Tuesday, November 07, 2006

dog health: the story until now

I'm planning on posting health updates about bad dog via blog. This is my first one, so it covers a lot of territory. BD started limping about 5 weeks ago, which I'll call time zero. After a few days, I took him to the vet. They took an x-ray, saw a shadow in the bone below the knee in his left hind leg, said cancer or fungus. Bone cancer is very common Rottweilers and in all dogs his size and age. Furthermore, the location of the shadow on his bone is a common location for osteosarcoma. Standard treatment: limb amputation, chemo. It is practically always metastatic. A chest x-ray was clear, so any metastasis isn't advanced. Two weeks after the first x-ray, a follow up leg x-ray showed that the shadow hadn't changed. Often bone cancer is really aggressive and will grow in that time period.

Three weeks after the first x-ray, I found out that the fungal test was negative, which is unfortunate. It means the shadow on his bone is almost certainly bone cancer. It is possible, but unlikely, that the bone damage could be an idiopathic infarct, which means destruction of the bone from an unknown cause.

Monday (week 4) I saw my regular vet to make a plan; she'd been on vacation. The choice was between a biopsy to confirm the cancer diagnosis or proceeding with amputation. The problem with bone biopsy is that they don't always get a diagnostic sample, it's painful, requires anesthesia (which has risks of its own) and, presuming it confirms bone cancer, requires him to recover from two surgeries rather than one. Even if it's not bone cancer, the biopsy carries risk of damage to the bone that can ultimately require amputation. The problem with not getting a biopsy is the chance of amputating a healthy leg. The biopsy test is not fast enough that they can test it while he's still under and then perform the amputation if it's positive.

I'm not especially worried about any significant decrease in Mac's quality of life if he has to have the leg amputated. He's in good shape, and dogs generally can get along quite well with 3 legs. I'm worried about the metastasis. The typical life expectancy after amputation is 3 months, 1 year with chemo. I had always assumed the pain and sickness of chemo wouldn't be worth putting a dog through, especially since they don't have the knowledge of the benefits to weigh against the discomfort. My recent research suggests it's usually not as sick-making for dogs as it typically is for people. Also, it doesn't simply prolong life expectancy but acts palliatively to reduce pain and secondary sickness from tumors. That's huge to me.

Right now Mac is on Rimadyl, a potent (and liver threatening) anti-inflammatory. It seems to be working pretty well. He's just as perky and happy as always, chasing squirrels and begging for food. My goal is to keep him pain free as long as possible. This is all quite expensive, of course, but hasn't exceeded my old-dog health cost expectations.

Here's a link with information about osteosarcoma in dogs. http://www.vmth.ucdavis.edu/vmth/clientinfo/info/onco/k9ost.html

Mac is already past the life expectancy of a dog of his size and (assumed) breeds. Hopefully my mental preparation for this kind of news has helped somewhat, but it's still incredibly hard emotionally. He's been a daily part of my life for eight years. He's got lots of qualities I could do with more in my life: happiness, enthusiasm, friendliness, outgoing (ness?), loyalty, stability. I can't imagine what my life will be like without him. My friends and family have been very kind and supportive, and I can only take it as it comes.

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