Carcinomas in Dogs

Spindle cell carcinomas in German Shepherd

Question: I am writing to you regarding our beloved family member Nikki. She is a purebred all black German Shepard. She was recently diagnosed with "Spindle Cell" carcinoma or sarcoma (as soon as I heard the "C" word I mentally blanked out).

To give you a little background information, we acquired Nikki a little over a 1 1/2 years ago after a loss of our Codybear (another GSD). She is originally from Egypt. Her owner was in the USA for cancer treatment and passed away. She will be seven in October. She is a great dog and real good with our two little girls. Loves people. She really helped with losing Codybear to a heart attack after surgery.

About 2 weeks ago I found a tumor about the size of 3 grapes on the inside left front leg just down from the elbow. I brought her right in to our veterinarian (she had a bath 2 weeks prior to this and I didn't feel anything). He was real concerned and scheduled the surgery 2 days later. We also had a biopsy done. The tumor was removed completely and the Vet said it was not attached to anything (muscle, bone etc.). Our vet said he had never seen "spindle Cell" in dogs before. She also has a small spot over her right eye (pencil eraser size) that was frozen and should fall off in a few weeks.

She seems a lot better than right after the surgery, no limping, eating well (real well!!) and she protected me from the vacumn cleaner a few days later.

My question to you is that when I bring Nikki in for the staple removal on Thursday, what should I ask about follow up care (ie Chemo, radiation) so that I am more informed to ask the right questions.

We live about an hour from Cornell in Upstate NY, so if we had to we could go there. I love our Veternarian, we have been going to him for over 15 years. But sometimes, you need to know more info and need to ask the right questions. I have tried researching on the Internet regarding Spindle Cell and there is not a lot of information regarding it. I just want to know what our options are. Any help that you could provide would be a great help!!

Answer: Carol-

Spindle cell carcinomas are tumors that usually develop in connective tissues. They are malignant tumors and it is very important to carefully evaluate Nikki's current status due to this.

If the tumor and tissue around it which was removed were examined by a pathologist and the pathologist felt that the surgical excision margins showed no sign of tumor cells, that would be very good. If the margins of the excision did contain tumor cells or if no examination of the tissue margins was attempted, it is probably better to assume that the entire tumor was not removed and make decisions based on that assumption.

In either case, it is a good idea to have X-rays taken of the chest looking for spread of the tumor. It is best to take three views, a view with the patient laying on her right side, then left side and a view taken with the patient lying on her back or upright on her chest. Taking three views gives the best chance of finding a tumor if one is there. Looking carefully for any similar tumors on a physical exam would be a good idea, too. It can be helpful to remove a lymph node from the armpit region to be as sure as possible that there is no spread of the tumor.

If the surgical excision margins were clean and there is no evidence of spread of the tumor on X-rays and physical exam (and possibly in the local lymph node) then it may be reasonable to do nothing else at this time.

If the surgical margins are not clear of tumor cells then radiation therapy would be a good idea. Radiation treatment works well in preventing recurrence and spread of these tumors, with a long increase in survival time ( 4 to 5 years) reported for patients receiving radiation treatments as long as the tumor grade is low (1 or 2).

Finally, what do you do if you find that the tumor has spread? In this case, radiation therapy combined with chemotherapy may help but the prognosis is very guarded.

The important things to know at this point are 1) were the surgical margins examined and were they clear of tumor cells? 2) did the pathologist attempt to grade the tumor and if he did, what was the reported grade? 3) has the tumor spread? It will be possible to develop a treatment plan based on this information.

It would be helpful to consult with a veterinary oncologist (I'm sure Cornell has one) if you find that the situation is anything other than a low grade tumor with clean surgical margins and no evidence of spread of the tumor.

I hope that you get good news on Thursday. In a dog of my own, I would strongly consider radiation therapy if it could be arranged, even if the surgical margins were clean and there was no evidence of spread of the tumor but the oncologist can give you a better idea of the necessity for this.

Mike Richards, DVM 7/26/2000

Transitional cell carcinoma in German Shorthaired Pointer

Question: My 9 1/2 year old German Shorthaired Pointer was diagnosed with transitional cell carcinoma of the urethra a couple of months ago. Since then he has gone through three chemotherapy sessions which did not stop the spread of the cancer. It has spread to his bladder and some lymph nodes. During the chemo sessions he was on Feldene. Well the Feldene combined with the sessions caused internal bleeding. His platelate and red cell levels were dangerously low so he was taken off Feldene to try and build up his blood. His blood is getting better but he is beginning to show that he is uncomfortable - especially when he walks. We gave him his first Feldene in 2 weeks last night and he did show a little improvement. I guess my questions are: Does it take multiple doses of Feldene to show more of an improvement? Can you recommend other pain relievers? The vet did not want to put him on Rimadyl.

I realize my baby doesn't have much time left but I want it to be comfortable for him. Please give me any suggestions you may have.

Answer: L-

Piroxicam (Feldene Rx) is specifically recommended for transitional cell carcinoma due to chemotherapeutic actions that have been described for this medication. I do not know if these actions have been proven or not, but the studies I can find are pretty ambivalent. It is not thought to work very well alone but is often used in combination with chemotherapeutic agents. It may take several months to see a lot of benefit when using piroxicam. I do not know if there would be a benefit to using misoprostil or one of the other GI protectants, such as cimetidine (Tagamet Rx) or famotidine (Pepcid AC) to try to decrease the risk of GI bleeding but I don't think it would hurt to try.

