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Need Advice; Dunkel, 3 year old Rottie with Chondrosarcoma and pre-existing heart condition
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Member Since:
18 February 2024
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18 February 2024 - 6:55 am
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Dear All,

 

we are happy to have found this forum as we found a lot of information already and there is a lot more to read still.

 

Our situation is as follows: 

We have a 3 year old Rottweiler "Dunkel". At 12 weeks old he was diagnosed with a severe subaortic stenosis, ie a heart condition that is unfortunately not treatable. The direct implications of it are a limited stamina/endurance (meaning he gets tired very fast), any form of anesthesia comes with an elevated risk and also a significantly reduced life expectancy. At the time of diagnosis the vet told us average life expectancy for his condition was 2 to 4 years. Though some live much longer.

A few weeks ago we noticed he was limping with the left front paw and since it did not go away with regular anti-inflammatory drugs we took him to the hospital for further investigation.  Since then he has had an X-Ray of paw and chest and also a biopsy of the paw. 

The x-ray and biopsy of the paw show he has chondrosarcoma though currently still pretty low grade, although the vet also cautioned us that even the biopsy is not 100% conclusive and it may be osteosarcoma or a more malignant chondrosarcoma after all. I did not 100% understand the explanation of why they were not 100% sure but it seemed to be mostly because of his breed and that there was something a bit off in the dna analysis of the tumor in the pathology report. 

Dunkel will have a full CT scan on tuesday as - though obviously there is always the possibility of microstasis - we would like to be as sure as we can be on whether the tumor has spread further already before we make the final decision on next steps.

The hospital is currently recommending to amputate his left front paw (full amputation) and says that the outcome of the CT scan will not influence that recommendation unless the tumor has spread much further already. Limb sparing surgery could also be an option but is not recommended in his case as it has significant risk of infection and requires a lot of after-treatment which would require to sedate him every time as well. 

Personality wise Dunkel is a Rottweiler 🙂 Meaning he is by himself super-friendly and social to humans, with other animals he is a lot more selective. But he also has a strong will and is not easy to treat. Eg just getting a cone on him is a nightmare as is already. We also - hopefully we are wrong - do not imagine him to adjust that fast to losing a paw. For reference the first time he had a cone on him it took him almost 2 full days to slowly get used to that the first two days he was 'frozen in place' and refused to move anywhere with the cone on at all, we imagine losing a paw will be much tougher for him still. 

Currently he gets 4 300mg tablets of gabapentin and an onsior each day against the pain. With that dosage he does quite well, i.e. he does not limp much and seems overall quite happy as he still likes to play and eats and sleeps well. 

For us it is very difficult to decide on what to do next.

- If the tumor has already spread we think we may not do the amputation but will just try to control the pain as best as possible untill the point that this is no longer feasible. 

- If it has not spread further we are inclined to go for the amputation still but to be honest still not 100% certain this is the way to go for him. With his heart this kind of big surgery is a big risk by itself and based on his character we also think/fear the recovery after amputation may be very difficult both for him and us. 

I would be happy to get some insights into experiences from people on the forum, specifically with.

-> What can we expect if we decide to just control the pain as best as possible and NOT do an amputation. Currently he is doing quite well with the pain medication but we also do not imagine this situation will continue indefinitely. 

-> I have read a lot of stories about dogs accepting amputation fairly well and recovering in a matter of days or weeks. But what is a worst case outlook after amputation? Do all dogs eventually adapt or do we also risk just making him much more miserable for maybe only a few more months of life with a low quality?

Livermore, CA




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18 February 2024 - 2:08 pm
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Hello and welcome, your future posts will not have to wait for approval.

I'm sorry you have had to find us, hopefully we can help you with the journey ahead.

I can't recall a dog here with Dunkel's heart condition. I did a couple searches of the forums and didn't find anything, maybe someone else here can remember, find or had experience with this condition.

