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Category: Veterinary
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I have a senior rescue poodle mix that I rescued in 7/2013

Customer Question

I have a senior rescue poodle mix that I rescued in 7/2013 diagnosed with a large Complex mammary gland adenocarcinoma, intermediate grade (MI:12 per 10 HPF's. was removedin 7/2013. She had more smaller masses on her mammary area...but I have not done anything with them since except watch them. since then 2 of them started feeling I brought her to my vet and they did X-rays...results look like neoplasia involving the thorax lungs. A moderate bronchointerstitial pattern, mild pleural effusion, and one suspicious nodular lesion are identified in the thorax. How horrible is this? Im just sick.. I have a follow up appt. with my Internal Med doc this thursday..but Ive been worried.

Blood work was done also this past week and looks pretty good- there were a couple things off not not really off

BUn/ creatinine 33 high  and it says the good range was 4-27

platelette count 457 high    good range was 170-400

T4 was 0.6 and good was between 0.8-3.5

other than that - she had a syncopal/seizure type episode in 7/2015 lasted less than a minute....she squealed and passed completely out..took her to the vets said seizure....didnt any more until 3 months later...same thing...was always after getting up from sleeping...I notice her gums and tongue are white when this happens.....had one more three months later....and the reason why we just had a vet check up lately is that she had one last Sunday and then one the following afternoon...hasnt had any since....and to be quite acting completely normal.  Playing and running etc.  as if she doesn't have  a thing wrong with her...eating good...and has always slept all day since Ive had her...but normal....just not sure what to do...when I go to the Internal med on Thursday...I want to know what to expect super anxious.  sounds like mammary metastasized to me...and if bad is it there any hope?

a little more from the report a three view study of the thorax was done includes the neck and cranial abdomen.  Moderate mineralization of the larynx and epiglottis is identified.  Tracheal carriages are also prominently mineralized.  The heart is at the upper end of normal size range overall.  There is a mild pleural effusion identified.  There is also a moderate bronchointerstitial pulmonary pattern. Pulmonary vessels are within normal limits.  There is ill defined nodular shadow in the cranial thorax at appox. the level of the third rib pair.  This is more easily visualized on the left lateral view.   It cannot be loccalized on the VD view: there is a subtle focal increase in opacity which might correspond to this lesion int he right cranial lung field, but this is not definitive.  The cranial abdominal organs are within normal limits.  Multiple subcutaneous nodules are seen suspected to represent enlargement of the mammary glands.  There is a focal subcutaneous mineral dense structure ventral  to the thorax, which might represent a mineralized memory gland.....

Just wanted to add more details from the report

Also overall heart size is borderline, but there is suspicion of left atrial dilation.

Hmmmmm...a couple I have not proceeded to remove additional lumps on her mammary area since 7/2013.... if I would have- would we be in a much better position or do you think this outcome would be the same.... I really didn't want to put her through more surgeries...but now I'm not sure I made the right decision.

