Archie has a mass in his shoulder with inconclusive biopsy
Hubby and I went on a week long vacation and left our daughter home to house/dog sit. She was 11 when we got Archie, so she helped raise him. He's her baby and she adores him with all her heart, and he does her. Everything was fine until the last day when she called, panicky because he had spent the previous night whimpering and wouldn't use his leg, had to be coaxed to go outside to do his business and wanted to come straight in. (So not like Archie). Also not eating (Archie has always skipped meals now and then so that wasn't unusual). She took him to the vet who found a large mass in his shoulder and suspected osteosarcoma with a small possibility of infection in the bone instead of cancer. We scheduled a biopsy and just got the results by phone: it does not definitely show cancer. The bad news is that it doesn't really show anything conclusive except something is bone reactive. The vet thought we had 2 courses of action. Re-biopsy or wait a month and take some xrays to see how the mass is doing. They felt they got two good samples with the initial biopsy so I am surprised. Hubby talked with vet while I was at work: she is going to post slides/pix on a vet chat group to try to get ideas. I don't have the slides or pix but hoped that maybe some OES experts would have some ideas or suggestions. On one hand, Archie seems to be genuinely improving. Last night was the first night I wasn't sure if he needed the pain meds (canine ibuprofen--don't remember name and don't have the bottle in front of me) or not. He is still limping a bit but his appetite is very healthy and he is eager to go on his walks and is feeling a bit playful (but still a bit more subdued than usual). Not sure how much of the improvement is pain management or if there is actual recovery from whatever is going on. Any suggestions? Should we re-biopsy and hope they get a better sample? He's 11 and I hate to put him through more than he has to undergo Wait a month (my concern there is losing time if there's a treatable infection)? Any other suggestions? |
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| I have no good suggestions - this is one thing I haven't ran across with my group. But, I want to send good wishes to Archie and a big  to him and your family. |
Sorry cant help but I hope things all work out.  |
| Me three.. Poor Archie!!! Hope you guys find a solution that helps the ol' boy!! |
| If the alternative to cancer is a bone infection, can they treat for that while they are unsure of what it is? Is there a downside to seeing if antibiotics shrink the mass? If it is osteosarcoma, what is the treatment for that and is that something you are willing/able to do? I've known some young dogs that have been managed for a few years but I'm not sure how hard the treatment would be on an 11 year old or how the treatment/lifespan calculation plays out. If it is not something you would treat for anyway, then pain meds and waiting is not a bad plan. I am sorry you are going through this. Inconclusive medical results are maddening. I hope Archie keeps feeling better. |
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| I don't have any advice unfortunately. I just want to send hugs to you and Archie. I agree with the poster who asked about going ahead and treating it as if it were an infection. Is there a down side to that? Sounds like it couldn't hurt. Here's hoping to a quick resolution (and a happy, healthy Archie as soon as possible.) Virtual hugs to you both. |
| ! Hope Archie is just keep doing better and better . |
| Unfortunately, no advice here either. Just wanted to send BIG to you and Archie. Inconclusive medical results can be very maddening!   |
| How confusing for you. to you and Archie. |
Valerie wrote: If the alternative to cancer is a bone infection, can they treat for that while they are unsure of what it is? Is there a downside to seeing if antibiotics shrink the mass? That what is my thoughts too maybe just starting a treatment for just in case it is just a bone infection rather then waiting for actual conformation of it maybe being a tumour. Cover both options there with him. Xray him 1 month later to see what is happening and if you do need to re-biopsy as well after seeing what the xrays show. In the meantime I would ask the vet to start treating for bone infection just in case it is that too, wont hurt rather then leaving it another month on a wait and see situation. Hugs for Archie and big hug for your family. So hard when our fur babies are unwell and the age factor as well knowing which way to go.  |
| Thank you all for all of your well wishes. I had to work and couldn't get back here until this morning. Starting antibiotics was my first thought when I talked with the vet the first time. She didn't want to do that because there was no way to tell what kind of infection it is --if it's an infection at all--and the medication for a bacterial infection vs a fungal infection are very different. And either one could be hard on Archie's body, especially his GI tract. But yes, when I talk with her Monday, I plan on re-visiting that. I was willing to wait a few days re: treatment to find out if he has something treatable. Not, not so much. My husband isn't the world's best reporter on all things medical so I want to hear first hand from her what her thoughts are. |
