Saturday January 22 – As we were getting ready for bed we noticed that Romeo was walking a little strangely.

Sunday January 23 – In the morning we saw the lump on Romeo’s front right leg and that he was reluctant to put weight on it. We kept an eye on him for the day and decided to head to the vet the next day if he didn’t seem to be getting better.

Monday January 24 – In the morning Romeo’s leg looked the same. I called the vet when they opened and they got us in right away. So I took the morning off work and Romeo and I headed to Corvallis to visit our vet. We saw Dr Porter who happened to be one of my sister’s classmates. She was great with Romeo and got us xrays and pain meds.

The xrays were inconclusive. This could either be an injury, which knowing my klutz of a dog was entirely possible, or could be osteosarcoma. The plan was to give Romeo a few days on pain meds and see if he improved. If not we’d pursue other diagnostics.

Romeo spent the day at work with me. In the afternoon I had a meeting with the two vets and the certified vet tech who work for the shelter. Romeo joined us for the meeting and all three of them looked at his leg with the look of “I hope that’s not what it looks like.”

Friday January 28 – Dr Porter called to check on Romeo. When I told her that unfortunately his leg looked the same she referred us to Oregon State University’s Veterinary Teaching Hospital for a consult with an oncologist. OSU saw Romeo that day and he spent the afternoon with them. We had a great experience there but unfortunately did confirm that Romeo has osteosarcoma.

First the test results –

Romeo’s bloodwork was great: CBC & chemistry “entirely within normal limits”

  • PCV 50%      TP 6.9 g/dl      Neutrophils 4538/ul     Platelets 246,000/ul

Fine needle aspirate of bony lesion: too few cells for a definitive diagnosis but cells present are suggestive of sarcoma

Chest xrays: no evidence of metastic disease

  • With osteosarcoma it is pretty much guaranteed that by the time symptoms are present the cancer has metastasized to the lungs. Since Romeo has no visible metastases that doesn’t mean it hasn’t spread, just that he has longer before that cancer becomes a problem.

Leg xrays: aggressive lesion of the distal radius and possibly the distal ulna

So really, this wasn’t a 100% diagnosis of osteosarcoma (just 99.9%), but everyone is convinced that’s what it is, so that’s how we’re treating it. Treatment for osteosarcoma just helps quality and length of life since it isn’t really curable. So while Romeo is terminally ill we do have a variety of choices that can significantly increase his life expectancy while giving a good quality of life.

We ended up with a full sheet of paper – smallish font, single spaced, narrow margins – of detailed treatment information from OSU. Here are the highlights…

Left untreated and managed only with pain meds, he could have anywhere from days to 2 months left before the pain is unmanageable. Amputation alone gives a life expectancy of 4-6 months. Adding chemotherapy can extend to 12-14 months.

I wasn’t convinced that Romeo would do well as an amputee but the vets said his other three legs were in great shape, overall he was in good physical condition, and he would be a good surgical candidate. The nice thing about amputation is that it takes away the pain since it’s the bone that hurts. No leg, no hurting.

Another surgical option is a limb spare surgery where they remove the painful section of the bone and fill it in with a plate or bone graft. Since Romeo’s ulna may also be affected, he isn’t a great candidate for this surgery. Plus the recovery time for this surgery takes months. Oh, and it could cost anywhere from $6000 to $8000. (We took this option off the list.)

After that we have the option of chemotherapy. Surprisingly, chemo for dogs has very very few side effects and they tend to tolerate it well. Chemo (Carboplatin) would be given at OSU IV every three weeks for five doses.

They also gave us information about a newer chemo drug, Palladia, which is given orally every other day. This is nice because it can be given at home, but it is a more expensive treatment and isn’t proven to increase life expectancy in osteosarcoma cases.

In case we weren’t opting for amputation, they gave us information about radiation to reduce bone pain and other drugs to help strengthen bone.

Saturday January 29 – I called our vet to schedule an amputation. The prospect of surgical recovery for a dog who is already beyond clumsy on four legs is a bit daunting, but amputation is the obvious first step for Romeo. His surgery is scheduled at our vet for this Thursday. We are still considering chemotherapy options.

Now the countdown to amputation begins. We already have the nickname ready – Sir Romeo Hopalong.