If there is pain beyond that which piroxicam is helpful for, it may be beneficial to use a more potent pain reliever, such as fentanyl (Duragesic patches, Rx). It is not a good idea to use piroxicam and another non-steroidal anti-inflammatory medication, so your vet is correct not to use carprofen (Rimadyl Rx) and piroxicam at the same time. Also, there may be significant pain relief by using a surgical procedure to relieve pressure, such as a cystostomy tube. This is a big decision because it is just a way to buy a little more time but reports suggest it does improve the quality of life for dogs with obstruction of the urethra due to transitional cell carcinoma.

Hope this helps some.

Mike Richards, DVM 7/9/2000

Squamous cell carcinoma affecting the tonsils

Question: My second Westie (BooBoo, 11 year old spayed female) has been diagnosed with metastic squamous cell carcinoma of tonsillar origin.We took her to the doctor when she quit eating and her lymph node was swollen and her tonsils red. After sending the tonsil off and taking a biopsy of the lymph node, the problem was confirmed. We will be seeing an oncologist this coming week, but the other vet wasn't very optimistic. He said even with chemo, since it was in the lymph nodes, she might have only 2 to 6 months. He did say however, it didn't appear to be in her lungs, and that miracles can happen. We are heartbroken. Please tell us what we can do to try to put this in remission, or if there are any new techniques to treat cancer out there. We will do anything for her.

This come on the heels of the diagnosis of Pulmonary Fibrosis in our first Westie Molly. By the way, your information on that was very helpful and it helped put us in touch with people that are studying the problem and she doesn't seem to be uncomfortable - 2 years is much better than the prognosis in BooBoo.

Thank you for this service. We really appreciate it.

Answer: V-

Squamous cell carcinoma affecting the tonsils is a very aggressive cancer. It is good that it was not obvious in the lungs but this is still considered to be one of the cancers that is most likely to have spread by the time it is diagnosed. Carboplatin seems to be the favored chemotherapeutic agent at the present time. Mitoxantrone and piroxicam are also mentioned. Radiation therapy in combination with chemotherapy was the most successful treatment in a 1988 study (Brooks, et al) but that is now pretty old data in the world of chemotherapy. Based on that study, there is probably about a 10% chance of long term (over one year) success for chemotherapy combined with radiation therapy. It has been my impression that radiation therapy alone does not provide much more than six months or so of palliative treatment when used alone, based on a couple of cases we have discussed with the oncologists at North Carolina State University.

It is really important to find a veterinary oncologist to discuss BooBoo's case with. Cancer treatment changes faster than almost any other area of veterinary medicine and it is possible that there have been major improvements in radiation or chemotherapy that I am not even aware of. Your vet can help you find the closest oncologist. If going to see the oncologist is not possible your vet can at least get information on the latest treatment and survival estimates for you if he or she talks to an oncologist.

Whatever you decide to do for BooBoo, make sure that you spoil her on all the days that you can. Dogs live from day to day and don't worry much about the future, so you can lift her spirits from day to day much more easily than a person with similar problems.

Mike Richards, DVM 2/23/2000

Transitional Cell Carcinomas and Piroxicam

Q: Dear Dr. Mike, I am looking for information on transitional cell carsylonoma, unsure of spelling. My dog Chrissy had been urinating alot so I took a urine sample down to Dr. Jack, our vet, and there was blood in it. So he took an x-ray and nothing, so he went a step further and did the balloon and dye x-ray and that showed up a tumor. Two days later he removed the tumor. It was on her bladder near her utera. When he removed it, there were kidney stones lodged into the tumor so he removed those also. My results came back yesterday and it was malignant. He feels that the part he did not get was to the lining of the bladder which was where the utera meets the bladder. He said it is localized and he has put her on prixocam, unsure of spelling, to help stop the spread of it. Do you have anymore information on this? He had some and I have that, but I found this website and just thought I would write to you about this. Chrissy means the world to me and I don't want to see her suffer at all. Right now she plays with her Mickey Mouse, eats, and drinks and I don't see signs of pain and suffering right now. I trust Dr. Jack and I am very confident that he will do anything to make Chrissy not suffer. Thank you for listening. A Concerned Parent with her only child. Kim

A: Kim-Piroxicam (Feldene Rx) is a non-steroidal anti-inflammatory medication that has a direct toxic effect on some cancers, including transitional cell carcinomas. I think the exact mechanism of this action is unknown. Other than the usual NSAID side effects (occasional kidney damage, gastro-intestinal irritation) it seems to be a pretty safe medication. Many vets use a medications to protect the stomach while administering this medication but some do not.

To the best of my knowledge there is not an alternative chemotherapeutic regimen with a better record against this condition.

I hope that things are going well.

Mike Richards, DVM

Basal cell carcinomas

Q: I'm looking for info on Multi-cystic invasive scirrhous carcenoma, as my Golden Retriever has just been diagnosed with this form of cancer. Any leads on treatment or general information would be greatly appreciated. Thanks in advance for your response. T.

A: I do not recognize the description of the cancer you have given. Where is it located and is there another name your vet can supply for this? There are cystic adenocarcinomas that occur in the prostate and liver, is it possible that this is what you are describing?

Mike Richards, DVM


It is located in her leg, and originates from her sweat glands. The only other name I have heard it reffered to is "basil cell carcinoma". The main concern right now is that there is adema in the leg. The swelling is so bad that the skin is beginning to split. Any suggestions would be greatly appreciated. Thanks in advance for your response. T.

A: Basal cell carcinomas are reported to be responsive to surgical removal in Dr. Morgan's book Small Animal Practice, so that seems like a reasonable alternative to me. Control of edema can be difficult in some cases and all I can suggest is the use of diuretics such as furosemide (Lasix Rx) and/or corticosteroids such as prednisone. I am pretty sure your vets have already considered these options.

I wish I could help more. Hope that there has been improvement since you wrote.

Mike Richards, DVM

Last edited 01/30/05


Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...