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pathology report: candidate for chemo?
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Winnipeg
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13 July 2009
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23 July 2009 - 6:40 pm
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Hello again fellow tripawds

My mum was talking to the 'local' general vet today when the specialist vet happened to fax the pathology report to her. It did not sound good, at least to the local vet, although she did not want to say, or probably even know, what it meant in terms of therapy to follow (she said she has only seen 3 cases of chemo in her career and she is not a young vet). My mum was a bit too shooken up to phone the specialist today - she will tomorrow morning. But I bet some of you know the answers to the basic questions, even though she should be talking to the vet about this.

The osterosarcoma was called "high grade" and they found metatastic cells in the lymphatics. Nothing was in the lymph node, but the specialist had previously say that would be really unusual to find anything in the lymph node anyway. A bit of reading this afternoon showed me that about 35% of OS are grade III (presumably same as high grade), which makes me fit reasonably well with the tripawd pack, and that 25% enter the lymphatic system. I am 8 & 1/2 yrs old.

I just wonder whether any of you fellow tripawds have 'high grade tumours' or 'metatastic cells in the lymphatic system', yet still were recommended to undergo chemo? (On the bright side, I know my Alk Phophate levels were totally normal in my last blood work, and I understand that is a good thing.) When I asked the specialist whether the pathology report would affect the decision to do chemo, he had said it would not, unless they got something totally unexpected (i.e., not osteosarcoma).

Tazzie - still laying low

Winnipeg
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23 July 2009 - 6:43 pm
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woops – that last sentence must have been confusing. My mum asked the vet about how the report might affect chemo a few days ago. The report itself just came today, so she wonders whether the response might have changed. Is there a point in doing chemo (or maybe more of a point!) if the cancer is high grade and already putting visible cells into the lymphatic system? Ok, now I really know I should be asking a vet – sorry

Kirkland, WA
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2 June 2009
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23 July 2009 - 7:20 pm
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Jack's tumor was "high grade highly productive" but they found no signs of metastic cells elsewhere in his body or body systems.  Our oncologist and ourselves just assumed we were going ahead with chemo and never even discussed not doing it.  We have our x-ray in the next couple weeks so we'll see if there's any evidence of mets yet and if so, we'll probably need to change our therapy.  Of course the decision to do chemo or not to do chemo is entirely up to you.  There are also homeopathic options to consider provided you have a homeopathic vet fairly close by (some people swear by it).  Just because a tumor is high grade doesn't mean that life is over!!!  There is still so much you can try.  And as for Tazzie, I'm sure he will do his best to fight off the evil cells!  Is he on K9 immunity or another immunity booster?  I have a funny story to share with you:  When Jack was first diagnosed and I was feeling like it was the end, I sent off e-mails to my former roommates (I got him the year I graduated college so he lived in a house with 4 girls for the first year of his life...no wonder he is so crazy!) to let them know he had cancer and to thank them for having been a part of his life and for giving him love.  One girl responded, "If he can chew up a table, he can fight cancer."  Now why haden't I thought of it that way before...  🙂

Let us know what you decide and best wishes!

On The Road


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23 July 2009 - 7:58 pm
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Oh gosh I wish I could help you with that. My situation was different. But I think you'll feel better when you talk to the specialist. If your vet doesn't have the background to help answer these questions, then go straight to someone who can. Knowledge is power.

Jack, I like your friend's "chew up a table" quote. That's funny, and a great way of looking at it!

If we can chew up tables, eat rugs, destroy sofas and fight our way out of crates, then we can certainly kick cancer's butt Laugh

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

Madison, WI
Member Since:
14 June 2009
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23 July 2009 - 9:44 pm
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Hey Tazzie and Tazzie's Mum,

