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Caring for a Three Legged Dog or Cat

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How much chemo?
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Santa Fe, NM


Member Since:
19 July 2016
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1 October 2016 - 11:10 am
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as in how many rounds? Isa just had her fourth round on Thursday and has handled it great, better even than the third round which seems odd to me but I'll take it.

The question is when we were diagnosed the vet set 4 to 6 rounds of chemo. I didn't ask what the criteria was between doing 4 or 6, at the time I had a few other things on my mind. So when I picked her up Thursday that was obviously the time to ask. He said it was up to me - however much I could afford. (Stinker also brought up how much a break on the bills he's given me over the summer. I told him I was aware of it and I appreciated it. Still, I think it was a stinky thing to bring up.)

I've run a couple of searches on the forums and have seen both 4 and 6 rounds of carboplatin mentioned. So who decided enough was enough? Is it really just a matter of money?

Thoughts? What's been your experience?

Thanks and hugs all around!

Right rear leg amp 7/12/16 due to OSA. Metastatic lesion on her right front leg, January 2017. Joined the Winter Warriors January 19, 2017. Run free my sweet girl.

Virginia




Member Since:
22 February 2013
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1 October 2016 - 11:34 am
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Ahhhh...the million dollar questionquestiin!

All I can tell you is my experience with my Happy Hannah, plus what I've observed here.

You will see some had four, some had five, znd some had six. Not much help, huh?!

My Happy Hannah had four rounds of Carboplatin as recommended by her Onco. At the time, the Onco was a somewhat recent graduate at Cornell (or Clemson?) and told me that's basically what they were being taught. She said that "more wasn't necessarily better".

It appears Oncos all agree on four, and then after it's a toss up. And, in my opinion, an individual decision based on what your gut is telling you and if your Onco is pushing strongly for more.

For me, I was had no regrets, no second guessing whatsoever, voing with four. It was time to stop with the vet visits, the poking and prodding a d getting on with life!!

My Happy Hannah and I had a glorious extended time of one year and two months of spoiling and loving and happy memories!

If I'm ever faced with the decision again (hopefully NEVER), and if chemo was the route, I would be very comfortable with just doing four.

Hope this helps!

Lots of 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!

Santa Fe, NM


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1 October 2016 - 11:47 am
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Thanks Sally, that does help, at least some.

That is the basic question - is there value enough in the extra rounds of chemo to justify the cost?

I know you're right about listening to my gut but my brain has a tendency to butt in when money is involved, whether I like it or not. I think that's why I was unhappy about him saying it was up to me.

How old was Hannah when she was diagnosed? At least with Isa I can't help but think that her age has to factor in. And you are so very right about being done with poking and prodding and vet visits! but even cutting back to every three weeks is huge now that the bandage is gone.

I appreciate your input and I'll keep hanging around to see what any/everyone else has to say. I've got three weeks to make up my mind (thank goodness).

Peace

Right rear leg amp 7/12/16 due to OSA. Metastatic lesion on her right front leg, January 2017. Joined the Winter Warriors January 19, 2017. Run free my sweet girl.

Virginia




Member Since:
22 February 2013
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1 October 2016 - 12:15 pm
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For a Bull Mastiff, my Happy Hannah was considered "mature" at 8 1/2.

Interesting about the "financial" comment your Onco made. The Onco ais d Surgeon worked with me on a payment plan. When I say (on here) hat some did five, and some did six, I was concerned she was suggesting four because of my finances. I did research and found four was indeed, a viable and acceptable number.

There was actually somewhat of a "study" trying to make a statistical comprions of days added as a result o more chemo.

I have an AWFUL time trying to "search" stuff, but oter tech will come along with the link. I think it showed some "extra" days statistically with more.

I guess I've been here long enough to realize statistics REALLY don't mean much around here! It goes back tot it all being a crap shoot.

heart

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!

On The Road


Member Since:
24 September 2009
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1 October 2016 - 1:58 pm
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Oy! Your onco said that? Eeek.

When it comes to osteo chemotherapy, this is the big question with everyone in veterinary oncology. Nobody really knows for sure. But here's a blog post that a super smart member wrote a while back, about four rounds of carboplatin (which I assume you're talking about) versus six:

How Many Chemotherapy Sessions are Best for Osteosarcoma in Dogs?

Don't forget you can also search our blogs for information you're seeking OK? Use this Site Search link.

