Caring for a Three Legged Dog or Cat
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Well, I know it has been forever since I've last posted. It seems like life is whizzing by, with no down time.
First off I would like to tell everyone that 4 weeks ago, Alexander received his final Chemo treatment. He did well with all four rounds, the only obvious side effect being that he got really thirsty, and susequently had to pee a lot. It's funny, his coat feels so much softer now......maybe the chemo?
Second of all, I want everyone to know, especially the newer members, that Alexander has takien to three legs in a manner that it is amazing he ever had four. I target newer members because if you pull up old posts from me you will see that I had the worst time emotionally with this whole thing. When Alexander was first amputated I thought he was never going to be himself again. He was lethargic, wouldn't eat and had no interest in life. Today he is happy, bouncy, playful and his usual crazy self. We take him out and people first notice his size, then a few moments later you hear them say "Oh, look he only has three legs"! That is how he is, it does not make him who he is, it is just part of him and he adapted amazingly well....Even after the first orthopedic surgeon we saw told us large breeds do not do well with amputations, especially front leg amputations!
The Tripawds website has been my go-to through everything. Through the hard times and the good. When I have been just freaking out or just had questions, everyone here has always been such a great support. In this month of giving thanks, I am thankful, not only for the great life of Alexander but the community and support i have found here.
Okay, I do have two questions. First, our oncologist saw Alexander today for follow up CBC, three chest films (CLEAR!!!!)and PE. It seems she wants to keep this regimine up every 2 months....does that seem a bit excessive? X-rays tear me up not only due to the cost, but because they have to sedate him....I hate that.
Second question. Today the doctor brought up Anti-Angiogenic Tratment. A daily dose of Piroxicam (NSAID), Doxycycline (Antibiotic), Cytoxan (Chemotheraputic Agent) and Lasix. Apparently this is a newer thing vets are moving into to prevent the development of new blood vessels in tumor areas that feed the cancer. She is suggesting the use as a preventative cancer therapy. Has anyone used this/ heard of it? Any opinions?
Okay, I am done writing my book. Alexander is waiting for his dinner. I'll be back soon!
Alexander The Great Dane
Suspected Osteosarcoma July 12
Diagnosed Officially 7/16/2010
Amputated 7/27/2010
Became Spirit Xander 2/20/2011
Wow, that's great. I'm so happy Alexander is doing well and done with those nasty chemo treatments.
Fortis was on the piroxicam for a short period but not the other drugs that you have mentioned. My vet stated similar reasons as yours for putting him on it. Fortis was taken off of the Piroxicam soon after starting it. I don't want to speak for Pam but I think she said she would prefer to use another NSAID in place of the piroxicam. Hopefully she will respond here. You might want to post this question under the "Ask a vet" forum.
Once again, I'm sure glad to hear how well Alexander is doing.
Fortis and Dad
xanderdane said:
The Tripawds website has been my go-to through everything. Through the hard times and the good.
Okay, I do have two questions. First, our oncologist saw Alexander today for follow up CBC, three chest films (CLEAR!!!!)and PE. It seems she wants to keep this regimine up every 2 months….does that seem a bit excessive?
Second question. Today the doctor brought up Anti-Angiogenic Tratment. Has anyone used this/ heard of it? Any opinions?
Yeay for Xander! These are amazing, beautiful accomplishments and it is SO great to hear you're doing wonderfully. Thank you from the bottom of our hearts for the kind words, we are deeply grateful for the support and sharing of stories here that others so freely devote their time to doing. It's what makes Tripawds so special.
To answer you questions; I don't know if the protocol for x-rays has changed, but for most dogs it seems that vets suggest x-rays every 3 months. But just remember, that part is up to you. You can do them as little or as much as you like, there is no "right" timeframe for doing them.
As for anti-angiogenic (you get a biscuit for spelling it correctly!), yes, it's also called "the Metronomic Protocol" or "The Navy Protocol" and it's great to see it has gone mainstream. When I was on it in 2008, it was still very experimental and few doctors were using it. I'm so glad to hear more and more pups are maintaining their health with it.
You can learn about my experience with Metronomics here, and of course search the Forums for other's experiences.
