NOTICE: I literally am pasting updates on here. These ‘pastes’ are from emails or Facebook posts I wrote at the time.
I have NOW separated this information into separate posts. I made two categories: About (pre-op) and The First Five days (post-op).
Its the same information. So if you read all of the text below, you may skip those two categories of posts listed above.
(I’m just trying to organize the posts for new readers.)
All my posts following this are found in the category: “Read the POSTS!”
ABOUT:
Background:
Myah is a nine year old Golden-Doodle. Her full name is: “Oh Myah goodness She’s Magic” She lives with me in the foothills of the Colorado Rocky Mountain front range. We are located not far from both metro cities of Boulder and Golden, and the mountain towns of Nederland and Blackhawk. Our house is at an elevation of 2500 meters [8200 ft.] she is a F1B doodle, her mother was a 50/50 Golden-doodle, her father was a Golden retriever. So she is 75/25 a Golden/Poodle hybrid. She weighs about 18 kg [about 60 lbs]
She previously had a benign fatty tumor removed from under her skin on her lower rib-cage in 2014. when this dime-sized new mass appeared on her leg, both a veterinarian and I, assumed it was another one.
What was very unusual about this mass, is that it would not grow for weeks at a time. Then it would suddenly have rapid growth spurts. I later estimated the mass to have increased 15-20% in size during each growth spurt. those spurts lasted from one to two weeks. In late 2015, the growth spurts were occurring every 3-4 weeks, previously they had occurred every 4-8 weeks
In January, for the first time, I noticed that the mass was bothering her. So I scheduled a debulking surgery to remove it. When the veterinarian made two incisions to remove it, she knew right away that it was not a lipoma. She described it to me as “nasty and invasive”. It was intertwined with muscle and tendons, and had its own blood supply. (blood vessels ran through it.) she took several biopsies from inside, and a couple of punch biopsies from the outside of the tumor.
Details on her particular type of cancer:
I found many descriptions online for Malignant Peripheral Nerve Sheath Tumors [MPNST], but they tend to be in the ‘medical-science-ese’ language. Here is layperson’s description I found online: [I still need to find, and credit this author]
“This is just the product of my analysis of information obtained during my research and shouldn’t be considered to be a medical opinion. MPNST is a soft tissue sarcoma, one type in a family of similar tumors that appear in the skin and fatty tissues of animals. What makes MPNST a differentiated condition is that it produces a cellular level tumor that occurs in the outer sheathing of nerves. These tumors are usually relatively slow growing and found most often in middle aged dogs on the extremities or lateral body surfaces. Metastasis is rare, but local recurrence is common when “clean margins” are not achieved surgically. Depending on the tumor’s location and other obvious considerations, amputation of the effected limb is usually curative.
Chemotherapy has been ineffective in treating these tumors; however radiation therapy (alone or in combination with surgery) is often successful in slowing, maybe stopping tumor growth. In the case of amputation, there is little evidence that radiation treatment is necessary. Especially if the tumor isn’t close to the physical site of the amputation.”
If you want to read all the scientific details, try reading this.
http://m.vet.sagepub.com/content/46/5/928.long
From reading that article, It seems the most likely to get MPNST are medium to large breeds. It seems 64% are female. Golden retrievers rank high in the list of common breeds for this type of cancer. There is no known cause, some references speculate that they occur after an injury, but that has not been proven.
Subcutaneous soft tissue sarcomas (SSTS) comprise a heterogeneous group of neoplasms, which make up approximately 8% of skin tumors. They include malignant peripheral nerve sheath tumors, hemangiopericytomas, liposarcomas, fibrosarcomas, myxosarcomas, perivascular wall tumors, and undifferentiated sarcomas.
Myah seems to be more comfortable, as she heals from the surgery that she had that wasn’t able to debulk, or remove the tumor. (The stitches have been removed on the two incisions.) She doesn’t seem to favor the leg anymore when she’s being her active happy self. So I believe her inflammation is much better.
