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Just Found Out My 9 year old, 105lb Boy Has Possible Osteosarcoma Bone Mass. Lost, hurt, and looking for advice - Long Post
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30 August 2024
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30 August 2024 - 5:45 pm
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Three days ago, my dog, Kevin, was diagnosed with a large bone mass on his front right shoulder, most likely osteosarcoma. The vet recommended X-rays and a biopsy, but Kevin has become increasingly aggressive with vets during these procedures. It took heavy sedation—double the dosage—just to get the X-rays done, which came back inconclusive/fungal & showed that his lungs are clear, and no blood work was done.

Yesterday, we met with an oncologist to discuss our options. She was wonderful with Kevin, approaching him calmly, and he responded well—sat right in her lap, gave kisses, and even enjoyed some butt scratches. However, sedation remains a challenge. She suggested using an IV, but I knew that would likely trigger his aggression again. I suggested using the same sedation method we used previously since it was just a quick shot in the butt, but the oncologist advised against it due to possible complications from repeated use in such a short time.

The oncologist had a candid discussion with us about our realistic options. Kevin is a 9-year-old, 105-pound large breed dog. While I have pet insurance, I’m EXTREMELY concerned about the upfront costs of chemotherapy and whether it's the right choice given the stress he's already experiencing. The oncologist mentioned that if we don’t pursue chemo, there’s little point in doing additional testing or amputating the leg—though amputation could alleviate pain and prevent future fractures. Radiation could kill the tumor but would also weaken the bone so much that it could break.

We left the appointment leaning toward focusing on keeping him comfortable with minor pain meds and monitoring his quality of life. However, I’m now feeling conflicted. I was hoping for more definite answers, but instead, I’m faced with many uncertainties.

Here's where I need advice:

  • We don’t have a biopsy confirming cancer.
  • No blood work has been done to assess the spread.
  • The X-rays show it’s not in his lungs.
  • Kevin’s aggression at the vet complicates any future procedures since he’ll need heavy sedation or be muzzled.

I'm torn between moving forward and accepting this or pursuing additional tests to get a biopsy that reads cancer and know how much its spread. If the cancer hasn't spread, I could be open to amputation, but right now, I just don’t know. If we consider amputation, does that mean we also have to commit to chemo regardless?

Additionally, I'd love to hear from anyone who has had an older, very large dog go through a similar situation. Kevin has the chest of a lion (not an exaggeration), weighs 105 lbs (a mix of fat and muscle), and is still jumping in and out of my large SUV, on and off our beds, and going on 1-2 mile walks every day. He just started showing a slight limp last week, but it’s not too bad yet—he’s still jumping, running in circles, and being his usual self.

Here are my main questions and concerns, but please feel free to add anything else you think I should consider or ask the specialist:

  1. Is he realistically going to be able to manage his weight and size with a front leg removed?
  2. Is he mentally going to adjust to waking up without a leg?
  3. Is it right for me to take his leg at this point in his life? Is that an unfair decision to make for him at 9 years old, forcing him to adjust to losing a leg?

Thank you all for listening and any advice or shared experiences would be greatly appreciated. I just want to make sure I’m making the best decision for Kevin’s quality of life over quantity.

The Rainbow Bridge



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30 August 2024 - 8:30 pm
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Hi Vincent and Kevin, welcome. Your future posts won't need to wait for approval so post away. 

I'm so sorry you are in this situation! It's a tough one and it's even harder when your dog is bigger than most. We will try to help you decide, and know that whatever path you take we are here to support you. 

So about this:

 The oncologist mentioned that if we don’t pursue chemo, there’s little point in doing additional testing or amputating the leg—though amputation could alleviate pain and prevent future fractures.

Are you positive that's what she said about amputation? Because amputating is the fastest way to alleviate the pain he is in. A limp = pain, bad pain when it comes to a bone cancer. I'm concerned about this comment because I've never met an oncologist who didn't stress the importance of at the very least amputating to alleviate pain, or doing stereotactic radiation therapy for palliative care if that is a possibility. Some people go the radiation route if their dog isn't an amputation candidate and that is perfectly OK.

