Sophie has a mast cell tumor

[AmandaMJL]

So happy to hear the surgery went well! Here's to a speedy recovery!

[Laurae]

So I got the histopathology report back today. It was definitely a mast cell tumor. (We were hoping it might not be, since the vet found a previous injury at the site, and apparently sometimes old injuries can trigger the appearance of mast cells without it being cancer, like what happened with Ancient_Dog's Casper. Unfortunately, that was not the case for Sophie.) It's classified as a grade I, which is good, and the vet got 1mm at the deep margins and 4mm at the lateral margins. We really needed to get 3mm margins all the way around, so looks like we're going to the oncologist Wednesday. But hopefully treatment will be simple, since the tumor is graded a I.

[Pippin's person]

Good news on the grading. Keeping fingers crossed that the treatment is simple. Give Sophie a hug from MI.

[Shoofly]

Good news on the grading!

[Sue R]

That's some hopeful news - wishing you both the very best outcome!

[Laurae]

So it turns out treating this mast cell tumor thing is going to be a little more complicated than I'd hoped. Although her tumor was graded a I via the lab, it is presenting as more of a II, according to the oncologist. My options are to do nothing, and there is a high chance it will come back (and be more difficult to treat). Or we can do chemo for the next six months (at a cost of about $2.5K) and there is an 80 to 85% chance it will not recur for two years, but that number drops dramatically for five years. Then we can do radiation every day for 15 days (at a cost of about $4.5K), which will give us a 90% chance it won't come back for five years. If I had unlimited funds, of course radiation is what I'd do. But who has unlimited funds these days? Sophie will be 10 in May. I will probably do the chemo, but I know I will feel guilty for not doing the radiation. But to be honest, I can barely afford the chemo. This sucks!

 

ETA: A friend of mine just told me "sometimes it's better to let them go." I am not one for against-all-odds heroic measures, but I don't know if I could live with myself if I didn't at least try to treat this, considering two-year prognosis with chemo is 80-85% likely to be disease-free. Thoughts?

[Journey]

Laura, you do what you can do and don't second guess yourself. You can't put yourself and the other pups out on the street, reality sucks sometimes. Do you have a care credit credit card? If not, google it and sign up if your vet will take it! Also, have you spoken with any holistic vets? It won't if you have one in your area just to talk to one about what you and Sophie will be dealing with.

 

K

[Sue R]

Sorry that you are faced with this dilemma. DH and I have often discussed "how far" we'd go for one of the dogs, quality of their life, health of our finances, emotional issues, possible regrets, and so on. It is never easy. I think the important issue is not "how long" but "how good" a life Sophie would be expected to have under the different protocols, and also how good that time would be for you, as well.

 

I wish you the best in making a decision, and feeling that you did the best you could with whichever choice you make or feel is made for you by circumstances beyond your control.

[Alchemist]

Laura:

 

I'm really sorry that you find yourself in this situation. As Sue and Journey say - life sometimes poses tough decisions. Far too many factors are completely outside of any of our control. You can't second-guess anything. Hindsight is always 20/20, isn't it? Trust your instincts, don't forget the "reality check", doublecheck back on "regrets-based decisions", move forward, and don't look back. And {{{hugs}}} and lots of mojo support from the BC boards, whatever your decision.

[juliepoudrier]

