Our old girl has bone cancer in her front leg. Our Vet feels that because of arthritis in her hips she is not a good candidate for the best treatment, which is amputation.
The internet has Bone-sparing Surgery and Palletive Radiation as new treatments. Has anyone tried these options? Any help is most appreciated, Thanks in advance.
I have done palliative radiation, and it has been helpful indeed for pain contril. I have not done the bone- sparing surgery yet so will be interested to hear what others experiences with that have been.
I chose to do palliative care when my doberman was diagnosed. Steroids and pain meds. He lasted four months from diagnosis. Since it was a battle I knew I couldn't win, I chose the least intrusive for the dog.
I say the best bet is to have a consult with an oncologist, they can give you all the updated information on the cyber knife, chemo, radiation etc.
I have known a dog go 6 years with amputation/chemotherapy, and another who is thriving after receiving cyber knife treatment two years ago. Some dogs dont do well with any treatments.
From personal experience, carboplatin (the general chemotherapy used for osteosarcomas) doesnt bother too many patients. Sometimes when it does, all it takes is a dose alteration. Chemo is genearlly not recommended unless you amputate. Radiation usually works well for patients who need to spare the limbs - and there's various kinds.
I would get chest radiographs before making any decisions. If those are clear, book an appt with an oncologist. Often they can give you great protocols for palliative care as well if that is your choice.
As for the bone sparing cyber knife surgery, not all dogs are candidates. You will absolutely need a specialist consult for this, and I think only a few states offer it. The dog I know that had it done is doing great...however I only know one dog that went through with it.
Thank you for all the good advice.
Our girl had chest x-ray today and they were clear.
What makes pallative radiation worth trying? Our girl is 12yrs and in good health. We want to fight for her, but we don't want to prolong her suffering.
I don't think there is a vet oncologist in town, LSU is the closest vet school, about 100 miles away,
Is ther a list of vet oncologists online?
Thanks in advance.
Honestly, at 12, I would say that unless you really want to sink thousands into treatment with a poor prognosis (and I'm not a vet), I would do the palliative care and then euth as needed.
You can slow down the progression but at X cost dollar amount plus X cost in emotional toll for her and you?
I'd rather make the last few weeks/months happy and then euth. That's just me though and I've spent a gazillion dollars on my dog. I'm not averse to spending the money. But at her age...is it really in her best interest?
Many jingles and ((hugs))
A good horseman doesn't have to tell anyone...the horse already knows.
I would absolutely make this decision with your vet or team of vets. Like St. Germain said, this is a losing battle. We did pallative care (just meds) on our 6 yo doberman. She had some other health concerns going on (unrelated intestinal issues, etc.) She also had arthritis (vet joked she would fail a pre-purchase). Before anyone comments, the vet is my friend, and it was an appropriate moment of levity when I was struggling to get it together enough to leave the exam room. I thought she'd sprained a ligament and was floored by the diagnosis.
She went a bit over 3 weeks from diagnosis to euthanasia. She had just started limping a bit the week before, but her leg x-ray was really bad. She had a big pain tolerance. The tumor grew like nothing I've ever seen (it was also warm). We started with NSAID once a day and were doing a combo of NSAID/narcotic pain killers every four hours by the end. When she started waking up in the middle of the night because the pain meds were wearing off was a pretty good sign that it was time. She had also become defensive, growled at my husband, really went after the cat, and was in general swinging from agitated to overly disinterested. She ate her food up until the end, but quickly lost interest in a real bone (you have to understand how much that dog loved food and bones were the thing she never got because she destroyed them). That was another sign. Sorry, I'm getting off topic.
My only concern with radiation was reading/talking about about catastrophic breaks (I assume without the pain the dog isn't careful?). Maybe somone on here can comment on those risks. I'm not saying don't do it, just mentioning it as one thing to talk to your vet about.
Our dogs play hard and she had HUGE prey drive. I started letting her out on a leash just so she wouldn't take off running after a bunny or something. We were very worried/stressed about keeping her alive too long and her suffering a break, or being in too much pain but not showing it vs. euthanizing too soon, but I had no idea it would be that quickly. I read that it is often faster in younger dogs vs. older however.
