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,my Boston Terrier has cancer on right front leg and

Resolved Question:

10yr old boton terrier has cancer (#3) on righ
front leg and vet suggests amputation....
please advise pros and cons...
I think it will hurt me more than the dog...
have heard they react very well...

please advise//

concerned mom, mary
Submitted: 10 years ago.
Category: Dog
Expert:  ZooCVT replied 10 years ago.

 The options you have are doing nothing, treating the cancer, which can get expensive and there are no guarantee's and you may have to opt for amputation in  the long run if it doesn't work or amputation which most dogs especially small breeds do very well with 3 legs. They tend to recover very quickly from the surgery and are running around soon like they still have all 4 legs. As long as your dog doesn't have any knee or severe hip problems, he will do fine. I have seen many dogs come thru the surgery and live long lives after. Some of the cons are, depending on the cancer, it coming back in another area, post surgically, the amputation site becoming infected but this can be prevented with good vet followup care. Here is some other info and pro's and cons of amputation and some treatments if it happens to be Osteosarcoma which is one of the more common bone cancers:


Amputation of the Limb: Removal of the affected limb resolves the pain in 100% of cases. Unfortunately, many people are reluctant to have this procedure performed due to misconceptions.



  • While losing a leg is very handicapping to a human (who only has two legs total), losing one leg out of four does not restrict a dog's activity level. Running and playing are not inhibited by amputation (after the surgical recovery period is over).
     
  • While losing a limb is disfiguring to a human and has social ramifications, dogs really are not so self-conscious about their image. The dog will not feel disfigured by the surgery; it is his or her owner that will need to adjust to the new appearance of the dog.
     
  • Median survival time for dogs who do not receive chemotherapy for osteosarcoma is 4 to 5 months from the time of diagnosis regardless of whether or not they have amputation. Do you want your dog's last 4 to 5 months to be painful or comfortable?

Limb-sparing Surgery: Limb-sparing techniques developed for humans have been adapted for dogs. To spare the limb (and thus avoid amputation), the tumorous bone is removed and either replaced by a bone graft from a bone bank or the remaining bone can be re-grown via a new technique called bone transport osteogenesis. The joint nearest the tumor is fused (i.e., fixed in one position and cannot be flexed or extended.)



  • Limb sparing cannot be done if more than 50% of the bone is involved by tumor or if neighboring muscle is involved.
     
  • Limb sparing does not work well for hind legs or tumors of the humerus (arm bone.)
     
  • Limb sparing works best for tumors of the distal radius (forearm bone).
     
  • Complications of limb sparing can include: Bone infection, implant failure, tumor recurrence, and fracture.

Radiotherapy for Pain Control: Radiation doses can be applied to the tumor in three doses (the first two doses 1 week apart, the second two doses 2 weeks apart.) Improved limb function is usually evident within the first 3 weeks and typically lasts 4 months. (Our local oncologists report a range of 0 to 19 months.) When pain returns, radiation can be re-administered for further pain relief if deemed appropriate based on the stage of the cancer at that time.



  • When pain is relieved in the tumorous limb, there is an increase in activity which can in turn lead to a pathologic fracture of the bone.
     
  • Radiotherapy does not produce a helpful response in about 1/3 of patients. (Remember, amputation controls pain in 100% of cases but if amputation is simply not an option, there is a 2 out of 3 chance that radiotherapy will control the pain.)

Drugs: Analgesic medications such as carprofen, etodolac, aspirin, butorphanol, and fentanyl patches are all available but, unfortunately, they are no match for the pain involved in what amounts to a slowly exploding bone. These medications may be palliative at some stage but generally do not provide meaningful pain relief long term.


How Do we Treat the Cancer?


Osteosarcoma is unfortunately a fast spreading tumor. By the time the tumor is found in the limb, it is considered to have already spread. Osteosarcoma spreads to the lung in a malignant process called metastasis. Prognosis is substantially worse if the tumor spread is actually visible on radiographs in the chest so if chemotherapy is being contemplated, it is important to have chest radiographs taken.



