Cancer and Tumors in Dogs

The following are real life cases of Cancer and Tumors in Dogs that have been treated by Dr. Mike Richards, DVM.

When is Cancer NOT Malignant?
What are Chemotherapeutic Agents?
Is there a Cure for Botryoid Rhabdomyosarcomas?
What is Malignant Schwannoma?
How to Tell if a Dog Has Cancer
Information on Bladder Tumors
Different Types of Cancer in Dogs
Tumor at Hock Area - Fibrosarcoma, Neurofibrosarcoma or Hemangiopericytoma
Cancer Terminology
Leiomyosarcoma of the Liver
How to Control the Pain from Metastasized Sarcoma
Sebaceous Adenomas
Treatment for Cancer in Dog
Cancer but Normal Bloodwork
Mass in Chest
About Cysts and Tumors
Disappearing Skin Tumors

When is Cancer NOT Malignant?

Question:

I would like to bring to your attention a statement at the following page: Hyperthyroidism "A small percentage of the cancers are malignant." Cancer IS MALIGNANT. As opposed to tumors in general, which may be EITHER bening OR malignant, such that if they are MALIGNANT, they ARE "cancers". Could you please rewrite this description at your page so that readers can understand what you are actually trying to say.  

Answer:

Not to be too flip, but the answer to your question: when is cancer NOT malignant is ---> when it is a neoplasia in a veterinary patient that is benign in nature. I think that you are probably correct that the term cancer, when used in human medicine, generally refers to malignant tumors --- although I can find some exceptions in the general use in human medicine, as well. In veterinary medicine, as taught at the veterinary schools I am aware of, cancer is used to describe neoplasia and then it is modified by the use of benign or malignant. If you trust me to quote them accurately, the following is their definition, which is consistent with what my wife and I learned about cancer at Iowa State University and the Virginia-Maryland Regional College of Veterinary Medicine, respectively: "Throughout this web site, the words TUMOR and CANCER are used interchangeably. Technically, a tumor is just a swelling which may or may not be a cancer. Cancer is a disease of uncontrolled cell growth which can be benign (not invasive and does not spread) or malignant (usually invasive into surrounding tissue and capable of spreading to other areas of the body)" (from the CSU site). The difference in the way that medical terms is used is sometimes confusing between veterinary medicine and human medicine and oncology is one of the areas in which there are significant differences. It is really important to have a veterinary pathologist, or at least a pathologist familiar with the use of pathology terms as veterinarians view them, perform the evaluations of veterinary tissue samples when cancer is suspected, because of these differences. I am glad you wrote to us, as it probably is best if we put the definition used above on our cancer pages, as well, since it does appear to differ from the way the term is generally used in human medicine.  

What are Chemotherapeutic Agents?

Question:

In the part about lymphoma you mention "chemotherapeutic agents" and then refer to prednisone. I think of pred as a steroid/anti-inflammatory. So may I have a definition of both chemotherapeutic agents and steroids? 

Answer:

These are the definitions that you were asking about: Chemotherapeutic agent --  technically, a chemotherapeutic agent is any medication that has targets a specific organism or disease process. This applies to a broad range of medications. It would be appropriate to call amoxicillin a chemotherapeutic agent for a staph bacterial infection using this definition. In practice, though, "chemotherapeutic agent" is usually reserved for medications that specifically target a cancer. Since there are a lot of cancers, there are a lot of medications that have a chemotherapeutic effect for one form of cancer that do not have that effect on other cancers. In addition, there are many medications that are ordinarily used for other purposes that have chemotherapeutic effects or specific cancers. This is the case for prednisone and other corticosteroids, which selectively suppress lymphocytes and mast cells, making them potentially useful chemotherapeutic agents for lymphomas and mast cell tumors even though that isn't the most common thing they are used for. Piroxicam (Feldene Rx) is a non-steroidal anti-inflammatory medication that is usually used for that effect but also has chemotherapeutic properties for transitional cell carcinomas, a tumor that affects the urinary system. There are other examples of medications that fit in more than one category, as well. The terms "steroids", "cortisones" and "corticosteroids" are often confusing as well.  Steroids are just compounds that have a specific chemical structure and there are a lot of them, some of which are natural hormones or are manufactured artificially to have similar actions. Corticosteroids refers to steroids produced by the adrenal cortex and are mostly glucocorticoids, which is just another description of chemical structure. Corticosteroids generally have anti-inflammatory properties, modulate stress and have many other effects, such as causing salt retention, increasing drinking and urinating, increasing appetite, suppressing lymphocytes and other immune system functions. These can be good things, when those effects are desired, or bad things, when they are not. Unfortunately, it is hard to have an "all good" effect from corticosteroids considering their broad impact on the body, so these medications have to be used carefully.      

Is there a Cure for Botryoid Rhabdomyosarcomas?

