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The following post appeared at Tripawds.com, the world’s largest resource for canine amputees and their humans.

During our video chats about canine bone cancer with Dr. Johnny Chretin, head of oncology at VCA Animal Hospital West Los Angeles Oncology Center, we asked him some questions that Tripawds members often ask, such as:

“Can Removal of the Primary Tumor Expedite Metastasis in Dogs with Osteosarcoma?”

Dr. Chretin states that in a small pilot study at a veterinary teaching hospital (likely Colorado State University), researchers studied a small group of 15 or 20 dogs who didn’t undergo amputation after being diagnosed with bone cancer because their owners didn’t want the surgery or couldn’t afford it.

The pilot study followed these dogs throughout the remainder of their lives and concluded that there was no difference in the rate of metastasis among dogs who had amputation surgery versus those dogs who did not. This has also been the case in Dr. Chretin’s practice at VCA Animal Hospital.

Will Radiation Help if Postponing Amputation?

Another study at Colorado State University showed that a large percentage of osteosarcoma dogs who were treated with stereotactic radiation therapy instead of amputation had good long-term survival rates. Instead of succumbing to sudden pathological fractures or untreatable bone cancer, the cancer eventually metastasized as it does for dogs who do undergo amputation.

Why Amputate Sooner Rather than Later?

Although stereotactic radiation therapy is showing great promise for bone cancer dogs, it’s only available at Colorado State University and the University of Florida. For the majority of dogs who cannot undergo this therapy, their pain must be addressed promptly to avoid additional suffering.

“There’s no way to completely get rid of the pain, except taking the leg off,” says Dr. Chretin. “We can do quite a few things that can make them feel pretty darn good, but there’s no way to take all that pain away from them if they have that leg intact. By delaying amputation, the dog is at great risk of a pathological fracture and “that’s as bad as pain gets in animals,” says Dr. Chretin.

Historically, cancer researchers believed that the longer the cancer tumors are left in the body the more time it has to spread. However Dr. Chretin states that this theory is being challenged. Nobody really knows for sure at this point.

“That’s why medicine is really interesting and challenging,” says Dr. Chretin. “Just when we think we understand cancer and say ‘OK this is how it works, this is how the cancer has behaved over the last 20 years,’ all of a sudden someone asks a different question (and everything changes).”

Does the Location of a Tumor Matter?

Finally, we wanted to know, does the location of a dog’s bone cancer tumor determine the severity of the cancer or a prognosis?

“I’m not aware of anything that says that radius versus humerus is any different,” says Dr. Chretin. Each individual dog’s cancer presents its own unique challenge. For example:

“If anything, having a tumor on a scapula might be better because (your dog) doesn’t necessarily have to lose the leg, you can just lose the scapula. So if you look at things from that perspective, then it’s better to have the tumor higher up.”

When a dog has a leg tumor it can be more challenging to treat, not because the cancer will behave more aggressively but because there is less tissue to work with when attempting to removing the tumor. This is why amputation is often the recommended treatment.

Moving down the leg, clinical studies show that if osteosarcoma is below the wrist, those patients tend to do better and live longer even without chemotherapy. The cancer will still spread but it seems to take longer. Unfortunately, it’s rare for osteosarcoma to present itself in that location.

What about limb sparing for lower extremity tumors?

Limb sparing is often presented as an option for dogs who aren’t amputation candidates or for pawrents who are hesitant about removing the limb. However, the reality is that a limb spare is a lot to put a dog through, plus there is a 30 percent risk of infection and a 30 percent risk of the cancer reoccurring in the same limb. Usually, the limb will have to be amputated anyways.

Stay Tuned for More Canine Cancer Oncology News

This is the latest in a series of video interviews with Dr. Chretin at VCA Animal Hospital West Los Angeles. Stay tuned for additional interview clips with Dr. Chretin that offer informative advice about canine bone cancers, such as:

Tripwds sends sincere thanks to Dr. Chretin and his helpful staff for allowing us to bring this impawtant information to you!

