Hi everyone, so glad to see I’m not alone.

Our husky, Derry is going to be 4 in December. He just had amputation surgery of his front right leg and shoulder blade on September 19th. On Thursday, we got the results of his histopathology. They feel it is a Fibroblastic osteosarcoma that affected both bone and soft tissue. There was no invasion of the lymph node or the blood vessels that were removed with the amputation. The surgeon had told us that he felt the surgery went very well and he got really good margins. A relatively clean surgery, with very little bleeding. He didn’t see any concerns with any other soft tissue he could see. He felt positive. The oncologist has said the next step would be chemotherapy which will be 5 treatments of Doxorubicin spaced 2 weeks apart. He would have to have a heart ultrasound first and then can start. This would all happen once his stitches are removed.

Back story

Derry had been a perfectly healthy, active and happy dog. We rescued/adopted him when he was 10ths old. At the end of May this year, our son noticed a hard lump on Derry’s front right elbow area. It was thought to be a Hygroma and we got the brace for it and waited a bit. After a couple of weeks, it was the same. The vet thought maybe the brace was not a great fit and recommended we go a size up so we did. She said she was 95% thinking Hygroma but always a chance something else like a bone cancer. She took a simple blood test to check that he was good to go on MetaCam. His blood was good so she put him on Metacam once per day and a broad spectrum antibiotic called Claveseptin. She did the antibiotic because it felt ever so slightly warm but said that could also be because of the brace. She also prescribed Trazohdone to give him if he was too active. She wanted him to rest and not be jumping. He loved to jump around off beds, couches, the deck etc. We were to try this treatment for 7 days. The day after this appointment, he was intermittently limping. I called them and they prescribed Gabapentin for pain. After the 7 days, there was no change and his limping was constant. He was still quite active but we did notice him resting more often and seemed calmer. His appetite wasn’t great either because of all the medication. They had given a probiotic to sprinkle over his food to help with that. Derry has always been on the picky side of eating and a bit of a grazer. The next step was a sedation X-ray of the elbow. We brought him in and he stayed there for a few hours. They called and said they had done 3 different view pictures with the X-ray and couldn’t see anything. The swelling was visible but the bones looked fine. They wanted to do a needle aspiration while they had him sedated. We said go ahead. They took samples from three different areas of the swelling. They put them under their microscope to make sure they were good enough to send off to cytology. They were. We picked him up and waited for the results. She had also consulted with the other vet on the lump on Derry’s elbow and the X-ray. Both vets said the X-ray was clear but said we could send it out to a radiologist just to confirm. We agreed. When she called with the results, she said the radiologist agreed the bones looked good and could see the soft tissue swelling around the elbow. The cytology results were also fair but did mention there were low amount of spindloid cells. The cytology listed lots of reason why they could be there and the less likely would be a well differentiated spindloid neoplasia. Based on all of this, our vet said the good news is not bone cancer or a bad cancer but to keep in mind that the spindloid cells were there. They were in agreement that they felt he had chronic soft tissue injury trauma. The treatment plan was 2 weeks of Claveseptin twice per day and Metacam once per day for two weeks. Trazohdone as needed to keep him calm. He was to rest and be off his feet as much as possible and no jumping. If no change after the two weeks, the plan would be to go to a specialist. We did the two week treatment. The medication did not decrease any of the swelling, which since the beginning of this entire journey had become bigger/ more swollen. Derry let us touch this and we photographed it every day. He never likes the vet touching it and feel him. He had also gone from limping to just not using the leg at all. He did everything on 3 legs and very rarely, if ever put that leg down. At the end of two weeks, we were referred to an orthopaedic specialist at the animal hospital. Our appointment was on September 15th. While waiting for this appointment, Derry continued on three legs, appetite was on and off and the rested a lot. He lived for car rides all summer as we couldn’t walk him because of the leg. He loved just sitting outside enjoying the weather. We did have Gabapentin and trazodone to give as needed. Three weeks passed while waiting for our appointment.