| Thinking of you and Archie to the both of you Lisa and Frankie |
| If they do the biopsy again, could they send some off for testing to see if it's a bacteria or fungus? Maybe they can culture it to see what antibiotics would be effective. It's SO hard sometimes deciding how to proceed... hoping Archie will be well again soon. |
| I assume it was a "blind biopsy" where they just stuck the needle into the mass. If the mass is necrotic and that is where the needle was placed then it would have been "non-diagnositic" I would say redo the biopsy but use ultrasound to guide the placement of the needle. they should be able to see "viable" tissue as it will have bloodflow and be solid on ultrasound. If it is an infection meds should be started before it sets into the bone. Did they do x-rays??? they would be able to see if the mass is from the bone or did it start in the muscle and the bone is not involved. This can be suggested by film and can help separate infection from tumor. The images can be sent for a second opinion at the University Vet school. they will have dedicated vet radiologists and ortho vets who should be able to sort this out. |
| They x-rayed initially, and identified a mass that seemed to have infiltrated bone. Using the x-ray as a guide, they took samples from 3 different sites. Not guided by ultrasound, but they did perform the xray first to determine they wanted to biopsy. Vet felt they got 3 good samples. Results were 'bone reactive' which is different than necrosis. She has also asked for input from other vets on a vet forum, posting slides and film. She felt that a second biopsy would be most beneficial if we planned to treat aggressively with chemo. Given Archie's age (11), I don't think this is what we would do. Chemo in pets is not curative but palliative. She also felt that if it were infection that we could afford to wait and do a second set of radiographs in a few weeks, which should give us a clearer picture. She sounds fairly convinced it is not an infection. On the other hand, Archie's decline was very sudden. Yes, he had arthritis and yes, at 11, we had noticed he was slowing down: sleeping more, avoiding rough housing with our younger dogs, sometimes limping a bit, which I had already planned to follow up on. When he declined, it was literally he's fine and then, whined all night and wouldn't eat and would only very reluctantly walk or go out. No walks, etc. Sleeping, lethargic, obviously doing very badly very suddenly. That was on a Friday. Daughter got him into the vet as soon as she could that day. Vet was very concerned: his heart was racing, he was in obvious distress. That was when she x-rayed him, felt it was probably cancer and advised a biopsy, and prescribed pain meds. When we got home on Sunday, he was obviously still doing very poorly, but not quite as bad. He ate a bit and would go outside for his business and briefly, around the block. Biopsy was scheduled for Tues. By Tues., he was again much better. Had been NPO since the previous evening. When he got home, he was sleepy but ate, went out for his (shorter) walk, etc. Since then, steady improvement. Our daughter (who grew up with Archie) is here this week, and he was very playful with her. He loves his toys and loves to play with them with her. This def. tired him out and right now, he and the other OES are taking their usual p.m. nap. The sudden decline and the gradual improvement to me suggest he could be recovering from an infection. Or it could be just that he's responding well to the pain meds. The vet seems to lean towards that scenario: he's just responding to pain management. What we've elected to do is to follow up with an xray and make some decisions after that. We live 120 miles from one university vet school and 165 from another. She's investigating what sorts of options they may have available if needed. |
| an x-ray will not really point to the location of viable tissue which should be sampled. Only US, CT or MRI will do that. It is possible that the mass started in the bone and the soft tissue mass tumor extending out of the bone ie osteosarcoma. If it was an infection I would expect that he would have a elevated white count and possible SED rate as well. did they run that kind of blood work. Lymphoma and leukemia would also show some abnormality in the bloodwork. was the bone destroyed??? they can take a digital photo of the x-rays, if not taken digitally and then e-mail the pic to the university. Most vets don't have digital xray machines so that is one way to get the image to the university for a second opinion. |
