Caring for a Three Legged Dog or Cat
Tripawds is your home to learn how to care for a three legged dog or cat, with answers about dog leg amputation, and cat amputation recovery from many years of member experiences.
Join The Tripawds Community
Learn how to help three legged dogs and cats in the forums below. Browse and search as a guest or register for free and get full member benefits:
Instant post approval.
Private messages to members.
Subscribe to favorite topics.
Live Chat and much more!
Register
Log In
Members
Add Topic
Offline
Okay, so here was my Friday post:
"Ajax had his MCT removed on Monday. Due to it's location (on his rump!) the giant incision looks scarily similar to the amputation scar from 1 year ago. Accordingly, I expected his behavior to be similar. Not so much. He's a maniac. Seriously. Tearing through the streets of NYC and with a giant incision on one side and a missing . If this is his post-surgery self, I guess losing the leg did slow him down for a few weeks, though we didn't notice because we feared it would be so much worse. ((Don't worry Tracy, we are slowing him down!)
Anyway, the surgeons were very happy with the operationa and his incision is healing nicely. Their goal was a 3cm margin on all sides and they got >3cm laterally and 2.5-3cm deep (due to the location). The mitotic index is very low, 1 in 10, which is great. They have staged it at Stage II (it doesn't sound like they are really ever willing to call an MCT stage I)."
But unfortunately the news from the IHC ("special stain" was not as good as we hoped. I've only spoken to the surgeon to give me the results, which were that it came back as an "intermediate to high grade II" (rather than an "intermediate to low" grade II). So the oncologist will give recommendations in the morning.
What the surgeon said is:
--The pre-op staging was good (i.e. no spread based on the abdominal ultrasound, no lymph node involvement, he feels good)
-- The surgical margins were good - they got the tumor out
-- The mitotic index is good (1 out of 10)
-- The IHC indicates "intermediate to high grade II" which means: we monitor for recurrence of this tumor in this location (but the good news is they got clean margins) and/or spread (with abdominal ultrasound).
-- The oncologist will give recommendations as to how to proceed. Surgeon thinks recommendation not likely to be traditional chemo, but more likely one of the newer drugs if anything (I assume that means Kinavet or Palladia).
Sigh. Just looking for any input/questions for the doctor etc.
thanks
K
Oh crap...I'm sorry for the news of it being a higher grade 
I don't have any input for you for the doctor - just wanted to know my thoughts are with you and Ajax...please keep us posted..
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
If it's any consolation at all, I've read that the stage of a cancer doesn't always correlate to the prognosis. Not sure where I read it, but I like that theory.
{{{hugs}}}}
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
I'm sorry to hear this. Oh man. I'm short on any meaningful input but wanted to send some pawsitive thoughts to you and Ajax.
Catie -
Birthday – November 4 2003
Amputation – January 13 2010
Crossed the Bridge – June 2 2011
I'm sorry you didn't get the results you were hoping for- mast cell is so tough.
I think you need to decide what you want for Ajax, and what you are willing or able to do. I've always tried to factor everything in to my decisions. For example: quad Pug Tani is 11.5 years old, and has multiple health issues to consider. Also she has multiple MCTs, 8 total now, so I don't consider surgery or radiation therapy to be viable options. She also is not showing any signs of internal cancer, although I have not done a US. She is not showing any stomach problems. For her at this point the only thing I would consider is kinivet or palladia. But I am not yet doing either of those.
I don't remember if you did a abdominal US? You could also ask about trying to get a lymph node sample to see if there is active mast cells there. You would want to rule out to the extent possible that there is any metastasis anywhere.
Ask about the cKIT test to see if the kinivet or palladia would be effective. I think it used to be if the test didn't show that tumor was positive for the cKIT test then the drugs might be less effective, or not effective. But I think more recent information shows they might work even if the cKIT was negative. Sorry I don't have experience with these drugs (yet), they were not available when Maggie started down the cancer road.
I think I left some other suggestions in your last thread.
You need to decide how aggressive you want to be treating this cancer. I chose to treat Tani's cancer conservatively for all the reasons I listed. I chose aggressive treatment and did chemo with Maggie after her amputation because there was spread to the lymph system. Maggie had six cutaneous MCTs, five after her amputation. I chose to remove them under a local and did no further treatment. Two of them were Grade II's, but they never came back and she never had internal spread.
I should say that all the treatment options, including doing nothing, were made in consultation with our oncologist.
Sorry- long winded again.... hope something here helps.
Let us know how the oncology appt goes tomorrow.
Karen and the pugapalooza
Thanks everybody - I was down a dark road yesterday ...
Surprisingly, the visit with the oncologist actually cheered me up a little! (I know, when does THAT ever happen)?
We had seen her before with Ajax'x chondrosarcoma, but since that was basically "cured" with surgery, we didn't have further interaction with oncology. Today, we went for the oncology consult and also to have Ajax's stitches taken out. Here's where we are:
The oncologist spent about 45 minutes with us explaining. I think that is the advantage of a teaching hospital - not only do they explain, but they are good at it. She has been doing extra research on MCT and also participates on a Cancer Advisory Board. Basically what she said is this:
-- MCT traditionally graded I, II, or III. I means it is basically cured with surgery. III means things are of serious concern. II can go either way.
