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Need advice for Derry. Almost 4yr old Husky recently diagnosed with Fibroblastic osteosarcoma
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Member Since:
16 September 2023
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30 September 2023 - 8:33 am
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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. 

Pennsylvania


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30 September 2023 - 9:25 am
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Welcome, Brenda, Derry & fam - so good to meet you! …so sorry it had to be this way! I feel you about the overwhelm - that was me in late June, early July at the beginning of this journey with our June.

It feels like you’ve done so much for Derry already and you and your family should feel really, really good about that. This is a scary experience, but as long as every choice is with love and the best information you had at the time that’s more than enough! …and I’m sure Derry knows how much you care about him. That’s what matters most. smiley4

Actually, you might have another good opportunity for treatment, especially since you’re in (the admittedly the very large province of) Ontario. The only clinical site offering the Yale EGFR/HER2 immunotherapy vaccine for treating some types of canine cancer (osteosarcoma among them) in Canada is in Omemee, ON. There’s likely a waitlist, and Derry will need to pass a battery of tests to be eligible for it, but it could be worth taking a shot if you and he would be up for it.

Rooting for you and Derry and sending care sp_hearticon2

Natalie & Juno (aka June)

The Rainbow Bridge



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30 September 2023 - 10:59 pm
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Brenda I'm so glad you posted about Derry's situation. Just sorry you are dealing with it.

Yes, you are very overwhelmed and who can blame you when things have changed from the original diagnosis. It does sound like you are working with a great vet team. Can I ask the name of the clinc?

We have quite a few members in Ontario, you're in good company!

I really recommend checking out the Dog Cancer Survival Guide to help you feel more grounded and less overwhelmed. There's lots of info about treating specific cancers, diet, nutrition, etc. 

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?

It's so important right now to remember that staying calm and centered is really good medicine for Derry. Try not to make too many major changes until you talk it over with his oncologist. They usually want to keep diet the same so that if there are chemo side effects they will know what's causing them. Too many supplements all at once and really throw a dog's body into imbalance, you want to introduce them slowly.

Derrylove
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30 September 2023 - 11:25 pm
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Thank you so much for the responses. It means the world.

Derry had his surgery at the VCA Mississauga/Oakville 24hr emergency and animal hospital. He was referred there from our vet at the VCA Pet-vet credit valley location. 

I think our biggest confusion is the prognosis is better if it was a soft tissue sarcoma that invaded the bone as opposed to the other way around. Everything points to the first. My sister and mother in law who are both nurses have also reviewed the reports and agree. We know that the treatment plan doesn’t change but it does improve the prognosis. The oncologist report seems inconsistent to the histopathology report. 

We did reach out to the Canine cancer alliance for information about the immunotherapy as mentioned to us above. 

The Rainbow Bridge



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30 September 2023 - 11:36 pm
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Oh that is a GREAT clinic! You are so lucky to be working with them. 

Yes, STS tumors are a better prognosis. But try as hard as you can not to focus on the prognosis. I know that'd difficult. But no matter what disease it is, you are still looking at numbers and statistics that don't take into account Derry's physiology. He is his own dog, and you never know what cancer will do. Many times we see dogs outlive the prognosis far longer than anyone anticipated, it's just so hard to predict. 

Sometimes we do see unclear an unclear diagnosis happen to members. That is so frustrating to the pet parent. I totally get it. 

Off topic here:

I have a question for you: did you log-in as a guest this last time? We are having some forums issues with posts, and yours required approval for it to appear. I approved it so it showed up, but I'm wondering what you did differently this time versus last time you logged in. Any details you can recall will help us pinpoint the issue. THanks!

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30 September 2023 - 11:50 pm
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Yes, I think I logged in as a guest. I am so bad with technology and sometimes haven’t got a clue what I’m doing. 

The Rainbow Bridge



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30 September 2023 - 11:52 pm
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Oh thank you, it's not your fault about the technical glitch, just glad to know what the process was when you came back. Thanks!