| Just came back from Archie's follow up x-ray, done about 5 weeks after the initial x-ray. The radiograph shows growth in the mass, which is located on the proximal humerus. There is some thinning of the bone along the shaft, on each side. At this point, we have elected not to do another biopsy, mostly because we are not certain that a definitive diagnosis would change what we consider our treatment options. At this point, Archie is doing very much better: Initially, he responded well to a full dose of Deramaxx and is now down to half a pill and doing very well. The lower dosage is to be easier on his organs and his digestive tract. He is tolerating the meds well and is doing very well: bouncy, even. It helps that it is cooler now than it was a month ago. We had initially decided that amputation was not an option for Archie. He is 11 and has other joints affected by arthritis. I am sticking fairly hard to that decision and would be open to palliative radiation or even palliative chemo if it would buy him good time, not just time. I am wondering if any of you have had experience with amputation of a front leg for an older OES? My concerns are: his age, his other arthritis, mostly. The vet doesn't sound hopeful that this would be an option that would give Archie years of extended life. I know that amputation would remove all possibility of any pain from the bone, but would do nothing if there is already metastasis (no signs of it yet). Metastasis would likely be lungs, and would be fatal. She thinks he could have some weeks or some months if we continue as is. She feels: less than a year. If the bone thins too much, he is at risk for fracture from..just every day activity. This would likely be an endpoint for Archie. If we do that amputation, it is not clear to me that we would be extending his life, for certain or even with reasonable certainty. I don't want to ask too much of Archie, who has been so generous to us. For now, his pain level seems very well managed. If it increases, we can try other medications and perhaps radiation, which seems to be immediately effective at controlling pain. What I want to do is what is best for Archie. What I really want is for Archie to be ok forever and ever and ever, but since that is not possible, what I want is for Archie to be as healthy and happy and pain free as possible for as long as possible. |
| That's not very good news. I'm not sure how a 11 yr old would do w/ an amputation. The front end is so heavy, it seems like asking a lot of an older dog. I know of a couple dogs personally with front leg amps, but they were done as relatively young dogs. They are doing great too. One is a bigger male golden, I would say Andy is similar in build to a lot of OES with the bone and structure. He had his amputated after a car accident that caused total nerve death to the front leg - he just dragged it. He is doing great - but he's young. The front leg amputations just seem to be a lot of effort for the dogs - but they seem to do well. But the older dog.... it seems pretty tough to think of making that adjustment. |
| I'm sorry to read this news. I've had several with bone cancer. Having used chemo on the Newf and not feeling the results justified the treatment, we treated the bone cancer kids with pain meds. When the meds were no longer working, we said our goodbyes and sent them on the Bridge. All were older so no way would I ask an older dog to undergo amputation, especially on a fore leg, when their hips and spine are probably arthritic. Young dogs, yes, I could do that. |
I'm sorry to hear the news about Archie.  I cant help with any advice but wanted to say that even though its a tough decision I can tell you will make the right one in the end, as you're asking for advice and obviously care so much about Archie. Good luck. |
| I'm so sorry to read this and for your pain. Poor Archie. |
| OK: update re: Archie. After a few weeks of being able to comfortably take only half a 75 mg deramaxx, we decided Archie needed to go back up to the full dosage of 1 whole 75 mg pill as of yesterday. He had been noticeably limping and is generally much less active We have been giving him the pepcid along with and no incidents re: tummy, but decreased appetite. It is hard to judge whether the decreased appetite is because he isn't feeling well or because he is simply not hungry: he's always been a very light eater and has always been quite thin under that shaggy coat. My other dogs would move mountains for the tiniest scrap of any treat. Archie has always ignored his food for a morning or an entire day, from time to time. So: no appetite is not easy to judge as a real symptom. Yesterday, after a some weeks of no limping on half a deramaxx, he began to limp and was not anxious to go outside to play and lay around in the sun and grass as usual with the other dogs. So, we upped his dose last night and had hoped he would seem better today. He was not: he was willing to go on his walks, but ignored breakfast, even with dried liver crumbled on top. He slept in one spot while the other dogs went out and would not move from his spot, which is simply not like him. Sometimes he elects to stay inside so he can have whatever humans are about all to himself in those cases, he wants some attention and wants to be nearby. Today: I called and asked my husband to come home between classes as I was worried that Archie was so completely disinterested in moving about. While waiting for my husband, it occurred to me that perhaps if I went ahead and vacuumed (one of the reasons I wanted