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Great Dane with Osteosarcoma and Palliative Care
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Forum Posts: 14
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18 May 2016 - 8:51 am
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Hi everyone,

I am new to the tripawds community.  I am looking for some advice and encouragement.

I am the proud mom to a wonderful seven year old Great Dane named Zayda. 

To give you a some background, Zayda was diagnosed with lymphoma in October of 2014.  We immediately started chemotherapy.  She got chemo once a week (on a four drug rotation) for 20 weeks.  She finished chemotherapy in February of 2015.  We continued to go in for check-ups.  This past February she was one year out of chemo for lymphoma, and lab work showed that she was still in the clear!

Unfortunately, about a month ago Zayda started to limp on her right front leg.  I assumed that she had pulled something playing outside at the park since that is when the limp started.  She avoided standing on the leg and walked with a limp for several days, but then it seemed to be getting better.  She still limped from time to time, though, so when she went in for shots I mentioned it to her vet.  She also figured that Z had probably sprained something and said we would keep an eye on it.  Early last week she still limped from time to time, so I took her back in for X-rays.  I was shocked to hear that her X-rays showed indications of osteosarcoma.  Zayda had a biopsy done last Wednesday, and this Monday we got results that it is, indeed, osteosarcoma.

I am absolutely heartbroken, to say the least.  But I am trying to figure out how to provide the best quality of life for Zayda moving forward.  After consulting with her doctor (who also consulted with an oncologist) and another doctor, amputation does not seem to be a viable option for Zayda.  She is very tall, lanky, and barrel chested so she carries the bulk of her weight in the front.  Additionally, she tore a ligament in her left front foot several years ago, so that bothers her from time to time.  Those factors together present some big worries for her ability to adapt without her right front leg.  On top of that, she has already been through chemotherapy once, and she is a year and a half out of lymphoma, so the doctors worry that that may show back up and/or that the cancer will more quickly spread to other areas of her body.  With all of those factors in mind, their recommendation is that she will have a better quality of life if we pursue palliative care.  They hope we will be able to get her some good time with all four limbs.  I know and they know that there are many dogs who do great with amputation (and chemo), but for Zayda that does not seem to be the best route.

That being said, her doctor started her on piroxicam last Monday for going into her biopsy.  Her biopsy went well, and while on the piroxicam she did not limp at all! Sadly by Thursday the piroxicam had really upset her GI tract and she started vomiting.  We ended up having to take her off of the piroxicam by Saturday.  Without the pain medications she has really been limping, but she definitely still wants to do things.

For now we have had her on tramadol (100 mgs 2 times a day).  We plan to up that dose a little bit and then to add on meloxicam as well once her digestive system has bounced back from the piroxicam (hopefully by the end of the week).  I am really hoping that those medications will help her and that her system will be able to tolerate them.  If not, the doctors said there are other ones we can try.

She still has a good appetite, but she has not been wanting to drink water.  I have been mixing some in with her food to make sure she is getting some hydration.

I guess I am wondering if anyone has any insights or suggestions or if anyone has been through a similar situation and can offer some encouragement or guidance.  Thank you in advance.  Zayda is awfully brave and tough, so we are going to take one day at a time and get the best time we can.

Courtney and Zayda

The Rainbow Bridge



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18 May 2016 - 10:50 am
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Hi Courtney and Zayda, welcome. Your future posts won't need moderation so post away.

I'm sorry about the extremely tough spot you're in. Clearly you've done your homework and getting all of the information you need to make the best choice for Z. Amputation isn't always right for every dog and we support folks no matter what they decide, throughout every step of the journey.

Have your vets mentioned the possibility of radiation therapy or bisphosphonates to you? Many times dogs who aren't candidates for surgery can do well with those two treatments, either separately or combined. The link has information about it if you want to learn more. Oh and this link goes to different folks who explored stereotactic radiation therapy.

It also sounds like your vets have a good grasp on how you'll need to start managing her pain, that's terrific. As for her water consumption, try adding things like no-salt chicken or beef broth or this yummy broth with Turmeric from the Honest Kitchen.

Whatever we can do to help don't hesitate to ask OK?

It's better to hop on three legs than to limp on four.™
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Forum Posts: 14
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20 May 2016 - 9:09 am
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jerry said
Hi Courtney and Zayda, welcome. Your future posts won't need moderation so post away.

I'm sorry about the extremely tough spot you're in. Clearly you've done your homework and getting all of the information you need to make the best choice for Z. Amputation isn't always right for every dog and we support folks no matter what they decide, throughout every step of the journey.