Laura,

When I first went to the oncologist, I applied for a Care Credit card and let the office staff tell me what was a reasonable amount of credit to apply for given Willow's case. For me, it was $4k. Do I expect to spend that? Not really. Willow will soon be 13, so I had a very frank discussion with both my regular vet and the oncologist, and we are working within those constraints. I have been unemployed for nearly a year, so money is really, really tight. So I am trying to balance her care with the my needs and the needs of the other animals here. I can't bankrupt myself to care for one animal, no matter which animal it is (and Willow has a very special place in my heart as the dog that basically started all this for me). You can always ask your vet about possible clinical trials being conducted (it was the hope of getting into a clinical trial that sent me to VSH in the first place) and alternative treatments. I've kept Willow's mast cell tumors at bay for close to two years using a combination of alternative, traditional, and new treatments. I don't think our latest treatment with Masitnib is actually working, so I soon will be faced with the same choices you are being faced with. I don't even want to think about it (and I start crying when I do), but I think I could be okay with opting for less time for Willow as long as it was *quality time* if it also meant I wouldn't bankrupt myself or be forced to neglect needed care for the other animals. No one would fault you for making the hard decision to end Sophie's life. Remember that animals don't have the same sense of time or regret that we do and your decision won't be as hard on Sophie as it will be on you.

 

I'll keep you and Sophie in my thoughts and prayers, and sending long-distance hugs your way.

 

J.

[urge to herd]

This is really the suckiest part of being in love with and responsible for dogs, or cats. The previous posters have said everything, really, but I'm going to tell you that we spent several thousand dollars on Buzz, (age 10) treating his bone cancer, and the only thing I regret at all is insisting on him having the last chemo treatment, the 4th one out of 4 total. He was showing signs that the cancer was progressing, and I didn't want to let him go.

 

But, we bought him 3 good months w/the treatments, months where he would still chase his ball and go for walks and just generally enjoy being his goofy, lovable self. I would do it again, in those circumstances.

 

With Sam being just a couple weeks away from age 15, and Shonie being at least 14, I think I wouldn't put them through anything so drastic.

 

Whatever you decide, we all know that you love Sophie, and are doing the best you can for her. Sending prayers for your peace of mind, and Sophie's peaceful and happy days.

 

Ruth

[NorthfieldNick]

Laura, do for Sophie what you feel is best and what you can afford. In the end, it's the quality of the time you spend with her, not the quantity.

 

When my Lu was diagnosed with cancer, I had the same choices you do. I decided not to go for any drastic treatments, as in Lu's case, it would have extended her life by weeks, maybe. Looking back, I'm not sure it was really "worth" it putting her through surgery & recovery, but at that time, no one knew how far the cancer had already spread. I wouldn't do anything differently now. I knew when it was time, and even though I wanted so much to keep Lu around for me, I couldn't do that.

 

Don't second guess yourself. Dogs don't, we shouldn't either.

[Cody & Duchess]

Laura - so very sorry about Sophie. Your decision is unbearable. I wish that I had some profound input. Just know that we are sending only good thoughts your way. Good luck.

[PSmitty]

I'm sorry the news isn't better, Laura. Ditto what Ben said, though. In your shoes, if it would buy a few more years, I would opt for at least the chemo, maybe even the raditation. If I had to get credit to do it, I'd do it. But regardless, whatever decision YOU make, will be the right one for you and Sophie, I'm sure of that. ((hugs))

[Blackdawgs]

My dog had a Grade 2 and a wide excision was curative.

 

I'm curious, what is it about your dog's Grade 1 tumor that makes your oncologist believe that it is acting like a Grade 2? When I was researching my own dog's condition, the conventional wisdom was that a Grade 2 can act like a Grade 1 or a Grade 3. So, it almost seems to me like your oncologist has upgraded this to an aggressive Grade 2 tumor. Why?

Did the surgeon sample any regional lymph nodes when the tumor was removed? What is the indication that this tumor may behave aggressively?

 

Here is my suggestion....before making a decision, have your dog's slides reviewed by a second pathologist and have the dog's case reviewed by another oncologist. Slides and medical records are routinely mailed for second opinions--you and the dog don't even have to travel.

 

Good luck.

[Anda]

Laura, I am so sorry for the latest news. Give her a very warm hug from me!

[Laurae]

Thanks for sharing your stories and sending your good thoughts, everyone. It is much appreciated.

