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Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24404
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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Can a benign tumor, such as a lipoma, grow large enough to

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Can a benign tumor, such as a lipoma, grow large enough to put pressure on the cerebellum and cause a stroke?
JA: I'm sorry to hear that. What sort of animal are we talking about?
Customer: a Yorkshire Terrier
JA: OK. Some lumps are serious and some aren't. Let's see what the Veterinarian has to say. What is the Yorkshire terrier's name and age?
Customer: His name was Chase, and he was 16 1/2.
JA: Is there anything else the Veterinarian should be aware of about Chase?
Customer: He had lipomas all over his body, many were growing fast. Other than those, he seemed to be in great health until last week when he had a stroke. I'm just wondering if a large lipoma could have caused the stroke.

You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

We have identified intracranial (within the skull) lipomas in dogs. These are quite rare and more appropriately called a hamartoma which is a benign, focal malformation that can resemble a lipoma. This isn't a malignant tumor and it grows at the same rate as the surrounding tissues. It is composed of tissue elements (such as fat) normally found at that site, but which are growing in a disorganized mass.

Potentially, then, such a mass could expand and cause a blood vessel(s) to rupture resulting in a cerebrovascular accident. Please respond with further questions or concerns if you wish. I have to leave my computer for the night but I promise to reply in the morning if need be.

Customer: replied 10 days ago.
Hello Dr. Salkin,Thank you for your prompt response. I'm just desperately trying to determine what happened to him. He meant everything to me - and still does. I feel like I will feel better if I know the cause, or at least have a logical possible explanation. If I give you a brief summary of his last few days, could you give me your opinion? Please note that the sole reason for me wanting to know is for me to have some closure. We love our vet, and don't feel that he did anything wrong. I would just like to get a second opinion as to what happened. I realize this is probably an unusual request considering the situation but I would much appreciate hearing your expert opinion (based, of course, on the limited information I will be giving you). It's ok to let me know tomorrow. Thank you.

I understand. Please proceed.

Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin
Customer: replied 3 days ago.
Hello Dr. Salkin,I'm so sorry for the delay in getting back with you. This week has been extremely difficult for me. I miss my baby boy so much that sometimes I feel like I will die. I've attached a summary of his last few days. As I stated before, I completely realize that your feedback will be an opinion based on very limited knowledge and based on never having even treated Chase before. I just desperately want to understand what might have happened.Can you please:(1) give me your expert opinion (again, based on the information I've attached) as to what he passed away from(2) tell me if you think he might have survived had I taken him to the ER - as I almost did - on his last day (as I explain in the attached). I know you may be tempted to say 'no' even if you think he might have, but please give me your honest opinion.The summary is longer than I thought it would be because I wanted to give you as much information as I could in order to obtain a well-informed opinion. I do no mind paying extra.Thank you in advance for your assistance,
Sandy

Thank you for the detailed history you provided. It's important to note that Chase's initial aimless wandering/staring indicated encephalopathy (brain disorder) involving his forebrain. He may have suffered from cognitive dysfunction but at his age this type of encephalopathy is usually due to brain tumor. He lost 25% of his body weight in a year. This is partially due to geriatric cachexia (wasting) but it's consistent with a chronic disease process such as cancer - in this case in his brain. His progressive symptoms referable to his central nervous system (brain, spinal cord) indicate a slowly growing tumor. The fact that he began to grow what most likely were lipomas may or may not have been a factor concerning a brain tumor although it's conceivable that one of those lumps was malignant and spread to his brain.

There's no reason to believe that an ER could have saved such a patient. Critical care can prolong survival but not for an appreciable length of time when my patient has cancer.

Please continue our conversation if you wish.

Customer: replied 3 days ago.
Dear Dr. Salkin,Thank you so very much for your reply. Every word you said makes perfect sense. In the past 2 weeks, I have spent literally hundreds of hours reading, and the more I read, the more I felt like this was something that progressed - not something sudden like a stroke. I do have just a couple of follow-up questions:(1) For no other reason than to pacify my own fixation with this, how confident are you on a scale of 1 to 99% of your assessment?(2) Regarding stroke, it's been suggested that Chase had a mild stroke on or around the 15th followed by a 2nd, worse stroke two to three days later. How likely do you think this could have been the case?(3) As I mentioned in my summary, Chase improved the night of his vet visit. Do you have an idea as to what might have caused this?(4) Being in complete shock and disbelief, the night he passed, we had him buried. We've since decided to have him cremated, which will take place this Tuesday, the 6th. Is it too late to have an autopsy done? Or are there tests or x-rays that can be done prior to the cremation that might help confirm his cause of death? I realize that this probably sounds bizarre, or at the very least, quite extreme, and I don't know that it's even something I would proceed with but I'm just wondering whether or not it would even be an option to begin with.I believe these are all of my remaining questions. I'm not sure how this works, as it's the first time I've ever used Just Answer, so please feel free to charge me extra if needed.Thank you so much for helping me,
Sandy

1) 99%

2) Very likely. Vascular accidents are a major cause of death secondary to brain cancer.

3) Symptoms can wax and wane. Overall, however, there will be an inexorable decline.

4) Yes, he would need to have been refrigerated for a necropsy to be informative. Basic testing is of no value and X-rays can't see inside Chase's head.

I regret that I'm not privy to the financial obligation you have with the site. I'm only allowed to say that I receive a portion of your deposit when you rate positively. Any extra you wish to pay needs to be in the form of a bonus which is an option the site offers customers.

Customer: replied 2 day ago.
Thank you, ***** ***** Dr. Salkin, for your thorough feedback to my questions. You have made my family and I feel so much better. We previously believed that he passed from a primary stroke, so we were blaming ourselves for not taking him for more walks and giving him more exercise. Everything you said makes so much sense, though. I am rating/closing this question now. Thank you very much.

You're quite welcome. Thank you in advance.

Dr. Michael Salkin and 4 other Dog Veterinary Specialists are ready to help you

Thank you for your kind accept. I appreciate it. You may receive an inappropriate follow-up from the site ostensibly sent by me. It wasn't and I apologize in advance should you receive it.

Customer: replied 23 hours ago.
You're very welcome. I haven't received a follow-up email that I am aware of, but I will keep that in mind should I receive one. Thanks again for your assistance!
Customer: replied 23 hours ago.
I should add that while I have zero plans to ever own another dog (I know that is a selfish position to take, but the pain of losing them is just too great), I do have many friends and family members who own pets. I will be telling them about you and will not hesitate to refer them to you for all of their pet questions. :-)

Thank you for your kind words.