Caring for a Three Legged Dog or Cat
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Dear Friends: I am so overwhelmed. I just don't know what to do. When we received Romeo's diagnosis we were going to do chemo, go all the way. Romeo had his surgery on Aug 17th and has recovered very well. Still, he is 9 1/2 years old and this has taken a lot out of him physically and emotionally (I know people have different theories about the "emotional" aspect, but I'm going w/ my gut (and heart) here). He is just starting to get some of his spark back. The vet called today to confirm osteosarcoma from the biopsy. Romeo's lungs were clear. He was not limping (well the day we took him in, but on pain meds he was himself that night)----I just noticed a bump on his leg--seemingly out of the blue. The surgery was a difficult decision because he just had the one freak day---he was running around happily, swimming, playing.
Romeo has struggled w/ GI problems all of his life. He had a two life threatening bouts of pancreatitis when he was ages two and four
(eating a very dead rotten fish on the beach and snatching an old roast chicken from the neighbors trash---gross.) They just seemed to take a toll---and we've had struggled w/ gastric reflux, possible irritable bowel etc for many years. This is complicated of course by the fact that he is a lab mix and wants to eat everything, all the time!
We live in CT but made the decision to have his surgery back at beloved vets in VT. It's about a 4 1/2 hr drive. One, we felt he should be treated by amazing vets who truly know and care for him. Second, a board certified surgeon in VT performed the surgery for @ 1500. In New Haven they wanted $4500. The same is true for chemo---here in CT they are quoting us a price about $4000 higher for chemo than in VT. We can only afford this treatment by driving up to VT---our family is there so it is somewhat possible to make this work.
Still, we are determined this will not be a financial decision. We love Romeo like a child. He is the heart and soul of this family and we want to do what is best for him. Still I had to mention the commute because it does complicate everything and is weighing into our decision---because it will affect how much time Romeo spends as a "patient." Romeo will need to go to VT for chemo every three weeks and this will take us through January (because they alternate the drugs).
We started to feel like he will just be getting his strength back and we will be jumping in with chemo. When he is not in VT he will
have to go to the vet in New Haven for lab work and an ekg. It just seems he will be hooked up to something/feeling crappy/at the vets for the next five months. I know Romeo and he will not like this, but he will chug along if we ask him to. What if he does not have much time left? This does not seem like a good quality of life for a boy who loves his bed at home, his family, and just loves to sniff around the barn and the park. I don't want him to associate going to VT with bad things (if you ask him if he wants to go to VT he runs to the car).But of course we are torn---what if we could save him w/chemo? I never thought I would have to deal w/ his mortality at this age---I thought I had a few more years.
One of the vets in VT now practices eastern medicine. He does a lot w/ acupuncture, herbs and supplements. We understand it is more of a quality of life approach. Wondering if this has helped others out there. My partner is a nurse practitioner. We are not anti-Western med, just thinking about our beloved boy and what would bring him the most peace and happiness. After the amputation, I felt like we bought ourselves two more years. I am afraid if we don't choose chemo we will lose those, afraid if we do we will spend precious time on ivs, exhausted, on the highway, w/ all sorts of GI complications.
Oh--the drugs they would use are Adrimycin, Carboplantin, and Doxorubicin (spellings?)
Any thoughts, experiences, opinions would be appreciated. Sorry to go on and on. We are trying to make this decision and I have not cried so much since surgery day. Thank you so much, Eve
Dear Eve,
I know it is so hard. Most of us on this web site have had to make the same decisions and know it is not easy. I think it you are considering chemo that you remember that dogs don't usually have the same side effects that people do from chemo. Emily sailed through her chemo with the exception of dipping white blood cell counts. She had about two days between treatments when she slept a lot and other than that she was her same perky self. You would think that Emily would hate going to OSU hospital but she loves it there. Most likely Romeo will still be excited to go to VT! By the way, this is from a dog that needs to be sedated for a nail trim! It's a good thing the chemo IV is not in her foot!
Try to not cry. I truely believe that you will do what is best for you, for Romeo and for your partner. I know you have heard it here before but it bears repeating: There are no wrong choices. We are all doing what we can for our babies and you will make the right choice.
