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Caring for a Three Legged Dog or Cat

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Should we amputate now or later?
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canada
Member Since:
16 June 2010
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17 June 2010 - 12:49 am
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Hi,

We are new members. Lovely Abby has been diagnosed with Fibrosarcoma on her front leg wrist joint. It is a low grade 1, but the tumor came up rapidly and was growing rapidly. Surgery could not remove it all as it was too involved with the ligaments and tendons. The surgeon's advise is to remove the leg as soon as possible, in the next 10 days.  Abby has no problems of pain or limping at this time and she seems very happy,healthy and loves to run. She is a 7 year old German Shepherd. We see that fibrosarcoma metasitizes around 10%-15% of the time. We are wondering why not wait until the tumor returns from the surgerical removal and begins to cause her problems. We want to give her as much time as possible to run and play. The surgeon said the sooner the better, to wait is to run the risk that it would spread and her lungs are clear now in the x-rays. The surgeon said the tumor would return in as little as one month or eight months maximum if we were lucky.

It seems that waiting until the tumor returns and begins to cause her pain is not that high a risk and may be a worthwhile risk to take for a possible 6 to 8 months of quality time before amputation. And then hopefully more years of quality time after the surgery.  Has anyone had similar experience or faced this type of decision to make. It is such a hard decision to make and any help or advice would be appreciated.

We would do anything to keep her with us everyday forever, but is that for us or her? Maybe it is best to move as quickly as possible, or how dangerous is it to wait until she starts to have some problems such as pain or limping. The tumor was about the size of a small walnut on her leg, but now after surgery it is not visible at all because the main mass was removed. But small parts did remain that could not be removed.

We would also be interested in radation treatment if that was a good option. Any experience with radation for fibrosarcoma that you could share would also be appreciated. Our surgeon said he did not think it was a good option, but would refer us if we wanted to persue that direction.

It does seem that all paths lead eventually to amputation. Should it be now or Later?

Pahrump, NV
Member Since:
17 February 2010
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17 June 2010 - 1:31 am
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Hi Abby"s Mom (or Dad),

The decision to amputate or not (or when) is  really difficult, and one everyone here has had to make.  I live in (well actually near) Las Vegas, and when I read your post, I can't help thinking about "the odds".  I think your vet is playing it safe (maybe he came out here and lost on a "sure bet".)  He feels amputation now would practically eliminate the chance of metastasis, even though it's only a 10% to 15% chance.  You're considering more than just the odds. You're looking at Abby's life now and how it will change. You want her to have 4 legs as long as possible (nothing wrong with that, by the way.)  My advice would be to play the scenarios in your head. Would you feel guilty if you waited and it turned out to metastisize? How do you think Abby will do on 3 legs? Do you think you (and she) would rather have the extra time with 4 legs now, even if it means less time total? As long as your decisions come from your love for Abby and what you feel is best for her (and I'm sure they are), there are NO wrong answers. I'm not familiar with fibrosarcoma (Sadie had osteosarcoma), but there are such knowledgable people here that I'm sure someone will have information or resources for you.  I'm really sorry that you have to make this tough decision. Please keep us posted whatever you decide.

Lisa (Sadie's mom)

Sadie is my 9yr old Rott/Shepherd mix. Diagnosed with osteosarcoma in her right scapula 1/28/10. Our brave girl had her amputation 2/13/10 and her last chemotherapy on 6/6/10. Unfortunately, a tumor appeared in her back right leg and on 10/7/2010 Sadie's earthly journey came to an end.  On 10/24/2010 we adopted Ranger, a handsome Rott/Lab mix tripawd (got hit by a car) I think Sadie sent him to us.
http://ranger.t.....pawds.com/

Orange County, CA
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2 January 2010
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17 June 2010 - 1:58 am
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abbydog said:

We would do anything to keep her with us everyday forever, but is that for us or her?


