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Cancer and Tumors in Dogs
When is cancer NOT malignant
Chemotherapeutic agents
Botryoid rhabdomyosarcomas in Bulldog
Schwannoma in Greyhound
What if she has cancer
Bladder Tumors
Cancer questions
Tumor in hock- fibrosarcoma, neurofibrosarcoma or hemangiopericytoma
Cancer terms
Leiomyosarcoma
Metastasized Sarcoma - controlling the pain
Sebaceous adenomas
Cancer
Cancer and normal bloodwork
Mass in chest
About cysts and tumors
Disappearing Skin Tumors
Please note: The most recent medical information is at the top of the page to least current at the bottom.
also see Dog diet
also see Adrenal tumors
also see Parathyroid cancer
also see Leukemia
also see Brain tumor
also see Biopsy
also see Adenocarcinoma
also see Carcinomas
also see Insulinomas
also see Histiocytoma
also see Hemangiosarcoma, Hemangiopericytomas and Hemangiomas
also see Lipoma
also see Lymphoma
also see Lymphosarcoma
also see Mammary Tumors
also see Mast cell tumor
also see Melanoma
also see Neurologic problems
also see Osteosarcoma - Bone cancer
also see Perianal Adenoma
also see Pituitary Tumors
also see Male Dog
also see Liver cancer
also see Lung cancer
also see dog lumps
Question: I would like to bring to your attention a statement
at the following page:"A small percentage of the cancers aremalignant."Cancer IS MALIGNANT. As opposed to tumors ingeneral, which may be EITHER bening OR malignant, such thatif they are MALIGNANT, they ARE "cancers".Could you please rewrite this description at your
page so that readers can understand what you areactually trying to say.
Answer: Kathleen-
Not to be too flip, but the answer to your question:when is cancer NOT malignant is ---> when it is a neoplasia in aveterinary patient that is benign in nature.I think that you are probably correct that the termcancer, when used in human medicine, generally refers to malignant tumors--- although I can find some exceptions in the general use in humanmedicine, as well.In veterinary medicine, as taught at the veterinaryschools I am aware of, cancer is used to describe neoplasia and then it ismodified by the use of benign or malignant. An example of this use, fromColorado State University's cancer web side, can be found at"http://mail.justice.com/jump/http://www.csucancercure.com/faq.cfm"
http://www.csucancercure.com/faq.cfmIf you trust me to quote them accurately, thefollowing is their definition, which is consistent with what my wife andI learned about cancer at Iowa State University and theVirginia-Maryland Regional College of Veterinary Medicine, respectively:"Throughout this web site, the words TUMOR and CANCERare used interchangeably. Technically, a tumor is just aswelling which may or may not be a cancer. Cancer is a disease of uncontrolledcell growth which can be benign (not invasive and does not spread) ormalignant (usually invasive into surrounding tissue and capable ofspreading to other areas of the body). " (from the CSU site)The difference in the way that medical terms is usedis sometimes confusing between veterinary medicine and humanmedicine and oncology is one of the areas in which there are significantdifferences. It is really important to have a veterinary pathologist, or atleast a pathologist familiar with the use of pathology terms asveterinarians view them, perform the evaluations of veterinary tissue sampleswhen cancer is suspected, because of these differences.I am glad you wrote to us, as it probably is best ifwe put the definition used above on our cancer pages, as well, since itdoes appear to differ from the way the term is generally used in humanmedicine.Mike Richards, DVM
12/7/02
Question: Hi Dr. Michael:
In the part about lymphoma you mention "chemotherapeutic agents" and
then refer to prednisone. I think of pred as a steroid/anti-inflammatory.
So may I have a definition of both chemotherapeutic agents and
steroids?
Thanks.
P.S. I'll be renewing when I go on line because this is important to me.
Answer: Charlotte-
These are the definitions that you were asking about:
Chemotherapeutic agent -- technically, a chemotherapeutic agent is any
medication that has targets a specific organism or disease process.
This applies to a broad range of medications. It would be appropriate to
call amoxicillin a chemotherapeutic agent for a staph bacterial infection
using this definition. In practice, though, "chemotherapeutic agent" is
usually reserved for medications that specifically target a cancer. Since there
are a lot of cancers, there are a lot of medications that have a
chemotherapeutic effect for one form of cancer that do not have that
effect on other cancers. In addition, there are many medications that are
ordinarily used for other purposes that have chemotherapeutic effects
for specific cancers. This is the case for prednisone and other
corticosteroids, which selectively suppress lymphocytes and mast cells,
making them potentially useful chemotherapeutic agents for lymphomas
and mast cell tumors even though that isn't the most common thing they are
used for. Piroxicam (Feldene Rx) is a non-steroidal anti-inflammatory
medication that is usually used for that effect but also has chemotherapeutic
properties for transitional cell carcinomas, a tumor that affects the
urinary system. There are other examples of medications that fit in
more than one category, as well.The terms "steroids", "cortisones" and "corticosteroids" are often
confusing as well. Steroids are just compounds that have a specific
chemical structure and there are a lot of them, some of which are
natural hormones or are manufactured artificially to have similar actions.
Corticosteroids refers to steroids produced by the adrenal cortex and
are mostly glucocorticoids, which is just another description of chemical
structure. Corticosteroids generally have anti-inflammatory properties,
modulate stress and have many other effects, such as causing salt
retention, increasing drinking and urinating, increasing appetite,
suppressing lymphocytes and other immune system functions. These can be
good things, when those effects are desired, or bad things, when they
are not. Unfortunately, it is hard to have an "all good" effect from
corticosteroids considering their broad impact on the body, so these
medications have to be used carefully.
