Caring for a Three Legged Dog or Cat
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We learned that Lexie appears to have soft tissue sarcoma. I've excerpted from the onco doc's notes, and follow with some questions.
-Lexie has two large masses on the lower part of her left front limb that we suspect are a form of cancer called soft tissue sarcoma. Masses palmar aspect left front limb (digit 1) 4x3cm and second mass lateral to main mass 2x3cm: ulcerated and bleeds when touched. Mass painful to touch.
-In her lungs, she has multiple soft tissue opacities measuring 5-8mm.
-Cytology was suggestive of a mesenchymal proliferation which translates as a cancer of the connective tissues – soft tissue sarcoma (STS). My hope with metronomic therapy is that we are able to stabilize her cancer and prevent it from growing for as long as possible while maintaining a good quality of life.
-Treatment plan: Rimadyl 2x/day, Cytoxan chemo tablets 8mg, 1 tablet once daily (metronomic therapy). Yunnan Baiyo every 12 hours for bleeding; Pepcid/Famotidine for stomach upset; Gabapentin 2x/day for pain management ; Tramadol as needed for pain management . Note: Lexie is not good with needles, which is why we opted for oral chemo.
-For possible chemo side effects:
Cerenia 60mg, #4, Give 1/2 tablet (30mg) once daily by mouth for nausea, decreased appetite or vomiting
Metronidazole 250mg, #10, Give 1/2 tablet by mouth twice daily for diarrhea or loose stools
-Palliative radiation to be discussed with onco radiation specialist.
My onco doc advises against amputation given size of lung mets and Lexie's age and other factors. That said, her bloodwork did come back normal.
So, my questions...
Q1. Anyone else with similar STS cases in an older dog? (I'll search the threads here too, of course)
Q2. Anyone have mets of this size at diagnosis who still decided to proceed with amputation?
Q3. Am I making the right tradeoff not to go with traditional needle chemo and do oral instead, given her fear of needles?
Q4. Any low-fat diet recommendations? (She also has pancreatitis...I'll do more reading on the diet/nutrition threads here, too.)
On the good news front: Lexie was feeling so good today that she tried to jump up in the air (Jack Russell-style) when she saw her treats -- on the flip side, not so good since I worry about her hurting herself. She also tried to steal a squeaky toy from the closet. Usually we only give squeakies when we leave to go to work or go out, and she grabbed one and threw it in the air -- so funny! It's always cute when she does that...and it's so puppy-like. She's definitely not like a normal 13 year old when she feels like herself.
Any thoughts welcome. Thanks again for the great support here.
Deb & Lexie
Deb and Angel Lexie* Diagnosed at age 13. Tried radiation first; wish we had amputated upon diagnosis (even with lung mets). Joined Club Tripawd April 2014 & Lexie loved life on 3 legs! Advice: Start physical therapy as soon as your vet clears it, especially hydrotherapy if available :-) See Lexie pics here.
One more Q... Has anyone dealing with lung mets tried herbal remedies? I saw this via Jerry in another thread. I'm going to ask my onco vet, but just wondering if anyone here has tried them.
Deb and Angel Lexie* Diagnosed at age 13. Tried radiation first; wish we had amputated upon diagnosis (even with lung mets). Joined Club Tripawd April 2014 & Lexie loved life on 3 legs! Advice: Start physical therapy as soon as your vet clears it, especially hydrotherapy if available :-) See Lexie pics here.
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Hi Deb and "pupoy Lexie"!
Love that's she's feeling so good! I know that is makingnyour heart sing withevery joyful move she mkes!
Don't jave much i sight into yor specific questions. My only feedback would be Metronomics seems like the best route because of her fear of needles. I "thik" metro. does require bloodwork at two weeks snd zi zz"think" it's monthy after ghat. More ore will chime in with their experience with metro.
You have a well thoughtout treatment plan...sorry...comp. starting to crash...grrrrrr
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!
Hi Deb, so glad Lexie is acting like a puppy!! Yay!
I can only chime in about Q1 and Q3. We chose oral chemo with Jake for many different reasons (Cancer #1 was a STS). The only difference was that we used Piroxicam instead of Rimadyl. Jake did well on it (and just so you know, he kicked Cancer#1's butt). I think the protocol you have there is a great option, esp if she doesn't like needles, (why put her through more stress?) and I know I've told you before but I'm really glad your vet added in the YB. I think that stuff is amazing. You do have to take them in for blood work. We went 2 weeks, then a month, then 2 months, then 3. They just like to make sure its not affecting their kidneys/bladder too much. I'm assuming too that the vet told you about wearing gloves. Their saliva, poop, pee is all considered toxic so there were "special handling" instructions. Also, to make sure she drinks lots of water and is peeing regularly to flush out out her bladder. I used to give Jake "broth treats" to make sure he was drinking enough and we never had any problems with blood in his urine or his kidney values. Not sure if you have kids around, but unfortunately when on the Cytoxan, they shouldn't lick kids and kids shouldn't play where they use the bathroom (its actually considered a carcinogen to healthy people, ironic I know). We quarantined a special spot for Jake in the side of our front yard so the kids could play in the back without fear. I'm sorry if I'm going over things you've already discovered.
Mom to Tripawd Angels Jake (2001-2014) and Rosco (2012-2015) and Tripawd Tanner. “Whatever happens tomorrow, we had today; and I'll always remember it”
Hmm. Well, given everything that was in the report, I think your treatment plan sounds right on target. Unfortunately the mets are big and while chances are they won't disappear with metronomics , there's a good chance you can stabilize them. We've seen it happen, our case included. I do not think that oral chemo is a bad tradeoff considering that her fear of needles and trips to the vet would bring down her quality of life significantly. Right now it's all about quality, not quantity so I think you're on the right path.
Cytoxan is the de-facto oral chemo drug but the thing you want to watch out for is UTI symptoms. It's common but no big deal if you catch it early, and you can always switch to the other oral chemo drug currently being used, Leukeran.
Oh when checking out diet tips, be sure to visit our Nutrition Blog for lots of tips and posts from others who've tackled cancer with diet and supplements.
Tripawds Founders Jim and Rene
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