Two Days Post Chemo and Doing Fine

Quack had his first chemo treatment two days ago. He had his amputation surgery 15 days ago. He’s been a bit more tired but he’s eating fine. He’s basically all systems go. Today he barked at the mail carrier and went tearing off like a crazy dog to the door. Good job Quack! We are once again safe from the mail. I’m kind of waiting for the chemo shoe to drop but it hasn’t really so far. He gets blood work next week and the following week and then chemo again in 3 weeks if all goes well.

Quack has a big day!

Quack has been doing well. Today is a big day for Quack. He got his stitches out from his amputation surgery. He’s really adapted to being a tripawd guy. Today he began his chemo therapy for osteosarcoma. We also found out today he is officially in a very cool clinical trial. This trial could extend or maybe even save his life. It involves the use of a vaccine, which has been modified to express a tumor protein (HER-2/neu). The vaccine hopefully will train the Quack’s immune system to attack the cancer cells. Quack is spending the day at Cornell getting some blood work and tests to establish a health baseline. Then he gets his first chemo treatment with carboplatin. He will have 4 treatments and then begin the immunotherapy. I was worried that he might be upset being back at Cornell, after all the last time he was there they cut off his leg and he had to stay for a couple days post surgery. After he came home from surgery he didn’t like to have his family out of his sight. Today he was happy to go in the car and even happy to get to Cornell and see all the other cool dogs and nice people. Everyone always makes a big fuss over him there. He’ll be going back again in 3 weeks for chemo again. Go Quack!!!!

Quack is Moving Fast Today.

quack day 6

 

Today six days after amputation surgery, Quack is really becoming pretty competent on three legs.  He was very interested in being outside (and yup we are getting more snow).  He still tires quickly though.  He is still on pain meds to keep him comfortable if he still has pain.  He seems way more comfortable with post operative pain compared to the pain in his leg from the large mass in his femur.  After being out this morning for a short while he is basically snoozing.

Quack is a giant snow cone

“Snow Cone”

Quack improves each day since his amputation surgery. Today 5 days after surgery he started showing interest in his toys. He even played with brother dog Bear a bit. He’s getting around better every day too. The giant cone that prevents him from going after his incision is a bit of a management issue but he is coping. We are coming off the third “Nor’easter” in 10 days so when he goes out he tends to scoop up snow in his enormous cone. We are waiting to hear from histology to confirm the mass was osteosarcoma and that there was no lymph node involvement and then he will be able to continue in the clinical trial. I feel like I’ll be able to breathe again when we know one way or the other.

Quack’s life changes in one instant at the vet.

We hate the cone!