Mike Richards, DVM
9/4/2001
Botryoid rhabdomyosarcomas in BulldogQuestion: Jake, my 2 year old english bull dog had a large tumor removed from his belly. The vet said the tumor
is called a RHABDOMYOSARCOMA. I've been trying to find out things on this type of cancer but i'm
having trouble. Jake had one dose of chemo-therapy. Today the vet told me no more chemo. his
kidney value is 2.5 and maybe due to the cancer or chemo. Also Jake has lumps in his back that turn
red. The vet said they are NOT mass cell tumors. They are probley the rhabdomyosarcoma. Is this
painfull for Jake? Bulldogs dont show pain so i dont know. He sleeps most the time, and i feed him
from my hands and give him water from a bottle. I love my dog more than any-thing. Do you know
about this cancer & the effects it has. The surgery to remove the tumor was 4 weeks ago and it hasn't
grown. The vet said she removed 80% of it because it was attached to his bladder. When she checked
the remaining she said she must have took out more than 80% because it seemed much smaller. I
guess my question is, how much time do you think i may have with Jake? or is there any thing else
that i can do to help kill this cancer besides Pray? Thank-you Erin
Answer: Erin-
Rhabdomyosarcoma is a form of soft tissue sarcoma. Botryoid rhabdomyosarcomas are a subset of
this tumor that is found in the urinary bladder in young dogs (usually big breeds).The best thing that you could do, if you wish to pursue all options, would be to ask your vet for
referral to a veterinary oncologist (cancer specialist) if there is one in your area. If this is not possible
you might consider asking for referral to a board certified veterinary surgeon to see if there is some
chance of removing the rest of the current tumor and enough of the bladder tissue around the
attachment points of this tumor to hope for a surgical cure. This may not be possible and most
general practice veterinarians would not be willing to remove a large section of the bladder even
though there are clinical reports of success with this procedure.Doxorubicin and cisplatin seem to be the chemotherapeutic agents that are most likely to be tried for
this tumor but I can't find any clinical trial studies to support their use. This is also true of radiation
therapy.I do not have enough experience with this tumor to give you information on the possible outcomes
based on personal experience. I couldn't find any mention of median survival times except in the
study in which the bladder was partially removed and the average survival time after that surgery was
about 2 years.I can't help you with the lumps on Jake's back. He would be really young to have mast cell tumors
but I wouldn't be too suspicious of a spread of the rhabdomyosarcoma, either. In my experience the
most common cause of red bumps on the skin of bulldogs is bacterial skin infection.There is one clinical report of long term remission of a botryoid rhabdomyosarcoma, in the 1993
Sep/Oct Journal of the American Animal Hospital Association. Extensive surgery followed by
doxorubicin and cyclophosphamide chemotherapy (this is detailed in the article) resulted in at least a
21 month remission, the time the dog was followed up until publication of the article.I wish that I could give you some information on the prognosis if nothing else is done, but I just don't
know enough about this tumor to do that. I do think that it is really important, if you wish to do
more, that you consult with an oncologist or surgeon. Your vet can refer you to one or the other. A
veterinary school or large referral center is likely to have both specialists on the staff, so that would
be a good option.If Jake strains to urinate, doesn't want to eat, seems lethargic it is reasonable to assume that he is in
pain. That is something that can often be controlled and it is usually best to try to control pain on the
presumption that it is present if any clinical signs suggest it might be.Good luck with this.
Mike Richards, DVM
5/1/2001
Schwannoma in GreyhoundQuestion: Hi Dr Richards,
My 9 1/2 yr old Greyhound Desi has a tumor removed from over
her eye last Tues-12/5/00. The biopsy results came back yesterday 12/11/00-not good. The tumor
was cancerous. I have done some research on the internet and can't find much about this particular
cancer. Most of the ones mentioned seem to be benign. The vet I used for surgery is going to
contact a specialty vet hospital here in north Dallas and check with the oncology dept. I was hoping
you would be able to help be understand something about this particular cancer and if there are
options available. My dog has had her head bandaged now for a week, with one eye covered. She is
understandably not happy. The drain tube he put in was taken out 12/11/00 and he said some skin
had died with it and that was the cause of bleeding the few days before. He rebandaged her head after
packing the open hole with antibiotics. I will type the wording from the biopsy report below. Would
you please be able to explain some of the wording?Histopathologic Diagnosis: Malignant schwannoma
Description: One mass is examined. The mass is infiltrative and poorly circumscribed and consists of
elongate to plump spindle cells that sometimes form partial whorls and storiform bundles. Dense
fibrous connective tissue stroma is prominent in some areas. Nodular aggregates of neoplastic cells
are tightly packed and exhibit cellular atypia, nuclear gigantism, and multinucleation. In these areas
the mitotic index is high, greater than 20 per 10 hpf.Comment: The microscopic findings are those of a malignant schwannoma. Neoplastic cells are
present at or near the surgical margins in some areas and recurrence is possible. The cellular atypia
and high mitotic index are features supportive of a high metastatic potential.I understand from my research and from the vet looking up schwannoma that this is cancer of the nerve
sheath. I truly don't want to put her thru anymore pain. I don't know what my options are. The chest
x-ray showed nothing and her blood work was normal. She is eating normally, and because she's
greyhound-sleeping like a cat, all day long. Plus, we've just encountered weather in the 20's so she's
