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Caring for a Three Legged Dog or Cat

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Are we doing what is best?
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Member Since:
21 March 2012
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3 April 2012 - 9:53 pm
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To recap: 2.5 weeks ago Jack was diagnosed with OSA in his front left leg. X-rays show he already has multiple quarter-sized lung mets and to top it all off Jack can't have an amputation due to weakness in his back legs due to an old back surgery for a ruptured disc. We are doing our best to manage his pain, but I don't know if it is enough.

We had a scary experience last night. At 2:00 am, Jack woke us up howling in pain. I'm sure you have all experienced when a dog screams in pain and that is what this was over and over again. We jumped out of bed and tired to comfort him and figure out what was wrong. He wouldn't put any weight on his bad leg and frankly we worried he had just had the pathological fracture we had been told might happen. Jack wouldn't settle and kept whimpering. I held him while my husband threw on clothes, then we switched places while I did the same. We decided he had to do to the emergency vet and figured this was the end. Getting Jack in the car (he's 80 lbs) was an ordeal given his bad leg and our efforts not to cause further pain.  The ER vets met us at the door and wheeled Jack into the back while my husband and I broke down thinking this was the end and our little world has fallen apart in 2.5 weeks. 

After an hour wait, the ER Vet walked Jack, under his own power-albiet limping badly on the cancer leg, to us in the waiting room. The ER Vet couldn't find a break in his leg or any reason for the howling pain. Jack was wagging his tail and clearly wanted to head home. So with more pain pills, we loaded him up and headed home. A long night and a roller coaster of emotions. We all slept together in the front room. I was afraid to fall asleep for fear it would happen again. 

We have existed in a world of gray "what if" since diagnosis on what to do for Jack and what course of action was best. What is his level of pain, has been a constant question. How will we know when it is time, another constant question. The thought of a broken leg provided a clear line of what needed to be done, even as it broke our hearts. But now what,  a dog that wags and begs to limp home isn't ready to go.

Our best guess is Jack might have stumbled or slipped when he shifted position (that circling dogs do before flopping down) or got up to get a drink. Perhaps he jarred the leg or fell outright. Our house isn't big, but he has traditionally had the run of the main floor. Since his diagnosis, we have removed the couch cushions and blocked the stairs. Our panic at his pain likely made it all worse.

For pain he now is on: tramadol, gabapentin, rimadyl, and a fentanyl pain patch (that is changed every 5 days). He is also on alendronate. For supplements glucosamine and fish oil. I think the biopsy made the leg much worse. I would trade the limp from 2.5 weeks ago for the limp he has now in a heartbeat. 

The thought that we will have a repeat performance of last night makes me sick to my stomach and it seems very likely that at some point we will have a repeat given the disease and our inability to amputate. Jack has dog insurance and we have met the deductible and the claim has been approved. It seem so unfair that here we have the resources, thanks to the policy, to try almost anything to help him and yet our treatment options are so limited and crappy. 

I have called Colorado State University about radiation for palliative care, but haven't hear back yet. CSU is our nearest option for radiation since we live in Utah (over 7 hours away). Since Jack's cancer is so advanced and we can't amputate, I just don't think I can put him through Chemo. I would love feedback from people that have been in a similar spot (can't amputate and are looking for pain management ). How long does the radiation treatment last? Would we have to leave him at CSU for a length of time? How long did the radiation hold things in check? Will we trade pain in his leg for the complications of the lung tumors and is that a good trade?

I feel so indecisive and unsure of what to do and what is best for Jack. All the choices break my heart.

  

San Diego, CA
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3 April 2012 - 10:12 pm
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I'm so sorry to hear what a difficult situation you're in. I can't really give any advice since we were able to do amp and chemo. I'm not sure if many folks on here have tried radiation, but hopefully someone will chime in if they have some words of wisdom.

Hang in there and keep us posted.
Jackie, Angel Abby's mom

Abby: Aug 1, 2009 – Jan 10, 2012. Our beautiful rescue pup lived LARGE with osteosarcoma for 15 months – half her way-too-short life. I think our "halflistic" approach (mixing traditional meds + supplements) helped her thrive. (PM me for details. I'm happy to help.) She had lung mets for over a year. They took her from us in the end, but they cannot take her spirit! She will live forever in our hearts. She loved the beach and giving kisses and going to In-N-Out for a Flying Dutchman. Tripawds blog, and a more detailed blog here. Please also check out my novel, What the Dog Ate. Now also in paperback! Purchase it at Amazon via Tripawds and help support Tripawds!