Question:

Jake, my 2 year old english bull dog had a large tumor removed from his belly. The vet said the tumor is called a RHABDOMYOSARCOMA. I've been trying to find out things on this type of cancer but i'm having trouble. Jake had one dose of chemo-therapy. Today the vet told me no more chemo. His kidney value is 2.5 and maybe due to the cancer or chemo. Also Jake has lumps in his back that turn red. The vet said they are NOT mass cell tumors. They are probably the rhabdomyosarcoma. Is this painfull for Jake? Bulldogs dont show pain so i dont know. He sleeps most the time, and I feed him from my hands and give him water from a bottle. I love my dog more than any-thing. Do you know about this cancer & the effects it has. The surgery to remove the tumor was 4 weeks ago and it hasn't grown. The vet said she removed 80% of it because it was attached to his bladder. When she checked the remaining she said she must have took out more than 80% because it seemed much smaller. I guess my question is, how much time do you think I may have with Jake? Or is there any thing else that I can do to help kill this cancer besides Pray?

Answer:

Rhabdomyosarcoma is a form of soft tissue sarcoma. Botryoid rhabdomyosarcomas are a subset of this tumor that is found in the urinary bladder in young dogs (usually big breeds). The best thing that you could do, if you wish to pursue all options, would be to ask your vet for referral to a veterinary oncologist (cancer specialist) if there is one in your area. If this is not possible you might consider asking for referral to a board certified veterinary surgeon to see if there is some chance of removing the rest of the current tumor and enough of the bladder tissue around the attachment points of this tumor to hope for a surgical cure. This may not be possible and most general practice veterinarians would not be willing to remove a large section of the bladder even though there are clinical reports of success with this procedure. Doxorubicin and cisplatin seem to be the chemotherapeutic agents that are most likely to be tried for this tumor but I can't find any clinical trial studies to support their use. This is also true of radiation therapy. I do not have enough experience with this tumor to give you information on the possible outcomes based on personal experience. I couldn't find any mention of median survival times except in the study in which the bladder was partially removed and the average survival time after that surgery was about 2 years. I can't help you with the lumps on Jake's back. He would be really young to have mast cell tumors but I wouldn't be too suspicious of a spread of the rhabdomyosarcoma, either. In my experience the most common cause of red bumps on the skin of bulldogs is bacterial skin infection. There is one clinical report of long term remission of a botryoid rhabdomyosarcoma, in the 1993 Sep/Oct Journal of the American Animal Hospital Association. Extensive surgery followed by doxorubicin and cyclophosphamide chemotherapy (this is detailed inthe article) resulted in at least a 21 month remission, the time the dog was followed up until publicationof the article. I wish that I could give you some information on the prognosis if nothing else is done, but I just don't know enough about this tumor to do that.  I do think that it is really important, if you wish to do more, that you consult with an oncologist or surgeon. Your vet can refer you to one or the other. A veterinary school or large referral center is likely to have both specialists on the staff, so that would be a good option. If Jake strains to urinate, doesn't want to eat, seems lethargic it is reasonable to assume that he is in pain. That is something that can often be controlled and it is usually best to try to control pain on the presumption that it is present if any clinical signs suggest it might be. 

What is Malignant Schwannoma?

Question:

My 9 1/2 yr old Greyhound Desi has a tumor removed from over her eye last Tuesday. The biopsy results came back yesterday -not good. The tumor was cancerous. I have done some research on the internet and can't find much about this particular cancer. Most of the ones mentioned seem to be benign. The vet I used for surgery is going to contact a specialty vet hospital here in north Dallas and check with the oncology dept. I was hoping you would be able to help me understand something about this particular cancer and if there are options available. My dog has had her head bandaged now for a week, with one eye covered. She is  understandably not happy. The drain tube he put in was taken out and he said some skin had died with it and that was the cause of bleeding the few days before. He rebandaged her head after packing the open hole with antibiotics. I will type the wording from the biopsy report below. Would you please be able to explain some of the wording?

Histopathologic Diagnosis: Malignant schwannoma   

Description: One mass is examined. The mass is infiltrative and poorly circumscribed and consists of elongate to plump spindle cells that sometimes form partialwhorls and storiform bundles. Dense fibrous connective tissue stroma is prominent in some areas. Nodular aggregates of neoplastic cells are tightly packed and exhibit cellular atypia, nuclear gigantism, and multinucleation. In these areas the mitotic index is high, greater than 20 per 10 hpf.   

Comment: The microscopic findings are those of a malignant schwannoma. Neoplastic cells are present at or near the surgical margins in some areas and recurrence is possible. The cellular atypia and high mitotic index are features supportive of a high metastatic potential.

I understand from my research and from the vet looking up schwannoma that this is cancer of the nerve sheath. I truly don't want to put her thru anymore pain. I don't know what my options are. The chest x-ray showed nothing and her blood work was normal. She is eating normally, and because she's greyhound -sleeping like a cat, all day long. Plus, we've just encountered weather in the 20's so she's not keen on going out. Sorry this is so long-thank you for any suggestions, explanations or help you can provide me. Thank you also for offering such a wonderful service. Bonnie    

Answer:

