Caring for a Three Legged Dog or Cat
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Hi, y'all -- I'm a newbie and I'm so glad I found this site and forum since my head has been spinning a bit given the cancer diagnosis. Lexie is a 13ish beagle/basenji/husky mix (best guess) and weighs about 30 lbs. She has a tumor on her front leg right around the dew claw. We just got an initial sarcoma diagnosis after a needle aspiration but unfortunately she can’t be seen by the vet oncologist until Thursday for further diagnosis, biopsy, etc. I’m nervous about waiting until Thursday given what I've outlined below, and would appreciate any feedback. Here is the timeline:
-Jan. 28: Saw internal medicine vet for Cushing’s disease check-up and blood work, and pointed out a growth on her leg which had been there for week or so (thought maybe it was a cyst – she has a benign fluid-filled one behind her ear). The vet did a leg X-Ray to rule out any breaks or fractures and when it came back she said it looked okay; watch and wait since Lexie wasn’t limping and didn’t seem to be in pain.
-February: Growth remains about the same. She’s not actively limping and doesn’t seem to be in pain; still jumps up and is excited about walks, treats, etc., but she is occasionally a bit whiny at night and is a little more "panting-y" than usual. She's eating and drinking normally, but has been gradually losing weight.
-March 4: Growth appears to be getting a little bit bigger and she is starting to hold the paw up occasionally. Still excited about walks, treats, etc., and seems to be putting full weight on the leg when walking. Sent photos to vet and she thought it would be worth trying antibiotics and giving her Tramadol to ease any discomfort the swelling may be causing.
-Friday, March 14: Back to the vet since antibiotics don’t seem to be working. Different vet palpates the tumor, looks at first scan and at her leg, and says she sees some potential issues and wants another X-Ray. Radiologist says there appear to be changes since the last one which could indicate a form of cancer; vet does a needle aspiration and sends to lab.
-Sat., March 15: Her tumor has gotten bigger since seeing the vet Friday afternoon, and it looks like a second one is appearing under the first; she also starts to limp a bit after our walk today.
Sat. evening: Internal medicine vet calls me with results: some form of sarcoma. Says Lexie should be seen by the oncologist who will likely order a biopsy and chest X-ray, and if it hasn’t spread that amputation is an option (possibly followed by chemo and/or radiation).
- Sunday, March 16, early a.m. Lexie starts throwing up some bile-y pinkish fluid (she is still on the antibiotic + Tramadol, btw). So, my questions..
My dilemma, and Q1: I'm thinking I should chest get X-Rays and find another local veterinary oncologist on Monday instead of waiting until Thursday. Even though I really like the vet practice where I got the diagnosis, I don't like the idea of waiting given how aggressive it seems that these things can be. There are a couple of other vet oncologists at other practices; should I call around and see if I can have her seen sooner?
Question 2: As fellow dog owners who have been down a similar road… If we can confirm that it hasn’t spread to her lungs yet, would you be tempted to go ahead and have the amputation done ASAP, and then do the tissue biopsy afterwards instead of waiting several days for an appointment, plus another 5-7 days for the biopsy result?
Her specs again…
13ish years old, 30 lbs, tumor is on lower third of front leg by dew claw; Lexie normally is extremely peppy and acts like a much younger dog always eager to walk; generally in good health except for pancreatitis (managed well for years and asymptomatic with a low-fat diet) and Cushing’s disease, which is being managed.*
Any thoughts on all of the above, especially questions 1 and 2, would be appreciated. Thanks in advance, and thanks for all the support and great information I've already found here...have learned a lot just by skimming other posts and stories. This is clearly a wonderful and supportive community!
*More on pituitary-dependent Cushing’s (and endocrine system disease, which she is on Trilostane for): http://www.vetm.....hings.aspx
Deb and Angel Lexie* Diagnosed at age 13. Tried radiation first; wish we had amputated upon diagnosis (even with lung mets). Joined Club Tripawd April 2014 & Lexie loved life on 3 legs! Advice: Start physical therapy as soon as your vet clears it, especially hydrotherapy if available :-) See Lexie pics here.
Hi Lexie & family, welcome. Your future posts won't need to be approved.
Let me say Kudos to you for being so conscientious and making such careful observations about Lexi's conditions. You've done a good job!
If you're lucky enough to have other oncologists (board-certified?) near you then I would move faster as it looks like things move slowly with your current practice. Better yet, if you can call your current practice tomorrow to let them know that the tumor has grown, she's in pain and throwing up, they will likely squeeze you in sooner.
As you know the most important thing is to help alleviate the pain she's in. Waiting for a bone biopsy has many disadvantages if they are almost 100% sure it's cancer. If they're pushing for a bone biopsy, I would ask if it 1) amputation is going to be required anyways and 2) if can be done later after amputation. Bone biopsies are extremely painful and require a general anesthesia procedure. They are helpful when a diagnosis is in question but when vets are pretty certain it's cancer and the leg has to go anyways, it's easier for the dog if the bone biopsy is done after surgery.
