osteosarcoma – Page 2 – The Journey of Ellie the Great Pyrenees Mix

1st Oncology Visit

It’s been a couple days since Ellie rejoined the pooper club, and it’s gone pretty dang smooth… Except for it freaking snowing every other day (Spring pleeease hurry up).

woke up to 5 inches of fresh snow. I’m over it.

We have our routine worked out, and there have been no accidents since. She has also started laying on the carpet again (but still says no to her fancy bed). She’s moving around fantastic, but definitely tires out pretty quick. She will need to stay pretty mellow for the next week, but after that we will start going on short walks, and slowly increasing the duration (vet said to start with 5-10 minutes, then add ~5 minutes a day, but watch carefully and pull back if she shows any signs of being uncomfortable that night or next day). Since she’s bound to get a little cabin fever over this next week I’ve made sure to have a selection of mental stimulation toys on the ready. I’ve already shown ya’ll the woof pupsicle, but I also made a snuffle mat for her to search for bits of her daily meal. I made it out of one of the sides of those metal cubes that use to be all the rage because you could arrange them however you wanted? along with some scrap fleece and t-shirts. I think I’ll have to make a few more, she loves the current one, but it only takes about 5 minutes to find all the goodies. Any other ideas for mental stimulation? I’ve hidden food around the house/wrapped it in a towel for her to find, but always looking for more ideas!

Ellie’s Snuffle Mat!

Yesterday we went for a little car ride, because I wanted to test if I would need help getting her into my SUV for the appointment we had today. I got this ridiculously long (7.25 feet!) ramp. Glad I did, because it’s still a decent incline, but Ellie (with my guiding/supporting in the harness) gets in semi-easily. It really shines when she gets out, I’m able to support with a harness so no heavy bounces down. Anyway, so since I already had her loaded up we went for a drive. She tried to stand for a little bit, but thankfully laid down and enjoyed the views comfortably.

Today is exactly a week since Ellie’s amputation and she is currently at CSU for the first step in the clinical trial she is in. They are giving her the study drug called Vismodegib orally and then doing an 8 hour serial blood collection to evaluate the safety and molecular effects of the drug. Vismodegib is currently used to treat humans with basal cell carcinoma that has spread to other parts of the body. From the study: “It appears that canine and human osteosarcoma, like human basal cell carcinoma, rely on a cell signaling pathway called the Hedgehog pathway (which is inhibited by vismodegib) for cell growth, survival and spread, treatment with vismodegib results in delayed osteosarcoma spread.”. In 2 weeks she will start the traditional chemotherapy Carboplatin, while also taking vismodegib daily. This study is top heavy- we will be going in every week for the first 5 weeks to do blood work, most of these will be short 1 hour visits except for her carboplatin days which will be closer to 4 hours every 3 weeks. I do feel anxiety about putting her in more stressful situations than necessary, and fear that this drug will have adverse effects. With that said, I never want to say no to treatment based on financial costs. Full disclosure between the diagnostic testing, surgery, and hospital stay I am close to spending $6,000.00 already. For a dog Ellie’s size chemotherapy would be over $5,000.00. This clinical trial will allow me to go ahead and get a PT appointments for Ellie without having to crunch numbers as well as taking some well deserved time off for her and I to enjoy whatever time the world decides to give us. It also allows for money for future appointments as well. Even if everything goes swimmingly, Ellie will need x-rays multiple times a year to check for lung mets so being prepared for that is necessary. Another alternative reason I went with the clinical trial was it bumped me up the lists. When I originally called CSU for an oncology consult they were booked out almost a month, but when I did a consult for the trial, I was able to get in, in less than a week and her amputation a week after that. It also gets Ellie seen by some of the best veterinarians in the country. So yes I am anxious, but also very confident in my decision.

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Houston…we have a poop!

After my anxious writing yesterday I wanted to jump on here to share the good news! Ellie pooped (and peed) outside multiple time now and has had no accidents inside today! I believe it was the Trazodone causing the incontinence since that’s the only thing that’s changed and will have to remember that in the future and hope we don’t need it moving forward. I did give her a couple tablespoons of pumpkin with dinner, not sure if it was the difference maker or if it was just time, I didn’t give her anymore so I guess if she get stopped up again then we’ll know.

we have started heat therapy (10min 3x a day) today to help with the healing of her incision and getting any seromas to be absorbed, she doesn’t appear to have but I’m not expert.

Its amazing how exhausting worrying is. I try very hard to focus on the positives, but can’t help searching to see if there’s something else I should be doing to fix whatever is ailing her. It’s one reason I’m trying to remain dedicated to having a detailed blog of her recovery, for others in the future to see. I know all dogs recovery is different, but knowing that it is completely normal for a dog not to poop for 4-5 days after surgery was so reassuring for me to not panic about that yesterday. Here’s to the rest of the day being smooth sailing!

