Very desperate (cancer stage one) advice PLEASE need to decide.

[Wiggy29]

My dog is about 11/12 (shelter dog so we're not sure) and we've had him for ten years. He is a lurcher with only three legs (front left missing).

We found a pea sized lump at the top of his back left leg a couple of weeks back, vet said just to keep an eye on it but within 10 days I noticed he was nibbling it, when I looked it was about four times the size, red raw and no hair on it. We took him straight back to the vets and they removed the lump and sent it off for analysis.

They found it to be stage one cancer and although they have removed all area around the lump, some of the roots going down into the muscle weren't removed. The vet advised a second operation going down into the leg muscle to remove the roots.

PLEASE HELP US DECIDE WHAT TO DO- YOUR EXPERIENCE WELCOME:

My family all think it would be kinder to him not to operate. They think: it won't 100% guarantee it not returning, he will find it almost impossible to do anything for nearly over a month (vet agreed) as he has no left front leg and left back will be out of action: this means he can't go to the toilet/eat/drink without being held up but my dad tried lifting him tonight without touching the wound area and said it is literally impossible to hold him to allow him to poo etc. They feel as he has had so many operations in his life and is an older dog, it would be best not to go ahead and just hope he has a happy year/two still (vet said this is possible).

I'm not sure I agree, but I'm aware that I'm far more emotionally attached to this dog as I got him and he's always lived with me. In fact, I'm too emotionally attached and love him too much to know what's best. According to the internet 90% of stage one don't remove if returned but I do agree that I don't understand how he'll manage without use of his legs for the recovery period and he's already old (has severe cataracts etc).

Please please give any advice/ experience as at the moment he's booked in for the operation on Tuesday but I'll need to cancel by tomorrow if we decide against it. I can't stop crying and just don't know what to do for the best.

[Jellykat]

Oh so sorry for you and your dear boy, it's a very very tough decision... i personally would not operate - it sounds impractical with the lifting/ holding up situation.

My darling dog had a tumour, and my vet said there is a theory that by removing, it can encourage the cancer to appear elsewhere at a later date. If your boy possibly has 1/2 years left i would go with that, and let him be happy for that time (presumably Steroids will help with that)

I have friends who have a 13yr old Goldie who was diagnosed with breast cancer 3 years ago. They left it undisturbed and shes still going strong. So you never know..

Good luck in coming to your decision

[Samvet]

What kind of cancer? A mast cell tumour? No one can give any advice if you don't know the type of tumour. More info needed as this totally influences prognosis.

[Samvet]

If surgery is not an option some tumour respond to other types of treatment. Radiotherapy, chemo. I would ask to be referred to an oncologist.

[Samvet]

If it is a mast cell tumour incompletely removed then radiotherapy is a better idea, same for a sarcoma. Revision surgery not always the best, plus should be done by a specialist. If I were you I would ask for a referral to discuss options with a veterinary oncologist. Radiotherapy available at Liverpool, Cambridge, Essex.

[Wiggy29]

Thank you so much for replying, I kept refreshing this link hoping somebody could offer their opinion. I'm worried that if I don't, he'll become very I'll very quickly& I'll hate myself for not operating. I'm also worried that if we do we'll aggravate it/ only buy him an extra few months/ make a 3 legged dog who has already suffered almost a year unable to walk when younger (due tonnumerous operations to try to save leg before vet said it was kinder to take it off) very unhappy as I have no idea how we could actually help him function on two legs (on same side)- it's hard enough briefly lifting his back left leg when wiping muddy paws.

[Samvet]

I think you are not being given all the options here.

[Samvet]

What tumour????

[poachedeggs]

It all hinges on his current quality of life, Wiggy. If he is an old boy - by this I mean obviously elderly, slow, any stiffness, and signs of heart problems or other issues, then I would probably avoid further surgery. It wounds like it may be quite radical and a bit of a challenge for an elderly tripod :(. However, if he's pretty sprightly and not showing big signs of ageing then I might lean towards the surgical option, provided I was confident I could maintain good standards of welfare for him throughout the recovery period.

It depends really what sort of cancer it is - did the vet say? I removed a sarcoma from my own dog's hindlimb nearly 6 years ago and was advised by the pathologist at the lab to operate again to remove more tissue. I didn't bother decided against it because I had a lot of other stuff going on that meant caring for him would be difficult and decided to monitor it instead. I operated again three years ago to remove a little bit more tissue that had grown and he has shown no further signs of recurrence (and is now a sickeningly healthy lunatic thirteen-year-old).

But make your decisions based on your dog and how he is, because a shorter lifespan of better quality is preferable to a longer life but with a significant element of pain/wound problems etc.

[Wiggy29]

Hi Sam, it's mast cell. I don't think I would want to pit him through radiotherapy over a long period, are the side effects not awful for dogs? I would just worry as we've been told his life expectancy would probably be less anyway as 3 legs put more pressure on heart/other organs. He's already 11/12 and half blind- would you advise taking him round country for radiotherapy is best? Sorry if I sound sceptical, I am just vary wary of making him suffer more than required when he's already had a tough life.

