Caring for a Three Legged Dog or Cat
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Osteosarcoma 13 1/2 year old chocolate lab
Well, I had typed up a long reply (and thanked Sally) and then UF called me with an appt. for Honor the following morning as they had a cancellation and I left my post unfinished while I scrambled to make plans and my ipad ran out of power so it was lost!
Anyway, Sally, thank you for those suggestions and I feel like you should be (or maybe are?) a counselor or motivational speaker!
I drove Honor over to UF yesterday. I felt terrible as he thought we were doing our usual 3 minute drive over to the lake and it was a 2 hour 10 min. drive to UF then 3 hours of him waiting around then a 2 hour and 30 min. drive home (because I missed a turn). Ugh.
As expected, I didn’t learn anything very new. The surgeon examined him and said she did not see any reason why he wouldn’t do okay after amputation. She agreed that his walking right now is not great after the stereotactic radiation, but she also thought things still might get a little better and, after spending all that money on the radiation, it made sense to wait a little longer to see if things improve and we can get the pain under better control. I asked about cementoplasty and they have done it there a handful of times. She said it is mainly palliative and can help with pain. She would be willing to do it. The problem is she said there is @7 percent chance of thrombus to the heart, lungs or brain ….which would result in death. 7 percent seems high? Almost 1 in 10? I don’t know what product they use. I’m going to write to bioceravet and see what their stats are on that.
I asked about limb sparing type surgeries where they put in a plate and she said he may well be a candidate for that although there could be some skin issues from the radiation but she said there is a 98% complication rate with those surgeries which means the dog is frequently going back in there and some end up amputating. She said that can be a quality of life issue question. So, not sure on that….especially since they are not an easy drive away. Also asked about prosthetics and not amputating the full limb. She said, with dogs his size, that usually doesn’t go well plus they’ve found that the dog having a partial amputation is more confusing/more uncomfortable for them.
I asked about immunotherapies but, as my consult was with surgical oncology, she said she would have to try to get someone else to get back to me on that.
I guess the main purpose was to get him registered as a patient because now, if we have a problem, we can get him in there much more quickly. For example , in the terrible case he fractured, we could bring him to their 24/7 emergency room where they could get him on IV pain meds but then the oncology surgical team could do his amputation.
The surgeon’s suggestion was to wait a couple weeks and see how he is doing. If things actually get worse then, yes, we may need to consider amputation again. She said, at that point, we could also consider trying the cementoplasty to see if that helped. Unfortunately, since he is also on chemo now which lowers the immune system, that makes surgery less ideal but they do treat with antibiotics in advance in that case. I don’t know if cementoplasty or surgery would be more risky….probably a question I should ask.
Eustacia! Glad to hear you were able to get into UF! That has to be a sigh of relief to be registered with them and have them as an emergency back up.
That's so interesting about the cementoplasty, I wonder why it's so much higher? With that said 93% not getting it sounds a lot better, but I would raise an eyebrow at 1 in 10 too. I would think the chance of infection would be lower in cementoplasty than amputation, but I'm not sure. maybe something to consider with him being on chemo already.
I know I'm being pretty bias towards cementoplasty, I just love the idea of there not being any recovery, I am envious of that, and he could keep his glorious coat (I know that doesn't matter in the grand scheme of things, but still!)
How is he doing with chemo? I'm hoping no news is good news on that front?
Good to hear from you Whitney. I’ve been thinking about you and appreciate your support so much.
I like the concept of cementoplasty as well. I just can’t figure out why more aren’t actually doing it…especially since it’s done in humans. Until she gave me that 7 percent stat, I was feeling really happy I finally found a place to do it. Unfortunately, I tend to be the type of person that will focus on the 7 percent chance of a bad scenario instead of the other 93 percent. I know it is probably ridiculous to worry about 7 percent when my dog has a terminal cancer. I just think it would be extra horrible to lose him that way and I would forever blame myself for having tried it.
Fortunately, I haven’t seen any chemo side effects….beyond that first night which we aren’t even sure if that was the chemo. When would we be out of the “danger zone” after having it done? It’s been a week as of today. They don’t check his bloodwork again until he goes in for his 2nd one on the 18th.