And always remember, whether you do four or six or none at all, it's always a crapshoot. Nobody can say your dog will live longer with or without it. We've had thousands of members here who've chosen both paths and it's always a toss-up what the outcome is. All we can do is make a decision we can live with, one that makes us and our Tripawd happy and provides the best quality of life possible.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

Member Since:
14 February 2016
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2 October 2016 - 2:12 am
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Otis had four.  That what was what recommended by our oncologist.  There was no financial consideration involved - that was the treatment plan established all along.  No idea whether six would have extended his life in a meaningful way, but I was really glad when chemo was done.  He got back to pretty much 100%, felt great, and we had a great four months until he passed. 

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.

Santa Fe, NM


Member Since:
19 July 2016
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2 October 2016 - 11:46 am
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Thanks for that link Jerry, read through twice and can almost wrap my brain around it. It has left me with a couple of questions for my vet before I make a definitive decision. With follow up questions on metronomics and/or Palladia.

Isa really has tolerated the carboplatin well - from what I can tell around here better than a lot of others. I've always known she was a tough cookie. I'm blown away at it getting easier on them as treatment progresses - my personal experience with human chemo is that the side effects with every round get worse. Note to self: don't confuse human physiological reactions with a dog's. (duh!)

Yes, it's all a crapshoot with this stupid disease and short of consulting my crystal ball, I can only do what I can do. All of your input has helped, tremendously so thank you. I'll keep you posted.

Teri and Isa.

Right rear leg amp 7/12/16 due to OSA. Metastatic lesion on her right front leg, January 2017. Joined the Winter Warriors January 19, 2017. Run free my sweet girl.

Santa Fe, NM


Member Since:
19 July 2016
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5 October 2016 - 10:56 am
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Sigh. Talked to my vet yesterday, asked about the predictors in the study linked by Jerry. He said Isa's mitotic count was "a little" elevated, then more or less negated everything everyone here said and discounted that particular study as not having enough data (and/or being inconclusive). Bottom line, he's encouraging me and would clearly like to do additional chemo but is reluctant to be pushy about it because of the money. I just got my Care Credit bill the other day and freaked out a little. I do this every month when the bill shows up; after a couple of days I manage to forget about it. So maybe in another week when I've gone back to the "money be damned" attitude, I can do this.

I still have two weeks to make a definitive decision. But if possible I'm even more confused. Isn't this fun?!

Take care all.

T&I

Right rear leg amp 7/12/16 due to OSA. Metastatic lesion on her right front leg, January 2017. Joined the Winter Warriors January 19, 2017. Run free my sweet girl.

Member Since:
15 July 2016
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5 October 2016 - 12:00 pm
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Hi,

Milo had his amputation at Tufts University.  They have two oncologists on staff there.  One did residency at Penn, one did residency at Cornell (I think.)  One was trained doing 4 rounds of chemo.  One was trained doing 6 rounds of chemo.  So they have chosen to settle on 5 rounds of chemo at Tufts -- simply splitting the difference.  The oncologist we talked with said there wasn't solid data favoring 4, 5, or 6, hence their decision to pick the middle.

We originally were in a clinical trial being hosted by 20ish research facilities around the nation.  The protocol for that trial was 4 rounds of carboplatin, and then some dogs would go on for additional treatment with Rapamycin. 

So, basically, I have nothing new to add other than there doesn't seem to be a definitive answer.

Peace,

-Jenifer & Milo

Santa Fe, NM


Member Since:
19 July 2016
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5 October 2016 - 1:55 pm
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Hi Jenifer,

I think you're right - the only answer is nobody knows. Too bad no vet will ever say such a thing, at least not to any of us. 

I have thought about doing five as a compromise position. That feels manageable budget-wise and perhaps in the interval between five and six, I will have won the lottery or something. Or maybe recovered from this particular chapter of money freakout.

Thanks for your two cents - Tufts is a good authority to cite to.

Take care

Teri and Isa

Right rear leg amp 7/12/16 due to OSA. Metastatic lesion on her right front leg, January 2017. Joined the Winter Warriors January 19, 2017. Run free my sweet girl.

Virginia




Member Since:
22 February 2013
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5 October 2016 - 2:49 pm
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It really does boils down to whatever "feels" right to each individual and their personal circumstances and each individual dog and how they feel about Vet trips, etc.

Just to muddy up the water for you, but to further prove itsw pretty much a crap shoot:

One of our heros, Otis, had four rounds and headed for the Bridge after four months.
One of our heroes, Sassy, had three rounds before mets were found, yet got almost eight months.
One of our heroes, Queen Nova, did four rounds and got FIVE YEARS.
Dr Pam referenced a dog who got two years with NO chemo and amputation only. Unfortunately I cant fi d the specific case.

NO ONE KNOWS WITH CERTAINTY!!

What we do know is we MUST savor every second and make every day the best day!!! We must throw away the calendar and live in the moment with our furbabies! Dogs don't use calendars! They don't love for days in a mk th, they live for love and spoiling!!