 If we consider amputation, does that mean we also have to commit to chemo regardless?

Not at all! Chemo can statistically give a dog a better chance at living longer but it still cannot guarantee longevity. Lots of dogs do the chemo and still do not live up to the prognosis. Lots of dogs don't do chemo and go way beyond it. It is a total crapshoot.

MANY people do not do chemotherapy for whatever reason, myself included. It is crazy expensive and many dogs just don't do well with multiple vet visits. And that is OK! We opted out of chemo for osteosarcoma, and our Jerry lived 2 years after amputation! Some dogs go longer too. Chemotherapy is 100 percent optional, please don't let anyone tell you otherwise. The point is to get rid of the painful leg. Any bonus time after that is icing on the cake.

 Kevin has the chest of a lion (not an exaggeration), weighs 105 lbs (a mix of fat and muscle), and is still jumping in and out of my large SUV, on and off our beds, and going on 1-2 mile walks every day. He just started showing a slight limp last week, but it’s not too bad yet—he’s still jumping, running in circles, and being his usual self.

Please do not let him jump, or go on long walks right now. There is a huge risk of fracture if this is indeed bone cancer. You don't want to let the pain get so obvious he's limping even more, and you don't want a sudden fracture. It's horrific and puts you on the spot to decide immediately. 

Is he realistically going to be able to manage his weight and size with a front leg removed?

104 pounds is big but not the biggest dog we've seen here, some up to 175! If he is overweight, that will impact his mobility but you can help him lose the weight with your vet's help. The best orthopedic vets tell us that size alone should not be a determining factor. Bigger dogs may take longer to recover by a couple of weeks or so but they do recover!

Is he mentally going to adjust to waking up without a leg?

Yes! Animals do not carry the baggage that we do about amputation. Once his recovery is over he will move on with life and be the dog he always was. You will be amazed.

Is it right for me to take his leg at this point in his life? Is that an unfair decision to make for him at 9 years old, forcing him to adjust to losing a leg?

Many bigger dogs have gone through this at an older age. See our Size and Age Matters Forum, and Giant Breed News posts. If he is otherwise healthy and doing well, there's no reason why he can't live out the rest of his life happy and without pain. Many giant breed dogs who are much bigger get that extra time with their people.

Here's what I want to add: although you don't have a concrete diagnosis, the important thing to ask is: is the leg beyond saving? If so, there's no point in more diagnostics like a bone biopsy, because you are just creating more pain and more risk of fracture. These tests can happen once the leg comes off, if that's what you decide. And those tests are only really necessary if you are sure you want to pursue chemo. 

A final option you may want to consider is cementoplasty. It's relatively new here in the States but not overseas, and it's been done in human medicine for many years.  The cost is similar to amputation surgery and the dog gets to keep the leg. It's not a sure thing but neither is amputation as far as guaranteeing longevity. Not too many vets here in the US are doing it but more are getting on board. It's a nice alternative to radiation therapy and amputation if your dog is a candidate.

I hope this helps! Please keep us posted.

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31 August 2024 - 7:46 am
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Thank you for your reply and everything you took the time to explain. I can't express how much I appreciate it.

Are you positive that's what she said about amputation? Because amputating is the fastest way to alleviate the pain he is in. A limp = pain, bad pain when it comes to a bone cancer

Here is what we were told which is similar to what you are saying. I believe their thoughts are we'd be amputating a leg for only 2-4 months (guestimate since all we have is xrays of the mass) - "If you elect to do an amputation, radiation therapy is then not needed.  Chemotherapy is recommended afterwards as that is the only thing that will prolong his life after amputation.  If you just amputate his leg then survival is only 2-4 months at best.  Amputation is truly only to get rid of pain and the tumor.  But the tumor has already been releasing tumor cells all throughout his body.  So once you amputate those cells will then begin to divide which will lead to his death.  Amputation followed by chemotherapy we would expect about 12 months survival. Again all of this data is if it is osteosarcoma."

