What to Expect

[sea4th]

Two weeks ago I brought back home a border collie. She is almost 15 yrs. old. About six weeks ago, the person who she lived with noticed a swelling on the side of her face and assumed it was an abcessed tooth, even though the dog continued to eat with no problems. It turns out it a rapidly growing tumor on the side of her cheek that could have been easily removed had it been caught in the first week, but the by the time I was able to get the dog, three weeks later, the tumor was so big that removal and resectioning of the area presents as much of a danger as the tumor itself. So we sit and wait now for this dog to die. Her heart is strong, she loves to eat and other than the tumor is in great shape.

 

A couple of weeks ago, she began to drool. The tumor is bleeding from the inside and the drool is more blood than saliva.

 

There is also an odor---nectrotic tissue(?) is what I think my vet said.

 

We agreed that surgery would not be a good idea at this time and while she's doing well, eating and enjoying life, then she can spend her days dozing under my bed or outside in the sunshine.

 

But other than not eating, what can I expect? My vet said that the bleeding might lead to anemia. (I didn't think to ask at the time what the symptoms of anemia in a dog are). Is this tumor likely to burst? My vet said it might get to the point where she can no longer close her mouth. It's not in a position where it would send runners into the brain and kill her that way.

 

Her face is disfigured by this tumor, but at this point in time---that's it. Her weight is ideal, her coat is looking great. She loves to eat----

and I know it's a death watch right now, but I'm wondering what to expect.

 

Thanks.

 

Vicki

[Gary M]

Vicki,

Bless you for your kindness.

As far as knowing what to expect I can't help.

 

I know its a hard decision, but a few years ago we had to make a similar choice on an older dog. We opted for the surgery knowing that the odds were tremendously against us and that the rehab after surgery would not be pleasant for us or the dog. We went for the surgery and because of it was able to have our little sweetie for 2 more years. It was a "nothing to lose" proposition and had the surgery not gone well we would know almost immediately and could prevent any lingering pain and at most lose a few weeks of companionship, which we had prepared ourselves for.

 

Our best wishes are with you.

[AK dog doc]

Depends on the type of tumor, unfortunately; they all have their "typical" behaviors, but even so, in individual cases they may not act as expected. That's the thing about cancer: it does what it wants, which is why it's cancer in the first place. If it was listening to normal inhibitory cues, it wouldn't be cancer. However, if you're noticing an odor, that might be an indicator to try some antimicrobials - if there's necrotic tissue, bacteria will be having a field day in there. It'll make her smell better (and maybe taste better to herself) and be one less thing she has to contend with. Also, judicious use of steroids will knock back many tumor types for a while (a temporary effect, usually lasting for 30 to 60 days). However, like all medications they have side effects, so you need to balance the benefits against the costs and make that choice on each individual case. If she develops pain at the site, some painkillers may be of use (these are NOT always appropriate to use in combination with steroids, so be sure you get good clear advice about that part from your vet).

 

The drooling will probably continue and may worsen. She may not care about this. What she does care about is if she feels well and can be a dog. So long as those two things are going for her, she'll have some enjoyment of her life. While she doubtless knows her face is different than before, she has no idea she's sick, so at this point it's all about her quality of life.

 

I'm not sure (without a biopsy) what kind of tumor it is, but it might or might not spread to distant body parts. You can try feeling the local lymph node to see if that's enlarged, but if there's bacterial infection in the tumor it'll be enlarged for that anyway, whether or not it's also enlarged due to invading cancer. Tumors also love to go to the lungs and liver (though they can go anywhere that blood goes), so watch for difficulty breathing and GI upset, as well as jaundice (look at the whites of her eyes for this). Naturally you'll want to watch for pain, pallor (her gums getting pale, which might indicate anemia), lethargy and difficulty eating, as well as marked weight loss. In human medicine, patients report that the two greatest negative impacts on quality of life are difficulty breathing and extreme thinness. We have to assume dogs feel the same way, so if either of these things occur, her quality will go down.

 

As a BTW, even if the tumor had been resected when small, depending on the type, it might've only delayed things a bit - some of them are difficult to get good margins on. Some are also worse in certain positions - for instance, squames that occur in the front of the mouth act much less agressively than ones which occur in the back of the mouth - the farther back you go, the more agressive they are. I have no idea why this should be so. Also, there's a tumor type called a histologically low-grade, biologically high-grade sacroma (HLG-BHG for short) which tends to occur almost exclusively at the upper carnasial teeth (the last premolar, the big shearing tooth on the side of the mouth) which is a bad actor even though under the microscope it looks like a mild-mannered little thing. Why this is, I have no idea, but if there's a disagreement between what the slide says and what the dogs says, believe the dog.

 

At any rate, I'm glad the old girl has someone to coddle her a bit during her illness. It's sometimes a tough call deciding when exactly the right day is to stop, but I'll tell you this: I've never once had anyone come to me and say "I'm so sorry I euthanised my dog two days too soon." I've had a LOT of people come to me and say "I'm so sorry I euthanised my dog two days too LATE."

 

Let me know if you have specific questions, and sorry I can't be more exact about this. Good luck with her, and bless your heart for helping her through this.

[Cheri McDonald]

Our thoughts are with you both. Vicki you amaze me, you are so much stronger than I could ever be. There will be a special place for you across the bridge!

[sea4th]

There will be a special place for you across the bridge!

With my luck, my ex will be waiting for me on the other side of the bridge. LOL----but thanks.

 

Vicki