not keen on going out.Sorry this is so long-thank you for any suggestions, explanations or help you can provide me. Thank
you also for offering such a wonderful service.Bonnie
Answer: Bonnie-
The pathology report says that this tumor is a schwannoma. These are also sometimes referred to as
peripheral nerve sheath tumors, if you wish to search for information using that name, too. These
tumors can be malignant (have the potential to spread to other areas locally or in other areas of the
body). In this case, the pathologist thought that the tumor was malignant and that the malignant
characteristics were strong.The best hope for controlling the spread of these tumors when they are malignant is surgery done
using strict adherence to oncological (cancer) surgical procedures. This means that a wide margin
must be removed in every direction around the tumor. It sounds like your vet made an effort to do
this but may not have been totally successful because there were tumor cells in the margins of the
tissue submitted to the pathologist. Another possible explanation for that situation is submission of an
incomplete sample. This happens when the tumor is cut into after it has been removed and made into
smaller pieces so that formalin can preserve the whole thickness of the tissue submitted. Sometimes,
this makes it very hard to identify the surgical margin. I think that you have to accept that the more
likely explanation is that the margin of tissue removed at the time of surgery was not enough to get all
of the tumor cells.Schwannomas do not respond well to chemotherapy, unless something very new is being used that I
have not heard of, yet. The oncologist would be aware of the most research on this option. Some
vets feel that these tumors respond to radiation therapy but more vets feel that they do not. I was not
able to find objective information on radiation therapy, so I think that these opinions are based on a
few cases and information from human research on similar tumors.The initial surgery is usually the best chance for getting all of the tumor. However, if this tumor returns
at approximately the same site, a second surgery may be beneficial. If that becomes necessary, it
would be best to have a board certified surgeon or oncology surgical specialist do the second
surgery, if that is possible. It takes a great deal of discipline, and faith in the technique, to remove
enough tissue around a tumor, if underlying bone or an eye have to be removed to get wide enough
margins. Oncological surgeons are used to making these choices and have more experience dealing
with the complications of this sort of aggressive surgical procedure.If the oncology specialist in your area feels that radiation therapy would be helpful, it seems
reasonable to me to give it a try, since other options are not available. However you do need to
remember that the general feeling among oncologists appears to be that the benefits of radiation
therapy are questionable for schwannomas.Hopefully, the recover from surgery has progressed smoothly after the initial complications and there
will be a long interval between this surgery and the reappearance of this tumor.Mike Richards, DVM
12/24/2000
What if she has cancerQuestion: Recently I took her back to the vet because she seemed hot and had breathing
problems. She was snorting . She had a upper respiratory infection. The
vet is still of the opinion that there is some ongoing problem/ disease
process going on. If it is a cancer, what can we do about it? First of
all, we live in Canada and my vet says she is too fat to palpate anything in
the abdomen. On top of this, I am surrounded by well - intentioned
doctors in my family, who reckon that they are capable of taking care
decisions about her on their own. They reckon that if it is a cancer there
is no point in doing further investigations. i would appreciate your
medical opinion concerning my pet. Sincerely Dawn
Answer: Dawn-
Cancer can be very hard to locate. Metastatic cancer in dogs often will
spread to the lungs, where it is visible on X-rays, though. In dogs, high
calcium levels are associated with anal sac adenocarcinomas and these can
often be palpated in the anal sac. Abdominal X-rays are often inconclusive
but they do sometimes show tumors or changes in organs that indicate a
problem. Unexplained fevers are associated with metastatic cancers but you
do have to be careful to actually take temperatures before assuming that
fevers are present, since dogs have higher body temperatures than we do and
since skin temperature and core temperature can be different depending on
blood flow to a particular area of the skin.Sometimes all that can be done is to treat the disorders that surface and
wait for a sign that finally indicates cancer is present or identifies some
other problem. It is important to consider other possibilities, such as
diabetes and hyperadrenocorticism (Cushing's disease) as potential sources
of immune suppression that can lead to secondary infections. General
chemistry panels can help to eliminate some of these possibilities
(especially diabetes) and can give hints about whether other problems, such
as Cushing's disease, are present.I hope that this helps some.
Mike Richards, DVM
11/15/2000
Question: I have researched a lot of your material, and I can't find much information regarding bladder tumors.
I have a cocker, 12 years old, who has been diagnosed with bladder turmor, probability cancer, from
ultrasound. I have been unable to contact the vet in the past days, and am quite anxious with regard to many
questions I have. He did mention trying to contact a vet in chemotherapy, but I am worried that such a vet is
not in the Atlanta area, and I would have to take my dog to the University of Ga. in Athens, or Auburn,
Alabama. The dog is not going to like this at all, and most certainly not if I have to leave him. I do not want to
put him in any more situations that would cause anxiety. The vet did prescribe Feldene 1/2 capsule every 48
hours to see what it would do. He had put him on an antibiotic thinking it was originally a bladder infection.
