What's up with Theo

Wednesday was oncology day for Theo.  We talked about the options for treating osteosarcoma.  They aren't 100% positive it's osteosarcoma because the samples are pretty small, but they are characteristic of it and there's only a fraction of a percent of a chance that it could be something else.

There are basically 2 treatment modalities.

1. Amputation.  Bone cancer is very painful and basically the cancer breaks down the bone to the point where it will break eventually.   One way to handle this is to amputate the limb with the cancer and then do chemotherapy to try and target the random cells that are almost certainly in the body.  Bone cancer is highly metastatic and sends cells out into the system.  Amputation would remove the source of the pain, but it's not a solution on it's own.  There is a minimum 2 week recovery from any amputation surgery.

2. Radiation with bone strengtheners.  This would help mitigate the tumor and slow (hopefully stop) any growth.  There's still a reasonable chance that the bone will be weak and eventually break.  If this were to happen then it would be necessary to look to option one depending on how he is doing in general (it doesn't sound like there's much of a chance of the bone healing in this situation). It's expected that the first treatment seems to cause more discomfort and after the second things will get better.  Following 4 treatments of radiation (1 per week for 4 weeks), we'd look at things and see about chemotherapy.

One thing to note is that chemotherapy for animals is much lower doses than we use for humans.  It's just a matter of the impact and being able to ensure the animal is comfortable.

Next Steps

Before anything can be done a chest x-ray and ultrasound needs to be done to make sure that there aren't any other nasty things waiting for us.  A blood panel is also done to ensure that Theo is generally in good health.

The good news is that they did the ultrasound and x-ray yesterday and the only thing of note was a small kidney stone that won't pass unless it breaks down (which is possible).  This isn't related to any cancer, but we just need to watch for the very small chance that he has trouble urinating.

The Decision

Partly because I'm going to be traveling in a little while, I am opting for the Radiation path for now. Theo can be treated while I'm gone and the dog sitter can get him to and from the vet without a problem.  I haven't talked to the radiation team yet.  I'm waiting for their call on Thursday, but it's more logistics at this point.

I'll need to establish a contingency plan in the case that Theo's bone breaks.  I have to figure this out and it's so subjective that I don't know if I can have a complete plan in place.  Knowing that there is no evidence of spread, my inclination is to do the amputation but so much depends on Theo's comfort level.