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Time to reevaluate treatment plan | Treatment, Recovery and Oncology

Caring for a Three Legged Dog or Cat

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Time to reevaluate treatment plan
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Forum Posts: 305
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9 January 2019 - 3:50 pm
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My dog is almost 1 year post diagnosis on 1/30/18.   We can assume his osteosarcoma was brewing for some time before that. The very first day he lifted his left rear leg,  off to the vet he went as I assumed it was a foxtail. Ff to today.  After cyberknife treatment and 6 carboplatin  cancer  treatments and monthly zoledronate infusions there is no obvious spread.  But osteosarcoma is bad. 95% bad. Now, im reevaluating my strategy.  I didn’t do metronomics etc.  not sure why i didnt.   This from my onco vet today, after i asked about treatment options:

The things we are 100% certain that delay or prevent spread of the tumor includes carboplatin and metronomic therapy. Published, Proven, Certain. Palladia has been proven to  not be very helpful. Losartan showed mild promise in one study involving a few dogs.

Thoughts?  Time for metronomics ?

The Rainbow Bridge



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9 January 2019 - 5:09 pm
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WOW! ONE YEAR? Oh my gosh it’s almost here, that is wonderful! clap

You asked for our thoughts so I’ll give you mine for what they’re worth: keep living life on Simon’s terms, making the most of every single day without worrying too much over the future. There is so much we cannot control, and so much we lose by worrying about things that may or may not happen. So don’t let cancer rob you of the mental energy it takes to love Simon to the max, and spend quality time with him. He is a ROCK STAR and celebrating every day is so important.

Meanwhile, you can start metronomics whenever you want as far as I know. We started it 17 months after Jerry was diagnosed. If your oncologist is game, and it’s in your budget, it’s an option for sure.

It's better to hop on three legs than to limp on four.™
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9 January 2019 - 6:52 pm
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thanks for the reply.. good to know you started at 17  months post…   I wracked my brain trying to remember why I didnt move to metronomics after the 6 carboplatin treatments..  Now I remember why..  my onco rad vet didnt think it did much…  I am now going to re visit… as the other vets in my arena.. do use metronomics

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9 January 2019 - 8:13 pm
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This was my onco vets reply to my email:

When you look at the things that have been shown to be effective, carboplatin is a five-star treatment. Zoledronate is a 2 Star Treatment . Metronomic therapy adds to the carboplatin therapy to make it a six or seven star therapy. If given alone, it’s a one star treatment.

I then asked if he’d consider another carboplatin therapy  ( 4-6 times,, etc)

 He replied back that carbolplatin or maybe preferably doxorubicin.

I was surprised at his response as I havent read of anyone repeating this regimen..  thoughts?  ( remember I do have pet insurance that pays 90% of this cost and while Simon is having a great life.( with his weekly 1 lb raw turkey neck etc) I  have not been able to be comfortable to just wait for lung mets..and we know that for over 90% of dogs.. even higher.. it will come.. If chemo does no harm… and it did no harm for simon.. I will know I did enough to grieve for him with a sense of calm.. which is what I want.. 

Virginia




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9 January 2019 - 8:44 pm
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Okay, the techie gurus can maybe figure it out, but I did recall one member who had their  dog on chemo for almost a year!!!  I don6 remember  if there was a break inbetween  or not.   Nor can I remember  if it was alternating carbo with doxo.  I DO remember  that it was given for a loooong time.  Nor do I remember  the results.  It may have been a European  member,  can’t remember.

While the  chemo may do no harm, does there come a point  where it can be too much of a good thing?

Luke, we know you are willing  to do anything and everything Simon.  You have already  done far more than most anyone we’ve ever seen!!!   The research you have done and shared with us is invaluable!  Some of the treat have been cutting edge and some more “standard “.  You truly have left no stone unturned, but I understand  your need to    make sure there are no stones hiding anywhere waiting  to be turned over!!