 
     That's the heart of this whole issue.  We all want our dogs to stay with us forever, and knowing that we'll outlive them is the cruelest part of our relationship with them.  But the one guideline you should always follow is to do what's best for the dog, no matter what.  And that's not always an easy thing to do.  No one wants to have to make the decision to turn their buddy into a tripawd, but if that's the best chance for survival then so be it.  It wasn't easy for my wife and I to do a year and a half ago, and it was even harder the day we realized it was time to let him go once and for all, before the cancer had a chance to truly cause him pain.  But if you can look back at what you did and truly feel like you did what's best for your girl, then you did right.  And never second-guess yourself once a decision has been made.  It's obvious you love your dog, so have confidence in your ability to choose the right course of action.

     The question, of course, is how to figure out what the "right thing to do" is.  The problem with waiting until the tumor flares up again and starts to cause obvious problems is that by that point, it's often too late.  Early treatment, even something as drastic as amputation, is often a lifesaver.  Vets don't recommend amputation lightly, so if he's already going there, you need to consider it.  Talk it over with your doctor, and maybe get a second opinion, then do some research of your own.  Our own dog had osteosarcoma, so I'm not as familiar with your dog's disease (but don't worry, plenty of people here will be).  In our case, the sooner he was amputated after dignosis, the better.  Some of the things we had to bear in mind may help you as well:

  • Osteo tumors are basically constantly spewing cancer cells throughout the body, so the sooner you disconnect them, the better.  The idea is to remove the source of cancer in order to keep it from spreading, and the sooner you do it, the safer the dog will be.  See what your vet says about the differences between fibrosarcoma and osteo, but I'd be leaning toward a "better safe than sorry" approach to the problem.
  • Bear in mind that just because a dog isn't showing signs of obvious pain, that doesn't mean there isn't any.  Our vet likened it to having a minor toothache – you don't show it, and it doesn't stop you from functioning, but it's always there.  Pain for dogs can be the same way.  It might be as subtle a sign as just slowing down a little while playing or something like that, but it's no fun having to live with that constant dull throb.
  • And don't forget this website's motto – "It's better to hop on three legs than limp on four."  I'm sure you're worried about Abby's quality of life once she becomes a tripawd.  You'd be surprised at how fast a dog adapts.  Our dog Max always loved to run, and he was damn fast.  I felt really bad when we amputated, because I figured that meant his running career was over.  Not so.  Believe it or not, he barely slowed down.  He learned to run again, and I don't think there was much difference in speed.  Dogs are far more adaptable than we are, and they don't need all their limbs as much as we do.  Abby will do just fine on three legs if that's what needs to be done.

     So carefully look into this, then make your decision.  There are no guarantees; you simply have to play the odds and do whatever is most likely to give her a long life.  She'll do just fine as a tripawd, so if that's her best chance at beating the cancer, then do it now before one more cancer cell has a chance to migrate out of her leg and lodge elsewhere in her body.  If your vet or vets think there's some good medical reason for waiting, then so be it, but if they keep recommending amputation, then you need to consider that they know what they're talking about.  Because in the end, all that matters is that you can look back and know you did right by your girl – no matter how much it hurt you to do so.  And don't hesitate to ask as many questions of us as possible.  You just discovered the one place on the internet that's full of people who have already gone through what you're experiencing now.  We all came here because we didn't know what to do and we needed help.  We got it.    Now it's your turn.  Keep us posted and we'll make sure you don't go through this alone.

My heart lives at Rainbow Bridge
Member Since:
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17 June 2010 - 3:59 am
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Maxidad covered my feelings exactly.  We, too, had osteosarcoma and the recommendation was to do it now. Don't wait even a day - make your decision tonight and have her in surgery tomorrow.  When they put it that way, I knew it was critical.

I know this is a tough call for you, we've all been there.  If radiation is an option, I would certainly look into it.  A friend of ours did radiation on her dog and his recovery was tedious - the radiation site is raw, ugly, and fragile for a long while, but his long term recovery was good.  Do your research, know all the options, then take the info you have and make your decision based on what it best for Abby. 

Good luck with your decision.

Shanna & Spirit Trouble ~ Trouble gained her wings 3/16/2011, a 27 1/2 month cancer survivor, tail wagging. RIP sweetheart, you are my heart and soul.  Run free at Rainbow Bridge.
The November Five - Spirits Max, Cherry, Tika, Trouble & Nova. 11/2008 - 3/2013 An era ends as Queen Nova crossed the Bridge.

