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Caring for a Three Legged Dog or Cat

Tripawds is the place to learn how to care for a three legged dog or cat, with answers about dog leg amputation, and cat amputation recovery from many years of member experiences.
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Whether or not to do chemo - for senior lab still recovering
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Member Since:
22 December 2022
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25 January 2023 - 6:55 am
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Hello dear Tripawd community. 

I'm very torn about a decision I have to make for my dog and I realized I'd love to ask the group about their experiences. 

I'm trying to decide whether or not chemo is the right decision for my dog, Eli--a 12 year-old lab/husky mix who got his front leg amputated a month ago. His diagnosis is synovial sarcoma, which the vet says is a bit rare form of cancer. It's joint cancer. Eli's results were "non-histiocytic," which means it's not the very, very aggressive kind. So it's a localized cancer that, if they got all of it out, isn't likely to pop up elsewhere...unless it's already there in him somewhere now. Which is why I'm writing to the forum.

Basically, according to studies (which there aren't many of), the vet says he thinks there's about a 75% chance the amputation removed the cancer completely. However, the vet estimates that there's a 25% chance that it's already metastasized beyond what we can detect, and that there could still be some cancer cells in him somewhere. After his amputation, they didn't detect any cancer in his lymph nodes or shoulder, and his x-rays looked like his lungs were clear. But there's always a chance. 

So basically I have to decide whether or not to do chemo. There's a good chance (75%, taken with a grain of salt) that he's okay! But there's a 25% chance not, in which case chemo could give him more time. The vet estimates that with chemo, if the cancer has already spread, there's a 50/50 chance he could get another year. 

The operation was so so rough on my pup. pain management was very hard--like kind of brutal for him. He also got an infection. Eli's a senior pup and big, and he's walking okay but he's certainly not one of the dogs who's bounding around immediately and feeling great. So I'm really hesitant to do another procedure that can hurt him while he's still feeling so weak and I feel still needs to recover. He's not even close to being himself yet. I've come out of it feeling so protective of his quality of life, and making sure he's pain-free. 

The other variable is his life expectancy. He's 12! And he's a large dog. If he's cancer-free, we already might just have a year left, two if we're lucky. So if that's the case, I really worry about having him spend a bunch of that time in chemo, when he might not even need it. And I really worry about that small risk that something goes very wrong 

The big variable is that I feel like I don't ACTUALLY know how hard chemo is for dogs. I feel like people told me that the amputation is easy for dogs, but it wasn't for Eli. But I hear that for many dogs, it's not that bad? Like for some dogs, it's fine? I'm very curious if there's any norm. How do recovering dogs cope with it? Does it seem like something a dog who's still weak (and a bit depressed) should go through?

I love my pup so much and want to do everything I can for him. I just want to make the best decision for him in this case. If chemo is easy on dogs, maybe I should just do it! But if not, maybe I should just cross my fingers and really hope he's cancer-free, and just make the best of whatever time he has left. 

Sorry for the very long post. I've been up all night trying to decide and this is really the team I wanted to ask.

Thank you so much, 

Lilly and Eli 

The Rainbow Bridge


Member Since:
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25 January 2023 - 10:48 am
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Lilly, your pup is so lucky to have you for his mom! It's good to know that he's gotten over the hardest parts of his recovery. As you experienced, amputation recovery is not identical for every dog. Generally it's over in 2-3 weeks and the dog gets their sparkle back. But sometimes that doesn't happen and it makes you question every choice you made for them. 

First, know that you did good. You gave him a chance at a good life without cancer or pain. That's awesome! He's enjoying that right now, so follow his lead. His sparkle is slowly coming back, and he will get there 100% soon!

When it comes to chemo, there are statistics that say it give a dog better odds of survival. But honestly we have felt for many years that it's still a crap shoot. We see different survival rates for all types of cancer among our members. Some dogs live longer with chemo, some do not. Some who don't get chemo go on to live much longer than the stats say the should have. 

So, what I'm saying is that try not to put too much weight in the stats. They are important and help with decisions, but they are not fortune tellers. Nothing can predict the future. 

Were any CT scans done to find other cancer in his body? Or just x-rays? A CT is a better, more accurate way to know for sure. 

Starting chemo soon after amputation is usually done for more aggressive cancers. Since this wasn't aggressive, you may have some time to think about this. Get a second opinion from an oncologist if that will help. And if you go forward, you can always stop chemo if Eli doesn't do well with it. Preserving quality of life is always the goal. But, if he had a hard time with vet visits and other treatments, then that's something to consider. He may do just fine with chemo treatments but he might not. If his personality tends toward not liking vet visits, then take the number of chemo visits needed into consideration. 

Older or not, if he is otherwise healthy, he should do fine with chemo. Most dogs do not get sick and only have a little nausea. But again, every dog can be different and Eli has already shown you he is his own dog. Things may get rough. But again, you can always stop if that happens.