From your articles, I was thinking he needed to continue on the antibiotic. I also thought I would try placing
him on a diet of fatty foods and try Vit E and Vit C, Selenium, and Essiac. I am discouraged that the tumor is in
the area of the urethra and I was told surgery was not an option. I am additionally discouraged that these types
of tumors are likely to reoccur and I am only buying time for Woode. I've been through a particularly rough
summer with several family problems and responsibilities, and I really hate to lose him right now. If you have
any further articles you could suggest to me or any other insights, I would appreciate anything you can give
me.Thanks so much, Dana
Answer: Dana-
The prognosis for the most common form of bladder cancer, transitional cell carcinomas (TCC) is
poor for tumors involving the trigone of the bladder. It is not very good even if it occurs in other
areas of the bladder but there is some chance of a surgical cure and some evidence to suggest that
just getting rid of the majority of the tumor prior to starting chemotherapy may be beneficial in the
case of tumors in other areas of the bladder.There are other possible bladder cancers and some of them are benign, so it is worth trying to get a
more positive diagnosis of this tumor. Sometimes it is possible to get tissue samples using a urinary
catheter and suctioning them from the bladder surface, by cystoscopic exam or by surgical
exploration of the bladder. I wouldn't rule out exploratory surgery for the purpose of diagnosis, if
positive identification of the tumor type can't be made by one of the other techniques.Some patients with TCC tumors respond very well to chemotherapy and live for extended periods
but the mean estimate for comfortable lifespan is usually quoted at around 6 months. The current
recommendations for chemotherapy usually are piroxicam (Feldene Rx) combined with another
agent, such as carboplatin or mitoxantrone. There seems to be a feeling among oncologists that these
combinations are increasing the likelihood of long term success but it would be best to talk to an
oncologist directly for more specific information on that.If there is obstruction to urinary flow, there are surgical procedures that can be helpful, particularly
cystostomy, which is making an opening from the bladder to the the outside of the abdomen. Most
dogs with this procedure are still able to maintain continence, so it isn't as bad as it sounds. There
are procedures for removing the trigone and urethra and joining the bladder to the colon. This works,
but it causes high ammonia levels in the blood stream, which is very uncomfortable for the patient and
so the general feeling is that this procedure should be avoided.I don't know how to evaluate quality of life issues in a pet who is stressed by veterinary visits but
might benefit from chemotherapy, which involves a lot of those visits. We have had a couple of dogs
in the past for which this choice would have been very hard. I did pursue treatment for a chronic
problem with one of them, Shasta, and she hated the visits but recovered from them pretty quickly so
in the end it seemed worth it. She did not require hospitalization during the series of return visits to
the specialist, though. I think I might have felt differently about the value of therapy to her if she had.Using anti-oxidants makes sense. Some cancers require carbohydrates for energy, so diets in which
energy comes from fat or protein do make sense for those tumors. I am not sure that is the case for
TCC tumors but dogs like those diets and this is a good time to spoil your cocker, anyway. Marine
fish oils (3V Capsules) have the highest ratio of n-3 fatty acids, which are supposed to be helpful, so
that is something else to consider giving.I hope that this helps some. If it generates more questions, please feel free to send them.
Mike Richards, DVM
9/4/2000
Questions: Dear Dr. Mike,
My 9 year old fuzzy son, Kaan, had two tumors removed. Both were
malignant. I trust my vet, but after seeing your website I see I need more
info. I have 3 fuzzy children and they are all Golden Retrievers. My vet
did not tell me what kind of cancer he had (I didn't know there were
different ones until I saw you website), and that all I could do was check
him monthly and treat him like normal. My fuzzy daughter, Keeli, is going to
have a tumor removed from her left front leg. Near the femal (sp) nerve.
This time I would like to be able to ask more intelligent questions. I live
in Hawaii right now, and will be moving to Japan. I am not sure if my vet
did not give me a lot of info, cause I'm moving, or because I did have tears
running down my face when he told me about Kaan's lab report. My mother died
of cancer 3 years ago, so I admit when I here the word I'm sensitive. I love
my fuzzy kids more than life itself, and want to do the best thing for them.
Could you please help me with my dilemma. What should I ask my vet?
Obviously, I need to ask him what kind of cancer Kaan has, but God forbid if
Keeli has it what intelligent questions can I ask? Thank you for listening.
Love,
Jo, Kaan, Keeli & Kai
Answer: Jo-
As you have discovered, there are a lot of different types of cancers. Some
are not likely to cause future problems once they are surgically removed
and others are highly invasive and are likely to spread to other organs.It is very important to know what type of tumor was present. It is also
important to know what the pathologist thought of the tumor grade, if the
tumor is thought to be of a type that is malignant. In addition, whether or
not tumor cells were found in the margin of the tissue removed is important
to know. Finally, if the tumor is a malignant type, it is important to know
if it has spread, which is determined through further testing, such as
aspirating tissue from, or removing, local lymph nodes, taking abdominal
or chest X-rays, checking blood chemistry values, checking bone marrow
---- the necessary tests vary depending on the type of tumor that might be
present.I am coming around to the opinion that it is better to biopsy tumors before
scheduling surgical removal, unless the tumor is a type that is readily
identified by appearance. This allows the surgeon to make a plan for
removal of the tumor that is appropriate to the tumor type. For tumors that
are highly malignant it is important to remove more of the tissue around
the tumor, if possible. Checking local lymph nodes is easier to do in the
initial surgery, when it is known to be necessary due to a prior biopsy, as
