treating cancer

[muddy bob]

Have any of your dogs been treated for a cancer that comes down from the roof of the mouth on a sort of stem? I refused the MRI for financial reasons but she displays no symptoms of it having spread into the nasal cavity. Nor do the chest x-rays show any obvious problems. The doc seems to think the odds of success for surgical removal are pretty good as the overall health is really good even though she is ten years old.

I think we'll go for it but I'd like to know of any similar experiences anyone has had.

[Little Bo Boop]

I can't tell you about that particular cancer, but I have had a dog with cancer, and he had surgery, his spleen was removed.He was 12 and came through the surgery with no problems whatsoever. Unfortunatley his cancer was a pretty nasty aggressive one, and the odds were against him from the start. If your vet thinks that this is a localized tumor, that has not spread/metastasized to the other regions of the body and/or nasal cavity, then I would go for the surgery. In addition I would look at helping your dog out with immune system building supplements, and maybe take a look at his/her diet in general. Good luck I hope I never have to deal with cancer in any of my buddies ever again. It really sucks.

[AK dog doc]

Two things: One, If it's pedunculated (as in, a big mass on a little stem, like a mushroom), resecting it is usually less involved than if it is not.

 

Two, whether or not it's malignant (which you can find out by sending it in for histopath after it's removed), it constitutes a space-occupying mass that is likely to get debris and bacteria packed around it, which is likely both uncomfortable and a potential health hazard. Hence you have a reason to remove it regardless of whether or not it's malignant, and you have the opportunity to find out after it's resected whether or not A) it's a malignancy, and if you have clean margins.

 

(FWIW, I'm doing a similar surgery tomorrow on a 10-y.o. Boxer.)

[muddy bob]

It is pedunculated. It is also lobulated. But my regular vet won't see us until the results from the biopsy are returned. I had all this work done at the emergency vet this weekend because I was too upset to wait.

Please let us know how it goes with this boxer. Of course it is of particular interest to me.

 

Muddy

[AK dog doc]

Boxer did great in surgery (which took about 10 minutes). I found another similar mass (though much smaller) on the other side way in the back and took it as well. The owner declined the histo; in view of age and breed, she feels that if the mass recurs to the point of being a problem, she's likely to euthanise (I should point out that this dog is one who she got 10 years ago as a puppy with serious problems, and it's something of a miracle she's still alive, really.) I'm leaning strongly toward these being epulides (the dread-sounding but not-so-bad-acting acanthomatous epulis), but of course we'll never know without the biopsy. I think this dog's case was more about getting the masses out of the mouth, since the dog was biting them accidentally while eating and the other dog was obsessed with the mass side of the mouth, and annoying the daylights out of the older bitch by trying always to lick inside her mouth. I'm sure it was niiice and smelly in there, since there was a nice wad of slimy and bacteria-laden grass and hair wrapped around the base of the big one, along with some gingival ulceration and infection. It remains to be seen how she does in the long run, but I'm feeling kind of positive about it so far. Her mouth already smells better, and I think once the gingiva heal, she'll be significantly more comfortable. As a fringe benefit, her lip no longer bulges out to the side like she has a wad of Red Man in her mouth (MOST unfeminine!)

 

I'll be curious to hear the results of the biopsy on your dog.

[muddy bob]

We now know this is a low grade sarcoma. From everything I've learned I should take this as good news as it could be much worse.

She is scheduled to have it removed on monday. The risk is that the pallette may be shortened by the procedure, increasing the risk of food aspiration. There are other risks too, such as not being able to get the whole thing. I'm told that in that case these sarcomas respond well to (read killed by) radiation. I'm also told that it is not easily accessible and quite expensive. One step at a time. But I'm not sure how much I will financially endure. It is not a case of "how much do I love the dog". I am real tore up.

Has anyone ever done radiation with a dog. What do they mean by expensive?

 

muddy

[Rebecca, Irena Farm]

I'm really sorry you are going through this, muddy. Thankfully I don't have any direct experience with cancer but I wanted to send you my hopes and prayers that you will have much more quality time with your dog and that future decisions regarding her care and treatment will be straightforward and not too much of a hardship for you.

