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Caring for a Three Legged Dog or Cat

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Grovers first met check ... could have been better.
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Forum Posts: 37
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4 September 2019 - 8:58 pm
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Today, we had our first met check since pre-op. We are 19 days after the second round of chemo (so right before the third dose of carboplatin) and about 7 weeks after surgery. The good news is that he didn’t have pulmonary metastases visible on radiographs. The bad news is that there is an osteosarcoma on one of his ribs. In retrospect they can find it on his radiographs from before surgery (it was much smaller and less aggressive looking). To be honest, I’m glad that they didn’t ‘call it’ back then because we may not have done surgery … and surgery was a GOOD decision for him. It has already given him more happy weeks. 

We are very grateful for our saint of an oncologist who tried to put a positive spin on it — the good news is that there are no NEW mets which means the chemo may be doing it’s thing. This is an old met that has always been there and she would not have expected to respond to the chemo. 

So, they very kindly squeezed Grover in for a radiation treatment today of the rib and he is scheduled for one tomorrow with dose #3 of chemo afterwards. The hope is that the chemo can keep the chest mets from becoming evident (if it has worked thus far) and that the radiation will slow down the rib tumor. And the good news is that neither chemo nor radiation really phase him much. 

Not the news we were hoping for, but as the oncologist said … it could be worse. And most importantly he felt well enough to go on three 0.8 mile hikes in the woods this holiday weekend. At the end of the day, that’s what really matters. 



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4 September 2019 - 9:10 pm
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Darn it. You have a good attitude and your oncologist sounds excellent. And dear Grover went for a hike. He’s leading the way and living life as he should.

Is there any chance the bisphosphonates with help Grover? My sister had cancer that metastasized to her bones and had bisphosphonate treatment by IV that really helped reduce bone pain.

Huge hug to you and Grover,

Kerren

Virginia




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4 September 2019 - 9:58 pm
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Well leave it to Grover to come up with the unexpected!  Of course, we know he’s a very unique-one-of-a -kind fella’!

  I really like the Onco though who put it into perspective (it could be worse)  and then immediately started focusing on the solution and proceeded with treatment.  Of course cannot recall specifics  roght pff rhe bat, but I do know radiation has  helped in some cases, as well as the bisphosphonate Kerren mentioned.  As Kerren pointed out, you have a great attitude and that really is a powerful energy to surround Grover with…truly powerful!

Of course Grover didn’t  pay any attention to those xrays snd didn’t  hear a word the Vet said.  All Grover knows is he’s having a blast living  lofe kn three with no pain.  Grover is being Grover and that is exactly why we do what we do!!

jkopper said
……In retrospect ……….. To be honest, I’m glad that they didn’t ‘call it’ back then because we may not have done surgery … and surgery was a GOOD decision for him. It has already given him more happy weeks. 

  

So very well said and with a very wise  spot on perspective!!  Actualky a lot of Bets are on board nowadays with dojng amputation even if lung mets show up jn the preliminary work ups.  First and foremost, it gets rid of the pain and gives the dog QUALITY extended time, however long that may be.  Secondly, no one knows which dog will be rhe dog who lives a year or longer with mets!

It makes all this a lot less stressful knowing  Grover is treated  like the RockStar that he is by the hospital staff!  You are stopping on the way home after each visit at a drive-thru for a cheeseburger, right??   He gets to eat fun and all!!!  And then maybe a stop at Dairy Queen for an ice cream cone!  Yeah, Grover thinks this chemo/radiation stuff is great!😉   Ahhh….the bliss of dog!

We’re  all cheering for that handsome voy! You two make a great team!

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!

Germany
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5 September 2019 - 5:17 am
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Hi and sorry for those news.

Osteo on the ribs is really so rare it does not even really make it into any medical journals. I am glad you are in the hands of somebody who seems to know their stuff. 

My dog also developed a second osteo on the ribs although his had definitely not been there when we amputated. Theoretically it is operable but in our case the oncologist and the surgeon said no because of the location -near his remaining leg just under the shoulderblade. 

Radiation is a good course to keep the pain in check and I was really hoping for the bisphosphonates that kazann/Kerren mentioned. -However, the oncologist said then that from his experience they only work on the tubular bones such as limbs. But it may be worth checking again.

We never got any mets, so there was that (and yes, we also did do chemo) and Manni made it another 6 months after the discovery of the second tumor. Altogether we got an amazing 2 full years. 

From the time I knew that our biggest issue wouldn’t be mets but rather another painful osteosarcoma the thing most important for me was a pain regiment that would allow Manni quality of life. I consulted with my two vets all the time, read everything I could find and made adjustments as time went on. If I can be of any help to you feel free to reach out.

all the best

Tina

Guardian of Manni the Wonderdog. -Or was it the other way around?
Osteo and amputation in Dec 2015. Second, inoperable, primary osteosarcoma found in June 2017.
The end of our adventures came Dec 10, 2017. 2 years to the day.