Debra
Debra & Emily, a five year old doberman mix, who was diagnosed with an osteosaecoma. She had a right rear leg amputation on May 19, 2009. On November 10, 2009 she earned her wings and regained her fourth leg.
As far as chemo goes I would probably avoid Adriamycin (generic name is doxorubricin) and just do carboplatin every 3 weeks for 4 or 5 treatments. I would avoid the Adria for your dog because it is the most likely to cause GI problems and must be given precisely in the vein or skin sloughing can occur. Any general vet should be able to administer carboplatin since it can be given directly IV and has very minimal side effects. It is now generic so the cost has come way down (drug cost for my Tazzie who weighs 184 pounds was around $125 per treatment). You may be able to get your local vet to administer it without driving 4 hours or paying so much.
Having said that chemo is not for everyone. I would see what your holistic vet has to offer. I am using artemisinin for Tazzie and my other dog takes a chinese herb called Stasis Breaker to help reduce blood flow to her tumor. Fish oil, Power Mushrooms, and other antioxidants can all help in addition to a good diet.
You also might want to consider Metronomic chemotherapy since that can be given at home and your local vet can monitor bloodwork, etc.
Pam and Tazzie
Hi Eve and Romeo
I understand many of your concerns. I was driving 3 hrs with my dog for surgery, for the first two chemos. It was a pain, but had to be done. My dog was also a slow-starter following surgery so I really wondered if he would be ready for chemo.
But around the time we went back to the vet for chemo, he started to perk up. That was at the end of week 2, so he actually became perkier after the chemo, just because he was finally past the 2 week hump following surbery. He did slow down 1 week later (after having Adriamycin) for 2 days when his cell counts became low, but I can't say he felt ill, he just slowed down.
On Adriamycin (doxyrubin), he had some side effects: loss of appetite, hair loss where it was growing back - nothing serious but on the carboplatin he hasn't had anything that I could notice. We are doing a combined protocol, but a single drug is just fine.
In any case, I don't think you need to worry about your dog feeling sick throughout the months he is on chemo. My dog has been getting better and better, with perhaps one slow day (someone else might not even notice that). Except for the darn hair which probably won't grow back until we are done, it gives some assurance that there are things that might keep the mets at bay.
Having said all this, you can always stop the chemo if it does not work out for some reason.
When we had carboplatin, I was able to drive Tazzie home the same day they gave the drug to him. You should not have to be stuck in Vermont for a long time - maybe one night before chemo so you can take him in the morning.
I am now in a completely different city, with no oncologist anywhere near, so a 'regular vet' will be administering the chemo. I called a few places to find a clinic that had some experience - not too many do. In any case, she can handle both drugs (has lots of experience with adryamycin and nastier drugs for different types of cancer). I bet it will be heaps cheaper than at the long-distance oncologist where we were going before. They charged me prices similar to your quotes, which are pretty high compared with most experiences on this website. Then again, I am paying Canadian dollars which are currently worth less than the US kind.
It is reasonable to be torn about these decisions and I empathize with your long-distance issues. I was facing those all summer.
Susan & Tazzie 2
Eve,
We hope you are finding comfort here by our friends at Tripawds. There is such a variety of experiences that everyone has to share. And like everyone says, there are no "right" answers. Every dog is different, every situation is too.
It's so weird how when dogs get cancer, making treatment decisions is so different than if you were talking about a human family member who's battling an illness. In that case, protocol says you do everything within your means to fight for their life. But when it's a dog we are talking about, all that goes out the window. Humans are so weird.
As I mentioned before, we opted out of chemo for the exact same reasons you are considering. I'm not saying this is the right decision for anyone, this is just our experience. For us, not doing IV chemo was less of a financial decision and more of a decision to honor Jerry's zest for adventure, and hit the road for a while as pack. We went with our gut feeling, and got very, very lucky that he was able to beat the odds for so long.
Despite our luck, the fear that we made the "wrong" decision never really went away, at least in me, especially when we discovered lung mets sixteen months after diagnosis. For a while I was wracked with guilt over not doing IV chemo, but I had to let it go. Being miserable was not in Jerry's best interest, and if his time was indeed limited, I didn't want him to remember me as a crying mess. So I did my best to hold off on the tears until a day that would hopefully be far off in the future.
