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Gossamer1

Rocco and bone cancer

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Gossamer1

My 7 year old, 145lb Saint Bernard, Rocco starred limping a couple of weeks ago. First visit to the vet was typical. We both assumed it was a soft tissue injury  and the vet sent him home with a few days of pain meds and instructions to limit the rowdy playtime with his Saint sister, Sophie. 5 days later, back to the vet because he wasn't improving.  X-rays this time, nothing to see in his paw as that was where he appeared to be feeling the pain. Another 5 days and we're off to see the specialist.  She got a pain response from his shoulder. More x-rays.  This time something showed up, it looks very fuzzy near the end of his leg by his shoulder. She said it was most likely cancer. She also mentioned that it could be extreme arthritis, but she didn't sound too convincing when she mentioned it as a possibility.  

Rocco went in for a biopsy yesterday and spent the night (so he can get IV pain meds.) I'll be bringing him home this morning. The test results won't be in until sometime between Saturday and Tuesday!

Now I will be faced with the decisions about amputation, chemo and radiation.  I will most likely persue all 3 since the outcome with only one or two of the options is not good at all. I've also been reading up on alternative medicine to use in conjunction with the traditional treatments. Artemix keeps popping up as treatment. I'll see what my vet has to say about it. 

Think healthy thoughts for Rocco please!

Rocco is on the left in the picture, they were celebrating Sophie's birthday in March. I can get her to wear the hat for 3 or 4 minutes each year. Rocco wears the hat for about 12 seconds so no pics of him wearing it.

20160301_203940.jpg

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Sad
Gobsmacked

They are beautiful dogs. Sending good vibes to Rocco. Also to you.

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Aggravated
GreyhoundFan

I'm so sorry to read of Rocco's diagnosis. Osteo is a monster. I have Greyhounds, which are one of the breeds that develop OS at far too high of a rate. I would suggest contacting Dr Couto. He is a top notch vet who has done significant research into OS and has treated countess dogs with it. You can consult with him from a distance. I've met Dr. Couto, and he is a wonderful and very knowledgeable vet.

I don't want to be a pessimist, but in Greyhounds, the average lifespan after amputation and chemo is 13 months. Some get way less, some get more. I will say that one of my closest friends had a Greyhound with OS who lived well for 50 months post amp. That is almost unheard of.

If you do go the amputation route, prepare your house and life beforehand. Both you and Rocco will be exhausted and out-of-sorts. There is a Greyhound chat board (greytalk.com) where OS is discussed in great length. I would suggest looking there, you don't have to register to view the Health & Medical forum. This is an extremely long, but very helpful thread about Winslow, a GH who had OS and survived a long time, before succumbing to other health issues. His owner wrote quite well and gave many good tips. This is another good thread with quite a few resources in the first post.

Gentle hugs for Rocco.

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Waffle Time
Palimpsest

I'm so sorry to hear about Rocco.  Both your dogs are beautiful.  

I gather that the biopsy is to confirm it is osteo and there is still hope that it is arthritis?  I will be keeping you in my thoughts and hoping for the best.

I'm going to second @GreyhoundFan's recommendation of Dr Couto.  We have consulted him many times (too many times) and he is the nicest man as well as being at the top of his field.  Also, if you are anywhere near Ohio State - they have an excellent oncology department lead by Dr Couto for many years.

Treatment is evolving all the time and tripods seem to adapt surprisingly fast - losing a leg doesn't seem to affect their quality of life.  Dogs also don't seem to experience the side effects of chemo and radiation in the same way humans do - so those options are very viable.

The pain of osteo - it is a horrible grinding pain - does effect their QOL.  The biggest thing is to keep them pain-free as far as you can.

Please keep us updated.  I'll be thinking of you.

 

 

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Hilarious
47of74

Sorry to hear about Rocco.  Hope he gets well soon.  It's never easy when the furry members of our families face health challenges.

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Gossamer1

Rocco is home now and resting comfortably. The tech who went over his discharge instructions with me told me the Fentanyl patch he is wearing until Monday makes dogs more vocal. In between naps I've been serenaded all afternoon!  

