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Caring for a Three Legged Dog or Cat

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Questioning Information in Cytology Reprots
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Member Since:
29 June 2024
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10 July 2024 - 8:54 am
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Hi all,

Hi all,

Our sweet 3-year-old rottie mix Luna had her right front leg amputed 8 days ago and is doing well.  She had a limp for a short time that we thought was a play injury but much to our surprise they suspected a bone cancer in her carpus.   A needle biopsy and a bone needle biopsy were performed.  The bone needle biopsy came back stating “non-diagnostic specimen,”  which was very disappointing.  The needle biopsy came back stating, in pertinent part, . . . Staining of neoplastic cells for alkaline phosphatase using NBT/BCIP as a substrate is NEGATIVE. INTERPRETATION:  Undifferentiated sarcoma with evidence of bone lysis. COMMENTS: The location of the lesion and the lack of Alk Phos activity would suggest the lesion is not an osteosarcoma. Other possibilities included clinical findings and cytological features of the lesion are synovial cell sarcoma, undifferentiated fibrosarcoma or neurofibrosarcoma, histiocytic sarcoma or less likely chondrosarcoma.

While we knew all sarcomas are bad, the report gave us some hope that it may be something less aggressive than an osteosarcoma, especially since it was caught fairly early.  The amputation was a no-brainer for us given her age and health (and we unfortunately had been through this before with a rottie girl who was much older, but did great).  They sent off the limb segment and we were called yesterday and told it is an osteosarcoma.  The comments on that report read: The mass is an osteosarcoma, correlating with her clinical differentials. No additional staining was done. When I questioned the prior report, and the fact we were told the results of staining for Alk Phos are highly accurate, the vet literally said “I don’t know.”

I’m trying not to be emotional (which is hard), but before we decide on chemo I want to be confident in the diagnosis. If it could possibly be a different type of sarcoma I wonder if different chemo protocols/medications would be necessary?  Just wondering if anyone else has any experience with staining for Alk Phos.

Virginia



Member Since:
22 February 2013
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10 July 2024 - 10:24 am
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Hi Laura...First of all, glad Luna is doing well!

While I personally don't have any insight ro offer regarding the findings, perhaps others do.

In the meantime I'm gping to ppst rhis in tje Ask a Bet" thread as our volunteer Vet may have more information, okay? Hang Iin there!
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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10 July 2024 - 3:30 pm
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Thank you.  I had not been to this site in about 10 years, it looks like folks are just as helpful and compassionate as they were then.

The Rainbow Bridge



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11 July 2024 - 8:19 am
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Hi Laura, welcome. Glad that Luna is doing well! I'm just sorry you are dealing with cancer again. Glad you posted in Ask a Vet, that was going to be my suggestion too. I'll be curious to see what Dr. Pam says as I have no idea what to think about the report specifically.

I would say though, that for your vet to say "I don't know" really is the sign of a good vet. One individual can't know everything, especially if oncology isn't their specialty. Did you get referred to an oncologist?

Meanwhile thank you for the kind words about our community, you really made our day. Please let us know how we can help you and Luna!

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11 July 2024 - 10:35 am
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Unfortunately, there are no board-certified canine oncologists where we live. The closest would be approximately 3 hours away and we were told getting a timely appointment is very difficult.  The specialty clinic (Capital Veterinary Specialist Tallahassee) that did the amputation does offer chemotherapy and we are scheduled to meet with them on Monday.   Also, I spoke with our vet last evening who is a general vet and readily admits this is not his area of expertise, he believes the sample from the needle biopsy likely did not stain positive for alkaline phosphatase because it was a small sample from one specific area (similar to the bone needle biopsy being a non-diagnostic sample).  But when the entire tumor was biopsied, obviously a much larger sample, alkaline phosphatase was present and the osteosarcoma diagnosis was made.  

 In any event, we are thrilled that Luna is still with us and doing well.  Trying to take things one step at a time. 

Virginia



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11 July 2024 - 10:58 am
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   In any event, we are thrilled that Luna is still with us and doing well.  Trying to take things one step at a time

      

  Yes, that's a great attitude to have.     To be able to live in the moment, one step at a time, and embrace and all-encompassing gratitude for every special moment you and Luna have.

The fact that the special Clinic can do chemo (if you go that route) is a plus.  Glad you have a consult  Monday.  It makes sense what your regular  Vet said about the aspirate,  etc. (And Dr Pam too on the Ask A vet thread).   Thanks for sharing that.

Stay connected!  Luna is rockin' recovery and it only gets better and better!!

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

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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27 July 2024 - 3:06 pm
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I hope I'm posting this update and question in  the correct place. 

Luna had her sutures removed and her first chemo on July 15th.  Prior to the chemo, we asked that they scan her abdomen and re- x-ray her left front leg because she was licking it a lot.  Thank goodness all was normal with both.   She had one morning post-chemo where she did not want her breakfast; but, by lunch time she was back to her chow-hound self, for which we were very thankful.

Every day we have been seeing her get stronger, with improved stamina and confidence (much more like her old self).  Unfortunately, she will still vocalize, for a few seconds, occasionally.  Sometimes she is just relaxing or sound asleep, other times she is on the move.  We have not been able to decern a pattern.  When we discussed this with the vet they said it was likely nerve pain and to continue with 300 mg of gabapentin at 8-12 hour intervals.  She will be 4 -weeks post-op this Tuesday.  Just curious if others have had a similar experience and how long this lasted.

The Rainbow Bridge



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27 July 2024 - 3:40 pm
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Hi Laura,

Wow she is handling treatment like a champ! That's awesome.

It does sound like she is dealing with some type of unaddressed nerve pain. This is not uncommon. And while Gabapentin can help, oftentimes treating and eliminating this type of pain needs a mult-modal approach. Aside from prescription medications, rehab therapy can do wonders to address and get rid of the pain. Other treatments like acupuncture, gentle stretching and massage can solve the problem sooner.

Tripawds Foundation can pay for the first rehab visit , so if you'd like help looking for a practice near you, DM me your location.

The Rainbow Bridge



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27 July 2024 - 3:41 pm
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Oh and do feel free to start a new topic in Treatment and Recovery, or wherever else is appropriate now that she's graduated from the Diagnosis phase smiley_clap

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