I took him over to the lake this morning and we stayed extra long to make up for yesterday!
So, someone in a Facebook group I’m on said her tripawd dog (amputated due to cancer) will be auditioning for America’s got Talent Tues 8 pm NBC! Thought some of you might like to watch as well.
Sooooo glad to hear from you! Actuall started getting a little "worried" there had been a downward turn. So see, it's easier to give "advice" that motivates, but it's hard sometimes to "practice what ya' preach". So yeah, I started "worey8ong" and thing bad instead of good! I needed to put that river band on my wrist and snap it a few times!
Thank you for taking the time to go into detail. You asked great questions and uou got great answers with a much clarity as one can get with so many "unknowns"
This what I got from your feedback.
Honor is s good candidate for amputation You have had that verified over and over again from Specialists on many different t levels of expertise.
You can pretty much take prosthetics off the table and partial amputation of the table for all the reasons menioned.
Limb sparing has an extremely high complication rate (seemingly almost guaranteed), back and forth Bet spots ending up in amputation anyway. So guessing that's off the table too
Cementoplasty with a 7% chance of a "complication" that is instant death is definitely concerning. The fact that they have only "done a handful", probably because not that maynhave been done across the cou try.....anyway, that would be concerning too. Don't know what the "death risk" is with amputation surgery. Can only say it's rare on this site that we ever see a dog have a complication resulting in death during amputation. It has happened but certainly not 1 in a 100.
Waiting to see if the stereotactic radiation makes things better..... Seems to me the Specialist who did that treatment said it may take up to two weeks for maximum effect. GWIW I would contact them again and see if Honor could still get more improved results by waiting another couple of weeks
Okay, keep managing Honor's pain and give him special relaxing time at the Lake.
Oh, as far as chemo side effects there shouldn't be any this far out. Obviously every dog is different, but Honor should be oit of the"danger zone". FWIW, I do think we've seen on rare ocassions where side effects can show up in the first 24 hrs. Rare but it does happen if I recall correctly. 2hqtever "it" was, you addressed it and took care of it!
And thanks for the AGT tip highlighting a tripawd!!!
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!
Wow that sounds like a really informative meeting! Totally worth the drive don't you think?
Who was your oncologist? I think their input was spot on, for everything.
I like the concept of cementoplasty as well. I just can’t figure out why more aren’t actually doing it…especially since it’s done in humans.
New procedures like this tend to happen slowly in any kind of medicine, there just needs to be more studies done with dogs for it to be embraced by the vet community.
Here is a link to the Biocera vet studies (scroll down to where it says Download Full Report):
Thanks for that. I found the email of the vet that I consulted with and forwarded it to her to ask if they are familiar with the product and whether it might have a lower complication rate.
I thought I’d mention that the discharge/summary sheet from both the place where Honor had his radiation and UF mention this website as an excellent resource for owners with pets who are considering/have undergone limb amputation!
Eustacia said
I thought I’d mention that the discharge/summary sheet from both the place where Honor had his radiation and UF mention this website as an excellent resource for owners with pets who are considering/have undergone limb amputation!
WOW! Super cool, thank you for sharing that, it's a real honor that they mention the community! 
The Dr. I consulted with at UF was kind enough to reply to my email and she is further looking into BiceraVet for the cementoplasty. She noted their study did use only a small number of dogs, but she said she’s contacting them to try to get further information and (I assume, pending what she finds out) she is willing to use the product for him.
