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
Has anyone experienced carboplatin extravasation with their tripawd? I think the last chemo treatment they overshot the vein and shot the chemo into the surrounding tissue. The skin on his foreleg appears to be all dying. Believe me, I've been to vets and ER's multiple times in the last week. I think a decision has to be made tomorrow after we see one more specialist...
Background: Duke is a 7 year old greyhound with osteosarcoma. Left rear amputation 11 weeks ago. Was doing AMAZINGLY well until the bad chemo administration.
I emailed Dr. Couto (OSU greyhound program, the guru for greyhounds with osteo) and he felt sure early last week that it was extravasation and said with carboplatin it wouldn't be as bad as if it were doxorubicin, and that the treatments were different. Unfortunately he was out of the country with spotty email access and said he wouldn't be back until Monday. I'm not sure we willl make it that long. Dr. Couto wasn't able to tell me what the treatment differences were. I know if it were a Doxorubicin extravasation it would be the end of the road. I'm not positive about that given it is carboplatin.
My oncologist has just not believed it could be an extravasation because the chemo was given a little bit further down the leg than where the damage was first seen and it took 6 days to see any problems. It started out with severe swelling in the leg a week ago and that has gotten better but the skin is now just dying and falling off. Basically his entire foreleg looks like it is going to lose the skin.
It has been amazing to see him get around on his two right legs - his left rear was amputated and now his left front is exceedingly painful such that he will use it for balance when eating or taking care of business, but he is running on two. Kind of like a bicycle - it's easier on two when you go fast. Although clearly painful, I believe his pain is being managed well with Tramadol and Gabapentin. He is not in discomfort when sleeping I don't think.
I'm just not sure what to expect. If this is treatable, ok. But if the tendons and ligaments are all damaged - he's a tripawd already, I can't amputate.
If you have any experience with this and can tell me what to expect or what your experience was I'd appreciate it. In the meantime - send good thoughts Duke's way. Thanks (And sorry for the rambling... it's been a difficult day/week.)
Welcome to Tripawds, your future posts will not require moderation.
I'm sorry I can't answer your questions. My pug had a different kind of cancer and different chemo drugs, and no problems with chemo administration.
You might also post in the 'Ask A Vet' forum. Dr. Pam (Tazzie) is a vet in Washington State who had a tripawd Mastiff due to OSA.
I don't know where you are located, but don't get discouraged if you don't get too many posts for a few hours. I am in California and it is almost 11:00 pm here- not too many people on the forums.
Sending strong, positive thoughts your way. I hope Duke can overcome this hurdle.
Karen and the pugapalooza
Thanks Karen. I'm in CA too. I know it's late but thanks for moderating so late and getting in on the board so quickly. And thanks for the positive thoughts. We need them... I'll also follow your advice and post on the ask a vet board. Thx.
Offline
So sorry for the complications--I have a greyhound also with a front leg amp. I also worried about this once with her fourth chemo (carbo). It wasn't extravasation, but her leg was very irritated. Greyhounds are so sensitive and thin skinned, so I know that with my Lily it sometimes looks awful but clears up.
I have talked to Ohio State also a few times-they're great! I have also spoken with Colorado State, and they were very helpful. Maybe you could try them also. Is there a university vet center nearby? I'm in Jersey-so I would go to U of Pa vet school.I am hoping that she will be able to hang in there until Dr. Coutro or someone else can help.
So sorry you are going through this-it's so very hard.
Our beautiful Lily was diagnosed with osteosarcoma in her front leg on 12/14/11 at age 8 and had amp on 12/16/11. She completed 5 rounds of carbo. She was so brave and kicked cancer's butt daily! She lived life fully for 4 years, 3 months, and 15 days after her amp. My angel is a warrior princess. I miss her so much.
You probably know this already, but when I looked up carbo extravasation it says this about carbo:
"Drugs which are capable of causing inflammation, irritation or pain at site of extravasation, but rarely cause tissue breakdown."
Hoping so much that this is a bad irritation, but treatable. Sending positive thoughts to you and Duke. Please keep us updated.
Joan, Lily's mom
Our beautiful Lily was diagnosed with osteosarcoma in her front leg on 12/14/11 at age 8 and had amp on 12/16/11. She completed 5 rounds of carbo. She was so brave and kicked cancer's butt daily! She lived life fully for 4 years, 3 months, and 15 days after her amp. My angel is a warrior princess. I miss her so much.
Oooooh poor puppy! I'm so sorry this is happening. In a search of our Forums for "Chemo leak", Dr., Wiltzius, who you asked your question of in "Ask a Vet," says:
tazziedog said
It is true that Adriamycin (doxorubricin) is the worst offender if it gets out of the vein (extravasation). If even a little gets out of the vein and gets into the subcutaneous tissues the leg will swell, tissue will slough (fall off) and in extreme cases the leg will need to be amputated or the dog put down. This drug can also be hard on the heart so you might need to have an echo of the heart muscle done prior to its use.Now this sounds scary but oncologists use this drug all of the time. Whenever I give this drug I make sure that the catheter goes in on the first try, and we dilute the drug in saline and give it over 30 minutes with a technician sitting with the dog the entire time so that the IV can not be chewed or the catheter pulled out.
I used carboplatin alone with Tazzie because she has crappy veins and her heart is slightly enlarged. All oncologists have their favorite protocol but current research shows no difference in survival times if carbolpatin is used alone or if combined with Adriamycin. Some dogs can't handle the combo and can get quite sick.
Talk to your vet or oncologist if you still have concerns!
Pam and Tazzie
What did your oncologist say? And the ER docs/specialists? What kind of treatments are they recommending and why haven't they started? Or have they? It sounds like time is definitely of the essence. I hope whatever it is they are doing will start working quickly. If not, go elsewhere until you get the right kind of help, please don't wait.
Paws crossed things get better, keep us posted.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Thanks for the responses, and reminder that supposedly carbo doesn't do tissue damage.
Update: He made it through the night comfortably I think. (Woke up to the soft cone I made him yesterday - I think I'm on to something for greyhound soft cones - in the middle of the living room floor. Clearly there is room for improvement in my design 🙂 but I think I'm on the right track! Darn needle noses make cones so difficult.) He seems to be resting comfortably now. (Thanks Gabapentin - that stuff knocks him out which is best right now anyway.) He got up for breakfast so that's good. I'm probably going to wait and see his orthopedic surgeon tomorrow - apparently he also has expertise in soft tissue damage. They sent him digital photos yesterday from the ER and he wanted to see him Monday. We were going to move it up to today but I think because Duke seems relatively comfortable, and the damage didn't progress substantially overnight, I'm going to let him rest today and wait another day. He was there most of yesterday and I'm sure he'd rather be here at home.
His oncologist is aware of everything - we saw her last Monday after spending Sunday and Sunday night in the ER. She remains firm in her belief that this is not an extravasation. I remain firm in my belief it has to be. If it is systemic why is the damage contained to the leg that received the chemo? It just doesn't make sense.
I'm not sure what treatments are available. It seems as if there is nothing more to do that what we are doing which is just supportive care right now. I'm concerned there may be more that we should/could do and if there is hopefully Dr. Couto (at OSU) will be able to tell me that tomorrow. I suspect they may debride the leg tomorrow but will have to wait and see.
Thanks for the help and support.
Sorry I don't have any good advice, but just know we are sending pawsitive thoughts out to you and your pup and hoping they can do something for him!
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!
1 Guest(s)