Have your vets mentioned the possibility of radiation therapy or bisphosphonates to you? Many times dogs who aren't candidates for surgery can do well with those two treatments, either separately or combined. The link has information about it if you want to learn more. Oh and this link goes to different folks who explored stereotactic radiation therapy.

It also sounds like your vets have a good grasp on how you'll need to start managing her pain, that's terrific. As for her water consumption, try adding things like no-salt chicken or beef broth or this yummy broth with Turmeric from the Honest Kitchen.

Whatever we can do to help don't hesitate to ask OK?  

Hi Jerry, 

  Thank you for the reply.  

  I have definitely been trying to do as much reading as I can so that I can do what is best for Zayda.  A couple days ago I talked with my vet about the possibility of radiation or bisphosponates, so I am glad that you mentioned that!  She just got back to me and said that she also consulted with another doctor and the bisphosphonates could be a good option (most likely pamidronate).  She is going to look more into cost and a plan with that and get back to me today, so maybe that will be an option for us soon on top of her pain management meds.

  Zayda has started to drink some water (we did some broth earlier this week, so thanks for that idea too!) and is getting back into eating her normal food.  We upped her tramadol dose to three pills twice a day, and her stomach/GI tract seems to be getting back to normal after the issues with piroxicam.  We are planning to try starting her on a low dose of meloxicam along with her tramadol and omeprezol hoping that her system does okay with it and that it helps curb her pain more.

  We would welcome any other ideas, insights, encouragements, etc...  and will keep posted moving forward!

Thanks again,

 Courtney and Z

The Rainbow Bridge



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20 May 2016 - 9:14 am
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Aww you bet. I'm glad to hear that you and your vet are on the same page, that makes all the difference at a time like this. Radiation therapy (especially Stereotactic) has helped many dogs, so I have my paws, fingers, tails & toes crossed that it does for Z too.

Don't forget to check our Tripawds Nutrition blog for appetite stimulation ideas.

You are doing GREAT by the way, hang in there.

It's better to hop on three legs than to limp on four.™
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Virginia




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20 May 2016 - 10:04 am
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Hi Courtney and Zayda....Right off the bat,.Zayda doesn't know she has a "disease" and certainly doesn't care about "statistics" or "diagnosis". She certainly doesn't have a timeframe stamped on her butt and, goodness knows, she's already shown she has a penchant for beating the odds!!

You are doing an OUTSTANDING job of researching options for keeping that bum.leg in check! I really believe you are going to beable to get more extended quality time for lpving and spoiling and tummy rubs and treats!

And ya know what? Even.if amputation was a possibility, there are NO guarantees! Unfortunately, we just had a new family member here wose bepved Turbo didn't survive surgery. Rare, but.it happens. We've had some who only made it a very short time after surgery. You just have to trust that, for whatever reason, amputation is just not the right choice for Zayda.

Another option you may check out is adding a holistic approach to what you are doing.

It's hard ro stay in the moment, live in the present with no worries about tomorrow. That's what Zayda is doing though. She's not worried about a thing! Shes not letting ANYTHING interfere with her time together withh you! Such a great role model. We call.that being more dog!

And the joy you...and she...will jave with all the spoiling............OMD! A scoop.of ice cream as a bedtime snack, a drive thru cheeseburger as an appetizer, all day massages, tummy rubs, sunbathing and that's just for starters!

We would LPVE to see.pictures of this magnificent miracle girl! I'll try and ppst the link on how to do that.....may or may not work (operator error).

Give Zayda a big smooch and hug for us! Your love for her comes shining.through!

Love and hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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21 May 2016 - 6:32 pm
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First of all your amount of care so far is incredible.  You are an amazing dog owner. 

Being an amputation here and brand new I can't offer a lot of advice, but from what I've heard the only thing I can say is keep an eye in her x rays and dont let her break that leg. I know from what my vet and other people on here have said that moment when it breaks will be traumatizing for both you and your pup. I had 1 week until a fracture so I amputated but she's only got a few months now despite it all. If you can limit her activity while preserving her quality of life it's the absolute best thing for you guys. But if possible I would keep up on the x rays and try to make sure that end break doesn't happen and she can go peacefully and happy with you. The transportation of a break and a yowling dog will suck so much more.

You guys will have a beautiful time together and know despite your doubts you really are making the right decisions. Your zayda is lucky to have you.



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22 May 2016 - 7:08 am
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Hi Courtney and Zayda,

Me and Eurydice are sailing through osteosarcoma as well but my girl was able to have her leg amputated a couple of weeks ago which was good news for us as she was in great pain. She weighed 77kg (now 70kg) and I was worried sick that she wouldn't be able to manage on three legs but I was wrong, our furry friends are incredibly resilient and only too happy to be around us. 

