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3-Month Post-Amp, Mets found, Need Advice for the Coming Weeks
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Member Since:
7 November 2015
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31 January 2016 - 8:53 pm
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Hi, I've read many posts on here and have made it this far in our journey from reading others' posts, but now I need advice from this incredible community. My ~70lb 7yo shepherd mix, Napoleon, got diagnosed with osteosarcoma in Nov (2015) after a noticeable limp that was not responding to the 2wks of NSAIDs the vet gave thinking it could be a sprained wrist. He had his left front leg amputated two days later. We immediately started 3 rounds of chemo (once every 3 wks) alternating carboplatin, mitoxantrone (newer drug similar to doxorubicin but with less cardiotoxicity), and carboplatin again. He handled the first two rounds like a champ and had some side effects with the last round and didn't recover as quickly according to his blood work. We went for his 3-mo recheck chest x-ray last Monday and, unfortunately, there were two visible metastases a little smaller than a quarter in his left lung. Since they were able to grow while he was on chemotherapy, the vet and I agreed that doing more chemo wouldn't be best for his quality of life, given his most recent round. My instructions were to keep an eye on his breathing/panting and let them know of any changes. The vet said he has several weeks-few months at best. 

I understood that there were only two ways to come out of a recheck visit: mets or no mets & wait to recheck again later. But no matter how much you think you've prepared yourself to hear both, there's really no preparation for that kind of bad news. I know I probably don't have to explain this to the readers in this community, but "devastated" is an understatement. I rescued him at 8wks old during my sophomore year in college and he's been with me for my entire journey of really growing up, and now I am a medical student. I've always taken him with me wherever possible and every decision, from vacations to length of study time, revolves around making sure he's taken care of and happy. Now, I make sure to not waste any moment with him. I am a positive and optimistic person but this has given my heart an anvil to carry, when I'm not busy/distracted enough to block it out.

I love him so much and I don't want him to suffer and I don't want to lose time with him. For anyone that has been through this process or know someone who has, how do I know when it's time? He still LOVES walks, although he noticeably gets tired more quickly and more time is spent laying in the neighbors' front yards in the sun (which I gladly allow), and pants more often. He is also still eating well and no noticeable changes there. The more information you can lend, the better. My huge board exam is in April, which is "several weeks-few months" away, and I want to be as prepared as possible for this process so that I can plan for many scenarios if/when the time comes, especially if before April. I'd rather know sooner so it has time to sink in. I really appreciate everyone on here and thank you in advance for any responses. God Bless. 

Livermore, CA




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31 January 2016 - 9:12 pm
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Welcome to the forums, your future posts will not have to wait for approval.

I'm sorry you are facing lung mets with Napoleon.  As with the whole cancer journey the lung mets part varies greatly.  I don't have direct experience, my pug had a different type of cancer, but there are many here who can share their stories.

Did your vet discuss metronomic therapy with you?  I know many here have used that for their pups after met diagnosis. HERE is a link to a thread with info on metronomics.

There will be more people along tomorrow to share their experiences with you.

No matter what, Napoleon doesn't know anything about this. He is living his life with joy in each day as dogs do.

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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31 January 2016 - 9:47 pm
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I'm so sorry you're having to deal with lung mets. I, too, am wondering if you'd want to ask your vet about metronomics . I was told that they could try that with my Susie if they found mets in her lungs during rechecks. I was told the metronomics wouldn't cure her cancer, but they could buy her time.

And, as long as Napoleon is enjoying life and food and his walks (and it sounds as if he's really happy), he is living, not dying! I know it's really hard, because we have a human (long-range) viewpoint, but the more that you can live in the moment and enjoy the hours and days and weeks and months that you do have with Napoleon, the better.

I totally understand how devastated you are. As far as knowing when it's time, I think Napoleon will tell you. When you can't control his pain and he can't (or won't) eat, and life becomes a burden for him instead of a pleasure, then it may be time.

In the meantime, Napoleon knows how much you love him, and how you've always given such consideration to his care. Even though the vet said, "several weeks or a few months," I hope others will chime in with accounts of how their dogs beat the "statistics" by many more months--even years! As a medical student, you probably already know how human patients can confound a doctor's prognosis. I think dogs are even better at that, as they live in the moment, so they always have all the time in the world.

((((hugs))))xxx to you and Napoleon! You sound like a wonderful team!

Nancy & Susie

Virginia







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31 January 2016 - 10:26 pm
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Look at that avatar picture and know that Napoleon doesn't give a rip about any ole' xrays!

