keep your sweet Rusty happy and enjoying ,life to the fullest. Glad all his xrays were good. And no worries about the lymph node being removed. And yes, the Onco can figure out the best path forward after everything is examined.
Glad the Onco added the Gabapentin.
I like that your Vet had no issues with referr6 Rusty out of he thou6 that amputation was too big a hurdle at his clinic. That's a good Vet.
Okay, paws crossed you can get this done next week and begin the recovery. And the "recovery road" is really not rhat long....just feels like it will never end for a bit. The sparkle will be back before you know it!
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!
I'm guessing it feels good to have a plan you will follow now?! That's great. Plus, his current pain/stomach issues are on the radar and being handled. I hope he feels better.
You've done your homework, laid out all of your options, and know which way to go. Great job! Keep putting one paw in front of the other and this phase of the journey will be in the rear view mirror before you know it.
We are cheering you on! Ask any questions, and keep us posted.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
We lost Rusty yesterday. The same day he was to become a tripawd. He declined rapidly over the weekend and his pre-surgery blood test verified our biggest fear, the fight had become too much. He was very calm and sleepy in his last hours, letting us know it was time, but it didn’t make the decision any easier. 
Stunned. Not expecting this all. My heart just breaks to hear such sad news.
This disease is so brutal and barbaric and cunning and horrible! Sadly we've seen this type of outcome before where, no matter what medical interventions are put in place, and no matter how thoroughly tests are done, the disease has already plotted it's course. Unfortunately the script was written in such a sneaky and silent way.
The gift of release you gave Rusty today was the ultimate act of selflessness. He knew you loved him enough to help him shed the earth c,others that no longer served him. Rustly told you he was ready. He was tired of the fight and, quite frankly, probably didn't have enough strength in him to handle amputation and recovery. You did the right thing today for Rusty and at the right time. It was true testament to your love and devotion to Rusty. He is free of pain and ran fast and happy towards the Rainbow Bridge.
No, there is NEBeR enough time with our dogs. Because you took Rusty into your heart and home six years ago, Rusty got to have his own person, his own home, his once in a lifetime chance to know what it felt like to be loved and spoiled every moment of every single day with you.♥️
Please stay connected and tell us more about this special Soul named Rusty. We would love to know more. We already feel in love from uour first post with that handsome avatar photo.
Surrounding you with Rusty's eternal llght. .....a light that can never be dimmed
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie
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!
Oh no! I'm so so sorry, this is just such a shock. I can't imagine how heartbroken you are feeling, these past few weeks have been so up and down and gut-punching. My heart and deepest condolences are being sent to you. ((((hugs))))
Please take comfort in knowing you went to the ends of the earth for him, and he knew that too, all the way to his very last breath. Rusty was so loved, and in his final hours my guess is that he felt some relief knowing that his humans were looking out for him, that you were putting his needs first, over your impending heartache. That is COURAGE! The strength you showed had to have made it so much easier for him to relax into his transition, while he knew that he touched his humans in such a life-changing, positive way that would carry on his legacy far into the future. Rusty's life mattered because of you, and he will never, ever be forgotten.
We are keeping you close in our hearts, and lighting a candle for your sweet boy. Please feel free to come back anytime and share some of the best times you had together, we would love to celebrate his life when and if you are ready.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
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