Sydney, Australia
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3 April 2012 - 11:42 pm
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I know all too well how much that scream of pain breaks your heart.  I can't comment on radiation either except to say that I heard of a dog at our vet who had done quite well with radiation for the pain.  I've found Demian Dressler's book very helpful in understanding osteosarcoma and treatment options.  You can buy it as an e-book and therefore don't have to wait to start reading!

Good luck and give Jack lots of kisses and cuddles.

Magnum: 30th May 2002 to 5th May 2012. Lost her back left leg to osteosarcoma on 5th Sep 2011. Lung mets found on 20th Mar 2012 but it was bone mets in the hip that ended her brave battle. Magnum's motto - "Dream as if you'll live for ever, live as if you'll die today" (James Dean). Loyal, loving, courageous and spirited to the end. My beloved heart dog, see her memoirs from Rainbow Bridge ...... http://princess.....pawds.com/

Calgary, AB
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30 January 2010
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4 April 2012 - 9:13 am
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Sorry you find yourself and your pup in such a bad spot, it's SO hard to make these heart-breaking decisions. Tai had OSA and I distinctly recall my vet advising me that, if we did nothing, within 2 weeks of diagnosis we would be unable to manage her pain. I suspect that Jacks increased pain and lameness is not a direct result of the biopsy but more likely a progression of the OSA. I have no experience with radiation but I have heard of good results when it is used palliatively. In my opinion, which may not be worth much, I think that if you are going to opt for palliative radiation you need to do it right away. The pain from Jack's OSA is only going to get worse and I know that you guys love him so much you wouldn't want to have him in distress.
Thinking of you and sending hugs at this difficult time.
Laura, AngelTai and Kali

Tai – 9 yr old lab. Diagnosed Osteosarcoma Dec 18/09. Front right leg amputated Dec 21/09. Started chemo Jan 7/10. Lung mets discovered Sept 16/10. Valiant to the end on Oct 26/10 when cancer reappeared in a leg and we made the decision to set her free. Forever in my heart where not even cancer can take her from me.

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17 March 2012
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4 April 2012 - 10:57 am
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I am so sorry that you and Jack are having such a very tough time.

 

I'm not sure where you're located... but a few places in the country offer stereotactic radiation to kill bone tumors. My dog, K, had this procedure 3 months ago, and it worked beautifully. It killed the primary tumors in her front leg bones. Alas, she did develop lung mets that we found a couple of weeks ago but that's a whole separate issue.

 

We had the stereotactic radiation done at Colorado State University (CSU) Vet School. I hear that they do it at Florida State vet school as well. It's growing fast so there may be more places in the country that offer it (e.g., Davis California?). People do fly into CSU to have the procedure done to their dogs. The procedure itself took three consecutive days of radiation (about 1 hr session each day)... I know that this possibility is probably beyond what you can do but I just thought that I'd mention it, just in case.

 

My thoughts are with you.

K, an 8 year old chocolate lab, was diagnosed with osteosarcoma of the radius and ulna on 12/23/11. She had stereotactic radiation to kill the bone tumors, and 3 rounds of carboplatin. On 3/16/12, lung mets were found. We tried several different kinds of chemotherapy to slow the lung mets but none worked. Finally, mets appeared at other sites, including her spine. She earned her angel wings on July 15, 2012. K changed my life, and I'll never forget her. Our/my journey is chronicled at romp-roll-rockies.blogspot.com.

Winnipeg
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13 July 2009
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4 April 2012 - 10:58 am
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I am sorry you are in this position. I agree that chemo is not a good option. It will lead to some side effects and as you are trying to do, your main goal is to minimize his pain and keep him happy. I hope you can talk to the CSU vets soon. It can take them a few days. Is there a vet that offers radiation closer to your home? CSU does have a facility for a certain type of concentrated radiation, which may or may not be needed in his case.

It is hard to control our emotions around our pups. I don't know if Jack is able to go outside or to the park, but I know Tazzie always cheered me up when we did go to the park and I saw that he was still happy there. For other people, those moments were car rides (if their dogs enjoyed rides - that was definitely not case with Tazzie). Just some place or activity that makes Jack, and therefore you, happy.

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17 March 2012
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4 April 2012 - 11:02 am
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I forgot one thing in my reply. If the primary tumor is in his ulna (a front leg bone), CSU and other places also offer "ulna-ectomies" (i.e., removal of the ulna bone). We almost did this for our K but, at the last minute, we found that the nasty cancer had already spread to another bone in the front leg (radius) so an ulnaectomy was not a viable option for us.

 

Our research and our vets told us that the recovery from the ulna removal would be fairly fast.

