Feeling very let down by vets. Probable lymhoma. Advice please. Any vets out there?(26 Posts)
Trying to figure out if I'm just displacing my upset onto the vets or not.
We have a very active and full of life 11 year old shih tzu with no previous medical problems. Noticed a lump under his jaw / neck on Sunday. Took him to the vets, said he would have taken a biopsy there and then (? lymphoma) but couldn't due to bank holiday Monday. Started on Abx / anti-inflammatories on Sunday just incase it was a deep tooth abscess and returned on Tuesday when fine needle aspirate was taken. I asked how long the result would be and explained I would pay whatever was necessary to expedite it. He said that wasn't an option but we would have the result by Friday (today) at the latest.
I'm fairly certain this is a case of lymphoma (or something equally horrible) as the lump is very hard and just feels nasty. ABx making no difference at all and he isn't acting as though he is in any pain. As I understand it, untreated lymphoma typically kills a dog within 4-6 weeks of diagnosis. Our boy is not ready to die and we want to do everything possible to save him. In view of this we have managed to secure an appointment with an oncologist on Monday morning.
Have been bracing myself for receiving bad news today (i.e. the result) only to find out that there is no result yet. Lab (Idexx) are giving the stock response - result will be available 'early next week'. This isn't what the vet promised me. The vet says he has contacted the lab and asked them to process it urgently yet they are still trotting out the 'early next week' response.
I feel so let down. Without the result it makes our long and expensive trek to the specialist pointless (unless they can repeat the FNA there? Davies specialists in Bedfordshire - any idea anybody?) I feel like the vet mislead us about the time frame for the result and the lab doesn't care. All the while the clock is ticking for my boy
I'm a medical doctor so not sure if it's the same but whenever I have contacted a lab to expedite an important test result they have usually been understanding and do so - and this is the NHS. We are not insured and are paying for all of this. Feeling a bit let down by our vets and the lab so far. Does anyone have any experience of lab turnaround times for suspected cancer diagnoses?
Feeling so sad. Really want Monday to be productive. I was hoping they would start the chemo there and then but obviously won't with no result.
Does the vet think that it's lymphoma? Typical FNA turn around times are a week - so Tuesday to Tuesday - unless it was submitted as probable cancer, and then typically two to three days where I am, although it can be longer.
Is the hard lump the only symptom?
Sorry to hear your dog isn't well. I'm pretty sure the turnaround at the two labs our practice uses is 3-4 working days and this week is likely to be busier than usual after the bank holiday so it sounds like a typical wait to me, although very frustrating for you. Our usual lab are open on a Saturday as well so it is still possible you will get a result before you appointment. I believe your vet, I have rung the lab in similar situations and struggled to get them to hurry up too.
In your situation I would absolutely still go the specialist on Monday. There is a risk that it's a wasted appointment if he turns out not to need an oncologist but that's not the end of the world if you can afford it.
I don't know the oncologist you are seeing sorry as we are the opposite end of the country. Best of luck with everything.
Anchor - Yes he thinks it could be. He said we could have a result Wed / Thurs even. Just feeling a bit mislead. Don't promise Friday at the latest unless you mean it! Yes hard lump is the only Sx. He is completely well otherwise.
3boys - I had a look at the labs website and can see it is open on saturday mornings. Do you think it's worth me calling them tomorrow? I imagine they'll refuse to give me any info though.
Thanks for your replies
Not a dog, but I've had a cat with lymphoma...the oncologist didn't use any of my vet's test results anyway, they did all new ones.
Don't know if that helps.
Tabulahrasa - That's helpful, thank you. Hopefully the specialist will just do all that is needed on the day. Just don't want to be held up waiting for the FNA result when we could be getting on with staging CT (i'm guessing) etc.
I hope your cat did well.
Five years of partial remission on steroids and leukeran before I had to have her PTS.
Though I wouldn't want to raise your hopes too much as I believe cats respond better to treatment.