I have already scheduled his amputation for next Thursday. I will get to bring him home that Saturday and happened to already have the following  week off from work so I will be home 24/7 to help both of us adjust to his new life on three legs. On the off chance the diagnosis isn't cancer I can cancel the surgery. 

Thanks for the links. I'm going to pour a glass of wine and dig in. 

Inappropriate humor is one of my coping mechanisms in stressful situations  so I've already started planning his peg-leg pirate costume for this Halloween! 

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Waffle Time
Palimpsest

Aww!  I'm glad Rocco is resting comfortably.

 Inappropriate humor is always good.  We've referred to Frankenhound (very inappropriately) in this household before.  I love the idea of Rocco in a peg-leg costume.  I'm also chuckling at the serenading. :)

I see @GreyhoundFan has given you the link to Winslow's Diary.  It really is a fantastic read.  Winslow was an amazing character and had a lot to share - on pain control and rehab for a rather amazing dog with really stellar adopters.

We are crossing fingers and paws here that it isn't osteo and you can cancel the amputation.

Seriously, please do keep us updated.  We really care and there are many dog-lovers here.

 

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MarblesMom

@Gossamer1 I am very sad to hear about Rocco.  This is no doubt a very hard time for all involved.  I will keep you and your Rocco in my thoughts and prayers.  As others have said, please update us.

Fingers crossed for a great outcome! 

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Gossamer1

Thanks everyone for your thoughts and prayers.  Rocco is on day 2.5 of the Fentanyl patch,  he won't shut up! Even with all three pain meds he is still limping. It's heartbreaking to watch. 

My other Saint, Sophie has her annual checkup tomorrow so I will have time to talk to the vet about Rocco. Rocco was supposed to have his checkup as well but, the specialist and regular vet agreed that postponing his shots was the right thing to do for the moment. The place I used for their training has a water treadmill, I'm going to ask the vet if he thinks Rocco would benefit from it as part of his recovery. I'm also going to talk to the vet about Sophie's meds. She has Addison's disease  (an adrenal problem) and she is on very expensive medicine for the rest of her life. Most dogs are on a 28 day cycle with their meds, she is on an 8 week cycle so there is a little financial relief there. I may have found an alternative that's less expensive but won't switch without his full blessing. My vet is very understanding about controlling costs and doesn't get mad that I get her prednisone filled at Walmart and buy her Percorten online and do the injections myself.

I keep telling them to get jobs but they just lay around the house, sleep and make a mess. Is this what it's like to have teenagers? 

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Waffle Time
Palimpsest

@Gossamer1 It sounds as though your regular vet is one in a million.  I have a vet like that too - and I frequently tell her that she is worth 3 x her weight in gold and that she may never retire.

1 hour ago, Gossamer1 said:

Rocco is on day 2.5 of the Fentanyl patch,  he won't shut up! Even with all three pain meds he is still limping. It's heartbreaking to watch. 

I'm so sorry.  This must be so hard.  I'm afraid that this level of pain really does sound like Osteo.  Hang in there.

Your plans for rehab sound very good.

Again, my thoughts are with you, Rocco and Sophie.

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Waffle Time
smittykins

Keeping you and Rocco in my thoughts, @Gossamer1.(BTW, I flipping love Gossamer!)

Edited by smittykins

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Aggravated
GreyhoundFan
1 hour ago, Gossamer1 said:

Thanks everyone for your thoughts and prayers.  Rocco is on day 2.5 of the Fentanyl patch,  he won't shut up! Even with all three pain meds he is still limping. It's heartbreaking to watch. 

My other Saint, Sophie has her annual checkup tomorrow so I will have time to talk to the vet about Rocco. Rocco was supposed to have his checkup as well but, the specialist and regular vet agreed that postponing his shots was the right thing to do for the moment. The place I used for their training has a water treadmill, I'm going to ask the vet if he thinks Rocco would benefit from it as part of his recovery. I'm also going to talk to the vet about Sophie's meds. She has Addison's disease  (an adrenal problem) and she is on very expensive medicine for the rest of her life. Most dogs are on a 28 day cycle with their meds, she is on an 8 week cycle so there is a little financial relief there. I may have found an alternative that's less expensive but won't switch without his full blessing. My vet is very understanding about controlling costs and doesn't get mad that I get her prednisone filled at Walmart and buy her Percorten online and do the injections myself.

