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HELP me prepare for life with Chemo.... if we need it so I can forward plan- just in case.
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13 August 2022 - 2:15 am
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Hi!

I'm in Australia. You have all helped so much already with all the topics to research but I need some more advice, please.

Peppa, our 8 year old Lab (going on 4 years!!) is now 3 days Post Op and it has been a vertical, emotional learning curve, in a winter, with awful rain- and with Mum,( me )getting a severe asthma flare up and NOT being allowed outside during the whole process!!! (Due to the cold air trigger!)

Peppa had a subcutaneous mast cell tumour on her front right leg- the sign was a swollen leg that was thought to have been bitten by an insect. So you can just imagine the shock!

Peppa has had a LOT of tests: Full body CT scan, biopsy to tumour (twice- once by our local vet via needle and once by specialist vet where they took a good chunk of the poorly defined tumour.) She has had a dye thing injected to see which lymph node the leg drained to (It drained to the shoulder.) She has had a biopsy of her spleen and liver to check that this tumour hasn't spread there. It hasn't! We now await the pathology results of her amputated leg, to see it was in the lymph node under the armpit and the one in the shoulder. If it was they will recommend Chemo and we will do it. I asked the vet when we had that discussion, about re chemo, is there anything special I would have to do- safety precautions etc?  Part of the answer was to ensure that none of her bodily fluids came in contact with us! Not saliva and not wee or poo. The latter isn't a problem, but the urine will be as she has falconi syndrome and drinks a lot.

So now I'm scared over that because I don't know what to expect and can't seem to find the answers on the forums. I'm scared because she will be home 6-8 hrs alone. She has some kidney issues- due to falconi syndrome and therefore drinks large amounts. This obviously also means a lot of wee! Right now it is winter and it keeps on raining non stop!!!! I have set up the laundry, where she sleeps anyway, as her recuperation room. I have down a mat covering the entire floor to prevent slipping and LOTS of towels and puppy pads. We are surviving ..JUST. (My washing machine and dryer haven't stopped!) We can't get her outside because of the rain. The puppy pads clearly don't really do the trick but with assistance of the towels, they help. However, inevitably it gets on the rug too and so I scrub it. AND inevitably it gets on me, even with gloves.  If she has to have chemo then how do I manage to stay safe? What do you do in this situation. I guess it won't be safe to wash the towels in the washing machine, so what do I do? We live on 2 undulating acres and there is no way I am leaving her unattended outside for that length of time in the cold! So that means there will be a big wee (or multiples) when we return. How do I safely clean it, the rug, the floor and the towels? How often do they normally give chemo? How long is it dangerous- 24 hrs -what? Please help. I cope better if I know what to expect. We will find out if we need chemo sometime this week. But I want to be prepared. 

Thanks. 

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The Rainbow Bridge



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13 August 2022 - 7:40 pm
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I know it feels really scary when the vet says that you can't come into contact with her body fluids or waste. Although we did not do IV chemotherapy with Jerry, we did oral chemo pills and were given the same instructions. I promise you, it's not as bad as it sounds.

 If she has to have chemo then how do I manage to stay safe? What do you do in this situation. I guess it won't be safe to wash the towels in the washing machine, so what do I do? We live on 2 undulating acres and there is no way I am leaving her unattended outside for that length of time in the cold! So that means there will be a big wee (or multiples) when we return. How do I safely clean it, the rug, the floor and the towels? How often do they normally give chemo? How long is it dangerous- 24 hrs -what? Please help. 

You will be fine wearing gloves when you clean, and putting dirty towels in the washing machine. Just do an extra rinse! Honestly it's not as dangerous as it sounds. Here is what Dr. Pam told a member who was concerned about their Tripawd's chemo because his significant other was pregnant at the time of treatment:

https://tripawd.....-pregnancy

I hope this brings you some comfort! 

How often do they normally give chemo?

Four to six sessions are standard for osteosarcoma, I'm not sure what they will give to Peppa for her type of cancer but your oncologist can clarify. If you'd like to see what a chemo session looks like, I have this older video we made a zillion years ago (I need to sit in on another session for a newer one with better quality!):

https://tripawd.....aisee-dog/

Also see:

and 

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13 August 2022 - 10:53 pm
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Oh THANKYOU, so very much. This has answered some questions and gives a bit more confidence, especially reading Dr. Pam's reply!

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The Rainbow Bridge



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13 August 2022 - 10:56 pm
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I'm happy to know you feel better! Yay!!

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17 August 2022 - 7:30 am
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Hi,

I need some more advice (reassurance) Plllleasse.

So Peppa had a subcutaneous mast cell tumour in her right front leg. They did a full body CT, plus liver and spleen biopsy. All was clear.