K, an 8 year old chocolate lab, was diagnosed with osteosarcoma of the radius and ulna on 12/23/11. She had stereotactic radiation to kill the bone tumors, and 3 rounds of carboplatin. On 3/16/12, lung mets were found. We tried several different kinds of chemotherapy to slow the lung mets but none worked. Finally, mets appeared at other sites, including her spine. She earned her angel wings on July 15, 2012. K changed my life, and I'll never forget her. Our/my journey is chronicled at romp-roll-rockies.blogspot.com.

Washington
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1 February 2011
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4 April 2012 - 11:31 am
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So sorry that you are finding yourself with such limited options.  If you can afford to do it, I would recommend going for the radiation therapy.  Even if all it does is manage some of his pain from the bone tumors, it will still give him a better quality of life.

My father-in-law has bone lesions on his spine and pelvis that were treated with pinpoint radiation to slow the cancer growth -- a little more involved than the type mentioned above, with sessions 3x per week for 6 weeks -- and it has improved his quality of life considerably.  My Rio also had radiation to treat recurrent mast cell cancer, and it was 100% successful at treating the tumors in that location.

Hopefully you can find enough information to make the best decision for your Jack.  Sending you our best,

 

Rio's momma, Micki

the Woo

~ ~ Rio ~ ~
Forever in my heart...

April 2000 – January 20, 2012
Diagnosed with Mast Cell Cancer in June 2007. Left rear leg amputated Feb. 8, 2011.
Mets discovered Aug. 31, 2011. Read more of Rio's story here.

9
4 April 2012 - 12:43 pm
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Sorry I don't have any advice for you but I really hope that you can find something soon to help Jack. I know how helpless you feel seeing Jack  in so much pain and only wanting to make him feel better. It seems extra difficult for you since amputation is not an option. I feel just awful for you and for your Jack. Adding you to my prayer list and praying that you can find a suitable option for Jack to minimize his pain and still be here with you. Good Luck!!

On The Road


Member Since:
24 September 2009
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4 April 2012 - 12:54 pm
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kbear said
I forgot one thing in my reply. If the primary tumor is in his ulna (a front leg bone), CSU and other places also offer "ulna-ectomies" (i.e., removal of the ulna bone). We almost did this for our K but, at the last minute, we found that the nasty cancer had already spread to another bone in the front leg (radius) so an ulnaectomy was not a viable option for us.

Our research and our vets told us that the recovery from the ulna removal would be fairly fast.

I've been curious about this procedure so whatever you find out, please let us know more. Maybe this is an option for you?

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

In your heart, where I belong.
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9 February 2011
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4 April 2012 - 5:10 pm
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Dozer's family are at CSU doing stereotactic radiation right now, this week. You should check in with them about all the details and what the whole shebang has been like.

Is Jack a candidate for amputation and a cart? Would your pet insurance pay for that? We've talked about Eddie's Carts a lot here and they make all kinds, even kinds that can accommodate a dog with bad rear legs and a missing front one. If insurance will pay for the amp but not the cart, they seem to be in the $600 range.

If you decide to come to CSU, let me know. I might be able to drive over and meet you, if you want to connect with someone from the area and the Tripawds community. I might even be able to round up a dog!

Shari

From abandoned puppy to Tripawd Warrior Dude, Dakota became one of the 2011 February Furballs due to STS. Our incredibly sweet friend lived with grace and dignity till he impulsively raced over the Bridge on 12-15-12.

Dakota's thoughtful and erudite blog is at http://shari.tr.....pawds.com/

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17 March 2012
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4 April 2012 - 6:43 pm
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I wanted to add one more comment based on my recent extensive experiences with the CSU Animal Cancer center. If no one is returning your call, I'd suggest phoning a specific oncologist. Our favorite is Dr. Lana. You can ask for her voice mail when you get through to the front desk. You might ask your vet to send CSU copies of your records so that a CSU oncologist can reply more informatively about whether Jack is a good candidate for stereotactic radiation (or palliative radiation).

 

I can't emphasize enough how easily my dog handled the radiation. She did get a radiation burn about a month later, and it bothered her for about a week. However, all of her limping and leg pain disappeared extremely rapidly after the treatment. Today, three months later, she went running with me!

 

As Jerry reassured me back when they found K's lung mets, a dog can live a robust life for a while (or even a fairly long time) even with mets.

 

I know that you are facing tough decisions. I hope that this helps a little.

K, an 8 year old chocolate lab, was diagnosed with osteosarcoma of the radius and ulna on 12/23/11. She had stereotactic radiation to kill the bone tumors, and 3 rounds of carboplatin. On 3/16/12, lung mets were found. We tried several different kinds of chemotherapy to slow the lung mets but none worked. Finally, mets appeared at other sites, including her spine. She earned her angel wings on July 15, 2012. K changed my life, and I'll never forget her. Our/my journey is chronicled at romp-roll-rockies.blogspot.com.

