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My male dog 10 yrs old has a lump on his right side above

Hello, My male dog 10 yrs...
Hello,
My male dog 10 yrs old has a lump on his right side above his hip. He's had that lump for months with no issues. It became bruised one day and he got an infection and a fever and kept throwing up. Nothing had changed in his routine or food so we don't know the trigger. He was given pain meds and antibiotics. After two days he was back to normal and running around. The lump although still there was no longer bruised and seemed smaller and softer. He has had no other symptoms in the last 3 weeks other than throwing up a couple of times. His appetite and energy is good. Poop and pee is fine. The lump has not changed size since. But needle aspiration result says it is a low grade mast cell tumor. Our vet said since he is not experiencing any symptoms other than the lump that he did not want to surgically remove it at this point as it might aggravate the tumor. He said that usually it should be getting bigger and be bruised and that is when he would know it is getting worse and remove it. Everything I've read online though says we should get it surgically removed as soon as possible. I am afraid if we do nothing, it may progress to a higher grade. I am looking for a second opinion from you as to what we should do about it. Is it safe to just leave things as is like our doc says or should we do something now while it is a low grade? What are the pros and cons of either approach. Thanks!
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Answered in 23 minutes by:
1/9/2014
Dr. Peter
Dr. Peter, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 31,417
Experience: 16 years of internal medicine, surgery, and preventive care.
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Welcome and thanks for asking your question. My name is***** am a licensed veterinarian. I am happy to answer your question today.

Friend, the standard is to surgically remove a mast cell tumor. The goal is to remove the tumor completely with clean margins to prevent further growth or spreading to other area. If it is not removed then we run the risk of spreading to other places or becoming larger making it more difficult to remove later with clean margins. Highly recommend speaking to your vet about removing the mast cell tumor as soon as possible.


My goal is to provide you with excellent service – if you feel you have gotten anything less, please reply back. I am happy to address follow-up questions. Thank you for your business and I hope to work with you again soon!

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Customer reply replied 3 years ago
Relist: Incomplete answer.
Please have another expert reply. Thanks!
Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 10,549
Experience: I have been a practicing veterinarian for over 30 years.
Verified
Hello, I'm Dr. Deb. I'll do my best to help you today.

I have a few questions to ask first about your dog, if you don't mind:

1. What breed is he?
2. How long has he had this mass in question? You mention months but could you give me an estimated number?
3. Did your vet examine the aspirate or was it sent to a pathologist for review?

There may be a slight delay after I receive your answers since I have to type up a response to you. Thanks for your patience. Deb

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Customer reply replied 3 years ago

Hello Dr Deb

He is an American Eskimo miniature size.

He has had it at least 6 months. We adopted him 6 months ago so we do not know if he had it earlier than that. At first the doc thought it was a fatty tumor when we took him for his initial exam when we first adopted him but when it became bruised 3 weeks ago he decided to do the needle aspiration and found it to be a mast cell tumor. The aspirate was sent to a pathologist for review and the vet examined it as well. He said he was confused why my dog is not showing typical symptoms coz he said typically the tumor would be growing bigger and looking worse. Instead it became smaller and all the bruising has disappeared. So that is why he does not want to do surgery and disturb the tumor. He fears that might aggravate tumor.

Thanks so much for the additional information.

The reason I asked about the breed is that Pugs can develop mast cell tumors which appear to be very low grade and will remain that way. So, a there's a little more leeway in deciding whether or not to remove them.

I agree that the biological behavior of this particular mast cell doesn't appear to have read the textbooks. They typically do grow faster in a short period of time.
However, I absolutely have seen mast cell tumors wax and wane, some even disappear to then reappear. This fluctuation in size is thought to be due to degranulation and histamine release (called Darrier's response).

To answer your questions though:

Pros of surgery:
1. Complete surgical excision when the mass is small should ensure complete removal. It can be better staged since more tissue will be available for analysis so if you decide to pursue options from an oncologist, they will want this information.
2. You don't have to worry about whether or not this mass will spread to other internal organs, if it has not already done so.
3. Removal should not aggravate the mass if complete surgical excision is obtained. I often will give these dogs Benadryl or low dose steroids prior to surgery to help prevent histamine release but I realize that every vet is different.

Cons of surgery:
1. Anesthetic risk although this is true for any surgery.
2. Incomplete removal of the mass, thus necessitating possible recurrence.

Bot***** *****ne: I agree with Dr. Peter that when dealing with a mast cell tumor in any other breed than a Pug, that it's best to remove them while still small and before they have the potential to spread.

I hope this helps. Deb

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Customer reply replied 3 years ago

Thank you Dr. Deb. Our vet did a second needle aspiration the other day and we are waiting for those results before we go talk to him again. I will bring up these points. Should an oncologist do the surgery or can a regular vet do it?

You're more than welcome.

I also neglected to mention under "Cons"....
3. Just because this would appear to be a less aggressive mast cell tumor now, doesn't necessarily mean it won't spread given enough time. In other words, it can change over time.