So we went ahead 7 days ago and took off the leg containing the tumour. BUT the first part of the pathology is back and devastatingly she had cancer in the lymph nodes in her armpit. (They all went too.) The sentinel node (that's the node the leg drains to) 'looks to be free sooo far.- nothing obvious', but no promises as they have yet to do a staining to check there are no cells hiding amongst normal cells. This info all relayed by a vet reading the notes. (Her vet has Covid!!) 

Needless to so we are devastated that it had spread to the lymph nodes. Subcutaneous as opposed to the cutaneous mast cell tumour,  is apparently the one to have, if you have to have cancer. But the does zero to take away the fear that it had made it into the lymph nodes.

We have yet to speak to the oncology team in Sydney (SASH) via tele health. We don't know if they will recommend a combination of radiation and chemo (meaning we have to somehow fly her to Sydney- we are in another state,) or chemo, or both. AND we are so confused and worried.

My very first question:- Is it possible to cure cancer in dogs using chemo and radiation if it hasn't made it to the sentinel node? Like is that a hopeless dream?

Is cancer ALWAYS palliative in dogs?

Do any of them get a cure? (Is it possible when caught early and the limb removed?) Not only was Peppa's leg removed but also her scapula- they took everything? So could we have a chance?- I know I'm not asking a medical team- I just want to know- Do you know of any dogs that have made it to cancer free, or cancer for free for a number of years? Peppa is 8, (turning 4- she is sooo lively! )

Are there any dogs who have made it past 12 months with cancer when the limb has been removed and they have had treatment? We are so lost and scared and Dr Google isn't helping at all! 

Thanks so muchsp_hearticon2

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Virginia



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17 August 2022 - 10:13 am
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Peppard is mighty lucky to jave such a caring and loving hooman.  The bond between you two is obvious 💖

I just want to pop in ver quickly to give you some reassurance  based on REAL experiences  here!

Like is that a hopeless dream?

Is cancer ALWAYS palliative in dogs?

  Do you know of any dogs that have made it to cancer free, or cancer for free for a number of years?

You have given Pepa a CHANCE....and with a chance, there is ALWAYS hope!!  

A Great Dane named Nova loved an additional  five years (at least) and, of I recall, passed from old age.

A hero dog named Miurphy lived an additional four years and did pass from a different  form of cancer. 

Stubborn Pug Maggie loved an additional  four years (?)  and eventually  passed from a different  cancer.

In all cases, the dogs were given a "statistic " or "-timeframe" of basically mo ths (plus or minus).

There are more examples  of these types of victories, but these are the ones that came to my mind right off the top of my head.

Stay off De Google!!!   Your Peppa is an individual and one who clearly jas lots of spunk.

I know this early part of the journey  is exhausting  mentally  and physically.   Take some deep breaths....b.r e a t h e.....and know  that the NOW is all that matters.    Peppa is not worried about anyone path report, or   about the tomorrows.  Peppa  lives in the present, in the moment, in the now.  What really matters in this journey is to make every moment together  the best mom ever!  I have no doubt you and Peppa know how to do that perfectly!!

Others will chime in, but just wanted to let you know about some of the success  stories around here!!!

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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The Rainbow Bridge



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17 August 2022 - 12:26 pm
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Hey there, I'll try to help with some feedback but to be truthful, you are going to get the most helpful information from your oncology team. I know the waiting is painful though! So here goes:

My very first question:- Is it possible to cure cancer in dogs using chemo and radiation if it hasn't made it to the sentinel node? Like is that a hopeless dream?

Honestly I know nothing about the sentinel node, you're the first person to mention it. I do know that with certain cancers, lymph node involvement is a make or break deal when it comes to treatment. I don't know if this is the case for mast cell cancer.

Please keep in mind that all dogs, and all of their associated cancers, are different. What works for one, may not work for the other and vice versa. It's impossible not to compare, we all want hope. But Peppa is her own girl, with her own physiology. It's best to not jump to any conclusions until you get the full report from the oncologists.

Is cancer ALWAYS palliative in dogs?

It depends on the cancer, the grade, and the dog. Some cancers can be zapped into oblivion, some just managed.

Do any of them get a cure? (Is it possible when caught early and the limb removed?)

Same answer as above.

Do you know of any dogs that have made it to cancer free, or cancer for free for a number of years? Peppa is 8, (turning 4- she is sooo lively! )

Many, many dogs here have gone on for years after their diagnosis, to live out their normal life expectancy. Check out Dexter's story as an example. He passed about a year after we published his story, and he passed from other reasons, old age mainly.

Are there any dogs who have made it past 12 months with cancer when the limb has been removed and they have had treatment? We are so lost and scared and Dr Google isn't helping at all! 

Yes see above. Lots of long-term survivors here! 

And you're right, Dr. Google does not help. Unfortunately you won't find answers to your questions as they relate to Peppa's case, because she is unique, she had a cancer that is 100% unique, and not knowing what your options are yet, it's hard to say what the outcome will be.