Portage Lake, Maine
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17 June 2010 - 6:45 am
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My dog had a soft tissue sarcoma as well - although we don't know which type but did know it was not fibrosarcoma, as I'm told that one is fairly easy to diagnose.  My dog was in alot of pain though...when we did the biopsy and found out it was probably cancer(my vet said cells looked like cancer before sending it out to the lab) - I didn't even wait for the following week for x-rays, as I was told typically, they'd do those prior to amputation.  It was suggested by my sister(a Vet Tech) to do them NOW...find out now if it has spread to her lungs - because Maggie cannot wait much longer...her pain was reaching the point of quality of life decisions had to be made NOW.  That week of waiting for the final results of the biopsy and amputation were llike time was stuck....the clock ticked so slowly because we wanted to get that nasty leg off NOW before it spread.

If I remember correctly, when reading about soft tissue sarcoma's, you have a really good chance of curing your dog with amputation alone for fibrosarcoma...but don't quote me on that. 

Trust your heart in your decision....we're here for you when you need support!

Tracy, Maggie's Mom

 

Maggie was amputated for soft tissue sarcoma 10-20-09

Maggie lost her battle with kidney disease on 8-24-13

http://maggie.t.....t-24-2013/

krun15
6
17 June 2010 - 8:23 am
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Hi Abby's folks,

Welcome to Tripawds.  You've already got a lot of good responses to your questions. 

Check out Jerry's Required Reading List, the information collected there may help you to make your decision. 

 

I sometimes looked at my decisions for my pug Maggie from the aspect of what I was not willing to do.  That can eliminate some options and make you decision easier.  For example I ruled out radiation treatment for her because at the time it would have involved putting her under many times.  Pugs tend not to do well with anesthetic, and Maggie had proven to have an especially difficult time.  Once I made that decision then amputation was really the only way forward for us.  Maggie had mast cell cancer.  She was not in much pain from the tumor in her knee, but it was starting to affect her leg function.  The danger for us leaving part of the tumor in her leg was the threat of the cancer spreading through the lymph system. 

Like everyone else has said- you know Abby best, and as long as you make your decisions with her best interst in your heart you can't be wrong. 

Keep asking questions and get all the information you can.  Everyone here will support you and help you as you start your cancer journey with Abby.

 

Karen and the pug girls

On The Road


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24 September 2009
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17 June 2010 - 9:29 am
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abbydog said:

We want to give her as much time as possible to run and play.


 

Then listen to your surgeon. The sooner Abbey recovers from her amputation, the sooner she will be running and playing again. You may think she has not pain now, but just because she's not limping does not mean she isn't hurting. Dogs are incredibly adept at hiding their pain. In the wild, if they show any signs of weakness, they will get thrown out of the pack, or worse. Jerry limped on and off for two months while the tumor in his shoulder grew to the size of a mango. Usually, by the time dogs show signs of pain it is only because it has become unbearable. If you don't beleve three legged dogs can run and play (and swim), spend some time watching Jerry's and Wyatt's videos or reading the Tripawds Blogs.

Too many times, we hear from people who put their dogs through multiple, painful, expensive surgeries only to proceed with amputation anyway. There are some wonderful treatments being done with radiation, however, if you have an advanced facility available. Check out the report from our tour of Colorado State University Animal Cancer Center for information about some of the lastest veterinary radiation technology.

For the more agressive ossteosarcoma tumors, their is some belief that amputation may expedite metastasis by removing the primary tumor, but as far as we know this is not the case for fibrosarcoma.

Best wishes in the decisions you face and thanks for joining. We look forward to following Abby's progress. If you are having a hard time coping with the decision to amputate, we recommend reading Without Regret, it certainly helped us when we felt the same way after Jerry's diagnosis.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

On The Road


Member Since:
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17 June 2010 - 10:00 am
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PS: You might want to review this comment Sophie's mom just posted in another topic. She refers to Sophie's soft tissue sarcoma and also also addresses the radiation option. Here's an excerpt:

... they reduced the lump as much as possible 3 times before we finally
went with amputation ... We spent a considerable amount of money having the tumor debrided –
about $1800 each time. It came back more quickly, and bigger each time.
Then the amputation surgery on top of that ...

