So... long story which I will update on this link a bit later (http://tripawds.....iotherapy/), but we are going back to UF next week for stereotactic radiation (SRT).  If you're not familiar with it, it's statistically as good as amputation and saves the leg (with the risk of fracture).

We just got thrown another tough decision.

Background... Bree, our 10 year old black lab, was diagnosed with OSA back in January.  We went to UF for SRT, but had a hiccup in the diagnoses so started carboplatin Feb 2.  Much longer story, but we decided on amputation instead before getting thrown off that road (again, I'll update more later).  So now we're back to SRT.

The carboplatin protocol is 21 days, extendable to 28 days.  Today is day 29.  Again, the delay requires more explanation (we were waiting to amputate, which isn't happening), but we have 2 options now:

1.  Do carboplatin tomorrow (day 30).  We have a local vet who can do it (way cheaper than UF).  This keeps her mostly on schedule.  However, we will do stereotactic radiation next Wed-Fri (days 4-6 post carboplatin).  Doing chemo prior increases the risk of side effects (skin rash, gastrointestinal upset), though this all should be temporary.  SRT would require her to feel ok, though we noticed no side effects from the last chemo dose.  Also, if there are any complications from anesthesia, such as pneumonia (very low risk), doing chemo prior would lower the white blood count and impair her recovery.

2.  Do carboplatin next Friday (day 36) at UF.  There would be less risk of side effects.  But it is off the chemo schedule a good amount.  UF also costs a lot.

3.  Do carboplatin locally the Monday after (day 39).  We *may* be able to do it locally on Saturday (day 37), but not sure since the Dr who does chemo is off that day.

The UF oncologist originally said plan 1 would be fine (the plan we liked, before knowing of the side effects) but she'd confirm with radiation oncologist.  She called back this afternoon and said the radiation Dr preferred plan 2 because of the side effects, and the oncologist now officially recommends plan 2.  She said she wasn't too concerned about changing the chemo schedule because "a lot of people do it", but did admit when I asked that it could risk some spread of the cancer.  Plan 3 just saves us money.

I should add that plan 1 was basically what we started doing for the 1st chemo dose (chemo followed by SRT the next week) before getting the diagnosis hiccup.  Another Dr had originally been fine with that plan, so whatever side effects could happen, it doesn't seem to be too concerning.

UF will work with us on any plan, as long as she is feeling ok for SRT.

Thoughts?