Submitted: 1 year ago.
Category: Veterinary
Expert:  Dr. Gary replied 1 year ago.
Hello. Thanks for the detailed history. The syncope episodes sound like an arrhythmia. This is not always a true structural issue with the heart. I would do an EKG and echo (ultrasound) of the heart to make sure there is nothing significant worth treating. It's so infrequent that I wouldn't worry much about it, to be honest. It does sound like there may be some metastasis to the chest. It sounds fairly mild at this point, though. If you want to do everything, I would consult an oncologist and see if there is any chemo worth trying. Otherwise, as long as she's having a good quality of life I would probably just let her live out her life and consider euthanasia once she's no longer eating, enjoying normal quality of life or having respiratory signs. I don't think the choice of doing more surgery in 2013 would have changed the outcome. No way to know for sure, but I bet it was from the other masses or even from elsewhere that metastasized. Hard to know, but don't second guess yourself. Let me know if you have any other questions.
Customer: replied 1 year ago.
Okay- I really appreciate your response. Are you a veterinarian oncologist?
Just curious really- I've never used this service - it's more to give me details. I like to have as much info as possible.
Wth the the lungs the way they are now- is there a way to figure out how much time she has... She doesn't show any labored breathing now. Wasn't sure if mammary adenocarcinoma in dogs had a travel quickness guesstimation on timeline and travel. I should have been a Veterianrain- as I like to learn as much as possible for my little furry friend.
Thank you again very much
Expert:  Dr. Gary replied 1 year ago.
I'm not, no. I'm an ER vet in MI. I do work a lot with the local oncologist with referral cases, though.
Expert:  Dr. Gary replied 1 year ago.
As for how much time, once I start seeing fluid in the chest and lung nodules I warn owners that we're in the last month or two. It's variable, but that's a realistic expectation. Mammary cancers can be tough to predict. Some stay local for a long time while others can be highly metastatic. The mitotic index on the biopsy tells us how aggressive it is.
Customer: replied 1 year ago.
Does the report details I shared with you show fluid in the chest and lung nodules?
Expert:  Dr. Gary replied 1 year ago.
Yes, it says there is pleural effusion, a broncho-interstitial pattern and a nodular look in a right lung lobe.
Customer: replied 1 year ago.
Wouldn't she be acting sick then? She is out running and playing - and eating like a swine as usual. Could this anything else? Seems like she would be a bit more compromised - if she were in the last couple months of life- at least to me- but I don't know- just guessing
Expert:  Dr. Gary replied 1 year ago.
Not necessarily. Sometimes the signs are mild and they are sub-clinical. Eventually it'll progress, but as long as the other lung lobes are compensating for the mild loss, they can have normal quality of life.
Customer: replied 1 year ago.
Any chance it could progress over a period of years instead of months?
Expert:  Dr. Gary replied 1 year ago.
Not typically, but anything is possible. Especially if there was a combination of a cancerous mass along with a non-cancerous mass. Just because one mammary mass is cancerous, that doesn't mean a second one has to be. A second one could be benign and just locally aggressive. Lots of possibilities here.
Expert:  MsAM replied 1 year ago.
Hello and welcome. My name is ***** ***** I'm a biologist with a special interest in canine cancer. I apologize that no one responded to you sooner. There have been some technical problems in this category of JustAnswer, which made it impossible to access your question until now. It isn't completely resolved yet, so if we experience more delays, that will be why.From what you have described, the cancer has spread. Of course, that is bad, but we won't know how bad until your next appointment. It's still possible that it may be treated with further surgery and chemo or radiation. If you haven't seen an actual oncologist yet, it would be a good idea to do that now. I wish your vet would have referred you to one in the beginning. If you'll give me your location, I can find an hour ncologist fir you. Oncologists have access to all the latest research and treatments, and are best qualified to deal with cancer.If you are asked to rate my service, there is no need to do that yet, since we are just beginning. Let me know if you want help finding an oncologist. Thank you.
Customer: replied 1 year ago.
Hello- I do have an oncologist - but thank you for offering.
With mammary adenocarcinoma's - once they spread to the lungs like this one has with Pleural effusion - would chemo and radiation be a possibility. I thought that would only be a possibility if it didn't spread.
Also- if this indeed is a metastasis from the mammary adenocarcinoma - how much longer would she have at this point?
Thank you
Expert:  MsAM replied 1 year ago.
You're welcome. There have been no studies to determine how effective chemo or radiation might be at this point in the disease process. There are individual cases, where dogs responded well, but others where they didn't respond at all. Oncologists often use chemo as a way to prevent spread to the lungs as soon as mammary cancer is found. Usually, all tumors, even small ones are surgically removed. Often, all mammary tissue is taken too - the equivalent of a radical mastectomy in humans. However, it is too late for that. The chemo most often used for prevention of spread is Adriamycin every 21 days and oral Cytoxan every other day for 8 weeks or on day 3-6 of each 21 day cycle. Some other possibilities include 5-fluorouracil, cyclophosphamide, doxorubicin, carboplatin, mitoxantrone, paclitaxel and docetaxel. Again, no studies have been done on this type of canine cancer. You can discuss this with your oncologist, but I suspect he/she may tell you it won't do any good now. Prognosis depends on many factors, but her life expectancy is probably a few months. Depending on those factors, it could be a only a few weeks. I'm going to give you a link to a veterinary journal article on the subject. It is three pages long, and all the factors linked to prognosis are explained. It is technical, but you seem well able to understand such things. Let me know if you need anything else. I am so sorry you are going through this with your beloved dog. Anna 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. Please remember to rate my service after you have all the information you need. I will greatly appreciate a positive rating as that is the only way I am compensated. Thank you!
Customer: replied 1 year ago.
I've read this article- but thank you for sending. I have been in the medical field for 20 years- just medical sales- but I know a good amount at this point. What I'm trying to figure out is - that when I rescued her she had a very large adenocarcinoma removed. How does that type of tumor react after removal? Is there always a chance that that actual tumor's cells could have lived in her for 3 years? The tumor was large at least 3-4 inches... That is why I selected not to do more surgeries... I rescued her with this tumor attached.. And just thought that it had been on her body for a long time to get that big- that cancer cells would already have been through her body. Does that makes sense?Also- she isn't showing any clinical signs now/ she is acting completely normal. Her last X-ray of her chest was 7/2015- and it was normal.
Expert:  MsAM replied 1 year ago.
Adenocarcinoma can grow rapidly or slowly, so size doesn't tell us how long a tumor has been there. Since you didn't rescue her until it was already there, there will never be a way to know. If all of the tumor is removed, the tumor can't react in any way. But many times with an adenocarcinoma, the spread has already begun. It would be impossible to remove every single cell, and over the next months or years, they can produce more tumors. That's good that she isn't showing any symptoms. Often dogs that don't act sick do better with treatment. But anything I could tell you would just be speculation. I understand that you want answers, but a lot of times with cancer, there simply are no definite answers as to how long a tumor has been there, when it spread, how long it might have taken for new tumors to grow, etc. You have an appointment coming up with a vet who can analyze the results you have obtained, perhaps do more tests, and then give you a better picture of how things might go.