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Osteosarcoma lung mets on X-Ray. What is the best next step in treatment?
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Forum Posts: 4
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23 August 2018 - 8:45 am
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My fur kid Radcliff was diagnosed with Osteosarcoma on May 3rd.  Since then, he has had a right forelimb amputation and two rounds of Carboplatin chemotherapy.  Raddy has been so resilient, energetic, and happy that it came as a complete shock when the x-rays taken this past Monday showed several mets in his lungs.  To say I am heartbroken and devastated is an understatement.

Now I find myself conflicted about the best next step.  I am in process of making an appointment with the complimentary and alternative medicine doctor at my animal hospital.  It seems that many of you on this site have had great success in maintaining health stability by integrating immune supplements and antioxidants for support. This strategy of maintenance feels proactive, and I imagine that it doesn’t cause adverse effects if correct dosage and correctly targeted supplements are given; is this right?

I am also contemplating trying the maintenance chemo regimen of Palladia and Cytoxan.  My awesome Oncology vet did honestly express concern that there is generally a poor response rate to these drugs once the Osteosarcoma metastasizes to the lungs, but she also stated that she has had the occasional dog benefit from this regimen.  My concern is of course quality of life.  If these drugs leave Raddy nauseous and with gastrointestinal upset, or the Cytoxan results in bladder complications for only for no or minimal maintenance, is it right for me to pursue this treatment?  

I guess my question here is do people have experience in treating Osteosarcoma at this stage with just dietary and supplement support?  Are there folks who have tried the combined approach?  How did these options go for you?  Which approach do you think would be most effective at this point where quality of life is also paramount in my decision?  Thanks so much for any advice anyone can give.  I have referenced this site numerous times during this difficult journey.  This community is so inspirational and supportive.  I truly appreciate you all.

The Rainbow Bridge



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23 August 2018 - 11:06 am
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Raddy and family, welcome. We are so glad you chimed in, but sorry you needed to do it because of mets.

To start with, first, celebrate that he is feeling so good and enjoying life! Don’t forget to remember that is such a blessing! He doesn’t know what the x-rays said, he just wants to keep having a ball for as long as he’s here.

Now, I’ll try to share our feedback:

I guess my question here is do people have experience in treating Osteosarcoma at this stage with just dietary and supplement support?  Are there folks who have tried the combined approach?  How did these options go for you?  Which approach do you think would be most effective at this point where quality of life is also paramount in my decision?  

Yes, it’s my guess there’s about a 50/50 split between people who continue some type of conventional treatment like Palladia, and those who only choose to manage the symptoms with nutrition and herbal remedies. We chose a combo of both for our Jerry, metronomics and also medicinal mushrooms (K9 Immunity ). He had no side effects to either.

Like Raddy, Jerry was showing no symptoms of his mets. We started the metronomics and herbs, and he did really, really well for much longer than anyone expected (7 more months, and he went on to live to the average life expectancy for his breed, 10 years). We were lucky, and so blessed.

What I’ve learned over the years is that however you decide to approach the mets, as long as you do it with his best interests in mind you can’t go wrong. Like traditional chemo, you can always stop the Palladia if you don’t like the results. Your onco is right: many dogs don’t respond to it, but we have seen dogs here who have. It’s a crapshoot, just like amputation itself (which you did, you took a leap of faith and he got more quality time right?). Then again so is metronomics and anything else you choose.

This cancer is such a nasty, do what it wants disease, and we’ve seen it go all sorts of ways. If you do what you think Raddy would want, it’s a decision you will feel good about in the long run. I hope this  helps. Please keep us posted and let us know how he’s doing. We send all our love for many, many hoppy times together.

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The Rainbow Bridge



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23 August 2018 - 11:07 am
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P.S. I”m in the Tripawds Chat room right now if you want to talk.

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23 August 2018 - 12:04 pm
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Hi Radcliff and family 🐾🌸

I am very sorry to hear your pup developed lung mets, these are the news all of us hope not to hear.

When my baby Eurydice developed lung mets we started metronomic therapy, when that did not work we started doxorubicin (IV chemo) and then briefly tried Palladia.

There were no side effects from any of these.

We also went the holistic route with regular acupuncture, mesotherapy and chiropractic treatments.

She had B12 injections which are supposed to boost the immune system but those were so brutal that after the second session I declined to have any more.

My girl lived 6 1/2 months with lung mets and she was her very happy, active self for the vast majority of that time. 

Others have tried lots of supplements and they will tell you about them.

You know Radcliff better than anybody else, if he wants to fight the fight then do it!

There is still lots of time ahead, you just have to rethink your strategy and continue enjoying your life with your gorgeous pup. 

We are all here for you, please keep us updated and ket us know how we can help.

Sending you an avalanche of kisses and cuddles 😘🐮💫✨🌟🌹

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

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23 August 2018 - 4:17 pm
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Thank you both so much for your responses!  You are right; I can stop the treatment at any time if Raddy experiences side effects that compromise his quality of life, and it really is a crap shoot–I won’t know if something will be effective unless I try it.  Radcliff is pretty strong at this point in time, so he definitely has some spunky fight left in him.

So, with the promise to him that I will stop the chemo if he has side effects that don’t respond to dose adjustments if needed, we are going to give it a try.  One question though…is the Palladia and Cytoxan that is being recommended the same as metronomics , or is it a different treatment regimen?  There is a lot if information to keep straight!

