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Ronnie, suspected Osteosarcoma amputation this week.
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8 July 2019 - 9:13 am
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We LOVE our harness, and it has helped a great deal with Mitchell’s mobility problems. When I was a vet tech, we always recommended harnesses for smaller dogs and dogs that had issues like a collapsing trachea. Taking that pressure off of his neck should help a great deal. 

He is totally gorgeous, by the way… and CONGRATS on clear CT scan!!!

Hugs,

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

Huckleberry's Blog

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6 August 2019 - 12:26 pm
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HI,

Brownie and I was just wondering how you and Ronnie have been?  We hope the both of you are doing well.

The Rainbow Bridge



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6 August 2019 - 1:35 pm
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Yessss! Do update when you can. Thanks for pinging this discussion, brownie!

It's better to hop on three legs than to limp on four.™
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6 August 2019 - 1:42 pm
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I miss seeing pictures of that little happy guy!

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12 September 2019 - 3:30 pm
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Hey everyone! i know its been a while and apologies for not keeping the updates going. Ronnie has last week completed his cycle of 6 sessions of carboplatin chemotherapy. Prior to the session he had a CT scan with side by side comparison with the previous 2 CT’s taken prior to amputation and at the time of his 3rd chemotherapy session. The out come according to the report?

‘Today was the final carboplatin treatment and it is great that Ronnie is still in complete remission from his
osteosarcoma’

So this means that so far, so good! he’s still in good spirits and taking the treatment after effects in his stride with very little discomfort, the most significant being the slight hangover he seems to get for 24 hours from the sedative or GA.

So! next steps this is where i need some advice. Our Oncologist has been very clear about the potential treatment and isn’t steering us in one way or another, but we are due to go back around in a weeks time ‘IF’ we decide to go through with the next step. From a financial POV, this is pricey but not an issue and all being well from December onwards the insurance will pick up the cost once the policy claim limit renews. 

I’ll post the follow up notes verbatim below and the only question is, do we or dont we?

Follow up
Today was the final carboplatin treatment and it is great that Ronnie is still in complete remission from his
osteosarcoma.
Going forwards there are two options:
1) Active monitoring (regular repeat CT scan and clinical examination)
2) Low-dose oral chemotherapy at home (~£250-300 per month)
The aim of low dose chemotherapy (cyclophosphamide + thalidomide + anti-inflammatory) is to slow down
tumour progression by limiting the production of blood vessels and simulating the effects of the immune
system against the tumour. There are only a small number of studies looking at using low-dose
chemotherapy tablets in osteosarcoma and these studies suggest there might be a benefit to delay disease
progression. However, the evidence is weak and the benefit of low-dose chemotherapy in uncertain.
Cyclophosphamide is given every day at home and are usually well tolerated although some dogs can
experience diarrhoea, vomiting or loss of appetite. Low-dose chemotherapy can also cause a decrease of the
white blood cell count and platelet and we will monitor that – this is uncommon and typically occur on a
longer term. More importantly, 20-30% of the cases treated with low dose cyclophosphamide can develop
a condition called sterile haemorrhagic cystitis (inflammation of the bladder and associated blood in the
urine). This is usually mild and usually switching to another chemotherapy medication is sufficient to resolve
the symptoms. However, for some dogs, it can be serious and be difficult to resolve. We would ask you to
monitor Ronnie’s urine every week at home using a urine dipstick to check whether there is any microscopic
traces of blood in Ronnie’s urine. We would also start him on a tablet which would encourage him to drink
and urinate more to reduce the amount of time the chemotherapy breakdown products sit in his bladder
and therefore reduce the risk of this condition.
Thalidomide is given every day at night and side effects are minimal. Only a mild sedation can be seen after
administration and it is usually non-significant when administered before bed. Thalidomide can cause
malformation in babies and caution is warranted.
As we discussed please make an appointment for Ronnie in 2 weeks’ time to start these tablets. Please bring
a fresh urine sample to this appointment. If you have any concerns in the meantime please feel free to
contact us.
Whether or not we start the chemotherapy tablets we would recommend repeating the CT in 3 months’
time to assess for any tumour recurrence.
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12 September 2019 - 3:38 pm
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And what good is any Ronnie update without a Ronnie pic or two?