The truth is, not even the best scientists or research can predict what will happen. Cancer sucks but it really teaches us to let go of our need to control situations and know the outcome. It reminds us that all we have is here and now. We call this learning to Be More Dog .

I'm sorry I know this isn't much help. The best thing I can offer is this: remember that Peppa just wants you and the pack to be happy. She wants to be pain-free. You are on your way to doing that, for whatever time she and you have left on this earth. It's all any of us can do, with or without cancer. sp_hearticon2sp_hearticon2sp_hearticon2

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The Rainbow Bridge



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17 August 2022 - 12:27 pm
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One more thing: you may want to get a copy of The Dog Cancer Survival Guide . It's really a dogsend at a time like this, and will also help ease your mind a bit.

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Livermore, CA


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17 August 2022 - 2:08 pm
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Hi. I'm sorry you got this news.

As Sally mentioned my Pug Maggie beat mast cell cancer.  Pre-amputation of her rear leg all tests and scans were clear and her prognosis was 'good', I was under the impression that amputation would be curative.  After surgery mast cells were found in the lymph node removed with her leg and her prognosis was changed to 'poor', the prognosis was 6 to 9 months with chemo.

We discussed radiation therapy before surgery but I would not have done that with Maggie- she was super sensitive to anesthesia, we actually almost lost her during the amp surgery.  After amp surgery we never discussed rad as a treatment option.

We did do chemo which Maggie tolerated pretty well.  She far outlived her prognosis and passed almost 4 years later from a second, unrelated cancer.  Our oncologist did say that Maggie was an exception- but it does happen.

Try and wait until you can talk with your oncologist about what the path report means and what the options are before you get too upset (I know it's really hard!).  The grade of the tumor and mitotic index might tell you more about how aggressive the cancer is.

Most importantly Peppa has no idea there are any concerns- it's important for her to keep it that way.  I made a huge mistake when I got the 6 to 9 month prognosis for Maggie- I fixated on it and I was honestly just watching the calendar and waiting for her to pass. Especially when we hit the 6 month mark- I woke up every day wondering if it would be 'the day'.  But you know what Maggie was doing?  She was living her best life and learning how to do what she wanted on three legs, she had no idea she was sick.  Thankfully I finally figured it out- she was doing fine and I needed to get on board!

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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17 August 2022 - 5:48 pm
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Benny 55, Jerry and Krun 15, I can't thank you enough. I woke up this morning and the very first thing I did was to see if anyone had replied. You guys are my life saver. I just had tears of relief, (for hope.) I needed those stories!

I have just had a phone call from SASH in Sydney, (we are in South Australia, another state.) They are going to phone me at 1.30 today with an hr long consultation with the oncologist who already knows her history. I have so many questions, I hope I ask the right ones.

First one being: If this was your dog, that you loved so much, which option would you choose? ( I believe there is more than one option)

I am going ask if any will impact her Falconi Syndrome

I am going to ask, obviously, what grade we are talking and whether curative is a possibility, (but am doing that with the hope I have gained here, to sustain me if the answer is not curative.)

I need to understand what it means when the mast cell cancer was in the armpit nodes, but if it turns out to be clear in the sentinel node  (where the leg drained to.) I need to know what it means if they did find some there. Does that mean it was contained since they took the leg, the shoulder and both those nodes?

I have to ask if we are better to send her to Sydney and for a better chance, the cost of that and can they help me work out how to get her there on a plane. (I wouldn't be able to go as I have just had 2 weeks off work with severe asthma.)

I have to ask about our safety with whatever they choose.

If anyone is still up and thinks of anything else on can put a link to questions, I'd be grateful.  Cross your fingers for us... I think our appointment matches midnight if you are say in Washington.

AND yes we adore her. 

sp_hearticon2sp_hearticon2sp_hearticon2sp_hearticon2

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The Rainbow Bridge



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17 August 2022 - 6:42 pm
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LOL of course we are up, it's only 5:40 pm here in California. I'm not that old! icon_lol

These are all great questions to ask. Keep in mind that most vets will not tell you the answer to this one:

If this was your dog, that you loved so much, which option would you choose?

There are many reasons for why most vets won't, but mainly because a good vet knows that all situations are different and it's very hard to judge one against the other and compare.

If anyone is still up and thinks of anything else on can put a link to questions, I'd be grateful.  

Got ya covered!

Questions to Ask Your Veterinary Oncologist

Good luck. I'll definitely be asleep when you meet, but let us know how it goes so I can find out in our morning over here. (((hugs)))

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18 August 2022 - 12:40 am
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We have had some tentatively good news but it is tinged with caution. The good news is that really, by removing the leg and shoulder we should have got all the subcutaneous mast cell tumour. With Chemo, it is potentially curative. HOWEVER, this tumour behaved in his words 'weird ways.'