By the way are you working with Dr. Boston or one of her colleagues? 

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30 September 2023 - 11:55 pm
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Derry has always been a bit of a picky eater. Often he grazes and prefers one evening meal as opposed to two meals per day. I find his appetite isn’t great right now and he turns his nose up at food. Some days I think his appetite is turning around and then other days not. I thought 11 days post surgery his appetite may have been better. Is the Gabapentin and Metacam making him not want to eat? Should I be worried of a different cause? 

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30 September 2023 - 11:58 pm
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The orthopaedic specialist/surgeon we saw on the 15th was Dr. Bos. The surgeon who did the procedure was Dr. Bichot. 

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1 October 2023 - 8:37 am
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Anybody believe in fate? Here’s a small world story.

Due this amazing Tripawd community, it was recommended to me to look into the trial available for immunotherapy. I ended up in touch with canine cancer alliance about the EGFR/HER2 trial. This is available at multiple places throughout the US however in Canada, only at one clinic available in Ontario. 

I live in Ontario. Yesterday, I sent an email to the Veterinary hospital to get more information about how to get approved or on the wait list etc….

 

This morning I went onto the website for the animal hospital. I immediately recognized the name of one of the veterinarians who also happens to be the owner of the clinic. She is the wife of one of my husband’s friends. This friend is someone my husband grew up playing hockey with and although life takes people in different directions, they stayed in touch through Facebook. 

We reached out to him seeing if he could get her to help us. He responded within 15 minutes from a golf course in Portugal where they are on holiday. They said YES, she wants to help us. She has told us to call the clinic tomorrow, tell them we are a friend of theirs and for them to help me through the steps of what I need to do. 

I am taking this as a sign! What are the odds that of all the veterinarian clinics and hospitals in Ontario, never mind Canada, the ONLY one that has this trial happens to be owned by someone we are connected to? 

Fingers crossed!!!!!! 

Now I need more information about the immunotherapy EFGR/HER2 trial. Apparently it’s doing amazing things, I wonder if anyone has tried this one. We are looking at doing Chemo for Derry. Does the immunotherapy happen at the same time? Before? After? 

Pennsylvania


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1 October 2023 - 1:56 pm
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Haha!!! Great news!!!!

It’s me again, and part of why I suggested it is that my June just got her first dose at a clinic here in the US on Tuesday.  (Yaaaay!!!) She’s currently undergoing chemo at the same time (currently 4 of 6 doses three weeks apart). You can do chemo and the Yale EGFR/HER2 vaccine at the same time. In fact, the clinic we worked with said that we had to be doing/have done “standard of care” (chemo + amputation) to get it. Though the requirements from one clinic to the next could be different depending on how they’re running the study(??)

Probably the best thing to do is let your oncology team know about your interest in and pursuit of the vaccine and let the team at the vaccine clinic know about your plans with your home base oncology team. (They will swap records as part of the process, but best to give them all the heads up so they can help work with you to develop a plant for Derry at the outset.) They are there to support, guide and facilitate your process, so keep them all informed and solicit their thoughts along the way.

As far as details about the vaccine, much like chemo, results are variable. However, in an earlier study of the vaccine of the dogs with osteo who received both the vaccine and standard of care (carboplatin + amputation) 65% of dogs were still alive after 12 months versus 35-40% of dogs after 12 months with only standard of care alone. In some dogs the vaccine had no effect on eventual metastasis, in some it prevented it, in others it halted or slowed it, and in a few it reversed it!!

I know with the shortage of carbo, your oncologist is using doxorubicin, and since this one of the options for “standard of care” I imagine the results may be comparable (totally not-a-vet perspective from me), but do bring this up with the vaccine team and get their thoughts. I imagine they see this a lot these days with the shortage!

