Big day today.

Ginger had her sutures removed, and the doctor said she looks fantastic!

No restrictions - we just have to be careful that we don't let her walk so far that she's too tired to get back.  So, we'll ease back into her regular walks.

We've stopped the surgery-related medication (pain and anti-inflammatory - the antibiotic finished a few days ago), so hopefully that will really let her get back to being herself.

She still needs a little encouragement to eat but eats her whole dinner and dessert once she gets started.  And, she still doesn't sit on her amputation side.  I imagine that will take some time for her to consider trying that again

We also got another ultrasound of her spleen to check on the mass in the spleen.  The dimensions changed only slightly - so little that it could be explained simply by a different orientation for the image and not actual growth (it's only 2 cm which the doctor said is relatively small - very low likelihood that it could rupture and since there's hardly any change in the last 16 days it's unlikely to grow significantly in the next month).  So, the doctor recommended we wait 2 to 4 weeks to let her continue to recover from the amputation before putting her through another major surgery.  It will be difficult waiting a month to get that out since we don't yet know what it is, but it will be a good month watching a girl get back to herself.

So, we're on the books for a Halloween splenectomy.

Thank you to everyone on this forum who has provided information and encouragement. 

Julia and Ginger

Just a summary for history in case it is helpful to someone in the future who is facing something similar so they have a better idea of what to expect.

We had an excellent recovery - no complications - couldn't have hoped for anything better.  I believe this is essentially the minimum we could have spent and the minimum timeline I could have reasonably expected since we spent very little time waiting for test results or doctor's appointments.  I am so grateful.

Note that Ginger had no lameness prior to the surgery (didn't appear to have any pain - was using her limb normally).  The doctor said that dogs who have pain in their limb prior to the surgery sometimes adapt more easily because they have gotten used to not putting much pressure on that leg or not even using it.  But, Ginger didn't appear to have any difficulty in that regard even though she effectively had to adapt from 4 legs to 3 literally in one day. 

We are in the suburbs of Los Angeles in 2019 with access to several options for specialists.

Rough Costs for diagnosis and treatment of fibrosarcoma

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$500 fine needle aspiration and initial x-rays

$700 biopsy

$800 surgical consultation and additional x-rays

$400 abdominal ultrasound (to confirm no other health issues that might influence long term prognosis or ability to tolerate the surgery)

$3100 surgery and related expenses (medication, hospitalization, etc.)

$300 miscellaneous (ramp plus other miscellaneous things that we bought to be prepared for her recovery - not counting time off work)

Timeline

8/30 Discovery and fine needle aspiration

9/4 biopsy

9/11 surgical consultation

9/17 ultrasound 

9/19 surgery

9/20 home from surgery about 25 hours after the surgery ended - walked to the car (sedan) and hopped in/out but was carried into the house (we have a few steps)

evening of 9/20 walking in/out of the house to pee (up/down two steps)

9/22 redness deepened and spread across the abdomen

9/22 a short walk

9/23 first post-surgery bowel movement

9/23 walked about 200 yards

9/24 most of the redness is nearly gone or significantly diminished

9/28 walked around the block (typical residential neighborhood block - about 10 minutes - she seems to be walking faster than before the surgery, in general - maybe that's due to how she's learning to balance - and she really didn't stop to sniff like she usually does)

9/29 reduced pain medication by half

10/2 walked around the block for the second time - about 15 minutes (stopped more often to smell the flowers and is starting to walk at a more normal pace)

Two weeks post-surgery 10/3:

10/3 digging in the dirt!  (I mention this because it takes a lot of balance for her to be able to stand on two legs and dig with the third, so I consider it a major milestone)

10/3 stopped pain medication

10/3 walked about 3/4 mile (up a relatively steep hill for part of the walk) - this is her normal nighttime route (she led the way - this is where she wanted to walk) - I think she was a little tired by the time we got back but was not in any distress

10/3 sutures removed

We got bad news today.  We went to an oncologist for another opinion on any further treatment.  Ginger had another round of x-rays and abdominal ultrasound.  The abdomen was clear, but they found one relatively large nodule and 2 or possibly 3 smaller nodules in one lung.  The most likely cause is that the soft tissue sarcoma has already spread to the lungs and grown large enough to see on the scans.  

The doctor said without further treatment Ginger probably would have 2-3 months symptom free but then could have only a month or so before her quality of life would deteriorate.

With chemotherapy (4-6 rounds of carboplatin, 3 weeks apart), we might be able to give her 6-8 months symptom free. The doctor said most dogs have few symptoms with this drug (not anything like the side effects most human experience because they don't treat dogs as aggressively).

We got the first round of chemotherapy today.  We haven't decided yet if we will continue it - it depends a lot on how she react to the chemotherapy.  If she has any problems, we won't put her through that just to buy her a few more months.  And, we have to travel about 90 minutes to the appointment (traffic).  She doesn't mind the car ride, but I think she's rather be sitting home under her favorite tree.  But, if she does well, we might continue it to give her the best possible chance.

It's a difficult decision.  They estimate that she is about 11 years old, but we were hoping for several more years - not just a few months.  But, letting her be happy and comfortable is the most important factor.  We don't want her to suffer unnecessarily.

Julia and Ginger