Speciialist appointment 

They had already reviewed the X-ray and cytology report that had been sent. They took Derry back and sedated him to do a physical exam. When the specialist came back in, she said in her opinion and based on her experience it looked like it could be a sarcoma. She said it feels like it wraps around the elbow and goes up a bit. She said it could be an abscess but he had no other clinical signs of sickness. She recommended either an ultrasound or a ct scan because she felt amputation was a must. We agreed to anything. She said she would start with an ultrasound because it is a less expensive route. She said she would wink her eye to the technician to start the ultrasound and if they felt enough information was evident we would skip the CT and just do the ultrasound. If the ultrasound didn’t look like it would provide enough, they would wheel him into a CT scan. Turns out the ultrasound was complete enough to confirm it was a mass of tissue as opposed to fluid filled. They could not know if it was benign or malignant without biopsy. Said we should do amputation right away. Said as a vet and as a dog owner, she wouldn’t even hesitate, she’d get him right into surgery to remove the limb and shoulder blade. She then asked us “would a biopsy change your mind on surgery?” We said NO. She then booked him for surgery on the Tuesday morning (our appointment was on a Friday) and said they would biopsy everything after surgery. While they still had him sedated, they did a chest X-ray that came back perfectly clear. She also said a physical exam with her fingers found nothing else on him and his lymph nodes all felt normal. 

Surgery

Everything went extremely well. Surgeon was very pleased with margins and how clean the surgery was. Said he felt positive but obviously we wouldn’t know everything 100% until biopsy. Told us to feel good, distract ourselves and take care of Derry. He said he will never remember having had a fourth leg and that dogs don’t experience phantom pain . The team had fallen in love with him. Told us to call in the morning for discharge. Next morning at 9:30 am, Derry was cleared for discharge. He walked out to us and he got his tshirt put on. He has been able to go through recovery with zero need of a cone. They said because he had only been using 3 legs for so long, he was an expert. He was sent home on antibiotics for 5 days. Gabapentin for 21 days and Metacam for 15 days. He has Trazohdone as needed.

Next steps

The oncologist after giving us the report, says once stitches are out is recommending a heart ultrasound and then 5 treatments of chemo spaced two weeks apart. The only chemo they have available here is Doxorubicin. We live in Mississauga, Ontario, Canada. The other drug that starts with a C (can’t remember right now) has a shortage across North America. 

We have asked a million questions 

Since the beginning, everything has pointed to soft tissue. The X-ray was great and they said not a bone cancer/tumour. Two vets, a radiologist, the cytology and the orthopaedic specialist all said soft tissue. 

It is possible for a soft tissue sarcoma to invade bone.

The specialist referred to a soft tissue sarcoma like an octopus. Said the mass is like the head and it has tentacles. It can be very locally invasive and can metastasize.

The specialist had said the surgery could be curative or based on biopsy we’d find out on the other side of surgery what was what with diagnosis, treatment and prognosis. 

The oncologist said that she doesn’t know why Derry’s limb X-ray was so good because, yes, X-rays although not always definitive on their own are the first step in a bone cancer diagnosis. Most dogs when brought in for mass, swelling, limping etc do an X-ray and the diagnosis or at least something visible is seen. In Derry’s case, all that was seen was soft tissue swelling/mass. 

When we keep going back over this with them they say yes, they can’t rule out that it is a soft tissue sarcoma that invaded bone. They want to think that it is a bone cancer that extended to the tissue. 

This makes no sense to us. When we dissect the report and use our nurse family members to help is understand, everything makes us think soft tissue invading bone. 

Report it says under microscopic findings, it says : sarcoma, boney involvement

The oncologist says that time will tell us which one it is. Whether it started as soft tissue or bone, it doesn’t change the treatment plan as amputation and chemotherapy. If in fact it was soft tissue, it would have a better prognosis.

She is calling it a Fibroblastic Osteosarcoma which apparently firbroblastic is a better subtype of osteosarcoma to have. 

She did agree that his age, his good health otherwise, the clear chest X-ray, no invasion of lymph node or blood vessels are all good signs and yes, we can hang on to the hope that he can live a long happy life, She as a typical vet/dr want us to know the statistics and the realities. 

I have been reading lots about organic turkey tail mushroom tincture as an amazing thing to give dogs with cancer. Any thoughts? Also CBD oil..thoughts?

She says every dog is different. She says hope is what gets us through. Is there a chance he falls in the 10% that the surgery was curative? Anything is possible however, again they always preach statistics.

He will be getting his stitches out next week. At this point we are thinking to go ahead with chemotherapy.

We feel overwhelmed.