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

On The Road


Member Since:
24 September 2009
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17 June 2010 - 10:14 am
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Thanks for joining us here. Abby looks like such a sweetheart, we're so sorry you're going through this together. Everyone here has offered such great advice, I'm not sure how I can top it except to share my own experience.

I was totally aysymptomatic too, and went from this:

To this, in less than a month:

Three legged Jerry with Osteosarcoma

The pain became so unbearable, I coudln't stand it anymore. We dogs are incredible at hiding our pain. After all, if we did show it, out in the wild, we'd get eaten. So I hid it as long as I could from my folks, even going on 12 mile hikes with them while osteosarcoma was eating my bone from the inside out. Later after we found out why I started limping all of a sudden, my pawrents felt horribly guilty to taking me on that hike, figuring that I had probably had the cancer for far longer than we knew.

Once I got rid of the leg, guess what? I had MORE quality time. And it was better because I was no longer in pain.

As for radiation therapy, keep in mind that it is only palliative and will not cure it. However, you may want to look into intralesional chemo and bisphosphonates , something that our friends at the Santa Fe Veterinary Cancer Care clinic are conducting clinical trials with:

intralesional chemotherapy Clinical Trial

"intralesional chemotherapy is a clinical trial; results are yet to be published. Tumors most commonly treated are: Osteosarcoma, oral melanoma and other oral tumors, soft tissue sarcomas, vaccine sarcomas, mast cell tumor, and squamous cell tumors. This procedure is used palliatively to control pain, to prevent or delay recurrence of tumor, or to decrease the size of a tumor that has not been surgically removed. intralesional chemotherapy is also referred to as intratumoral or local chemotherapy. intralesional chemotherapy is the administration of cancer fighting drugs directly into the tumor, tumor site or adjacent tissues. The goal is to improve local tumor control by achieving high local chemotherapeutic drug concentrations while maintaining low plasma concentrations.

intralesional chemotherapy is being used extensively at Veterinary Cancer Care, P.C.. Although this treatment has been successful, it still remains investigational. Advantages compared to surgery or radiation are ease of administration, low risk of side effects, low cost and that subsequent treatments can be administered in the future if there is recurrence."

"Zoledronate for Osteosarcoma Clinical Trial

Osteosarcomas (OSA) of the appendicular skeleton in canines are the most common form of bone tumors. Bisphosphonates inhibit bone resorption, without inhibiting the process of bone mineralization, and may prevent or delay metastatic disease. Zoledronate is a bisphosphonate that has been shown to decrease malignant skeletal destruction, severity of bone pain, and frequency of pathologic fracture. At Veterinary Cancer Care, P.C. we have a partially funded clinical trial to test the effectiveness of zoledronate in dogs with appendicular osteosarcoma. The goals of this study include showing that zoledronate is safe, decreases bone decomposition, provides pain management , and delays metastatic disease. Our study dogs will be treated with four milligrams zoledronate, infused over one half hour, every thirty days for twelve treatments each."

Check out our YouTube discussion about bisphosponate with Dr. Kelly.

Good luck. We hope this has helped somewhat. Remember that no matter what you do, we're here to help and support you in your decision OK? Keep us posted.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

Member Since:
14 June 2010
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17 June 2010 - 11:01 am
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Hi, I don't have an answer for you but I'm in a very similar position.  Search "chrondrosarcoma" and "radiation as an alternative to amputation" to find my posts.

Basically, my 8 year old Lab was diagnosed with chondrosarcoma - another soft tissue sarcoma, in the cartilage, also level 1, lungs clean, no pain in leg, running, jumping, swimming, allowing it to be pushed, pulled, prodded etc.  not sure how chrondrosarcoma and fibrosarcoma may be different.  the initial rec was surgery with radiation, potentially curative.  it turns out they can't take the tumor out surgically due to the location (near the knee), so the options become amputation or radiation (with strong possibility of later having to amputate).

i am in the process of making the same decision you are faced with.  however, the docs say radiation is not palliative, it is definitive - i.e., with the hope of being curative - though of course cutting of the limb has a better chance of removing all the cancer cells. 