-- There is vast disagreement among oncologists as to the grading, and the "high II" and "Low II". Some pathologists are even going to a grade system with only 2 grades, I and II. In that system, II is bad, and I basically incorporates what is traditionally I and II - so doesn't tell us much.
-- Scientific evidence shows that both traditional chemo (vinablastine + prednisone) is effective, as can be palladia. There really isn't a study clearly comparing traditional chemo vs. palladia - the studies are still separate. She and everyone she talks to agree that there is not scientific evidence to NOT treat with traditional chemo, or to start with Palladia.
-- Most MCT, if it is going to recur (particularly at same site) will do so w/in 6 months.
-- Ajax has complete excision of tumor, large clean margins, low mitotic index. Of the other makers tested, 2 are "intermediate" and 2 are "high".
-- Except for his cancer (!), Ajax is in perfect health. Blood work, lung xray, abdominal ultrasound, lymph node aspirate, all clean. Also he is strong tripawd trooper and, at 9, not terribly old.
-- Therefore she recommends 6 mos. treatment: 3 mos. chemo (viniblastine intravenous + prednisone by pill), followed by 3 mos Palladia.
-- The goal of this treatment would be, as she puts it, "to have a 15 year old Lab." The prognosis is "excellent" (which on the form they give you is "12+ months". There are no other categories.
-- Her expectation is that Ajax will have little to no side effect, at least from the chemo. I asked does that just mean that he won't be miserable, or that we should expect him to run around and play frisbee. She said her expectation is he would run around and play - no change in behavior other than he will think he is hungry on the prednisone and we can't feed him more. (we're pretty much used to him pleading starvation; he is a Lab after all).
Based on this, and the reading I had already done, and the info you guys had all provided on this site, we started the chemo today. He was already there, and this gives us 2 treatments before Thanksgiving. We will do chemo 1x/week for 4 weeks, then every other week for 8 weeks, then the prednisone.
So far, it's only been an hour, but he is his normal self. NOTE TO ALL who may have this situation: need a 1 week flush between the Rimadyl and the prednisone.
We feel good about this, assuming he tolerates it as she expects. So far, they have taken us through removal of a benign thymoma and cure(amputation) of chondrosarcoma, so we feel that we are in pretty good hands despite all the New Yorkers who claim all vets here are overtreating. It is certainly not any sort of financial bargain, but I don't think these teaching vets would give my dog unnecessary treatments.
Sorry for the long post. Both my husband and I have seen parents through long and multiple bouts of chemotherapy, so we don't like the word, but Ajax doesn't know that's what it's called, and if we have a chance of killing the little b@stard mast cells for good, we think he would want to do it.
Re diet: no raw diet during chemo due to risk of infection. our oncologist doesn't feel strongly about the science behind the grain free thing, though is willing to support a grain free diet. she also isn't pushing the K9 Immunity . I'd be interested to hear peoples views on that, as msot of the info I can find is produced by the manufacturers, so I can't take it at vace value. Currently(and for years) Ajax has been getting fish oil and glucosamine/chondroitin.
So - long morning, but we are feeling pretty hopeful and pooch is just happy to have the doggone stitches out.
sorry for the long post (occupational hazard) and of course I forgot the main point:
oncologist says if this does nto come back in 6 mos to a year, it may be that the surgeon cured him, even though the oncologist will be happy to take credit. Point being, the best best thing is good surgery wiht clean margins. We have now had 2 surgeries from this surgeon. This one was a little close to the anus which made it a little difficult. My point being, if you have a tricky surgery and you live where you have options, I recommend finding the surgeon who does this procedure the most. Ours had done 150 already this year and I think her skill is part of the reason we got such good margins.
krun15 said:
I think it used to be if the test didn't show that tumor was positive for the cKIT test then the drugs might be less effective, or not effective. But I think more recent information shows they might work even if the cKIT was negative. '
Karen: Based on what I read and what the oncologist said, thsi is correct.
Sounds like a good report!!! Thanks for the lengthy report...all educational for me! Here's to hoping his treatments don't bother him in any way!!
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
kazy55 said:
Re diet: no raw diet during chemo due to risk of infection. our oncologist doesn't feel strongly about the science behind the grain free thing, though is willing to support a grain free diet. she also isn't pushing the K9 Immunity . I'd be interested to hear peoples views on that, as msot of the info I can find is produced by the manufacturers, so I can't take it at vace value. Currently(and for years) Ajax has been getting fish oil and glucosamine/chondroitin.
Information is power, this sounds like a great visit!
Sounds like your oncologist is pretty traditional, which is fine. Many others like the one I had are willing to explore dietary changes and mushroom therapy. It all depends on when and where they were schooled. Here is what Dr. Demian Dressler, author of the Dog Cancer Survival Guide, says about K9 Immunity:
"When I first came across the scientific literature about how effective mushrooms are at stimulating the immune system, I was very skeptical. But as I read, my skepticism softened. I remembered that penicillin - perhaps the greatest advance in medicinal history - was created from fungus. Maybe the use of mushrooms isn't such a weird idea after all.