ARchie to move is so that I could vacuum without bothering him and well, actually: vacuum). Archie hates the vacuum and got up out of the way when I got too near him, just as my husband got home. At least hubby got a home lunch and Archie ate a tiny bit and then wanted to join the other dogs outside. It was a wonderful mild day and so they stayed out until our son stopped by to take them all on their p.m. walk. Archie went, albeit much more slowly. No limping reported, but he clearly favors the affected leg. And again: he came in, lay down in one spot and does not move, even for dinner, which was the spoil the poor dog dinner of: deli chicken and brown rice with carrots. He eventually ate some when I brought it to him but was uninterested in going to his food and water dishes. Mostly, he just slept. This is my long and drawn out way of asking: what next? How far do I take this? Aside from today with a lot of sleeping, he has been very happy go lucky, eager to spend time with his people, more willing to romp than I have been willing to allow. The vet cautioned that it was possible the bone would weaken enough that ordinary activities could cause a break which would be an end point for Archie. If he generally seemed ill or unhappy, it would be so much easier to feel I was approaching the time to let him go. But, except for today, he is still his bouncy, happy self, stump (he was docked very poorly) wagging, ears cocked, eyes gleaming. It's just his leg. The rest of him is great. If we go to the next set of pain meds, will they make him more sleepy? The last trip to the vet, he was a wreck and he's always been happy to go to the vet. I just am not ready for this. |
| I'm so sorry no one can answer when, your the only one that knows your baby. I know I am no help, palative care is making sure they are not in pain, have a quality of life still and not rapidly loosing weight (Eating well). Just one suggestion for him, google "Cancer Diets in Dogs" lots of info there to get them eating well still without rapid weight loss, foods to avoid with cancer and lots of support supplements to help them through this period. 11 years old I would not opt for amputation either, just keep him comfortable, enjoying life, food etc and again only you will know when it is time or wether you need to up his meds to keep him comfortable and happy. Hugs to you both hard times ahead but know we are thinking of you all, you know archie well and you will know when it all becomes too much for him . |
| I'm sorry to hear your news. Its so hard to know as they hide pain well. Thinking of you at this difficult time. |
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| I'm sorry that Archie is having more pain. I hope the increase to the full pill will make a bit of difference and let him be more comfortable. Dawn...not logged in |
| I am so sorry that you and Archie are going through this. I had a cat with cancer and she declined so quickly and didn't want to be around anyone. I would carry out on a pillow to enjoy the sunshine but she didn't have the energy to move. She just wanted to stay in a closet in a hallway in the basement. For a black cat, she could not have hidden herself better. I also gave her chemo although there was really no hope for her, given her particular brand of cancer. When it was all done, I believed the Vet should have gently talked me out of it and I should have let her go sooner than I did. I just did not want her sweet life to be over. But, for her, it really already was. tgir wrote: If he generally seemed ill or unhappy, it would be so much easier to feel I was approaching the time to let him go. But, except for today, he is still his bouncy, happy self, stump (he was docked very poorly) wagging, ears cocked, eyes gleaming. It's just his leg. The rest of him is great. It sounds like Archie is not at that point. You will know when he is. For whatever time he does have left, I think it is worth trying a variety of pain meds because they don't all have the same side effects. My heart goes out to both of you. |
| I am so sorry for you and for Archie. When I read your line about "it's just his leg, the rest is fine" it brought back a lot of hard memories. Our Jake was very happy on the front end, but his back end just wouldn't cooperate. It makes things sooo very hard. In the end it became clear that he was no longer a happy dog and that glimmer had gone from his eyes. You'll just know when the right time is for you and for Archie. |
| Thank you, everyone. Archie is having a much better day today. Perhaps it just took longer than I expected for the increase in his pain meds dose to kick in. He ate well today, went up stairs last night and was eager to go outside for his morning play/nap in the yard time. He is noticeably slower on his walks but obviously really enjoys the attention he gets from passers by. We live quite near a university campus and many students want to pet the dogs and talk about the ones they left at home. I think it is just hitting me harder than I would have thought. Up to this point, I intellectually know that he will probably not be with us many more months but the emotional impact has been...unexpectedly harder than I had thought it would be. You all are great for the information, yes, but also for the support. Very much appreciated. |
