Caring for a Three Legged Dog or Cat
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Hello Tripawds Friends --
We unfortunately got not so great news at Clyde's checkup last week. It seems both his tumor and lymph node are starting to grow again, indicating that the Cytoxan isn't working. We are pretty much out of conventional options to try except for Palladia. Our doctor is not very optimistic that it will work, but we are considering it since there is some chance that it might slow the growth down. We're getting especially screwed because of the location of his tumor - on the roof of his mouth, right in the middle, so it doesn't have to be as big to cause major eating and drinking problems as it would have to be if it was in a "better" location. Without Palladia (or if it doesn't work), we are likely looking at just a few more weeks. Now I'm even worried about getting that, though, because as of yesterday he is doing a weird hacking thing and seems to be starting to have a bit of trouble eating. He was due for chest x-rays but we ended up skipping them because a) the treatment would be the same whether he has mets or not and b) the doctor thinks that mets would not be a factor at this point - the tumor impeding function is going to be what causes the end to come before mets would be a problem.
So, it looks like our options at this point are:
1) Stop all treatment/hospice
2) Palladia
3) Palladia + artemisinin and/or other holistic treatments
4) Holistic treatments only
I'm pretty torn - if you followed Holly's illness and my difficulty dealing with the aftermath, you probably know that I have some guilt issues and I really don't want to feel like we didn't try everything we could try. On the other hand, I have to balance that with making sure that I'm not making decisions that are more for me than for Clyde. We're really worn down at this point, which doesn't help. Plus, any hope or optimism that I had when all of this started 7 months ago has pretty much vanished.
Anyway, if anyone has any thoughts/ideas on our treatment options, please share!
I mentioned to you before about our not-great results with Palladia, but also that I'd seen another dog do great on it.
I did want to add here though that one of the 2 main researchers studying artemisinin told me in an email to not give artemisinin at the same time as Palladia. He simply said they had not been tested together so we shouldn't mix the two.
In a way, I regret giving her the Palladia because we could have started her on the arte 3 months earlier if we hadn't tried it.
It's so hard to know what to do and I don't think it's ever easy to make these treatment decisions. Sending hugs and pawsitive thoughts.
Hang in there,
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!
I have no advice for you, but I wanted you to know I'm thinking of you and hoping you find the clarity you are looking for. We all know that regret doesn't do much for us, but we humans still engage in it. You loved Holly and made the best decisions you could for her, and you're doing the same for Clyde. (Maybe post this in the vet forum?)
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/
Hi Alex, I've told you some of my thoughts on Palladia previously. We saw the growth of Magnum's lung mets slow down over 1 month BUT the GI issues were just awful. Protective meds for the tummy are a must.
Why does your vet thing the Palladia won't work? There is so much I don't know about it. Maybe it works better with certain cancers and mets than with others?
There comes a time when quality of life rather than quantity is more important. Whatever choices we make we will always struggle with the guilt of having not done "something" different to make it a better outcome. That's why we are only human! Talk with your vet and go with your heart. You will then make the right decision. As Shari says, you made the right decisions for Holly and you will make the right decisions for Clyde.
Thinking of you and sending you lots of hugs.
Karen and Spirit Magnum
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/
I can't offer any advice either, as we never faced the same challenges you do with Clyde. Just wanted to let you know we are thinking of you and your boy. Like Shari said, you did the best you could for Holly, and you'll do the same for Clyde. It's all any of us can do. Clyde will be in our thoughts and prayers.
I am so very sorry to read that Clyde's tumor is growing again. Everything seemed to be going so well. I'm afraid I don't have any advice than go with your gut feeling. Holly gave you one final gift; the ability to deal with cancer. Use what you learned from Holly, and you cannot go wrong. Thinking of you and Clyde.
Catherine
Scout: January 31, 2002 to November 7, 2011
Scout's diagnosis was "poorly differentiated sarcoma"; amputation 1/11/2011. Scout enjoyed 9 fantastic years on 4 legs and 9 glorious months on 3 legs. If love alone could have saved you…
Alex, I'm sorry Clyde's check up wasn't better.
What to do- that is so hard. Try and put all the distractions aside- what do you feel is the best thing for Clyde. Don't doubt yourself, you have done the best you can all along, for Holly and for Clyde. I know there are always some 'what ifs' but the truth is you will never know what would have happened if you made a different decision.
Here is my advice: I found it helpful to write down my thought process when I made decisions for Maggie, and more recently for Tani. When Mag was diagnosed with the melanoma she had been sick for a couple weeks and I was exhausted. I was faced with the same decisions you are now... what to do?, how aggressive should I be?, was I doing the best thing for her? After she passed I of course wondered if I should have done something else- but when I look at my though process I know I did the right thing.
Karen and Spirit Maggie
krun15 said
What to do- that is so hard. Try and put all the distractions aside- what do you feel is the best thing for Clyde. Don't doubt yourself, you have done the best you can all along, for Holly and for Clyde. I know there are always some 'what ifs' but the truth is you will never know what would have happened if you made a different decision
I agree about the 'what ifs' always being there. We were very fortunate that money was not a concern in our treatment decisions, so we pulled out every gun we had. We did everything from the amp, to chemo, to home-cooking for him. We tried MP, we did every follow-up x-ray. Everything that was recommended. He was only left alone twice from the time of his biopsy until he passed - each time for no more than two hours and we were still in the neighborhood. Yet still I wonder if I should have added artemisinin or holistic supplements. Maybe we should have started MP sooner. Maybe, maybe, maybe... No matter how much we do we will always wonder if we could have done more or should have acted differently. It is human nature. It is a flaw, but it is a flaw that is born out of love.