The one positive was that the vet euthanized her at our house and she was busy staring at a squirrel she needed to go devour when it happened and it was really quite peaceful. Horse vets rock (my small animal wouldn't do house calls).
I'm so sorry. (((((HUG)))))
Wanted to add, your vet should be able to give you oncologist referrals--at least ours did.
Last edited by TrotTrotPumpkn; Apr. 24, 2013 at 06:09 PM.
Palliative radiation absolutely helps with pain control, and can (sometimes...depending on radiation used) slow/cease tumor growth.
Palliative supportive treatment is typically NSAIDs or steroids, along with a combination of tramadol, gabapentin etc.
If you choose to go radiation route, you will need to go to a specialist. Its well worth the time to at least speak with one, even an internal medicine specilist if an oncologist isnt within reach. They deal with this on a daily (sometimes hourly!) basis and can really answer all your questions in more detail than your regular vet. Ask your vet for a referral to an oncologist/internist and they will find one close to you that they can develop a working relationship with.
Thanks so much once again. I'm sure it's all the CLOTH good wishes working because this morning the vet called and said that the radiologist who reviewed the x-rays does not think the big lump on her bone is cancer, ( it's in the middle of the ulna in her left front leg ) he thinks it's an on-going problem. but what the..? could that be? Our vet says that the only way to be sure is to do a biopsy, and we can't do pallitive radiation unless we know for sure it's cancer. Then he said he does not want to risk putting her under general anesthesia to do the biopsy. He wants to wait two weeks then re-do the x-rays, and see what changes occur.
We have opted to do the much less invasive wait and see. In the meantime, our girl is not getting much relief with the Tramadol/Rimadyl he has perscribed. And the Rimadyl always gives her reflux/ulcers so she is on Prilosec too.
I just want to know what is wrong, and I want her pain controlled.
Inspite of her pain she helped sing Happy Birthday to my Mom, and "helped" open the presents last night. She has so much heart!
What, other than cancer could this be? Vet would not speculate.
Will ice, or a splint relieve any of the pain in her leg? I don't feel much heat, just the hard lump.
Last edited by csaper58; Apr. 27, 2013 at 12:36 AM.
Thats great news. Recheck radiographs are a good idea, but if you do want a diagnosis I would ask for a referral. Bone biopsies are the only way of receiveing an actual diagnosis and if your vet isnt comortable doing it I would ask him to refer you to a specialty practice. Bone biopsies are a very common procedure which takes about 5 minutes. Anesthesia at age 12 should not be an issue, especially for those experienced in geriatric anesthesia.
That being said, lotd of things can cause a lump including other forms of cancer (osteosarcoma most common, fibrosarcs and chondrosarcomas are less common but do appear), infection or inflammation from trauma etc. If it doesnt bother him at all (not lame) and you are not planning on persuing radiation etc if it IS cancer then I would skip any biopsy and just let it be. If you do plan on treating, a biopsy is the only way to tell you a.) IF its treatable (ie. is it a cancer) b) what you are treating.
Step 1 is to recheck the rads. If its disappearing than youve got a really really good chance you are not dealing with cancer.
From my experience, often osteosarcomas have a very lytic (moth eaten)appearance to them. If this bony growth on xrays looks solid I would have a hard time convincing myself to persue anything at the moment
Thanks Squish, she is very lame, but does bare weight on that leg. I looked at the x-rays and IMO the area looked honey-combed, not like solid bone, but I am not even close to an expert. Obviously the radiologist sees something my untrained eye does not, so I am trying to be positive.
Dont worry yet - honey comb/mottling CAN mean cancer, but also typical of infection. You can often get cells on fine needle aspirates for osteosarcomas too, if you didnt want to do a full bone biopsy. You would need light sedation, and thats about it. Not always diagnostic, but an easy and not really invasive first step. Jingles for your pup!