| Here's hoping that Archie has more than just a few good months. |
| I lost my first OES to cancer when she was 11 1/2 years old. She wasnt acting sick, ate well, and very playful. Just one day when I was brushing her I noticed her chest was very red and hard. We took her right away to the vet. They ran all sorts of blood work, told us her white blood cell count was so high they couldnt read it and had to send it off to A&M to be tested. Came back as leukemia. We were willing to do anything for her so we tried chemo treatments. This only gave her a few weeks. Her spleen ruptured and she started bleeding internally so we had to say our good byes and let her go. It was the hardest thing Ive ever been through, so my heart goes out to you. This was 14 years ago and its taken me this long to be able to have another sheepie. I still miss her like crazy but knowing she is waiting at the bridge for me makes it a little easier to know I will be with her again. Love and hugs to you and your baby. |
| There are several other types of pain medications that you can use in addition to Deramaxx that can help with pain and not make Archie feel overmedicated. I would ask your vet about adding in Tramadol. Most OES do great on it, at best may only cause mild sedation but can be a great pain med. Best of luck with keeping this boy comfortable. Michelle Mattie and Billy Bob |
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| Lisa and Frankie |
| I am so sorry Archie & your family is going through this. It's been over 5 years since we had to make heartbreaking decisions with our Jake. Archie sounds like he has good & not so good days. I would try to keep him as comfortable and safe as possible. As mentioned Tramadol could be used when Dermamaxx becomes less effective, a mild narcotic could be added in the evenings so that he can be comfortable at the end of the day and enjoy a good rest. |
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| Another update: Archie began to have extreme difficulty in using his hind legs, which is really not good since the tumor is on his front leg. Hubby took him to the vet and $500 later, he's on Tramadol for a week until the deramax is out of his system at which point he will be on steroids for a partially herniated disc. He also has severe arthritis in one hip which wasn't there in previous x-rays a year (or was it two? too long a day to remember) or so ago. Possibly the disc and hip are made worse by the strain the front end has put on the back end. And yet, he is happy enough. We've always seen Archie as kind of a wimp when it came to pain: the slightest hint of hitting a snarl while brushing brought all kinds of squeaks and yelps, sometimes even before you touched him with a brush. I think he learned that trick from my daughter who has thick, curly hair I used to braid every da. Unfortunately for him, he has a very soft coat which snarls and mats at the slightest provocation. However, knowing how much a herniated disc hurts humans, I have profound respect for him. He needed help getting up last night but was very obviously pleased to be up and to walk about. We've been doing some reno in the kitchen/family room and it's nearly complete. We're using the kitchen but haven't moved into the family room yet. This is where we always 'lived' pre-reno and will again, once it's painted. He walked around the family room and looked at me like: what's the hold up? Isn't it time we all started hanging in here again instead of the living room? He is so obviously happy to be around people and is eating as well as he ever has. He actually gained 5 lbs from his last visit, which is really good. He's always been on the thin side so I hate to see him lose and am always happy to see him add a couple of pounds. He's never been close to over-weight. Which is good, given his current issues. I just feel bad for him. His spirit is obviously still so very strong. I hate to see his body fail him. I am hoping that we can still give him some good time. Right now, it's just a lot of rest and a lot of attention from his family. But I may be spending nights on the couch downstairs since he can't make the stairs now (and may not again, really) and he's awfully heavy to carry, even for hubby. Again, thank all of you for your support and your advice. |
| Thinking about Archie and wondering how he's doing? |
| The tramadol seems to be knocking him out, pretty hard. Decreased appetite, much sleeping. Am anxious to get to the 1 week off of deramaxx so that we can get him on steroids and hopefully, help alleviate the disc issues. One of Archie's nicknames has always been Squeakers, both because he has a habit of squeaking when he gets an owie (or thinks he will get one). And he loves--I mean LOVES squeaky toys of any kind. When I got home from work, he was really sleeping hard and was disinterested in....anything, including eating or drinking. I brought over a squeaky toy and at the first squeak, his head popped up. After a bit of playing, with Archie continuing to lay down, he was ready for some water and a little bit of food. More play, and he really revved up. But isn't able to stand without assistance and today, would do so only with both assistance and insistence to go outside to relieve himself. I so hope he rallies. I know it won't be for as long as I had hoped but still I had hoped for more good time. Both times he went down, it was very sudden: he had been fine (when he first showed symptoms) until suddenly he was not. He rallied with the deramaxx and was doing well---until suddenly he was not. It is hard to say he is happy. Or not. We'll try to ride this out until Wed. and see if we have a prognosis for some improvement. |