We don't like to put too much weight into statistics and timeframes around here. For starters, Jerry had an extraordinary seven months after mets showed ul, as did Sassy! And seven months in doggy years is equal to over three years in human years!

Yes, you can't really "prepare" for the news. I can only share my experience with my beloved Happy Hannah, a somewhat "fluffy" Bull Mastiff. My Bet said, "It's the sixe of a baseball!" The met was the size of a baseball. I wouldn't look st the xray. I couldn't see through the tears anyway, but I refused to acknowledge it existed. Somehow, vy not looking at it, I didn't give it any "power over us". Nothing had changed in her world. And I was committed to keeping it that way as long as I could.

Your love for Napoleon comes shining through with every word. Your commitment to his well being is clearly unstoppable! While you feel like you have had the oxygen has been sucked out of you and you have been kicked in the gut, this is by no means the end of the road!

Happy Hannah had SPECTACULAR exte quality time even after the "baseball" size thing was found. Sure, there was tiredness and some off and on cha ges in breathing patterns, but as long as she was getti g loved and spoiled and tummy rubs and scoops of ice cream and steak and anything she wanted a ytime she wa ted it, she was HAPPY!!!

I did introduce Prednisone into the mix when needed to help with her breathing. I also used some Tramadol on occasion to help her rest comfortably when needed. Must letting you knlw there are thi gs that can be done to help symptoms when needed.

Like everyone on this journey, we know everyday is a bonus day. We also vow from day o e not to let them suffer, if at all in our power. Sometimes it is, sometimes it isn't.

In my Happy Hannah's case, we were "lucky". She never missed a meal and she always wagged her tail. As our treasured and sacred time went on, it became such an exhausting effort to go out and do her "bidnezz", she would come back in and plop on ner bed, always happy, always wagging. She started having more difficulty sleeping. It wasn't a case anymore where she may have some good days and some bad days. It was a case where time coukd start being her enemy. It was a case where she didn't need to stay around anymore if it was starting to be too much of an effort to get more loving and spoiling. Happy Hannah was loved and spoiled everyday of her life, without having to be exhausted.

So, for me, there was no "look in jer eyes", she still had an appetite, but it was taking "effort" to for Happy Hannah to be Happy Hannah. She was on her Big Barker Bed laying in front of her woodstove eating a celebration dinner of steak, ice cream, M&Ms and her favorrie food of all time, a scoop of DEER POOP! I made it a party. I applauded her for a job well done. She transitioned seeing me with a smile on my face, being hugged, and wagging her tail and licking the last morsel of deer poop off her mug.

Your love for Napoleon is so strong you will NOT waste one precious second on the future. You WILL stay fully present in the NOW. You will greet everyday with joy and gratitude and excitement about how else you can fill Napoleon's bucket list! Napoleon is goinb to be crazy happy at all the McDonald's Cheeseburgers and bowls of ice cream he gets! You will let nothing rob you of your time together! You will do all this because you love Napoleon so much.

You asked. I sincerely, with all my heart, hopes this helps.

Sending you all the love in the world

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!

On The Road


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1 February 2016 - 9:48 am
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{{{{hugs}}}

I know what this is like, and it hurts like anything. But yes, look at Napoleon, he's still the same dog and doesn't care what the reports said. He feels great and he's loving life, and he wants the same from you too. Of course that's hard knowing what you know, but pretend you don't for a minute, pretend you see the world as he does, and you will see that the reality is, all we have is right here, right now, so why not make the most of it?

Our own Jerry was diagnosed with mets at 17 months out. He could have had them all along, we don't know because we never did xrays. When we found out, he wasn't showing signs, he was the same old dog. But what changed was we decided to try metronomics and K9 Immunity and it gave him seven more great months of quality time. Of course it wasn't long enough but it was icing on the cake and we don't regret a thing.

Work with your oncologist to come up with a plan to manage the mets. They are not an instant death sentence, they just need managing and there are many ways you can do that. We have lots of posts about it here in the community so check this post for metronomics and you'll find some links.

Stay strong and know that we are here for you both.

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

Member Since:
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1 February 2016 - 11:49 am
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Boy did you ever come to the right place.  You've got some dynamite information posted in those replies.  I have a different twist to add that gives you more options.  I have blogged our entire experience at sweetpatches.tripawds.com but let me summarize briefly for you from diagnosis to now.  