 

I'm curious, what is it about your dog's Grade 1 tumor that makes your oncologist believe that it is acting like a Grade 2? When I was researching my own dog's condition, the conventional wisdom was that a Grade 2 can act like a Grade 1 or a Grade 3. So, it almost seems to me like your oncologist has upgraded this to an aggressive Grade 2 tumor. Why?

 

Did the surgeon sample any regional lymph nodes when the tumor was removed? What is the indication that this tumor may behave aggressively?

 

There are a few reasons for this. The location of the tumor, on her hock, was one reason. Apparently, the area where the tumor appears on the body has a lot to do with how aggressive the cancer is. Tumors on the torso are often the slowest-growing, and most likely to be grade I, and there are some places (underarm, base of tail, ears) where tumors are typically often grade III. The leg is not a great place for a tumor to appear. Also, Sophie's tumor was fast-growing, as far as I know. I don't think it was there for very long before I discovered it, as I put my hands on my dogs a lot--I'm always removing burrs and giving scritches. It was also relatively large (I thought three-quarters of an inch was small, but I guess it's kind of large). In addition, the mass was not very well defined. Finally, she had taken prednisone for a week before her surgery, and while that did a great job of shrinking the tumor so it could be removed easier and with larger margins, the pred-treated tumor was what was analyzed at the lab. There is no way to know if the prednisone masked the true character of the tumor or if it curtailed the division of the abnormal cells. So the histopathology report is helpful in that it told us what the excised margins were, but its analysis of the tumor is not completely reliable.

 

Here is my suggestion....before making a decision, have your dog's slides reviewed by a second pathologist and have the dog's case reviewed by another oncologist. Slides and medical records are routinely mailed for second opinions--you and the dog don't even have to travel.

 

I suppose I can see what the oncologists at CSU say...I may do that, though I am starting to really be cognizant of how I'm spending my money. I have another option, which is to do nothing and then amputate her leg if/when it comes back. To be honest, though I understand dogs adapt really well to the loss of a leg, I am not sure how well her body would handle it, given that she already has some rear-end arthritis. I do think if she could no longer hike, for example, her quality of life would definitely be affected. I think I am going to do one round of chemo and see how she tolerates it and make sure I'm not putting her through anything too difficult. If she has a difficult time tolerating it, I'll reassess.

 

Thanks again, all, for the words of encouragement.

[bc4ever]

I look for your latest posts, but can barely bring myself to read them. It breaks my heart. Praying for you and Sophie for the best possible outcome.

 

Pam

[Laurae]

Someone recently asked me a question about mast cell tumors, and I was just rereading this old thread to help me remember what happened when Sophie was diagnosed. We had a good outcome, so I thought I'd update this thread. I did end up doing a full six-month course of chemotherapy with Sophie. She tolerated the chemo well--she didn't get sick or too terribly lethargic, and it didn't seem to take an unacceptable toll on her body. It did make her a little crabby, so I am sure she didn't feel super during treatment, but she really seemed okay. It has now been almost three years since the diagnosis and start of her treatment, and she shows no recurrence of the cancer. She will be thirteen in May, and her quality of life is excellent.

[Sue R]

It sounds like that plan of treatment worked out excellently for Sophie and for you!

[Dana Nichols]

What great news Laura! I'm glad Sophie is still going strong.

[Laurae]

Thanks to the timehop app on facebook, yesterday I was alerted to the fact that Sophie had been diagnosed with mast cell cancer exactly five years ago. Since I updated Sophie's status on facebook, I thought I'd share the news here as well, in case it may help anyone else facing a similar decision about treatment down the road. I am delighted to report that Sophie is going on 15 now, and so far the cancer hasn't come back. She is doing very well :-)

 

[Gloria Atwater]

Fabulous! That is wonderful! Give that sweet girl a hug from me.

~ Gloria

[GentleLake]

That's fantastic news! So happy it all turned out well for the 2 of you.

[mbc1963]

Excellent. It's wonderful to hear about good outcomes like this!