Osteosarcoma - what to do?

[Dogsnob]

Hi! first time poster, long time lurker.

 

This week I was told it is highly likely my 8 year old dog has Osteosarcoma in his shoulder. I don’t know what I am hoping to achieve from this post, but I’d love to hear from others who have been through a similar situation.

 

He pulled up lame out of no where a couple of weeks ago and I thought he had just been playing too rough so I put him on crate rest for a week. There was no improvement so off to the vet. They happened to have an osteo specialist visiting the clinic that day so he had a feel and suspected something sinister due to the swelling he could feel on the bone. We went ahead and booked him in for xrays, they showed the bone in his shoulder was rotting (black) and around the joint looked moth eaten. Due to his symptoms and the results of the X-ray, I was told that all signs point to Osteosarcoma. There is a small chance that it could be cysts or a bone infection but not likely and they didn’t want to give me false hope.

 

The options from here are to do a bone biopsy to confirm cancer, followed by a CT scan to see if it has spread, and then amputation of the leg and shoulder followed by chemo, or (given how aggressive bone cancer is and the high chance that it has already spread) start palliative care with pain relief to keep him comfortable. Life expectancy is a few months. Treating with chemo could extend that but the end result would be the same and he would eventually be put to sleep.

 

Given that it is Osteosarcoma we are talking about here, and not a less aggressive cancer, I wouldn’t put him through amputation only to lose him in the end. I don’t want him living out his last days recovering from such a huge surgery and adjusting to life on 3 legs. I would also personally never put a dog through chemo. 

 

Honestly, we are having a shocking year and are not in the financial position to proceed with surgery and CT scans, and the vets are not hopeful for a great outcome even if we were to go ahead because there is a high chance that it has already spread.

 

We have decided rather than do the bone biopsy and confirm Osteosarcoma, because the vets are so certain already, we will start palliative care now and let him enjoy his remaining weeks or months free from surgery recovery (the bone biopsy itself has a long recovery period - around 4 weeks of minimal exercise and crate rest). When he is ready to go, we will do what we need to do.

 

Can anyone else share their experience with Osteosarcoma? Do you think I am doing the right thing by skipping the bone biopsy? It is so hard to know what the right thing to do is, but I feel that I would be putting him through it all for nothing. If they were hopeful that it could just as easily be something else then I would find the money somehow for the biopsy, but all signs point to the big C.

 

Its also hard to know when the right time to let him go is, at the moment apart from his limp, he is his happy self and is very stoic. I don’t want him to get so sick that I am forced to make that decision on the spot one day, and I don’t want to watch him decline in health. He has been an amazing dog and I don’t want him to experience unnecessary pain. Am I being selfish by keeping him around?

 

Sorry for rambling, I just needed to vent to doggy people who I know will understand my sadness.

 

 

 

 

 

 

[The Spotted Devil]

Sorry to hear this. Can I ask where you are based and which specialist you’ve seen?

 

There is absolutely nothing wrong with opting for palliative care so please don’t beat yourself up about it. Cancer diagnosis and treatment in our pets is bloody expensive (remembering it’s not subsidised like human treatment is) and not everyone is fortunate enough to be able to afford it. Quality of life is more important than anything. 

 

Things I consider when facing end of life decisions is appetite, activity, pain and enjoyment. You can have one hour of awake time that is enjoyable and relatively pain free for an old dog for example and that is ok. 

 

My final decision always rests with: better a week too soon than a day too late. Take care. 

[tdierikx]

I've had 3 dogs over the years pass from the big C... each had something different... and each had different timeframes after the diagnoses.

 

Don't beat yourself up about not going all out with explorations or treatments that are uncomfortable for your boy... I wouldn't either faced with osteosarcoma that has taken hold and messed up at least one large bone/joint.

 

Enjoy your boy, and let him enjoy you for whatever time you have left together, and analgesics will make that time more comfortable for him.