Just remember,  many dogs do NOT get  mets!  And goodness knows, Simon has a “leg up” in being in that victorious  10%!   😁

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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9 January 2019 - 8:53 pm
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Thank you for the reply. When I asked my onco vet  about a repeat chemo series I assumed he was going to say no. So this is all new to me that’s why I thought I would bring it up on the forum. . Yes,  too much of a good thing is not wise.  Do no harm etc.  my onco vet thinks higher than 95% get lung mets.  Osteosarcoma is tough.  

The Rainbow Bridge



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9 January 2019 - 10:02 pm
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I also understand how difficult it is to put the lung mets worry out of your mind, especially when your dog is beating the odds for so long. It often feels like the clock is ticking. Only you know what? WE are the only ones who hear that clock! Our dog doesn’t. They just go on life, living it as usual and making the most of every day.

Oftentimes, a dog may pass away from something unrelated to the cancer. We all hope that will be old age. But whatever happens, if we know that we are following our dog’s lead and living up to their hopes to make the most of life, that can bring us a never ending source of comfort over time. 

And Sally I’m having a total brain fart about identifying the long-term chemo dog! Anyone? Anyone? Bueller? 

It's better to hop on three legs than to limp on four.™
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10 January 2019 - 1:48 am
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jerry said
Anyone? Anyone? Bueller?   

*snort* muahaha!

I am actually not the European that did chemo for 12 months but I know that Teresa/Eurydice asked multiple times about doing repeat chemo and was told by different vets that it wouldn’t make sense. maybe you could pm her about it. I also remember asking my vet something similar only to get a similar response. Both she and I always felt that you had to go into this fight with the big guns and we also felt that chemo was it. 

Our chemo regiment by the way was alternating between carbo and doxo and our oncologist back then said that doxo is the more aggressive of the two. 

It feels like we are pretty similar in our approach to things. My vet calls me her “colleague” by now because I researched everything I could get my hands on. My main worry was also always lung mets and I also always had the stats in my head constantly and couldn’t put that knowledge aside for even a minute. 

Manni made it to 24 months to the day and I like to think that this had to do with all my preparation and research and my sheer will, however, he never got lung mets. never. Imagine that. You prepare for nothing but that and then you get hit with another primary osteosarcoma. 

I am all for doing chemo, especially since we never had any side effects but I seem to remember that we were told that potential lung mets are either there already, as micro mets that you can’t see yet and will show up eventually, or not. in both cases, one round of chemo will keep things either at bay or can prevent the start of lung mets as in the spreading of the osteo. I think they told me that doing more chemo later wouldn’t affect existing mets (as in micro mets) and that by the time osteo is usually discovered in a dog they have also already developed those (yet invisible) micro mets. Those generally are the 95% -keep that in mind. Meaning, they don’t usually develop mets after the amputation but already have them (even if they don’t show up on x-rays yet). -Not saying that anything isn’t a possibility, after all, Manni got another primary osteo and that supposedly never happens either…

Sorry, long rant that I am not sure is helpful. If your onco says another chemo round could possibly help: I would totally go for it. Guns blazing… 

Tina

Guardian of Manni the Wonderdog. -Or was it the other way around?
Osteo and amputation in Dec 2015. Second, inoperable, primary osteosarcoma found in June 2017.
The end of our adventures came Dec 10, 2017. 2 years to the day.

Manni's blog -dogblog-

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10 January 2019 - 9:48 am
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Thanks for the reply.  I think ill get a 2 nd opinion on a 2 nd round of chemo.  There is another onco vet i saw that administers the vaccine.   

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10 January 2019 - 5:24 pm
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I have been doing a lot of reading about the metronomics protocol, our dog Calvin was diagnosed with a high grade soft tissue sarcoma. Our oncologist is putting him on metronomics after doing 5 rounds of chemo. If you do decide to go the metronomics route, I think it is a good route to go. I wish we could get away with only doing that. They get to stay home more, minimal side effects, and they feel good. Our oncologist said the main side effect is the bladder issues, but when paired with a dirutetic the likelihood of that goes down tremendously. You sound so thorough, so just out of curiosity what food do you feed? Do you do a cancer diet or any supplements? We’re new here so I like to hear what others are doing. Good luck no matter which route you go!

Here and Now


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10 January 2019 - 6:27 pm
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kaylamichelle7 said
Do you do a cancer diet or any supplements? …I like to hear what others are doing.