The pathology report says that this tumor is a schwannoma. These are also sometimes referred to as peripheral nerve sheath tumors, if you wish to search for information using that name, too. These tumors can be malignant (have the potential to spread to other areas locally or in other areas of the body). In this case, the pathologist thought that the tumor was malignant and that the malignant characteristics were strong. The best hope for controlling the spread of these tumors when they are malignant is surgery done using strict adherence to oncological (cancer) surgical procedures. This means that a wide margin must be removed in every direction around the tumor. It sounds like your vet made an effort to do this but may not have been totally successful because there were tumor cells in the margins of the tissue submitted to the pathologist. Another possible explanation for that situation is submission of an incomplete sample. This happens when the tumor is cut into after it has been removed and made into smaller pieces so that formalin can preserve the whole thickness of the tissue submitted. Sometimes, this makes it very hard to identify the surgical margin. I think that you have to accept that the more likely explanation is that the margin of tissue removed at the time of surgery was not enough to get all of the tumor cells. Schwannomas do not respond well to chemotherapy, unless something very new is being used that I have not heard of, yet. The oncologist would be aware of the most research on this option. Some vets feel that these tumors respond to radiation therapy but more vets feel that they do not. I was not able to find objective information on radiation therapy, so I think that these opinions are based on a few cases and information from human research on similar tumors. The initial surgery is usually the best chance for getting all of the tumor. However, if this tumor returns at approximately the same site, a second surgery may be beneficial. If that becomes necessary, it would be best to have a board certified surgeon or oncology surgical specialist do the second surgery, if that is possible. It takes a great deal of discipline, and faith in the technique, to remove enough tissue around a tumor, if underlying bone or an eye have to be removed to get wide enough margins. Oncological surgeons are used to making these choices and have more experience dealing with the complications of this sort of aggressive surgical procedure. If the oncology specialist in your area feels that radiation therapy would be helpful, it seems reasonable to me to give it a try, since other options are not available. However you do need to remember that the general feeling among oncologists appears to be that the benefits of radiation therapy are questionable for schwannomas. Hopefully, the recover from surgery has progressed smoothly after the initial complications and there will be a long interval between this surgery and the reappearance of this tumor.         

How to Tell if a Dog Has Cancer

Question:

Recently I took her back to the vet because she seemed hot and had breathing problems. She was snorting. She had a upper respiratory infection. The vet is still of the opinion that there is some ongoing problem/ disease process going on. If it is a cancer, what can we do about it? First of all, we live in Canada and my vet says she is too fat to palpate anything in the abdomen. On top of this, I am surrounded by well-intentioned doctors in my family, who reckon that they are capable of taking care decisions about her on their own. They reckon that if it is a cancer there is no point in doing further investigations. I would appreciate your medical opinion concerning my pet. 

Answer:

Cancer can be very hard to locate. Metastatic cancer in dogs often will spread to the lungs, where it is visible on X-rays, though. In dogs, high calcium levels are associated with anal sac adenocarcinomas and these can often be palpated in the anal sac. Abdominal X-rays are often inconclusive but they do sometimes show tumors or changes in organs that indicate a problem. Unexplained fevers are associated with metastatic cancers but you do have to be careful to actually take temperatures before assuming that fevers are present, since dogs have higher body temperatures than we do and since skin temperature and core temperature can be different depending on blood flow to a particular area of the skin. Sometimes all that can be done is to treat the disorders that surface and wait for a sign that finally indicates cancer is present or identifies some other problem. It is important to consider other possibilities, such as diabetes and hyperadrenocorticism (Cushing's disease) as potential sources of immune suppression that can lead to secondary infections. General chemistry panels can help to eliminate some of these possibilities (especially diabetes) and can give hints about whether other problems, such as Cushing's disease, are present. I hope that this helps some.

Get additional information on the Symptoms of Cancer in Dogs

Information on Bladder Tumors   

Question:

I have researched a lot of your material, and I can't find much information regarding bladder tumors. I have a cocker, 12 years old, who has been diagnosed with bladder turmor, probability cancer, from ultrasound. I have been unable to contact the vet in the past days, and am quite anxious with regard to many questions I have. He did mention trying to contact a vet in chemotherapy, but I am worried that such a vet is not in the Atlanta area, and I would have to take my dog to the University of Ga. in Athens, or Auburn, Alabama. The dog is not going to like this at all, and most certainly not if I have to leave him. I do not want to put him in any more situations that would cause anxiety. The vet did prescribe Feldene 1/2 capsule every 48 hours to see what it would do. He had put him on an antibiotic thinking it was originally a bladder infection. From your articles, I was thinking he needed to continue on the antibiotic. I also thought I would try placing him on a diet of fatty foods and try Vit E and Vit C, Selenium, and Essiac. I am discouraged that the tumor is in the area of the urethra and I was told surgery was not an option. I am additionally discouraged that these types of tumors are likely to reoccur and I am only buying time for Woode. I've been through a particularly rough summer with several family problems and responsibilities, and I really hate to lose him right now. If you have any further articles you could suggest to me or any other insights, I would appreciate anything you can give me. .