So, Patches, my 45 lb Canaan started without a limp but we noticed her "tripping" around June 2015.  After a progressively worsening limp she was diagnosed with osteosarcoma and suspected lung mets on August 21st and had left front leg amp August 27th.  She got three rounds of carboplatin and unfortunately the prominent nodule went from 5 to 8 cm.  The vet suggested Palladia, which she has been on since November and I saw a show on cannabis oil being used experimentally in oncology patients which the vet said was ok to try so she is also on the CBD oil.  We are 5+ months post op and to date Patches has been happy, energetic, hungry and comfortable. She has chased her frenemy more times than I can count, including today. She was supposed to have a re-scan today but the vets office made a mistake so now we wait until next week.  I am hyper vigilant for signs of discomfort or difficulty breathing.  There are none.  Her blood work on palladia has been fine.  She tolerates the regimen like she's not even on medication.  The drawback for some with this regimen is cost.  It's not outrageous, it's less than the carboplatin cost but it's still a three pill a week regimen and the CBD oil comes in syringes that last up to two weeks.  

I will be giving updates on Patches in my blog after our reevaluation.  Please know......I definitely know how you feel.  Everyone in this community does.  There aren't words to describe how I felt upon diagnosis, during and after amputation, during chemo and presently.  But this community got me through all the emotions and some of the toughest times.  I know you will find the information you need to make the most informed decision and please, feel free to reach out to me for any information I can provide.  I wish you the best of luck,

xoxo

Debbie and Patches

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1 February 2016 - 12:08 pm
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Thank you for your encouraging words! That is very helpful. I have looked into some of the links posted on metronomics and it seems that they've mostly been used when there is no evidence yet of mets? But it also says that they're starting to give it a try when mets are present. Has that been the case with any of you? Since there aren't any true veterinary oncologists in our area, we see an internal medicine vet but he deals with a lot of the canine cancers around here and has been open to new information when it seems helpful. I will certainly ask him about this as an option! 

Did those pups who had metronomics seem to be affected by the low-dose chemotherapy (i.e. neutropenia, lethargy, GI problems, etc.)? 

Virginia







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22 February 2013
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1 February 2016 - 3:17 pm
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Just wanted to add a PS ro my earlier post. I did do metronomics for a couple of weeks with Happy Hannah with no side effects per se. However, she did develop a uti which is something that happens quite often. Should you go that route, you'll want to make sure Napoleon drinks lots of water and take him out to pee often. It helps if you give the pills in the.morning so you can take him out often to pee.

And I had Happy Hannah on the K9 Immunity during her one year and two month Victory Tour!

Others who were in it longer can give you their input.

Another thing I'll throw out that some have used here is Lukeran (sp). It's also in the "unproven" category like metronomics ,

Jerry or Michelle can give you the link to a great discussion on Lukeran and Metronomics that Katy (Jackson) started a year or two ago.

Should I ever be faced with this journey again, I would definitely check further into Cannabis as well if mets were found.

When you can, you know we have ro see some more photos of your handsome boy!

More hugs to all

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!

Schofield, WI
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13 August 2015
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1 February 2016 - 4:33 pm
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You've gotten such great advice from everyone here but I wanted to stop in and offer support.  Sending positive good energy yours and Napoleon's way.  Please keep us posted on your journey because your experiences will help others traveling this same road.  Hugs,

Linda, Ollie, Riley & Spirit Mighty Max

Orrtanna Pa.
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1 February 2016 - 5:21 pm
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I agree, great advice! That's what you get on here. I have no experience with mets, we did not get to that point, just wanted to reach out and give a virtual ((((hug)))). You get those here also! Lori, Ty & Gang

TY GUY, Best Black Lab ever! Diagnosed  and had amp in January, 2014. Kicked MRSA's butt. Earned his angel wings on April 16, 2014. Run Free my boy and don't forget a shoe. Ty is a proud member of the " April Angels". Ty sent us Daryl, a Tripawd rescue in Sept. of 2016. Daryl is 5 +or -. We are also Pawrents to Chandler, a Border Collie mix who is 15 and 1/2, Lucy, a Corgi who is 7, 2 minis, 2 horses, and a feisty cat named Zoe. Zoe had a non skeletal Osteosarcoma removed in July 2015. No Chemo, she was at least 16. She is going strong although she is now completely blind. She is now close to 20 and her hobbies are eating and sleeping in front of her personal heater. 

On The Road


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1 February 2016 - 6:04 pm
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jessieall8 said
I have looked into some of the links posted on metronomics and it seems that they've mostly been used when there is no evidence yet of mets?

We did not start Jerry on metronomics until about 18 months post-amp when we discovered at least three considerable lesions on his lungs. Click any of the highlighted -> metronomics <- links for details about his treatment.