A regular vet, comfortable with surgery, should be able to remove this mass. There's no need to have an oncologist or even a specialist do the surgery. And, given that it's not on a limb where there's often not enough skin to adequately close the incision or to possibly completely remove it, there shouldn't be a problem to obtain wide margins when it's removed.

Deb

Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 10,549
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Customer reply replied 3 years ago

Thank you very much Dr. Deb. Your answers are very thorough and useful.

I'm glad you think so and I'm happy to be able to help:) Thank, also for the rating; it's greatly appreciated.

Good luck with your boy. I'd appreciate an update after you discuss the situation with your vet. I'd like to know what you decide to do.

Even though you've rated, we can still continue to communicate at no additional charge to you. Just reply to this email exchange as you have been.

Regards, Deb

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Customer reply replied 3 years ago

I appreciate that very much Dr. Deb. Thank you. I will definitely ping you once we get the results back and talk to the vet. We love our boy and it is heartbreaking to find out he is sick just when he finally found a forever home and has grown to trust us. Hopefully we can get him set right so he can live a long and happy life.

What a real cutie!!!! He looks so happy and I'm sure he couldn't be more pleased to have found someone who obviously cares so much about him...but then, how could you not!! Look at that face:) He makes me smile just looking at him smile.

Anyway, I'll stop gushing and just say I look forward to chatting with you when you have an opportunity to let me know what you decide to do:) Deb

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Customer reply replied 3 years ago

Hi Dr. Deb

Cornroy's test results came back positive again for mast cells. Cry Our vet has decided to go ahead with surgery on Thursday. They only told us not to feed him after 10pm the night before. He is still not showing any symptoms. I hope he will survive surgery. So worried.

Oh, I'm sorry to hear that but I guess that's not too surprising since the aspirate indicated that this was likely the case.

Obviously, there's always a risk any time anesthesia is used (human, dog or cat) but many advances have been made in this field as well as monitoring equipment during the procedure. If pre-anesthetic bloodwork was normal, then the risk is very, very minimal.

I know you'll be worried about him until he's back home safe and sound but I do agree that this is the best course of action.

Not all vets will premedicate with anti-histimines when mast cells are to be removed but you might ask your vet about it.

Please keep me posted. Deb

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Customer reply replied 3 years ago
they are doing complete blood test with clotting test and giving antihistamine. I dropped him off at the hospital so now the wait begins. hopefully I will have good news to share later. for now anxiously waiting. thanks for the tips.
I know you'll be on pins and needles for most of the day but, hopefully, everything will go just fine.
I'll look forward to an update when you have more news to share. Deb
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Customer reply replied 3 years ago
we were able to bring Cornroy home this evening. we have pain meds, antibiotics and antihistamine to administer. he has a 4 inch cut and we are scheduled to take the sutures out in ten days. the biopsy will take another week. hoping for good results.
https://m.facebook.com/photo.php?fbid=671761926218060&id=440261966034725&set=a.599720383422215.1073741829.440261966034725&comment_id=1961825&offset=0&total_comments=17&ref=m_notif¬if_t=photo_comment&actorid=766926025&__user=100000152382445

So glad he's home with you:)

He still looks a little groggy from the anesthesia though.

Incisions always are so long when mast cells are removed but this was a good place for one to be located.

Keep me posted when the biopsy results return. Deb

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Customer reply replied 3 years ago
we were instructed to give 25mg of tramadol every 12 hours but he woke up 6 hours after the last dose frantic and groaning in pain so i gave him another 25 mg and he calmed down. he is 23 pounds. now it is 6 hours later and he is starting to groan again. it looks like the 25mg every 12 hours is not sufficient to control the pain.

Sorry I was offline when you posted this additional concern about Cornroy.

You may already have been in touch with your vet about this but the ere's quite a wide dosage range with Tramadol and it can be given every 6-8 hours, if necessary.
If this were my case, I would have given him 1/4th of a 50 mg tablet of Tramadol at one time (12.5 mg) but as I said, there's quite a wide range.
So, if he needs 25 mg every 6 hours to control his discomfort/pain, then this is an acceptable dosage for a 23 lb dog.

There's no reason why he should be uncomfortable. Deb

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Customer reply replied 3 years ago
thanks Dr Deb. I was able to reach our vets office and they said to do pain meds 25mg 3 times a day instead of 2 and to come in for a pain patch this morning.
Sounds like a reasonable plan:)

I'm a little surprised that he's so painful but, hopefully, he won't be after a few days.

Deb
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Customer reply replied 3 years ago
hi Dr Deb, Cornroy's stitches were taken out today. they said the incision was healing nicely. but the biopsy results said it was a grade 3 tumor. :(
That's great that the incision looks good since I've seen some that didn't when mast cell tumors were removed but that's too bad about the biopsy results:( This is disappointing.

Did your vet indicate if the margins were clean? Was it completely removed, do you know? Did they mention anything about the mitotic index? Was chemotherapy or radiation suggested?