is other necessary lab work, such as X-rays.Once you know exactly what the tumor types are, I will be glad to try to
help you understand the tumor type and what that means for treatment and
prognosis.If it is hard for you to ask questions and listen to the answers when you
are experiencing strong emotions, which is a problem for many people, try
to take someone with you who has a list of your questions and can ask them
for you. Preferably someone who listens well and can then remind you of
what was said later. Then call your vet later when you feel up to it and
discuss the options when you can do it calmly and rationally.Mike Richards, DVM
8/4/2000
Tumor at hock area -
fibrosarcoma, neurofibrosarcoma or hemangiopericytoma
Question: Dear Dr. Mike,
If it's not one thing with my dogs, it's another. My dog that had the
endoscopy also had a mass on her ankle. After 2 aspirates, then a
tru-cut biopsy, then another aspirate, a diagnosis of spindle cell tumor
has been given. The differential includes fibrosarcoma,
neurofibrosarcoma or possibly hemangiopericytoma (from the last
aspirate). The oncologist I go to for the dog's mast cell monitoring
will probably try to remove as much as possible this coming week. The
ankle area doesn't have a lot of extra skin. I have not had a chance to
talk with the vet yet about all the details. I looked on your website
and really did not see anything. I realize that removing the mass and
getting a path report will probably guide us to what further treatment
there might be. However, I would like to get your input. I did not
check your schedule on the website so don't know what it is with the
holiday weekend. Thanks for your help and Happy New Year!!Debbie
Answer: Debbie-
We have had pretty good success removing tumors in the hock region, despite
the obvious potential for problems due to the lack of loose skin in the
region. It is very difficult to get wide surgical margins in these areas
but most of the tumors in these regions are either benign or tend to be
locally invasive. So we usually remove the tumor and a small tissue margin
and hope for the best. When the tumors are locally invasive types, like
chondromas, we just plan on removing recurrences when they crop up. We
have not tried chemotherapy or radiation therapy in conjunction with one of
these types of tumors but would be willing to refer a patient for these
options if consultation with an oncologist indicated it might be helpful,
based on the tumor type after it is identified.Malignant tumors of a lower limb are probably best handled through
amputation of the limb but you definitely want to have a good pathologist's
opinion on the tumor type prior to considering that option. Amputation is
the only practical way to get sufficient tissue margins for tumors that
appear to be malignant, such as fibrosarcomas. This is a difficult decision
but should at least be considered as an option if there is a malignant
tumor type identified. Your vet will be able to give you some idea of the
chance of metastasis after surgery, chest X-rays and consultation with the
pathologist.It is always hard to wait for information when a tumor is removed but it is
just part of the process. Our experience has been that most tumors in these
regions can be handled without resorting to really aggressive surgery or
secondary treatments like radiation therapy, though. So the odds are on
your side. I hope this does all work out OK.Mike Richards, DVM
1/5/2000
Question: Hi I go to Purdue University and I am writing a paper and I need some
help with terms if you could please help me clear up what the terms mean
so I can explain to my english and try to make him understand. Some of
the terms I have are: simple carcinomas, carcinomasarcomas, complex
carcinomas, sarcoma, serum samples, epithelial cancers, and TAA. If
could help me out in any way I would much appreciate it. Thanks Amy
Answer: Amy-
I do not know for certain that these terms are used identically in
veterinary medicine and human medicine but here are the definitions that I
can find:simple carcinomas - I have no idea what would make a carcinoma "simple"
but a carcinoma is a malignant tumor arising from epithelial
cells. Epithelial cells are cells that cover the lining of any body
surface (internal or external), so skin, the bladder lining, the lining of
blood vessels, etc. could all give rise to a carcinoma. My guess (and it
is a GUESS) is that simple carcinoma involves only one epithelial tissue
and a complex one involves more than one epithelial tissue.sarcoma - a sarcoma is a tumor arising from connective tissue, which
includes bone, cartilage, muscle, blood vessels and lymph tissue. Usually
there is a prefix describing the tissue of origin, like fibrosarcoma or
osteosarcoma. These tumors are malignant, too.carcinomasarcomas are tumors that contain a combination of cells of
epithelial and connective tissue originTAA -- I think that this is an acronym for "tumor associated
antigens". There are a lot of these, so if I am right it would not refer
to a specific antigen but would refer to proteins that are associated with
tumors and can be identified by the body's immune system, in general.
Examples of tumor associated antigens include glycoproteins 75 and 100,
RAGE-1, MAGE -1 and many others. In some cases it is possible to design
tests for these antigens which can help to determine if a cancer is present
or if it is being controlled by chemotherapy.I am not sure that I know of any particular difference between a carcinoma
and an epithelial cancer. I have always assumed that any tumor composed of
abnormally growing cells forming in tissue was a form of cancer but
recently I have noticed that cancer seems to be applied specifically to
tumors that are malignant, in many references.A serum sample usually refers to a sample of blood which is allowed to clot
and then centrifuged. The clot, which contains the cells and most of the
clotting factors in the blood, is separated from the liquid portion of the
blood, which is the serum.A plasma sample is a sample in which clotting is inhibited using a clot
inhibitor such as EDTA or heparin. The blood sample is allowed to settle,
or is centrifuged, and separated from the blood cells. The difference is
that since no clotting occurred, the clotting factors are usually still
present in a plasma sample. There are some tests for which a serum sample
and plasma sample are essentially identical and some for which the presence
of the clotting factors does make at least a small difference.Hope this helps.
Mike Richards, DVM
3/25/2000
Question: Dear Dr. Mike,
Warning - this is a long letter!