Recommended Reading

North Carolina State University College of Veterinary Medicine: Osteosarcoma in Dogs

PubMed: Palliative radiation therapy for canine osteosarcoma

PDF: Bone Cancer in Greyhounds, Dr. Guillermo Couto, DVM, dip. ACVIM

Dr. Charles Louis Davis, DVM Foundation: Outline of Veterinary Skeletal Pathology

Veterinary Practice News: How to Treat Osteosarcoma When Surgery is Refused

All content Copyright Tripawds.com, July 2011. If you like this article enough to mention it on your website, we simply ask that you attribute the source and contact us when you post it. Thanks!

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The following post appeared at Tripawds.com, the world’s largest community for three-legged dogs and their humans.

What used to be known as “alternative” medicine is now mainstream therapy for many lucky dogs like Lobo, the senior Tripawd, who undergoes regular acupuncture sessions to alleviate back pain and age-related ailments.

In last week’s video interview at California Animal Rehabilitation (CARE), we learned about how Lobo regained his health, thanks to the doctors at CARE and his pawrent, Dr. Lisa Swan.

In this video, we learn about Lobo’s acupuncture sessions, how canine rehab therapy can benefit Tripawds and how to find a qualified practitioner. After the video, read on to learn more about these topics and where you go for more information about effective canine rehabilitation therapy.

Acupuncture Alleviates Pain in Dogs

Lobo is a front leg Tripawd who has returned to the clinic after suffering from severe back pain. Dr. Jessica Waldman, VMD, CVA, CCRT, explains that Lobo has a weak front wrist, which is most likely caused by overuse from years of excessive weight bearing on the remaining front leg.

Front leg Tripawds like Lobo are at risk of this condition, which happens when the fibrous tissue in joints breaks down. Spinal problems are also a potential challenge Tripawds may encounter. Both of these conditions are the result of aging, as well as living life on three legs.

Dr. Waldman says that Tripawds “put a little more stress on their back. It is going to happen with older dogs too, but with Tripawds we see it a lot more.”

This is because Tripawds must alter their natural body mechanics to get around on three legs. It’s similar to when a human walks with a limp; eventually the limp will lead to back pain. If a dog’s natural gait is totally altered over a lifetime, aches and pains can arise.

Core strengthening exercises and fitness games done at home can help to offset this compensation. Additional benefits can be enjoyed by regularly consulting with a certified canine rehabilitation practitioner to learn how to alleviate age-related aches and pains.

In the past, pain medication wasn’t helping Lobo to feel better. Just one month prior, his back pain was so bad he couldn’t walk. But now, Dr Waldman explains that with rehabilitation and acupuncture, Lobo is back to “his old rowdy self and ready to go!”

What Can Acupuncture Do?

According to an article in WholeHealthMD,

“Acupuncture practitioners believe that the therapy stimulates the body’s internal regulatory system and nurtures a natural healing response.” The article explains that acupuncture works by “release of endorphins and monoamines, chemicals that block pain signals in the spinal chord and brain.”

Acupuncture is a safe, non-invasive way to help alleviate pain when performed by a skilled, certified practitioner. When considering what types of pain relief options are available for animal patients, Dr. Waldman says:

“I tell patients that acupuncture can’t hurt. There’s so many things that we can do that do hurt. Surgery has a lot of good and bad things about it. And medications have side effects. So why not try this plan?”

Anyone considering acupuncture should keep in mind that for the best results, you’ll need to make an ongoing commitment to the therapy. At Dr. Waldman’s clinic, pawrents are encouraged to try a comprehensive, four week acupuncture treatment plan before moving on to more invasive options. If a pawrent doesn’t see results, or the doctors at CARE don’t see improvement, treatment can be halted. Usually, though, acupuncture helps.

“Once they see that their dog is improved, they’re sold (on acupuncture),” she explains.

