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Pathologic Fractures: Osteosarcoma's Painful Message
The following story is reprinted from GRI NEWS with permission from the author: Kelly Kennedy Yokoyama of Greyhound Rescue of Idaho
(Excerpt from Spring 2005 issue of GCNM News)

ďIím in an emergency right now with Faun.Ē These are the last words I wanted to hear when I got a call far from home about my dog. My nine-year-old, newly adopted Greyhound, Faun, had a diagonal fracture to the left humerus with severe swelling and possible nerve damage.

I was in Montana the night my husband called. I had just left Boise that morning with a friend who flew all the way out from Chicago to go on a camping trip planned months in advance to Glacier National Park. It was difficult to be far away hearing the bad news about Faun.

Apparently, after my husband came home from work, he let the dogs out in the back yard as we would usually do. He heard a cry and saw Faun unable to walk on her left foreleg. Not having much experience with dogs, especially injured ones, my husband was in a panic and being new to the area we werenít familiar with the animal hospitals. The accident occurred on a Friday night; the nearest vet wouldnít do the surgery Faun needed until Monday. We didnít want Faun to have to wait that long and it was very difficult to immobilize her leg to move her, especially since we have small cars. Finally, my husband found a vet who would do the surgery the next day..

After returning to Boise, I went to see Faun. She looked awful. She wasnít fully conscious, was breathing hard and her temperature had risen. I felt terrible seeing her like this and really started to wonder if she was going to make it. That night her temperature returned to normal. She stayed at the hospital for a week. She came home with pain medicine, antibiotics, and her leg pinned and wrapped. She was able to get up and walk a little and she was eating and drinking normally..

The doctors said she may have damaged the radial nerve which was very close to the injury site. If this were the case, she would not be able to ever use her leg again. It was an unusual place for a bone fracture. A dog usually must suffer quite an impact to break that part of the foreleg. We thought maybe she had run into something and being older, had weak bones or possibly a previous racing injury since we knew nothing about her past..

"Faun" after First Fracture

Faunís first surgery took place on July 12. On July 30, Faunís leg bandage was removed. She still didnít walk on her leg, but she seemed to have feeling in it. X-rays were taken August 8 and August 22. The x-rays showed no sign of the bone healing back together Ė it looked like a ďnon-union.Ē It was so disappointing. Everything else had healed well and I was expecting her bone to be fine, too. I worried about what to do. I didnít think amputation of a front leg was a good option with a large, senior dog that likes to be active. There was only one other choice left and that was to do a type of reconstructive surgery. Since Faun was still active and healthy, I decided to go with trying another surgery although there still werenít any guarantees..

The whole time I thought about what to do with Faun, she seemed to be looking at me as if to say, ďDonít give up on me.Ē It just wasnít her time to go and I had to try one more option. I noticed that she started to progressively use her leg more, which I took as a good sign..

She was scheduled for surgery on September 18. When the day came, I asked the vet to do one more x-ray before the surgery because I felt that the bone may have improved on its own. To our relief, they said it had!.

On October 20, Faun had the pin in her leg removed. We were so relieved and happy. We thought the hard part was over and she seemed to be slowly recovering. She was able to go for short walks and the leg was looking healthier and functional. Then in February, she started to limp again. I took her in for an x-ray to the same vet to make sure the bone setting wasnít disturbed. The vet couldnít see anything wrong and prescribed some pain medication..

Right after she had her leg checked, I had to unexpectedly leave her to attend a funeral in Michigan. While I was gone Faun didnít improve and she had another accident. She slipped on the floor and her leg was worse. When I got back home I could tell she was in a lot of pain. I took her back to the same vet for more x-rays. They still didnít see anything wrong except tissue inflammation; again sending me home with pain killers and antibiotics. I saw no improvement..

After being encouraged by a member of the Greyhound adoption group to take Faun for a second opinion, we had her original x-rays looked at and a whole series of new x-rays done. It was discovered that she did indeed have a slight fracture, but that was the good news. That day I also found out that she had bone cancer. A cancer tumor was actually spotted by this new vet on the emergency hospitalís original x-ray from July when she mysteriously broke her leg. It was a tiny but deadly weak area in the bone. That would explain the slow bone growth. I found it quite incredible that she had any recovery period at all and had so much energy. Faun was diagnosed with bone cancer on the evening of March 12 (although it had begun its deadly invasion months earlier) and she barely made it through the weekend until I had her put down the morning of March 15. Even in all her pain on the last day, she still enthusiastically jumped into the car excited to be going for a ride. At that moment, she didnít look anything like a cancer victim except for her swollen leg..

Editorís note: Faunís fractures were what are termed ďpathologicĒ in nature Ė this basically means there is underlying disease responsible for the break. This type of fracture should be suspect when there is nothing to suggest severe trauma having occurred to produce the break. Many veterinarians are aware of the high rate of osteosarcoma in Greyhounds, but it is wise to mention this to an attending vet anyway. If supplied with an accurate history which suggests there was no severe trauma to the fractured area, a vet should immediately suspect the fracture could be pathologic in nature and should consider bone cancer when evaluating x-rays and the injury site. Any Greyhound limping and especially if exhibiting swelling in the leg should be closely scrutinized for the possibility of bone cancer.

 


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