To try and explain it as concisely as I can: My dog is lovely and seems about 6 but she's really chronologically 17 (will be 18 in Oct). She had a lump on her neck and has just been diagnosed with cancer (Sarcoma) and had surgery to remove it but sadly there still remains some at the borders. The report says it was stage 3 and that there's 40% chance it will spread (so 60% chance it won't), but that unfortunately there's 75% chance it will come back. The prognosis is "guarded" which the vet said means it's likely it'll come back. The vet was just like ... sorry. And it didn't seem there was anything more they could do. Just bring her in monthly to check if its coming back and then every couple of months if it's not showing up after that. I (finding it hard to think straight) asked about chemotherapy and the vet said there's only a small chance it would work and that chemotherapy can make them feel ill and while she's happy as she is it's best not to do that. I also mumbled something about would there not have been enough tissue to have taken more. While of course I don't want her to suffer I am worried/wondering that there's a chance maybe they're just sort of writing her off now because of her age and think oh let's just let her die gracefully now. I'm scared maybe if she was younger but the same physical health they might be offering to do something more While of course there are some selfish reasons (she assists me getting around with my disability and anxiety and been with me for my whole adult life so far so I owe her a lot, she's like my little sister, she's my family and the person I can depend on etc and I help her get around too when she has laryngeal paralysis related wonkiness sometimes, we help each other), it's actually not for selfish reasons I want to keep her around. I want her to be around because she is happy and likes being alive. I always save any little animals I can help and they always seem so relieved and happy as they go off to live their wild life. I want to keep her alive for her, not for me. It seems so counterintuitive to allow cancer to take hold of my own sweet Sam, if there might be something I could do about it. And should I be asking for further help as soon as possible before it does come back again? Leaving it till this monthly checkup might be too late if we should be acting now. My Dad says don't mess her around any more (not that I've currently been given a choice). And I do understand the whole quality over quantity of life for your pets thing. But he's also a glass half empty person with less animal observing experience and I'm a glass half full type person. Obviously I don't want her to suffer but it feels like I should be fighting for her with all my might. I have also emailed a (non local) vet whose opinion I respect to see what she says about it all. My heart is fractured and I have to keep going into the other room to cry so Sam doesn't know anything is wrong. By the way despite loving dogs an extreme amount, I actually didn't choose to even get a dog in the first place (and might not have wanted to because of not liking the sad parts), but she was given to me so then I knew she was my responsibility so I've tried to do the best I can for her. But it's this very worrying part which I would likely have not wanted to have a dog for if I'd had a choice (and why despite loving animals I couldn't be a vet - as I find it so upsetting when animals suffer). But now obviously I'm in it and have to step up and do the best for Sam. Also it's difficult trying to balance work (luckily I work from home) and desperately researching ways to help her like the optimal diet etc - while not being able to think straight - and spending time with her. Sorry if I explained this badly, my mind is kind of frazzled right now. Any advice or words of wisdom etc would be greatly appreciated. Best wishes, Jack --- I used to be a member of this forum years ago but couldn't remember my log in details so made a new account.
Hello Jack I'm so sorry you're facing this problem with your girl. Although I work in human clinical research, I'm not a vet so take what follows with this in mind. You mention your girl has been staged as stage 3. Does this mean the vets determined there is no cancer anywhere else in her body except for the tumor that was operated on? Is there any chance you can get a second (expert) opinion, preferably at a university vet school? It would be helpful even if it were a teleconference after reading her records. Your vet could set this up for you or you might have to do this yourself, including seeing to it that records are sent (electronically). Maybe I'm misunderstanding but if the margins are positive after surgery, is the vet saying there's X chance it will spread or recur? If the cancer is still there??? I would ask if radiotherapy were possible. It may or may not be depending on the location of the tumor, but if successful it would take care of the margins not resected at surgery, at least in one spot. Obviously you'd have to travel because community vets don't keep radiotherapy machines in their offices. Treatment is not always curative - think of diabetes - but can make all the difference in terms of quality of life. In humans radiotherapy can be used for local pain control even when there is no chance of controlling metastatic disease. I've had several friends with dogs on chemo and the dogs did fine, which is to say the adverse effects were minimal or fixable with drugs. Your question here is, I think, would chemo decrease the likelihood of spread or slow it down, and WHAT IS THE EVIDENCE FOR THIS? Some chemo drugs require a lot monitoring to prevent problems like dehydration or funky blood chemistry. You should ask about this and consider how life would be with weekly or twice weekly vet visits. Might be no problem or might be troublesome depending on circumstances. I'm sure you feel frazzled but your thinking is remarkably sound because you've put your girl's well being at the forefront. Just because she's 17 doesn't mean she shouldn't get the best care possible. Remember to care for yourself too
Hi Athena thanks so much for your reply. Yes at the moment it was just in her neck. I am speaking to a different vet tomorrow on a video call to see what she thinks of it all. She studied physiology with biochemistry before she was a vet too so that might be handy. Yes the report says that there is 75% chance it will recur (((( (It also said there is 40% chance it will spread.) Okay I will make sure to ask in the video call tomorrow about radiotherapy, and again about chemotherapy. I get the feeling that the vet I am speaking to tomorrow is quite knowledgeable and also someone who is compassionate about animals, so I really hope she has some good advice. I have also bought a book on what diet to feed dogs with cancer. I'm going to look at the other book the same author has written too. Aww thank you very much. And thank you very much for your advice and support. I really appreciate it. Best wishes, Jack
Hi Jack So sorry that you find yourself in this position. My dog Toby’s cancer story is in this thread. https://thelabradorforum.com/threads/mast-cell-tumour-diagnosis.26856/ His cancer was removed along with his ear with 3 cm clean margins so radiotherapy was unnecessary. However it was a highly aggressive form of skin cancer and he was given a 6% chance of being alive 2 years on. His final check up is in August when he will hopefully be signed off. Chemo was a no brainer for him at 18 months to mop up any cells but was very stressful for him even though the side effects were minimal(loose stools for 2-3 days and 1 missed dose due to blood in stools and low blood count) He hates being manhandled and any noise now that sounds like a pair of clippers he is a quivering wreck! If he had to go through it again in old age I would certainly have to think very hard about spending 3 months of his life doing that again and would almost certainly choose not to.Sam may be completely different and love the attention the vets give. Ask about time to spread. Yes it probably will spread given those percentages but how long would it take to become an issue? I am resisting looking up sarcoma as like you I would want to know all the details and possible help. Be careful able changing diet at this stage just keep it as healthy as possible. I stopped his flea/tick tablet and give minimal vaccinations(plenty of threads on here about those) Let us know how your consultation goes. Take care.