I also heard back from the Department that focuses on Immunotherapy. As expected, Honor doesn’t qualify for any of their clinical trials now since we did the radiation. They suggested looking into the Yale vaccine, Elias or Torijen. The latter two require live tumor cells so I messed up those opportunities when I did stereotactic radiation. It’s really back to the Yale vaccine as being our only option. Even if I could overlook the strain of the long drive on Honor, I’m worried that we would be in a hotel in an unfamiliar place and he would have some kind of medical issue like a fracture or a chemo bad reaction and we wouldn’t be anywhere near all of the providers I’ve set up for him. I determined the other day that I can’t drive for more than 4.5 hours in a day so it would be a 3 day drive there then 3 days back and multiple hotel overnights. And, unless we stayed for 3 weeks, we would have to do it all over again 3 weeks later. It just seems like there is far too much room for something to go wrong. And, this is all assuming, I leave my husband with our 2 teen boys (who will be back in school with multiple sports to be driven around to) and all of our other pets while he is working a very hectic job. It seems like it leaves too much open to go wrong on that side of things too. He is willing to drive Honor and wouldn’t need to stop as much, but then Honor wouldn’t have me which would be extremely stressful for him for that amount of time. I’m just trying to tell myself there have been people who have done amputation and chemo and their dogs have made it 2 plus years. There are people who have only done amputation and their dogs have made it 2 plus years and there are people who have done some combination of those things with the Yale vaccine and their dogs have made it 2 plus years. By not getting it, it doesn’t mean he won’t beat the stats. By getting it, it doesn’t mean he will beat the stats. If it was within maybe a 6 or 7 hour one way drive, I’d get it for him…. because it probably couldn’t hurt but the extra long drive makes it far more complicated. Does this thinking seem correct?
Yes it seems correct. That long drive is a huge commitment and really messes with the family / pack structure, which may stress out Honor more than its worth. Dogs like structure and knowing their people are happy. If a drive like that will stress out everyone, to me it doesn't seem like good medicine. We opted out of chemo for our Jerry because the nearest clinic was 6 hours away, so similar situation, I totally get it.
Thanks for updating us about your vet looking into cementoplasty. That's super cool, let us know what they say.
I don't have much to add except for how proud I am for you setting boundaries on what is feasible for you and your family. Everything you stated makes a lot of sense, and I hope lets you make some contentment with whatever decision you decide, and when the what ifs come up you can remind yourself why you chose what you did. Someone has mentioned writing those down so you can look back at them later...because there will be a later.
Yeah, agree with your logic that this is just not feasible for soooo many legitimate reasons. Anf to put Honor through all the various stresses you mentioned is not adding to his quality, but taking away from it,
Continue. to stay present with Honor and enjoy the now. Regretably there are no crystal balls telling us what approach gives us the most extended quaily time. All we know is we must not squander whatever time to we do have
💖💖💖
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!
Last night was not very good. Honor wasn’t so interested in dinner. He ate the ground turkey that I put on top of it, but nothing else (this may be the first time I’ve ever seen him not finish dinner). Then he was up most of the night needing to go outside with complete water consistency diarrhea and that has continued into this morning. He also started licking his lips again as if he was getting nausea too so I gave him one dose of the remaining 2 doses of cerenia I’m down to having left.
Of course, it’s Saturday, so the cancer clinic is closed and I can’t ask them to prescribe something. I have 3 days worth of Flagyl left, but am kind of afraid to give him that again since I still don’t know if what he experienced that first night and next day after chemo was the flagyl or chemo.
I have proviable but he’ll only take that mixed into a little food and not sure I can (or should) try to have him eat anything.
I set some water in front of him but no luck getting him to drink it so will try bone broth in a bit.
No lake this morning. 🙁
Bummer.....and like you said, these "issues" always pop up on a week end. Ugh!
Yeah, other than some small amounts boiled rice and chicken I wouldn't try to give him much of anything else right now. And maybe even hold off on that until later tonight.
Don't have any input on the Flagyl for you.
Just to rule anything out I would take a sample of his stool into the Vet and make sure there are no parasites, bacteria etc. Obviously the Vets are closed right now but you could do that Monday morning. You can take a sample Sunday evening and store in your refrigerator. I know, that sounds gross, but if it's going to be 12 to 24 hours before you can take the sample into the vet, you can store it in the refrigerator. You only need a small amount.
How does he seem to be doing pain wise as far as his leg?
Let us know how he's doing later today. For now, just give his tummy a rest and yes, if you can get him to drink some water, that would be good.
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!
Just to say I appreciate how awful it is to wait out a weekend when your boy is feeling terrible! And these issues often seem to arise on the weekends. This entire experience has helped me to appreciate my own primary care vet more and more. I can speak to him anytime on the phone, weekends or no and he knows my dog well.
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