Our surgeon says amputate, the radiation oncologist says radiation is a good alternative, our regular vet says try radiation before cutting of his leg, one oncologist won't give a recommendation except to (correctly) say surgery can be expected to most likely be curative, and the other oncologist says if it was her dog she'd radiate.

I'd say do some reading and get a second opinion if you can.  Sorry not more helpful.  Would like to know what you ultimately decide.  I have been convinced by this site, other reading, and live dogs that tripawds do awfully well, but also want to keep in mind that in many cases amputation is really the only treatment option (osteosarcoma is painful and more aggressive).

 

Las Vegas, Nevada
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14 August 2009
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17 June 2010 - 2:55 pm
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Welcome Abby (and even Kazy55)

What a tough decision.  I'm so sorry that this all had to happen.  She's a beautiful dog! 

I have no experience with cancer except hemangiosarcoma in my german shepherd mix...and my experience was a whopping 3 hours!  But I did want to offer you a little advice like other's have said...My Rugby showed now signs that he was dying of cancer.  I had no clue and I was with him 24/7!    He seemed a little tuckered out but it was July in Vegas and 115 degrees outside    - plus he was 8 years old! 

He was his goofy self all morning and then collapsed.  His heart couldn't beat anymore from the tumors. 

So, judging pain is very tricky in dogs - and sheps are even more tricky because of the protective and easy going nature.   Unlike my Comet who will cry her eyes out for attention or a peanut butter cookie!

I found this article you may want to read regarding Fibrosarcoma

http://www.vetc.....20Cell.pdf


SPINDLE CELL TUMORS AND FIBROSARCOMA IN DOGS


..."The treatment for this tumor is surgical removal, usually of the lump but occasionally more

radical such as amputation of the limb.

These tumors do not respond to chemotherapy. The tumors are sensitive to radiotherapy,

including interstitial brachytherapy, but direct beam radiotherapy has been discontinued

because of side effects and disappointing results."...


"Low grade (slow growing) tumors have a recurrence rate of 25% after surgical excision.

Median survival time is 2-4 years."...


 

 

 

Best of luck to you on your decision.  It's hard one.  Follow your heart and you won't make a wrong decision.

Keep us updated!

Comet's mom

 

Her Retired AvatarComet - 1999 to 2011

She departed us unexpectedly  January 23, 2011 at the age of 12 1/2.

She was born with a deformed front leg and a tripawd all of her life.

Kirkland, WA
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2 June 2009
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17 June 2010 - 3:21 pm
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Welcome to Tripawds!  I think I'm one of the few here who had absolutely no hesitation when it came to amputation.  As soon as I heard the words "cancer" and "tumor", I wanted that thing gone.  Because of the location of Jack's tumor, he was a candidate for limb-sparing surgery, but the fact that cancer cells would be left behind was unacceptable to me.  We had to wait almost a week (I think...) before we could get him in for surgery and it was soooo hard to know that the cancer was growing and all we could do was wait.  He had been limping on and off for 8 months before the tumor became visible and our doctor and oncologist thought it was probably chondrosarcoma because of the bone it was in (the ulna not the normal radius...or the other way around?).  I somehow knew Jack would be fine, and he proved me more than right.  Some dogs do have a very hard time recovering after the surgery and this can be extremely hard on us pawrents (not only do we have to face the fact that our dog has cancer, we also have to watch them struggle to walk, eat, use the bathroom, and even sometimes have phantom pains).  Despite the possible negatives, amputation was all that I even considered, and it has allowed me to enjoy over a year with the Captain despite his high grade, highly productive osteosarcoma diagnosis.  The decision is personal and I believe that someday soon you will just know what the right answer will be.  We are very supportive of these decisions here and will be there for you even if Abby remains a quadrapod for a little while longer 🙂  Best of luck!!