As far as controlling the pain- it won't work for long.  Dogs are really stoic so it's sometimes hard to see how much pain they are in.  How damaged is the bone?  There is a risk of pathological leg fracture if the bone is too damaged.

As far as adapting- I've been around here since 2009 and don't recall a dog not mentally adjusting.  Once in a while we see a dog not be able to fully cope physically but there is usually another un-diagnosed medical issue that is in the way.

My little Pug Maggie took 6 weeks to get used to her new normal after her rear amp for mast cell cancer but once she did she hopped happily through life for almost 4 years.  Every dog recovers on their own timeline, but what we see here is that most pups are back to themselves in 2 to 3 weeks, especially with the younger dogs like Dunkel. 

If you do decide on surgery perhaps you could work with your vet on alternates to the cone of shame .  Maybe a shirt plus one of the inflatable donut type collars.  Of course protecting the incision takes president- but you might be able to find something that works.  I had a Pug who could not function with a cone and I used pants (I made) combined with a donut collar.  You could ask about how the incision will be closed.  In many of surgeries my dogs have had they have internal sutures which seem to be less irritating for the dog.

 

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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18 February 2024 - 8:09 pm
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Hi there,

I just wanted to respond to your post about Dunkel; I don't know anything about the heart condition, but I also have a three-year-old dog (Trevor) with a chondrosarcoma diagnosis and understand the weighty decisions you're wrestling with. 

I'm still pretty early in this journey but can offer the following if it's helpful:

-  We opted to do a bone biopsy to confirm diagnosis, as it initially looked like osteosarcoma, and we considered not amputating despite his being only three. When they felt confident it was chondrosarcoma and slower moving, and his prognosis looked better, we learned all we could about amputation and made a pretty quick decision to do it. 

- He has a front limb amputation last Wednesday As of Day 4, he's tolerating the amputation ok, in that he's getting around with support from us and is pretty engaged with the world already. Frustrated in some ways, yes, but moving in the right direction. He was standing up the morning after the procedure. The surgeon said he was doing "phenomenally well." (Even so, recovery at home is not without challenges as meds wear off).

- I feel immense relief that the fear of sudden pathological fracture is now gone. I have new worries, but that was a big one. We drastically curtailed his activities while awaiting his surgery date. That was also stressful.

- My guy is also anti-cone. He did leave the hospital in one and wore it until this evening (day 4). I was surprised how well he tolerated it for awhile, but then it felt like a safety hazard as he was banging it on things and startling himself. We switched to a t shirt and inflatable zen collar, and I let him take breaks from the collar if I'm sitting right by him and can monitor. He's happier and has been able to get better rest. He has internal sutures, but we still want to restrict access of course. 

- We have been told he won't need chemo because of the chondrosarcoma diagnosis, but we'll get the histopathology report next week and know more from the limb they removed. Still a small change it could be chondroblastic osteosarcoma, so I don't feel we're totally out of the woods, but I do feel more hopeful that I did a few weeks ago. 

None of it is easy but there is a lot of info and support here! 

Diana

The Rainbow Bridge



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18 February 2024 - 9:23 pm
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Hi Dunkel and furmily, sorry you had to be here but we are glad you found us. Amputation decisions are hard enough but when you have other conditions involved, it's even harder.

I'll echo what Karen and Diana said, and just add that if it is osteosarcoma, you might want to consider a new limb sparing procedure called cementoplasty if you can find a vet in your area who is practicing this new technique. I feel like it's a really great option for dogs in these types of situations. I can connect you with the company that invented if if you would like to speak with someone who can point you in the direction of a practitioner. And while I don't know if it can help with a chondrosarcoma tumor, it may be worth looking into if.

As for dogs not adapting, I can't recall any who just absolutely did not. Like Karen mentioned, those who had a really hard time usually had other mobility issues affecting them. But the majority of dogs will adjust, although recovery may be challenging at times. 