In my book, going with your original gut feeling is important. That feeling comes from all those years you have spent together with Romeo, knowing his personality and what he would want; your decision didn't just appear out of the blue.
Should you go the holistic route, remember that that option also comes with a high level of time and financial commitments, if it is to work the way it's supposed to. In many ways, traditional chemo could be a lot easier to deal with.
Talk about it some more with your partner, and just keep telling yourself, there are no "right" answers.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Eve, the final decision is yours and you will make the one that is right for you and Romeo. I had much the same fear as you when it came to making the chemo decision. I was terrified it would be much too hard on Trouble and would wreck her quality of life. I have an awesome vet, who along with my husband convinced me to give it a try. Do one treatment and see how he responds. Trouble did well with minimal side effects. She was a little nausious for less than 24 hours, and a little tired which ranged from a few hours to a couple of days.
Trouble had Carboplatin, and we asked our local vet to administer it. He consulted with a veterinary school 3 1/2 hours away and saved us a long trip for a patient that wasn't totally feeling well.
You might take my approach and see how one goes, you may be surprised.
Shanna & Spirit Trouble ~ Trouble gained her wings 3/16/2011, a 27 1/2 month cancer survivor, tail wagging. RIP sweetheart, you are my heart and soul. Run free at Rainbow Bridge.
The November Five - Spirits Max, Cherry, Tika, Trouble & Nova. 11/2008 - 3/2013 An era ends as Queen Nova crossed the Bridge.
I have nothing more to offer than what others here have said, but I just wanted to let you know that we are thinking about you and are making the same decisions. Jack just had his 4th chemo last Wednesday (adriamycin) and had clear x-rays before it was administered. He has had no side effects (sans 2 days ago, and once he got his anti-nausea pill he was fine) and actually seems perkier the day of chemo and the couple days following, but he loves our Oncologist and her tech, so I think getting to see them brightens his day 🙂 However, we are now having to decide if we want to continue with the last 2 treatments, try just one more, or just call it good and keep him on his supplements. It is a financial burden for us as it is almost $400 every 3 weeks, but Jack is obviously responding well to the chemo so we are going back and forth weighing the finances vs. the potential health benefits. As you can see, many dogs here have decided on different treatment options, and there is no right or wrong answer. You can always try one chemo session and see how it goes. I even read yesterday about a dog who had amputation only and is about to celebrate his FOUR YEAR anniversary. Every dog battles the disease in its own way, and you know Romeo better than anyone else to know what's best for him. Let us know what you decide!!
<3 Laura and Jackers
Hi Romeo and Eve
I guess you are hearing from us blabbermouths more than you bargained for! Me especially. As Jerry said, there are options and the decision depends on you, your dog and your lifestyle (e.g., an extended road trip like Jerry had might make traditional chemo hard!). Certainly we never got into a decent rhythm or away from the constant worry when I had to travel long-distance for Tazzie's treatment. The choice of carboplatin made it much easier on us, because there is so little worry about side effects. Having to worry about side effects is the pits.
But using metronomics
the way that Jerry did instead of chemo is not abandoning him. Metronomics is considered a legitimate treatment scientifically (although don't expect all vets to know about it), even though it has a slightly different role than traditional chemo. There are many different reasons to do or not do chemo - a few of us piped in simply to indicate that chemo will probably not lay Romeo low or mean he will become a lab rat (a role reserved for Tika 
). (Cherry had a different story in that she would not eat for a prolonged time throughout chemo - which might be a good thing for a crazy Lab like yours, ha.
But lots of dogs have happily hung around without having gone the chemo route too. Romeo is 9&1/2 and you probably caught the cancer early. He may do very well if you go the metronomics and holistic route.
I know what you mean about that darn Lab stomach and tummy-driven brain. My last dog was a yellow lab x shepherd cross, ALWAYS getting into something (often in someone's trash or some dead thing in the park) and ALWAYS getting sick. As it sounds for Romeo, he was totally fat intolerant by the time he was 5 and from then on was often confined to a diet of rice and cottage cheese or baby food for much of the last 11 years of his life (he lived to his 16th bday). (You might need someone to advise you on a cancer diet that is not too high in fat for Romeo given his GI history.) He even opened the oven door to get food and share it with his doggy visitors once when we stepped out of the house.