Deb
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Customer reply replied 3 years ago

He said it was completely removed along with some muscle too. I can ask about the margins and mitotic index. He said to come back in two weeks. He is going to consult with an oncologist next week. He mentioned we might need to be giving two kinds of oral medication.

Here's Cornroy. I made him a soft collar so he would not mess with the incision site. He did not like the plastic cone the vet provided.

https://scontent-b-pao.xx.fbcdn.net/hphotos-frc3/t1/p403x403/1509797_674233129304273_1219398891_n.jpg

https://fbcdn-sphotos-b-a.akamaihd.net/hphotos-ak-prn1/t1/s403x403/1011434_673549159372670_1527860039_n.jpg

He looks absolutely ridiculous and adorable at the same time:)))

That's good that he's going to consult with an oncologist; then, you can decide the best way to proceed.

Please keep me posted as more information is made available to you and after you discuss additional options with our vet.

He really is the cutest dog:) Deb
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Customer reply replied 3 years ago
He is a happy goofy dog 😄I'll let you know as soon as we get more information. Thanks so much Dr Deb.
You're more than welcome.

Yes, he does look like the kind of dog who sees the glass as "half-full" rather than "half-empty":))))

I'll look forward to updates when you have them. Deb
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Customer reply replied 3 years ago

Hi Dr Deb

Sorry it took so long to get back to you. We finally got the results from the pathologist and our vet has referred us to an oncologist for further treatment. I asked for a copy of the results:

Previously diagnosed as mast cell timor in the skin on the right paralumbar area. Section of lumbar muscle removed but not submitted. An excisional biopsy. Cutaneous mast cell tumor, histologic high grade, Patnaik grade III. This is considered a histologic hight grade mast cell tumor based on the mitotic index which equals 3 per high power field (30 per 10 high power field). It is considered Patnaik grade III mast cell tumor for the same reason.

It does not soud good at all. Cry We made an appointment with the oncologist for Sunday. But from what I've seen on the internet it sounds like Cornroy might not have much time. Sniff! He coughs in the early morning and breathes noisily sometimes. His front legs shakes sometimes. Other than that he does not look ill or in pain. Scared he might suddenly go downhill based on these results despite not showing too many symptoms. Or that any treatment might make him feel worse.

No worries about the delayed response but I'm so, so sorry about Cornroy; I'm sure you must continue to be absolutely heartbroken about his diagnosis.

Unfortunately,as you indicated grade 3 mast cell tumors are clearly not as good as lower grade ones especially since they do tend to metastasize.

I'm assuming that chest x-rays will be done ( if not already to evaluate his cough) and probably an ultrasound in an attempt to stage the disease.

There are a lot of variables as to how quickly he might decline but the fact that he appears to be doing well so far it excellent.
I don't have information about how much time you might expect that he would have but I'm certain that the oncologist will be able to provide you with those numbers.
I do know that dogs treated with chemo have a longer survival time than those left untreated.

His bloodwork looks good, though.

Please do let me know what the oncologist says after your visit. I'll be thinking of you both. Deb

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Customer reply replied 3 years ago

Thanks Dr Deb. We will keep you informed. He has had the cough since we adopted him in June. The rescue said he had kennel cough earlier and when we took him to the vet to get xrays the vet said he had a collapsed trachea. They gave him prednisone and cough stuff but it did not fix the cough. When we got his weight down it seemed the cough was not as bad. But after diagnosis for the cancer it is back. But mostly in the early mornings. He wakes up coughing. Still hoping against hope it is just the tracheal collapse that is making him cough. But like you said most likely the oncologist will want xrays and ultrasounds so we'll find out. Hope you have a good weekend. And thanks again.

let's just hope it's his trachea which is causing the cough which certainly can improve with weight loss.

I hope your weekend is a good one as well but I know you'll be worrying about Cornroy until (and probably after) your oncologist visit.

I'll look forward to continued updates about him. Deb
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Customer reply replied 3 years ago
hi dr deb
to stage the cancer the oncologist said they need to do ultrasound X-ray blood spleen kidney etc tests costing $1600. what is the minimum test we can do to stage as we don't have that much and would like to put our money on the treatment side rather than tests if not really required for staging. he said our opinions were kinavet, radiation, chemo or prednisone. he gives 3-5months without treatment and maybe a year or two with kinavet. he recommends the kinavet but it is $500 a month. he said the cheapest treatment is prednisone but we tried pred for his cough before and he did not do well on pred. we are at a loss how to afford treatment and how to get treatment that will give him good quality of life as opposed to lengthening his life but if it is a life of side effects from the drugs then we do not wish to subject him to that. what do you think we should do? he says we have to decide quick as the mitotic index is so high.

In situations such as this, it's always a really difficult decision trying to balance quality of life versus quantity of life.

I have absolutely no experience with Kinavet, unfortunately. When I researched a veterinary sponsored database about it, there would appear to be a reasonable response to it in treatment of Stage 3 mast cell tumors but from what I can tell, not all oncologists are using it as a first treatment option but only if there is something called a c-KIT mutation.
But at a cost of $500 a month, I honestly don't think many of my clients would be able to afford it.

