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Dr. John
Dr. John, Texas Veterinarian
Category: Dog
Satisfied Customers: 8567
Experience:  Over 12 years of clinical veterinary experience
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10 year old Dog has 7 tumors in his liver, as seen in ultrasound.

Customer Question

10 year old Dog has 7 tumors in his liver, as seen in ultrasound. X-ray found no spread to the chest. Dr said tumors are pushing on his stomach to the side. Biopsy not done yet. This is not my dog. Is my best friends dog, but I love the dog like my own. What do u think about treatment possibilities? My friend would not want to put him through chemo, but what about prednisone or something to shrink the tumors?
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. John replied 1 year ago.
Hello. Thanks for writing in. I am sorry to hear about Louie's diagnosis. Definitely not something that is easy to deal with. Different types of cancer respond to different types of therapy and/or medications. Knowing what may help the tumor would depend on the type of tumor it is. Prednisone most likely won't shrink any tumor to any appreciable degree. The exception would be lymphoma. Even then, it will only work so long. You may get a couple months extra with prednisone therapy alone. If your friend doesn't want to pursue any other additional treatment options, such as radiation therapy or chemotherapy (again, it would be based on the type of tumor, which is determined from the biopsy), then prednisone should be used as palliative therapy to make him feel better. It probably won't change the prognosis, though. If your friend is concerned about the effects that chemotherapy would have on Louie, that may not be as big of an issue as she would think. It doesn't tend to cause the vomiting, lack of appetite and hair loss that it causes in humans. There is usually more of a concern about it causing bone marrow suppression and make them more susceptible to anemia and/or infections. That is something they monitor very carefully with each treatment, though. The biggest problem with chemotherapy is the financial impact it has and the fact that there is no guarantee it will give him that much more time. Different tumors respond to therapies like chemo and radiation in very different ways. Please let me know if you have any other questions. Hope this helps.
Dr. John, Texas Veterinarian
Category: Dog
Satisfied Customers: 8567
Experience: Over 12 years of clinical veterinary experience
Dr. John and 5 other Dog Specialists are ready to help you
Customer: replied 1 year ago.
What if it is not cancer or is it likely to be since there are so many tumors?
I am suggesting we take him to uc Davis vet clinic which is a great place , but what kind of treatment possible? Sounds like only radiation r chemo from what u write.is that correct? No meds? And surgery on liver with several tumors is not advise able, correct?
Expert:  Dr. John replied 1 year ago.

The best way to determine if it is tumors or cystic lesions is to biopsy. There is no other way to tell. I wouldn't say that cystic lesions are out of the question, but tumors are more likely due to his age and the amount seen. Depending on the tumor diagnosis from biopsy, further information on what will work as far as radiation therapy and/or chemotherapy will be more evident. Medication is a very broad term. Chemotherapy drugs are considered medications. As far as non-chemotherapy medicines, anti-inflammatories, such as steroids (prednisone) or non-steroidals (aspirin, Rimadyl, etc) are most effective at limiting tumor growth (affects blood vessel growth in tumors) or even shrinking them. They are only palliative therapy, though, to make them feel better and give them longer. Eventually the tumor will become resistant to the effects and start growing again. It could take a couple week, or it could be a few months. Difficult to predict. With that many tumors, surgery probably wouldn't be feasible. You would have to remove too much of the liver.

Customer: replied 1 year ago.
So, it sounds like it must be cancer of he has so many tumors. And the only issue is what type?. Can u give me a resource that explains the types of cancer an the type of treatment connected to each? Or tell me yourself? If it was my dog, I'd do the but she thinks it will cause him suffering. I'll explain to her, it's not so bad. But it also depends on how much time more he gets from chemo. Is there an average.? And is chemo less severe than radiation. I had radiation on my thyroid cancer but I know it's different . I'm going to help pay , so she should no make decion based in money. I guess I'm not ready o accept he won't live long. She is deaf and he is a service dog, but still very connected to me and a Special dog.
Expert:  Dr. John replied 1 year ago.
Well, there can be many types of cancer in the liver. It could be a primary tumor, meaning that it originated in the liver, or it could be a metastatic tumor, meaning that it spread from somewhere else. Primary liver tumors are uncommon compared to metastatic liver tumors. There are many different types of metastatic tumors you can find in the liver. The two most common ones are lymphoma and hemangiosarcoma, but primary tumors from the pancreas and GI tract can find their way to the liver. It would be impossible to find a resource that would list every metastatic liver tumor you can find and what treatment options are available for each one. What it boils down to is either chemotherapy, surgery or radiation therapy. With metastatic tumors, surgery is not an option. Chemotherapy is the only option. The specific drugs to use greatly depends on the type of tissue and where it came from. Like I said, there are dozens of possibilities. The expected prognosis will vary greatly with each type of tumor. Those questions are extremely difficult to answer without having a firm diagnosis on the type of tumor first. The websites below will have more information, but you won't find any resource that will pack all those answers into one area. A veterinary oncology textbook may be the best. I know this one is a good resource (http://www.amazon.com/Withrow-MacEwens-Animal-Clinical-Oncology/dp/1437723624). Hope this helps.


http://www.vetinfo.com/liver-cancer-dogs.html#b
http://www.veterinarypartner.com/Content.plx?A=2895&S=2
Customer: replied 1 year ago.
Ok I see a biopsy is necessary. I will suggest she do it and hope she will. One more thing. What the most life extension one can expect from chemo. I realize it depends but still want t o know the most. I think she should do the biopsy local and we bring the info to uc Davis. Have u heard bout their reputation?
Expert:  Dr. John replied 1 year ago.
UC Davis is a great facility. You should be well taken care of there. Lymphoma usually responds best to chemotherapy. You can sometimes expect 2 years of remission if that is the case. It can still vary greatly, though. Hope this helps.
Customer: replied 1 year ago.
Did u specify lymphoma cause that type has longest life extension with chemo, or cause liver tumors often come from lymphoma?
Expert:  Dr. John replied 1 year ago.
I mentioned it because they tend to have the longest life extension with chemo.
Customer: replied 1 year ago.
I see. That is the max to expect of any type. That info helps. I gather that and prednisone or similar would be the likely combo. Correct? We will go to uc Davis , I think. Unless my fried decides to just leave it be. But I will tell her that com if not like she sees I humans, as I think that fear is affecting her thoughts on this. Thanks.
Expert:  Dr. John replied 1 year ago.
You are very welcome. Lifespan with prednisone alone is generally not that good. That is with chemo and pred.
Customer: replied 1 year ago.
Yes I understood it would be combo treatment.
Expert:  Dr. John replied 1 year ago.
Oh sorry. I misread. Yes, there really isn't any other non-chemo drug you would add to a chemo protocol beside prednisone. Now, you can also talk to the vet about adding something like Denamarin, which is a supplement that supports liver function. It can't hurt and help some.

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