[juliepoudrier]

Muddy,

I have not personally had to deal with something like this, but my landlord had a dog with cancer in her jaw. Surgery and chemo (not sure if they did radiation) ran somewhere close to $20,000. But the surgery was much more involved (pretty much removed the jaw) and the owner was basically pulling out all stops. Your best bet is to ask your vet to give you an estimate of costs, best case and worst case and then go from there. Also I think I'd wait to see how the surgery goes (how well she responds after the surgery) before worrying about the next step (radiation).

 

What a hard thing to go through and I feel for you. If it were me, I would consider quality of life issues before anything else. Frankly I think my landlord went to the extremes he did for *his* sake (he had bottle raised this dog) and put the dog through more than it should have had to endure. But of course that's just my opinion, and he did what he thought was right for himself and Sadie.

 

There is no shame in choosing not to continue treatment at some point and to eventually end her life. Loving her also means keeping her as comfortable as possible and being willing to end it when her suffering becomes greater than the joy she gets out of life.

 

It's never easy to choose to stop treating or to end a dog's life, but unfortunately it's one of those decisions that we all will eventually have to face when we give our hearts to our canine partners.

 

Please keep us updated on the surgery and how she's doing.

 

J.

[bc friend]

It's hard not to go to the worst case scenario but it sounds as though there is a good chance the surgery may be successful w/o a bad outcome. Yes, a bad outsome is possible, but so is a good one. Over the years I've had several pets with cancer - some were easily treated w/good results, others were kept comfortable as long as possible; when "success" meant lowering their quality of life, I didn't pursue any treatment except their comfort. Hopefully her surgery will go smoothly and you won't have to make any other decisions. We're always here to listen if you need to talk.

[Allie Oop]

So very sorry to hear of your dog's problems. Hang in there! My previous dog got cancer at age 14, but unfortunately, by the time we discovered it (he had no symptoms) it had spread to his lungs and was basically untreatable. At least you have a good chance with this surgery. I wish you the best of luck and hope all goes well.

 

Regards,

[Miztiki]

I hope the surgery goes well Monday. I know how difficult this is for you. I'm not famliar with sarcomas or radiation but I can relate to how you must be feeling. If you just want to talk and let it all out of your system then I'm just a click away. I'd be happy to help in any way I can, even if that just means letting you talk. It really helps to just be able to say what's on your mind sometimes and have someone just listen.

 

How did you come up with the name "muddy bob" anyway?

[muddy bob]

20,000 dollars! Holy moly. Surgery estimate for us is under a thousand and I thought it quite reasonable. That's even with a couple hundred bucks thrown in for unforseen expenses. And this new vet of mine, WOW, does he ever come recommended. I do have a very good feeling about it in general. This dog is not acting sick at all. The only reason I found the dang thing was because she was holding her head to the side while eating. I looked at her teeth but did not open the mouth. I figured she could use a good cleaning so I scheduled one. At one point I decided to give her one of the other dog's rimadyl and that's when I saw the THING. It covers the whole back of her throat and I can't believe I didn't know there was something wrong.

Now I have one more thing to pester the dogs with! They will all be periodically getting their jaws pried open for an "oral exam".

Hey, you ladies are great. Thanks for the encouragement. I'm really not doing as poorly as my last post may have led you to think. I think I just got cought in a moment of pity. Generally, I'm pretty tough.

 

muddy

[muddy bob]

Miz,

DH is terrible at names. He thinks everyone is Bob. When we first moved here he'd be talking about the neighbor, Bob. Then he'd talk about Bob again but in reference to the other neighbor. This went on until I realized we could not be surrounded by Bobs on all sides. The female version of this is Vickie. We do have a Vickie close by but not a single Bob to my knowledge. He doesn't even know he's doing it. He thinks that's the right name!

So when the colt was born he named him Bob. Officially, it's Sideshow Bob. You know, from the Simpsons. Unofficially, it's Muddy Bob because the mud shows up real nice on him. I needed a handle and I like the way it sounds. I get pretty dirty at work myself. But Muddy Vickie just doesn't have the some ring!

I know it's odd but you did ask.

 

muddy

 

P.S. I hope that the Boy continues to improve.

[Miztiki]

LOL! My husband suffers from Bob Syndrome too!

 

Every dog he sees is a Chihuahua and ever tree is a Pine! He doesn't have a clue what the different breeds or species are, so I just say yes honey, that huge dog is a Chihuahua and that flowering bush is a pine. Lovely, aren't they?