Each case is a case but in the end it is all about making our babies happy and spoiling them rotten! 

After amputation my girl didn't want to eat but they gave her hot dogs at the hospital, after having tried all kinds of "human" food to no avail. Just go ahead and spoil your girl she will eventually develop her appetite again and eat doggie food.

Eurydice stopped drinking after the op and I was advised to give her Oralade, it tastes like chicken and dogs cannot resist it! Eventually I started mixing Oralade with water and after a couple of days she was drinking pure water. I am still giving her water with a 60ml syringe  as she won't drink on her own but I am confident with time she will drink on her own. 

You have got to keep a very close eye on your girl's leg to try and avoid her breaking it but at the same time you both have to have as normal a life as possible, so don't dwell on it too much and live one day at a time with your beautiful dane. 

Sending you a hug Eurydice sends lots of slobber heartheart

Eurydice 77kg/170lb Great Dane limping end of April 2016, amputation (right front leg/osteosarcoma) 4 May 2016 6 courses of carboplatin followed by metronomic therapy, lung mets found 30 Nov 2016. 3 courses of doxorubicin, PET scan 26 Jan 2017 showed more mets so stopped chemo. Holistic route April 2017. Lung X-ray 5 May 2017 showed several tennis ball size mets, started cortisone and diuretics. Miss Cow earned her XXL silver wings 12 June 2017, 13 months and 1 week after amputation and 6 1/2 months after lung mets, she was the goofiest dawg ever and is now happily flying from cloud to cloud woof woofing away :-) 

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22 May 2016 - 8:59 pm
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Another option you may check out is adding a holistic approach to what you are doing.

Thank you for your reply!!  And for the encouraging and helpful words.  I teared up just realizing that you are right; Z doesn't know about the situation in the same way that I do, and we need to make the absolute most of her time and "Be More Dog "!

I will work on trying to upload more pictures of her (besides my profile pic).  She's a gem 🙂

Do you have any suggestions in terms of holistic approaches to add to what we are already doing?

Thanks again!!

Courtney and Z

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22 May 2016 - 9:04 pm
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jenandteaka said
First of all your amount of care so far is incredible.  You are an amazing dog owner. 

Being an amputation here and brand new I can't offer a lot of advice, but from what I've heard the only thing I can say is keep an eye in her x rays and dont let her break that leg. I know from what my vet and other people on here have said that moment when it breaks will be traumatizing for both you and your pup. I had 1 week until a fracture so I amputated but she's only got a few months now despite it all. If you can limit her activity while preserving her quality of life it's the absolute best thing for you guys. But if possible I would keep up on the x rays and try to make sure that end break doesn't happen and she can go peacefully and happy with you. The transportation of a break and a yowling dog will suck so much more.

You guys will have a beautiful time together and know despite your doubts you really are making the right decisions. Your zayda is lucky to have you.  

Thank you so much for your reply and your encouragement.  It sounds like you are having to make some tough decisions for your best buddy as well; it's so hard.

Do you have any advice as to how often we should x-ray to know when fracture/break could happen?  It is something that I am trying to be very careful about while still letting her be a dog and have fun.  But I am definitely worried about it and want to know what to watch for and how to know.

I am getting steps made so if she wants to get up onto or off the the bed she will not try to jump (I have been lifting her, but she is stubborn and independent).  If you have any other ideas too, we would appreciate them!

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22 May 2016 - 9:14 pm
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You have got to keep a very close eye on your girl's leg to try and avoid her breaking it but at the same time you both have to have as normal a life as possible, so don't dwell on it too much and live one day at a time with your beautiful dane.  

Hi Teresa and Eurydice,

  Thanks for the reply!  I am so glad to hear that Eurydice is doing so well!  

  Zayda has started getting her regular appetite and thirst back, and so far it seems like the pain medications that we switched her too are settling okay with her system.  We are easing her onto them after her last GI system upset, so hopefully it continues to go well and she can get good pain relief while still being able to eat and drink and be herself!  I am glad to hear about the Oralade idea just in case though!!

  Can you tell me any more about what I should do to keep an eye on her leg to avoid breaking?  That is something that I am very worried about since the amputation route is not an option for us.  I am trying to balance being careful and still letting her be herself.

  Thank again!  Sending hugs to both of you as well!