I will mention that some follow up tne rounds of chemo with Artemix (it combines the tnree herbs of the Artemisinin family)

Hugs to you and Isa!

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!



Member Since:
21 May 2016
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7 October 2016 - 5:51 am
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Hi Teri and Isa❤️🐾

I am sorry I am late joining in, just saw this thread and wanted to share our chemo experience.

My girl Eurydice did 6 sessions of carboplatin with zero side effects.

Her onco mentioned in the beginning, treatment would be between 4 and 6 but it would depend on how well she would tolerate it and blood results. 

He said there is a consensus that 4 is the minimum and 6 is ideal if the dog reacts well and blood is ok.

He added there is no point doing more than 6 sessions because damn cancer cells 💩💩💩 learn how to replicate despite of chemo, after that. 

Isa has done as many sessions as a lot of others here and in the end we have no guarantees whether we do 4, 5 or 6.

I personally felt reassured by doing the maximum possible but a lot of it is to do with the fact that I am anxious to try anything and everything (within reason) that might get us more quality time. 

Of course, you never know with this crap disease💩💩💩

Eurydice is now on metronomic therapy, we started 2 weeks ago and she is doing really great. 

This is a long term daily treatment (chemo, antibiotic and anti inflammatory pills) so it requires monitoring blood and urine very regularly as there are potential side effects which need to be taken seriously.

Nevertheless, with regular monitoring we can stop or reduce treatment before damage is done.

I am not sure how much cheaper metronomic therapy would be compared to carboplatin but maybe it would be worth for you to investigate it?

Sweet Teri, I so understand your doubts and worries, it is impossible to follow a route with garanteed results, all we can do is what we feel is best for our babies, here's the plain truth.

Wish you the best of luck for Isa, follow your heart and keep pampering and loving your girl every day 💘 

We are all here for you 💓

Sending you a big hug and cuddles to your sweetie 😘🐾❤️

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 :-) 

Santa Fe, NM


Member Since:
19 July 2016
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12 October 2016 - 4:08 pm
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Oh thank you! I have decided on doing the fifth round of carboplatin (due next week) and am deferring the decision on the sixth until after number five is over and done. If I split them up in my thinking, I can handle the financial aspect a little more easily. As you say, doing the maximum possible is reassuring and Isa has had no real adverse effects - her appetite is off and her nap schedule increased for a couple of days.  I feel better about adding the two "extra" sessions with the "if the dog reacts well and blood results" rather than what my budget will tolerate. Much better criteria to my thinking.

I will look into metronomic therapy when we're through with the chemo. Seems pretty popular in these parts.

I'm really grasping now what a crap shoot this journey is. I haven't been here for about a week and the first thing I see is Tess has gone to the bridge. So grossly unfair, I've been crying at my desk all afternoon.

As for Isa and I, we're going to head to the river this weekend. Too soon it will be too icy and cold to make it down the steep, scary road to our favorite spot.

Right rear leg amp 7/12/16 due to OSA. Metastatic lesion on her right front leg, January 2017. Joined the Winter Warriors January 19, 2017. Run free my sweet girl.

Member Since:
27 September 2016
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12 October 2016 - 4:59 pm
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Thanks for asking this question Teri. It is a question I have as well and the responses have been helpful. My Fionn will start carbo next week at UC Davis. Someone mentioned the osteo trial going on right now. Fionn was rejected for the trial sad which would have included only FOUR rounds of carbo for half the participants and 4 rounds carbo and the addition of Rapamycin for the others. Now that he isn't in the trial, they are recommending 6 rounds. I will be asking why 6 vs 4 at our first treatment next week. There is such a thing as chemoresistance. Its very similar to bacteria becoming resistant to antibiotics. 

Don't ever feel bad about money playing a part in our decisions! We've all been there and it matters, unless we have unlimited cash available and, even then, there are no guarantees spending more will play any part in survival times. Like you said, it's a crap shoot. Best wishes to you and Isa! Enjoy that swimsmiley

Nancy- mom to the FABULOUS Fionn. He rescued me in 2015 when he was 6. 

Right front leg amputation at age 7 for osteosarcoma 10/6/16. Taken too soon 6/12/17. Read about our journey here:

http://fionnsjo.....pawds.com/

Virginia




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22 February 2013
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12 October 2016 - 5:03 pm
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Alright, you have a plan and can put that behind you now! A d, .lst importantly, it "feels right", and sometimes that's an important deciding factor when there are no real clear answers. As one member recently said, "Onward and upward"!

Have a GREAT time at the river! We expect to see lots of pictures and videos, okay?! 🙂

Love to Isa and all!

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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