I have an eleven year old spayed Beagle bitch who has been
diagnosed with leiomyosarcoma of the liver. Our vet and the
oncologist we consulted feel this began with a tumor on a strange
diverticula in her large intestine. This tumor was removed a year
ago, and it appeared at that time to be encapsulated and no
other growths were observed during the surgery. Then, last
June, we found the mass on her liver which was determined
to be leiomyosarcoma.My poor dog also has a heart murmur, for which she takes Enacard
daily, some kind of chronic lung condition (I think she never
really recovered from a bout of Bordetella she had 5 years ago), for
which she takes Aminophylline daily, AND Cushings disease, for which
she takes Anipryl daily.At the time the liver cancer was diagnosed, we were told she would
not live more than 6 - 9 months, but that this was a fairly rare form
of cancer in dogs, so not much information existed upon which to
base a prognosis. We have elected not to have her treated with
chemotherapy (the only treatment option) as 1.) we were concerned
with her quality of life and 2.) the oncologist was not very hopeful
about the success of the chemo. Surprisingly, Kichwa seems to be
pretty happy and much of the time and does not seem to have any pain
or discomfort. She is slow to climb the stairs, has times where she
eats a lot of grass and/or acts lethargic. I can't tell how much is
the Cushings, and how much is the cancer, heart condition, old
age, etc.I'd like to get as much information as I can about this form of liver
cancer, particularly in conjunction with the Cushings and the heart
murmur. My goal is to make sure the rest of Kichwa's life is as
comfortable as possible, and to be able to understand the symptoms
of each disease and how her various conditions and medications interact.
I am attached beyond all reason to my dog, and I want to do the right
thing for her as her disease progresses. I would appreciate any infor-
mation you could provide as well as any resources you may know of
that I could access.Thank you very much for your help on this - you're really a saint.
Cathy
Answer: Cathy-
Leiomyosarcomas are difficult to find a lot of information on. There are
some references that I have found on the PubMed web site. If you search at
this site using "Crawshaw J" as your search term you can find one of them.
there is a bleaker reference that can be found using "Kapatkin AS" as the
rearch term. You can search on the "related articles" links to find a lot
of reference titles but not many abstracts. If your vet saves journals you
may find that he or she has some of these articles you can read. That is a
lot better than just reading the abstracts and it would also allow you to
review the references listed with each article. There is a link to the
PubMed site from our link page.Unfortunately, I think that you are in a situation in which there isn't
going to be a lot of solid data. In the one study I characterized as
"bleak" all of the dogs with liver metastasis were euthanized. This
obviously affected the prognosis and I am not sure it is correct to assume
that all of these dogs would have suffered from the disease or even that
they all would have died within a very short period of time. As long as
Kichwa seems happy I'd ignore that study and enjoy being with her.I don't think that there is a lot of reason to think that the other
conditions will have a strong negative impact on her ability to deal with
the cancer. They are just complicating factors in her life, overall. The
stair climbing problems and overall slowing down are probably mostly
related to the heart problems but there may be some impact from the liver
tumor.Chemotherapy doesn't seem like a very effective option for leiomyosarcomas
so even if you were considering it you'd have to accept that it would have
a low probability of a really successful outcome. Radiation therapy seems
to be preferred by oncologists but I couldn't find any reports that had
statistics for success rates and I suspect that this may help some but
can't be viewed as a likely cure.I wish that I could find something more helpful but hopefully there
references will at least allow you to find accurate information that you
can use to make decisions about Kichwa's therapy options. I do think you
have probably chosen the best course right now, though.Mike Richards, DVM
3/15/2000
Metastasized sarcoma -controlling the pain
Q: Dr Mike
Please-- how to subscribe to your page? It has been invaluable the past few days in
providing information about Rimadyl, aspirin, & pain in dogs. I would like the
privilege of writing to Dr. Mike.
Our 10-year-old Lhasa has been diagnosed with metastatized sarcoma on
the basis of x-rays and physical observation. He also has a greatly enlarged spleen
that has calcified. We were told the only remaining course is to control his pain &
provide him good quality of life for his remaining weeks or months. The vet prescribed
Rimadyl plus Lasix for fluid buildup. A week later, when Max showed greater lethargy
on this regimen, he prescribed an antibiotic Amax in case of secondary infection.We live in a rural area. We asked around for a small animal specialist from whom
we've sought a second opinion. The second vet examined the x-rays, did blood tests,
and said neither are conclusive it's cancer. She wants to do a thyroid test. We are
waiting to hear back from her. In the meantime she removed Max from the diuretic.
We ourselves removed him from the Rimadyl as we discovered it's giving him insomnia.
(We discovered this when we gave a tablet to our other Lhaso, who has arthritis, and she
too did not sleep that night.) We're now giving him three 86 mg tablets of baby aspirin
per day. He is sleeping well with less apparent discomfort and occasional outright life
in him. He has consistently eaten and drank normally; his problem is inability to get up
on his haunches, lack of his normal enthusiasm, and mild pain or discomfort as
indicated by lethargy and unwillingness to take stairs.
I would like some indication of what this could be besides sarcoma.
About a year ago both dogs got 1/2" lumps (Max more than the other dog)
over their bodies after getting bitten by earth-burrowing bees in a cemetery.
We wonder if that could be a cause as he licks several of the lumps until they bleed.Thank you for any help you can give us.
Becky
A: Becky-
It is not possible to help you much by computer. I think you made a good
choice asking for referral to a small animal specialist. If it is possible,
it would be a good idea to consider seeing a board certified internal
medicine specialist but that may be hard to arrange in a rural area.In humans, arthropod bites (insect bites) can cause lumps that last for as
long as a year and can be pretty itchy throughout that time, according to a
friend of mine who is a dermatologist. I am not sure whether this syndrome
has been reported in dogs but it is likely that it occasionally occurs.
Removing the lump, which is usually done to be sure it isn't a problem like
cancer, is usually curative in people. If your dogs are chewing on the
lumps it may be a good idea to remove them and have a pathologist examine
them to determine what they are.At this point the best course of action is probably to keep working with
one or both of your vets until a clear diagnosis can be made. This may take
several rounds of tests or even exploratory surgery in some cases, so
patience may be necessary for a while.Mike Richards, DVM
Q: Dr. Richards
First, thank you again for your informative news letter. I really look forward to receiving it monthly. There is so much that I don't know. You and your staff are really a blessing to us here at the home of Charlotte and Darby.