Manni's blog -dogblog-

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5 September 2019 - 6:56 am
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Many thanks for everyone’s support, ideas and experiences. 

Thank you for reminding me about the bisphosphonates . Our oncologist did mention them yesterday, but wanted to wait until next week because he’s already getting so much this week (two radiations and a higher dose of chemo than last week) that she thought it may be a bit “much” for him. 

I suppose some good news is that if we did not have the radiographs we would not know about the new tumor — even when we press hard on it, it doesn’t seem to cause him pain. I always worry about dogs hiding their pain (he also didn’t cry when we pressed on his ulnar osteosarcoma so maybe not a great indicator in him) so I want to be proactive in anything we can do to keep him comfortable. 

We also talked about surgery … it’s technically operable (same side as the amputation) but our oncologist told us that it’s a bigger surgery than you would initially think in a dog (he would likely need a mesh implant put into the area) and given that he is seemingly comfortable and happy and struggles a bit with anesthesia she didn’t think it was a great first option and wanted to see what happened with radiation first. 

Thanks for sharing your dog’s experience Tina — you’re right. You can hardly find mention of this in the literature (I was really hoping we would fall into a “rare” group … but not THIS rare group!) which is making it hard to wrap my head around what to expect from this new finding. 

There was another “spot” on his opposite radius that gave the radiologists pause before his surgery as well. Grover had HOD as a puppy and his bones are markedly deformed so his radiographs are harder to interpret. They couldn’t find the same spot on ultrasound and they didn’t get any neoplastic cells when they tried to do an FNA of it (but they couldn’t breach the outside layer of the bone either). We rechecked radiographs  two weeks later and there was no change, but I’ve decided to ask the oncologist to re-radiograph it as well given that the other “probably not” spot turned out to be something. Finding an osteosarcoma in the other leg would be devastating and a part of me thinks that ignorance could be bliss but it seems like information we should know or owe it to him to find out. 

Thanks again to everyone — this group is incredibly valuable. 

Germany
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5 September 2019 - 9:09 am
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I actually felt like someone pulled the rug out from under me when I found out that we fell into that “rare” group. You try to come to terms with what usually happens and then all of a sudden everything is different and all the info before is obsolete. 

From everything I’ve read and been told it is not likely that Grover would have yet ANOTHER osteo on his remaining leg because USUALLY osteo just does not work that way but rather metastasizes to somewhere else. But, having found myself in that “rare” group once my gut would also go: anything is possible with that crap piece of disease. So I, too, would have it checked out.

Manni was never pressure sensible in the osteo spots and a friend of mine, whose child actually passed from osteo, told me that it seems to be more of a “inside the bone” kind of a pain, if that makes sense at all. I was actually pre-emptive in pain meds with Manni. He was a dog that did not show pain AT ALL until it would be too late. My vet (and I) assumed he had to be in some pain if it is osteo so we started him on pain meds right away. I then watched him every day for any signs and every time he was less willing to walk, for example, or less spunky, we upped the dose or changed meds. It was also trial and error to find out what worked and what didn’t.

But I do firmly believe my dog had a good quality of life until the day, months later, that he didn’t. Since you are already so very much on top of things I believe that Grover has a fantastic life ahead of him.

You’re in my thoughts

tina 

Guardian of Manni the Wonderdog. -Or was it the other way around?
Osteo and amputation in Dec 2015. Second, inoperable, primary osteosarcoma found in June 2017.
The end of our adventures came Dec 10, 2017. 2 years to the day.

Manni's blog -dogblog-

Germany
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5 September 2019 - 9:23 am
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oh, and maybe this is helpful, I don’t know:

https://tripawd…..-dressler/

Guardian of Manni the Wonderdog. -Or was it the other way around?
Osteo and amputation in Dec 2015. Second, inoperable, primary osteosarcoma found in June 2017.
The end of our adventures came Dec 10, 2017. 2 years to the day.

Manni's blog -dogblog-

The Rainbow Bridge



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5 September 2019 - 2:31 pm
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I’m so glad you posted here! There are so many perspectives and helpful tips from the community. Thanks everypawdy.

How did the radiation therapy go today? How wonderful that Grover is such a laid back boy. His cool personality and your great attitude are just what a situation like this needs to keep order and balance in the pack. Your oncologist is the icing on the cake. What a team he’s got.

It's better to hop on three legs than to limp on four.™
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6 September 2019 - 4:34 pm
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Read your blog, adore that pic of you guys. I am so sorry you got that news. Keeping you in my thoughts and sending you wishes for health and a way to keep this thing under control so that you can continue to enjoy each other.

Hugs,

Jackie and Huck sp_hearticon2

Hugs,

Jackie, David, Bo, Andy, Oscar, Angel Mitchell, and the coolest feral tripawd kitty Huckleberry

Huckleberry's Blog

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7 September 2019 - 8:24 pm
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Hi all — Thanks again for the replies and support. 