How to Find a Qualified Acupuncturist and Rehabilitation Therapist
Canine rehabilitation is a growing field and practitioners are opening rehab centers all the time. How do you know who’s qualified and who isn’t?

Dr. Amy Kramer, PT, DPT, CCRT, co-founder of CARE, advises pawrents to seek out practices that have a veterinarian and a licensed canine rehabilitation practitioner working together.

“If there’s no therapist and no veterinarian involved, then I think you’re missing a link in the chain of what works,” she says.

This collaborative approach works because canine rehabilitation veterinarians are trained to recognize and diagnose animal diseases, but canine rehab practitioners are not.

When a dog is undergoing rehab therapy but his condition is not being monitored by a rehabilitation veterinarian, small signs of disease and illness could be missed, which puts the patient’s health in jeopardy and possibly lead to additional treatment costs.

Pawrents can find certified canine rehabilitation practitioners by visiting:

These organizations certify veterinarians, veterinary technicians, physical therapists, and physical therapy assistants. Both U.S. and International practitioner directories are available.

Acupuncture therapists can be located at:

Additional Reading

Therapies: Acupuncture, WholeHealthMD.com

“The Benefits of Canine Rehabilitation & Conditioning”, Whole Dog Journal, by Lisa Rodier, September 2009

Many thanks to everyone at California Animal Rehabilitation Center in Los Angeles for helping us bring this series to you. If you are lucky enough to live nearby, be sure to visit their facility and see how staff can help your canine amputee stay strong and live hoppy!

Learn more about Lobo in Part 1 of this series with CARE, “Canine Rehab Therapy: Senior Tripawd Bounces Back with CARE”

If you don’t already subscribe to Dr. Dressler’s Dog Cancer Blog, we highly recommend you do. As a veterinarian who believes in a “Full Spectrum Cancer Care” approach, he covers all of the latest advances in not just holistic medicine, but traditional canine cancer treatments too. We really like this about him.

Dr Dressler Dog Cancer GuideEarlier this year, Dr. Dressler came out with his first e-book, the Dog Cancer Survival Guide. While not specific to bone cancers that affect many of us, this is a 300 page PDF filled with information that presents the latest findings in suspected causes of cancer, treatment options, nutrition and supplements, and kindhearted advice to help you stay strong throughout it all.

We recommend this book because it’s as much a resource guide as it is a mental health guide for coping with canine cancer cancer. Using the old adage “You must put on your own oxygen mask first,” Dr. Dressler explains why your mental health is mission critical.

“”You must get into a state of mind where you can be most effective as your dog’s primary caregiver. You have some big decisions to make, and they require a clear mind. Your ability to focus and be totally available to your dog — who really needs you — is your number one job.”

In a step-by-step, straightforward manner targeted at the layperson who has just learned that their dog has cancer, he turns complex information into easy summaries the layperson can understand and utilize, such as: what are some suspected causes of cancer, questions to ask your vet, what a pathologist’s report is and why you need a copy, financing treatment and more. You’ll learn basic cancer terms, causes, and why your dog’s immune system is his own best defense.

Because the book is for anyone coping with canine cancer, it covers eight major types of cancers in detail. Later, you’ll learn how Dr. Dressler’s “Full Spectrum Cancer Care Plan” can be tailored specifically to your dog’s health status. You’ll learn what strategies (from chemotherapy to natural medicine) and techniques have scientific studies that support their effectiveness, and the pros and cons of each.

Another thing we liked about the Dog Cancer Survival Guide is, unlike a lot of traditional veterinarians, Dr. Dressler doesn’t ignore  alternative nutrition therapies as a way to combat cancer. He understands that what you feed your dog during his battle with cancer is just as important as what kind of surgery you decide  to have performed. You’ll learn about foods and supplements that can enhance treatments and improve your dog’s quality of life, and how to feed them to your dog.

