Tuesday, February 9, 2010

How this story begins...


October 6, 2008-
Our dog Sam goes in for a TPLO (Tibial Plateau Leveling Osteotomy. He had completely ruptured his Cruciate Ligament. At this time he is a 9 year old, going on 10 the following May, Chocolate Labrador Retriever. We knew he needed the surgery and it was going to cost a lot of money but he's Sam so of course we'll do it. So, after spending the night at the vet, he came home the next day. We were ready for him. We had an area cordoned off so he couldn't hurt himself. After a month he went back for follow up x-ray and everything was healing the way it should. In case you are wondering that surgery cost $3398.93. Ouch.

January 19, 2009-
Sam is back at the vet having to have his plate removed from his knee. Although it is not common to have them removed, Sam's body was having a hard time accepting a foreign body.

January 24, 2009-
Sam back at the vet, AGAIN, because he is not using his leg the way he should. It was determined that due to the lack of use during rehabilitation from his TPLO surgery he had developed generalized atrophy in that foot. We continued to try things at home to get him to use his leg. We'd have him jump up to catch a frisbee, lift up his good leg to make his weaker one support him, even have him put his front feet up on us so as his back legs would have to be used.

Finally after months of not wanting to use that "bad" leg as we called it, we put a boot on him. BAM! It worked. For some reason that extra cushion made it easier for Sam to walk on that foot. So from that point on through the summer into fall we would fashion him with a yellow Muttluck for every walk or outing.

November 25, 2009-
Our family's yearly outing to take our Christmas card photo. So this year we decided to have Sam join in on the fun. He is now 10 years old and going to be 11 in May, so we thought it was a good idea....just in case. What a trooper that dog was. All day we spent in the car, driving from one location to the next just trying to find that perfect spot. His patience paid off because after all was said and done (everyone was tired), we took Sam to the park to run off his pent up energy. He loves chasing golf balls so that was what we brought with us. The entire world could be coming down around him and he wouldn't care as long as someone is still there to throw that ball!

December 2, 2009-
Sam stops using his "bad" leg. He doesn't want to put any pressure on it at all. I am thinking uh-oh this can't be good. So we just kind of take it easy for a few weeks.

December 14, 2009-
I decide it's time to call in the big guns and contact the wonderful surgeon who did Sam's TPLO surgery a little over a year ago. She says, bring him in as soon as you can. X-rays are taken and the leg looks a little suspicious. So she says, lets redo an x-ray in two weeks to see if there is any change.

December 28, 2009-

Sam is dropped off at the vet to have his follow up x-ray and a few hours later I get a call. Not good news. The vet is having a hard time, I could tell giving me the news. She said after consulting with a radiologist they think Sam could have Osteosarcoma, bone cancer. However, a fungal infection looks similar radiographiclly as the cancer. The only way to know for sure is to do a bone biopsy. Immediately, I am thinking, how much is this going to cost? Well, in the end, the biopsy has to be done to know for sure and $800 later, Sam is back home resting. The vet says, we should hear something in a week.

A week later....the results were inconclusive. The piece was not big enough to get a conclusive answer. We needed to do another biopsy. This time, it was free of charge...thank god.

January 12, 2010-
Results of second bone biopsy come back indicating no signs of cancer. Phew! Wow, dodged that one. Ok, so now we test for fungal, $406.37 later, Sam is back home from having blood drawn. So these results could take a week or longer.

Few days later we get some results back, saying negative on the fungal front. Still waiting for a few more to come it. When all is said in done, all tests are negative for fungal infection. In the meantime, however, some one else is giving the second bone biopsy another look. BINGO, found the cancer cells, Osteosarcoma. UGH!

So now you are probably asking, where does that leave you? Well, here are the options: 1) amputate the limb and follow up with chemotherapy, 2) amputate the limp and do nothing else, or 3) do nothing. I am assuming you are all thinking, well of course, you will amputate, anyone else faced with this decision would. Well, let me break it down for you. Based on my findings from what the vet is telling me, in medical articles and personal accounts (other blogs) this is how the survival rate looks for a dog with this cancer. First all, it is known to be one of the most aggressive kinds of cancers a dog could get. Once it is diagnosed in the limb it has most likely micro-metastisized to the lungs. So you amputate the affected limb and follow up with chemo you could give the dog up a year, maybe a little longer. If you amputate the limb but do nothing else, you could give the dog, up to 6 months to live. Doing nothing, the dog probably has a only a few months.

We were down to the wire because obviously the sooner you take the limb off the better the chances. My husband and I decided long before this was even an issue that if any of our animals got cancer we would not do chemotherapy. We love our animals almost as much as we love our children but we have to be realistic. We have two kids to take care of. They come first. So after a long and painstaking week of going back and forth we made the decision to do nothing. It was by far the hardest decision we have had to make as far as our animals go.