Your local, regular vet may be really knowledgeable about OS and otherwise awesome, but you reminded me of how it went when my regular vet(s) gave me Yoda's prognosis vs. when the Vet School vets they referred me to gave me Yoda's prognosis - hugely different!!!  The first of Yoda's regular vets that I spoke to said Yoda probably had 2 months and when she summarized the likely treatment options the Vet School might have for us if I wanted to pursue that, she focused mainly on radiation and never mentioned amputation.  When I spoke to another of Yoda's regular vets who was also familiar with Yoda's x-rays, etc., and I got her to give me her take on it as well, she told me she had once had a patient go 4 months.  She did bring up amputation, but (brace yourselves) she said "...but amputation is a very painful procedure and Yoda is already in a lot of pain."  Lucky for me I had seen Jerry on PBS, so I did a little research online and ended up finding a lot of info on the standard of care (amputation + chemo) that the Vet School would recommend when we got in to see them.  So - now to the point I was making - the specialist's take could be way different from your local vet's.  That was my experience at least.  Good luck!!

Yoda&Mom united: 9/5/06 …….… Yoda&Leg separated: 6/5/09……… Yoda&Leg reunited: 10/14/09 ……… ……………….………….………….……. Yoda&Mom NEVER separated! …………………….….……....….…… Though Spirit Yoda currently free-lances as a rabbit hunting instructor for tripawds nationwide

Winnipeg
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13 July 2009
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23 July 2009 - 10:03 pm
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Similarly, when Tazzie was first diagnosed, a friend and vet tech said, "Well he survived an Advil overdose (a mega-overdose at an estimated 80 sugar coated pills) and stomach torsion, so who knows . . . ".

But right now, he is not nearly as energetic as Jack. I must say, his full stomach torsion was a breeze compared with this. He hardly noticed it and most people consider that major surgery.

He did have a nice evening laying out under the stars in a cool breeze tonight, although that is all he is up for these days - quite unlike the excitable 8 yr going on 1 yr pup he was 4 weeks ago. I think I'll put the tent up tomorrow so he can spend the whole night outsid


Member Since:
22 August 2008
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25 July 2009 - 9:02 am
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I always think it is worth trying chemo no matter what type or grade of OSA that you have.  Some dogs do really well and survival times don't seem to follow histologic grade. Most dogs have metastatic cells in their lungs anyway even if they don't show up on the xray; that is the whole point of chemo.

Age does matter and the younger dogs seem to do worse.  I would consider Tazzie middle-aged so I say go for it if you can afford it!

Pam and Tazzie

Winnipeg
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13 July 2009
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25 July 2009 - 11:32 am
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Hi Tazziedog

Your name, Tazziedog, got me this morning. At first glance, I was thinking that last post was by me, having forgot about the 'other' Tazzie (of course the first!). Thanks, I was hoping for your opinion.

The vet from the specialist clinic did not phone yesterday, so I only got to speak with a health tech at the end of the day (which is why I really value your comments - if they do not think it is worthwhile doing chemo, I hope they would have told me yesterday). I picked up the pathology report from my "local" (1 hr) vet today. The condition of the radius was pretty ugly, poor thing, and they indicate there are probably mets to the lungs and lymphs.

Question: I see lists of factors that are correlated with survival: location of tumour; age; and many other things. Are those factors correlated with survival time independent of the grade of the cancer?

Tazzie had his first outing yesterday. He enjoyed a short car ride and was keen to explore a friend's yard and soak up all the attention they gave him (he always loves attention). Nice to see!

Storm
9
25 July 2009 - 9:20 pm
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Hi Tazzie and Susan and everyone else,

Tazzie I am glad that you are slowly getting on your feet and out and about exploring!!!  Well Koda had a few firsts in the last couple of days, he lied on his amputation side and didn't show any signs that it bothered him.  I think I let out the biggest gasp when he flopped on to that side but he didn't even seem to notice.  And Koda went for his first "big walk" yesterday along the beach.  I figured he would stop when he had had enough.  It was quite funny as we passed a few people they would look at him and smile at us and then a lady commented "oh is he limping?" hahaha  I proudly noted back "no he only has 3 legs".  And explained to her that he has bone cancer.  She gave him a pat and off we went.  I had read comments that sometimes people don't even notice.  He was buggered in the car on the way home but had a smile from ear to ear.  He played with his cousins today and was completely fine running around with them. 