The most common side effect is a sterile, marble-sized cyst at the injection site in 10-20% of dogs, very rarely it’s golf ball sized and oozes and can be soothed away with warm compresses. Regardless it is harmless, and will resolve in a week or two.

Let me know if you have any other questions.

Cheering for you and Derry!smiley_clapsp_hearticon2

Natalie & Juno (aka June)

The Rainbow Bridge



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1 October 2023 - 4:05 pm
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Oh my gosh that IS a small world story! Wow, I'd take that as a sign too. I'm glad that Natalie was able to share her experience with this vaccine. It's all the buzz over here, you'll find lots of folks asking about it in our Forums.

 I thought 11 days post surgery his appetite may have been better. Is the Gabapentin and Metacam making him not want to eat? Should I be worried of a different cause? 

11 days is not a long time for a major surgery like this. The body is putting energy toward healing, not so much toward eating. It's not unusual for a decreased appetite at this point. Typically we don't see Gabapentin cause decreased appetite, just some lethargy. Metacam not at all, it's a daily supplement for most dogs and doesn't have that kind of side-effect. If you do see any change in his stools (black, tar-looking), then that's something to discuss with your vet as the Metacam could be causing GI issues. It's rare but it does happen.

Give him time to heal, try not to pressure him too much to get back to his old self. We tend to expect way more from our dogs than we would of any human after amputation surgery. Most people would not be doing much at 11 days out.

There's a fine line we walk at this stage, between helping our dogs be comfortable versus babying them so much they don't want to do anything. You're learning as you go!

By the way Dr. Boston is GENIUS. Like seriously one of the smartest vet oncology surgeons out there. I'm sure her associates are pretty smart too. She was recruited back to Canada after doing amazing work here in the States and while we are sad to have lost her here, we are glad for the dogs and cats of Toronto who got their first full-service oncology clinic because she decided to go back and start one up. I'm so happy you get to work with her team!

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1 October 2023 - 5:41 pm
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Thank you so much. I have been sick to my stomach with worry about his lack of appetite. He does sleep quite a bit and I had wondered if some of this was weakness from not eating much. When he is up and about, he’s amazing on three legs. When we take him out, he is trying to walk us and just wants to move quickly. It’s hard to keep him from overdoing it. We bring the dog pram we got for him as well so that when he feels tired but wants to enjoy the breeze and scenery, we can take him much farther with him enjoying the ride. So far his poop hasn’t had any signs of concern. 

We have not met Dr. Boston. The oncologist that did our report is Dr. Sarah Laliberte. Perhaps I would have preferred someone as genius as Dr. Boston to have done his report. 

Thanks again so very much. The community here means the world to me. Everyone sharing the same passion and love for our furry family members. We really don’t deserve dogs and my heart is completely shattered that they don’t understand which I know, it’s good that he doesn’t know. The amount of tears we have shed and the pain I feel in my heart and stomach of guilt and sadness has me a mess. I’m trying so hard and really do appreciate this community. 

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1 October 2023 - 5:49 pm
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Natalie, thank you so much for all of the support and information. It means a lot.

My confusion/concern is that the surgery plus chemo gives a 12mth prognosis. It seems surgery + chemo + the vaccine, is still 12mths. I’m trying to figure out what changes? We want to do everything thing possibly available to us but don’t want him feeling poorly and constantly being prodded and tested. I know there’s continuous X-rays and bloodwork etc plus the treatments. I didn’t even realize they are done at the same time. I thought it was one then the other. It’s a lot to take in and try to understand everything. 

I’m so happy that such knowledgeable people are here to help. 

New England
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1 October 2023 - 6:01 pm
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When we take him out, he is trying to walk us and just wants to move quickly. It’s hard to keep him from overdoing it. 

The tripawd gait tends to be rapid because it's easier to maintain balance. As Derry becomes stronger and more familiar with his new gait, he'll be able to do it more slowly - but he may not want to. My tripawd, Loki, is half Siberian and running is her preferred speed. She can do a nice polite walking pace, though. 

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