Thanks again; the support and the information you are offering is SO appreciated!  heart

Minneapolis, MN
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23 August 2018 - 11:52 pm
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Hi:

What your vet oncologist is suggesting is a hybrid approach between the metronomics , which will be the Cytoxan, an NSAID and Doxyclene probably 4 days of the week and the Palladia on 3.  Our vet oncologist clearly read the same studies.  We did this two years ago for Pofi – he had a soft tissue sarcoma and we had bad margins with the amputation. As the tumor had compromised a lymph node, it was considered remote metastasis.  CT scan had some questionable white spots, but he never did have lung mets.  

In general, Palladia has been most successful, I believe, with Mast Cell Tumor inhibition, but there has been some indication it can slow lung mets down and there were studies that indicated the alternating metronomics adn Palladia could yield better results (more time).

We had to stop Palladia for a few weeks because there was a non cancerous growth that needed to be removed and it is contra indicated just before and after surgery.  During that period, the STS came back in force for our boy. But I think it may have held cancer at bay for several very good months.

Let me know if I can answer any more questions about our experience.

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His canine sister also succumbed to cancer on March 1, 2019 - we lavished her with our love in the interim, but life was never quite the same without her only real canine friend. Cliff kitty had to leave us, too, suddenly, in August 2019. Lucia kitty grieved all these losses, but helped us welcome two new Lurchers into our home and our lives, Shae and Barley.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation

Virginia




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24 August 2018 - 10:16 am
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Jist catching  up on your handsome  Raddy.  Can’t  wait to see more pictures.  He looks so cuddly.

You’ve gotten great input from Teresa, Jerry and Lisa.

It sounds like yoh hace a really good plan of action AND a solid Warrior attitude!  Radcliff clearly is a fighter  and has no intention  of going  anywhere  anytime  ecer.  And yes, you can cancel the meds at anytime and, if any side effects did appear, they should clear up in a couple of days.  

It’s  so important  to follow Raddy’s lead.  He could care less about any ole xrays.  He doesn’t  count days on a calendar.  He doesn’t  have a timeframe  stamped  anywhere on his butt.  He is flowing  effortlessly from one happy moment to the next with no worries.  

Just continue to make every moment the best moment  ever!  Spoil like crazy and give him a scoop of ice cream  daily!  Hapoy Hannah had me convinced  ice cream was a nutritious food!

We’ll be watching  for pictures….HINT

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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24 August 2018 - 6:42 pm
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Lisa, thanks for clarifying the medications so clearly.  That was super helpful, and it is good to know that a similar regimen benefited your pup Pofi by giving you some extra quality time together.  We may have some doctors in common since Raddy and I live in the Minneapolis area too!

Sally,  thanks for the encouraging words.  It sure helps at this stressful cross-road.  

I truly appreciate both of your responses!

Minneapolis, MN
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24 August 2018 - 7:50 pm
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Well, small world indeed!  Pofi was treated at U of MN…but the onco we worked with was a male doctor.  

Please, let me know any way I can help. Oh, I did feel like Pofi was a bit queasy post Palladia – we did Cerenia with the Palladia.  On the Cytoxan days, I would give him a Zantac just out of abundance of caution, but he did not seem to have upset tummy with that.

What did not work well for him was Piroxicam – that made him sick as a proverbial dog.  So we stuck with Rimadyl/Carprofen for an anti inflammatory.

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His canine sister also succumbed to cancer on March 1, 2019 - we lavished her with our love in the interim, but life was never quite the same without her only real canine friend. Cliff kitty had to leave us, too, suddenly, in August 2019. Lucia kitty grieved all these losses, but helped us welcome two new Lurchers into our home and our lives, Shae and Barley.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation

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24 August 2018 - 10:53 pm
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I agree with the piroxicam.  3 days on and 3 days of vomiting. I will try metacam in 2 weeks. Do u have access to thc.   Ie. Feco?   Full extract cannibas oil.  I am starting this now as well .   

The Rainbow Bridge



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25 August 2018 - 11:59 am
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hester said
Hi:

What your vet oncologist is suggesting is a hybrid approach between the metronomics , which will be the Cytoxan, an NSAID and Doxyclene probably 4 days of the week and the Palladia on 3.  

Ditto on explaining it Lisa, thank you! I may reference this for a blog post, stay tuned…

It's better to hop on three legs than to limp on four.™
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25 August 2018 - 2:53 pm
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Yes, Raddy is also being treated at the U of M.  I have been so thankful for all the help, options, and support they have provided there!  As we move forward in the coming week I will reference these posts about medications as I work with them to get Radcliff dialed into a treatment regimen.  Again, thanks so much to everyone!heart

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25 August 2018 - 11:29 pm
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Following.   Didnt i read that prednisone helped with lung mets?

Virginia




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26 August 2018 - 5:47 pm
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As you know, not a Vet and not giving  Vert advice.  There certainly  may ve different uses for Pred when treating  mets so you need to discuss with your Onconif that’s  the case.

I can only share my experience.  When Happy Hannah  was diagnosed with mers and when she showed symptoms, my Vet prescribed  Pred because  it could help with any inflammation  resulting around the met.That was my understanding  anyway.  He wasn’t an Onco, so ,maybe there are other reasons  for giving it.

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

The Rainbow Bridge



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27 August 2018 - 9:24 am
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luke4275 said
Following.   Didnt i read that prednisone helped with lung mets?  

Yes, the way Sally described its use is accurate. Our onco prescribed it for Jerry after we stopped metronomics , but Pred did not agree with him so we stopped it. However Pred does work well for many dogs with lung mets.

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