Have you seen our Tripawds Quality of Life Survey results

Sadly, pain control with medication only lasts a few weeks at best. Usually the pain comes back in a big way and decisions must be made quickly. I hope that you don't find yourself in that situation, so it's good you are doing your homework now.

Please keep us posted on how things are going this week. 

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19 February 2024 - 1:10 pm
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Hi All,

 

thanks all for the replies and tips so far.

Dunkel will have the CT scan tomorrow if all goes well results on wednesday. 

Bad as it seems we now very much hope there is no further spread and if so he will have an amputation. 

It still feels like a horrible thing to do to him for me and my wife to be honest but the feedback and survey results help to convince us it is probably the best choice. We are also more convinced now that we have no time to waste as although with the meds he seems 'fine' right now once these stop working or even worse - ie a pathological broken paw things will be much much worse still. 

I will ask the vet about the cementoplasty technique. When we discussed limb sparing earlier he thought that though with chondrosarcoma he could be a candidate for limb sparing instead of amputation but that a. it often comes with complications and b. the combination of his heart issue and the fact that he is NOT going to be a nice doggy just allowing strangers or even us to do the necessary after treatment without sedating him every time would make it very difficult. 

Fingers crossed for the results of the CT scan, well and the scan itself .. we get extremely nervous from just the fact that he has to be sedated already with his heart and the associated risks.   





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19 February 2024 - 2:37 pm
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Hello,

I can chip in about the Subaortic stenosis.  I lost an 8 month old puppy to it.  I can say that anesthesia is very hard on them.  They are very compromised as it is.  I am no vet but I wouldn't even neuter my boy had he lived.  What you said about "any form of anesthesia comes with an elevated risk and also a significantly reduced life expectancy." is 100% true.  It is that way for a dog with subaortic stenosis even more so.  You have to weigh the risks of him not coming out of surgery. 

I am no vet.  What does chances does your vet give you with the anesthesia.  I am sorry your boy has this horrible disease and trust me it's one I hope no one ever has to live.    

I am not sure about the procedures that Jerry aka Rene recommended.  Hopefully they are an option for you. 

 

Michelle & Angels Sassy, Bosch, Baby Simba and Sweet Snickers

sassymichelle-sm.jpg

Sassy is a proud member of the Winter Warriors. Live long, & strong Winter Warriors.
sassysugarbear.tripawds.com
07/26/2006 - Sassy earned her wings 08/20/2013

05/04/2006 -  Bosch, Sassy's pal, earned his wings 03/29/19  fought cancer for 4 months.

"You aren't doing it TO her, you are doing it FOR her. Give her a chance at life."

Virginia







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19 February 2024 - 4:23 pm
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Michelle, thank you so much for taking time to share your insight

Diana, as you can tell from Michelle's post she,  unfortunately, has experience with a Rottie with heart issues from birth.  She also has been an owner of wo derful Rotties  for ma y years.  In fact, her Rottie (Sassy) had osteo and that is what brought her to this site approximately ten years ago.

Just wanted to give uou her background.

For now, I'll just see what the CT scan shows and then come back and offer  more support based on your path forward.  It's clear  how much yiu love Dunkel and you will. Ake a dec out of love.....and that always the right dec.

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!

The Rainbow Bridge



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20 February 2024 - 8:33 am
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Michelle, thank you for sharing your experience! That is a pretty tough condition, I'm so glad you were able to chime in. 

Jeroen, in this case I would absolutely want at least one other opinion in regards to his anesthesia risk. 

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20 February 2024 - 9:59 am
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Ok the CT scan went fine, he is at home with us now and still quite sleepy/groggy but the doctor told us his heart was perfectly stable during the scan at least. We had given him some trazedone in advance so they could use the mildest sedation possible. 

The full scan results we will have on thursday only. 

She told us that there are some line fractures in the bone already so we definitely need to be careful with his activities. She also spotted something small on the lung though it may have been just because of the position he was in an expert radiologist will have to look into that further. 