One thing you may want to run past your vet is Dr. Kelly's Metronomic Protocol system, which is slightly different and new. She also includes fish oil (because of the anti-tumor properties of Omega-3) and uses alkeran as the chemo agent instead of cytoxin.
She says she is seeing AMAZING results with this revision, with some dogs living longer than 2 years after starting the protocol. I'm sure in a while, more doctors will adopt this method. This is the clinic where I had my treatment, and they are well ahead of most others when it comes to new, successful cancer treatments.
Hope this helps! Keep on keepin' on Xander, we're so hoppy for you!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
On the plus side, I had a great oncologist for Yoda (UW Vet School) and she recommended Yoda start Piroxicam (just Piroxicam) after he developed lung mets despite his Carboplatin treatments (we had one more to go). She recommended it both for pain relief he might need and also for its anti-tumor properties (hoping it would help slow the development of the mets).
On the minus side, Yoda couldn't stay on it as he did get black/tarry stool fairly soon after he started it (within a couple weeks, I think). So he was taken off of it and needed to be on Pepcid too for a while before he fully got over that.
So, I guess, you just might want to weigh how comfortable you are with being vigilant for the side effects, so you can take Xander off it right away if he does have problems with it. It's kind of like with the chemo decision - some dogs take that much harder than others and so sometimes their people feel its best just to discontinue it. The difference with Piroxicam is that you'll DEFINITELY stop if you see the black stools and any other side effects your vet may warn about. But at least then you know you gave it a shot, in case it could have helped kicked his cancer's butt real well.
Hope that was somewhat helpful and not just rambly. Not enough time to edit this evening!
Best wishes! You'll make the best choice you can and that's all you can do. The only wrong choice is not living in the moment with your pup!
Yoda&Mom united: 9/5/06 …….… Yoda&Leg separated: 6/5/09……… Yoda&Leg reunited: 10/14/09 ……… ……………….………….………….……. Yoda&Mom NEVER separated! …………………….….……....….…… Though Spirit Yoda currently free-lances as a rabbit hunting instructor for tripawds nationwide
Glad to hear Xander is doing sooo well. And he handled the chemo like a pro! Wow.
Catie's fur didn't get softer after chemo; she actually lost most of the feathering on her tail and all her facial whiskers. 
But, finally, her tail is filling in somewhat and her whiskers are back.
I can't offer anything on the Anti-Angiogenic Treatment. As far as x-rays go - when Catie was done her chemo treatments the oncologist really suggest any follow-up exams, x-rays, etc., just to watch and check her and contact her or our regular vet if we had concerns or noticed changes (and to keep in mind that not every little hiccup meant the cancer had returned!). Frankly, I don't think I could bear the anxiety of taking Catie for regular xrays. I believe we'll know if and when the cancer returns and right now, nine months after surgery, I'm content - and so is my husband - to be blissfully ignorant of what may or may not be happening because she's happy and continues to enjoy her life and her food and treats and trips to the park and I don't want to disrupt her content routine by dragging her off to the vet all the time. The financial hit isn't insignificant either, but it's less a concern for me than being able to enjoy her. But that's just us.
Keep up the good work, Xander!
Catie -
Birthday – November 4 2003
Amputation – January 13 2010
Crossed the Bridge – June 2 2011
Glad to hear that Alexander is doing so very well. Their resilience will always amaze me. Not everyone in this community did as well as Alexander on the chemotherapy front, and for your good luck we are pleased. Our team also suggested that we do xrays every two months to monitor the progress. While I quit keeping a total of the bill when it reached $13,000.00, my decision not to follow through on the x rays was not based upon finances. We had a very good indication that Miss Cherry already had a growth on her kidney and there were other indications that the cancer had spread. She had such a bad time with the chemotherapy, I was not about to subject her to additional surgery or chemicals. I was not going to change the way that we interacted based upon excellent or horrible x rays. To me - it just did not make sense to look every two months for the time-bomb that we knew was coming. However, Shanna would tell you that the x rays and the clean bill of health that our Trouble gets really puts her mind at ease. So - this is just one big wishy-washy - it all depends, but no matter what your decision, enjoy your precious time with Alexander.