Answer:

The prognosis for the most common form of bladder cancer, transitional cell carcinomas (TCC) is poor for tumors involving the trigone of the bladder. It is not very good even if it occurs in other areas of the bladder but there is some chance of a surgical cure and some evidence to suggest that just getting rid of the majority of the tumor prior to starting chemotherapy may be beneficial in the case of tumors in other areas of the bladder. There are other possible bladder cancers and some of them are benign, so it is worth trying to get a more positive diagnosis of this tumor. Sometimes it is possible to get tissue samples using a urinary catheter and suctioning them from the bladder surface, by cystoscopic exam or by surgical exploration of the bladder. I wouldn't rule out exploratory surgery for the purpose of diagnosis, if positive identification of the tumor type can't be made  by one of the other techniques. Some patients with TCC tumors respond very well to chemotherapy and live for extended periods but the mean estimate for comfortable lifespan is usually quoted at around 6 months. The current recommendations for chemotherapy usually are piroxicam (Feldene Rx) combined with another agent, such as carboplatin or mitoxantrone. There seems to be a feeling among oncologists that these combinations are increasing the likelihood of long term success but it would be best to talk to an oncologist directly for more specific information on that. If there is obstruction to urinary flow, there are surgical procedures that can be helpful, particularly cystostomy, which is making an opening from the bladder to the the outside of the abdomen. Most dogs with this procedure are still able to maintain continence, so it isn't as bad as it sounds.  There are procedures for removing the trigone and urethra and joining the bladder to the colon. This works, but it causes high ammonia levels in the blood stream, which is very uncomfortable for the patient and so the general feeling is that this procedure should be avoided. I don't know how to evaluate quality of life issues in a pet who is stressed by veterinary visits but might benefit from chemotherapy, which involves a lot of those visits. We have had a couple of dogs in the past for which this choice would have been very hard. I did pursue treatment for a chronic problem with one of them, Shasta, and she hated the visits but recovered from them pretty quickly so in the end it seemed worth it. She did not require hospitalization during the series of return visits to the specialist, though. I think I might have felt differently about the value of therapy to her if she had. Using anti-oxidants makes sense. Some cancers require carbohydrates for energy, so diets in which energy comes from fat or protein do make sense for those tumors. I am not sure that is the case for TCC tumors but dogs like those diets and this is a good time to spoil your cocker, anyway. Marine fish oils (3V Capsules) have the highest ratio of n-3 fatty acids, which are supposed to be helpful, so that is something else to consider giving. I hope that this helps some. If it generates more questions, please feel free to send them.   

Learn more about Bladder Tumors in Dogs

Different Types of Cancer in Dogs

Questions:

My 9 year old fuzzy son, Kaan, had two tumors removed. Both were malignant. I trust my vet, but after seeing your website I see I need more info. I have 3 fuzzy children and they are all Golden Retrievers. My vet did not tell me what kind of cancer he had (I didn't know there were different ones until I saw you website), and that all I could do was check him monthly and treat him like normal. My fuzzy daughter, Keeli, is going to have a tumor removed from her left front leg. Near the femal (sp) nerve. This time I would like to be able to ask more intelligent questions. I live in Hawaii right now, and will be moving to Japan. I am not sure if my vet did not give me a lot of info, cause I'm moving, or because I did have tears running down my face when he told me about Kaan's lab report. My mother died of cancer 3 years ago, so I admit when I hear the word I'm sensitive. I love my fuzzy kids more than life itself, and want to do the best thing for them. Could you please help me with my dilemma. What should I ask my vet? Obviously, I need to ask him what kind of cancer Kaan has, but God forbid if Keeli has it what intelligent questions can I ask? 

Answer:

As you have discovered, there are a lot of different types of cancers. Some are not likely to cause future problems once they are surgically removed and others are highly invasive and are likely to spread to other organs. It is very important to know what type of tumor was present. It is also important to know what the pathologist thought of the tumor grade, if the tumor is thought to be of a type that is malignant. In addition, whether or not tumor cells were found in the margin of the tissue removed is important to know. Finally, if the tumor is a malignant type, it is important to know if it has spread, which is determined through further testing, such as aspirating tissue from, or removing, local lymph nodes,  taking abdominal or chest X-rays, checking blood chemistry values, checking bone marrow ----  the necessary tests vary depending on the type of tumor that might be present. I am coming around to the opinion that it is better to biopsy tumors before scheduling surgical removal, unless the tumor is a type that is readily identified by appearance. This allows the surgeon to make a plan for removal of the tumor that is appropriate to the tumor type. For tumors that are highly malignant it is important to remove more of the tissue around the tumor, if possible. Checking local lymph nodes is easier to do in the initial surgery, when it is known to be necessary due to a prior biopsy, as is other necessary lab work, such as X-rays. Once you know exactly what the tumor types are, I will be glad to try to help you understand the tumor type and what that means for treatment and prognosis. If it is hard for you to ask questions and listen to the answers when you are experiencing strong emotions, which is a problem for many people, try to take someone with you who has a list of your questions and can ask them for you. Preferably someone who listens well and can then remind you of what was said later. Then call your vet later when you feel up to it and discuss the options when you can do it calmly and rationally.     

Keep reading about the Different Types of Cancer in Dogs

Tumor at Hock Area -  Fibrosarcoma, Neurofibrosarcoma or Hemangiopericytoma

Question:

If it's not one thing with my dogs, it's another. My dog that had the endoscopy also had a mass on her ankle. After 2 aspirates, then a tru-cut biopsy, then another aspirate, a diagnosis of spindle cell tumor has been given. The differential includes fibrosarcoma, neurofibrosarcoma or possibly hemangiopericytoma (from the last aspirate). The oncologist I go to for the dog's mast cell monitoring will probably try to remove as much as possible this coming week. The ankle area doesn't have a lot of extra skin. I have not had a chance to talk with the vet yet about all the details. I looked on your website and really did not see anything. I realize that removing the mass and getting a path report will probably guide us to what further treatment there might be. However, I would like to get your input. I did not check your schedule on the website so don't know what it is with the holiday weekend.    