  • Chemotherapy is the only meaningful way to alter the course of this cancer.

Cisplatin (given IV every 3 to 4 weeks for 3 treatments)



  • The median survival time with this therapy is 400 days.
  • Survival at one year: 30% to 60% 
  • Survival at 2 years: 7% to 21%
  • Giving less than 3 doses does not increase survival time (i.e., if one can only afford one or two treatments, it is not worth the expense of therapy)
  • Cisplatin can be toxic to the kidneys and should not be used in animals with pre-existing kidney disease.

Carboplatin (given by IV every 3 to 4 weeks for 4 treatments)



  • Similar statistics to cisplatin but carboplatin is not toxic to the kidneys and can be used if the patient has pre-existing kidney disease.
  • Carboplatin is substantially more expensive than cisplatin.

Doxorubicin (given IV every 2 weeks for 5 treatments)



  • The median survival time is 365 days.
  • 10% still alive at 2 years.
  • Toxic to the heart. An ultrasound examination is needed prior to using this drug as it should not be given to patients with reduced heart contracting ability.

Doxorubicin and Cisplatin in Combination (both given IV together every 3 weeks for four treatments)



  • 48% survival at 1 year
  • 30% survival at 2 years
  • 16% survival at 3 years.

Quoted from http://www.veterinarypartner.com/Content.plx?P=A&A=1035&S=1&SourceID=42


Hope this answers your questions!


Good Luck with your decision

 Disclaimer: The above is provided for informational purposes only.  As I am not a veterinarian -- the above should not be considered, or relied upon as, veterinary medical advice.  I strongly encourage you to consult a Licensed Veterinarian regarding any serious animal medical matter.  
    






ZooCVT, Certified Veterinary Technician
Category: Dog
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Experience: 25 + years of experience w/ sm. animal, fish, exotics, orthopedics, ophthalmology and zoo medicine.
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Customer: replied 10 years ago.
You have been a GREAT HELP !!!!
Expert:  Dr. Katie replied 10 years ago.

Hi There,


 


It is very late, but, I want to help you, so please bear with me until tomorrow morning.  I will tell you this now: bone cancer in dogs i susually fast, cruel and quick.  Amputation is the best solution and will solve the problem.


I can appreciate your difficulty with the surgical procedure, but this is not a time for 'anthropomorphism", (attribution of human feelings).  It is our job as pet owners to protect/care for them.


You ma want to get a second opinion to feel better, but, i would advise you to do it within a day, (I expect that your vet wants to perform the SX. as soon as possible).


I will write more tomorrow.


Dr. Katie

 
Expert:  DanaDVM replied 10 years ago.
I may have missed something...what kind of cancer is this?
If it is advanced in the bone of a forelimb, amputation DOES NOT influence longevitiy of the animal...it WILL eliminate the bone pain in that leg, since the leg is gone.
If NO chemo or further treatment is done the survival rate is usually less than 6 months.
I would like to guide you further, but I would need to know if this is osteosarcoma or not. Also, if you pursue treatment I would recommend referral to a veterinary oncologist vs. your regular vet...there are "quality of life" issues to be discussed with you and options of treatment that need to be discussed beyond amputation.
Dr.V
Expert:  Dr. Katie replied 10 years ago.

Hi There,


I have nothing further to add to Dr. Vamikias' advice, other than to encourage you once again, to act quickly, (you do not mention how quickly this problem appeared, nor if it is getting worse daily).


The best of luck to you and your pet.


Dr. Katie

Customer: replied 10 years ago.
thanks for your help...

yes, the vt wants IMMEDIATE action so
will get opinion from oncologist...

thanks again
Expert:  ZooCVT replied 10 years ago.
 

Good luck with the oncologist and with whatever decision you make!


Customer: replied 10 years ago.
I already answered you on the other "way"..

   is that o.k w/you?

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