So here we are 6 weeks since that second x-ray showing considerable change in his leg. Since that first x-ray, two weeks prior, Sam has been in a splint. The vet decided that is was best so as reduce the chance of him fracturing the bone. What this cancer does is it weakens the bone. Eventually his leg bone will get weak and break. If the cancer doesn't take him first, a fractured leg will. We won't be able to repair it because his bones will be too weak. We have come to terms with that but it still isn't any easier.

I never thought I had much to talk about, why would I want to blog? What do I have to say that would be so interesting to make other people want to read about me? My answer to these questions became very clear when I couldn't find anyone else's account of their dog having Osteosarcoma and deciding to NOT amputate the limb. It's not about the money, it's about reality. The reality of it is, by taking the limb off we are not taking the cancer away. Even by doing the chemo, our dog is not guaranteed 100% survival. He is going to be 11 in just over 3 months. We didn't want to put him through another major surgery. He is a happy dog from the time he wakes up until we go to bed. So if by me telling our story of what life is like with a dog that has bone cancer and just living out his days as that, can help someone in their search it will have been worth it. There are plenty of blogs and opinions out there for someone who wants to take that step and amputate. There are even videos you can watch to see three-legged dogs so you're prepared for what your dog may look like. I think dogs with three legs are just incredible. They seem to adapt very well.

I will continue to post updates even if it's just to say, Sam had a really good walk today. Really, this is good therapy for me as well.

By the way, Sam did go in today to have his splint changed after having his last one on for two weeks. They say everything looks great. He can still maneuver his leg without discomfort. Wouldn't you know it, since having a splint on for a month and a half he uses is "bad" leg, no problem! I was told this next splint could stay on for 3-4 weeks unless it gets wet or something else happens. I will cross my fingers.

7 comments:

  1. Its good to hear Sam is doing well and is still the same ol' happy dog with his new splint. A few greenies and a pancake or two on Sunday will keep him smiling.

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  2. Great job, Niki! Your blog will definitely help someone else make this difficult decision... your POV is one from love!! Bravo!

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  3. Have to admit I cried all through that blog for our dear Sam. Also I would like to go back to the happy days in ND when we visited the 3 of you. Grampy loved taking Sam for a long walks through the beet fields. He was a handsome, frisky young dog. I look forward to seeing him on Tues. Love, Grammy

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  4. It's good of you to share your experience. It is never an easy road, but you and Steve were smart to have discussed what you would do "if one day." Your choice was made with love and compassion for Sam...and that is what matters.

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  5. I'm now signed up for your "blog". We read your latest blog and are a little misty. We believe your a writer that hasn't been discovered yet. You should consider writing "Adventures of the Big Brown Dog" and then follow it up with "The Big Brown Dog and the Twins.
    Love you Ray and Mom

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  6. Ray has a great idea! I think you and Steve are doing a great job, and made the right informative decision, if that helps any. It sounds like you have made him very welcome and happy to be part of your caring family for many years. Kari P.

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  7. Thank you so much Niki, you have really helped me confirm my decision to not amputate. Lady, my beautiful, gentle, loving, emotionally supportive Doberman will be 11 in 4 months and has travelled down the same path as your Sam. It all started with the rupture of her cruciate ligament exactly 12 months ago and subsequent operation 2 x months later, which was not as successful as hoped. Her limping came back and 5 months post op I noticed a slight swelling around her hock, which she was licking, but was quite separate to the stifle where the initial injury had been. I thought she may have sprained her ankle and never imagined it would be cancer, until I decided to x-ray this week, due to swelling in hock slowly increasing in size over the past 6 months. My hopes were up, though, because her health, spirits, appetite etc had not changed. Unfortunately, the x-rays confirmed bone cancer of the distal tibia and have now spent many days agonising over what to do. I have decided to spare her another operation (as the last one was horrible to go through) and instead have continued with the carprofen NSAIDs (100ml once/day) along with Tramadol (50mg 3 x times/day)for pain relief . Thus far it's doing the trick. Like you, I have decided not to amputate for similar reasons and, as a Doberman, being close to 11, she is apparently nearing the end of her expected life anyway. I too have 2 x children under 7 and have to weigh up the financial commitments for all other treatment options involved, but at the end of the day, she has had such an amazing life and has been such a wonderful family dog that keeping her medically pain free is currently my preferred option, until we say good bye and send her to doggy heaven. It is proving almost impossible to think of how I will function properly with out her in my life. Currently, nothing in her personality has changed, her weight is the same and her eating habits are normal, plus she still wants to run around every where - which is what makes the diagnosis so damned hard to swallow! However, I have just noticed in the last week that she now lifts her leg off the ground, rather than the toe pointing she has been doing since the cruciate ligament rupture, which was the reason for me to investigate with further x-rays. BTW, no cancers were evident in the other x-rays taken of stifle, chest and abdomen. I will now walk her on a leash, as I don't want a pathological fracture to occur prematurely. I too hope she will give me the signs for when she is no longer in "comfort". Quality of life now is better than quantity. I work/study from home, so can keep a strict eye out for any minimal changes. I am interested, however, in the leg brace, I will ask my vet about it.
    Thank you again for your blog,
    All the best,
    Dimity, Sydney, Australia

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