 

As for "knowing" when will be the "right" time for him to leave you... that can be a hard one to answer when one doesn't know the dog or family in question... but please believe me when I say that he will let you know when he wants to have that final long sleep, OK? Also trust in your vet and listen to him/her when you have progress checkups... he/she will keep you informed of the progress of the growth, and the general wellbeing of your boy from a health perspective.

 

Massive hugs to you and your family... from someone who has been there too, and can feel your pain and confusion...

 

Please give your boy an extra cuddle and kiss from me too, OK?

 

T.

[Diva]

So sorry you are going through this.

 

it is an extremely aggressive cancer in my breed and has usually metastasised before symptoms are noticed, even if the xrays show no spread. 

 

I have have experienced it three times over thirty years and never opted for amputation. I have for a non-disease based leg problem, but all evidence and anecdote  I have found shows  you are lucky to get 8 months survival after amputation in my breed with osteosarcoma even with chemo. I will not put a dog through it all just for a few months. 

 

Last time, last year, I used a range of prescribed meds and herbs to try and slow progression. But the most important were fentanyl patches which gave excellent pain relief. Because of the problems with human abuse of fentanyl only the vet could administer and they had to be replaced on exact three day rotations. My vet let me come to her house if that fell on a Sunday, to avoid pain breakthrough we had to be precise.

 

if you are taking the palliative care route I recommend the fentanyl patches. Best wishes 

[Dogsnob]

Thank you so much The Spotted Devil,  Tdierikx and Diva from the bottom of my heart for being so kind in your responses. I really needed the support, because I feel so guilty and it’s so hard to get my heart around what is to come. I see a healthy little dog with a limp in front of me, it’s so hard to imagine that I won’t have him for another 8 years.

 

The Spotted Devil, I don’t know the specialists name sorry, they just happened to be at my usual vet on the day I took him in by pure luck. 

 

Diva, thank you for recommending the patches, I don’t know if that’s an option due to how much I work, I would find it hard to get to the vet that often before they closed, but I will definitely discuss it with my vet.

[Two Best Dogs!]

I am so sorry you're going through this I went through very similar last year and I think it was quite possibly the worse experience of my life.  I opted bone biopsy and CT scan. My dog however is much younger than your dog, and the xrays were not showing as an advanced illness as you, so the bone biopsy and CT scan were to find out *what* we had (super early cancer? infection? something else?) and determine our course of action. The bone biopsy recovery was a truly miserable time, I felt like I could do nothing with her for fear of making things worse.

It sounds like your xray it is advanced enough the diagnosis it is obvious though. A repeat xray in a few weeks would also likely confirm, because of how fast osteosarcoma and cousins attacks the bone. And the shoulder is an unconventional place for it to present

If your course of action is likely the same regardless if it is cancer or something with similar effects, then the biopsy is likely unnecessary except to answer your wonderings. Especially since bone biopsy weakens the bone and reduces activity even MORE for an entire month there is no "right" decision, just what is best for your dog and yourself financially. It doesn't help the dog to drown yourself in debt or for your last few months to be miserably restricted.

I keep the quality of life measure in mind for pets, when it comes to trying to "know" when it is time.
https://journeyspet.com/pet-quality-of-life-scale-calculator/

 

I also try and keep in mind...my vets won't let me make the wrong decision. If it is too early, I trust them to let me know. If I'm pushing it a bit too long beyond what is kind to the dog, I expect them to let me so. I'm the owner, there's no way my mind will be clear so I need my vets to help me on that stuff.

 

There are a dog cancer support facebook group. It is very good for connecting with people, but also to caution those taking advantage of people's desperations to sell snake oil products with no consideration for the other medications dogs may be on. One recently hastened the death in a painful way on the dog, instead of easing its pain, due to how it conflicted with the condition on hand (the product seller got kicked out of the group). Remember to check with your vets for any alternative medications you might be tempted to use - to make sure it can mesh and compliment the existing medication and not inadvertently hamper or cause harm.

 

I also found it very helpful to follow dogs on isntagram who also are working with the big C. It was comforting to see others going through similar fears and doing their best to provide as much comfort and joy to their dogs as possible in their last few months or years (in some rare cases).