Spirit Cherry's Dad
Hi,
My dog Champ started on this regimen after his regular chemo was done. His case is a little different in that he had a spleenectomy first, then chemo, then a leg amputation (to get the last remaining cancer in the left rear femur). Two weeks after the amputation he started on the following regimen:
1. Cytoxin (6 mg) once daily in the morning Monday thru Friday
2. Piroxicam (4 mg) once daily every day after a meal
3. Pepcid AC 1/2 tab preferably an hour after the meal
Plus, I put him on the K9 Immunity Plus (K9 Immunity , K9 Transfer, and Omega-3 oils) 2 wafers per day to build his immune system. He also take one vitamin a day which is high in iron. His blood work used to come back slightly anemic.
We were told to look out for stomach upset and blood in the urine. So far, you'd never know he was on meds at all. But he's been that way through all the surgeries and the chemo.
We are doing CBCs every couple of weeks to make sure he is tolerating the regimen well. Plus he has to go back to the oncologist at the 4 week mark for x-rays, CBC and Chem Panel.
I think we are doing x-rays every 2 or 3 months after that.
This regimen is currently for 6 months but I believe the oncologist said we could continue on it longer as long as he was tolerating it well. I have tried to look up on the internet more information about using this long-term but with little success.
I feel anything that will keep my baby healthy longer is worth it. And it's a lot cheaper than the chemo was. This costs us $94 a month I think for all the meds which isn't bad.
Hope some of this information helps you. I will keep you all posted.
Joy & Champ
Yay, Alexander! You are doing pawsome!
Holly had 6 rounds of carboplatin IV chemo, and had some side effects, so hurray that Xander went through chemo with flying colors! 
Holly is now on metronomic therapy, and has been for about 4-5 months. She is on piroxicam and cyclophospamide (which I think is the same as cytoxim) daily. She also gets a pepcid ac twice a day, and fish oil tablets twice a day. So far she's doing great! Our vet did bloodwork a week after starting metronomics
and I think twice more roughly every 3 weeks after that. Now they check her blood every 3 months because everything looked good. I do remember we took her off the metronomics
for about 2 weeks because she had been panting and we couldn't tell if it was the heat, the meds, or something else. We ultimately decided it was just the heat - she's never liked hot weather and I think the heat was worse for her this summer than in the past. Now that the weather has cooled down she's a happy little pup!
The vet and oncologist both recommend x-rays every 3 months. I think her last x-rays were done in June - I am not in a rush to take her in for more x-rays. She's enjoying life, and we're enjoying how happy she is and so I really am not sure I want to know if the ticking bomb is coming back. But there's a part of me that would be so relieved to hear that all is clear... so we may head in for x-rays yet. As others have said, Xander is your dog, so you need to do what feels right for Alexander and you.
Sending lots of hugs to our hero, Xander!
Holly, Zuzu and Susan
PS - thanks for this post - I'm now going to look into what the newest metronomic therapy is that Admin mentioned!
Holly joined the world of tripawds on 12/29/2009. She has a big little sister, Zuzu, who idolizes Holly and tries to make all of her toys into tripawds in Holly's honor. And she's enjoying life one hop at a time!
http://anyemery.....ipawds.com
My Nova started on piroxicam and cytoxan immediately after her last round of chemotherapy way back in Spring of 2009. We had to stop the cytoxan after a few months, but she has remained on the piroxicam to this day with no problems. She takes it daily with a Pepcid. I like to think that the piroxicam has helped her make it to her 2 year ampuversary!
Nova's oncologist recommended chest x-rays and blood work every few months, but I decided against the x-rays. Nova has only had them twice since after the chemotherapy, and both times they were clear. We still have blood work done every 2 months to make sure there are no negative effects from the piroxicam.
I am so thrilled to hear Alexander is doing so well. I just knew he would! I hope he will continue to follow the same healthy path as Nova and have a great life ahead of him!
Sue and Niva
Dane Mom Sue at nova.tripawds.com and Mom to Beautiful Great Dane Queen Nova, a Blind Tripawd, who kicked cancer's butt from 11/08-03/13. The Queen is Spirit Nova now, but her legacy lives on here at Tripawds!
