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Sophie has a mast cell tumor


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Hi all,

I recently found a small lump on Sophie's leg right where the hock meets the thigh. It's about 3/4 of an inch in size right now. I took her to my vet yesterday, and he did a needle aspiration. He just called me and told me it is a mast cell tumor. He didn't grade it, but he said it was malignant. She'll need to have it surgically removed, and he said normally there is a very high success rate when treating mast cell tumors with surgery alone, but it is important to have very clean, wide margins for the surgery to be successful. Unfortunately, due to the placement of Sophie's tumor (basically on the front of her hock at the joint), he will not be able to get a big enough margin all the way around the tumor to ensure he gets everything, so she will need chemotherapy as well. Does anyone have any experience or knowledge about treating mast cell tumors that they'd like to share? Sophie is my first dog, nearly ten now, and the one who changed my life. I am a little devastated but trying to remain rational and educate myself about what to expect.

Thanks!

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I have no advice or experience, but I wish you and Sophie the very best possible outcome. I am sure you are quite upset and I am feeling for you. Thoughts and prayers from WV.

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I'm sorry to hear you had to get bad news about Sophie. It is never easy to deal with cancer.

 

Before you do anything I would speak with an oncologist. It would be well worth your money if you are considering chemo to hear an expert's opinion.

 

I don't mean to shock you by asking this, but have you considered taking the whole leg? Chemo in dogs very rarely gets all of the tumor cells. Veterinary oncologists use relatively low doses as compared to human doctors because pet owners put quality of life first. In humans higher doses are used hoping for a cure, but higher doses makes for much worse side effects. I know some oncologists prefer radiation treatment for mast cell tumors.

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Just my experience...

 

Casper, out 13+ year old BC, was diagnosed with a Mast Cell Tumor when he was 11. Evidently it is a common cancer in dogs. The tumor was on the underside of his tail (near his anus, Ouch!). Seemingly, the most recommended treatment is surgical removal, but the recommendation is also to remove 2 centimeters of surrounding tissue. The basis for the diagnosis was four (4) needle biopsies. They were all sent to Texas A&M and the results came back Mast Cell Tumor. Well, we thought about not doing the surgery but our vet convinced us to do it. They cut him from stem to stern and needless to say he had a terrible time healing. Every time he wagged his tail he pulled his stitched out. We ended up letting him heal from the inside out. They sent the tumor off to A&M and the results came back totally different from the original diagnosis, the tumor was benign. It seems that the way mast cell cancers are detected is through the release of histamines which can mask the true diagnosis. Anyway we were lucky, perhaps you will be too.

 

My thoughts and prayers are with you!

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I've already sent some information to Laura, but just thought I'd post here as well in case anyone else ever has questions about mast cell tumors.

 

Willow and I have been dealing with this type of cancer since fall 2008, when I noticed a lump in her groin. We started treatment with my holistic vet and alternative medicine, neoplasene, largely because the tumor was in a difficult-to-operate-on spot. The neoplasene actually took a good part of the tumor away and then that January on recommendation of my holistic vet, I had an allopathic vet (same practice) remove the rest surgically. She was unable to get wide margins because of the location, but was able to get a margin at least and was reasonably certain she had gotten it all.

 

Pathology showed it to be a grade II, with no active mitoses. Within 4-5 months, the tumor was back, though it had a changed appearance (instead of being a lump it was a series of long ropelike structures, resembling a river delta). We put her on high-doses or prednisone (mast cells are part of the immune system that deals with allergic reactions, so the immune-suppressive effects of prednisone was what we were working for), which knocked the tumor back again, but was miserable for us because Willow was already incontinent (and taking PPA) and on furosemide for her heart problem--she leaked urine pretty much constantly. Once we finished that regimen, the tumor was in remission for a couple of months and then reappered in the fall, appearing as several lumps, but along the same pattern as the previous time.

 

At that point we made an appointment to enter her in a clinical trial, but by the time of my appointment the trial had been closed. The oncologist opted to try her on Palladia, a new c-kit inhibitor medication that has had some success and was recently out of clinical trials. Willow's tumor actually shrank over the first couple of months while on Palladia, but over the next couple of months she stopped responding, and the tumor started to progress, so we are trying a different c-kit inhibitor, which, according to the oncologist, works a bit differently from the Palladia and might work since Willow did have a good initial response to the Palladia. This new drug is from France and we're getting it through a compassionate care agreement. It's called Masitinib. If this doesn't work, we'll probably go back to more traditional chemotherapy. And I will have to decide just how much more I want to put Willow through. For now, she is in good spirits and although the tumor irritates her enough that she licks at it, she's not having any real obvious health/quality of life side effects yet.