Answer:

We have had pretty good success removing tumors in the hock region, despite the obvious potential for problems due to the lack of loose skin in the region. It is very difficult to get wide surgical margins in these areas but most of the tumors in these regions are either benign or tend to be locally invasive. So we usually remove the tumor and a small tissue margin and hope for the best.  When the tumors are locally invasive types, like chondromas, we just plan on removing recurrences when they crop up. We have not tried chemotherapy or radiation therapy in conjunction with one of these types of tumors but would be willing to refer a patient for these options if consultation with an oncologist indicated it might be helpful, based on the tumor type after it is identified. Malignant tumors of a lower limb are probably best handled through amputation of the limb but you definitely want to have a good pathologist's opinion on the tumor type prior to considering that option. Amputation is the only practical way to get sufficient tissue margins for tumors that appear to be malignant, such as fibrosarcomas. This is a difficult decision but should at least be considered as an option if there is a malignant tumor type identified. Your vet will be able to give you some idea of the chance of metastasis after surgery, chest X-rays and consultation with the pathologist. It is always hard to wait for information when a tumor is removed but it is just part of the process. Our experience has been that most tumors in these regions can be handled without resorting to really aggressive surgery or secondary treatments like radiation therapy, though. So the odds are on your side. I hope this does all work out OK.

For further information, see our overviews of Fibrosarcoma and Hemangiosarcoma

Cancer Terminology

Question:

Hi, I go to Purdue University and I am writing a paper and I need some help with terms if you could please help me clear up what the terms mean so I can explain to my english and try to make him understand.  Some of the terms I have are: simple carcinomas, carcinomasarcomas, complex carcinomas, sarcoma, serum samples, epithelial cancers, and TAA. If could help me out in any way I would much appreciate it. 

Answer: 

I do not know for certain that these terms are used identically in veterinary medicine and human medicine but here are the definitions that I can find: simple carcinomas -  I have no idea what would make a carcinoma "simple" but a carcinoma is a malignant tumor arising from epithelial cells. Epithelial cells are cells that cover the lining of any body surface (internal or external), so skin, the bladder lining, the lining of blood vessels, etc. could all give rise to a carcinoma. My guess (and it is a GUESS) is that simple carcinoma involves only one epithelial tissue and a complex one involves more than one epithelial tissue. sarcoma -  a sarcoma is a tumor arising from connective tissue, which includes bone, cartilage, muscle, blood vessels and lymph tissue. Usually there is a prefix describing the tissue of origin, like fibrosarcoma or osteosarcoma. These tumors are malignant, too. carcinomasarcomas are tumors that contain a combination of cells of epithelial and connective tissue origin TAA --  I think that this is an acronym for "tumor associated antigens". There are a lot of these, so if I am right it would not refer to a specific antigen but would refer to proteins that are associated with tumors and can be identified by the body's immune system, in general. Examples of tumor associated antigens include  glycoproteins 75 and 100, RAGE-1, MAGE -1 and many others. In some cases it is possible to design tests for these antigens which can help to determine if a cancer is present or if it is being controlled by chemotherapy. I am not sure that I know of any particular difference between a carcinoma and an epithelial cancer. I have always assumed that any tumor composed of abnormally growing cells forming in tissue was a form of cancer but recently I have noticed that cancer seems to be applied specifically to tumors that are malignant, in many references. A serum sample usually refers to a sample of blood which is allowed to clot and then centrifuged. The clot, which contains the cells and most of the clotting factors in the blood, is separated from the liquid portion of the blood, which is the serum. A plasma sample is a sample in which clotting is inhibited using a clot inhibitor such as EDTA or heparin. The blood sample is allowed to settle, or is centrifuged, and separated from the blood cells. The difference is that since no clotting occurred, the clotting factors are  usually still present in a plasma sample. There are some tests for which a serum sample and plasma sample are essentially identical and some for which the presence of the clotting factors does make at least a small difference. Hope this helps.

Leiomyosarcoma of the Liver

Question:

I have an eleven year old spayed Beagle bitch who has been diagnosed with leiomyosarcoma of the liver. Our vet and the oncologist we consulted feel this began with a tumor on a strange diverticula in her large intestine. This tumor was removed a year ago, and it appeared at that time to be encapsulated and no other growths were observed during the surgery. Then, last June, we found the mass on her liver which was determined to be leiomyosarcoma. My poor dog also has a heart murmur, for which she takes Enacard daily, some kind of chronic lung condition (I think she never really recovered from a bout of Bordetella she had 5 years ago), for which she takes Aminophylline daily, AND Cushings disease, for which she takes Anipryl daily.