Since I don't have any experience with it, I'd be curious to know the expected survival time with conventional chemo and radiation as opposed to use of Kinavet. Is there a significant difference? I understand the oncologist told you no-treatment versus Kinavet usage but what about other traditional chemo/radiation options?

What about Palladia? It's a similar class of drug as Kinavet (a kinase inhibitor) but, again, I have no personal experience with it to know how expensive it might be. From what I could find on the website I mentioned there apparently is no data yet about whether use of kinase inhibitors are any better than traditional chemo and radiation alone....this was as of 8/13 so I don't know if any new studies have been published. I would assume a specialist in the oncology field would have this information, though.

Staging is primarily aimed at providing a prognosis but it may also be used to determine which particular chemo drugs will be of most benefit. Additionally, if there is widespread disease already, then you may not want to pursue expensive medical therapies. But, while it's definitely recommended, I personally don't necessarily think it's critical since radiation can still be done and chemo (usually vinblastine with pred) could still be given. But, for me x-rays are not necessary since mast cells tumors rarely spread to the chest; an ultrasound can better help determine if there's already metastasis to the liver or spleen or gi tract.

What sort of side effects did he have when pred was used before? It's possible that radiation and Vinblastine could be used without pred but once again, my experience is limited in how effective this might be.

If this were my dog and I were in your shoes, I'd probably discuss radiation and chemo with the oncologist in terms of cost and average survival times. This may be a reasonable compromise for that balance of quality of life versus longevity that you're trying to achieve.

Deb

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Customer reply replied 3 years ago

Hi Dr Deb

I have asked about the c-Kit mutation and Palladia. And about survival time compared between Kinavet and chemo. Waiting to hear back from the oncologist. Yes, $500 a month is way too steep for us. Wish we had unlimited funds. Sigh!

When he was on prednisone before he got really hungry and thirsty and peed a lot. Our dog before who had Evans Syndrome took prednisone for 6 years so we were already familiar with the side effects. But unfortunately with Corn, if he gets super hungry he starts to bite us. So we had to stop the prednisone because we could not take care of him if he is trying to bite us all the time. But he was just so hungry from the pred so we do not blame him. Anyway it did not help his cough so it was no use keeping him on it. Once he was off it he went back to his usual calm self.

Again, thanks for all your help Dr Deb.

I don't know what dose of pred he was on, obviously, but the dose for this condition would be fairly high. If he didn't tolerate it at lower dosages, then you know for sure his side effects will be even worse if it's increased.

My personal opinion is that quality of life trumps quantity any day, but this is just my personal opinion. Each case is different, of course, as to side effects which might be seen from the therapies that we suggest but clearly pred is not a drug which he tolerates so I wouldn't use it. Whether or not he might tolerate another form of steroid (budesonide for example) wouldn't be known until you tried it but another question to ask the oncologist when you chat with them again (as to whether it's a feasible option).

Your list of questions is getting longer but hopefully you have an oncologist who has good communication skills:)

I know this is just tearing you up, having to deal with this and feeling that financial realities may not get him the care he needs but I hope you know that you're doing the best that you can, under the circumstances.

I'll look forward to an update when you have a chance. Deb
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Customer reply replied 3 years ago
Hi Dr Deb
the oncologist estimated staging would cost $800 plus another $800 for molecular staging for the c-kit. and the kinavet and chemo he estimated is out of our reach. and even with that price it is estimated to prolong his life for just a few more months than the initial prognosis. we are frustrated and guilty that we do not have the resources to provide Cornroy with the best chance for treatment. and even if we did it did not sound like it would buy him much quality time with those side effects. we are going to have to settle for prednisone after all and hope for the best. also looking into alternative medicine and diet to help him. :'(
This is just so disheartening, isn't it?

Your experience is why many of my clients don't elect to pursue further diagnostics and treatment since the outcome is not generally a particularly positive one when cancer is diagnosed.

I know you feel helpless about this but I hope you take a modicum of comfort in knowing that even if finances weren't a consideration, stage 3 mast cell cancer is a very poor diagnosis in most cases.

As to alternative options:
1. I've had a few owners who feel that the cancer diets are effective, those with high protein and low carbohydrates. Studies haven't been done to confirm whether or not they actually help but they certainly won't hurt. A prescription diet is available (although expensive, of course!) or you could formulate one of your own. (LINK)

2. Probiotics such as Forti Flora may be helpful; these products can help boost the immune system.

3. High dose fatty acids (fish oil) may also be useful (the prescription diet contains a huge amount of fish oil which is why it's only available in cans, not dry). Welactin in a veterinary product which I like because it's liquid that can be drizzled onto the food.