The vet rang last night to tell us that the test results came back and it is oesteosarcoma.  When we get his stitches out this week we will talk further about chemo.  Still not sure what to do yet.  We are trying to find a vet closer to where I work that can administer the chemo drugs for ease of getting him there.  We know that either way we will spend every moment we can with him and let him run around like crazy!!!  He even sleeps in our bedroom now beside our bed.  Just so I can make sure he is with us every opportunity. 

Till next time,

Storm and Koda:)


Member Since:
22 August 2008
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25 July 2009 - 10:39 pm
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Tazzie,

It is true that if you look at averages, dogs with lymph node and lung mets don't fare as well but you have to look at the individual dog.  Usually tumors close to the shoulder or hip are the worst but Jerry lived almost 2 years after surgery without traditional chemo.  I have seen dogs live 2 years with amputation alone and some not make it through the second or third cycle of chemo.

My Tazzie had 5 cycles of carboplatin followed by metronomic chemotherapy (oral pills). We had to stop that after about 6 weeks due to a bladder infection but I still give her artemisinin and lots of antioxidants as well as Power mushrooms.  None of this may help but it makes me feel better and Taz seems to be doing okay.  We are having hot weather here again so every time she pants I think it is lung mets!  She is due for xrays again at the end of August so we will see.  Today marks her 11-month anniversary since surgery.

Pam and Tazzie

On The Road


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24 September 2009
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26 July 2009 - 2:46 pm
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tazziedog said:

 Today marks her 11-month anniversary since surgery.


Yipee!!!!! SuperstarSuperstarSuperstar What an awesome inspawration you are Tazzie. The ultimate big dog amputation success story. Thanks for being a part of our family.

And three cheers for Koda too! Way CoolWay CoolWay Cool So glad to hear you're feeling better. Whatever your Mom decides to do about treatment, just remind her that there are no "right" answers. Do what feels right, what works for you and the family, and don't "should" all over yourself. My own pawrents felt that for us, chemotherapy wasn't an option (it was a 6 hour drive to an experienced vet or the university hospital). We took that gamble and I did pretty darn good all things considered. It's always a gamble. The only thing that matters is that we have more quality time with our people, like taking over Mom and Dad's bedroom! Laughing

Keep it up, you're doing great.

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

Member Since:
26 November 2008
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27 July 2009 - 9:23 am
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Tazzie, the family, and all our friends posting here,

First, feel confident that no one knows Tazzie like you do and no matter what you decide regarding further treatments, it will be the best for your situation with Tazzie. For us, there never really was any question, only amputation followed by agressive chemotherapy would return the quality of life to Cherry who celebrated her eleventh birthday the day before the amputation. Our local vet (who is also a personal friend) quickly referred us to specialists and these specialists took over the treatments. When I say agressive chemotherapy, that is exactly what I mean. Cherry's first treatment was just hours after the amputation. They wanted to attach any cancer within her system before it had a chance to settle somewhere else. For Cherry, the chemotherapy was far worse than the amputation and she literally stopped eating or drinking. I had to stuff nearly every morsel of food during the two months of treatment. Cherry marked her eighth month of recovery last week and is doing great. The sparkle in the eye has returned, the ability and desire to get into mischief is back, and she just”hoped” into the room to lay here beside me.

In case you can not tell, I am attempting to give you encouragement. The early part of this journey will be tough and you have already demonstrated your devotion to Tazzie. You are doing great and we want to send you all the positive thoughts possible, support, and encouragement. From this point in time, things will improve for Tazzie. For me, I will enjoy every day for the precious gift of time with Cherry.