At the time the liver cancer was diagnosed, we were told she would not live more than 6 - 9 months, but that this was a fairly rare form of cancer in dogs, so not much information existed upon which to base a prognosis. We have elected not to have her treated with chemotherapy (the only treatment option) as 1.) we were concerned with her quality of life and 2.) the oncologist was not very hopeful about the success of the chemo. Surprisingly, Kichwa seems to be pretty happy and much of the time and does not seem to have any pain or discomfort. She is slow to climb the stairs, has times where she eats a lot of grass and/or acts lethargic. I can't tell how much is the Cushings, and how much is the cancer, heart condition, old age, etc.

I'd like to get as much information as I can about this form of liver cancer, particularly in conjunction with the Cushings and the heart murmur. My goal is to make sure the rest of Kichwa's life is as comfortable as possible, and to be able to understand the symptoms of each disease and how her various conditions and medications interact. I am attached beyond all reason to my dog, and I want to do the right thing for her as her disease progresses.  I would appreciate any information you could provide as well as any resources you may know of that I could access. Thank you very much for your help on this - you're really a saint. 

Answer:

Leiomyosarcomas are difficult to find a lot of information on. There are some references that I have found on the PubMed web site. If you search at this site using "Crawshaw J" as your search term you can find one of them. there is a bleaker reference that can be found using "Kapatkin AS" as the rearch term. You can search on the "related articles" links to find a lot of reference titles but not many abstracts. If your vet saves journals you may find that he or she has some of these articles you can read. That is a lot better than just reading the abstracts and it would also allow you to review the references listed with each article. There is a link to the PubMed site from our link page. Unfortunately, I think that you are in a situation in which there isn't going to be a lot of solid data. In the one study I characterized as "bleak" all of the dogs with liver metastasis were euthanized. This obviously affected the prognosis and I am not sure it is correct to assume that all of these dogs would have suffered from the disease or even that they all would have died within a very short period of time. As long as Kichwa seems happy I'd ignore that study and enjoy being with her. I don't think that there is a lot of reason to think that the otherconditions will have a strong negative impact on her ability to deal with the cancer. They are just complicating factors in her life, overall. The stair climbing problems and overall slowing down are probably mostly related to the heart problems but there may be some impact from the liver tumor. Chemotherapy doesn't seem like a very effective option for leiomyosarcomas so even if you were considering it you'd have to accept that it would have a low probability of a really successful outcome. Radiation therapy seems to be preferred by oncologists but I couldn't find any reports that had statistics for success rates and I suspect that this may help some but can't be viewed as a likely cure. I wish that I could find something more helpful but hopefully there references will at least allow you to find accurate information that you can use to make decisions about Kichwa's therapy options. I do think you have probably chosen the best course right now, though.     

Also see our page on Leiomyosarcoma in Dogs

How to Control the Pain from Metastasized Sarcoma

Question:

Our 10-year-old Lhasa has been diagnosed with metastatized sarcoma on the basis of x-rays and physical observation. He also has a greatly enlarged spleen that has calcified. We were told the only remaining course is to control his pain & provide him good quality of life for his remaining weeks or months. The vet prescribed Rimadyl plus Lasix for fluid buildup. A week later, when Max showed greater lethargy on this regimen, he prescribed an antibiotic Amax in case of secondary infection. We live in a rural area. We asked around for a small animal specialist from whom we've sought a second opinion. The second vet examined the x-rays, did blood tests, and said neither are conclusive it's cancer. She wants to do a thyroid test. We are waiting to hear back from her. In the meantime she removed Max from the diuretic. We ourselves removed him from the Rimadyl as we discovered it's giving him insomnia (We discovered this when we gave a tablet to our other Lhaso, who has arthritis, and she too did not sleep that night). We're now giving him three 86 mg tablets of baby aspirin per day. He is sleeping well with less apparent discomfort and occasional outright life in him. He has consistently eaten and drank normally; his problem is inability to get up on his haunches, lack of his normal enthusiasm, and mild pain or discomfort as indicated by lethargy and unwillingness to take stairs. I would like some indication of what this could be besides sarcoma. About a year ago both dogs got 1/2" lumps (Max more than the other dog) over their bodies after getting bitten by earth-burrowing bees in a cemetery. We wonder if that could be a cause as he licks several of the lumps until they bleed. Thank you for any help you can give us. 

Answer:

It is not possible to help you much by computer. I think you made a good choice asking for referral to a small animal specialist. If it is possible, it would be a good idea to consider seeing a board certified internal medicine specialist but that may be hard to arrange in a rural area. In humans, arthropod bites (insect bites) can cause lumps that last for as long as a year and can be pretty itchy throughout that time, according to a friend of mine who is a dermatologist. I am not sure whether this syndrome has been reported in dogs but it is likely that it occasionally occurs. Removing the lump, which is usually done to be sure it isn't a problem like cancer, is usually curative in people. If your dogs are chewing on the lumps it may be a good idea to remove them and have a pathologist examine them to determine what they are. At this point the best course of action is probably to keep working with one or both of your vets until a clear diagnosis can be made. This may take several rounds of tests or even exploratory surgery in some cases, so patience may be necessary for a while.