4. There are a number of spices shown to have anti-cancer activity.

a) Garlic --Try FRESH minced garlic - about 1 clove per 40 pounds of body weight. Be careful of the dose, though, since in large amounts, garlic can cause toxicity (anemia). A cbc (complete blood count) should be monitored regularly to detect potential problems.

b) Turmeric, the yellow (and rather mild) spice that gives curry its yellow color, is a strong antioxidant. Most dogs accept it readily. The dose of turmeric up to one tablespoon daily for large dogs; 1/2 that for smaller ones. It would be best purchased from an Indian spice shop or from a place such as Penzey's (LINK) which sells fresh spices and herbs. I wouldn't buy it at the supermarket.

Please continue to keep me posted as you move forward. I know you love Cornroy so much and are completely devastated by this turn of events:( Deb

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Customer reply replied 3 years ago
Hi Dr Deb
thanks for the info. I switched Cornroy to a grain free diet some weeks ago and only give him alkaline foods for treats like kale, spinach, strawberries, etc. I also give him pepcid, Benadryl, turmeric, canine comfort, and also the budwig protocol of cottage cheese with flaxseed. I'll add the stuff on your list to our diet.
i had a question about the fortiflora. coz if we will be starting him on prednisone which is an immunosuppressant. will that be affected by the fortiflora if this boosts the immune system or will they work ok together?
Good to know that you're already ahead of the game with his supplements and diet:)

No, pred wouldn't be affected in any way by the Forti Flora. They would behave independently of each other. How effective probiotics would be in this case is not something that we'll be able to assess but they certainly won't hurt which is the important thing at this point. Deb
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Customer reply replied 3 years ago
ok great! I'll order some fortiflora for him.
that is our same thought regarding the stuff we've been giving him. I surfed the web and found those things. no idea how effective they will be fighting cancer but they don't seem to hurt and he is definitely enjoying the diverse diet he is getting.
That's often the problem with the claims that are made about so many supplements...the studies haven't been done to prove (or disprove) what they say. But as long as it's not hurting, then I will try them. And, who knows, maybe they will be effective, at least hopefully in some small way.

I'm sure he's enjoying all the attention, too:)
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Customer reply replied 3 years ago

yes he is enjoying the attention but sometimes he wants his space coz i keep hugging him all the time. his sister Cali who we also adopted from rescue gets jealous so now we have to give her the same food and treats or else she gives us the stink eye. Corn loves car rides so when he is not up for a walk we take him around the block in the car.

https://fbcdn-sphotos-c-a.akamaihd.net/hphotos-ak-frc3/t1/1549292_660748327319420_721405276_n.jpg

OMG!! That picture is just TOOOOO adorable:)))
They look like mirror images of each other.
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Customer reply replied 3 years ago

Hi Dr. Deb

Just wanted to let you know Cornroy is doing well so far. We went to get checked yesterday. No new lumps found so far. He is eating, drinking, peeing and pooping well. No vomiting. Reduced sneezing and coughing. Our vet has agreed to let us reduce the prednisone at this point to help with the thirst and hunger. The only thing we can see wrong is his jaw and leg trembles sometimes and he does not want to go for walks anymore. He used to tremble before the prednisone so we don't think it is the prednisone causing it. I hope the cancer is not causing it. He is in good spirits. Here is a picture from the waiting room at the vet's office yesterday.

https://scontent-a.xx.fbcdn.net/hphotos-prn2/t1/1897965_698755560185363_1826355179_n.jpg

Great minds truly do think alike because I was wondering about Cornroy just yesterday. Since I hadn't heard from you in a while, I just assumed that he was doing really well....and I'm glad to hear that this is the case:)

These two clowns must be huge hits at the vets!!! And, anywhere else they go together! Two cuter dogs I haven't seen in a long while:)

I don't think the cancer is causing him to tremble; I suspect this is more age related than anything so I wouldn't worry too much about it.

Please give him a kiss and a hug for me....give one to his partner-in-crime as well:) Deb
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Customer reply replied 3 years ago

These two make me laugh every time I see them!!! Thanks so much for the picture. I love it:))) Deb
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Customer reply replied 3 years ago

hi Dr Deb

we found a lump on Corn over the weekend. it is in his gums. we are not sure how long it has been there as that part of his mouth is usually not visible to us coz his tongue covers it. from scanning pix online it looks like an epilus? could that be what it is and not another mast cell tumor? here is a picture of it. it looks like it has caused a couple of his little teeth to move out of place.

https://scontent-a.xx.fbcdn.net/hphotos-prn1/t1/1926853_703678873026365_481507216_n.jpg

thanks

leslie

Hi Leslie:
That would be my assumption as well....that this is an epulis unless it starts to significantly enlarge in a relatively short period of time (which I hope against hope that it doesn't). Don't drive yourself or Corn crazy constantly looking at it but I'd probably take a peek at it at least once a day to monitor it.

Deb

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Customer reply replied 3 years ago

ok thanks! we will monitor it for growth. we sure hope it will not grow. so far all the stuff i saw online says surgery is needed to remove it. the last thing he needs is more surgery. :(

My pleasure:)

Yes, surgery would be needed. Given the location of most oral masses, it's not usually possible to remove them completely. And, they tend to regrow more quickly after you start messing with them.