I keep telling them to get jobs but they just lay around the house, sleep and make a mess. Is this what it's like to have teenagers? 

Yes, water therapy is wonderful for rehab, but you may not be able to do it for the first few weeks because of wanting to ensure the wound heals properly, If you don't have a harness, you may want to get one now as Rocco may need some help. This one is quite popular amongst the pet parents I know.

Your vet sounds wonderful! You may want to ask the vet now if there is anything you should plan to have on hand as you probably won't want to leave Rocco for a while once he gets home. Since the Fentanyl is making him vocal, you may want to ask if you can give him a combination of Tramadol and Gabapentin. Many vets don't dispense Gabapentin automatically, but it's a good nerve pain medication (I should know, I take it myself), and it can really add some "oomph" to other meds. Also, ask if Rimadyl (or the generic version, Novox) is an option after surgery. It is such a powerful anti-inflammatory and makes the dogs feel better. A caution with Rimadyl, it can tear up the stomach, so it has to be given with at least a half-meal. Ask about having an anti-diarrheal like Metronidazole on hand, because you don't want to be dealing with diarrhea from the stress of the situation or new meds. Also, you may consider having some tasty treats on hand (beef baby food is a favorite) because sometimes pups are loath to eat after surgery.

I don't mean to be macabre, but you may want to prepare yourself by looking at some pictures online first. It's always a shock when you see them post-amp, but you may be able to take some of the sting out of it. A friend suggested that when I told her about Rocco's diagnosis. She said that was so rough on her.

Remember that the first few days will be the roughest, but that dogs usually learn to get around with three legs fairly easily.

I can relate about the lazy dog syndrome. I keep telling my Sammy that things are reversed, I should be retired and he should still be working! I hope Sophie's checkup goes well!

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Dizzy
Grimalkin

I am so sorry to see this. You are in my thoughts.

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CrazyCatLady

It's so heartbreaking when pets are in pain. Glad Rocco is so well loved and cared for!

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Gossamer1

@GreyhoundFan Rocco is currently on 600mg Gabapentin 3x a day, 100mg Novox 3x a day and the Fentanyl patch! The patch comes off Monday. Before the biopsy he was on 150mg Novox 2x a day and 50mg Tramadol 2x a day.

He's been drinking but hasn't eaten much since I brought him home. He is happily taking his pills wrapped in cheese though. The first few days on the pain meds were rough on his insides. I'm still cleaning the carpet so I ordered a whole case of Spot Shot!

Oddly enough, I'm more worried about some of my friends. They seem to taking even harder than I am. A co-worker who has a SUV and ramps will be taking me to bring him home next Saturday after his surgery.  She told me today she isn't sure she will keep it together when she sees him. 

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Gossamer1

You were right about the bracing myself for what it will look like. I just googled some pics. That definitely would have freaked me out if I were unprepared.  

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Waffle Time
Palimpsest

Yes, looking at post surgery photos does help prepare you a bit.  :group-hug:

We used this harness with Miss P. http://helpemup.com/ and were very pleased with it.  I also have a couple of slings that we used with one of my other greys.  There is one that goes over your shoulders and helps spread the weight but I can't remember the exact brand.  My boy was very heavy, but not as heavy as a Saint, and I struggled to lift him  I do think it is a bit easier to maneuver them gently when it is a front leg but you don't want to chafe the incision.  

I'm glad Rocco is taking the Tramadol easily in cheese.  I had a huge battle of wits over Tramadol with Miss P.  It tastes horrible.  Tramadol is a narcotic-like med, BTW, and does have a sedating effect so he may be feeling very sleepy.

I second @GreyhoundFan's medication advice.  Gabapentin helps the effectiveness of other pain meds.  Also on having baby food and other tasty but easy on the stomach stuff around.  Scrambled eggs with a sprinkle of parmesan cheese go down well to cushion the stomach against Rimadyl.

The ramps will be helpful but can be frightening if Rocco isn't used to them (they bounce and shake).  If the ramps your friend has aren't carpeted then try to attach a cheap runner.  