Charlotte is doing very well following her 'liver surgery'. She is responding well to the oral neomycin and lactulose. However, we have a question for you regarding her sister Darby. Darby is an 8 year old spayed Jack Russell who is a typical terrier. Generally in good health, I have recently discovered a few small, white skin nodules in various locations. One on her neck, about 3 mm. in diameter, and one on her stomach, and a few on her legs, but these are a bit smaller in size. They are just large enough to be able to feel them as sort of raised 'mosquito bite' size. They don't seem to be attached to anything below the surface of the skin, as they move around with the skin.
Have you seen this before, or is this information too general to tell you anything.
Thanks again for your wonderful site.Maureen
A: Maureen-
These sound like sebaceous adenomas. They are a benign skin tumor that is pretty common in small dogs of all breeds. Sometimes epidermal inclusion cysts (used to be sebaceous cysts) look like this. There are other possibilities, too. The only way to be sure what is going on is to remove one or two of them and send them in for examination by a pathologist. Your vet may not feel that this is necessary based on a physical examination. I do not send in a biopsy from most of my patients, just the ones where the lumps don't look quite right or where the owner prefers to be certain. Usually there are a lot of these when they are present and trying to remove all of them is not very practical since they continue to develop.
So the best thing to do would be to get your vet's opinion of what these are, since he or she can see them and feel them. There probably isn't a rush to do this since the odds are very good they are a benign problem. If your vet thinks they should be biopsied, it would be best to do so.
I'm glad that you have enjoyed our site. Thanks for letting us know. It helps to know that our efforts are useful.
Q: Hello. My name is Leo. My girlfriend Grace and I have a very uneasy problem. You see, about a month ago we found a lump in my Golden/Cocker. It was located right under his rib, and it felt round and smooth and you could move it around. We took him to a vet. The lump was very hard, and being smooth I actually thought it was a piece of rib that might have broken off. The vet took an x-ray and didn't find anything. He said the dog probably hurt himself or bumped himself and to put a warm compress on the lump and to come back in two weeks if it didn't go away. I felt unsure of waiting so long, but we trusted him and took his advice. Two weeks went by, the lump was still there. It didn't seem to have grown but we took him back to the vet as instructed. We asked him if he could do a biopsy. He said that a biopsy wouldn't be very accurate, and that he just as well open the dog and remove the mass for examination. We again took his advice, and after the operation he said he couldn't tell what it was and that a biopsy was in order.
The tumor was smooth and pale pink, the size of a walnut, with some grey speckle. My mom, who is a nurse, described it as "encapsulated" when she felt it under his skin. We then asked him why he didn't do a biopsy before he said he didn't have the right "facilities" to do one. He said to call back in a week to find out the test results. I just called today, and he said that the tests show the mass to be cancerous. He said for us to come in tomorrow to talk over what we should do (Chemo, rad...) I really don't trust our vet. Please answer me this....
1. Should a biopsy have been performed the first day we brought in Max (our dog) 2. What kind of cancer could my dog possibly have? 3. We told him over the phone we wanted a second opinion. He told us this was not possible because the tumor has already been removed. Is this statement true? Can we diagnose Max without the tumor through blood tests or some other means? Please respond. We have already decided to get a second opinion anyway, I guess it wouldn't hurt anything. Max is a very energetic and loving dog. Our vet just didn't seem to care enough,making us wait a month before telling us this horrible news. Thank you so very much. Leo and Grace
A: Leo-It is not an unusual practice to observe a lump for signs of growth or to see it will resolve prior to taking a biopsy of it. Whether or not this is a good idea is often learned only in retrospect. If the lump disappears then it seems like it was a good idea. If the lump remains then it doesn't seem as good a plan.
Using a needle to aspirate a small amount of the contents of the lump and examining it (a fine needle biopsy) is a good compromise between the two practices, since many lumps can be identified in this manner. The ones that can't are then better candidates to be removed and examined by a pathologist. Many veterinarians feel competent to examine tissue aspirates and it is possible to get a pathologist's opinion by sending a slide in of the aspirate. There are lots of times when this doesn't really help much due to difficulty identifying what is going on even after microscopic exam. Some vets just don't think that it is worth attempting a needle biopsy due to this.
Removing the lump and submitting it to a pathologist to be examined is good medical practice. Your vet is trying to do the right thing in this case. It is the only way to positively identify the lump and determine if it is cancer and if so, what kind. The results of this exam will help you and your vet decide how to handle the situation.
Mike Richards, DVM
Michal Response: Leo and Grace, Please let you vet know that you want more information and have concerns about your cocker's treatment. You should know what type of cancer the tumor is and all the possible treatment options. Your vet should be able to provide a history of your dog's treatment for a second opinion. You also need to let your vet know how far you are willing to go with treatment . Talk to your vet - hopefully you can develop a trusting relationship.
Q: Dear Dr. Mike My 3 l/2 year old mix large dog developed a mass on his rear left hip. It appeared to be present within a short period of time - I brought him to be groomed and saw it as soon as I picked him up. The groomer assured me he was not hurt or injured while there. Thinking perhaps he sprained himself getting into my jeep, we watched him over the next few days. He then began not putting all his weight on his left leg and then gradually started to limp and favor his right leg. The vet immediately thought it could be cancer and wanted to take blood work as well as an X-ray. The X-Ray machine was broken, however, the blood work came back all within normal limits. The vet at that point seemed to rule out cancer and referred me to an Orthopedic Surgeon for X-Rays and further testing. The Surgeon seemed to think my dog was not out of the woods with cancer regardless of what the blood work showed. He proceeded to take two X-Rays along with four biopsies - one bone biopsy to rule out cancer. The results are not in as yet and needless to say I am desperate for any information I can obtain. Is it possible for a dog this young and fine up until that day - whose blood work was just perfect - as the vet told me - to develop cancer? His appetite is the same, his coat is shiny he does seem to be a little lethargic but I was told the procedure he had done could make him uncomfortable. Any info would be greatly appreciated.