So, we'll keep fingers and toes (and multiple body parts) crossed that it doesn't get much bigger. Please tell Corn that I'm willing to look like a very weird pretzel just for him if it helps:) Deb
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Customer reply replied 3 years ago

Corn says thanks Dr Deb! We too will be in pretzel form hoping it won't get bigger.

Customer reply replied 3 years ago

Hi Dr Deb!


We had a good visit with the vet today. He says he does not feel any new lumps on Cornroy. Yipee! He is very pleased about our progress. I showed him the epulis on Corn's gums and he verified that was what it was and that he does not think it needs to be removed at this stage. He wants us to continue on with the same treatment for another month before re-evaluating again. So goodie. No poking for one whole month!


A friend of mine got Corn a stroller so now he can still join Cali for walks even if he is not feeling up to walking himself. He loves it!



Here he is watching tv with me and trying on my glasses. He reminds me every night to make his budwig protocol. He won't go to bed until he gets it. He will keep coming over to remind me between 930pm and 10pm not to forget it. As soon as I prepare it and he eats it, he is content and will go to the bedroom to sleep.

Leslie:
Thanks for the update about Corn; I've been wondering how he's been doing:) And that is excellent news about the epulis:)

Needless to say, I loved, loved, LOVED the pictures you sent of him!
I think you should write a children's book about his adventures or at the very least put together some sort of montage and post it on the internet. He'd be an overnight sensation!

His popularity could rival Henri, the cat (LINK)!!! Deb

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Customer reply replied 3 years ago

Glad you loved the pictures! He is a cutie!

I have had people requesting that I write a children's book about my first Eskie, Casper. Lots of people on the internet followed his adventures and even sent him mail and gifts from around the world. When he passed in 2012, I adopted Cali and then Corn. So some of Casper's followers now follow Cali and Corn. Maybe one day when I retire I will have time to sit down and write a book about all my furkids. :D Right now between work, the furbabies and taking care of my mother-in-law, there is not much time for anything else.

Here is Casper :D Corn actually looks like him from the side but Corn is bigger than Casper.

http://3.bp.blogspot.com/-KPCv4ktikb0/Tt0wSwn492I/AAAAAAAABw4/jWBfR61YjMg/s1600/IMG_3444.JPG

I definitely think it's something you should plan on doing when you have more time.

Casper was as adorable and as photogenic as Corn and Cali are!!!

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Customer reply replied 3 years ago
hi Dr Deb,
I found a new lump on Corn. it is near the front of where his incision is. he is showing no symptoms aside from that. since his first lump was grade 3 with high mitotic index and dirty margins, is there any possibility this new lump will have better stats like clean margins or lower grade or do they typically all come back with same severity as the old one? we are quite depressed and scared finding this new lump. we check everyday and last night was the first time I detected it. hubby was checking this morning and confirmed he felt it too. :(

Leslie:

I'm sorry but I've been off my computer and have just now seen your update about Corn.
This is obviously quite distressing news:(
Unfortunately, more than likely, this is a recurrence of the original mast cell tumor given it's location.
It's possible, I suppose that he might develop one with a lower grade but I would expect it to located on some other area of his body, if that makes sense.

Of course, it may not be a mast cell at all since dogs develop lumps and bumps all the time but I personally don't think this is very likely to be the case, under the circumstances.

I suppose it was just a matter of time that a new lump would develop but it's still very unhappy news. Deb

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Customer reply replied 3 years ago
hi Dr Deb
our vet has confirmed it is another tumor. he says it is still small and not yet spread to organs as the X-rays were clear. he wants us to decide whether to operate again or not ASAP before it grows again. he says most likely it will grow back again and surgery will only delay the inevitable. since corn recovered well from surgery few months ago does that make his chances of surviving surgery better or worse? what is your opinion on whether we should try again or just leave it alone?
Leslie:
This is what I was afraid of, obviously:(

And, this is a really tough question to answer about whether or not to remove this mass now before it enlarges.

I wouldn't expect him to have a more difficult time with surgery this time since he did so well the first time.
I agree that additional masses will eventually recur but if Corn were my dog, I'd probably remove this one but this might be the last surgery that I'd consider.

But. if you elect not to have the surgery done, I can absolutely understand this decision, under the circumstances.

My thoughts are with you and Corn as you move forward with whatever decision you make. Deb
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Customer reply replied 3 years ago
does it typically grow back faster after second surgery?
should I stop the turmeric now in anticipation of surgery?
thanks again Dr Deb
Leslie:
It's been my experience that subsequent mast cell tumors tend to grow back faster after each subsequent surgery, especially if no chem or radiation is done.

I wouldn't stop the Tumeric; no reason to that I can see.

