One thing that isn't really part of Nikki's story on the blog pages is that earlier in the year we lost our 14 year old (actually she wasn't quite 14) Lab/Spaniel mix Patches to cancer. We don't really know for sure what the type was, as the tumor was internal and it burst. We had no idea at all that Patches was sick.

At about the same time, Nikki had a small growth on her underbelly, so we took her in and got it all checked out. They determined at that time that she had some "fat deposits" in her abdomen that were not cancerous in nature. We had them removed and double-checked just to be sure. All of the tests done, and the bloodwork showed no signs of cancer whatsoever… Then only 4 months later we started down this path….

Anyway, the point that I am making is that Mary and I were completely and totally shocked by the diagnosis for Nikki. When she started limping, we were convinced (along with Dr. Pyne, who's the one that did the mass removal in the first place) that it had to be something like an ACL tear. When we took the X-Rays to the ortho specialist and he said, "Cancer", we were sure he was wrong. That same day though we started down the path of checking everything. They did an Ultrasound of Nikki's internal organs right there, with us present, to make sure that nothing else was out of the ordinary. They checked everything, and the visit (keep in mind that this is a specialty vet) with both the ortho specialist and internal doc that ended up doing the ultrasound cost us $400. I think that was money well spent, and it let us know that at least the cancer hadn't spread at that point.

If you look at the X-Rays that I posted to Nikki's blog, you can clearly see the bone lesion, but it really is small enough that you would miss it if you weren't looking for it. Between that, the Ultrasound, and the X-rays before surgery, we are confident that we made the most informed of decisions when it came down to the amputation.

As for Chemo, well, since we're still pretty confident that there's nothing in her lungs or other internal organs, I think we're making the right choice to not go down the Chemo road. It might be a different decision if we had detected mets.. (But then again, we might not have done the amputation either, hard to say)

It is interesting that your onco said that 5-6 Carbo might extend the life by another 6 months versus 4 treatments. Oslo had mentioned that and was going to double-check with his onco. That would be a great statistic.

Remember that mets do not always show up as predictably in the lungs as most oncologists indicate. During our short time in tripawds, we have seen dogs develop mets in other locations. If dogs do get through chemo, my onco said it is more likely to show up in the spine. (But we had dogs who did not have chemo or did not get through chemo develop mets in the spine, and other locations.)

Do your best to give your pup a long happy life. But try not to worry about how long she has. I absolutely hated it when people at parks asked "how long does he have" or "did they get it all", implying that amputation would not have been worthwhile unless it was a cure. That totally missed the point. He was happy right at that moment and THAT is what mattered!

Information from ultrasound, which is not as pricey as a bone scan, can be a useful indication of the health of those organs (kidneys, liver, spleen) and also possible mets. Such baseline information can be helpful down the road if something shows up in a location other than the lungs.

Apparently the 5-6 chemo treatments is based on a recent study that was done (not sure how far back it goes.) Probably even a year ago, the protocol would have been to do 3 - 4 treatments. When I first took Mackenzie to one oncologist in October, they recommended 3 - 4 treatments. Then when we started her first chemo round after her surgery, which was at the end of Nov, another oncologist who is now treating her at the same facility, told me about the recommended 5 -6 treatments and the stats for that so I think this study is relatively new. For Mackenzie our oncologist is recommending 5 treatments - she's a little bit more on the sensitive side. Tazzie, your comments on the mets developing in other locations, very good point. I'm not sure why the oncologists don't really mention the spine area as a possibility- which never even occured to me until I did research on this website and found that mets did develop in the spine with other tripawds. As Jerry mentioned, mets can develop suddenly and without warning. It kind of makes me wonder if just doing the chest X-Ray is enough. Today though Mackenzie had her 3 month chest X-Ray and it came back clean - big sigh of relief in any event!

I didn't know that bone mets were more common than lung mets when doing chemo. Kind of scary, especially since it's more difficult and expensive to detect. Interesting how all these vets and specialists have different types of information on all of this, even within my own vetinarian cancer group.

Speaking of costs, before we amputated Mackenzie's leg, we opted to do radiation on the leg with the tumor. It was very expensive ($3500) which included a bone strengthening agent (that alone was $1000). Unfortunately Mackenzie didn't respond well to the radiation after 2 weeks and it turns out that when they did the biopsy on the amputated leg, they found that she had a fracture in her leg from the cancer which prevented the radiation from really working. However, the good news was that she was clear of any mets in that leg when they amputated and it turns out that the radiation did help afterall. From what I understand, radiation is good for areas of the body that can't be amputated (I can't think of another way of putting this). So in our case, we would have been better off skipping the radiation. But lessons learned. I'm glad your doctor is being cognizant of all the costs involved. After the amount of money we spent on radiation, the amputation, chemo, etc., we've realized that we only want to do what's necessary and required while maintaining the best quality of life. I believe we were quoted about $3000 +/-for a bone scan. They wanted to do this before the amputation and we decided not to. Some vets can throw out all these options at you and it can get so confusing and so expensive too.

I agree with you Pam that recommending 6 treatments would be good if dogs can tolerate it. That's great to hear that Tazziedog lived for 14 months. We're going on the 5th treatment in 3 weeks. All we can do is take it one day at a time and hope for the best. Good luck Holly with your decision! Kami (Mackenzie's Mom)