Courtney and Zayda

  

Virginia




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22 May 2016 - 9:59 pm
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BTW, as hard as this is, I can feel yiur sense of empowerment as you move forward researching the best possible care for Zayda. Thst kind of energy has it's own healing effect on Zayda on a level that we, as humans, cannot perceive.

Suggestion: We have a thread called "Ask the.Vet". Perhaps you can post your question over there about anyway to determine the strength of the leg bone. I know on occasion, a dog has not limped st all and the first indication of the osteo was the unexpected fracture. Some.dogs limp off and on for months while being (mis)treated for arthritis, or strain, etc. and it never fractures

Sounds like your doing an excellent job of balancing letting Zayda be Zayda and being cautious. The steps are a great idea for the bed. If you have any hardwood floors or vinyl floors, cover them with non slip scatter rugs for traction .

I am the world's worse at trying to.figure out how to."search" things here. I know we have many, many posts/blogs where outstanding holistic/alternative/complimentary therapies have been used. Illq be dang if I can find the right combination.of words or, if something does pop up, why it seems completely unrelated to my "search"! Okay, TMI!!

I'll keep.working on it through!!

Glad to hear she's eating well and seems to be getting more comfortable with the pain meds.!! 🙂 REALLY GOOD NEWS!!clap

We're all cheering for you Zayda! Loudly! Can you hear us?

Hugs and love!

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

The Rainbow Bridge



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22 May 2016 - 10:01 pm
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I saw you had some questions:

Do you have any suggestions in terms of holistic approaches to add to what we are already doing?

Do you have any advice as to how often we should x-ray to know when fracture/break could happen?

Have you hopped over to the Tripawds Nutrition blog ? We have lots of dog cancer diet tips there.

As for the risk of fracturing: the best thing you can do is to avoid letting her jump off furniture and out of cars, which you're already doing. A Webmaster harness will help you help her, it's an awesome device. Unfortunately the fractures usually happen unexpectedly, sometimes when just doing ordinary things. Yes, allow her to be a dog, but do what you're doing and keeping a close eye on her activity. As for frequency of x-rays, that's a good question for your vet, I don't know the answer but would be interested in hearing what they have to say.

It's better to hop on three legs than to limp on four.™
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23 May 2016 - 5:09 am
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Hi Courtney and Zayda,

I understand you are very worried about the possibility of Zayda's leg breaking, suggestions from our other tripawds friends are all good and I don't think there is much else you can do, really... so, prevent her from jumping as much as possible (get a dog ramp or steps for her to get in and out of the car) and pay attention during her outings.

When we were considering radiotherapy instead of amputation, the oncologist advised us to avoid walking alone with E in isolated areas as if a fracture happens it will be very difficult to move a Dane. But he did say it could happen doing "normal" activities as the bone gets really week from cancer.

Please speak to your vet to see if there are other suggestions, covering all wood floor areas is really important, we also did that for E.

I am sorry I cannot be of more help, a fracture may happen but it may not. Just keep an eye but don't dwell on this too much, do what you can and spoil your girl rotten !

Sending you a big hug and big slobber from Eurydice to Zayda heart

Eurydice 77kg/170lb Great Dane limping end of April 2016, amputation (right front leg/osteosarcoma) 4 May 2016 6 courses of carboplatin followed by metronomic therapy, lung mets found 30 Nov 2016. 3 courses of doxorubicin, PET scan 26 Jan 2017 showed more mets so stopped chemo. Holistic route April 2017. Lung X-ray 5 May 2017 showed several tennis ball size mets, started cortisone and diuretics. Miss Cow earned her XXL silver wings 12 June 2017, 13 months and 1 week after amputation and 6 1/2 months after lung mets, she was the goofiest dawg ever and is now happily flying from cloud to cloud woof woofing away :-) 

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23 May 2016 - 5:53 am
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Don't want to be a downer, but Otis' leg broke when he was walking outside in our backyard to do his business.  Get advice from your vet, but I am not sure there is much you can do.  Of course, the no jumping is a great idea, and had I known, we wouldn't have been doing our normal walks - he did 1 1/3 mile the day before without any sign of discomfort.  Even after the break, and while he was in great pain, Otis hopped into the house and in and out of my car at the emergency vet on the other 3 legs.  Focus the most on the things you can control, like loving Zayda!

Otis - 106 pound lab/Dane mix, lost his right front leg to osteosarcoma on Febuary 9, 2016.  Four rounds of carboplatin completed in April, 2016.  Lung mets August 25, 2016.  Said goodbye too soon on September 4, 2016.   Lost his adopted sister, Tess, suddenly on October 9, 2016. likely due to hemangiosarcoma.  

Wherever they are, they are together.

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