Quack’s journey began February 18th, 2018. That was the day his vet said he thought Quack had osteosarcoma. I guess strictly speaking his journey began in January when he first showed a slight limp. Off to the vet we went, just a sprain they thought. It made sense Quack is one active guy. We kept him from doing too much and he got previcox and his leg got worse. We returned to the vet and the vet directed my hand to his right femur.
“Feel that”? Dr W asked me. I did.
“What do you feel?” he asked.
I felt it, and I felt Quack’s other leg, “It feels hard!”
Then the worst possibility came right out of Dr. W’s mouth, “I think he has osteosarcoma.”
I was floored. It was just a sprain a couple weeks ago? My eyes filled with tears and I choked it all in, not just because I didn’t want to cry in front of the vet and the tech but I didn’t want to cry in front of Quack. Great Danes are so sensitive, if I cried he would worry. I made it to the car called Andy my husband and then sadly I lost it. I knew in my heart Dr W. was right. The mass had appeared so fast.
The frenetic quest for information began. My husband Andy and I are both college professors so we dove into empirical research on canine osteosarcoma. I found a really good review of canine osteosarcoma research and the news was grim. Untreated Quack had on average less than 2 months, amputation only and he’s have 2-4 months but his quality of life would be better. Amputation plus chemo got him maybe 10 months to a year and if he was very lucky 2 years on the very outside. The bad thing with osteosarcoma is by the time it is diagnosed it has usually already metastasized with “micro-mets” into the lungs. It was all so hard to read. I knew that people called Great Danes the “heartbreak breed” because of their relatively short lifespan but Quack was only four.
Was there anything out there that could change the game for Quack? Andy remembered his friend Jonathon who had lymphoma and had gotten into various clinical trials and was doing really well. Both Andy and I started looking for clinical trials for canine osteosarcoma. We found a very promising one on an immunotherapy therapy vaccine right in our own backyard at Cornell. We also found one at U Penn. The problem was they couldn’t see him right away and we were worried about the progression of his cancer. Andy called the company that was making the immunotherapy vaccine used in new trials and they were sponsoring a trial near where we grew up in Pennsylvania about 3 hours away. The vet practice there could see Quack the next day. He had to qualify for either trial meaning, confirmation of osteosarcoma and no obvious mets in the lungs. We made the drive to PA and Quack was so excited! He loves going for rides in the car. This however at 3 hours was the longest ride of his life. We got there and everyone was so nice. X-rays showed his lungs were clear and his blood work was good he qualified! They could do his amputation surgery that day! But then the information on the methodology of the trial came, it was a “double-blind” study meaning half the dogs got a placebo. This would mean there was a 50/50 chance Quack would not get the promising vaccine. Andy actually started crying, we had been so hopeful. The oncologist assured us it would not endanger Quack to wait for the spot he had to be evaluated for the Cornell trial. The oncologist was so nice and so sweet with Quack, she really gave us such good information and you could tell she wanted what was best for him.
Last week Quack went to Cornell for evaluation, given the parameters of the study he had to have all the same tests again. More x-rays, more blood work and this time a biopsy of the large mass in his right hind leg. Tentatively he qualified although the biopsy was inconclusive. His amputation was scheduled for 9 days later. If it went over 10 he’d have to have all the tests again.
Waiting for his surgery was hard, his pain increased daily. Every time we saw another vet they added a pain med. Dr W put him on previcox, the vet we saw for a second opinion put him on gabapentin. As we were preparing to leave Cornell the oncologist there handed us a bottle of oxycodone. We were shocked! Andy had just fallen on the ice a couple weeks back and wrenched his back and bruised his ribs badly. His doctor told him to take Tylenol. Here was Quack with 3 meds including oxycodone. For me it let me know how bad the docs thought the pain was going to get. Each day that went by Quack limped a little worse. The oncologists emailed us daily to find out how he was doing. How was his pain?
Another hazard of osteosarcoma is the bone becomes fragile and breaks. Our house is big and rambling. Quack sleeps with us upstairs down a long hallway and up on a high bed. We were very worried he’d break the leg. We were worried the pain was already getting problematic. They moved his surgery up one day.
The big day arrived. I realized a couple days before we were freaking Quack out. We hadn’t been outside much, we all were sleeping in the living room. It confused him and he didn’t understand why our routine was so messed up. Two days before the surgery we went for a walk. That night Quack broke the gate to the stairs and went up to “his” (translation our) bed and stretched out. He slept well for the first time in days. We kept to his routine the next day taking a short walk, letting his sleep upstairs. He was so happy.
His check-in for surgery was 7:30am. We left our farm in the dark for the hour-long drive to Cornell. There is no quick easy way to get there, instead it’s a beautiful drive through farm country. Dawn broke and we were just coming through a winter “Nor’easter” there was fresh snow on the ground and in the trees. We didn’t see it we saw only Quack.
Quack had his surgery March 8th, 2018. The mass in his leg was in his right hind femur. When they amputated his leg to prevent reoccurrence they had to take it completely. We were waiting by the phone the whole day; They called that night and said it went really well. Then the next big question: When could he come home? They wanted him to be walking fairly well and he had to be able to pee. It took him until Saturday to accomplish both things. I was absolutely shocked when I saw him, his entire undercarriage was badly bruised and swollen, he “walked” with his back leg bent kind of like a frog hopping. He tired easily. I questioned if this had been the right decision. The first night home was rough. He was so happy to be home but he couldn’t get comfortable and he couldn’t easily go to the bathroom. We put icepacks on his bruises and incision.
The next morning, he was remarkably improved. The bruising had faded a bit. He was stronger and more stable, he was re-learning how to walk and sit. Things were looking up.