Hello, this is such a difficult situation and you rightly are seeking a second opinion. I hope your consultation today brings some clarity to decision making and potential outcomes. For what it’s worth my view would be a minimal approach. Whilst chemo may help, it’s all the vet visits, blood tests, investigations etc. that go along with that which are tough. All those episodes are pretty unpleasant and can hurt. I would not want my dog to spend her latter years going through that unless there would be a huge extension of life guarantee at the end, and for a dog that is nearly 18 that would not be possible. I would spend my time with her enjoying together the things she loves and cherish the time she has.
Hi J.D & Edp, thank you very much for your comments and advice. Aww so sorry to hear Toby had cancer, I'm so glad he's doing much better now. That's excellent. He looks very sweet with his 1 ear bless him. Sam is quite chill about noises like clippers (probably from where I do her nails with a grinder thing she's used to it). But the vet today said apparently chemo doesn't work well on this kind of thing anyway I haven't done her flea stuff for a while either. And she's missed some vaccinations too. I get a bit confused and overwhelmed working out the exact benefits and chemicallyness of things. I tend to prefer things to be as natural as possible (but also don't want to get it wrong and miss out something important). Health seems like such a delicate balancing act and so hard to know if you're doing it right or not. I will try and do some research and find the threads you mentioned. Yes that makes sense about the blood tests and things, and horrible vet visits and things. It would be nice to just sit back, and do nothing and let her be, and just do nice things with her. But... It also just seems so difficult to "let her die" sort of thing, and I don't know if it's the right thing to do. It's my instinct to want to protect her and help her survive. I wish she could live out the rest of her days happily and healthily without cancer. I know she's chronoligically 17 but I (not in a deluded overly-optimistic way, just a factual one) see the same pup she's always been when I look at her. Just with a few little bits laid over the top which we adapt to. I know she probably doesn't have that much time left anyway but I guess if you're a happy little animal every extra moment counts. I... I just don't know. Often when I've pushed myself to do things I'd rather not (like in this case checking for other treatments) but know it would help them, to help little animals and insects survive and stuff it's really helped them. So it's all a bit confusing. I know in a buddhism/spiritual way though, that sometimes you have to just let go/accept, to then take positive action, but not sure how or if that applies here. I don't want to just... let go of her hand as she dangles over the cliff, if I could pull her up. Here are the main things I've taken away from the video call today: The recurrance is likely to be fast because it's high grade. So it'll probably grow back (the same place) and soon. Because it's still there (at the edges) it will just re-grow. That recurrance is likely to be fast -- likely weeks to months. (Though it could be longer. It's individual.) Chemotherapy doesn't work too well on this kind of thing. Radiation does. However it also kills all the stuff around it not just the cancer, and there's quite a lot of important nerve and veins around where it is on her neck, so it's probably not feasible. If it was on her leg or something she'd say no hesitation do radiation therapy, but it's in such a delicate place. She suggested maybe a referral to a dog oncologist for a consultation who might have more answers and be able to know if maybe there actually is another bit of tissue which could be taken. The referral would probably cost around £300 or £500. Yikes. I don't have very much money but would try and find or borrow it to help her. My dad has been paying for most of it so far which has been amazing of him. But of course there's only so much he'll be able/want to do. And then the treatment of course if there was anything possible would be loads of money too. While this type of sarcoma doesn't normally tend to spread when it's low grade, Sam's might/might have already, because it's aggressive. (Likely that it has or will spread into her chest.) So if going to look into other things the vet said do chest X rays 1st, as there's no point thinking about any further stuff on her neck if it's already spread to her chest. She was saying some other things which sounded like she was describing living with the cancer when it comes back and if it had spread and what it would be like. Saying that for a while it would grow on the neck and then after a while start pressing on the nerves and things which might not be too bad for a while but then would get uncomfortable. And about if it's spread to the chest that it could fill up the lungs up to 60% before it causes a big problem, and that you can live with 1 lung. But then when it got to 60% it would be noticeable in her breathing and it would be harder for her to breathe and so on. We talked about her diet a bit too (as I'm researching the dog cancer diet). I am a bit confused about how I am going to balance everything to get it exactly right to feed the cancer as least as possible while also feeding her the best as possible. So far in the book (I'm only a small way into it) it sounds like you have to be careful to give more protein than carbs, the vet today said about older dogs needing more carbs than younger dogs though. So that is going to befuddle me a bit, finding that balance. Thank you again for all your advice and the support I appreciate that so much, sorry if this doesn't make too much sense. Best wishes, Jack