I think Greyhound fan has covered all my other thoughts too. :)

I am so sorry you are going through this.

 

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Gossamer1

I think short term I will stick with a towel. I don't want to get a harness that will interfere with his incisions so until I see exactly where and how long they are  I'll keep it old school.

I'm pretty lucky with the pills. As long as it's wrapped in cheese they both will take anything I hand to them!

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Gossamer1

So now I'm hungry and want to get into the kitchen. Guess who finally settled down, stopped vocalizing and is fast asleep in the doorway? Maybe this is his way of keeping me on track with my diet.

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Waffle Time
Palimpsest

Aww. Rocco.  What a great dog! 

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Eater of Worlds

I'm glad the Gabapentin is working for you, GreyhoundFan, because it did shit all for me.   Turns out, looking at the data fewer than half are helped by it.  Pfizer did tests with Lyrica, pregabalin, a relative of gabapentin and they found that their own drug did nothing for what they were marketing it, neuopathic pain.  

My dog has had cancer for 5 years now.  She was supposed to make it 18 months after diagnosis.  Her tumor couldn't be removed entirely so we debulked it.  It grew back in under a month, even larger than before.  So we went to palliative chemo, it was metronomic chemo.  It's basically continuous low dose chemo that targets the blood supply of the tumor cells.  They expected the tumor to shrink some, so she'd be more comfortable for a longer time and we could have her around more.  It shrank her tumor out of existence.  Then she started hemorrhaging from her bladder, which is a side effect of chemo.  So we switched her to a different one that was less effective, but it was either that or none.  She was on chemo for almost 4 years and it was starting to mess her up.  It was time to just get her off chemo anyway and see how she has done.  She just passed her year mark off chemo, maybe closer to 1.6 months so we're due for a checkup to see how she's doing.  I suspect her tumor has started growing again, but we'll see how she does on chemo again.  I think that we'll have her for another 2 years, maybe.  But that's 6 years longer than we expected to have her.  The vets were shocked, too, her type of cancer generally doesn't respond to chemo that well.

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Gossamer1

@Eater of Worlds, thank you for sharing your story. It gives me hope. The reality of Rocco's situation is starting to sink in now and I've been questioning my decisions. 

He is already 7 years old and the life expectancy of a Saint is 8 - 10 years. Am I doing this for him or for me? 

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Waffle Time
Palimpsest
On 5/15/2016 at 9:50 AM, Gossamer1 said:

He is already 7 years old and the life expectancy of a Saint is 8 - 10 years. Am I doing this for him or for me? 

That's always the hardest question.  It is something to think about and discuss with the vets.  Do  ask about his prognosis after the amputation - how many months you are buying and what his quality of life will be during those months.  Ask them to lay out and explain all the options to you before you make a decision  I've also looked vets straight in the eye and asked them what they would do if it was their dog.  They hate that but sometimes they answer rather than laying out the choices yet again.

Part of my reasoning always takes into account how my dogs experience vets and hospitalization.  I have one at the moment who would flip his lid (vet phobia dog) at this sort of surgery.  I would not choose amputation, hospitalization, and rehab for him.  For Little Guy - who has tolerated lot and would be OK with major surgery - I would definitely go for the lot.

You know Rocco best, so it is your decision that matters.  You want what is best for him. :group-hug:

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church_of_dog
27 minutes ago, Palimpsest said:

I've also looked vets straight in the eye and asked them what they would do if it was their dog.  They hate that but sometimes they answer rather than laying out the choices yet again.

I didn't realize vets don't like that question.  I think it's the best way to get a straight answer, given my assumptions that they love their animals but have a clear concept that sometimes it's time and more treatment is only prolonging the pain.  I trust their ability to distinguish that time from other times when treatment could resolve or reduce a problem and allow the animal to continue with an enjoyable life.  Asking them this question also allows them to step outside of any cultural or business pressure to try to "sell" life-extending treatments when they aren't appropriate.

My biggest worry as my now-gone furry family members got older, was not knowing when it was time.  I lean on friends and the vet to help me know; otherwise it's just so hard to make that decision.

Many virtual hugs to Rocco and Sophie and you and your family too. :group-hug:

Edited by church_of_dog
hugs are important

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