Honestly, we opted out of chemo for our Jerry because we didn't want his remaining time (predicted to be 6 months) to be spent feeling crappy and going to the vet. Well, he surprised us and lived two years without chemo! So you just never know.

I don't know if this helps or not. But just know that it's important to go with your gut feeling right now. Take a leap of faith and trust it. There are no right or wrong choices, and we will support you no matter what you decide. 

New England
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25 January 2023 - 11:09 am
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I haven't had to make this kind of decision for my dogs.  I can appreciate how difficult and heart wrenching it is to make, though.

You said that there is a 75% chance the amputation removed 100% of the cancer.  That means there is a 25% chance there is still cancer present.  Another way to look at this is, if you pursue chemo, there is a 75% chance it's unnecessary.  That would give me pause, personally. 

There is no right or wrong answer here.  I think Jerry's suggestion of getting a second opinion is a good one.

Virginia




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25 January 2023 - 4:27 pm
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Hi dear Lilly💖  Can only second and third how very Licky Eli is to have you as his hooman.  You clearly care about his  quality  deeply and will do evrrything possible to help him ,maintain quality and happiness.

First, do want to ask about any improvement on the infection?  

As already been said, there are NO guarantees one way or another with, or without chemo.  It really is pretty much a crap shoot.

You have shared  a very well thought out process in trying to figure out the best path forward for sweet Eli.   FWIW I want to sort of mirror back what my "perception " is on what I feel like you have expressed.  You've given weight (artfully so) to the fact that Eli is already a "senior"  in his sunset years, he's not regained all his sparkle back, very slow recovery, he's maybe still dealing with an infection, chemo does require Vet visits, poking and proding,etc.  All of these  things help "muddy the water" when trying to look into a crystal ball.  The main thing I've read (or sensed) over and over though, is focus on quality.  

I really like what "Mischief" said:

Another way to look at this is, if you pursue chemo, there is a 75% chance it's unnecessary.  That would give me pause, personally. 

Use a technique  long time member Karen always suggests.  Basically a pro and con list. Not only that though, write down the reasons you are deciding  on one decision  or the other.  

And we mean this with all our hearts, there really is no right or wrong.  Any decision made out of love is always the perfect  decision. 

Let us know if we can help further, okay?  

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

PS. Just want to add that, while CT scans are a plus, they, like chemo are costly and not every has those types of funds available.   You have already done more than some can do.  You proceeded with an expensive amputation to give him  a chance at a pain free life.  And I do believe he will get more of his sparkle back.  He had a setback with that infection and senior dogs do need more time for recovery. 

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!

Member Since:
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25 January 2023 - 8:18 pm
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Coco was diagnosed with Histiocytic sarcoma on her front leg at 10 yrs old. We had to amputate and we choose chemo which she did 6 rounds of Lomustine with very little side effects other then a little rundown towards the end of it. At four months she had a tumor come back at the removed lymph node area. At that time a sample was drawn and was seemingly not a concern at the 6 month mark the lump got larger and hardened.  We opted to try a trial drug called Tramtinib and after the 2nd month her white blood cell count was to low and we had to stop at the 7th or 8th month. They didnt believe she would live past her 9 month mark. I am happy to say she has made it over the year mark and still with me. Unfortunately she fell coming up my steps and ruptured her tumor and injured herself. I might add her tumor grew a 1/2 or better a month. For a visual it went from a grape to a grapefruit in 9 months. With all that said,  I dont regret a dime I have spent or a decision I made. I gave her 1yr and a month and Hopefully a few more if she can recovery from this. My advice is go with your gut only you know your dog better than anyone else. Either way there is no wrong decision. Sorry for the long winded post. Unfortunately, everyone on here understands your position.

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25 January 2023 - 8:34 pm
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I can't tell you how much I appreciate you all. First, Sally helped me over the help line to think through how to talk to my vet about pain management for Eli--and her suggestions completely worked. And now you're helping me through this impossibly hard decision. These responses are giving me hope and confidence. Thank you all so so much. 

I'll answer some questions first. 

Jerry--CT scans. Interesting! No one brought that up to me. He had a sonogram (ultrasound? I forget what it's called) on his organs in the fall, so I think that was helpful to them, but no one did new CT scans. I'm not sure whether that's the same thing. And a second opinion is a good idea. I should have said, this vet I was talking to is an oncologist. What I keep hearing, though, is that it's just tricky to predict anything because there aren't good studies on this kind of cancer. It's worth thinking about though. 

And Sally, so nice of you to ask about his infection. I think it's doing fine. The vet says it looks good. The antibiotics seem to have cleared it up. And you're completely right. He's staring to get his sparkle back. A month after surgery, he's finally getting up more, hopping around, and he's getting his sparkle back. It's so good to see. 

Thinking about the reasons behind one decision or another is really a good way to think about it. That's something I'm going to try to keep in mind. 