...There are many studies that look at medicinal mushrooms and cancer. There is some evidence for direct anti-cancer actions in the body when they are given by mouth, but even stronger evidence that they boost the immune response and increase life quality for cancer patients.
...There are several medicinal mushroom supplements on the market. I have used and recommend K9 Immunity from Aloha Medicinals for a couple of reasons. It's engineered specifically for dogs, they include a wide vareity of potentially beneficial mushrooms, the enzyme bromelain is added (which helps the polysaccharides get absorbed and into circulation even more quickly and efficiently) and they also sell a companion product, called K-9 Transfer Factor, which seems to support the activity of the beta-glucans.
The Bottom line on Mushroom-Derived Polysaccharides: Supplementing with beta-glucans may help boost your dog's immune system."
You'll find a good discussion about K9 Immunity and other mushroom therapy strategies here. Hope this helps.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi thanks - I do have Dressler's book but have been unable to determine if he is separate from the K9 Immunity or if he profits from it. Nothing personal, I just can't tell.
I meant to add: the oncologist is pretty traditional, though AMC does do a lot of research as an institution. When I raised K9 Immunity as an "it couldn't hurt" add on, she said that in fact, there is no science to show that it doesn't hurt. I plan to take the literature in to her next visit. I'm sure she is familiar with it.
Like last time, I think that one of the reasons they have been generally conservative with AJax is that - fortunately - we have so far been in the "pretty good" category where they being proactive by treating as much as they are. We have not yet been to the "try anything you can" point. That being said, we had a complementary medical center (for people) in the family, so I do understand the common tension between the traditional and more "holistic" or "experimental" or "alternative" approaches.
Sounds like I'll ahve to make this decision on my own. Going to wait a few weeks in any event to make sure he is tolerating the chemo, but would appreciate an input. Will also look at the thread you included. Thanks!
- Kathleen and her million-dollar doggy
kazy55 said:
...in fact, there is no science to show that it doesn't hurt.
This is basically what Dr. Mullins summarized when reporting Jerry's K9 Immunity clinical trial results.
FYI: Dr. Dressler is not affiliated with Aloha Medicinals.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi Kathleen,
I think all in all a good report for Ajax. And good post with all the information- it will help someone else someday.
For what it is worth- I think I get the same take on things from our oncologist as you did today. One of the things that makes me really trust her is the fact that she has had dogs with multiple MCTs so she gets how hard the decisions are to make.
And I like your oncologist approach too- kill the MCT while maintaining a high quality for Ajax (again, always the goal of our onc).
Maggie was on two chemo drugs: CCNU and Vinblastine, in addition to the pred, benadryl, and pepcid AC. Her regimen lasted 6 months, plus a taper off the pred period. Her only real reactions were a fatigue and a little nausea- usually about 7 days after treatment, and not every time. Seems like the vinblastine was a little worse, but never really bad. You can read about it in her blog- the link is in my signature box. We did a more aggressive treatment because the cancer was confirmed to be in the lymph system. And I think I said before- Mag had multiple MCTs after her amp- so for us recurrence was common, but not the end of the world.
I would recommend you keep a log while Ajax is in treatment. Log treatment days, food and water intake, pee and poop, any meds, and overall mood. It helped me track Mag and know when to expect the slower days.
I went to a grain free diet years ago when Tani developed IBD, I have keep my pugs on it ever since. I really like how they look, and once I put my rescue pug on it most of his skin issues cleared up. Tani is on glucosamine/Chondroitin (for the last several years), and both pugs get fish oil. Tani is getting K9immunity plus, and has been since the most recent MCT diagnosis. I don't know for sure if it helps with the cancer- but it definitely helps her energy level. She is 11.5 and has several health issues. But all of this must be doing some good because when they see her people are always surprised about how old she is.
I hope Ajax does well on the treatment, please let us know how it goes.
Karen and the pugapalooza
p.s. don't forget about green beans for snacks! I have been converted, the pugs LOVE them.
Thanks, both posts are very helpful, re non-affiliation of Dr. Dressler and re Karen's experience. And great idea about the log. We kept one when he was a puppy - startedd out for the dogwalker and training period, and then became a fun family activity. One night we went out without coming home first and he shredded it. I cried and my husband spent the night taping it back together!
And just in case anyone is trying to learn from this, I mistyped above. In the sentence below, last word should be "palladia" - i.e., chemo of vinblastine + prednisone for 3 mos, then the palladia ( i think still w/ prednisone, tho not sure):
kazy55 said:
Based on this, and the reading I had already done, and the info you guys had all provided on this site, we started the chemo today. He was already there, and this gives us 2 treatments before Thanksgiving. We will do chemo 1x/week for 4 weeks, then every other week for 8 weeks, then the prednisone.
1 Guest(s)
