Caring for a Three Legged Dog or Cat
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Like so many other posts I've seen here I'm going to start with "Help!"
here's the story: I have a 75-80 pound lab mix that is only 6 1/2 yrs old. His name is Argos. He'd been favoring a front leg off & on for quite a while when we finally went to the vet. X-rays and fine needle aspiration (no fluid, though) indicate a mast cell tumor on, around & in his left elbow. There was bone damage but the vet wasn't sure if it was related to the cancer or to some (unknown) prior injury. She used the "a" word. We went to the oncologist, who used the "a" word but also understood my reluctance due to Argos' hip displasia so she recommended a trip to an onc. specializing in radiation therapy. This oncologist pointed out that we really don't know what's inside the joint, just the MCT on/around the joint. An orthopedic surgeon concluded that the bone damage seen in x-rays was from some sort of malignancy & whatever is going in inside the joint capsule is malignant. The radiation oncologist suggested that, before completely ruling out amputation (the only possibility for a "cure"), I have Argos' hips evaluated since they haven't been x-rayed in the 5 1/2 yrs since the displasia diagnosis. I arranged for radiographs with our regular vet and scheduled the appt. with the orthopedist: both say severe bilateral displasia. The orthopedist pointed out that hips can be replaced (albeit at $5k each) but also concluded that Argos is already a good candidate for at least one new hip and is certainly better off with 2 front legs. Which brings me back to where I started.
I've spent a lot of time thinking about Argos as a tripawd and after lots of reading, video watching, picture viewing on the Web I was feeling some hope that it might be okay. After the visit with the ortho., though, that initial gut feeling of not wanting to take away even a partially useful leg is back. I spent several hours "here" and at a few other sites last night and I can't shake that feeling, especially after watching his gait during our walk yesterday. But this morning I watched him as he walked toward me and I can see that the front leg bothers him, too. Even when standing still most of his weight is shifted to his right and he holds the upper leg at a funny angle.
I do have calls in to the orthopedist & the oncologist with more questions but, while I would wish this on no one, I'm hoping that if anyone has been faced with any "piece" of this mess they will share their experience(s).
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Thanks for joining the discussion! We are sorry to hear about the trouble Argos faces. And you have some difficult decisions to make on his behalf indeed. While my inclination is to say he is already only using three legs, and that he risks seriously damaging that joint should the tumor continue to grow, only you and your vets know what is best for your big boy.
Do you happen to be anywhere near a leading vet teaching facility? CSU (Colorado) has some amazing radiation treatment options with the best available equipment. Best wishes for you and Argos, we look forward to following his progress.
PS: If you don't hear from tazziedog, consider getting Pam's professional opinion by posting in the Ask a Vet forum.
Tripawds Founders Jim and Rene
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Dogs can have severe hip dysplasia on an xray and still function pretty well. Does he limp on his hind legs now? Is he able to use his rear legs to get up or does he rely on his front legs to pull himself up? If he is already limping on the front leg then he may do okay without it.
Have they fully staged his mast cell disease? Grade III mast cell tumors carry a pooreer prognosis and can sometimes involve other organs like the spleen and liver. Has he had an abdominal ultrasound and liver/spleen aspirate yet?
I'm sure that your oncologist has discussed Palladia. This drug may help shrink the tumor if used in conjuntion with chemo and radiation.
Pam and Tazzie
Beth, I am so sorry to hear about Argos. I don't have any veterinary medical expertise. I just wanted to say that I also have a Lab mix who had a mast cell tumor on her front leg. We are 3 weeks post amputation now. I know it is one of the hardest decisions I have ever had to make. Zoe is older around 10 and has never had hip problems but when they did the ortho consult on her they said she does have a little weakness on one side of her back hip. She is doing well on 3 legs. Zoe did the same thing before amputation, she wouldnt put weight on that leg, so that made me feel a little better knowing that post amp she could be a success. I was wondering like Pam said, what grade did they give on the biopsy, did they check lymph nodes, do xrays/ultrasounds, bone marrow? Zoe is doing very well amputation wise but having known then what I know now I don't know that I would have put her through it.