[poachedeggs]

Radiotherapy side effects are not necessarily awful - there's a risk there but veterinary treatment of cancer has to have quality of life as its central aim, rather than quantity as it is for humans.

But I stand by my thoughts that the dog's current QOL is the main concern here. Everyone should have all the options offered to them but I always accompany this offer with the advice that just because we can do something doesn't necessarily mean we should.

[Wiggy29]

Poachedeggs- he's a really happy lovely dog but slowed down a lot over past couple of years. Often if we go for a walk he'll just stop&turn around after about half an hour to show he's had enough. That said, some days he'll run around merrily for hours.

My partner and I both work full time though I'd be willing to take unpaid leave to care for him, I'm just not logistically sure how it would work using toilet etc. As much as I want him
To be better and have many years with us still, I can't argue with my dad that I don't know how we would support him to go to toilet as would have to wrap arms around his bumming order to help him stand without weight on back leg that would need op.

[Samvet]

Ok. You are being given inappropriate advice. Incompletely removed mast cell tumours That are low grade do not always recur. They have a low rate of recurrence and spread.
This is NOT a euthanasia or surgery decision.
The best treatment in this situation is radiotherapy. This has virtually no side effects and likely will be a cure.
However ii understand your reservations. I would just observe the area for recurrence and it may not come back at all.
There are also medical treatment options now too.
I am sorry but your vet is misinformed if they think aggressive revision surgery for a low grade MCT is best.
I am a specialist so basically know more than your vet. You could also just go and see an oncologist for a consultation.

[Wiggy29]

Poached- vet's advice seemed to me to be to go ahead with op, parents went into vet to ask about tecovery& only then was there any mention of how deeply they would need to cut into muscle&that it was minimum 6 weeks recovery. He can barely walk with plastic shade on his head so when he had initial operation I was sleeping on sofa so he didn't try to go upstairs (he normally sleeps outside our room).

[Samvet]

Side effects of radiotherapy minimal and treatment not prolonged. Ridiculous to suggest such a surgery on a dog with 3 legs!

[poachedeggs]

Mast cell tumours are not good news. It's a question of balancing risks and benefits really. And you also need to know what the chances of total resolution are after this surgery - MC tumours can be aggressive and it would be utterly shitty to put him through the surgery then have recurrence. Have you been given any info on how radical they can make the excision if you do choose further surgery? That depends a bit on location.

Feel for you though. :(

[Samvet]

Vets in general practice are GPs - would you let your gp tell you what to do about cancer!

[Samvet]

Poached eggs- it is a grade one, low grade MCT - different behaviour to a high grade MCT.

[Wiggy29]

Sam et- your opinion is very valuable, thank you. Can I just clarify (v. Emotional so want to check I've understood): do not opt for second surgery, instead, closely monitor the area/ whole dog. If we notice re- growth in same area/ other area, ask for referral and look at radiotherapy? Thank you again for taking time to advise.

[Samvet]

Given the dogs age and 3 legs, options are

1. Revision surgery (I would not recommend)
   
2. Wait and see approach
   
3. Radiotherapy (gold standard)
   
4. Chemotherapy if recurs

[follyfoot]

Our Lab had radiotherapy in Cambridge and didnt have any side effects really, apart from becoming extremely restless post anaesthetic. They were very lovely and the Oncologist (Malcolm) was excellent to talk to - explaining the benefits/risks very clearly to enable us to make a decision. I dont know that personal experiences are much help as each dog's situation is different and of course the outcomes vary hugely, but all the very best with what is a difficult decision.

[poachedeggs]

What are your thoughts on Masivet Sam? I've never used it but am sceptical that it will be used in cases where recurrence is not really a massive concern anyway. Rep was a very um enthusiastic lady

[Floralnomad]

If he was mine I think I'd leave him alone and see how it goes considering his age and other problems . Provided he is not in pain surely a shorter life of a good quality would be kinder especially as there is no guarantee that the next op will get it all and would leave him with a possibly intolerable recovery. It's so difficult to make these decisions on behalf of animals but IMO quality of life is the most important factor.

[Wiggy29]

It's top of thigh area. Parents asked about what the chances were of reoccurrence& told they couldn't say but it was best to do it. They then asked about life expectancy if we didn't have operation and are told it could be months or years! I know there's no guarantees but it doesn't help us make choice.

My parents are a bit sceptical of vets after all the issues with his leg whereas I generally (hope) it's a calling to majority who act in best interest of animal.

[Samvet]

Ideally radiotherapy (or an appointment with radio - oncologist to chat about it) tell me where you are and I can recommend one.
To clarify stage is an odd word - do you mean low grade? Mcts are graded low, intermediate and high.
Tbh if he was my dog I would wait and see, quite a few don't come back. There are also other tests that can be done on the tumour to assess it's 'aggressiveness' which is why your vet should ideally discuss the case with an oncologist not just go and cut more tissue out!
If you wait and see you have to accept if it recurs you may need to decide to put him to sleep, but at that point chemo could be tried.

[Wiggy29]

Should add, we live Newcastle in North East. Would radiotherapy be a one off?