| I know this is really difficult for you. Hoping you and Archie will have more good days to enjoy together. |
| Sending postive thoughts for you and Archie. |
| Thanks for the update on Archie. I know this is incredibly hard, my heart is hurting for you. It's amazing how stoic our sheepies can be. My Chloe was like that as well. She was fine and her usual self, and then, three hours later, she was gravely ill. Their fortitude is amazing. Wishing you and Archie a good Sunday. |
| Thank you everyone. I don't know why this is hitting me as hard as it is, but it is knocking me down more than I would have expected. Can anyone suggest a different pain med than Deramaxx, which Archie must stay off so that he can take steroids to hopefully help his disc issues or Tramadol, which certainly seems to be eliminating the pain but is very sedating? Plan to talk with the vet first thing Monday a.m. |
| I don't know if this would be helpful but this appears to be a good list of pain medications with a brief description. It might at least provide something to talk over with your vet. http://www.2ndchance.info/pain.htm Quote: I don't know why this is hitting me as hard as it is, but it is knocking me down more than I would have expected. ALL dogs are special but the OES just seems to make a deeper bond with our heart and soul. We do the best we can do with the condition they have... you're doing a good job helping your baby through this difficult time.  |
| This post is breaking my heart. It was from hip problems that we lost our Drez and it's still hard to read about another sheepie going thru even somewhat the same thing. Don't know if it's strong enough, but for the longest time before she passed, Drez was on Metacam for pain. Prayers and hugs for Archie and you!  |
| Update: Consulting vet with specialty in radiology does not believe that whatever it is on Archie's leg is cancer. They aren't even calling it tumor. They don't know what it is but it hasn't grown since July which argues against osteosarcoma, which is usually very fast growing. Downside: he has very, very severe arthritis. Tramadol is obviously not the right med for him, but we are sort of stuck with it if we want to give the steroids (prednisone) a shot. That starts Thurs. a.m. Am hoping that will provide fairly quick relief. Other options include: trying him on deramaxx again, trying another NSAID. Referral for acupuncture. But his joints are in pretty bad shape. Certainly, he is far tougher than we ever gave him credit for being. He has always been at or slightly below an ideal weight. Unlike my other sheepies, he's never been a big eater or one to carry an extra pound. He is taller/bigger than average but never even a little pudgy. He's been on double strength Cosequin DS for a few years now....Several walks a day, every day until very recently. Now he cannot. I don't know what I could have/should have done differently. Or what to do now. Pain management is our goal. If not with medication, then we will let him go on to that place where there is no pain. |
| I hope the medication does the trick. We had a dog on prednisone for several years and it made his life much better but of course each situation is different. I'm sure he knows how much you love him and that you will do what's best for him. |
| Can your vet offer him Zubrin for the arthritis (it's a little expensive)? Rebecca has pretty severe spinal arthritis, plus an oral cancer, so she is on the Zubrin for the arthritis & Tramadol for the cancer pain management. We had a little scare last week, and we had to take Rebecca off of the Zubrin because she had gotten really sick, and she almost became lame in the rear just after a few days of being off of it.. The Tramadol does not really do anything for arthritis as I think it is more a neurological medicine. Sorry to hear about Archie and how rapidly things are moving. I definitely think you are doing the right thing just making him comfortable, and not trying to do anything aggressive to treat the cancer. I am sure he is happiest being surrounded by all of your love. |
| I'm so sorry about all of this. Mulligan has done well on Deramaxx and Tramadol combined. No sign of sedation at all. (BTW: Deramax is QUITE expensive, 15 pills cost $136, he gets 1/2 pill per day) Our boy Jake had severe arthritis as well as Degenerative Myelopathy and we found another pain regimen to be best for him. See the following info: Old Age Medications for Pain |
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