Please continue to keep me posted, when you have a chance. Regards, Deb
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Customer reply replied 3 years ago
hi Dr Deb,
we took corn in for his surgery today. doc says he did very well. he has another long incision with drain tubes sticking out.
https://fbcdn-photos-b-a.akamaihd.net/hphotos-ak-ash3/t1.0-0/1962819_730705096990409_105277873011404953_n.jpg
Leslie:
The incision looks great, doesn't it???

And, Corn looks like he's happy and that it was as easy as a walk in the park:)

I'm so pleased for you both; I hope this has bought him some more time. Deb
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Customer reply replied 3 years ago

There's been fluid coming out of there since last night so looks like the drain is doing it's job. I wipe what I can away from the stitches to keep them dry. I just need to keep giving him his pain meds coz he gets franctic when they wear off. He is eating well and went outside to pee a couple of times already. Thanks for advising us to go through with this second operation. I do hope he will recover quickly from it and hope it buys him more quality time. We go back to get the drain removed on Monday.

Leslie:
Yes, it sounds as if the drain is doing what it should be doing although I know it can sometimes be something of a mess until it's removed.

It sounds like he's doing really well, so far, and I hope that this continues to be the case...I would have felt really badly if things had gone wrong after I encouraged you to have the second surgery done!

Please continue to keep me posted when you have a chance. Deb
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Customer reply replied 3 years ago
hi Dr Deb,
Corn got the drains removed today. they said things look good and we will return to get the stitches out in nine days. I asked for more tramadol coz the incision bothers him a lot despite us dosing him three times a day. they did give us some ace sedative coz he couldnt sleep and we tried one pill on Saturday. but it only let him sleep soundly for about four hours. then it seemed to paralyze him for the next 14 hours. he was awake but only his head moved. the rest of his body was limp so it kind of stressed him out. so we did not give him any more of that. it was pretty scary seeing that. today he is much better. he is smiling, more relaxed and able to nap. he still jerks toward the incision when it is painful but not as frantically as before.
Hi Leslie.

Glad to hear about Corn's incision but really sorry to hear that he had such an intense reaction to the Ace he was given!!
That's certainly one drug that will be on his "do not give" list, won't it????

I know seeing him happy makes you happy, too:) Deb
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Customer reply replied 3 years ago

hi dr Deb,

this new lump they took out was located on the right side of the incision Corn had in January. last night i found a new lump on the left side of the January incision. i guess that is because they got dirty margins so it is now growing lumps in the 'leftover' areas. i am devastated that a new lump has showed up so soon. his stitches aren't even out yet. Cry he has bounced back from the surgery and has happily been walking around the house since yesterday. he even learned to use a peepad yesterday. i am just heartbroken that again this cancer is attacking him. it seems everything we are doing is not enough to slow this cancer down. he also started coughing again two weeks ago. other than that he seems normal. we had decided not to put him through yet another surgery. but now that another one has popped out so soon, i feel in a panic as to what to expect if we leave it alone. how fast will he deteriorate? will he suffer? what else can we do for him? i've been trying to brace myself for the worst but now that it seems we are on the verge of getting there, i just can't breathe. no matter how i try, i am not prepared to lose him so soon.Cry

Oh, Leslie, this is just heartbreaking, isn't it???

Unfortunately, what you're seeing is what happens with nasty mast cell tumors: they appear to develop almost overnight:(((

It's hard to predict how quickly he will deteriorate. Originally, the oncologist said that he might have 3-5 months without treatment and it's been three months now since his diagnosis if my math is correct.

Symptoms which might develop depend on which organ is hit first and the hardest but lethargy, disinterest in food, vomiting and/or diarrhea are the most common ones seen.

I honestly don't know what more you can do for him than what you've already done, unfortunately. I don't know if he's still taking steroids but this might buy him more time if they're restarted if they were discontinued.

I wouldn't be ready to lose him either if he were my dog; this is just the worst news:(((( Deb

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Customer reply replied 3 years ago

hi dr Deb,

yes we continued with the prednisone, benadryl, etc since the first surgery. we never discontinued it.

thank you for the list of symptoms to expect. it is better knowing rather than going crazy imagining all sorts of scenarios that can happen to him.

I wasn't sure about which drugs he's still been taking but glad to hear that they weren't discontinued.

This is just so unbelievably heart breaking. We all knew it was coming but as you said, now that it might appear to be imminent, it just doesn't seem fair or right that he can't have many more good, healthy months.