 

According to Willow's oncologist, mast cell tumors can create ulcer-like conditions in the stomach, so Willow is taking Pepcid AC daily. Additionally she takes Benadryl twice a day--it's antihistamine action is supposed to counter the histamine-release of the mast cell tumor. I'm sure your oncologist will tell you this as well, but both do seem to help Willow to not be so bothered by some of the side effects of the histamines, etc., that result from the presence of the tumor.

 

When I first went in for a consult, Dr. Kozicki said that Willow could have additional tumors internally. The only way to know was to do ultrasound, but given my unemployment and tight finances, we opted not to do that since knowing whether there are additional tumors wouldn't change the course of treatment anyway.

 

On grading these tumors, apparently a vast majority will fall into the Grade II category. In addition to giving the tumor a grade, the pathologist will also look for actively dividing cells in the sample and note how many--this is to give a better idea of where within the Grade II a particular tumor falls. But it's no guarantee. Willow's biopsy showed no actively dividing cells, and yet according to Dr. Kozicki her tumor is behaving more like a Grade III tumor (recurring repeatedly), so while the pathology report is helpful it's not necessarily definitive with regard to how the tumor will behave.

 

That's our journey so far and it's all I can think of for now. I know it's a lot to think about, but at least for Willow, a year and a half from when I first noticed the tumor she's still going strong and doing all the things she loves to do. Her two bad knees seem to give her more trouble than anything else!

 

J.

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Thanks everybody for your much-appreciated support, information, and experiences, and special thanks to Julie for writing up such a helpful, detailed post! Liz, I hadn't thought about amputation, but I will ask the oncologist about it when I get a consult. Thanks for alerting me that this may be an option.

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I havent had any experience with the mast cell tumors , but I do wish Sophie all the best.

 

I am so sorry for this very sad news. Stay STRONG and stay POSITIVE Laura. Sophie needs you to be strong for her so she can fight this . With you by her side , she will put up the best fight she possibly can. The both of you will survive this together .

 

You to will be in my prayers.

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My lab mix Chilli has had 2 mast cell tumors removed over 2 years ago. My vet took very wide margins and when they sent them away for biopsy they came back with clear margins (and was graded a 2)! NO repercussions at all! (Knock on wood!) They are very common, and can return. If I were you and I were worried, I would have her blood work done and an xray to see if you see anything internally "fishy". But STAY POSITIVE!! I do give Chilli Quercetin (http://en.wikipedia.org/wiki/Quercetin) as a supplement.

 

We'll be thinking of you and crossing our fingers & paws!

 

~Amanda & Chilli

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How upsetting. We had a scare with Scooter when he was only two with a possible mast cell tumor in just about the same area as Sophie's. One of the vets in the practice (not his usual one) took a look at the lump, tried to do a needle biopsy, said she couldn't get anything from it and scheduled him for surgery to see what it was. I left the office completely devastated, but as the day went on and I started to think more clearly I decided to get a second opinion. A few days later another vet had no problem with the biopsy and it came back negative. That second opinion saved Scooter from unnecessary surgery.

 

I certainly don't mean to cast doubt on your vet's competency. I'm just wondering if you should maybe get a second biopsy done on Sophie too since this is such a serious diagnosis you've received.

 

Whatever you decide, prayers being said for you and Sophie during this difficult time.

 

Pam

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Thanks again for all of your support and information, everyone. Sophie has very recently had blood work done, and we are planning an x-ray while she is under for the removal of the tumor. To help keep costs down, my regular (awesome smile.gif) vet is doing the surgery, and then I'll consult with the oncologists here. (I am very fortunate to live in an area with two very well regarded canine cancer treatment centers within an hour's drive--my other option is Colorado State University's vet school.) The surgery is scheduled for next Tuesday, and I'll have a much better idea of what we'll be dealing with after the tumor is analyzed at the lab (it hasn't been biopsied yet, Pam--my vet just did a needle aspirate and found the mast cells "everywhere," sigh). I'm crossing all my fingers and toes that it'll be graded a one and the vet will be able to get clear margins, even if they can't be very wide.

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I'm crossing all my fingers and toes that it'll be graded a one and the vet will be able to get clear margins, even if they can't be very wide.

 

 

I have my fingers crossed for you too and hope and pray that is the outcome of the surgery. I am so sorry Sophie has this, good luck for Tuesday. Keep us posted on how she is doing.

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  • 2 weeks later...

Thanks for asking, Megan. The surgery went pretty well. Sophie was on prednisone for a week before the surgery, and it did its job of really shrinking the tumor nicely. It was still a difficult surgery because apparently there is a major artery right at the site of the tumor. But the smaller size meant that the vet could stitch up the wound instead of having to leave it open to heal, so that is good. Now we're waiting for the histopathology report to see what the next treatment steps will be. We have an appointment with an oncologist next week and will decide whether to treat with chemotherapy or radiation then. But Sophie's x-rays looked clear, so at first glance it doesn't look like there are any other tumors. We are cautiously optimistic right now. And Sophie is doing great today. :rolleyes:

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