One thing I should have mentioned is that, if we did chemo, the oncologist said he'd just need four to six sessions. Maybe that's less than lots of dogs. It's really good to know most dogs respond okay to it. I was having a hard time understanding the reality. 

All this said, tonight I'm leaning against the chemo path. I'm not sure, but that's where my gut is right now. He's finally recovering a little and I just feel worried about putting him through more difficult stuff in his current state. I want him to gain strength so he can start enjoying his life again. However much time he has, I want to make it as good as possible. I'm not sure, but I'm leaning that way today. 

I really don't know how we'd be getting through this without this community. Thank you, everyone. 

Lilly & Eli

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22 December 2022
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25 January 2023 - 8:48 pm
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Oh duckdiggler13 -- How incredible to hear about your dear Coco, beating so many odds. You sound like such a wonderful parent, like you're doing every single thing you can for her. It sounds like a lot of hard decisions. I wonder how you made them all. Coco has a wonderful family. 

It's really helpful to know that a vet's prognosis isn't always right. That's really good to keep in mind. It sounds like she's doing way better than they predicted. I'd been researching histiocytic sarcoma and it sounds really hard. (For a while, it looked like Eli might have it, too, so I was reading up on it.) 

It's also good to know that chemo can often be okay. I think we humans have such trauma from human chemo--and it's hard to remember that human chemo and dog chemo are very different, and that dogs can do just fine on it. It sounds like Coco has. 

Thank you for telling me about your experience with this. 

Lilly & Eli 

Livermore, CA




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25 January 2023 - 9:51 pm
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I've dealt with three cancers in two Pugs, I chose chemo once and declined twice.

And I am the advocate for writing things down, especially your decisions and what your decision is based on.

Maggie lost her back leg to a mast cell tumor, her prognosis was 6 to 9 months WITH chemo. Going into surgery I thought the amp would be curative but when the pathology report came back it indicated her cancer had already spread.  This was the time I chose to do chemo- honestly partly because I was so shocked at the poor prognosis and I was thinking I had done the amp and I couldn't give up.  Mag's chemo lasted almost 6 months (again, mast cell cancer) and she did pretty well.  Once she was nauseous and when that happened the oncologist reduced her remaining doses.  Mag actually outlived her prognosis living almost 4 more years.

About 3.5 years post surgery Mag developed incontinence, kidney failure and then a second cancer.  Because of her other health issues and the fact that she HATED going to the vet I decided to do holistic/palliative care. This was the first time I wrote everything down.  Pros/cons to the suggested surgery and chemo treatments.  The melanoma vaccine had recently come out and that was offered although without surgery it was not very effective.  I also defined her minimum quality of life before it became a question. I knew Mag didn't have much time but I just focused on making every day her best day.  I was so glad that I had written everything down because after Mag passed I would sometimes think 'what if I had done chemo...'.  Looking at my notes reassured me that I had made the best decision.

Mag's little sis Tani also had multiple MCTs.  As she got older I even stopped taking them off because they came back faster than the path reports.  Although 3 oncologists suggested chemo I chose not to... Tani had more health issues than 10 dogs put together so the cancer was not at the top of the list! Tani lived to almost 15 and passed from strokes.

What I want to get across is not so much what you choose to do but to document why you chose the path you do.  You can never know what would have happened if you chose something else but since we are human we tend to beat ourselves up when things don't go the way we want. Do your research and go forward with confidence knowing you are doing your best for Eli!

Karen and the Spirit Pug Girls and Boy

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

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28 January 2023 - 5:30 pm
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Lily,

I'm glad to hear Eli is better. With the exception of his age ( Casey is 7.5), your story sounds much like mine regarding chemo. Casey  (mostly lab) has Mast Cell cancer, high grade (3)and high mitotic >50 (and >5 is bad). But the good news was there was no metastasis in the ultrasound and xrays before surgery, or in one of the lymph nodes that was sent out. He had been through 2 months of some treatments and the tumor on his leg kept growing and bleeding and was painful. The vet wanted to start chemo pretty quickly but Casey got an infection too, which was treated. I struggled with the idea of chemo b/c there was no sign of metastasis.And I wanted him to feel good again. But what she told me was b/c of the grading the chance of it returning was very high, like 85%. (MCT is horrible and I've learned more about cancer than I ever wanted to)  I still wasn't sure. Then one of the vet techs spoke to me who had been through the same ordeal with her dog, same leg, high grade MCT and a metastasis and she opted to do chemo. And it's been 3 years and her dog is still around. So far the chemo hasn't had much of a side effect, maybe a little nausea one night, but other than that he seems ok. His surgery was on 12/9 and he's been on chemo for 3 weeks. We'll do a total of 12 treatments I think. 

No one can make the decision for you, and whatever you decide will be ok. Every situation is different. This group has been great support for me. I am holding onto the belief that Casey is going to be one of the long term survivors, even knowing what the future may hold given what he has. 

And I am taking it one day at a time and enjoying every moment I get with him. 

sp_hearticon2 Patti & Casey

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