Finally he has been sneezing a bit lately as well so we were worried that maybe there was already something in his nose. That seems fine but it seems he has an ear infection - which weird as it may seem felt like a relief to hear that. 

Fingers crossed that the lung thing is nothing. 

The one thing we know at this point is that we have very limited time to make a decision, even if the painkillers keep working the risk of a bone fracture means we have to really restrict his activity a lot already now.

It is quite a rollercoaster of emotions for everyone. My wife sometimes thinks it may be better to just put him to sleep to save him a lot of suffering, I understand her fear but when I look at him I don't see a dog that is ready to go yet.  

Difficult times. 

Virginia







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22 February 2013
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20 February 2024 - 2:32 pm
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Yes, once you are on this journey, an ear infedtuin is a big sigh of relief.😉  Hearing about the   more imminent possibility  of a fracture sure does add another layer of difficulty  to an already difficult  situation.

All this is in the FWIW column, okay?  As you already know, his heart condition  is a huge issue.  As you read from Michelle 's post, failure can hsppen in an instant and, regardless of the "timeline prognosis",her pup did make it to a year.  I can assure you, her Simba had THE best care and constant monitoring  with a Cardi a y dog could have.

Is it possible. if you haven't already done so, to get a Cardiologist  Specialist  to at least look at Dunkel' records and five you a phone consult asap??

Of course every surgery, small or big has a "risk".  As far as just a "regular"  amputation. ( if there is sich a thing), once recovery is done Dunkel  will handle being a tripawd like a Champ.

We would hope he would make it thru surgery and recovery with no hiccups.

So gonna suggest a process to may be help in your decision from long time member Karen.

Write down all the reasons you would proceed with surgery. Then write down all the reasons you were not. And use these notes as a tool to help support you for whatever path you take.

Another thought that helps me (a little anyway) when making decisions for my dog is the second guessing  test I give myself.  First of all, we almost ALWAYS second guess  ourselves, simply that aspect aside.

If you proceed with surgery and, as a hyperthetical,  he didnt make it through (regardless of the reason), could you be at peace knowing you tried and you made the decision  to give him a chance at quality  painfree life.  Would you be able to reconcile that with yourself knowing you made that decision out of love and hope?  It does sound like the chondrosarco would be a better "outcome" than osteo.

 

Conversely,  could you be at peace  and not second guess yourself if you just manage  palliative, manage pain, keep activity  to a low level.  It does sound like chondrosarcoma would be "better" than osteo, if that makes sense.  

I hate that anyone is having to face decisions on this journey, but for you to have the extra heart issue, the personality issues, just sucks! I'm just so sorry you are having to deal with this. Of course, the better news is that Uncle is oblivious to all of this and is just enjoying the Bliss of living from one moment to the next. Your love and care has gotten him this far and your love and care with whatever decision you make will continue to get you on the right path.

(((((((((((((((((((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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20 February 2024 - 6:23 pm
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Hi,

He is being treated at an animal clinic that also has an oncology department, so its all in one place.

I.e. the cardiologist, the orthopedian, oncologist and the radiologist. So we make sure they exchange information with one another.

The suggestion on writing things down is a good one. 

When we first learned about his heart issue the cardiologist told us there was nothing we could really do other than 'locking him up so he cant get excited' so to say. 

We thought this was no life and then better that he has an as normal dog life as possible but maybe a shorter one. 

This kind of comes back now as well. 

I.e. what kind of life does he have if he is on severe pain medication all the time and on top gets severely limited in his activities to minimize any risk of fracture? Not much of a life right.

So for me if it is not spread further I would go for the amputation. If he doesn't survive the surgery I would be at peace with it.

I am not quite sure yet on what to do 'if it is a little bit in his lungs already', as that is a much more difficult scenario. I am still leaning towards having the amputation then if it buys him many more months of a happy and painless life, my wife is on a bit a different track in that scenario, she is more focused on the pain and frustration he might experience and whether we would be able to manage it well.

