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petdrz
petdrz, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 7267
Experience:  Over 30 years of experience caring for dogs and cats
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I have a 6 year old female "lethal" or "double Merle"

Customer Question

I have a 6 year old female "lethal White" or "double Merle" Australian Shepherd dog with a recent diagnosis of Hermangiosarcoma. I have a histopathology report I can upload for your examination. I need to know what this means in terms of severity, possible or suggested treatments, long term prognosis.
Other health issues are allergies, at the moment constant licking at one toe on left rear leg, and now a spot on the right rear lower leg. Glaucoma since birth, apparently controlled with Pred acetate, timodol and donzolamine (pardon the spelling), slow progression of cataracts. Tiny heart concern at 4 months of age, grown out of it, genetic defect herniated belly button, repaired and no further concerns. She's always been healthy, demonic if she does not get enough exercise, and ready to eat, ALWAYS.
Currently no weight changes, or appetite changes, she does seem less energetic but not lethargic. Just seeming to sleep more quickly and for longer periods of time.
She is a breeder mistake whom a kindly vet would not euthanize. OF course she is the best dog in the world.
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  petdrz replied 1 year ago.

I am sorry that you have been waiting for a response. I recently just logged onto the site and noted that your question hasn't yet been answered. I am a licensed veterinarian with over 25 years’ experience and would be happy to work with you if you are still needing assistance.

I would be happy to review the histopath report and comment further in prognosis if you can upload her for me to read.

One other thing, I have read and reread your original post and do not see if you stated where the tumor is located on the body?

Thanks and I will respond further after you reply. There may be a slight delay while I formulate and type a thorough response or I may be offline, but if so, I will respond as soon as I am able.

Customer: replied 1 year ago.
I cannot upload the file you site sucks, your service sucks. i have used this service perviously without these issues.
Expert:  petdrz replied 1 year ago.

I am sorry you are having problems. It does appear that the histopath report uploaded. Please give me a short while to review it and type a reply.

Customer: replied 1 year ago.
I paid for a doctor to answer the question, after having to type it twice I realized the site was changing froma vet to a human doctor. after trying to add the file and being furious because it would only Open and take over the page, it shows attached. I am beyond livid right now with the site refusing to let me log in with my original email even though it asked for it. then I have to enter the question, very lenghty a thrid time and I cannot get past the BLEEPING trial sign up!!! itOPNLY allows me to SELect one of the monthly charges AFTER I aSAID I DO NOT WANT A FREE TRAIL!!! THERE IS NO OUT!!! THERE IS NO ANSWER AND I HAVE A SICK DOG IN NEED!!!
Expert:  petdrz replied 1 year ago.

I am sorry that you are having issue with the site, but on my end, everything looks quite normal. As an expert, we are only allowed access to the information regarding the questions and reply, but none of the billing or personal contact information. I will send you my reply in regards ***** ***** pet to hopefully answer your questions and I will refer you to customer service to address your site issues. They should be able to take care of that for you.

In regards ***** ***** girl, the most worrisome part of the history and the histopath report is the fact that the margins were not clean. There are two ways that a hemangisarcoma can end up on the third eyelid. One is if it is a primary tumor that originated on the eyelid itself. These tend to be solar or UV light induced. They rarely metastasize to other parts of the body, but can be locally aggressive, so if cancer cells are still present, without additional therapy, it will likely recur. Additional therapy can include cryotherapy or additional surgery to remove the entire third eye lid.

Of greater concern however is that this could be a metastatic manifestation of a primary hemangiosarcoma tumor eleswhere in the body, usually spleen or heart. With this in mind, I would proceed with a thorough search for a primary tumor. This would include abdominal and cardiac ultrasound as well as thoracic radiographs. If a primary tumor was identified, that would change the prognosis dramatically and pursuing additional eye surgery would be less important.

I hope this is helpful. Please let me know if you have ANY other questions. My goal is to give you 100% satisfaction and if you are not yet satisfied, please reply so I can clarify for you.

Dr Z

Customer: replied 1 year ago.
What does the Nictating membrane item mean?Due to her genetic deficient eyes it is highly probable my dog may have sun damage in the eye as to cause the tumor, but if the margins are not clear, it could metastisize to the vital organs? Correct? How do I get the Eye Dr to be sure the margins are clear as it appears he may not have removed a large enough portion of the tumor? Do we need to remove more tissue? the entire eye? Is my first line of action to proceed with looking for a primary?There are additional terms in the report I recall the Eye vet mentioning some item that seemed positive. The mitotic index is 0. What does that mean?
Expert:  petdrz replied 1 year ago.

Nictating membrane is another name for the third eyelid. They are just referring to where the hemangiosarcoma (HSA) is located.

It appears that when HSA occurs on the third eyelid, it is more likely a primary tumor (especially in a dog with her genetics) and as such, is much less common to metastasize to other organs than to recur in that site if the margins were not clean. Removing more tissue is an option, but that would most likely mean removing the whole third eyelid. Cryotherapy appears to be a viable option as well and would preserve the eyelid.

Even though it is not likely to metastasize, it would be prudent to screen as outlined above to make sure there is not a primary tumor that this tumor may be secondary to. Yes, it is a good thing that the mitotic index is 0, but the unclean margins need to be dealt with, in my opinion, not just monitored. I would strongly suggest having her case reviewed and having her examined by an oncologist who can probably do the cryotherapy or make sure that there are no other options for follow up care that we haven't considered.

Customer: replied 1 year ago.
I will pursue all avenues of therapy. Thank you. ***** understand you correctly in that it is most likely this in the eye tumor is the primary tumor? Of course we already have an appointment to screen for any other tumors. I will contact an oncologist for her as well regarding perhaps further treatment on the eye tumor.
Expert:  petdrz replied 1 year ago.

I don't know if I can say that I think that is most likely, but I would say there is a good chance due to her UV sensitivity secondary to her lack of melanin. Good luck to you and please keep me posted as to how things progress for her.

I apologize again for all of the confusion as you were trying to upload and post things. I hope customer service got that all worked out for you.