Though of course you don't know yet that it is definitely lymphoma, so I'll hope it's something better for you
That's amazing! How lovely that you got 5 extra years with her.
From what i've read chemo buys around a year for dogs that respond.
So so hope it's something better but got a bad feeling about it
There is huge variation in lab turn around I use idexx for bloods, but won't use them for path due to their slow turn around. I use a lab that reports FNA's the same day they receive them.
But before you can start any chemo you need more staging than the FNA, which may involve a lymph node biopsy, chest X-Ray's, bloods and abdominal ultrasound. In most dogs either COP protocol or Madison-Wisconsin Protocol will gain you an average of 9 months remission. Certain cases of lymphoma you can gain longer. Waiting till Tuesday is not likely to significantly slow down your time scale to start treatment.
Thanks for your reply Lonecat. This is why I am so frustrated, with the FNA result we would have been able to do the further Ix on Monday (we have to take him there starved etc so that they can do whatever is necessary on the day +/- they will keep him there overnight if needed). I know a day or two realistically isn't going to make a difference, it's just shitty for us
Called the vets just now, still no result.
Any tips on questions to ask the specialist assuming it ends up being what we think it is?
You don't always need referral to a specialist we do full diagnosis, work up and treatment in house at my practice ( with good success). Lymphoma management invert much a step wise process.
That's interesting and good to know you have good success with it. I don't know if our vets would be the same as you. They haven't mentioned that they would be able to manage this all the way through.
What would you say the average time from first visit to starting chemo is?
Usually about a week to 10 daysfor diagnosis, staging ordering in drugs and being able start on appropriate day of week ( Monday's are better for many reasons).
Thanks Lonecat. Day 8 tomorrow, Got my fingers crossed we'll be able to make some progress.
If money isn't that much of a concern, my tuppence worth is to go for the specialist oncologist - our dog has had cancer twice and recurred after treatment at vets and since then managed at specialist and then teaching hospital and we've had no further serious problems and he's a good age now. Everyone's experience is particular but we would go for the specialist straight away if we had the same thing with another dog. Appreciate cost wise not always possible.
I'd suggest not feeding your dog breakfast in case they want to do anything involving sedation or anaesthetic, if you have a morning appointment. You could just pack breakfast.
Thanks Munch - I agree with you. We are willing to do anything to keep him around for as long as possible (whilst he is feeling well and enjoying life of course). Sorry to hear that your poor dog had cancer twice but fantastic news that he has recovered.
Hi Villainous - thanks for your input. We are doing just that. They have instructed us to only allow him water from 10pm.
In a slight twist to the the story we have noticed that the swelling has actually gone down (has been on ABx and anti-inflammatories for 1 week now). Still a clearly palpable and firm lymph node there though so I'm trying not to get my hopes up too much.
I hope it isn't cancer for all your sales - given my dog first had it at 2 years old he's now outlived 50% of his litter so we feel very lucky l, good luck today
We've just had the all clear!!!!!!!!!
Mark Goodfellow at Davies was absolutely fantastic. Took various FNAs (as other lymph nodes were very marginally enlarged too). He looked at a smear there and then, couldn't see an obvious cancer. We've just had the final result from their onsite lab which shows no evidence of cancer in any of the nodes. We are obviously absolutely thrilled!
Oh and p.s. our vets called whilst we were en route to the appointment to say that the FNA they took was inconclusive as there wasn't any tissue in it. I know this can happen and is a risk with FNA but still makes me mad that we waited so long for a useless 'result'.
Really glad to hear it! Your vet does sound a bit hmmmm
Glad it has all worked out okay for you.
I am over the moon for you. We lost our beloved 10 year old dog to Lymphoma this time last year so I am pleased to hear you've had the all clear and wish you many more years with your DDog.
Congrats! That's fantastic news. I was really hoping it wouldn't be cancer.
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