Hi, Stellasmommy:

stellasmommy said
Hey everyone!

My 7 year old Rottie mix has been dealing with a waxing and waning limp for a little over year. We've had many many vet visits and sets of X-rays and medication and explanation after explanation. But about two weeks ago she started knuckling on that limb and seems to have limited control of that leg. We of course went to the vet (again). As a nurse, this symptom made me think something nerve related, but I was shocked when they said cancer, nerve Sheath tumor to be exact. My head was spinning with talks of MRIs and amputations and survival rates, possibilities of radiation, etc etc. I made an appointment with the specialists and began my research ( to which I was able to find very little). Not only am I a nurse,but a pediatric oncology nurse at that, so my brain went into overdrive. Needless to say, we met with the specialist and they examined and sent of a specimen for pathology, we are still waiting on results. However, they feel pretty certain that this is it. Nerve Sheath Tumor of the right brachial plexus. I am seeking out anyone who can share their experience with this. Did you amputate? How was your pups lifespan and quality of life following amputation. Did you do radiation therapy? And where? Would you make the same decisions again? Anything anyone has to share would be greatly appreciated.   

I am going to be one of your go to people on peripheral nerve sheath tumor in the brachial plexus as it was my boy's cancer, too (front left).  First off, you may want to look at my blog (see link in my signature), which is not a complete history, but I think will give you some idea of the quality of my boy's life post amp.  Yes we did amputate. It was also, like your pup, at least a year past initial signs before we had the right diagnosis.  Unfortunately, that meant a few things

1. Due to late diagnosis the tumor was much larger and a higher stage then is ideal for a longer term post amp prognosis. It was, in fact, very, very large and perilously close to his spine and also wrapped around a rib and destroyed a lymph node. It was Stage 3 of 3 rather because the rib and lymph node equate to local metastases.  Also, most unfortunately, the mass was "messy" and we did not get clean margins. We did not get it all.
2. On a positive note, because he was a virtual tripod with the intermittent limping and lameness having gone on for so long, he had one of the easiest transitions to getting around on 3 that I think most of us can point to.  Some others have done about as well, but Pofi REALLY bounced back and especially considering size (large, tall, deep chested) and age (which was 11.5). He SAILED into life as a tripawd and he was amazing.  He had a wonderful summer.
3. I did want to do radiation, but there were some irritating road blocks - the specialists were very worried about lung mets and lymph nodes. Wanted CT scan post amp to determine if there was cause for worry.  Felt it was indeterminate, recommended second CT.  Also, CT scan for this process could not be used for radiation treatment mapping. So I was essentially scared out of just pursuing radiation therapy.  By the time we had done one scan and another 8 weeks later, when he was given the all clear, I was growing loathe to actually put him through the many, many more GA sessions and days in hospital to do radiation treatment.
4. He was, at that point, seeming to have a tougher time (trachea especially) recovering from the GA.
5. Our only possible vet hospital for treatment in state does not offer stereotactic radiation. I really wanted to inquire about that in a neighboring state, but we did not make it.
6. What would I do differently? I wish we had had a better initial consult and an earlier diagnosis so we could amputate sooner.  I would want to alleviate him of that pain and give him a better prognosis with or without radiation.  I also think I wish I had skipped the lung and lymph node CT scan and gone straight for radiation or better yet, traveled to get him stereotactic radiation.

We had 6 months and I treasure them. He walked, he swam, he went to dog park and begged for his Daddy's beer. He was pain free and was "our boy" again fully, despite the missing limb.  It wasn't long enough, not nearly, but when is it?  I would also cook him more steaks.  

We did do metronomic chemo and Palladia.  I do think the Palladia may have been slowing the recurrence down, but it did come back in his spine, which was soul crushing and shocked everyone. He bounced back with such vigor, we all started to think he was invincible. 

I hope this helps.  I hope it was not too much, but being a peds onco nurse, I figure you want the details.  Let me know if you have more questions - I will be here for you.  Forums or PM me.

Best thoughts for your pup!  

Hi, Stellasmommy:

I never mind talking about Pofi, even the tough stuff. He was an abandoned pup, but was dumped in proximity to several musher yards on the north shore of Lake Superior in MN.  So we always suspected he was a sled dog mix. Likely what is often called an Alaskan Husky mix which often will have some sighthound in the mix.  DNA breed test said he was a lot of Malamute, which makes sense, and then a long line of mixed breeds on the other side.  However, I always considered him a Lurcher because of those legs and speed and his lean physique; he may not have been a first gen sighthound cross, but there was very clearly Saluki or Greyhound in him or both and he had a lot of traits that were very much like Lurcher crosses.  He was tall - 29" to the shoulders and very, very long. And he was fast and strong and perhaps too stoic; like Stella, he was very understated in showing pain.

We had a lot of red herrings on this journey. I first noticed he was perhaps making just a bit of a grunt when he settled down next to me to sleep and within days of that observation he went out to potty one night and came back furiously obsessed with and licking one toe. He would not go to sleep.  I took him to e-vet at 5 in the morning after neither of us had slept for several hours.  So initially we thought it was a sting. By follow up with my own vet, the licking had led to infection.  And of course, he was now limping.  

I struggle very badly with the length of time it took to diagnose.  It was not for lack of trying or earnest effort and care from my own vets. I did not have a warm fuzzy feeling for the lead vet in the specialty consult, but I did not question when they told me why the ongoing issues did not add up to cancer. I need to write all of this down.  All the vet visits, PT and treatment - I keep thinking maybe it will convince me I did all I could or at least did my best. There are times I know I did and times I am consumed with doubt. But, aside from a moment of being truly incensed when the same specialty hospital, but a different doctor, diagnosed the problem just looking at him and the muscle mass change (which was noted over and over in first consult), I just tried to move forward and concentrate on what was best for him in the now.  I found this place post amp, but the community here really did help me stay focused on him and his quality of life - "Be More Dog ." It was the best advice.

I have heard of this tumor in children - it seems like I have heard of it in the spine. Our dogs were just unfortunate enough to develop it in a place that kept it hidden. I hope Stella's tumor is lower stage. I think a pain management plan utilizing different modalities, will be critical with both the tumor and the amp. I really, truly believe the discomfort of the amp was dwarfed by the pain the tumor had been causing just prior to amp and it was over soon.  

Very best thoughts for Stella!  Please post a picture soon.

My now-12 y/o dog Buster was diagnosed with nerve sheath tumor two weeks ago and will have right front leg ampu this Wednesday. It was a real gut punch, I love this dog to bits. He started limping at the end of last summer, and it came on out the blue. Cancer Diagnosis took 8 months. In the fall, his scans revealed a tear in a shoulder tendon, so he had a tendon release surgery. But the surgery didn't resolve his limp. We did physical therapy and eventually he started putting muscle back on. But about 7-8 weeks ago, there was a sharp reversal in his progress. His limping became profound. Phys therapy stopped working. His deterioration accelerated in terms of discomfort over past month. And then we got the diagnosis after an MRI. As upset as I am that my dog is losing a leg, I now just want it done to alleviate his pain and discomfort, though gabapentin + rimadyl are working pretty well. But then we'll learn how advanced the cancer was, whether he needs radiation or not. I'm already learning a lot from this website, im sure I'll learn more.