Getting her well deserved rest after being the pooping queen👑

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3/4 days post op

I’m writing this the evening of Ellie’s 4th day post op. Things are still overall good, but not without struggles. The good news- she has a great appetite, readily drinking water, readily taking her medication, allows me to ice, her incision looks really good and she can get up easily (she can get down on her own, but more tricky) and moves around quite well- though you can tell she’s sore and gets tired easily which is to be expected.

The not so good news is we continue to have pretty bad potty issues, I’m back to thinking it’s incontinence as she’s very much dribbling, but also sometimes has full on accidents- she has also made no effort to squat outside in the past 2 days which makes me worried. It’s odd because she voluntarily gets up to see if I’m making food or when visitors have come (2 in 2 days, we have been very quiet), so she’s not so uncomfortable to get up, it’s odd she wouldn’t get up to potty. Also no poop yet, which I’m not overly worried about after reading around, but I did go ahead and give her some pumpkin since she has been eating regularly from the get go.

The other odd thing is she refuses to lay on her bed or even the carpet now. At night she goes to the shower (which is close to my bed) and all today she was trying to find patches of the cement floor to lay on. I ended up pulling up one of my runners and now that is her go to spot. She doesn’t seem in pain, she falls asleep readily and when awake seems fine, but obviously something must be making her uncomfortable. any ideas? She’s not panting or anything. She does have a decent bruise running from the bottom of her incision down her belly where they shaved her. I’ll admit I’m a bit at a loss.

her current favorite napping spot. Also please ignore the stained cement- old shop flooring.

Lastly, my dad came to visit today and Ellie was very happy to see him, but after they said hello she started crying a little and looked incredibly uncomfortable. I let her outside and she threw up. I’m pretty sure she was just over excited- after she came in she drank water and ate a carrot with zero issue, and she’s had dinner without issue as well, still upsetting and very out of character. I blame the medicine. sigh.

I do have an email into the vet, but haven’t heard back yet. I can honestly deal with the incontinence if it’s caused by the meds, that’s temporary and I would much rather her be peeing than not at all, carpets can be cleaned. I do worry about the not trying to squat- I attempted to put the harness on today, but she wouldn’t move at all so I gave up pretty quick on that- I hope it’s just general soreness and that she didn’t already tweak something. We have been very quiet since she’s been home, she doesn’t have to maneuver any steps to get outside, and doesn’t have to walk more than 10 ft to get to lawn, and there have been a few visitors, but not excessive. any advice is always welcome, I know I have seen you guys say the recovery is always a roller coaster and that it is, lets hope tomorrow goes a little smoother 🙂

Meeka being extra cute for the camera to end on a high note.

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2 days post op

Ellie has been doing so great overall. We are both finding our groove with moving around the house and making sure to stay ahead of the pain. She was sent home with this great harness called a “hold-em-up harness” I used it the first evening and some in the morning, but Ellie really didn’t like me standing next to her to help keep her balance and she has become an expert at getting up on her own (going down is still a little tricky, depending on the surface, but she really won’t let me help her there). I ended up taking it off, and since she is thankfully still very much food motivated I just used positive reinforcement whenever we went inside and outside for potty breaks.

Potty is probably the biggest issue currently, I don’t even want to call it an issue just that we haven’t quite figured it out. The first evening and over the night Ellie had two accidents where it seems like she just peed while laying down and making no attempt to get up (or possibly she did get up, but I missed the signal that it was so go potty). I spoke to the vet about it and they said incontinence is possible with gabapentin, but it’s just as likely that she is too exhausted/uncomfortable/sedated at that moment to try to tell me she needed to go out and to keep an eye out if she was “dribbling” vs full accidents as that would be a much more clear sign of incontinence. I write this on the morning of 3 days post op and she didn’t have a single accident yesterday, but did have one over the night again. So, that leads me to believe it’s not incontinence. The silver lining is where she’s had accidents have been so dang convenient. Her bed has a washable cover, and then an additional waterproof cover around the actual bed- that is an absolute god send. and then she had an accident in the shower ( I have a walk in shower, that tends to be her favorite place to sleep if she gets hot)…so I’ll take it.

