Bone Cancer in Dogs

Pain Management

Bone Cancer in Dogs

Management Options

Limb-Sparing Surgery

The goal of limb-sparing surgery is to preserve the leg (instead of amputating) by providing a functional, pain-free leg while not jeopardizing the chances of survival. The procedure involves removing the affected bone and replacing it with an implant and a metal plate. In dogs with underlying neurologic or other orthopedic issues, limb-spare surgery may be preferable to amputation. Limb-sparing surgery is most successful for dogs with primary bone tumors of the front leg at the wrist in the distal radius or ulna. Limb-sparing surgery is not an option when there is evidence of metastasis.

To determine eligibility for surgery, blood tests, x-rays and other radiology studies will be done. If limb sparing is contemplated, the biopsy technique and position should be carefully planned. Preoperative treatment with chemotherapy and radiation may be recommended.

In limb-sparing surgery, the tumor and the affected piece of bone are removed and an absorbable chemotherapy-soaked biodegradable sponge is inserted into the wound to kill any stray local cancer cells. The body eventually absorbs the sponge and very little chemotherapy gets into the blood stream. Further specifics regarding technique should be discussed in detail with the surgeon.

After surgery, a soft padded bandage (usually not a cast or splint) will be applied to the leg, to prevent licking of the wound. The bandages may be changed every few days. Elizabethan collars should be used for dogs who are adamant about licking the bandages. Weight-bearing and range-of-motion exercises will be determined by the surgeon. Exercise is important to prevent contractures of the toes and to decrease swelling in the limb. Most dogs resume normal activities within one to two months after surgery. Medications that are routinely used after surgery include antibiotics and pain medications.

Chemotherapy is usually started 2 weeks after surgery to prevent development of metastases. The type of chemotherapy should be discussed with the oncologist. If no chemotherapy is given, there is only a 10 percent chance your dog will be alive one year after surgery. However, if chemotherapy is given, the 1-year survival probability is 50 percent and the 2-year survival is 30 percent.

The most commonly reported complications with limb-sparing surgery are implant failure, local tumor recurrence, and infection. Implant failure occurs in approximately 10 percent of cases.

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