[AK dog doc]

Muddy, do you by chance have the histopath report? I'd be curious to hear exactly what kind of sarcoma it was, if I'm not prying.

 

I did radiation therapy on my first dog - she had a neurological tumor. I got 4 years after that - the best 4 years of her life, actually, because all those great things I was going to do with her "someday" I did today. MAN did we have fun. Some of my best memories ever.

 

As to cost, I can't say - I was a vet student, so I was getting the student discount. She had radiation for 3 weeks, one of which was pretty rough. After treatments were over, she had a couple of more days of not feeling great and then she just started getting better and better.

 

Every tumor is different, though, and there are different types of radiation therapy, so investigate a little before you decide. If the mouth is included in the radiation field (and in your case I don't see how it could be avoided) you're likely to have a side effect called mucositis, which is a right pain in the buttockal area (as they say) but only lasts for a little while. My dog Merrik had it with a vengance - but it didn't start right away, and it didn't last very long, only a few days after radiation was over. Also, if the eyes are included in the radiation field, you may have some retinal hemmorage about 6 months out, which might impair vision. Merrik had this as well, in her one remaining eye (the tumor was on the optic nerve of the right eye, which cost her that eye right off the bat). However, she never went blind - she did develop some impairment, but she remained visual 'til her death.

 

I traded her (all told) about 10 hard days in exchange for 4 top-flight years. That's a good trade, IMO. I was grateful for every day of it. I hiked that dog nearly every day in the mountains (sometimes twice a day), took her with me everywhere it was legally permitted (and a few places it wasn't), spent countless hours just appreciating her for what she was, snuggled her, played with her, petted her and cosseted her and generally gave her the best time I could. She was a happy little thing, and even though it was pricey (for a vet student) it was worth every cent. I'd happily have paid five bucks a day just to see her jump up and down when I came home. She'd have paid off that debt several times over in the time she had left, and if I prorated that over her entire lifetime, it was peanuts.

 

This is me, and my dog and her disease, of course, and I can't say how it would go for you. I can't begin to quote you for costs in your area, but I imagine someone who does it would be able to ball park it for you.

[muddy bob]

I'll see if my vet will give me a copy of the histopath report. I was given the results over the phone so they dumbed it down for me and just said it was a low grade sarcoma. I am just guessing that the "low grade" refers to how quickly it grows. Correct me if I am wrong.

 

muddy

[AK dog doc]

There's grade and stage. Grade is how many mitotic (dividing) figures are seen per high-power field. Low is good, high is bad, because it means a more rapidly-growing tumor. Faster growth usually equates to two things: One, it's getting big more quickly, and small disease is best. Two, it generally relates to a more undifferentiated cell type, which means it's more out-of-control and invasive in its growth and more likely to be a bad actor with unpredictable and agressive behavior.

 

Stage is how many body quadrants it's invaded. That would be based on lymph node assessment, chest films, etc. So best thing is low grade, low stage.

 

I'm wondering what the tumor type is because the location in the mouth can affect prognosis with some kinds of tumors, and some are considered malignancies without really ever acting much like them. You always want to believe what the dog has to say about it before you want to believe what the paper has to say about it. If the paper says bad but the dog doesn't, then good, you may be done after the first surgery and no chemo or radiation. By the same token, if the paper says good but it's eating the dog's head, we go with it being an agressive malignancy no matter what the histopath says. If you have dirty margins, of course, you have to assume the tumor is going to act like the worst one if its grade and stage, since that's the safest assumption for the dog. But if you have clean margins you may have more latitude to watch and see what your dog is telling you about it. Does that make sense?

[muddy bob]

Yes, thank you very much.

So, if she's got a great appetite and actually gaining weight (I'm worried she won't want to eat after the surgery) and playing ball every morning is she telling me perhaps it ain't that bad?

I voted to send the tumor to the lab so I'll know what those margins are. A slightly enlarged lymph node will also be removed and sent. The more accurate lab takes longer but the docs seem to have more respect for the results.

Waiting is the hardest part.

 

muddy

[Northof49]

Muddy Bob - I don't know if you are interested in any holistic approaches to treating cancer, but if you are, please email me privately.

[AK dog doc]

The more accurate lab is probably worth it - and yes, the waiting IS the hardest part in many ways. I can tell you to try not to worry til the path comes back - there's nothing that you can do, or NEED to do, til it does - but that's much more easily said than done.