Don’t Miss:

Jerry’s Canine Cancer Diet and Supplements

And in case you don’t know: Jerry’s Story

Michigan
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11 January 2019 - 12:00 pm
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Since Murphy was a long-term survivor, I can tell you that I understand that ticking.  Murphy had a different kind of bone cancer, and his prognosis “if we were lucky” was 12-18 months.  But his lymph node they removed was positive and they found another mass right after they finished his chemo, so we thought, well …  

So at first we did chest x-rays every 3 months or so … then every 6 months or so… and time went on and they were still clear, and the mass on his other shoulder wasn’t changing.  So we decided to stop doing x-rays.  As a nurse it was really difficult for me, because I want to know – I want to plan – I want to figure out how much time is left.  But Murphy just kept going forward a year, two, three … when we found a local vet who could do chest x-rays for much less than Michigan State, we did a set, just to check – it had been awhile, and you know, I had to know lol.  I was standing there and starting looking at the images expecting to see little white spots – nothing!  what?  It was 3 1/2 years and no mets.  So we did a dental cleaning (I had been putting it off even though a couple of teeth had fallen out, because why spend the money when the clock was ticking?) … 

Murphy celebrated 4 years!  He was 11 and getting stiff, so we started seeing a rehab vet for chiropractic adjustments and exercises.  That helped.  

But eventually we lost him to hemangiosarcoma.  Totally unfair.  But our Amazing Warrior beat the odds heart

We understand the ticking, it’s so hard to ignore, but Murphy ignored it and he just lived his life!

Donna

Donna, Glenn & Murphy  http://murphyh......pawds.com/

Murphy had his right front leg amputated due to histiocytic sarcoma at 7 years old.  He survived 4 years, 2 months & 1 week, only to be taken by hemangiosarcoma at 11 1/2 years 6/12/17  

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11 January 2019 - 3:13 pm
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 I use  honest kitchen bone broth to add to my alkaline water to mix my supplements with 1 cup ketona kibble. With that i add lightly cooked 80/20 beef, lightly cooked chicken liver , riced cauliflower broccoli and 1/2 can sardines in oil. I give that for 6 days.  On the 7 th day. A 1 lb raw turkey neck that was previously frozen for 2 weeks to kill parasites 

my herbs are four marvels, coq10, omega3, dha, milk thistle, dandelion ( new starting today) k9 armor up, canine matrix turkey tail, and 1 omperazole and metacam, though i might try piroxicam again bec of its anti cancer benefits ( simon vomited on it for the. 2 days i tried.  I might re try?

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11 January 2019 - 4:17 pm
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After Jet’s experience with Doxorubicin, I would hesitate using prophylactically . . . it took a lot out of him and he’s still growing his whiskers back poor guy.  That said, something worked and he seems to be doing fine, but it took nausea meds and appetite stimulants to get him through the chemo, and time to get him fur again.

Casey had five round of carboplatin and was on metronomic therapy briefly before we pursued the vaccine.  Two months after his one vaccination, he started back on metronomic therapy.  That never caused any side effects.

Ultimately, we believe the calendar took Casey, not osteosarcoma.  He never developed lung cancer to our knowledge, but at the end, he did have some (a lot) of fast growing, hard, subcutaneous lumps.  His shortness of breath, which troubled me in the heat of summer, turned out to be laryngeal paralysis unrelated to his osteo, and his vet believed that is what led to his general paralysis.  She said the osteo may have spread to his spine and that led to the paralysis, but as he only exhibited pain intermittently and then only at the very end, that was kind of ruled out.

One final note . . . I spoke to the center that administered the osteo vaccine to see whether we had any obligations there.  You might remember that Casey tolerated the vaccine poorly, and I understand they altered their protocol slightly after that experience.  Anyway, they told me that all of the dogs in their study have survived to-date except one that passed due to a fatal joint injury.  I believe Casey was their first vaccine patient in early April, so that says good things about the vaccine.

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11 January 2019 - 8:10 pm
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Thanks for the reply.   Perhaps another regimen wo the doxorubicin? Simon had no problems with the chemo.   

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