However there is an area that is now the size of a dime that is not healing. This is the site where they did a small punch biopsy from the outside. (They also took several biopsies from the tumor, internally.) The area that won’t heal is slowly growing, and it is because the skin has been compromised by the tumor and is not able to heal. Every time I clean it and apply the Silver-Sulphadiazine healing cream, she begins to lick at the edges of the bandage. So keeping those area from becoming hotspots is a challenge. She does also lick at the bandage at that site where it won’t heal. Even though its covered with a Telfa pad, gauze, and then another layer of protective bandaging. I have had to stop letting the area stay exposed to the air at night. (along with the dreaded ‘cone-of-shame’) Because if there isn’t bandage pressure over the open wound, it oozes without abating.
Overall, Myah is doing all the activities she did before the surgery! The only time I know for sure that she is in pain, is if the tumor is bumped, or directly touched. However, even though I feel I am in tune with Myah’s reactions, (By watching her eyes, unusual movements and licking) It is very difficult to know how much pain she actually is in. The canine breeds are tough and I do know that they do not feel pain the same way we humans do.
My goal remains to be able to have the amputation completed by the end of this month.
Myah’s surgery will be happening this Thursday, March 31st!
Myah’s condition took a turn for the worse last weekend. I originally thought it was from some increased activity. I eventually figured out that her tumor went through another growth spurt. Add to that a couple of times where she was able to tear off her bandage, even while wearing the inflatable cone. So if she is not being directly watched, she must now wear the full size plastic ‘cone’.
I’m not sure if the short time she was able to lick, (that part of her tumor that will not heal), has aggravated or increased the size of that wound, or if it is a normal amount of growth of her non-healing area. That open wound is now larger that a quarter, (started as a 2mm punch biopsy site, and was the size of a nickel about 7 days ago.) I can only slow the growth, with wound care, at this point. Mostly I need to remove the necrotic tissue, clean and cover it with silvadene cream, and then bandage securely.
I just discovered that the tissue is rotting not only around the edges, but deeper into the tumor as well. The wound began to smell like rotting meat. [You bet I called the doc.] At their suggestion, I began to scoop out the rotting tissue more aggressively. I think they called it abrading? As i did the deed, my finger went at least 6mm [1/4 in] into the would. [yuck] I am now guessing that some of her recent strong desire to lick at the bandage over the tumor was likely an instinctive drive to remove the rotting tissue.
Luckily her surgery is now only a matter of days away!
Since last Monday, she has been taking prescribed pain meds to give her relief from the tumor. As the pills wear off, she begins continually licking the site. Which means she is licking the bandage. The meds to make her a bit drowsy. I think that is a good thing! I would swear that she verbally tells me when the pain is bad. She had occasionally whined, and stared at me as it approached the time for another dose. (every 12 hours) Although the last two days I believe the meds are keeping up with her pain. (no whining for 2 days.)
My focus is now on studying for my upcoming post amputation care and her rehabilitation. I discovered a fantastic resource for this challenge!
tripawds.com – a user-supported community for sharing people’s stories and learning about amputation and bone cancer care for pets. There are blogs written by people that have gone through a similar process with their pets. I also have access to write a blog of my own experiences. Many other resources; videos, articles, books, etc. Except for some of the books, much of this is all free of any charge. There is also a Tripawds Amazon blog area: http://amazon.tripawds.com/store
I would encourage any new people interested in helping this cause to donate to the tripawd organization here: http://tripawds.org/
The First Five Days
Tripawds.com says, “All dogs (& cats) are born with THREE LEGS and a SPARE. Sometimes they use up their spare leg.” Myah is likely in pre-op right now. I’ll pick her up about 5pm this evening. She will be a new member of the Tripawd club! No more painful leg with nasty cancerous tumor! Stand-by for post-op update(s)
Snow-tripawd… notice my expert t-shirt sewing taping skills (Yes its a Ringmaker t-shirt… seemed appropriate)
After Myah’s big 48hr day on Saturday, Sunday was a lot different. I could tell that her ‘only front leg’ was pretty sore, which is to be expected. I didn’t really think she did all that much on Saturday. However looking back, I realized she spent a lot of the afternoon ‘sitting’ rather than laying down. Probably to get up off the incision? I think that is why her only front leg is so sore. Just the change in balance is likely using her muscles in brand new ways. She really uses much more of her front paw. Picture her having a much longer footprint, with her dew claw almost touching the ground with each step. She definitely uses it to stand-up. Imagine formerly walking on mostly your front of your foot. Then when the weight is more, or you need the extra strength, you put the heel of your foot down to be more steady. (Perhaps similar to the difference between high heels and flats. 😉
I decided to revisit some pain control posts on tripawds.com. On one forum, I found some new pain blogs, and that brought me to more information off of the tripawds site. I then realized that Myah has been in more pain than she should be. I guess I’m overly concerned about giving too much medicine.
