15 Month Old Boxer
Hi all!
Back in May, our then 13-month-old boxer, Scout, was believed to have partially torn her CCL since she was still weight-bearing but occasionally toe-tapping. They treated it as such and hoped for a recovery, but it progressed to a full limp and non-weight-bearing. Since the beginning, she's been on carprofen. Once it progressed into a full limp, they added gabapentin.
TPLO surgery was scheduled, and at the consult, the DVM felt the mass on her inner tibia, which I pointed out early on during the diagnosis of her CCL. It was believed to be scar tissue early on. They did X-rays and believed it to be, unfortunately, osteosarcoma. This vet wanted to amputate and send the leg in for testing, rather than biopsy to know what we were dealing with. (Cart before the horse?) I called my normal vet (they don't do TPLO) and we decided a biopsy was the best route. On 7/9, it was performed with the DVM noting there was fluid in the joint, as that is not typical of osteosarcoma. He was able to get 3 good samples and one deep right where the tumor is. (Can see the biopsy in the X-rays.) A little over a week later, with retesting, it came back as:
"The sample consists primarily of well-differentiated bone along with reactive bone and areas of fibrosis. Overt evidence of neoplasia is not observed."
At the bottom, with the secondary observation, it had this:
"Obtaining biopsies from bone cases like this is extremely difficult. Within the submitted sample, there is no evidence of neoplasia, but we cannot unequivocally state that this patient has no neoplastic change at this general location."
Assuming that's a COA.
Since 7/9, they placed her on clindamycin and amantadine, and continued the carprofen and gabapentin. The day after the surgery, she was using the leg somewhat again and has continued to occasionally use it, sometimes knuckling and/or toe tapping. Since the biopsy didn't really give any real answers, last Friday, 7/17, they also put her on fluconazole for a potential fungal infection.
Yesterday, 7/22, we had a follow-up appointment, and the vet is now again leaning towards osteosarcoma due to the X-ray getting slightly worse. I've been changing the contrast and messing with them; personally, I think they look better, but I am not an expert.
Currently, we have amputation scheduled in two weeks, 8/6. The vet wants to give the clindamycin and fluconazole more time to hopefully work. We will do more X-rays of the leg before making the decision to go or not go.
Blood was drawn yesterday as well; everything is normal there. The WBC count is at the lower limits of normal, which from my research really doesn't point toward or away from cancer or infection.
I know a lot of people have been through this or similar and are hoping for some advice or anything else we should be looking at. I know osteosarcoma is something boxers are predisposed to, but she would be on the extreme rare side at her age.
Obviously, we are absolutely devastated that our dream dog is going through all of this. We just want to make sure we are not missing something while also doing what is right for her.
Xrays are attached with the dates at the bottom.
Thank you for any input!