Meeka is not a doting cat, but she’s become much more watchful/loving towards Ellie right around the time Ellie started favoring her leg

She’s currently on 5 different medications: Gabapentin (for pain 400mg 3x/day), Carprofen (for pain 100mg 2x/day), Trazodone (anti-anxiety/mild sedation give up to 3x a day as needed), Ondansetron (anti-nausea 2x/day), Metoclopramide (anti-nausea 3x/day). I didn’t give her any trazodone during the day, but around 11pm she seemed like she could not get comfortable on her bed (this was when she moved to the shower). I knew the Nocita (long term pain relief given at the site of the incision) was probably about out so it made sense she would be more uncomfortable. I ended up giving her a 100mg Gabapentin and 150mg Trazodone, I’m not sure if it was absolutely necessary as she laid down in the shower right after I gave them, but hopefully it helped. I am curious if the sedation effects of the trazodone caused her to have her accident this morning, though. Either way, as yet another brag on Ellie she takes all her medication readily- as long as there’s peanut butter involved. I know with the Nocita out of her system this may change, so I’m staying cautiously optimistic, and making sure to stick to a pretty strict schedule (seriously strict, I’ve put everything into my phone so I get alerts, haha) so we hopefully continue to stay ahead of the pain.

I was told to attempt to ice the incision 3x a day for 10 minutes each for the first 3 days, but if she didn’t tolerate it to not push it. I can’t say she loves it, but enter more food motivation (I have a pattern don’t I?)! Before Ellie was sick I loved giving her stuffed frozen kongs- nice treat, that kept her mind engaged for a while, she equally loved them. what I hated was the kongs themselves, they were impossible to clean and would get stuck under furniture a lot, plus I ended up having like 6 (off brand ones, because dang those puppies are overpriced) so I could freeze multiple at a time. Enter in the Woof Pupsicle. It’s basically a kong that you can open into two sections to fill and/or clean. It also comes with the most adorable ice tray that is the exact size of the opening so you can freeze multiple treats, put them in a bag, and freeze more. So I only need to have one pupsicle, but have multiple homemade treats on hand. It’s seriously been the best thing ever (though also overpriced in my opinion). What does this have to do with icing? Well, Ellie will technically let me ice regardless, but she will fuss with what I’m doing the whole time, but if she has a pupsicle she does not giving a flying pea what I’m doing. I get exactly 8.5 minutes of uninterrupted icing and then we survive the last 90 seconds of her trying to eat the bag of frozen vegetables, haha. Highly recommend it as it also allows me to make sure she’s getting some water since most of the treats I make are half water (some that I’ve done: are a cup of soaked dog food heaping tablespoon peanut butter and water, straight chicken broth, leftover chicken blended with water)

A little sweet potato for my Sweet Potato.

The last big task we’ve been working is exercises. Ellie met with a PT multiple times while she was at the hospital to give her a jump start on mobility and they sent home a packet of exercises which include a balancing exercise, a spinal stretch and shoulder massage (more like a lymphatic drainage massage around incision). the packet says to do it 2-3 times a day, we did everything once yesterday, which I will take as a victory. Not sure about the shoulder massage, I know how great lymphatic massage can be, but I also know Ellie doesn’t really want me anywhere near that incision even if it’s a very light touch.

So overall- a fantastic start, I know it’s not this easy for everyone, so I’m just going to remain so grateful and stay in the moment as the future is still full of unknowns. We go in for Ellie’s first oncology appointment in 4 days! one bummer with the clinical trial is we will be going into the vet quite more often and for longer periods, but she is already well loved there and so far I continue to be so impressed with the professional care we receive.

Ellies Home!

I just took my first full breath in about 48 hours. The hospital was fantastic with letting me know when Ellie went in, when she came out how she went through the night. I only heard positive things (except for an upset tummy that was resolved with an anti-nausea), but I couldn’t really imagine her state and kept ebbing towards the negative side. To add insult to injury it snowed alllllll day today so I was stressed about how she would do in the snow (which is so weird as Ellie would live in the snow if she could).

When I went to the hospital my mind strained trying to guess how she would look/feel. So when I see her walking through the door with no assistance, I was utterly flabbergasted. I about fell out of my chair when she laid down on her own and then stood back up! The resident said she was a great patient and that she was the favorite for many of the students.

I ended up borrowing my mom’s Subaru which has a much lower clearance than my Xterra. I was most nervous about loading her in and out of the car, but it proved very easy.

this evening has been overall smooth, she readily ate her dinner and medication and drank quite a bit of water. She settled down pretty easily, and I was able to ice her incision. She did end up having one little accident, I’m not sure if I missed her signals or if she was just still super drugged up.

she did have 2 stumbles which I blame myself for not being there to steady her. I’m still not completely sure how much assistance to give her, she doesn’t love me helping, but obviously needs a little help.

Overall, I’m just so happy to have her home, and so thankful that she’s doing as well as she is. I know we have a long road ahead, but this is one huge one down.