I know how frustrated you must feel. Many of us had our diagnosis unfold in the exact same way. The good news is that you're catching it now and being proactive about taking care of it.
Oh and as far as her age, 13 isn't young but many older dogs do fine. Check out "Size and Age Matters" for some great examples.
Thanks again for joining! Please keep us posted, we hope she had a good day today.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi and welcome to the family. You sound like a wonderful advocate for Lexie.
Q1. I agree with Jerry. If you can get her in sooner with a phone call tomorrow that would be best.
Q2. If she is in generally good health and active I don't see why she wouldn't be a good candidate for an amp. I definitely would not get the biopsy prior to amp for all the reasons Jerry mentioned. Our vet's biggest fear was the bone breaking at the site of the tumor, prior to surgery. We were told a pre amp biopsy would also weaken the area putting her at greater risk of a break. We would have then been in an emergency situation and have to make quick decisions.
Good luck and I look forward to your updates.
Amy & Libby
Liberty (Libby) was diagnosed with OSA on 1-22-13. Right front amputation on 1-31-13. No IV Chemo. Metronomic Therapy started 2-19-13 along with supplements and some home cooking. Lungs clear until 1-06-14. She's still her happy, hoppy, bossy self. Living the dog life to the fullest and a proud Winter Warrior. :) RIP my Libby 4-21-03 to 3-19-14
*Update below* Thanks for your replies and for the warm welcome and good advice, Jerry and Amy & Libby.
Unfortunately Lexie had a very rough night last night and went downhill fast; she was clearly in distress (shaking, fast heart rate, throwing up). We took her to the emergency vet and they gave her subcu fluids, stronger IV pain meds, an anti-inflammatory, etc., and also did a chest X-ray. Unfortunately they did see signs of mets in her lungs.
Obviously news we did not want to hear, as it may indicate that it's spread too far too fast to warrant the amputation and buying her more time. I'll search and post on a new thread (maybe different forum?) to get input from others who have dealt with this. I'm definitely going to call around first thing Monday to see if any local vet oncologists have a cancellation.
Unfortunately the cancer caseload at my current practice is extremely high.
Thanks to all for your support and advice.
Deb and Angel Lexie* Diagnosed at age 13. Tried radiation first; wish we had amputated upon diagnosis (even with lung mets). Joined Club Tripawd April 2014 & Lexie loved life on 3 legs! Advice: Start physical therapy as soon as your vet clears it, especially hydrotherapy if available :-) See Lexie pics here.
Lexie is a cutie pie!!
Just saw your post and so sorry you're javng to deal with this.
The i creased pain meds and antibiotics "could" have caused some of the sysmptons you were seeng last night.
I do know that, depending on over-all general health, etc. vets will now do ampitations on dogs with early signs of mets because it does remove the lget pain and extended quality t e is a treasured gift.
I know Lexie as other health challenges, alnb with benb a "mature lady" kknd of muddies he sater a little.
Just want you to kow yo are ot alng, o,ay? We are all pulling fr you and Lexie. Shenis a very, very loved girl and she KOWS you are doing every thing possible fr her!! She's withnyou now, stay in the moment, hopefully you'll jave a plan the first of the week.
How 'bout posting somepictures of your adorable Lexie. We wold love to hear more avout jer and see someof her potos.
Keeping all paws crossed for you and sendingyou lots of healing enerfy.
(((((((((((({hugs)))))))))))))))))
Sally and Happy Hannah
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!
Ohhhh I'm so sorry to hear about last night and the xrays.
It's a lot to take in, the news about the mets, her age, and the general prognosis for this disease. One thing to consider is that no dog is a textbook case; everyone has a slightly different outcome, and when we start this journey all we can do is hope for the best. There are no right or wrong decisions here so whatever way you decide to go, we will support you in that.
Sally is correct, not all oncologists will immediately say no to an amputation if there are lung mets. In this article by veterinary oncologist Dr. Joanne Intile, she writes:
If a CT scan shows hundreds of tiny tumors throughout all lung lobes, I agree the prognosis for long-term survival is poor. But do we not consider amputation of that pet’s limb to control pain while they are still asymptomatic for spread? What if the scan shows two tumors, or just a possible tumor? How do we decide the right answer?
In my opinion, whether metastases are detected or not at the time of diagnosis, surgical amputation of the affected limb in an otherwise asymptomatic dog is something I will recommend in nearly all cases. I didn’t always feel this way, and this stance is something I’ve adopted through my years of working as an oncologist trying to medically manage the discomfort of dogs with bone tumors.
Of course, not every owner elects for amputation, and not every dog is a candidate for this surgery (e.g., they may have severely debilitating orthopedic or degenerative neurological diseases that hamper their ability to ambulate even with four limbs). In those cases, we have several options for palliation of pain, each with it’s own varying success rates, which will be the subject of next week’s article.
Just something to consider. Please let us know how it goes today.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
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