I, too, am sorry that Clyde is having problems. My heart breaks for you and your family. This crap is not fair, but it is even more unfair in your case. Please know that you are in my thoughts.
Zeus was a Husky mix diagnosed with Osteosarcoma at age 11. A visible lung met and suspicious spot on his liver meant a poor prognosis-six weeks was our vet's best guess. We decided to fight for our boy and his right front leg was amputated on 12/1/11. We did six rounds of chemo, changed his diet and spoiled him completely rotten. We were blessed with 10 great months after diagnosis. Against the odds, the lung met remained a single met and grew very little over those months. A wonderful furbaby with the most gentle spirit, he fought with a strength that we never imagined he possessed. We have no regrets...
http://zeuspod......pawds.com/
Thanks, everyone, for your encouraging words.
I think that we are going to give the Palladia a try for two weeks to start - if there are side effects, we will stop, and if it grows in that time, we will likely stop; if it remains stable or shrinks we will stick with it. My ridiculously wonderful oncologist has about 10 weeks worth of the right dosage for Clyde that he got a while back when they were still distributing it to oncologists for free, and the dog that they got it for ended up not using it, so he offered it to us. I was leaning toward going that way anyway, and it is certainly a bit easier to give it a try when it's not such an expensive try. We'll also start him on protective tummy meds and see how things go.
Jackie - I was just thinking of asking you that, so I'm glad you have the answer! 
We will wait to try the arte until we stop Palladia, or I guess we can always stop the Palladia and switch to arte if we decide we are more comfortable with that. I found Lucky's blog, and that was definitely a very hopeful story...thanks for pointing him out.
Karen (and Spirit Magnum)- You know, that's a good question. I'm not sure why he isn't very optimistic. I think that it is possibly just lack of evidence - there isn't as much research into the drug's use with melanoma, and I think that what there is out there indicates that it may not be quite as effective in melanoma as it is in mast cell (not sure about osteo since we never got to this point). Also, I think that the fact that it was already in the lymph node brings the odds down a bit, and I believe there's a little bit of concern that since the tumor appears to be resistant to cytoxan, it may also be resistant to other drugs. On the other hand, I know that he is trying really hard to manage my expectations. He is always very careful with word choices, but I think that he would really rather get me ready for the worst and then hope to be proven wrong at this point.
Karen (and Spirit Maggie) - I love that idea! When I think hard about it, I know why I did what I did for Holly in the moment and that I thought I was making the best decisions that I could with the info that I had, but sometimes it is hard to remember that in moments of doubt and grief. Being able to go back and actually read all of my thoughts would be really helpful.
Catherine - I've been thinking about that a lot. I hate that sometimes it feels like Holly was a trial run, but you're right. Her situation was her situation regardless of what is happening with Clyde, and my experience with her has certainly informed the way that I think about things and helped me to make decisions.
In the meantime, Mr. Flying Dutchman's harness is getting a bit tight and there is lots of snuggling (and mommy smushing) going on!
Alex, I'm sorry to read about this latest news. My heart goes out to you, I know you're in a tough spot.
Your plan sounds good. Give the Palladia a try, if there are no results (dear Dog I hope it works!), take it from there. You are absolutely doing all you can for Clyde, always remember that. No matter how much money anyone has, it never seems like enough, and the hardest part is that in the end, it's not about money but about quality of life. The decisions one must face when questioning quality of life are heartbreaking, but as long as you can face them with Clyde's best interest in mind, you are honoring his spirit and what he's all about.
We have our paws crossed for good news, please keep us posted.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
How is he doing on the Palladia? (Did he start it already?)
Hope the tummy meds help and he's okay on it. That's so nice/cool that your vet had some that you could try without the financial commitment! It's pricey stuff.
Continuing to send good thoughts his way!
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!
Jackie, you're so sweet to ask! And thanks for the good thoughts! He has had three doses so far (every other day) and things are going pretty well so far (knock on wood!!!). I thought that it might be suppressing his appetite a little bit, but now I think that his hesitancy to eat is more about the hacking/coughing fits that he's started having when he eats. He still seems quite hungry, and now has me trained to spoon feed him so that he only gets little bites at a time, which has helped a lot with the coughing. He had moderately runny poo on Sunday, but yesterday and today it's been perfect! I think I might order some of the edible clay so that we have some extra tummy protection just to be on the safe side. He goes back for a recheck next week, so hopefully his tummy will stay healthy between now and then...I'm a little worried about tumor progression since it is now very obviously causing him some difficulties where it wasn't before, but just trying not to think about that for now.
Oh, I am just saddened to be reading your post on Clyde. I wish I had some advice -- actually I wish I had a magic wand to make everything bright and happy. I think it's worth it to try the palladia and then you will never have to ask yourself "what-if . . " You have done and will always do everything possible for your dogs so just follow your heart. Sending you lots of hugs, prayers and well wishes. Kathy & Harley.
Harley is an 8 year old Golden Retriever. Amp surgery for an infiltrative lipoma canceled due to two masses in chest. A rescue, he found his forever home on 3/18/07 and left for his eternal home on 1/09/13. His story and medical history are at http://myharley.....pawds.com/
Hooray for good poops! Sounds like he's doing pretty well on it. I hope it's helping!
Way to go, Clyde - training Mom to spoon feed you. That's a good trick. 
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!
I'm so glad he's tolerating the Palladia like the champ that he is!
The green clay will most likely help, it's excellent for loose stools. When it seems like nothing else would work for us, it worked, along with a good probiotic. Let us know if you decide to try it.
I hope things continue along their pawsitive path. Keep us posted.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
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