Member Since:
21 March 2012
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5 April 2012 - 12:52 pm
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Thanks everyone for the feedback. This site has been an invaluable resource. Just to know someone out there gets what we are going through make me feel a little better.

To update you all, Jack had another episode where he stumbled getting off of his dog bed and had a howling-in-pain-attack. We were able to calm him and gave him more tramadol. After about an hour, he was back to limping around (which appears to be our new normal). The greater damage was likely to me and my husband as we now fear leaving him alone at any time and are terrified about his pain levels. My husband is a teacher and is on spring break this week, so he can be with Jack at all times. I'm not sure what we are going to do next week. I can take him to work with me sometimes, and I can have family and friends drop by to check on him, but we won't be able to have someone with him 24/7. I'm worried he will stumble again and it will be the pathological fracture that will end things and he might be in agony for hours before we get home. In addition Jack's back legs have deteriorated significantly in the last week. He's back to dragging them as badly as he did before his back surgery for the disc. 

I was finally able to get in touch with Dr. Custis at CSU, who spent a bunch of time answering my questions. I think because it is spring break, they are short staffed. He was very nice and spend more time that was likely necessary listening to my "what ifs".

This is what I learned: for pallative radiation, CSU recommends 2 courses of radiation. We could probably be in and out in three days if everything went well. 80% of dogs experience pain relief that lasts 2-4 months. The radiation is not painful, it might cause a little hair loss at sight and possibly a "super sunburn" a week after. If Jack has a pathological fracture, he is not eligible for radiation. I was told the cost for radiation & consult would be $820 (not including travel costs). Also Jack can be on bisphosphonates (which I think I misspelled) while also doing radiation.

Dr. Custis also suggested that Jack might have micro-factures in his leg that don't show up on an x-ray. That is likely why he is so painful.

Someone mentioned a cart- if Jack's back legs were working, I would consider it, put I don't think he can push himself around with his back legs deteriorating again. Jack's cancer is in his humerus so the limb sparing stuff is not an option. 

I have talked myself into and out of radiation and putting him to sleep multiple times. Complicating things is my husband is also see-sawing on what to do, but he is leaning more on the putting him to sleep side of things. He thinks Jack pain is too great and we are being cruel to keep him here with us.  

knoxville, tn
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12 February 2010
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5 April 2012 - 2:11 pm
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obviously you love jack dearly, and this is just so awful to be in the middle of all of this.  if you can take action to improve and extend jack's quality of life, then that's great.  but, if his suffering is continuing, then maybe you need to take a step back.  none of us want to 'quit on our dogs', or 'give up' or 'not try', but you have it within your power, to give jack a final, selfless gift...if it is time.  you will know if it is time.  i knew with jane, i knew with gayle.  jack will tell you. 

i don't want to be a storm cloud on your hope, but i've seen too many times that folks can lose perspective when all of these options and procedures are thrown at them.  not saying you have, but just saying you are jack's advocate.  he loves you and he depends on you.  as long as you make your decisions out of love, they will be right.

sending our best to you all.

 

charon & spirit gayle

Life is good, so very, very good!!! Gayle enjoyed each and every moment of each and every wonderful day (naps included).  She left this world December 12, 2011 – off on a new adventure.

Love Never Ends

http://etgayle

Las Vegas, Nevada
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14 August 2009
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5 April 2012 - 3:24 pm
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I, too am just so sorry to hear Jack is not doing well. 

We totally understand the overwhelming decisions and the heartbreaks that come with having to make these decisions.  There is such a fine line between helping and hurting when it comes to a terminal illness in someone we love.   In your first introduction of Jack, you said you wanted to ensure his time left was of quality.  Since he is in pain, you have to ask yourself the very hard question, "is he suffering?".    The other questions are, "are you doing what is best for him?"  As my vet had said to me when I let go, "putting an elderly dog through procedures isn't good for them since the recovery is so hard and the stress is overwhelming."

Unfortunately, our fears of letting go and being without someone we love dearly can easily cloud our judgement.  It's human nature to want to hang on and want to fight for those we love. And there are times, the fight is for the good.  But sometimes the fight can cause too much stress and harm to our furbabies.   

Your heart will tell you if you are doing what is best for Jack. 

I'm just so sorry. Lots of vitual hugs coming your way.

Her Retired AvatarComet - 1999 to 2011

She departed us unexpectedly  January 23, 2011 at the age of 12 1/2.

She was born with a deformed front leg and a tripawd all of her life.

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