Dr Dressler Dog Cancer Guide BlogThis book will also help you manage the side effects of most conventional and alternative medicine treatments for canine cancer (did you know you can give your dog fresh ginger to manage nausea?). You’ll learn how to evaluate your dog’s quality of life, and how to figure out when the time is right to set aside cancer weapons and begin hospice care for your beloved companion.

We wholeheartedly endorse Dr. Dressler’s e-book because it’s one of the few we’ve found that addresses all aspects of ways in which you can battle the evil monster called canine cancer. But a word of warning: Dr. Dressler is an eloquent writer. The book’s last chapter, “If Your Dog Could Speak, This is What She Would Say to You,” is a real tearjerker:

“And if their short lives are to be useful, it is to remind us of a few simple facts that we humans forget pretty easily.

‘We are alive. We are breathing. We are here. We are smelling and tasting and the breeze feels good. We are holding each other and we like each other. We play and walk and run. This is good. You are good.”

Be sure to subscribe to our new Tripawds Downloads blog for more e-book reviews and updates about other downloadable resources we find! Have you started your Tripawds Blog yet?

Tripod Puppy Jerry before AmputationNine years ago, when Mom and Dad took me to my first vet visit, Mom saw pet insurance brochures on the counter. She remembers thinking to herself; “Insurance, for dogs? You’ve gotta be kidding.” Being new to dog parenting, she didn’t give it a thought after that, for a while.

During the first several years of my life, my vet bills were never more than a couple hundred bucks a year. But then I got cancer.

And as they say, houndsight is 20/20. Mom now thinks differently about insurance. She feels that if health insurance is so important for her, and my Dad, why not for me? I’m a family member too!

Plus, pet insurance premiums are less expensive than human medical insurance. My Mom knows that if she had signed me up long ago, she would’ve saved a ton of money when I got sick. Since my diagnosis, my pawrents have paid out about ten times more in health care costs for my vet bills, then their own health care bills!

Is pet insurance worth it?
Tripod dog post amputation surgery photo If your dog became a Tripawd because of cancer, and you didn’t have health insurance before the illness was diagnosed, you’re already well acquainted with treatment costs. It may too late to buy insurance for your Tripawd (pet insurance won’t cover pre-existing conditions). But if you ever add another furry friend to your family, it’s a good idea to sign up for pet insurance as soon as s/he comes home.

Because sadly, until there is a cure, cancer will keep happening to dogs. And if your dog is one of the unlucky ones and isn’t insured, and you’re in a tight financial position some day, you may end up in the heartbreaking situation of having to put a price on your beloved dog’s life.

Tripawds recently asked pawrents on the Bone Cancer Dogs group if they had pet insurance on their dogs with cancer, and if so, what their experiences were like when filing claims.

“I lost a dog 10 years ago. I had to make a decision about putting her down based purely on what I could afford. I swore I would never do that again if I didn’t have to,” says Mary Beth.

She added, “What they pay back seems worth it to me. Like any insurance policy, you are playing the odds as to how often and how badly your dog will need extra care.”

Affordable Pet Health Insurance For Cats And DogsThere are a variety of companies such as Quick Care Pet Insurance, ASPCA Pet Insurance, and Veterinary Pet Insurance.

You can buy a basic plan that just covers office visits and routine tests, or you can get a comprehensive policy with cancer riders that will pay out higher limits should your pup get sick.

With all of these options, it’s a must that you do your research first. Here are three places to start:

Enroll While They’re Young
Roddy Bone Cancer Dog Bone Cancer Dogs member Ana, says “I would suggest to anyone looking into pet insurance that they do it early, while the dog is still young, before any issues come up. They do require records and will take note of pre-existing conditions.

For example, they will only cover a torn cruciate if the dog has been insured for at least a year prior to the occurrence,” she added.

Ana has had her pet insurance for over 12 years, and it’s covered bills for two of her dogs that were diagnosed with bone cancer, including Roddy (pictured at left).

Although many insurance companies will insure adult dogs, their premiums will likely be higher. And keep in mind that breeds prone to certain health problems, like Shepherds and hip displaysia, may not be insurable at all.