Bob & Cherry

Winnipeg
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13 July 2009
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28 July 2009 - 2:29 pm
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Hi Guys, Tazzie 2 here:

We made the 3-hr trip (pant, pant, pant, at least one thing hasn’t changed since surgery) to Calgary this morning to see the oncologist. She went over chemo options (also started by explaining reasons to amputate, although it is a bit late for that one! This is a case of rotating vets on vacation because it is July!). Some of the information on chemo was surprising to me:

(1) She recommends Cisplatin over Carboplatin (as long as the chemo is administered in a clinic set up to handle the side effects with diuretics and anti-nausea drugs). She says they are starting to think the cisplatin dogs are doing better. This was a surprise to me, but I did a quite web search and found a human study in which people did marginally better (e.g., 24 vs. 30% difference in survival) on Cisplatin. At the clinic here, they take the dogs in well before the chemo and keep them overnight so they can manage renal and nausea issues related to Cisplatin.

They would start with Adriamycin (DOXORUBICIN), then alternative with the Cisplatin every 3 weeks for a total of 6 weeks. In our case, we need to do the 3-6 treatment in Winnipeg, where there are only ‘regular’ vets. If they are not set up to provide diuretics and otherwise handle side effects of Cisplatin, she said we should just switch to Carboplatin at that time.

From the description, it sounds as though there is about 2-3 days downtime (or more?) on Cisplatin vs. 1 on Carboplatin. But perhaps he will have more problems once getting home on Cisplatin.
Any thoughts/disagreements on the chemo situation?

(2) Given the pathology report, I think we need to act quickly with the chemo. At the same time, given Tazzie’s current lethargy, I question the whole thing.

I realize most dogs bounce back after amputation, but the bounce has still not happened. Despite the bone pain that must have been present, he is in far worse condition than he was before the surgery. He is spending the afternoon at the clinic so an orthopedic specialist can check him out. He still has that hunched posture with tail curled under when standing or walking. He usually looks okay when resting (23 hrs per day). After 1-2 hours of ‘activity’ (very mild activity, such as a short car ride and a 25 yard walk), he is ready to lay flat for the next 18 hrs. He does not look bad for a 13 yr old dog, but looks pretty bad for what used to be a youthful 8 yr old dog.

A friend said that humans typically have a lot of trouble recovering from two major surgeries in a row. I wonder if that is true, and if it might apply to dogs?

I take heart from Cherry’s situation that things can brighten up after a long period of downtime.

Question for Cherry: You say your problems were related to chemo. But if you began chemo right after surgery, how do you know it was not the surgery that caused your problems, or the combination of the two?

Although we are a bit green, congratulations to Koda and the other new tripawd who can ‘only’ walk 4 blocks shortly after her amputation! That’s pretty cool.

Tazzie and Susan

On The Road


Member Since:
24 September 2009
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28 July 2009 - 3:21 pm
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All dogs are different, hang in there and try to take things one day at a time. One surgery is major enough. Sounds like Tazzie has a lot to recover from!

If you don't hear from Tazziedog, consider posting your veterinary questions in the Ask A Vet forum. Thanks for the update.

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


Member Since:
22 August 2008
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28 July 2009 - 8:56 pm
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Here are my opinions on chemo, keeping in mind that all oncologists have their favoite protocol but no one drug or combo of drugs has been shown to increase average survival.  Average time to mets is 7 months and average survival is 1 year with 20% of dogs living 2 or more years and only 5% considered a cure.

Large breed dogs are more susceptible to cardiomyopathy or heart muscle disease than medium or small breeds so I decided against using adriamycin on my Tazzie.  If this drug goes out of the vein it can be damaging and too large a quantity can damage the heart muscle, but it is commonly used without many side effects. Most oncologists do not favor cisplatin due to the risk of kidney failure and need for diuresis so carboplatin seems superior due to increased safety and ease of use.  The only reason more dogs were not treated with carboplatin in the past was cost.  Now that it is generic the price is much more reasonable.  In my research most long-term survivors were given carboplatin so that is what I gave my dog (5 doses 3 weeks apart). 

As I said there is no standard protocol and your oncologist may favor a combo approach since your Tazzie's cancer is a little more aggressive.  I was lucky to have caught my dog's cancer early so it was still considered low-grade on the biopsy.  You have to do what you and your oncologist think is best for your individual dog.  I would also consider starting an NSAID now since it may help reduce new blood vessel formation.  I have also used holistic meds and supplements.

Good luck!

Pam and Tazzie

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