Resolution

Back from CSU today (Colorado State University vet practice -- the Mayo Clinic for dogs, really) with Rukh. Our vet had referred us initially to a vet specialty practice, who immediately sent us on to CSU because there were opportunities for clinical studies that Rukh might qualify for, and which might offer a better prognosis than standard treatment.

The vets at CSU confirmed the diagnosis of osteosarcoma, even without a bone biopsy; his signs and xrays are perfect examples of osteosarcoma in the tibia. The joint is really swollen now, and he's gotten progressively worse over the last week, despite a few good days where he was walking around a bit. He's basically three-legging it most of the time now, when he works up the gumption to stand up and go somewhere.

They did another set of chest xrays (clear! No signs of metastasis in this set) and went through our options.

• pain treatment only (nsaids/narcotics) -- 1-2 months
• radiation -- palliative (2 sessions) -- 1-3 months
• radiation -- treatment/palliative (20 sessions/30 days) -- 4-6 months
• amputation -- 10% 1 year/0% 2 years
• amputation with chemo -- 50% 1 year/ 30% 2 years

Most dogs are euthanized because of pain, and the only real way to alleviate the pain is amputation. Which, as the vet(s) explained to us today, is almost instantly less painful than the condition Rukh is in right now. Even the day of surgery, the reduction in pain from bone-pain to incision-pain is so dramatic that they are up and around immediately. I'm having a hard time wrapping my head around that, but after talking to a few of the people there with dogs, it seems to be true.

So -- we are going forward with amputation of his rear leg, scheduled for Wednesday. We were not sure about it, but dogs really do seem to do well and barely even notice that they only have one rear leg (once they figure out how to balance). I'm still not sure how we'll deal with it, but all the data we have says that Rukh will be better. We'll start chemo about two weeks after surgery.

There were a couple of clinical trials at the university, but those that we felt comfortable with all had a delay before amputation (which was required by all) that was unnacceptable. We can't wait for 2-3 weeks before we do surgery, to see if drug A or drug B are useful. I'm not willing to bet on "should provide alleviation of pain" for the beastie.

Of course, with surgery on Wed, we can bring him home on Thursday, just in time for the Adorable Husband to go to a weekend-long seminar. He's been signed up for months now, and can't really miss it. He'll only be a few hours away, so he can come home if there's an emergency but otherwise, I'm on my own for the weekend. I'm not looking forward to that -- I can deal with wound care, I can, but I get awfully squicked out by the incision itself. Hopefully, the beastie will sleep most of the time and I can manage to get him outside by myself. They recommend a sling or towel to support him for a while. Yikes.