Did those pups who had metronomics seem to be affected by the low-dose chemotherapy...

Jerry had no noticeable adverse side effects from his Cytoxan (cyclophosphamide) metronomics .

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





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1 February 2016 - 7:51 pm
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Ok here goes my take.   Sassy was diagnosed approx 3 months after amputation with lung met which put her between her 4th & 5th chemo.  I know that feeling devastation doesn't describe it either.   She survived 7 3/4 months with lung mets almost 8.  I say she won her battle.  We stopped chemo and did metronomics .  Sassy did Cytoxin & an NSAID about 5 months after doing the Cytoxin she got Cystistis (like a uti).  We stopped that and did Leukeran.  Like Sally said it doesn't have the "studies" behind it like Cytoxin does but does not have that side affect.

Would i give the metronomics again yep I sure would.  Sassy really didn't have any other side affects until the end she didn't want to eat but I that was towards the very end.  I wasn't sure totally when it was time except that she was scheduled for a follow up appointment and was having troubles breathing.  I knew when I took her in and the vet had this look on her face that I wouldn't be taking her home that night.  She had fluid on her chest cavity.  I was told we could drain it.  Two things could happen she wouldn't make it through that procedure or she would and if she made it through the fluid would come back.  Not a matter if it could it would come back and it would be worse.  I made my decision to give my girl the best gift I could give her.  She still smiled and waggled.  She just had problems breathing.  I let her go that day.

You know your fur baby you will watch for those signs.  I know I made a promise I wouldn't let Sassy suffer so I stuck by my promise to her.

here is one article that Katy wrote

http://tripawds.....-leukeran/

here is the other one this one is about 4 pages long

http://tripawds.....tronomics/

sassymichelle-sm.jpg

Sassy is a proud member of the Winter Warriors. Live long, & strong Winter Warriors.
sassysugarbear.tripawds.com
07/26/2006 - Sassy earned her wings 08/20/2013

05/04/2006 -  Bosch, Sassy's pal, earned his wings 03/29/19  fought cancer for 4 months.

"You aren't doing it TO her, you are doing it FOR her. Give her a chance at life."

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1 February 2016 - 8:59 pm
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I have no experience with metronomics (as my dog is only three weeks post-surgery and her chest X-ray about a month ago showed no lung mets), but I was told by an oncologist at K-State that they are what could be used IF Susie developed lung mets. I got the impression they'd use carboplatin first, then metronomics if lung mets developed.

pennsylvania
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2 February 2016 - 9:55 pm
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jessieall8 said
Thank you for your encouraging words! That is very helpful. I have looked into some of the links posted on metronomics and it seems that they've mostly been used when there is no evidence yet of mets? But it also says that they're starting to give it a try when mets are present. Has that been the case with any of you? Since there aren't any true veterinary oncologists in our area, we see an internal medicine vet but he deals with a lot of the canine cancers around here and has been open to new information when it seems helpful. I will certainly ask him about this as an option! 

My vet essentially explained that there is evidence to show that metronomics can shrink lung Mets and help when lung mets are present. But that there is mixed evidence when it comes to preventing lung mets from developing. However the side effects of metronomics are very low, so there is often not a large risk to using them preventatively before lung mets are present. Again, that's just the advice of one vet. 

Murphy, became a tripawd on August 17, 2015. Went to the rainbow bridge on July 5, 2016.

http://www.inst.....hythedingo

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15 February 2016 - 10:12 pm
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I've talked with my vet about the metronomics and was told that Napoleon would be a candidate but they had to order them at the office as the medicines were not in stock. That took a few days and then my vet was out of the country and Napoleon's breathing condition worsened last Tuesday. It was the first time that I got home from class and he didn't want to go outside on a walk and he wouldn't even get up. I did get him to eat his food by adding sweet potatoes and some gravy from a baby food meal we had on hand as a just-in-case and he was still drinking water fine. He perked up a little after that and I was able to get in touch with my vet the next day who called in some prednisone and Napoleon has gotten much better. My vet said that the predisone use does not rule him out as a candidate for metronomics but he didn't ask me to bring him in to start the metronomics as soon as he got back (today). I'm more than willing to be Napoleon's advocate, but I can't tell if my vet is stalling? Did any of you who did metronomics start it right away once mets were found? 

Also, has anyone tried acupuncture with their tripawd? I've read things on it but haven't talked with anyone who had done it and there is a new vet in town that says she uses it as a therapy in her practice. I'm sure it can't be comfortable on your hips and shoulder once you go from 4 legs to 3.

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