Deb
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Customer reply replied 3 years ago

hi Dr Deb,

Corn says hi!

https://fbcdn-sphotos-f-a.akamaihd.net/hphotos-ak-prn2/t1.0-9/1531537_746821448712107_567074396661510880_n.jpg

he is still doing ok despite everything. we dealt with a tapeworm infestation a couple of weeks ago. the dewormer gave him the runs. but he was fine after that. we have another dose of dewormer next week to kill off any eggs in case there are any. the lump he had kind of went away but we feel like the area behind and on top of the new scar just feels really hard. i am scared that means that whole area might now be a lump. it does not seem to be bothering him as he is acting and eating normal and sometimes even asks to walk instead of riding in his stroller. he shows no other symptoms except for the hardness in the area.

we took him and Cali to the beach on the weekend and he was so excited and happy. he even got his feet wet.

https://scontent-b.xx.fbcdn.net/hphotos-prn2/t1.0-9/10172759_746810072046578_6833636226567239664_n.jpg

this was from when we got his stitches out

https://scontent-a.xx.fbcdn.net/hphotos-frc3/v/t1.0-9/10305427_740203219373930_8271183550373177700_n.jpg?oh=e19b80368ef8f13cf737adeba89389f6&oe=54009238

Hi Leslie:
Thanks for the update about Corn and the adorable photos; I'd been wondering how he had been doing.

Let's just hope what you're feeling is scar tissue since I don't even want to consider the alternative.

Both he and Cali look extraordinarily happy and content which is why he's winking in the one picture, I guess:) ....if that is him, since I can barely tell them apart! On the other hand, maybe he just got some sand in his eye:))

Please give them both my best and say hello back to them from me:) Deb

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Customer reply replied 3 years ago

yup that is Corn winking. he was squinting a lot maybe from the sun and wind or sand. forgot to bring a pair of sunglasses for him. :D

Well, hopefully, you'll remember the next time:)
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Customer reply replied 3 years ago

hi Dr Deb,

out of the blue Cornroy suddenly could not get up on Friday. He was lethargic so we took him into hospital today where he spent the day getting iv fluids. he is still lethargic. the doc said she saw one of the disc on his 5th-6th spine things and suspects ivvd. she said that could explain the lameness on his legs. his kidney values are up so she hesitated giving the iv steroids and now he is also anemic. his rbc was normal this morning at 46 but down to 19 this evening. he would only eat a few pieces of chicken today but still drinking. no diarrhea or vomitting but just so weak. don't know what happened to suddenly bring this on. :(

Oh, goodness, Leslie, he must have you worried sick:(

I'm at a loss to explain this sudden behavior as well although I've seen some dogs with tick diseases behave as you describe although their kidney values aren't affected in most cases.
Leptospirosis is another disease which can mimic many other conditions and can cause elevated kidney values and weakness. These dogs aren't usually significantly anemic though.

Nor are dogs with IVDD anemic either.

I suppose it's possible that the mast cell tumor has spread to his bone marrow or other internal organs although this is a possibility that I don't even want to consider.

I'll be thinking about you and him all day so please keep me posted. I know this is breaking your heart to have him so ill, so suddenly. Deb
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Customer reply replied 3 years ago
hi Dr Deb
we lost Corn at around 3 this morning. the ER doc said he was paralyzed in his hind legs and he was critically anemic. he was crying and we could not let him suffer. the doc said even if we did a transfusion it may not do anything because for his rbc to fall that fast must be bleeding internally and they would have to open him up to fix it and even that would not be a sure thing that they could fix. he stopped eating and kept crying so we had to decide to let him go. so hard. can't understand he was doing so well despite everything. how could this new stuff just happen on top of everything else. so unfair my poor boy had to fight one thing after the other.
Oh, Leslie, there are tears in my eyes as I type this:(
I am so, so sorry for you and your family; this is just devastating news and I can just imagine how incredibly heart sick you are right now.

Obviously this you made the most humane decision for him but I know it must have been so difficult.

Without an autopsy (and sometimes even with one), we may not know for sure what happened but I have to agree that it sounds as it he were bleeding internally. Perhaps the mast cell broke through a blood vessel or a splenic mass ruptured?

The world just became a little dimmer without this sweet fellow in it. My sincerest condolences to you and your family. Deb
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Customer reply replied 3 years ago

we are still reeling from what happened. can't believe he is gone just like that. Cry just so unfair. our hearts are broken and Cali is having the runs since he passed. i think she is stressed because of what happened.

we wanted to again thank you Dr Deb for everything. all your help and invaluable advice. he would not have made it this long without you. here are a few more pix of our happy time going to the beach. the last pix we have of him are such a big contrast from a few days before.

https://www.facebook.com/princesscaliofcalifurnia/photos/a.440344212693167.99478.440261966034725/746887562038829/?type=1

https://www.facebook.com/princesscaliofcalifurnia/photos/a.440262076034714.99457.440261966034725/748084875252431/?type=1&source=11

https://www.facebook.com/princesscaliofcalifurnia/photos/pcb.751727084888210/751725514888367/?type=1&relevant_count=2

https://www.facebook.com/princesscaliofcalifurnia#!/princesscaliofcalifurnia/posts/750623214998597

Leslie:
It has definitely been my privilege to travel this journey with you and Corn although the destination leaves me immensely saddened.

I'm grateful, as always, for the pictures you sent which capture his spirit and love of life and the inordinate bond he and Cali shared.

I have no doubt that she's experiencing a physical manifestation of her grief and stress but hopefully her loose stool issues will resolve soon.

I know there's going to be such a huge hole in your heart for such long time to come. Deb
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