Premiums start from about $20 a month on up. Many plans offer discounts for more than one dog.

Despite the growing popularity of pet insurance, many pet guardians still suggest just putting the money that would go toward premiums, into an interest earning savings account every month. But Bone Cancer Dogs member Diana says that wouldn’t work for her.

Savannah Bone Cancer Golden Retriever“I know some people say just put the premium money in the bank. Well, even if I had done that, there is no way it would have added up to what they have paid so far let alone all the other things they have paid for in Savannah‘s life.

I think it is well worth it and I wouldn’t be without it especially after having a dog with cancer.”

How Insurance Helped Tasha’s Mom
Mary Beth shared her experience and suggestions with us. She had a standard pet insurance plan with a “Cancer Rider” on her dog Tasha, that cost $9 a year. Sadly, they had to use it.

When Mary Beth filed a claim for two biopsies, the second of which determined Tasha had osteosarcoma, the company paid out $500 toward the $800 in biopsy costs (some x-rays weren’t covered). And it also paid $1800 toward the $2000 in costs for the amputation surgery.

three legged rottweiler tasha bone cancer dog

Her standard plan is also covering up to $374 a year of chemotherapy treatment, with a maximum payout of $1600 (other plans offer higher benefits). The company isn’t paying out any more lab work this year, required as part of the chemo treatment, because Tasha has reached the maximum payout for tests.

Like human health insurance, when the policy renews each year, deductibles and payout limits start all over again. If Tasha lives past the renewal date, the company has stated that they will not cancel the policy.

“I consider it catastrophic insurance,” she says, “and all in all, I think they have done pretty well. I wouldn’t expect the insurance to cover all costs, as it will not. Some allowance levels are high, others too low, but it seems to even out. What they pay back seems worth it to me.”

Denied Claims: Another Side of Pet Insurance
Not everyone has great things to say about pet insurance. Sometimes, technicalities in diagnosing an illness like cancer can lead to headaches when filing a claim.

Three legged husky dog BusterTripawds member Kim just ended a battle with her pet insurance company, after they refused to pay out a claim for her Tripawd Buster’s amputation surgery.

For about two years, Kim has paid about $45 a month to insure Buster and her other dog with ASPCA Pet Health Insurance. The policy renews annually.

Over the course of the first policy year, Kim was taking Buster to the veterinarian to try to figure out why he was limping. Nobody could figure it out. Just about one year later, when bone cancer was diagnosed, the policy had already renewed, but Kim thought nothing of it. Buster had his amputation surgery, and submitted a claim for $2600 in pre-and post-surgery costs. Her claim was denied.

The company told Kim that because records showed that Buster’s symptoms started during the previous policy year, they wouldn’t pay because for the surgery appeared Buster had been treated for osteosarcoma the previous year, making it a “pre-existing condition” that they would not cover during the current policy year.

Kim fought the denial, and had to go through hours of research and paperwork. Finally, her persistence paid off, and the company decided on a settlement (not the full amount of the claim), but only if Kim agrees not to pursue any other claims for Buster’s cancer.

“If I had to do this over again, (and I had a crystal ball) I would of done my homework on pet insurance protocols. Also, I would of insisted on an initial better diagnosis of Buster’s condition,” she said.

So when it comes to technicalities, wrong diagnoses and difficult situations, pet health insurance can be as stressful as dealing with human health insurance (at least in the U.S.!). Be prepared, and keep thorough documentation of all of your pet’s vet visits, tests, etc. Hopefully you’ll never be in the same situation as Kim.

Tripod Dog Jerry relaxes on his bedSpend Money on Toys, Not Bills

Health Insurance For Pets was unheard of not too long ago. But as veterinary medicine becomes just as technical as human medicine, the costs rise accordingly.

In this day and age, taking out a policy on your furry family member definitely makes good cents!

What do you think? We’d love to get your feedback or hear your own reviews if you have or ever had a pet insurance policy.

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