Here he is at our groomer, The Dog House in Tottington getting a little pamper

View this post on Instagram

Bath time… #puggle #pugglesofinstagram #beagle #dog #pug

A post shared by Ronnie (@ronniethepuggle) on

And this was taken just before his final chemo

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12 September 2019 - 4:09 pm
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That is terrific news! What a wonderful pupdate sp_hearticon2 And the pictures… he has the most smoochable adorable face. I am really, really glad that you are all doing well sp_hearticon2

Hugs,

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

Huckleberry's Blog

The Rainbow Bridge



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12 September 2019 - 6:28 pm
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Awww sweet Ronnie! It’s so good to see your handsome face. I’ll bet you just smelled soooo good after that spaw day! We always appreciate those pupdates.

OK so as for the metronomics decision…that’s a tough one. Everything your onco vet said is spot on. In the recent past, we would always say “Yeah, metronomics is a good idea!” But after recently interviewing CSU oncologist Dr. Bernard Seguin, we won’t be so quick to say “Go for it.” It’s such a toss up now. I would say that if you can afford to pay for the treatment, and Ronnie tolerates it well (most dogs do), then it’s just like trying out an herbal supplement: if it doesn’t hurt, and doesn’t make him miserable, or you broke, then why not? 

Here is that interview with Dr. Seguin:

It's better to hop on three legs than to limp on four.™
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Virginia




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12 September 2019 - 9:12 pm
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CUTENESS ALERT!!!   ADORABLE ALERT!!!    PRECIOUS ALERT!!!   Grinning ear to ears big it hurts my face looking at those pictures of Ronnie!!   

And on top of all that cuteness we get to CELEBRATE  end of chemo and a PERFECT check-up!!   We are all,over rhe moon happy for you and Ronnie!!!

As far as the metronomics , just like everything  else on this journey.  There are no right or wrong decisions.   No guarantees  one way another.

In addition to the “research aspect'” of any further “treatment”, on thing you can ask yourself, “I  I don’t  pursue any additional treatment,  am I comfortable with that decision?    Is it time to free Ronnie up from any more Vet visits, no more poking, prodding, etc, with no regrets or second guessing?”

Finances DO have to play a role.  Some are not even able to pursue chemo because of finances.  Same thing, sadly, about amputation..  How each dog handles Vet visits, carrides, etc, all play a role in sections  for them.

The Onco for my Happy Hannah recommended  four rounds of carboplatin.  After completing  that I did Metronomics (this was six years ago) for a couple of weeks.  If I recall, she did develop at UTI.  Additionally,  more Vet visits for bloodwork and checkups were necessary every….whatever…couple of weeks.  Anyway, at that time, it wasn’t  just a matter of giving  pills at home, it still inv Vet stuff.  I just wanted to free her up from that,  And the UTI wasn’t  a good sign.

Anyway,   all that’s in the “for whatecer it’s worth column”.  Others who did pursue metro can share their views and their experience.

Afain, no right or wrong!  Clearly Ronnie is thriving and that’s  all that matters!! YAY RONNIE!!!

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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14 September 2019 - 8:45 am
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YEAH! Ronnie is back! Brownie and i was wondering how you two were doing. Happy that everything is going well!

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17 September 2019 - 3:12 am
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Thanks for the well wishes all, i think what we’re going to do is start the daily chemo and see how he takes to it. if i feel a behavioral change takes place or he isn’t as comfortable or happy then we can cease and continue as is managing with only diet and exercise. 

I had a chat over instagram yesterday with Sawyers owner Ashley @bluegrasshoppercreations about post chemo care as they’re such an inspiration to see him cancer free still 30+months later, and got some great tips around supplements and it’s made me see that the metronomics aren’t quite the necessity i saw them as, but i still think it’s prudent that seeing as i can afford it, i give him every chance possible. 

We are back over to start the new tablets from Thursday this week so expect the updates to start coming more regularly again as i try to chart the progress for other owners in the future. 

thanks!

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17 September 2019 - 3:48 am
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Fingers, toes, paws, and tails crossed for you guys! He is truly a lucky pup to have someone that takes such good care of him. I am glad that you have had an opportunity to chat with a cancer survivor’s pawrent too. It’s so amazing how things align just at the right time. 

Will be looking for your posts and of course more adorable pictures smiley4

Jackie and Huck sp_hearticon2

Hugs,

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

Huckleberry's Blog

Virginia




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17 September 2019 - 9:03 am
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Glad you’ve  decided  on a plan that feels right for you and Ronnie. 😎

And yes, keep the good updates coming…HOWEVER…they must ALWAYS include pictures!!  We cannot get enough of Ron ie! He is such a smile maker!😊

Hugs

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

PS. When you do update, we would love to hear what supplements  Sawyers Mom suggested and which ones, if any, you are adding.  We all learn from each other.  Thanks!

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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