Osteosarcoma~Norman’s Story

Today I am joining in on the Caring For Critters Round Robin started by our host Jodi at Heart Like A Dog. Each day “a blogging team member” will write a post about a specific illness, injury, disease, condition that they have experienced with their pet and share their story with us. Each member will pass the “round robin baton” on to the next blogger in line to share their story, I will pass the baton on at the end of this post. All posts are lined up on the community page over at Heart Like A Dog, you can go to that page and read all the stories here.

First off I have to admit in one month it will be one year since Norman’s passing from osteosarcoma and writing this post brought a tear to my eye. I still miss that boy and think of him each day. When Jodi first tossed out the idea of a round robin blog hop so to speak I was on board with her and told her I would like to contribute, then the more I thought of it I didn’t really think I had anything to contribute as my gang is healthy and I wasn’t going through anything I thought would be worthwhile to talk about so I told Jodi I was bailing. She got back to me and told me if I wanted to bail I could but she thought it would be nice for me to share my thoughts as to why I chose to go the route I did with Norman’s care when he was diagnosed with osteosarcoma. I then decided I would join in again on the round robin and share my story.

You can read my original Osteosarcoma post here that I wrote after Norman was diagnosed.

My story of why I chose not to treat Norman’s osteosarcoma beings with a little bit about myself. For those of you who don’t follow my blog I have been a certified Veterinary Technician since June of 1990. I currently work in a small animal practice where we have diagnosed several dogs with osteosarcoma. Some dogs have had treatments. Some with amputation and chemotherapy, some with radiation, and some with just pain control like I did with Norman. This wasn’t the first time dealing with a patient who was diagnosed with osteosarcoma but this time the patient was my own. After consulting with my boss and a specialist John and I decided we would not treat Norman, we would try and control his pain with Rimadyl, gabapectin and tramadol until the pain could no longer be managed then we would make a decision to say goodbye at that time.

A little bit about osteosarcoma. Osteosarcoma is cancer of the bone. It usually affects the  bones of the front and rear legs,  it is rarely cured with chemotherapy alone, but amputation or radiation combined with chemotherapy can increase the medial survival.  Ostersarcoma is a very painful disease if you don’t amputate or do radiation to the lesion you need to use some pretty good pain control to help manage the pain. Usually by the time you diagnose a dog with osteosarcoma it has already spread to the lung, you may not see the mets on the lungs but it doesn’t mean they aren’t there, so if you are going to amputate you should follow up with chemotherapy, average survival time is >1 year . If  you Amputate and don’t do chemotherapy metastatic disease can occur within 1-3 months. If you chose not to amputate you could do palliative radiation therapy to take away  the pain from the lesion. You won’t be trying to cure the disease you will be just making the dog comfortable. You will be making them comfortable for approximately 3-4 months, median survival time for palliative radiation or amputation without chemotherapy is 5 months. It typically is administered as a outpatient session of 2-4 visits where the patient is heavily sedated to prevent movement during the procedure. It will not lower the risk for pathologic fracture. A pathologic fracture is where the cancer has weakened the bone and it can break at any time. It is something no dog should have to go through.

A little bit about Norman. Norman was 12.5 years at the time of diagnosis in June. He had lead a very healthy lifestyle with no health problems except a ruptured cruciate. He was our foundation stud and why we started Sand Spring Chesapeakes. He sired two litters and gave me a daughter and a son whom we still have. He was our first competition dog in UKC and AKC hunt tests. He was our first dog that won any titles for us. He received his AKC Junior, senior and master hunter titles, he also received his UKC finished title. This was a big deal to us as we have never done this stuff before or had a dog to  this caliber. He was also the best hunting dog, companion, best friend and family member anyone could ask for. When Norman was sedated for his bone biopsy my boss also diagnosed him with a tumor on his spleen. She took aspirates from his spleen that we sent to the pathologist to tell us if the tumor was cancerous or not but the results were inclusive. So now he had two things against him, well really three if you count his age. One should not put a time on a dog’s life and  not treat because “he is old”. Knowing what I know and seeing what this disease has done to other dog’s and seeing what the owners have gone through I put a time on my dog’s life which I feel was in the best interest of Norman. After your Veterinarian goes over the pro’s and con’s you need to think long and hard on what is the best thing to do for your pet and your lifestyle.

After weighing all the pro’s and Con’s we decided not to amputate. The lesion was on his front right shoulder so he would have to have his whole arm removed in order to get the cancer. The majority of the dog’s weight is on the front half of the dog. So we needed to think of his lifestyle. Our home is not set up for the recovery of a three legged dog. Norman also had a tumor on the spleen so if we were going to amputate we should also do another surgery to remove the spleen. These types of surgery are very hard on any dog and now we have to think about his age and how he will recover from two major surgeries. We have to figure in his age on doing chemotherapy also, with chemotherapy the average length of time a dog makes it afterwards can be a  year. At his age is it fair to put him through all that when we may or may not get a year?

The main reason we made the decision not to treat Norman was because after the wonderful life he gave us for the past 12.5 years we just could not put him through all that could of been done and let what time he had on earth be spent in hospitals with major surgeries, major recoveries and continued care for however long he had left. He came into this world with dignity he was going to leave this earth in dignity and not have to go through all kinds of stuff just so we could prolong his life because we weren’t ready to say goodbye. We wanted to do what was right for Norman and not make him suffer for us. We made a promise to Norman that we would not let him suffer, when it got to the point where he was in more pain (limping more, tumor grew more) we would say goodbye. He was always a happy dog, I don’t think he ever had a sad day so we were going to make sure he left us the same way.

Since we knew we had limited time with Norman we lived like he was dying. We made our rounds and took Norman to all his favorite spots, visited our friends and had them say goodbye to him. I took lots of pictures and we made lots of memories. I had everything planned out right up to the end. He held on and gave us 5 months to cherish each moment.

The day I made the decision I came home from work and the tumor grew and he was limping more and stumbling more. It was time. A friend told me what her Veterinarian told her when she was trying to know when the time was right. The Veterinarian told her that in a terminal disease like this there isn’t a time that is too early but there can be a time that is too late. Some people hold on too long and that is ok for them but it isn’t ok for me. I never regretted our decision or if the time was right. It was right. I was at peace with the time we had with Norman.

Every medical decision is a individual one, it should be thought out carefully with the help of the Veterinary professionals and family members. To me there is no right or wrong answers as to what or how far someone should go for their pet. Each individual needs to make decisions that are right for them and ones that they will be able to live with.

Thank you for listening to Norman’s story. Tomorrow our host will be talking about Elevated Liver Levels, I pass the baton back to Jodi at Heart Like A Dog.