 

Many internet hugs for you in this challenging time. Maybe you would like to share all the things that makes your dog so awesome and special in your life? Or to start recording all the awesome fun things you can do daily with your dog. No time like now to spoil them rotten

 

 

[The Spotted Devil]

For anyone in Victoria I cannot recommend Dr Maureen at http://maccvet.com.au/ more highly. She is extraordinarily professional, knowledgeable and empathetic. You do require a referral from your vet. The initial consultation is not expensive in my opinion and is so worth the peace of mind. 

[Diva]

8 minutes ago, Dogsnob said:

 

 

Diva, thank you for recommending the patches, I don’t know if that’s an option due to how much I work, I would find it hard to get to the vet that often before they closed, but I will definitely discuss it with my vet.

Yes it was very difficult. And expensive. I was lucky to be able to manage it. I am sure your vet will have other pain management options 

[Loving my Oldies]

It would not matter if you were a millionaire, the only consideration is your dog’s health and happiness.  Going on your description of what has been found via the xrays and the prognosis, I think you are doing 100% the right thing to opt for palliative care.  Doesn’t mean it isn’t damned hard and you’ll question every decision you make.  Nothing but support  and empathy from me. 

 

    

[persephone]

2 hours ago, The Spotted Devil said:

My final decision always rests with: better a week too soon than a day too late. Take care.

Heartily agree with this. 

I am so very sorry that you are facing a trip down this road so soon

make the next weeks as full of good things as possible . Favourite places , foods and cuddles . Good pain relief to make it easier for you all ... Lots of happy photos
before he becomes really miserable , have the vet booked to come to your house perhaps .

Take care ...

[Deeds]

One of my Giants was diagnosed with osteosarcoma around 4 years ago.  Our vet told us it was hopeless as the cancer would be everywhere.  They didn't x-ray his lungs to see if it had spread.  They told us if they amputated he would have to spend months in a cage/crate & he would be miserable and it would probably only extend his life by a few months.  

 

We treated him with tramadol and he had palliative care by way of radiation.  He was diagnosed in very early November and had to be put to sleep late March.

 

The radiation was expensive but it bought him some time. We were absolutely heart broken.  

[Deeds]

I forgot to add to be very careful with your dog running around etc because if they fracture the bone where the tumour is it is very painful for the dog and will bring about the end sooner rather than later.

 

Our dog had the tumour in his back leg .  He was a very active dog and ran to the front door & fractured the bone. He was in a lot of pain after that and we had to put him to sleep as a result.  Until then then he was doing well on the tramadol.  We had a script from the vet & had it filled at our local chemist.  It was a lot cheaper than the vet.

 

I hope this helps you.

[Tassie]

@Dogsnob, no personal experience of osteosarcoma or amputation, but I have seen friends go through it.  I just wanted to say how sorry I am that you're facing this while your dog is relatively young and apparently healthy .. that makes it tough.   But on the basis of what I've seen, I'd say you're absolutely making appropriate decisions in not going to any extreme lengths of either diagnosis or treatment.  Palliative care is absolutely appropriate IMO, in circumstances where it appears the cancer is advanced.  And as far as end of life goes .. it's good if you can think about and plan things you might do.   I found it helpful that we have good cremation services available now .. for me that was an important decision to make, as was planning where and when I would be saying a final goodbye.   In my most recent case - 15 year old BC with lymphoma - I knew my vet, who had known her since she was a puppy, was happy to PTS in the back of my SUV in the car park at the end of clinic hours.  That was very sweet and peaceful for her I think.  Others are able to have their vet come to their home, or even to some favourite place.

It is important to have a good relationship with your vet - sounds like you do have,  and TSD's recommendation is definitely worth considering.  But IMO it's all about quality of life for the dog .. managing pain, for sure, but also the ability of the dog to find enjoyment and comfort.  When that diminishes significantly, it's time to act.

Most of us here have faced these sorts of situations with our own dogs in different ways over the years, and my experience has been that it's a very supportive and understanding group.