Here's what I want to add: although you don't have a concrete diagnosis, the important thing to ask is: is the leg beyond saving?

How do I get this answer? If it is or is not beyond saving, how does my path forward change? Does that mean radiation would be better than amputation? We were told radiation would just weaken the bone as much as the cancer is so we kind of put that option to the side all together.

A final option you may want to consider is cementoplasty. It's relatively new here in the States but not overseas, and it's been done in human medicine for many years.

Thank you so much for teaching me about this. How do I find a vet to consult with in the US that would perform this? Are there resources that list approved or willing vets? I'd love to see if he is a candidate asap

The Rainbow Bridge



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31 August 2024 - 1:41 pm
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OK thank you for clarifying. A few thoughts:

I'm not a vet, so FWIW. But I take exception to "Chemotherapy is recommended afterwards as that is the only thing that will prolong his life after amputation."  The fact is, nothing will guarantee prolonging of life after amputation. Not chemo, not cementotplasty, nothing. Many people spenda  LOT of money for chemo, only to find that their dog did not live up to the prognosis of treatment. Chemotherapy is still a big crapshoot based on what we have seen here. Despite more and more dogs getting chemotherapy, survival rates have not improved for osteosarcoma. Don't get me wrong, I'm not against chemo at all. I Just feel like more people are given the impression that it's mandatory, and it is most definitely not. 

Treatments using chemo and immunotherapy can boost the odds, and recent studies are showing that it's the most promising treatment in three decades. But even then, it does not guarantee longevity or quality of life. Did the oncologist mention anything about immunotherapy as an option? 

Yes, "micrometastasis" is usually happening behind the scenes by the time a bone cancer diagnosis is given. But how fast those mets will impact quality of life is anyone's guess. Many dogs will go on for a long time with a great quality of life after amputation alone, despite micro mets coursing through their body. And, micromets can still be present even with chemo, there is no guarantee chemo will knock them out. That is the goal, but it's not a guarantee.

Yes, radiation therapy can weaken the bone, which is why bisphosphonates (bone building infusion therapy) are given. Most people like Hazel's dads, however, find themselves back at the amputation decision within a year because the tumor either comes back or the bone is weakened to the point of needing amputation asap.

As for finding out if the bone is beyond saving, just ask the vet. A destroyed bone will have a moth eaten appearance, or a tumor that is so big there is nothing that will decrease it. An x-ray alone will show if the bone is so far destroyed there is no saving it with radiation or cementoplasty. An orthopedic vet surgeon can give you the best answer but even a general practice vet can look at an xray and tell. Your path forward changes because it rules out limb-saving therapies like cementoplasty or radiation therapy, and it's either amputation or euthanasia.

Reach out to Biocera Vet and ask for a list of US vets who are doing the cementoplasty therapy. Let them know where you are in the U.S. 

Amputation can bring back quality of life once recovery is over. No, dogs are not exactly the same physically afterward, but they are happy and able to enjoy life again, in a slightly modified way. If chemotherapy visits will stress your dog, at what cost is that potential longevity? That's what you need to ask yourself. 

All stories are different, and all studies do not take your dog into consideration. Your decision is personal, as unique as your dog. Some people do chemo because they want to leave no stone unturned and their dog doesn't mind the vet. Some people don't do chemo for financial or temperament reasons. There is no judgement here. We will support you no matter what you decide.

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31 August 2024 - 7:53 pm
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Did the oncologist mention anything about immunotherapy as an option? 

No, but I started looking into holistic changes I could make in his diet asap (just like a human would) and found mushrooms + CBD oil with a raw diet have been successful in prolonging the life of a couple dogs that didnt have their legs amputated or do chemo. I already ordered the supplements and diet options they used, it doesnt hurt to try and start as early as possible.

Yes, radiation therapy can weaken the bone, which is why bisphosphonates (bone building infusion therapy) are given. Most people like Hazel's dads, however, find themselves back at the amputation decision within a year because the tumor either comes back or the bone is weakened to the point of needing amputation asap.

