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MYAH – A Tripawd-Goldendood's Story
23 Apr 2016

ABOUT (pre-op)

Author: myah | Filed under: 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.

End of February, 2016, Myah had a racquetball-sized, grade 1, Malignant Peripheral Nerve Sheath Tumor on her right front leg, just below her elbow.

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.

Also:
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.
One of Myah’s doctors initially called it a Fibrosarcoma
March, 2016

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.

March, 2016

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/

March 31, 2016 SURGERY DAY
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!
You may now read my various posts on this blog for my post-op update(s)
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2 Responses to “ABOUT (pre-op)”

  1. Linda Says:

    Please let me know how your dog is doing after the surgery. I have a dog with a similar tumor and am considering amputation as well, but my dog is 10 years old and overweight. I would be very interested to find out how your dog is doing. Thanks!

    • myah Says:

      Hi Linda,

      I can’t believe its been so long since I got back on tripawds.com [guilt]

      Myah is doing wonderfully! Myah was 9 years old at the time of her amputation, and is now 10.5. I think a lot depends on the specific breed, health, and their expected lifespan. Myah was a very active and athletic Doodle, and was not overweight at all at 62Lbs. I think she lost 10-12 lbs post amputation, but she then gained a LOT of muscle-mass in the remaining shoulder, and is consistently 55-56 lbs. now.

      She will still act very puppy-like in the first half of the day, and still hops and spins around repeatedly when she greets me if I have been gone. (even for 15 minutes 😉 Since she became a tripawd, I can tell she is often thinking about her economy of movements, in the second half of the day anyway. That could also be from her age though. My previous dogs, mostly golden retrievers, were definitely less active than Myah is now, at the same age. If she is in ‘afternoon laying around’ mode, I can tell that she has to really think about the importance of standing up for something. She generally will still end up standing up, after her short consideration period. (i.e. “Is it a person that will give me scratchies? Is it potential food or a treat?” …If there are ‘human puppies’ present, that alone is always motivation for her to get up without her even thinking about it.

      If your dog has a nerve sheath tumor, on an overall healthy dog, it seem to me that its a no-brainer decision to have the surgery. That type of usually painful tumor does not generally metastasize. So with the cancerous limb gone, the cancer is gone. No chemo, with an extremely low risk of returning. (Myah has two other lipomas (benign fatty tumors) that I continually check for changes in texture, looseness and size. Her leg tumor started growing quite rapidly and was quite obviously painful for her.

      Myah is one of those tripawds that needs to take gabapentin every day for the rest of her life. I often tried to skip doses on the occasional weekend, where I could really observe her. However about 36 hours after taking her last pill, she would begin stumbling, and falling, as she tried to take a step with her missing leg. I hoped her nerves would quiet down over time. Now, it is obvious I need to continue giving her the gabapentin, I don’t try to skip her does anymore. I get it filled at the grocery store pharmacy (King Soopers) where I get 3 month’s supply for $15 (90 capsules). So the cost is not a factor. If a veterinarian won’t call in an Rx to a people-pharmacy, just get a new veterinarian. They don’t need to make that much money off long term chronic medications. I “think” perhaps only half of tripawds need to take something long-term for phantom leg syndrome? But you better check on that.

      Myah still works 5 days a week at our retail jewelry store. She is very popular, and it keeps her activity level up. Taking her ‘hiking’ has been a frustration. She starts out gonzo, so excited to be on a hike. She tires quickly though. I had another tripawd owner told me about a type of ‘joggin stroller for dogs’ Her tripawd also gets tired after a about half mile, and gets in the stroller-buggy thing. Then later in the hike, he is back out hopping with joy like only a tripawd can! I am seriously considering buying one of those. My own health would benefit from taking longer, more strenuous hikes. I also had to learn to speed-walk. It is quite easy for her to run on three legs. It is a lot more tiring to hop at a slower walking pace. So I can just barely keep up with her. Luckily she takes many rest breaks, 🙂

      The only other negative thing I can possibly think of is that she ha so much trouble following a scent trail. As a front leg tripawd, she has to hop along and will temporarily lose a scent. (normally her nose would be locked to the ground as she crept along a ‘trail’. I think its may only be frustrating for me though? (Myah was a hunting dog in her youth. She has hunted and retrieved many different kinds of game birds. “We” had stopped hunting a few years before her surgery. For reasons I won’t go into here, nothing to so with her.)

      I think I have now mentioned every downside, post amputation. In reality it is still mostly all positive experiences I have had with her! She is a bundle of fluff, fun and joy!

      I guess I thought I should mention all of the less positive experiences for your benefit. However, in overall consideration, those negatives almost seem trivial. At least from my perspective.

      I hope this information helps!!

      Randy & Myah

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