I wish I could be more helpful, I know what a difficult time this is for you. There are only me and one other, that I know of, on here that are fighting mast cell tumors, most are bone cancer, if I can help in anyway please let me know. If you are anything like me you will come to find this website to be a great source of comfort.
Karin and Zoe
Thanks for the welcome, Jerry! We're in Portland, OR & I'm not really up to moving to Colorado. I remember seeing a reference to Oregon State (OSU) somewhere though all I know is that they have a program.
Pam and Tazzie,
Unfortnunately, my reluctance to amputate the front leg stems frp, watching Argos move every day. He's such a trooper, and never complains but I can see that he's stiff when he gets up from a rest after our walks and in the morning. And he's always had the 'classic' standing with his toes turned out and bunny-hop when he tries to run (& frequently when going up stairs). Even though his legs are longer he's never been able to keep up with his sister (litter-mate) when she gets going - she has such a beautiful stride. I don't know if I'd call it limping but when he walks his hips really sway from side to side. It's been gradual but it's definitely more pronounced than it used to be.
I'm trying to picture him jumping. I'm inclined to say he's tended to pull himself up with his front legs a bit. I'm having visions of him jumping right down from the car but hestitating or "preparing himself" before jumping up. Lately he's less likely to jump up on the bed until he's certain I'll be staying in the bedroom for a while.
MCT has not been staged. We've put off cutting into it because just the 4 needle jabs for the aspiration triggered inflamation. The first oncologist is concerned about trying to remove the tumor because it would involve cutting the joint capsule: a recent patient went through a similar procedure and the joint capsule refused to seal up leading to lots of complications & not-nice conditions for the dog. In a recent voice message she indicated that the radiation oncologist agreed that trying to remove the tumor was not a great idea and made a reference to not being able to get the tumor down to microscopic level. (and doing a CT scan before doing any local surgery)
He's had chest x-ray, abdominal ultra-sound and bloodwork to check for signs of spreading (& the local lymph node): all came back clean.
Palladia has come up but I haven't had a real conversation with the first oncologist since our one visit. How that would fit in with a radiation+chemo plan & likely effectiveness is one of my questions. We started vinblastine right away - & I have cytoxan to administer - to keep the tumor from doing anything crazy for the time being.
Karin & Zoe - I appreciate hearing from you! Can I ask about the line "Zoe is doing very well amputation wise but having known then what I know now I don't know that I would have put her through it." What do you know now that might have changed your mind?
I really do want to do what's best for Argos and I know 'the sooner the better' but I seem to be finding more questions than answers! I've spent the past 5 years trying to protect his hips (to postpone the inevitable) - I want to be sure I'm not so stuck in that rut that I'm missing something more... important? serious? traumatic? not sure of the right word.
Hi Beth, Zoe had her biopsy done at her regular vet and they didnt think it was mast cell, so after her biopsy she practically went into shock. So at least your vets are on the ball with that, I guess when these nasty tumors are poked or prodded it is like waking up a sleeping lion. Anyway, what I was referring to in previous post, Zoe on her original biopsy they had the tumor a grade 2, which from my understanding, there was a 50/50 shot that they could take the leg and keep it contained, with possibly a little chemo after. When they amputated her leg they also removed the local lymph node, I got the biopsy back on that this week. Now they are saying that it was alot more aggressive than they originally thought, the tumor was 8.2 cm, pretty much up her entire leg and said it is Grade 3 now,which is bad news. They did a lymph node aspirate before surgery said it was clean. I guess right now I just feel like I put her through all of this for nothing. I will say if it werent for this bad news, I would be fine with the amputation part, it is true what they say, they do surprisingly well. Zoe is already chasing rabbits at 4 legged speed.
I'm sorry to add more to think about, I know your plate is full right now. It was one of the toughest decisions I have ever made and I didnt have the hip issues to weigh into it. I think you just have to go with your gut instincts here. It was my understanding that radiation is also very effective at treating MCTs. Its tough because they say surgery is best chance at survival. Will they be able to get a biopsy once they get it shrunk a little from chemo?
I hope you find the strength to deal , I was in your shoes about a month ago, I would have to say that the decision part of it was the worst, the second guessing and guilt is enough to drive anyone crazy!
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