 

Right now she's telling you she feels well and has no idea she's sick (from her point of view she's NOT sick.) WE know she has a mass, and that there might be more to it than that, but she's perfectly happy with her life. That's a good thing. If she were having a lot of invasion, I'd expect more signs from her - reverse sneezing, respiratory problems, excersize intolerance, dysphagia (difficulty eating), etc. That she doesn't have those is not PROOF that there's nothing worse happening - but it is definitely encouraging.

 

FWIW, my opinion (having not seen the dog) is that you should have the surgery done, see what the margins and the lymph node say, and also what the "big gun" lab reads the mass as - sometimes smaller biopsies are less clear on diagnostics because it's not just the kind of cells you see, but also the architecture of the mass, that may be of value in getting a firm diagnosis. We biopsy before going for the complete resection for two reasons: if kowing the biopsy results first will change IF we treat, or if it will change HOW we treat. My guess is that your vets felt that the biopsy result might change both. For instance, certain cancers of the mouth are not particularly agressive if they occur in the front of the mouth, but for unknown reasons if the self-same tumor type occurs in the back of the mouth, it can be HIGHLY agressive and very hard to control. That information might have affected the type of surgery done, and it might also have affected whether you went after it or not.

 

That said, IF you should come back with an unfavorable diagnosis &/or dirty margins (and remember that surgery can be curative, depending on the mass), then you have some choices to make. In vet med we're going for quality of life more than length of life (since, unfortunately, none of them will make it to 60), so follow-up treatments are aimed at maximizing good quality time. I personally have no problem with holistic therapies, although my own feeling is that these should be considered in conjunction with more 'traditional' Western medicine. That may just be my bias, having grown up in a Western civilization and knowing what Western medicine can do. My personal opinion is that I prefer to ADD alternative therapies to ones of known effectiveness, rather than SUBSTITUTE them - but I would by NO means discourage you from investigating all options available to you. With luck, you may need no further treatment after surgery. Let's hope for that. If we don't get that, by all means DO investigate all options available to you and pick what works best for you. Bear in mind that not every tumor type responds to every treatment, and that applies to holistic as well as traditional medicine. Things that generally support immune system function, for instance, are generally helpful to the dog over a broad spectrum of situations, so are always useful; however, that will prove to be MORE useful for some tumor types than for others, if that makes sense.

 

One caveat - you do want to check with your vet to make sure that ANY therapy - even holistic ones - will not interfere with whatever your vet is doing theraputically. Also, there are holistic vets out there who can work in tandem with the more traditional Western-medicine types, if you have questions. I believe several people on the Boards take that approach. I personally advocate nutritional support for my patients, particularly those with chronic disease - and remember, cancer is THE most curable chronic disease out there. We don't cure chronic renal or hepatic or cardiac failure - we can treat them, but not cure them. But we DO cure cancer some some of the time. So, tell her a lot of jokes and pray for good disease, and let me know what happens.

[muddy bob]

Oh my beautiful, beautiful girl. I lost my darling girl. Her tumor turned out more complicated and we euthanized while still under anesthesia. My young male stayed with her body until she was buried.

We planted a clump of Japanese iris over her. I will add some lamb's ears later.

I was really expecting to see her again when I dropped her off this morning.

Thanks to every one for their kind words and a special thanks to the doc for all her support and a big hug to Little Bo Boop because I know what she went through.

My heart is breaking.

 

Muddy

[Allie Oop]

I'm so very, very sorry for your pain and loss! I lost a wonderful dog to cancer last year and know the emptiness you must feel right now. I am trying hard to type this through my own tears. Best wishes to you and your family.

 

Regards,

[urge to herd]

I'm so sorry to hear, what a harsh shock for you and your family. Will be sending prayers your way for healing your heart.

 

Ruth

[muddy bob]

Allie Oop, I think my hug was meant for you too. Oop and Boop. I got confused.

 

Muddy

[Dixie_Girl]

Muddy bob, I am so very sorry for your loss. My Cheyenne has a recurance of her cancer, and it is so hard knowing what is coming. That is so terrible that it happened that quick, but for her, she just woke up at rainbow bridge, that is a good thought to keep! She will be in great company.

 

My thoughts and prayers for you.