Amputation and Chemo

Maggie had her left rear leg amputated on September 7, 2006 due to a large mast cell tumor in her knee.  The tumor could not be surgically removed from the leg.  She was sent home the next day on the following medications (she weighed 17 lbs at time of discharge):

Fentanyl patch, 25 ug to remain in place on right rear leg for 3 days.  Pain med.

Tramadol, 50 mg tabs.  Give .25 tab every 8 to 12 hours (2 to 3 times a day) as needed for pain.  I think we used 2 per day for a week and a half, then stared to taper down.  She took at least one dose a day for 14 days.   Pain med.

Clavamox, 250 mg tabs.  Give 1 tab twice a day for six days.  Antibiotic.

She had also been on the following for a week prior to surgery, and continued on until suture removal (14 days post amp):

Benadryl, 25 mg caps.  Give 2 caps twice a day.  Standard supplemental med when dealing with mast cell cancer.

Pepcid AC, 10 mg tabs.  Give 1 tab once a day.  Standard supplemental med when dealing with mast cell cancer.

At this time the prognosis was good pending biopsy results, I was not expecting further treatment.

When the biopsy results came back her prognosis was down graded to fair, with a 6 to 9 month average survival time WITH chemo treatments.  The official diagnosis reads “Mast cell cancer with regional lymph node metastasis”.  Cancerous mast cells were found in the lymph node removed with the leg.

Maggie’s chemo treatments started on September 21st, two weeks after her amputation.  Her last chemo treatment was on March 1st 2007.

The mast cell tumor protocol used by our vet was a combination of two drugs, with a scheduled treatment every two weeks, the drugs were alternated each treatment.  There was a total of 14 treatments, 7 of each drug. The two drugs used were CCNU or Lomustine, an oral drug, and Vinblastine, an IV drug.

Mag spent the day at the oncology vet for each treatment.  Prior to the CCNU treatment blood work completed was a CBC and comprehensive chemistry.  Prior to the Vinblastine treatments  blood work completed was a CBC.  If she seemed nauseous between treatments or off in any way we completed blood work at our local vet during the ‘off’ week.  Treatment had to be postponed once due to a low WBC.

The treatment stradegy was to start with low doses of each drug, and increase the dose with each subsequent treatment until she had a negative reaction.  Then the dose was dropped back to the last value that did not cause a negative reaction, and that dose was continued for the remainder of the treatments.  The negative reaction in each case was nausea.  We never had vomiting or diarrhea.  There was some tiredness or fatigue noticed about 7 days after each treatment.

In addition to chemo drugs Maggie was also perscribed:

Benadryl, 25 mg caps.  Give one cap twice a day.

Pepcid AC, 10 mg tabs.  Give one tab once a day.

Prednisolone, 5 mg tabs.  Give one and one-half tabs once a day for two weeks, then one and one-half tabs once every other day throughout chemo treatment.  Chemo was completed on March 1st.  On March 29th we began to taper off of the pred.  Her last dose was May 13th, a taper of about seven weeks.

We also had metoclopramide, 5 mg tabs.  We were to give one-half tab every 8 hours as needed for vomiting or nausea.  We only needed it a couple of times after the Vinblastine treatments.

During chemo treatment I kept a log of all meds given, her mood and energy level, her appetite, etc.  I also had to monitor her temperature which I recorded in the log.  This helped me keep track of which meds to give when, and gave me an overall view of her condition during treatment.

5 thoughts on “Amputation and Chemo”

  1. Hi there. My 5 year old lab had a MCT removed last May. We went through a course of Vinblastin treatment and prednisone, which was completed in January this year. Today, we found a new tumor near the original one. I immediately called the oncologist and had her seen. She took a sample and confirmed MCT. She started her on the Vinblastin again. I am to watch it for a week and then call the office and let them know whether the tumor has increased, decreased or stayed the same. Then we will discuss further treatment options.

    She did mention amputation, however, also thinks that the tumor is in the lymph node…which from what I am learning, means that it is most likely spread throughout her body and amputation will not help.

    Honestly, I am not sure what I am asking. She is a young girl and of course we love her dearly! We rescued her when she was 2. And almost 4 years with her is not nearly enough.

    Any help or advice is welcomed. Thanks!


  2. Hi Jeanene,
    I’m sorry to hear about your pups diagnosis. Would you mind if I send you an email? I have the address from when you posted here.

    You can also consider joining Tripawds and posting questions there. Not many of us who dealt with mast cell cancer, but there are a couple. It doesn’t matter that your pup is not a tripawd- tell them spirit Maggie’s mom sent you!


  3. Hi Karen,

    Beautiful story and thank you for sharing.

    Our 8 year old pug Penny was last week diagnosed with a recurrence of multiple MCT’s (7 of them) on her hind leg. Due to the extent of the tumors our vet has suggested that the leg be amputated.

    Naturally we are all very upset and my wife and kids are particularly distraught, we are weighing up other treatment options (radiation therapy etc.) and will seek other opinions however we have been advised that amputation is the most appropriate treatment.

    We have so many questions to ask the vetinery surgeons, and we will, however what we also would like to find out from someone who had a pug go through it, was how well does a pug with a rear leg amp adapted cope with what were previously routine activities and what the quality of life is like for the dog after the operation?

    Please feel free to email me and any response would be appreciated.



  4. Karen, thank you for sending me the link to this. It truly helped.
    Thanks again

  5. Thank you for sharing your experience. It’s interesting to learn about other dogs’ treatments.

    When we found out that our dog had a high-grade mast cell tumor, the oncologist suggested alternating Lomustine and Vinblastine (with Prednisolone once a day). She responded well to Lomustine, but 2 weeks later, she took Vinblastine and 2 days after taking a capsule of Vinblastine, we noticed a new mass on her paw.

    The oncologist encouraged us to continue the treatment, saying that it would allow us to see if it was effective, as the mass should decrease. However, the mass only increased, leaving us with only the option of amputation.

    6 days after the amputation, Kelly is doing much better. We will see the oncologist again on March 20th to decide on the next steps in her treatment. He has ruled out Vinblastine due to its ineffectiveness. I hope we can find an effective treatment to fight our dog’s cancer!

    Do you have any resources that we could consult to prepare for this?

    Thank you very much!

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