It should have drained to the sentinel node that they mapped in the shoulder, yet they found mast cells in the nodes in the armpit. So from there who is to say a little hasn't jumped to the nodes in her chest? 

We still are waiting on a mitotic(?)  count from the actual tumour.

Chemo is strongly advised and we will do it, to try and "get" any little cells that decided to travel to far distant (or nearby spots). We don't need radiation as there is nothing to irradiate. That means we don't need to get her to Sydney. Phew!!! smiley_clap Soo relieved I don't have to figure out how you do pet transport on planes etc and don't have to worry about all that additional cost. (We have maxed out our Pet Insurance until end Jan)

She will have injectable chemo called: Vinblastine once a week X4 and then 1 a fortnight x4 together with steroids. 

 We do have to be careful of the urine, salvia and poo. If she has a wee accident, never hose down, put kitty litter, absorbent material etc and bin it. Towels can be used but and can be washed but has to be really hot. (Then probably rinse machine before we use it.) Think I am going to buy a LOT of towels plus kitty litter. He also suggested continence pads as something to throw on top. Has anyone else used something if there is an accident during the chemo stage. Peppa is likely have an accident because she has falconi syndrome and that means she drinks enormous amounts anyway. Together with the steroids her intake will go up, if I am at work, she just simply may not be able to hang on with all that urine filling up her bladder.

He has told us that the thing with Mast Cells is that it is genetic and as such, we could get another unrelated one down the track. (I can't worry about mights, I just need to deal with this.) 

So we are still needing the results from the mitotic??? count in the  tumour and I want to know if they do end up finding anything in the shoulder nodes. There are considerations regarding her Falconi Syndrome... but that is for another appointment with the medical vet here in Adelaide SASH.

Thanks so much for all your help and what you wrote because it meant that I was calm enough to look up what questions to ask and  when the oncologist rang, I was calm, not a shaking mess. sp_hearticon2sp_hearticon2sp_hearticon2

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The Rainbow Bridge



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18 August 2022 - 4:07 pm
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Wow that sounds like a VERY efficient discussion, and you took some amazing notes! I'm so glad you were able to do that, and keep your mind focused on what you needed to know.

When it comes to cancer, what we see here is that it often does what it wants to do, no matter how much chemo you throw at it. And then there are many times when cancer does exactly what you want it to do. It's such a toss-up. All you can do is get the diagnostics done, decide on a treatment, and hope for the best. You are right on track for that.

We do have to be careful of the urine, salvia and poo. If she has a wee accident, never hose down, put kitty litter, absorbent material etc and bin it. Towels can be used but and can be washed but has to be really hot. (Then probably rinse machine before we use it.) Think I am going to buy a LOT of towels plus kitty litter. He also suggested continence pads as something to throw on top. 

What a good suggestion to use the kitty litter! I don't recall that being mentioned, I love that the oncologist is so proactive about making sure it doesn't get into the ground. 

Has anyone else used something if there is an accident during the chemo stage.

Not me personally, but may others have. I think what the oncologist suggested is perfect.

He has told us that the thing with Mast Cells is that it is genetic and as such, we could get another unrelated one down the track. (I can't worry about mights, I just need to deal with this.) 

YES! So true. I was told that Mast Cell Cancer is like that icky description of whack-a-mole games. You throw something at it, it disappears, and can crop up somewhere else. Not always, but it can. And your attitude is EXCELLENT! You are so right. Mights are not predictions, or set in stone. Don't waste energy worrying about them.

Here is an older interview with a mast cell cancer expert. Still relevant information today that may help you feel better about all of this:

https://downloa.....er-basics/

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18 August 2022 - 9:35 pm
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Our oncologist called mast cell the most frustrating cancer to treat because it is so unpredictable.

Maggie actually had a tumor removed from her side about 6 months before her amp, and then after her amp she had several more tumors pop up.  After her amp we just had the tumors removed with a punch and a couple of stitches instead of the bigger removal surgery.  Maggie's little sis Tani also had multiple MCTs during her life.  Tani had so may other health issues that the MCT was not the biggest worry. I found her first tumors 1 week before Maggie's last chemo!  Then we did the big surgery with wide margins.  Later on we just took them off with a punch... until the time that new ones popped up before the path report even came back.  After that I just left them alone, I watched them to make sure that they were not ulcerating but decided not to do any more treatment. 

As a reminder- Maggie lived almost 4 years after her amp for a MCT and did not pass from mast cell cancer.  Tani lived to be almost 15, had at least 12 MCTs over her lifetime and she didn't pass from mast cell cancer either.

No way to tell what will happen so just stay as calm and as positive as you can. Good job dealing with what is in front of you now!

Karen and the Spirit Pug Girls

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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