I would agree Tina, that describes it perfectly. I felt like I had a realistic outlook and had wrapped my head around what the likely outcomes could be and had “the” plan if he was lung metastasis free (radiographically) and “the” plan if he had lung mets. This was not part of any of my plans so to speak. 

Jerry — Luckily he is such a trouper and handled everything well. He was a little groggy Wednesday night and Thursday night (after anesthesias) and we put him on cerenia which we don’t usually do after chemo since he’d had two anesthesias + chemo and Friday morning he was back to being himself. 

After discussions with some additional oncologists based on some of their clinical impressions and unpublished research data, tentatively, if he is still doing well he will get carboplatin in 3 weeks +/- radiation, and in 3 more weeks radiation followed by starting an osteosarcoma vaccine a couple days later. Potentially, radiating the tumor followed by inducing an immunologic response *might* help stall it out. We understand that there is no tried and true data … but when you fall in the <5% group, that sort of goes out the window. 

But ultimately it will rely on how he is doing clinically. Somewhere in there we will also start bisphosphonates as well I think and have loosely discussed metronomic chemo … but our oncologist is worried he is already getting a lot and handling it well, so at what point do you risk tipping over the apple cart so to speak. Or as she likes to say “don’t kill the dog while trying to kill the cancer.” 

We just have to take and appreciate each day for what it is and realize that at this point, we can’t rely on data or studies to predict what to expect. 

Virginia




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7 September 2019 - 9:01 pm
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You absolutely  are doing everything possible for handsome Grover.  Thanks fot sharing all rhe teeatment information.  I’m  sure this type of scenario  will, unfortunately,  rear its ugly head somewhere in the future for a dog.  This will be extremely  helpful for someone  facing the fight.

Yes, if the treatment causes Grover to not be Grover anymore, he will let you know.  “Extra time” without quaility  means nothing to Grover.  Living each day happy spoiled,  loved and pain free means ecerything  to Grover.

I’m  glad to hear he bounced back after his treatment.   Good sign!

Extra 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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17 September 2019 - 8:22 pm
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I thought I would provide a little update in case someone else finds themselves in similar shoes – maybe it will give them something to consider with their oncologist. 

After consulting with several oncologists at other universities we have decided to add losartan to the carboplatin and continue with radiation therapy as needed and monitoring for other metastases. Losartan is traditionally an anti-hypertensive medication that, when used at high doses may have anti-vegf (from what I understand a growth factor that tumors use to make new/more blood vessels) properties. Grover is already on a different medication for systemic hypertension (unrelated and pre-existing) so the switch seemed intuitive for us and after asking around to other places that have used it in clinical trails no adverse effects were reported with that medication.  

It has been a painstaking decision for me, but at this time we have decided against using the Aratana Her2/Neu vaccine. We were not eligible for the Univ. of PA vaccine clinical trial but could have had off-trial access to the Aratana version of the vaccine. All along this had been my plan, but I have become increasingly uncomfortable with the lack of safety data the company is willing to share and recently heard that one of the clinical trial sites pulled out for the same reason as well. Psychologically, this has been an incredibly hard decision for me – I wanted to do EVERYTHING for him, but a company that wouldn’t share their basic safety data was making me increasingly uncomfortable. I hope it’s the right decision and who knows maybe we will change our minds at the end of the day. 

I have to say though that I have been overwhelmed by the kind responses that I have received from osteosarcoma researchers at other universities – those people do amazing work and couldn’t have been more generous with their time and knowledge. 

In the mean time Grover says “what’s a met?” and continues to love life every single day. 

Virginia




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17 September 2019 - 8:45 pm
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jkopper said

In the mean time Grover says “what’s a met?” and continues to love life every single day. 

  

Grover sums it up beautifully.   Dogs are so wise.

In unchartered  territory, sometimes following your gut and listening to your inner voice, outweighs anything research can offer.  Yeah, not sharing the safety data on that vaccine is concerning.

Thank you for sharing the plan you are following with Grover.  It certainly  sounds encouraging and “logical”.  And no apparent  side effects?  Yay!

And make no mistake about it, your love and devotion  to  Grover comes shiniing thrpugh.  You ARE doing everything  for Grover by putting his best interest and focus on quality  first and he KNOWS it!!  

Picture time!!!  Always love looking at pictures of that majestic boy.  Hint!

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!

The Rainbow Bridge



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17 September 2019 - 9:22 pm
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I haven’t heard that about the vaccine, but I see why it would concern you. Following your heart and your gut feeling is the way to go in this situation. It’s the best medicine for Grover, and knowing you are at peace with the decision is what will make him happiest. Good job! 

Yes, Losartan does hold promise! Dr. Seguin from Colorado State talks about it in our interview. It is still in the study phase but looks hopeful according to him and obviously other clinicians. We’ll keep our paws crossed for Grover!

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