Sebaceous Adenomas

Question:

Charlotte is doing very well following her 'liver surgery'. She is responding well to the oral neomycin and lactulose. However, we have a question for you regarding her sister Darby. Darby is an 8 year old spayed Jack Russell who is a typical terrier. Generally in good health, I have recently discovered a few small, white skin nodules in various locations. One on her neck, about 3 mm. in diameter, and one on her stomach, and a few on her legs, but these are a bit smaller in size. They are just large enough to be able to feel them as sort of raised 'mosquito bite' size. They don't seem to be attached to anything below the surface of the skin, as they move around with the skin. Have you seen this before, or is this information too general to tell you anything. Thanks again for your wonderful site. 

Answer:

These sound like sebaceous adenomas. They are a benign skin tumor that is pretty common in small dogs of all breeds. Sometimes epidermal inclusion cysts (used to be sebaceous cysts) look like this. There are other possibilities, too. The only way to be sure what is going on is to remove one or two of them and send them in for examination by a pathologist. Your vet may not feel that this is necessary based on a physical examination. I do not send in a biopsy from most of my patients, just the ones where the lumps don't look quite right or where the owner prefers to be certain. Usually there are a lot of these when they are present and trying to remove all of them is not very practical since they continue to develop. So the best thing to do would be to get your vet's opinion of what these are, since he or she can see them and feel them. There probably isn't a rush to do this since the odds are very good they are a benign problem. If your vet thinks they should be biopsied, it would be best to do so. I'm glad that you have enjoyed our site. Thanks for letting us know. It helps to know that our efforts are useful.

Treatment for Cancer in Dog

Question:

My girlfriend Grace and I have a very uneasy problem. You see, about a month ago we found a lump in my Golden/Cocker. It was located right under his rib, and it felt round and smooth and you could move it around. We took him to a vet. The lump was very hard, and being smooth I actually thought it was a piece of rib that might have broken off. The vet took an x-ray and didn't find anything. He said the dog probably hurt himself or bumped himself and to put a warm compress on the lump and to come back in two weeks if it didn't go away. I felt unsure of waiting so long, but we trusted him and took his advice. Two weeks went by, the lump was still there. It didn't seem to have grown but we took him back to the vet as instructed. We asked him if he could do a biopsy. He said that a biopsy wouldn't be very accurate, and that he just as well open the dog and remove the mass for examination. We again took his advice, and after the operation he said he couldn't tell what it was and that a biopsy was in order. The tumor was smooth and pale pink, the size of a walnut, with some grey speckle. My mom, who is a nurse, described it as "encapsulated" when she felt it under his skin. We then asked him why he didn't do a biopsy before he said he didn't have the right "facilities" to do one. He said to call back in a week to find out the test results. I just called today, and he said that the tests show the mass to be cancerous. He said for us to come in tomorrow to talk over what we should do (Chemo, rad...) I really don't trust our vet. Please answer me this.... 1. Should a biopsy have been performed the first day we brought in Max (our dog) 2. What kind of cancer could my dog possibly have? 3. We told him over the phone we wanted a second opinion. He told us this was not possible because the tumor has already been removed. Is this statement true? Can we diagnose Max without the tumor through blood tests or some other means? Please respond. We have already decided to get a second opinion anyway, I guess it wouldn't hurt anything. Max is a very energetic and loving dog. Our vet just didn't seem to care enough,making us wait a month before telling us this horrible news. 

Answer:

It is not an unusual practice to observe a lump for signs of growth or to see it will resolve prior to taking a biopsy of it. Whether or not this is a good idea is often learned only in retrospect. If the lump disappears then it seems like it was a good idea. If the lump remains then it doesn't seem as good a plan. Using a needle to aspirate a small amount of the contents of the lump and examining it (a fine needle biopsy) is a good compromise between the two practices, since many lumps can be identified in this manner. The ones that can't are then better candidates to be removed and examined by a pathologist. Many veterinarians feel competent to examine tissue aspirates and it is possible to get a pathologist's opinion by sending a slide in of the aspirate. There are lots of times when this doesn't really help much due to difficulty identifying what is going on even after microscopic exam. Some vets just don't think that it is worth attempting a needle biopsy due to this. Removing the lump and submitting it to a pathologist to be examined is good medical practice. Your vet is trying to do the right thing in this case. It is the only way to positively identify the lump and determine if it is cancer and if so, what kind. The results of this exam will help you and your vet decide how to handle the situation.

Michal Response: Leo and Grace, Please let your vet know that you want more information and have concerns about your cocker's treatment. You should know what type of cancer the tumor is and all the possible treatment options. Your vet should be able to provide a history of your dog's treatment for a second opinion. You also need to let your vet know how far you are willing to go with treatment . Talk to your vet - hopefully you can develop a trusting relationship.    

Learn more about the different Cancer Treatment Options for Dogs

Cancer but Normal Bloodwork

Question:

My 3 l/2 year old mix large dog developed a mass on his rear left hip. It appeared to be present within a short period of time - I brought him to be groomed and saw it as soon as I picked him up. The groomer assured me he was not hurt or injured while there. Thinking perhaps he sprained himself getting into my jeep, we watched him over the next few days. He then began not putting all his weight on his left leg and then gradually started to limp and favor his right leg. The vet immediately thought it could be cancer and wanted to take blood work as well as an X-ray. The X-Ray machine was broken, however, the blood work came back all within normal limits. The vet at that point seemed to rule out cancer and referred me to an Orthopedic Surgeon for X-Rays and further testing. The Surgeon seemed to think my dog was not out of the woods with cancer regardless of what the blood work showed. He proceeded to take two X-Rays along with four biopsies - one bone biopsy to rule out cancer. The results are not in as yet and needless to say I am desperate for any information I can obtain. Is it possible for a dog this young and fine up until that day - whose blood work was just perfect - as the vet told me - to develop cancer? His appetite is the same, his coat is shiny he does seem to be a little lethargic but I was told the procedure he had done could make him uncomfortable. Any info would be greatly appreciated.