A: Nancy- Pets with cancer often have perfectly normal labwork. In fact, when a dog obviously has a serious problem and I can't find a cause and blood work is normal I really start to think about cancer as a possibility. The biopsies of the lump were the right thing to do. I hope that the results have been reassuring or at least helped in devising an appropriate treatment plan.
Mike Richards, DVM
Q: Recently we had our dog to a vet because of coughing which has been going on for 3 to 4 months. The first vet gave us medication, which didn't work. We went to a second vet who put our dog to sleep and after a check and xrays it has been determined that our dog has a mass in the chest that is pushing against the throat and the cough is actually a choke. The vet told us he expects death within 1 to 2 months. He said to have surgery would be very expenseive $4000-5000,and that the success of full recovery is a very low rate, and that if it were his dog he would not do the surgery,and have the dog put to sleep when he started to get bad.Our dog has been very healthy, weighs 85#,aand always a great disposistion. If you have any information, and advice we would certainly appreciate. Thank you, Dick, karen and family
A: Dick-If you are uncertain of the diagnosis or if you are uncertain of the treatment advice whenever a fatal disease is suspected it is best to get a second opinion. In this case, the best second opinion would be from an oncologist if that is possible. There are good oncologists at most vet schools and larger referral centers. Your vet can help you find one. The advice and the outcome may all be the same but certainty can be important. If confirming this doesn't overextend your finances it will be worthwhile in the long run. Plus some tumors are responsive to surgery or chemotherapy and the cost may be less than your vet's estimate (but no guarantee on that).
Mike Richards, DVM
Q: I have an eight year old male Shih Tzu. He has what appears to be a cyst (3 mm in diameter) on his back. The cyst is a small raised area that is the color of his skin, with a very slight gray coloring. My fear is that it may be a malignant tumor; however, my veterinarian said that it may just be a wart or mole. My veterinarian will not make a recommendation as to what action I should take. I know early detection is important in malignancies, but I also fear anesthesia. He suggested that I wait and see if any other cysts appear elsewhere.
I don't want to put my dogs life at risk by waiting. Is it possible to remove skin lesions on animals without using general anesthesia? The reason that I am so paranoid about the anesthesia is that a friend of mine took her eight year old female Shih Tzu in for surgery. She had a reaction to the drug and never woke up. Are all mast cell tumors malignant? Is it possible to distinguish between a malignant skin growth and a benign growth without surgery? Does the whole cyst have to be removed for analysis? I apologize for having so many questions and for sounding so paranoid about the anesthesia. My dog is very important to me, and I don't want anything bad to happen to him. Thanks for your help, (worried mom)of Rufus (A Shih Tzu that feels great, but has a wierd bump on my back)
A: It is possible to diagnose some tumors and other skin conditions, such as cysts, by aspirating from the lump with a needle and examining the material from the aspirate. If there are questions about the diagnosis then the material may be submitted to a veterinary pathologist for a second opinion.
It is also possible in most cases to remove skin tumors using a local anesthetic, possibly in combination with a sedative and/or narcotic agent. We have really good luck using acepromazine and oxymorphone or butorphenol for sedation and pain relief and then using a local anesthetic. If this doesn't work these are the same medications we use as preanesthetic agents for isoflurane anesthesia. This has been a very safe combination for us.
Mast cell tumors are usually malignant. It is best if these tumors can be identified by biopsy prior to removal so a plan can be developed to remove a wide margin if the lump is a mast cell tumor.
Good luck with this. Talk to your vet again -- make sure that your vet listens to your concerns as they are reasonable.
Mike Richards, DVM
Q: Dr. Mike- I commend you and your staff on a great website. I couldn't believe you actually had information about Chocolate posioning. My mother had warned me but I thought it was a myth. Thanks for the information. My concern is that my 4 year old cocker spaniel mix developed a round raised lesion in the black lower lip area of his mouth. As I became aware of it I continued to watch it grow to the size of a pencil eraser. It looked similar to a large pimple but was hard and never popped. It happened over the holidays and I didn't have the opportunity to see my vet. A little over one month later it began to decrease in size until it was only a small white mark. It never opened or drained but appears to be gone now. Can you tell me if this was just some type of acne. Did he possibly bite his lip causing a sore or could it be some type of internal problem? Thanks for the help and keep up the great work.
A: I think that your cocker probably had a histiocytoma. This is a skin tumor that usually will go away on its own. They can occur in any age dog but are a little more common in young dogs. These tumors are benign. Sometimes dogs will get more than one but most dogs seem to get one and when it goes away it stays away. If this does come back, especially in the same place, it would be a good idea to get it biopsied because mast cell tumors can look like histiocytomas and they are a much bigger problem.
There are other possibilities. A granuloma (excessive scar tissue) and some fungal lesions can also look like a lump on the skin without many other signs. Both of these often go away on their own, too.
In all of these conditions there is usually no worry once the lump disappears, so your cocker will probably be fine.
Mike Richards, DVM
Last edited 01/30/05