Glad to hear that Alexander is doing so well. And posting your story will definitely help someone who is just starting out- thanks for sharing it here.
I don't have any experience with a maintenance protocol, Maggie had mast cell cancer and was on a different protocol.
One of the reasons I decided against a radiation protocol for Mag was that she would have to be put under each time. Mag did not handle that well, pugs tend to have problems with anesthetic in general (in my experience). Not directly applicable to your situation, but my point is that I chose not to do it with her quality in mind.
One thing to consider while deciding about doing X-rays- would you do anything different if there are signs of mets? If you wouldn't change your treatment plan then do you need to know? You should do what feels right for you. As many have said here- there is no wrong approach. You do the best for your pup- and have no regrets about your decisions.
Keep it up Alexander, and happy almost 4 month ampuversary!!
Karen and the pugapalooza
Cherry said:
To me - it just did not make sense to look every two months for the time-bomb that we knew was coming. However, Shanna would tell you that the x rays and the clean bill of health that our Trouble gets really puts her mind at ease. So - this is just one big wishy-washy - it all depends, but no matter what your decision, enjoy your precious time with Alexander.
Spirit Cherry's Dad
Oh, Bob, sorry not me. 
In the two years, Trouble had her initial x-rays prior to surgery, and a set post chemo. Dr F asked me the same thing Karen asks "If you knew it was there would you do anything different?" His advise was to not put myself through the agony until we had reason to suspect there was something there. He stands on his belief that even though you always hear about the lung mets, they really are not that common. He feels you are more likely to see a secondary cancer type in another area than to see lung mets.
Up until this year we did bloodwork every two to three months. Starting this year he went to every six months. The first six months the wait about killed me, but when her bloodwork came back perfect, I was able to relax a bit. She gets a checkup with her bloodwork, and if I get paranoid about something she goes in to be checked. I think they have us on the senior maintenance plan - I generally pay less than $25 for a vist, get a good pep talk, Trouble gets lots of attention, and we're on our way!
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.
Woohooo Alexander! So wonderful to read your update!!! I'm glad that the chemo treatments were "kind" to you and life is just pawesome for you now! 🙂
I can't comment on the chemo treatments as I am not treating Maggie with chemo but it was suggested to me to do x-rays on her 3 months after surgery and then 6 months thereafter. I, like Catie's pawrents, have opted to not do the x-rays either. For the very same reasons she states.. Besides, I promised Maggie that she wouldn't have to go to the vet anymore 😉 Trying to keep my promise to her...(unless absolutely necessary). Vet offices really whack her out now..
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
Yay Alexander! It is great news. I don't have any advice other than my vet saying that it is totally up to me whether we want to know or not.
Elizabeth and Sammy
Diagnosed with osteosarcoma in the right front leg 8/23/10,
leg fractured 8/27/10,
leg amputated 8/30/10
http://sammyand.....pawds.com/
I couldn't begin to say how special Sammy is to us. Living and laughing with and loving this wonderful boy is priceless.
Xrays are a personal choice. I did them every 3 months with Tazzie but she didn't require sedation and I would have tried Palladia if we had found lung mets. I know that the costs can add up!
There are many protocols for metronomic therapy. Most vets have dropped out the doxycycline but that won't hurt. Piroxicam can work well for many dogs but can also cause perforating gastric ulcers/ bleeding so I prefer meloxicam instead. There are 3 main drugs used for the chemo part. Cytoxan (cyclophosphamide) is probably the most common but can cause bladder problems. The Lasix is given as a means to prevent this. Some vets use CCNU (lomustine) but that can cause low platelets or elevated liver enzymes in some individuals. The newest drug being tried is Leukeran (chlorambucil). I think this is the drug that Jerry is referring to. It has very few side effects.
Both Palladia and metronomics are very new so there is no "right" or perfect protocol at this time so I would use what your oncologist is comfortable with. I have heard from our local oncologist that Palladia has been helping dogs with lung mets and if used at proper dosages the side effects are minimal, but the drug remains expensive.
Pam
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