I will suggest her to write it down as well it may help bring some clarity.  

Virginia







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22 February 2013
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20 February 2024 - 8:40 pm
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You are doing such a good job of processing  everything.  It's an extra bonus that you and your wife can communicate clearly your own  individual  thoughts.  It seems you both have great respect for each other's feedback.  Without a doubt you are both dedicated and so devoted to Dunkel and he is soooo Licky to jave such powerful advocates for him.

I'm so glad you have sich a diverse team ciommunicating with each at the clinic to best support Dunkel through the whole process.  That is auch a HIUGE plus.

You expressed your thoughts very well on why you would proceed with amputation and why you would be at peace with it.  A whole lotta love for Dunkel wrapped up in that.

As far as the "what if" about lung mets.  Right now, unless you find out differently,  that's  not anything you have to put into the equation right now.  Goodness knows you have enough on your plate right now!

We had a group "zoom" call tonight  and one of the things brought up as how important it is to let dogs be dogs.  Of course, with a tripawd we still need to monitor some of their activities, but without  depriving them of the joy of being a dog.  It sounds like you have a really good grasp on letting Dunkel  be Dunkel. with some boundaries,  but still letting him be dog

As we often say, dogs don't have a timeframe stamped on their butt and they don't count days on a calendar.   Quality of days  without pain is better than  quantity of days with pain.

We will support you on any  decision.  One thing so clear, you will make the right deci out of ,ove for Dunkel, and that is always the right decision. 

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!

The Rainbow Bridge



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20 February 2024 - 9:16 pm
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It's great that the CT anesthesia went well! Hopefully a sign that his heart is much stronger than anyone thinks! 

I agree this is an especially tough situation. It's even harder when you don't see eye-to-eye with your partner on making a decision. This happens a lot, and it's a huge risk no matter how you look at it. So yes, write your feelings down. List all the possibilities, and how each of you might cope with the outcomes. As you noted, move quickly though, there is a risk of fracture and nobody wants to be in that horrible situation.

It sounds to me like your wife is focused on the what ifs, which are all things that we cannot control. Oh boy do we like to think we can control the future, but this really teaches us that it's not reality. Nobody knows the future for any of us, regardless of the scenario. All we can do is make the best decision we can based on the information we have at the time (and it sounds like you are getting excellent care and info from the vets!). And of course, taking your dog's personality, and your finances, into the equation too. 

We never say amputation is the right or wrong way to go for any animal. All situations are different, all play out in their own way.

What I can tell you is that the vast majority of people who respond to our surveys (over 90%) say they are glad they made the decision to amputate, even when their dog didn't live up to the projected life expectancy. The ability to see their dog living pain free and making the most of every day they have left is an incredible lesson in being present, and it leaves us changed people, for the better.

Not all situations turn out great, there are many heartbreaking ones here. But each can be a lesson in letting go of our perceived control of life, and allowing things to happen as they will, based on informed decisions we feel most comfortable making. 

I hope this helps. Keep us posted.

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24 February 2024 - 11:33 am
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Hi,

 

just a short update: we received the full results of the CT scan and luckily there are no signs of metastasis yet so our choice on how to proceed was 'relatively easy'. Dunkel will have amputation of the front paw on the 8th of march, in the meantime we need to be careful with his activities but the state of the bone is not that bad overall that we needed to rush the surgery.

So next step is hoping no mishaps in the meantime and then that all goes well on the 8th. 

 

Jeroen

Virginia







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24 February 2024 - 12:07 pm
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Alrighty, clear xrays always great news!!

You've done your research, you have a well versed team of medical staff on uour team and now you have a clear path forward.

Mr. Dunkel,  you take it easy sweet boy.and no crazy ten mile running marathons and jumping  over hurdles😉

Thanks for the update and continue to keep us posted.

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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