I have to share this quote from one article I found. It was especially interesting as it tied my own personal pain experiences to hers.
“Pain in cats and dogs (as in humans) causes other complications and can impede recovery from illness, surgery or injury. Pain spurs the body to release the hormone cortisol, which increases the heart rate, slows digestion, impairs sleep and reduces blood flow needed for healing.
Over time, pain also disrupts the nervous system, causing changes in the spinal cord and brain that make people and pets more susceptible to pain. Chronic pain affects the region of the brain that modulates human and animal responses to pain, creating more sensitivity, which in turn destroys still more brain matter that regulates pain—a vicious cycle. Chronic pain also gives the nervous system way too much practice at transmitting pain. The longer that nerves carry pain messages along their routes, the more efficient those pathways become at conveying that message.
“Chronic pain is like water damage to a house,” says Daniel Carr, a professor at Tufts University School of Medicine and director of its Pain Research, Education and Policy degree program. “If it goes on long enough, the house collapses. By the time most patients make their way to a pain clinic, it’s very late.”
I did use my sewing skills today. (I really only know how to sew on buttons) I found my smallest t-shirt, and removed one arm. then I tacked it so it was smaller, and tighter. I used button-like sewing spots to create this better shirt for Myah. I think she needs a real ‘tripawds dog-shirt’ So I have 2 styles on order from the tripawd designs on cafepress. She needs a proper work uniform after all.
BTW: You-all will begin to notice my hobby of making quick collages, rather than sharing several photo files.
On a side note, perhaps this is just a ‘brag’ but, I took a snip of a post I made on Facebook. This is to a closed group on Facebook, its a Golden-Doodle owners group. If you can’t read the small print, it says: 328 likes/reactions, and 76 comments! She has a lot of people pulling for her!
Today she decided to drink at her regular water dish, not the raised dish I set up for her in the bedroom. I think its is good physical therapy for her to drink this way. (if its her option) Although it seems most of what I have read recommends a raised food/water dish for front leg tripawds?
Notice her collar hanging to her right; Every morning when I put my shoes on to leave for work, I just tell Myah, “fetch collar” and she goes and gets it from where it is hanging in this photo, and then she sits in front of me, so she can get dressed for work, as well. Below it is her new EZYDOG Harness. Another great idea I found from tripawds.com! (The flash from the camera lit up the reflective portions of her para-cord collar, and the harness.)
April 5th, 2016 at 12:25 am
Wow I’m in complete Awe of how well prepared and what a handle you have on this whole journey. Myah is absolutely gorgeous! Welcome and thanks for sharing your beautiful girl with us.
Linda, Ollie, Riley & Spirit Mighty Max
April 5th, 2016 at 1:12 am
Thank you for sharing your girls story. Welcome and good luck to you & her
hugs
Michelle & Angel Sassy
April 5th, 2016 at 8:05 pm
You have done a superb job of chronicling Myah’s “adventure” so far! It is chock full.of so much valuable information for anyone facing this journey.
I found the article you shared about chronic pain quite interesting.
You’ve done an EXCELLENT job “reading” Myah and realizing when she needed pain meds, when she was overdoing her muscles in the snow, etc. You are clearly very tuned into her.
And the pictures of Myah….OMD! She is absolutely ADORABLE! She is sooo cute! You can just see she has tons of personality. Her eyes just sparkle with joy…even days after her recovery. I love your banner picture too…lovely.!
Can’t wait to see more pictures of this amazing dog, especially sitting in front of you with her pretty collar waiting ro go out!
Thank you so much for taking the time to give such an invaluable accounting of your experiences and learning lessons on this crazy journey. Again you’ve done a superb job!
Looking forward to more great updates AND adorable pictures of precious Myah!
Hugs to all!
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!
PS. Yes, the theory is that their is less strain on a front legger if they have their bowls raised a little. My Happy Hannah was a rear legger and it seemed she like her bowls raised a little bit, but not a lot. Mynrescue Frankie, a front legger, prefers tomlayndown while eating!! I also think giving them a “choice” is the best way to go. They know what works best!!