Susan & Tazzie 2
Eve and Romeo,
I'm so sorry you are here, but so glad you found us! It's a great place to identify resources and 'talk through' things.
There have been several pieces of advice that I have found that have helped me in my decision. First, there is NO wrong decision that is made in love. No matter what you decide, it's the right answer for where you are, with the information you have. You can only look at the information from the vets, and know your dog and your life, and weigh it all to come up with a decision.
I just finished the book Help Your Dog Fight Cancer and there was a section in there about how there are no contracts in this fight. You can start chemo and decide not to finish. You can start the more eastern medicine and then add chemo or the metronomic protocol type chemo later when lung mets appear.
It may help to think about what decision is going to make you feel less guilty. What I mean by that is that if you do get chemo and Romeo isn't feeling well throughout treatment, than that might make you feel terribly guilty. On the other hand, if you do the eastern approach, and then he gets lung mets, that too might make you feel horribly guilty.
Regardless, there are NO guarantees throughout. You could do chemo and get lung mets or you could do nothing and live cancer-free for 6 years. You could do chemo and he'd be fine, but then get into something else and have another bout of pancreatitis or similar. You just never know.
Here's my story. McGwire is an 8 year old Golden Retriever who has always been a grumpy grandpa type dog (not the typical happy-go-lucky Golden retriever like you think of, like his brother!) He has not been a healthy dog either. He has had terrible allergies throughout his life. He was on long term steroids for that which affected his liver. He's had every weird complication you can imagine and then some. When he started limping and I noticed the bump on his wrist, I 'knew' it was more than a sprain or broken bone. (We've known a dog with osteosarcoma so at least I'd heard about it, and I did have a feeling…) We amputated and I'm happy we did that. He's not in pain anymore and it hasn't affected him too much. We have decided not to do any chemo though because I know Mac wouldn't do well with it. As you said, he'd go with it if I asked him to, but he wouldn't be happy. As it is, he feels great! He's actually gaining weight-something that he's struggled with for his entire life! We are doing a high protein diet with lots of fresh food, K9 Immunity and transfer factor and he's loving it. He doesn't even mind taking the pills! Now that I have this food/supplement routine down, I am looking into adding some more supplements.
I have struggled with the idea that we aren't doing enough, but I know that we made the right decision for Mac. I did decide to get lung x-rays yesterday, about 6 weeks since the first, and so far so good, so that was a big relief! I just had this terrible feeling… I guess it just reinforced the idea that we are doing the right thing for McGwire, and that is everything.
Good luck in your decision. Read, read, read!!! Look at what stories you are connecting with. You will make the right decision! ((HUGS))
Dear Eve,
As everyone before has said, I totally understand where you are right now. I was actually just there over the weekend. It was a real struggle to decide whether or not to subject our puppy Bradley to chemo as we're used to the human experience of those drugs, and that is scaring the crap out of me. I have no way of knowing what his reaction will be or how sick he will feel. In the end we decided that chemo was one weapon we were not willing to give up in this fight. Bradley is a pretty young guy (6 yrs old in Dec. He's in his prime ladies, catch him if you can!) and pretty spunky so we are pretty sure he's going to handle it like a champ.
I wholeheartedly agree that there are NO wrong decisions, every dog is different and every cancer is different. I do like Mac's mom's philosophy of going with the decision that makes you feel the least guilty. I firmly believe that guilt is our heart's way of telling us what our brain can't digest yet. For me, I felt the most guilty when I was thinking of not doing chemo. Given Romeo's disposition and health you might feel more guilty doing chemo than going with less invasive treatments. I know you are going to do the best job caring for Romeo because you are his person and you wouldn't be on this website otherwise. Good luck with your decision and keep us posted on how Romeo is doing!