I do hope you and your girl are able to have a relatively easy journey, although it's way sooner than you were expecting.   The other thing that I find comforting, is that your dog doesn't know about cancer and prognosis and so on.  She just knows love and comfort and support, and lives day to day.      ,

[Dogsnob]

I genuinely appreciate each and every reply. You have ALL helped me emotionally as I was really struggling with the guilt. From the bottom of my heart, THANK YOU all for taking the time to offer kind words of support and clarity. ❤️❤️❤️

[Dogsfevr]

Our girl got 3 months more after diagnosis ,We opted for the pain meds & enjoy each day BUT trust me you will now when its time  & its better a day sooner than a day too late .
For our girl her pain got worse quickly,she struggled to keep warm even though a heatwave & her enjoyment of life clearly sucked out of her so we never regretted making the decision sooner than later .Our memories of her in her final stages where still pleasant ones & she left with dignity & respect a very special gift we could give her .
Make the most of the healthy time sooner than later so if you want photos at special places go for it now.

My suggestion if you haven't already thought about it is what your plans are when the time comes.
Cremation,burying in a spot ?
Do you want to be there when the time comes (there is no right or wrong answer here because everyone can/cant deal with last moments the same)
Would you prefer at home final wings or going to the vet .
Having a plan where everyone is in agreement can really make the time easier when it happens

[Rebanne]

My vet said the bone biopsy was not reliable. My Greyhound Sam also had it in the shoulder. I opted for pain relief only. After our experience I have vowed that if I have another with osteo then I will PTS once diagnosed. Bone cancer is incredibly painful and I went 12 hours too late. Never again. Better to go too early then a second too late. The dogs don't know what it coming except to react to their owners distress, they don't think oh but I might have a few more good days, they live in the here and now and don't worry about tomorrow's.

 

I am so sorry for you and your dog.

[ish]

I had a young dog, 3 or 4, who had bone cancer in a back leg. Didn’t do any tests past the X-ray, she was put straight onto pain relief. Unfortunately she only had about 3 weeks with good quality of life and was then PTS. In hindsight, I wish I’d spoilt her for a special day and made the decision to put her to sleep before she had bad days. 

 

I’ve sadly said goodbye to 2 very old dogs in the last 12 months and I try to look at it this way - they had blessed, long, happy lives and they were put to sleep before either of them had more than a few bad days. They both could have gone on longer - but to what avail? I know they aren’t thinking “she’s a terrible owner, she made the decision to end our lives when we could have gone on for 3 more weeks” I miss them immensely but I feel no bad feelings about the decision to say goodbye. 

3 months ago I lost a young dog to bloat and I am still wracked with guilt and sleepless nights over the thought that she suffered. 

Its the hardest thing to have to do, but please make the decision to say goodbye to your beloved dog before things get too rough for him. 

[persephone]

5 minutes ago, ish said:

3 months ago I lost a young dog to bloat

@ish   I know what that's like  

[Akay]

My dog just passed from osteosarcoma.  I read the posts saying amputation is traumatic and takes months of confinement.  This was NOT my experience.  The day after amputation my dog was up and hopping around, second day he was powering along, 3rd day he came home and on lead led me quickly to the backyard.  He used the ramp that was built for a few days then resumed using the steps, by choice.

 

He was so happy to have the painful leg gone and within a week resumed normal activity.  At his peak I could walk him 1km on 3 legs.  He adjusted to 3 legs so well and I would amputate again.  I got 4.5mths extra with him before the osteosarcoma took hold of his lungs.  He was still wanting to go for drives and very short walks up until 4 days before putting him to sleep.  Orthopaedic surgeons suggested to amputateand I believe this was good advice.  He was only 7 and a strong dog with a strong front end and his remaining rear leg was pretty good.  He was 39kgs and exceeded expectations with how well he did.  

 

I know this post is from2019, but I case anyone was looking through the archives like I just was, I wanted to provide another side to the discussion from my experience.  

Edited April 17, 2023 by Akay