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Dr. John, Texas Veterinarian
Category: Dog
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Experience:  Over 12 years of clinical veterinary experience
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My dog has had 4 mast cell tumors located on the leg, left

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My dog has had 4 mast cell tumors located on the leg, left side and under both from front legs, removed all under local. 3 months ago. now vomiting all food up, vet took xrays - tumor is in stomach 1/3 size of stomach. All CBC lab work normal but Calcium and Alk Phos elevated, proteins borderline low. He is a male Boston Terrier 10 years old, appears to be in no pain- just can not eat. No fever, alert mental status. What shoudl we do- he is a candidate for surgery?
Submitted: 4 years ago via Dog-Health-Guide.
Category: Dog
Expert:  Dr. John replied 4 years ago.
Hello. Thanks for writing in. Sorry to hear about your Boston. Did the vet get an ultrasound of the abdomen to look for spread of the tumor elsewhere? Is he on any medications now?
Customer: replied 4 years ago.
She took two views- side and on back. Mass was more visible on view while he was on his back-white mass top third of stomach, side view was very white, she said the liver was possibly blocking the view of tumor- no ultrasound. She gave me Prednosone 10 mg- give for 2 days and cut back to 5 mg til gone and she would renew if improvement seen. She saw not other tumors in the abdomen on these views
Expert:  Dr. John replied 4 years ago.

Thanks for the information. Just one last question, and I will address your concern. What grade did the pathologist give the previously removed mast cell tumors?

Customer: replied 4 years ago.
I wish I could remember- I think she said grade 3- she said it was all removed- but to expect reoccurance- the first one was removed about a year ago- it was small 0.5 inch, the next one was 1 inch- the last one removed 3 months ago was over 2 inches- she found 2 little ones under each front leg and removed those also- the only one sent for biopsy was the first one. I guess that actually makes 5 tumors in all- She thought they were all the same type- but is holding the specimens if we wanted further tests, at the time we figured these were all the same. Today after 3 days of vomiting, I took him in to vet. the "on call " vet saw him and thought the tumor in the stomach would probably not be the same type of cancer in that area- would only know if another biopsy was done. But she figured I should prepare our family for the worst. Any advice? He is in good spirits- what is the expected outcome here
Expert:  Dr. John replied 4 years ago.
Thanks for the information. A grade 3 mast cell tumor can be a very aggressive one. Spread to the stomach and other abdominal organs is very common. Spread to the liver and spleen is the most common destination. It is very difficult to evaluate for abodminal tumors on an x-ray. It doesn't really allow you to see the architecture of the abdominal organs, only an outline. His prognosis can vary greatly, depending on the type of tumor. Usually tumors in the stomach do not offer a good prognosis. Endoscopy of the stomach would be the best way to evaluate this tumor. A biopsy can be taken from there. I would also highly recommend an abdominal ultrasound to fully evaluate the liver, spleen and kidneys for any masses. Other types of tumors may include and adenocarcinoma of the stomach or intestinal lympoma. Neither offer a good prognosis either. If there are tumors on other organs, surgerical removal of the stomach tumor would not offer any real help. The increase in liver enzymes suggest that a tumor may be located here as well. If no other diagnositics or surgery is pursued, you can add Benedryl, Pepcid and anti-vomiting medications to help keep him comfortable. The Benedryl will block histamine release from a potential mast cell tumor, and the Pepcid will help to protect the stomach from this histamine release and excess acid secretion in the stomach. I would keep on prednisone as well. In my opinion, if this is spread of the mast cell tumor, surgery is probably not going to be a good option for him. The tumor will most likely come up somewhere else. Please let me know if you have any other questions. Hope this helps.
Customer: replied 4 years ago.
three last questions, I really appreciate your advice on the benadryl and pepcid- what doses for a 24 lb Boston? and is this cancer a common ailment in bostons, should I have done something with his diet to strengthen his immune system?
Expert:  Dr. John replied 4 years ago.
For Benedryl, I would give 25mg every 8-12 hours. For Pepcid, I would give 5mg every 12-24 hours. 10mg every 24 hours would be fine. As far as stimulating the immune system, recent studies suggest that giving probiotics help to stimulate the gastrointestinal immune system. I think this would work best. Not really a common ailment in Boston Terriers. It is very common in Boxers, but it can be seen in any breed. Mast cell tumors are one of the cancerous tumors that are seen in younger dogs more commonly as well. Hope this helps.
Dr. John, Texas Veterinarian
Category: Dog
Satisfied Customers: 8554
Experience: Over 12 years of clinical veterinary experience
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