Our Best,
Erin & Bradley
Eve and Romeo,
Nearly everyone contributing here has been where you are now with the decision of how to best treat the Osteosarcoma. Every one responds to the treatment options differently and there are no hard-and-fast rules. Our local vet is also a family friend and has told of us two who were given the same diagnosis as Cherry shortly after Cherry's diagnosis. They either could not or would not take on the battle like we have and while I do not want to know the details, neither lived long after the diagnosis. Another who manages the local Pet Food Express chose to go solely with the holistic approach and they too did not have much of life afterward either in terms of length or quality. However, Jerry had a very high quality for an extensive period of time without the immediate chemotherapy. I only hope that Cherry can do as well for as long a period of time. We chose the amputation and chemotherapy and Cherry had a much more difficult time with the chemotherapy. It definately was the low point in the recovery and her complications prompted the oncologist to suggest reducing the dose to ease the complications. After making it know that I did not want the extreme reduction in the effectiveness of the chemotherapy that would result from the small reducitons in dose quantity, we moved forward with the full treatment program.
This journey has been both emotionally and financially draining. I retired in 2001 and am on a fixed income. At $11,000, the expenses for the surgery, chemotherapy, tests, and follow on visits represented 50% of my cost of living for the previous year. There has also been numerous additional expenses and there are no regrets. Cherry completed her 9th month of recovery last month and is doing quite well. Because of Cherry's age, I felt that I was on “borrowed” time prior to the diagnosis and this just pushes that out further.
It may sound from the above that I am pushing you but that is the furthest thoght on my mind. You have well researched the subject and will make the best decision for Romeo and your family. Please find comfort in the knowledge that what ever your decision, it will be the best for all of you. Another way of repeating – there are NO wrong decisions. If only medicine was an exact science, and there were a simple formula that would provide the optimal answer, but there isn't. The one constant though is that you should live for today and enjoy this extended time you have with Romeo. Stay as pawsitive as you can and project optimism constantly.
Paws crossed and nothing but pawsitive thoughts headed east,
Bob & Cherry
Dear Tripawd Friends: Thank you so much for your heartfelt and informative responses. I can't thank you enough. I wanted to write sooner, but it was a crazy day (I feel like I spend half my day on the phone with the vet), and I wanted to be able to write more than a sentence or two---so I waited until this evening. It 's reassurring to hear chemo went relatively well for most of the dogs (so sorry you had a rough time Cherry). Also, that some people chose not to do it---and that is ok too.
I think one of the things that is hard is the pressure to make a decision quickly and start coordinating the commute now---which
feels very overwhelming. Our daughter just started first grade at a new school and I am already pulling her out for two days to go to VT to check in with the vet. And Romeo is just getting some energy back. I really just want him to have a little time to adjust. I just think he needs a little break before gets started on this regimen. I feel like we've asked a lot of him to readjust to life on three legs. Of course, I understand the reasons for jumping in with chemo asap. Initially, the vet who diagnosed him said we should have his leg amputated immediately (like w/in 48 hrs)---we needed some time as a family to wrap our heads and hearts around it all. We took two weeks, and I'm really glad we did.
Now that I'm out of panic mode I think we have to try the chemo. This is an aggressive disease and I want to try and give Romeo every option possible. I pray we could be as lucky as Jerry. Sixteen months is wonderful. I could live with that. If we did not try chemo, however, and Romeo only lived two more months I would never forgive myself. Of course there are no guarantees---if he does not tolerate the chemo we will definitely not continue. Or if he is clearly miserable by all the commuting/ivs/vet time we can stop---he is very good at communicating his opinions. He has the world's most expressive eyebrows! He is also very adept at the "I am not moving" pose! It is good to be reminded--we can stop at any time.
This is difficult because my partner feels strongly we should not go the chemo route and we always agree when it comes to what's best for our family. But I think I've convinced her we should give chemo a try. Romeo really relies on Sylvia for her strength and calm.
She was the only one who could get him up and about those first 48 hrs post-surgery. And no matter what---he will jump up and hop to the door, tail wagging like crazy when she comes home from work.
And I will inquire about just doing the carboplatin--that sounds like a good option for us. Other thoughts, to talk more extensively w/
the New Haven vets about cost/regimen now that we have the biopsy results. $5500 was thrown out to us as a ball park figure (VT vets thought about 1500). Doing chemo here would be considerably less stressful than commuting. I am also wondering about
researching vets in other surrounding areas---outside the city. I have been trying to ask for recommendations. This practice in New Haven is very good clinically, but they are very, very expensive.
