Repeat surgery or amputation

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Repeat surgery or amputation

This is a discussion on Repeat surgery or amputation within the Dog Health forums, part of the Keeping and Caring for Dogs category; I know this is ultimately our decision, but I'm looking for a bit of feedback. Ginger's tumor has grown rapidly again. We have to decide ...

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Old 11-02-2016, 10:49 PM
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Repeat surgery or amputation

I know this is ultimately our decision, but I'm looking for a bit of feedback. Ginger's tumor has grown rapidly again. We have to decide quickly whether to amputate, repeat the surgery we did 2.5 months ago, or let her go. She is in incredible health at the moment, and has no issues. She's not on any medication and has always been a super healthy girl.

The backstory: a lump popped up on her right front leg in May, right before we were flying her cross country for our move. It was initially diagnosed as a lipoma after x rays, and the biopsy came back clean. Chest x rays were clean as well. At the end of July it started growing rapidly, and by the beginning of August it was softball size. We repeated the biopsy and again it came back clean. Bloodwork was perfect as well. Surgery on August 18 to remove the mass went well, and she healed quickly. However, the mass grew back and popped the stitches within 10 days. At that point, the pathology results came in and it's a soft tissue sarcoma. Our vet (young and inexperienced) told me it's most likely spread (but the pathology report says this type of cancer doesn't have a high spread rate) and she has maybe 3 months to live.

The tumor stayed fairly small for awhile, but now it is back to softball size, but it's completely open and visible since there is too little skin there to cover it. It's been 5 days since her latest vet visit (different vet than last time) and we have to make a decision. We were hoping to get a specialized surgeon to do it, and possibly do a skin graft to add extra room for the tumor when it grows back, but there are only 2 in the entire state and one hasn't responded to requests for his schedule. Our vet is going to try to reach out to the other one, but believes he is extremely busy and unable to fit her in. Which means our vet would have to do a basic removal, and we'll most likely be back in the same spot in a month or two. Ginger hasn't been showing pain until the past 2 days where she tries to lick it often. We keep it covered with bandages and topical antibiotics, so she doesn't get access to it, but it's definitely bothering her at this point.

Amputation was mentioned as a possibility, and while I'd ruled it out in my head, my husband wants to consider that as an option. But at 14.5 years old, is it really for her benefit, or ours. I just don't know. Any input would be appreciated!
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Old 11-03-2016, 02:25 AM
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im so sorry you are in this position :-(
What I would suggest is to buy yourself a little time. Let the vet do the procedure for now and then hope the specialist gets back to you in the next few weeks. Amputation at her age would not be a easy thing to adapt to I would imagine. all the best of luck! keep us updated.
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Old 11-03-2016, 06:21 AM
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At 14.5 I wouldn't put her through the trauma of amputation. That's just me. Tough decision. I wish her many good days ahead
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Old 11-03-2016, 11:27 AM
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What I would suggest is to buy yourself a little time. Let the vet do the procedure for now

Totally agree.
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Old 11-03-2016, 11:42 AM
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That's a tough one, and only you can make that choice. I wouldn't even attempt to suggest.

Can only wish you the best in what you decide.
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Old 11-04-2016, 12:12 PM
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There are a few things to consider.

Her overall health. You say that other then the tumor she's very healthy, so that's a thing in favor of amputation, or more surgery.

The other thing to consider if amputation is being considered is how her other joints are doing. Does she have arthritis in her joints? How are her hips and knees?

A third thing to take into consideration is just how her overall quality of life will be after the surgery. If you opt to just go in and try to remove the tumor what's the chance of their fully removing it so that it remains gone? If they do not get clean margins then the chance of you ending up in the same boat in a few months time is pretty good. If they amputate, I'm assuming they will amputate above where the tumor is and that tumor will be fully removed, but does she have metastasis or not? If so what's the odds of those quickly growing and causing her problems?

I'm so sorry that y'all are going through this! I'll keep y'all in my prayers.
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Old 11-04-2016, 02:47 PM
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Thanks so much, everyone. We didn't have any luck getting into the specialist surgeon, but it definitely needed to be removed ASAP, so our new vet is removing the tumor today. Ginger's there now. We decided to wait and reevaluate whether to amputate when it grows back. Due to the location (on her lower front leg) there's almost no chance of removing it with clean margins, but the vet said she'll be as aggressive with removal as possible.

@Rain - Appreciate your help! Her joints are in really good shape and she still regularly hops on the sofa (despite us telling her not to so she doesn't slip and hurt herself) and runs and plays. But winter is coming, and with it will be lots of snow. I know that in itself will cause some joint issues. As far as we know, it hasn't spread. She has no other lumps, and the chest x ray back in May was clean, but at the rate this thing grows, she could have something not quite visible yet, which is another reason I'm hesitant to amputate. I'd hate to put her through that for only another 2-3 months with us. At this point, I just want her to get through the holidays. Thanksgiving is her favorite since she gets a full turkey dinner!
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Old 11-04-2016, 03:23 PM
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I hope it goes well and she has a great Turkey Day!
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Old 11-04-2016, 06:49 PM
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Well, just got a call from the vet and the specialist surgeon was actually in town and decided to stop by for a consult. The tumor is completely wrapped around the tendon, and is virtually impossible to remove. If we do nothing, she'll have a week or two left. If we try to remove as much as possible, they may not be able to stop the blood loss and we could lose her, and best case if they do stop the blood loss would be 2-4 weeks before it grows back. They did a mobility exam and bloodwork and both vets highly recommended amputation. So, that's what we're going with. Our baby girl will be a tripod. The vet says it'll be a rough 36 hours, but she'll have strong pain meds, and then she should adapt fairly quickly. Her bloodwork was apparently pretty impressive, which is always good to hear. This could get her another 6 months to even a year, so it's worth it since her quality of life is still at 100%. But it is pretty terrifying, man.
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Old 11-04-2016, 07:50 PM
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Given the circumstances as you have described them, I would probably make the same decision you have. How far up will they amputate. Any chance for a prosthesis after the surgery. Its going to be a pretty intense process getting her used to missing a leg at her age. Keeping her around for another year or two, as long as she is not in pain and her quality of life is good, is the right thing to do. Your work is cut out for you, keep us posted on how she, and you are doing.
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