People often tell me they think the hardest part of my job is euthanasia. Yes, that can be emotional and very sad but it’s not the hardest part for me. I have to take a deep breath and compose myself when I am entering an exam room to give a client a diagnosis that I know will eventually take their pet’s life. One of those diagnoses is osteosarcoma or cancer of the bone. Often found in the long bones, a dog will come in limping and their parent is thinking it is a strained ligament or sore hip, but in actuality, I have to tell them their dog has cancer and will die from this disease. It’s heart breaking. Truly.

After the shock of that conversation, the talk goes to treatment options and the inevitable questions of “What would you do if it was your dog?” and “If I do all of that, how long will my dog live?” Those questions can be hard for a veterinarian to answer but can go hand in hand when making a decision. If your dog will live 2 years with a great quality of life if we amputate and perform chemotherapy, would you choose those options? What if your dog will live 2 months and struggle through the whole process, would you still treat him?

On average, a dog with a long bone osteosarcoma will live for about a year with amputation and 5 treatments of chemotherapy. I give my clients those numbers because they ask for them, but it is a median survival time. Some dogs live much longer. Some are euthanized or die while still healing from their amputation. It can be a difficult conversation to convey the hope their dog could beat the average while still being rational that the opposite could occur.

This brings me to the stories of Floyd and Bailey.
Bailey is a 9 yr old German Shepherd diagnosed with osteosarcoma in June 2022. Her chest radiographs were clear of metastasis and the amputation went well. She started chemotherapy shortly after her amputation healed and overall was not doing well after chemotherapy. She was not eating well, was developing a fever, had very low white cell counts, and was quite lethargic. We decided to stop chemotherapy but she still didn’t improve on supportive care, pain meds, and antibiotics. Within 3 months of amputation, Bailey had developed a large mass in her abdomen and she was euthanized due to poor quality of life.

Floyd is an almost 12 yr old German Shepherd diagnosed with osteosarcoma in April 2021. At that time, we also found a tumor in his mediastinum on chest radiographs. Did he have 2 cancers? Should we still amputate the leg? Even with a CT scan, we could not biopsy the chest mass so Floyd’s owner just had to decide about his leg, not knowing if the mass in his mediastinum would become a big problem sooner or later. His owners decided to amputate and do the five rounds of chemotherapy post surgery. Floyd continues to do great! He has a normal quality of life almost 2 years later. The mass in his chest has grown significantly but it is still not bothering Floyd. I plan on rechecking him in 3 months just to keep on eye on everything.

Median survival time. That’s all it is. An average amount of time dogs will live after an amputation and chemotherapy. It’s impossible to know if your pet will be the Bailey or the Floyd in this scenario. This is one of the many reasons making decisions for your pet’s care can be so difficult. I have been in a similar situation with my own pet and felt the same agony I see on my client’s faces when they try to make the best decision for their dog. So what is my advice? Trust your gut, you know what is best for your pet and allow yourself grace if the outcome is not what we were hoping for. You made the best decision for your pet with the knowledge you had at the time and that is the best we can do for beloved pets.