I really appreciate everyone being up front about the financial strain too. I know it is a very difficult place to be. Did anyone else buy a lottery ticket post diagnosis just for the hell of it? I am always afraid dog people will judge me for not doing enough. Of course then there are non-dog people, like my parents, who think I am jeopardizing my child's future by spending so much on "the dog" (although in fairness they have also been very considerate and concerned even when Romeo threw up in the guest bed!). Ok forgive me if I've divulged too much. I just really appreciate other people chiming in about the financial strain and difficult decisions. I know dogs don't care about money at all. I just love them for that---"Who cares! Let's go for a walk!"
Speaking of walks, Romeo had a breakthrough today. Romeo ran down the driveway and headed up the street on our old neighborhood route. Our routine has always been to go to the park in the morning and the neighborhood at night. Romeo had refused to go down the driveway. He would hang out in the yard, go to the neighbor's yard and ride in the car to the park. We're not sure if it was the concrete or he felt vulnerable, but he would not go out front. Today, however, I tried to get him in the car to go to the park. He refused and at first I thought he was too tired. But then I could see a little bounce in his step. I took out the leash and he started really running down the driveway! He was so excited, he just wanted to keep on going. I made him turn back at the end of the street---then we had to sit down for about 15 minutes on the corner. To be honest I'm not sure if he was exhausted or protesting the fact I made him stop!
Thank you all so much again for your help and good wishes. Love to all your beautiful, heroic dogs. I would not be able to make it through this without you. Love, Eve (And Romeo!)
(forgive me I just tried to post a p.s. and it didn't go through---hope this isn't a duplicate)
p.s. We are still going to try some acupuncture to help Romeo's quality of life. For human cancer patients I've known, acupuncture
has really helped them feel better. Also, I had trouble w/ the quote function so forgive the paraphrasing but I just wanted to say how much it helped to read "There is no wrong decision made with love" from Macsmom. I also loved Jerry's advice that "you don't arrive at a gut decision/feeling out of the blue---it's based on your history and relationship with your dog."
I think these sentiments were more eloquent the first time around....
Ok. Goodnight! Thank you all again, Eve
I wanted to say hey and comment, but I'm not sure if there's anything I can say that hasn't been said better by everyone else. I understand your stress so much and I'm sorry that you have to feel it too. The past few months have been so frikkin' trying. I have had to drive 4 hrs every time my dog Mac has to go to the specialist, and he never liked car rides to begin with. Including surgery and all the tests I've spent about $5,000, which was my life savings. Not to mention I was going to start school this year but couldn't since I had to stay home and take care of Mac. All the driving and money has been hard to deal with but he's worth it. I don't know if it's all been harder on Mac or not.....he's 13 and has some other health problems, but they don't worry about things like we do. When I need to cry I go in the other room so he doesn't see or hear since that can worry them though.
I have been on the phone nonstop too ever since I found out about the cancer. I've paid for consults with very good oncologists and specialists and have contacted more. I was wrestling with the chemo vs holistic thing or not too--I started a forum thread a little while ago http://tripawds..... , just in case there is something there to help you out. I have decided against chemo myself and am looking fervently into holistic options like artemisinin . Mac has hemangiosarcoma, which I'm told is the most aggressive cancer a dog can have. At first we were told he had osteosarcoma which is horrible enough, and now I wish that is what he had. So I am trying to gather as much information on treatment options as I can.
You will make the right decision, because you will make an informed and compassionate decision. I imagine you will have regrets either way after the fact, as so many people do, but we have to make the best decision at the time. I am glad that Romeo is doing well and running around even--3 1/2 weeks after amputation Mac is just walking around a bit.
Romeo is very loved and you're doing the best you can. He is lucky that you are going to such lengths for him. Some people hear cancer and automatically put their dogs to sleep, even if they can afford treatment. Hell, some people even shoot their pets once they get sick! I just know Romeo is thankful to have you and Sylvia.
It sounds like both of you - Jacki and Sylvia - have made good decisions for your dogs.
Jacki - it sounds like Mac is getting around pretty well for only a few weeks after surgery for a dog with health issues. You have probably noticed the crop of slow-starters that have showed up recently, even though they are young'uns. Mac looks perky in his new photo.
The dogs on this website are definitely well-loved. Judging from their photos, I amd sure that Tazzie would like to meet and play with every last one.
Susan
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