Answer:

Pets with cancer often have perfectly normal labwork. In fact, when a dog obviously has a serious problem and I can't find a cause and blood work is normal I really start to think about cancer as a possibility. The biopsies of the lump were the right thing to do. I hope that the results have been reassuring or at least helped in devising an appropriate treatment plan.     

Mass in Chest

Question:

Recently we had our dog to a vet because of coughing which has been going on for 3 to 4 months. The first vet gave us medication, which didn't work. We went to a second vet who put our dog to sleep and after a check and xrays it has been determined that our dog has a mass in the chest that is pushing against the throat and the cough is actually a choke. The vet told us he expects death within 1 to 2 months. He said to have surgery would be very expenseive $4000-5000,and that the success of full recovery is a very low rate, and that if it were his dog he would not do the surgery,and have the dog put to sleep when he started to get bad. Our dog has been very healthy, weighs 85#,and always a great disposistion. If you have any information, and advice we would certainly appreciate. Thank you, Dick, karen and family

Answer:

If you are uncertain of the diagnosis or if you are uncertain of the treatment advice whenever a fatal disease is suspected it is best to get a second opinion. In this case, the best second opinion would be from an oncologist if that is possible. There are good oncologists at most vet schools and larger referral centers. Your vet can help you find one. The advice and the outcome may all be the same but certainty can be important. If confirming this doesn't overextend your finances it will be worthwhile in the long run. Plus some tumors are responsive to surgery or chemotherapy and the cost may be less than your vet's estimate (but no guarantee on that).  

About Cysts and Tumors

Question:

I have an eight year old male Shih Tzu. He has what appears to be a cyst (3 mm in diameter) on his back. The cyst is a small raised area that is the color of his skin, with a very slight gray coloring. My fear is that it may be a malignant tumor; however, my veterinarian said that it may just be a wart or mole. My veterinarian will not make a recommendation as to what action I should take. I know early detection is important in malignancies, but I also fear anesthesia. He suggested that I wait and see if any other cysts appear elsewhere. I don't want to put my dogs life at risk by waiting. Is it possible to remove skin lesions on animals without using general anesthesia? The reason that I am so paranoid about the anesthesia is that a friend of mine took her eight year old female Shih Tzu in for surgery. She had a reaction to the drug and never woke up. Are all mast cell tumors malignant? Is it possible to distinguish between a malignant skin growth and a benign growth without surgery? Does the whole cyst have to be removed for analysis? I apologize for having so many questions and for sounding so paranoid about the anesthesia. My dog is very important to me, and I don't want anything bad to happen to him. Thanks for your help, (worried mom) of Rufus (A Shih Tzu that feels great, but has a wierd bump on my back).

Answer:

It is possible to diagnose some tumors and other skin conditions, such as cysts, by aspirating from the lump with a needle and examining the material from the aspirate. If there are questions about the diagnosis then the material may be submitted to a veterinary pathologist for a second opinion. It is also possible in most cases to remove skin tumors using a local anesthetic, possibly in combination with a sedative and/or narcotic agent. We have really good luck using acepromazine and oxymorphone or butorphenol for sedation and pain relief and then using a local anesthetic. If this doesn't work these are the same medications we use as preanesthetic agents for isoflurane anesthesia. This has been a very safe combination for us. Mast cell tumors are usually malignant. It is best if these tumors can be identified by biopsy prior to removal so a plan can be developed to remove a wide margin if the lump is a mast cell tumor. Good luck with this. Talk to your vet again -- make sure that your vet listens to your concerns as they are reasonable.

Disappearing Skin Tumors

Question:

My concern is that my 4 year old cocker spaniel mix developed a round raised lesion in the black lower lip area of his mouth. As I became aware of it I continued to watch it grow to the size of a pencil eraser. It looked similar to a large pimple but was hard and never popped. It happened over the holidays and I didn't have the opportunity to see my vet. A little over one month later it began to decrease in size until it was only a small white mark. It never opened or drained but appears to be gone now. Can you tell me if this was just some type of acne. Did he possibly bite his lip causing a sore or could it be some type of internal problem? 

Answer:

I think that your cocker probably had a histiocytoma. This is a skin tumor that usually will go away on its own. They can occur in any age dog but are a little more common in young dogs. These tumors are benign. Sometimes dogs will get more than one but most dogs seem to get one and when it goes away it stays away. If this does come back, especially in the same place, it would be a good idea to get it biopsied because mast cell tumors can look like histiocytomas and they are a much bigger problem. There are other possibilities. A granuloma (excessive scar tissue) and some fungal lesions can also look like a lump on the skin without many other signs. Both of these often go away on their own, too. In all of these conditions there is usually no worry once the lump disappears, so your cocker will probably be fine.