Bone infusion therapy was not discussed with us but our oncologist shut down radiation pretty fast. It seems they don't see much success normally with that route.

Thank you again for just talking me through this and teaching me about Cementoplasty,

The Rainbow Bridge



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1 September 2024 - 10:27 am
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Ok don't confuse immunotherapy with the marketing angles of boosting the immune system. Immunotherapy in the more evidence-based world is cancer vaccine therapies like the Yale Vaccine. This is a well studied treatment that is shown to boost the odds of longevity, and has legit science behind it. Check out the link.

Also, please be careful with any supplements that promise remission without amputation. Bone cancer is a seriously painful disease that needs addressing asap and no amount of CBD oil, food, or mushroom therapy will help with that pain. Don't get me wrong, I'm all for upgrading a dog's diet, but this type of pain is really bad so please don't put off veterinary treatment OK?

If it will make you feel better to get another opinion from a different oncologist, you might want to do that just for peace of mind.

The Rainbow Bridge



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1 September 2024 - 10:33 am
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Vincent said

No, but I started looking into holistic changes I could make in his diet asap (just like a human would) and found mushrooms + CBD oil with a raw diet have been successful in prolonging the life of a couple dogs that didnt have their legs amputated or do chemo. I already ordered the supplements and diet options they used, it doesnt hurt to try and start as early as possible.

Forgot to add: I'm curious where you saw this information, can you share? Thanks.

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1 September 2024 - 10:37 pm
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Forgot to add: I'm curious where you saw this information, can you share? Thanks.

Here are the 2 stories I've been deeply researching. Regardless if either of these owners believe what they did was a cure, I will not be ignoring professional opinions for my dog, especially the mass and his bone. Any diet changes I make from these stories will be to give my dog the best fighting chance internally against the cancer eventually reaching his lungs. Since Osteo can't be cured, best I can do is make healthy changes and/or chemo.

https://angelaa.....e-with-it/
(Note - the second link is just the best link to share for you to find the entire story. It was their first post since diagnosis and the dog did have to have their leg amputated 22 months later - however no metastatis in those 22 months. Both of these stories are absolutely extremely rare and they got very lucky. I'm so happy they were able to get to spend that extra time with their families with a great quality of life.)

The Rainbow Bridge



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3 September 2024 - 9:30 am
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You do have a really good perspective on things, keep it up! And thanks for sharing. I don't know if the person in that video had their dog on any kind of pain control but I sure hope so. This cancer is painful and nothing compares to it, only dogs are so good at hiding that pain you'd never know.

Honestly I understand the need to try to make these changes. We did the same for our Jerry, researched diet like crazy and tried our best to keep the cancer from spreading. It didn't spread for two years, but we have no idea if what we did for him was the reason for him beating the odds. I've learned that you can spend a ton of money on these changes, and still end up with the same result as someone who doesn't. Same holds true for conventional chemotherapy. But you have to do what you feel is best for your dog, and his quality of life. I get it, we all do.

Thing is, over the years I've seen lots of questionable sales pitches from companies selling unproven and untested products to desperate pet parents wanting to help their pets with cancer. It makes me smiley7! These companies pop up every day, and often disappear as quickly. My advice fwiw: the best thing you can do if you're going the natural care route is to work with an integrative veterinarian who can guide you so you aren't wasting your money on ineffective products. Every dog is unique and so is the cancer in their body. A vet can assist in choosing diet and supplements that work with your dog's physiology. You will feel so much more confident if you do.


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6 November 2024 - 2:53 pm
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Can you post an update on Kevin and what you decided to do? We have a 98 lb malamute mix who is 8.5 years old and in exactly the same boat today and we're trying to figure out what to do!

Virginia



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6 November 2024 - 5:06 pm
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Hi Rebecca....your post has been approved so we look forward to supporting you in any way you find helpful.

Here is any update from Vincent, Kevin's hooman. 

  https://tripawd.....r-2-weeks/

Feel free to start your own journey with your pup and then we can focus just on your pup.  What's his name?

Keep us posted and let is know any questions  you may have, okay?

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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