 

<3 Laura and Captain Jack

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17 June 2010 - 4:35 pm
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Welcome to the family. When we found out Gus had cancer, it was a no brainer, tha bad part was waiting for the surgery, But I haven't regretted one second, Your first two weeks aren't pretty, not much sleep. alot of stress, some people struggle with guilt for what they have done to their dog, trust us, the dog will be fine, it's you that has the emotional roller coaster. But after saying that, most dogs have a rough time after the surgery, one day ok, one day sucks. they aren't themselves, appetite so-so, so don't think just because the leg is off it's all downhill, cause it ain't!! Gus' xrays showed negative in the chest also, even his biopsy was negative, but we still felt we were dealing with cancer so that is how we handled it. But we found out about three weeks ago he has it in his lungs , but your dealing with a different cancer, but I wouldn't wait myself. You will be amazed at how a dog handles three legs. Gus was doing everything he was before, just maybe a little more tired after doing it. Your decision should be based soley on quality of life for the dog. You know your dog,and if it is something you are going to do anyhow, why prolong the agony of making the decision of when to do the surgery, get it over with and let him heal. Sorry if I'm blunt, but when I look back now, I wish we would have just done it right away, not even mess with the biopsy, who knows, maybe we might have kept it  from spreading as fast as it did. This is the best place to be for help, support and answers, you've come to the right place. Good luck, gus and Dan

My buddy Gus had a left front amputation on April 7, 2010 and lived a great life until July 26,2010

Minneapolis, MN
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23 May 2010
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17 June 2010 - 9:27 pm
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I know how hard this decision is. Because Daisy was 11 1/2 when diagnosed, I originally made the decision to NEVER amputate but to give her a good life for however long. In the meantime, I set about treating her holistically. Occasionally during that time I would reconsider the amp, but not amputating felt right. When 5 1/2 months passed with the tumor enlarged but Daisy seemingly in otherwise good health, I made the decision to amputate. I won't repeat here everything that factored into my decision, but if you're interested you can read my blog, "For the love of Daisy." In the second post I explain how I came to the amputation decision for my now 12-year-old lab. (She's doing great, by the way!)

 

One thing that helps me is knowing that there's no right or wrong decision. One decision will take you in one direction, the other in another. Just different directions--no right or wrong. I'm sure you'll end up doing what feels right for Abbydog. She's beautiful, by the way.

Daisy, 12 years young, had left forelimb amp on 5/19/2010 due to osteosarcoma. She left her body behind and joined the other spirit tripawds on 7/16/2010.
So grateful for each day with her!
Lexi (Daisy's momma)

canada
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16 June 2010
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18 June 2010 - 10:49 am
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Hi to all who offered so much support,

Abby dog and I are so grateful for the caring and support of the Tripawd family members. It sure seems like if you are destined to join a family, this is a good one to be a part of.  We are still struggling with the decision, maybe it is a form of denial not to make a choice. Which ever choice is made will be for our desire to do the best thing for Abby. My sister told me not to fool myself by thinking I could choose to do what was best for Abby, that we always are guided by what is best for us. So I can only hope that we choose for us based on our love for Abby.

The central question that would give me the most direction is one that may not have an answer, which is why this is such a hard decision.

Fibrosarcomas are locally invasive and will eventually lead to death. They rarely spread to other parts of the body. I have seen reports of as high as 20% to a low of 10% mets rate to the lungs normally. I am not sure if the percentage of risk grows over time delayed until amputation and if so how much increased risk is involved. It may be that the 20% of cases where the fibrosarcoma did spread to the lungs are in those cases where amputation was delayed. If so, how long was it delayed? How much time do we have to make a choice, one week, two months, 6 months? Certainly any indication of the tumor recurring on the front leg ankle joint, pain or limping would  mean immediate surgery. Who knows how much pain they may be hiding. It wil come back because the surgeon could not remove it completely due to location and "intimate involvement with other critical structures in the joint".

I am watching very closely to make sure she is not favoring one foot over the other when she runs, lands after jumps or goes up stairs.

This decision is complicated because my wife and I do not agree. She wants to wait and also try to explore naturalpathic options to help Abby. I want to act in a more definitive manner and "just do it". Like a male would as my wife says. Our last beloved German Shepherd developed cancer when he was 11 and I made the choice for immediate surgery as the best choice to help him, either as a cure or to prolong his life. He died on the operating table. That he died, alone and not peacefully with us causes us pain to this day. My wife does not trust my desire to be more actively interventionist. So the decision to wait ,if possible, gives us time to resolve the differences in how we would both do it. I just wonder how safe is it to wait, and should I demand to act now. My track record in this is not good, but if the risk of waiting is significantly higher I would push my wife harded to amputate now.

 

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