Tumor on Dog's Paw - looking for second opinion
Our dog is an 11 ½ year old Border Collie Mix. We have been patients of a vet for most of her life who has been an excellent Veterinarian but for some time now, we have been feeling extremely rushed when we visit his office. Being very busy with our jobs, we have been taking her to him mostly because he knows her and for the convenience of being able to get an appointment when we need it.
We are looking for a second opinion on her condition and feel that we owe it to her to give her the chance at a few more years of a good life before making a big decision to either have him perform a very risky surgery or euthanize her.
She was very recently (in December 2011) diagnosed with having a tumor on her paw. We originally thought her nail had fallen off but upon examination, the vet confirmed that she in fact, has a tumor on her paw. He did blood work and x-rays and found that the tumor is benign. He told us to “get through the holidays” and make a decision as to whether or not we would like to have surgery done. He said that if the tumor was anywhere else on her body, that we would not even have to discuss surgery but since it is on an area where it will continually be opened up and bleed, that we should consider it. She is fairly healthy otherwise. Her heart is strong but she gets extremely anxious and her breathing becomes slightly labored when she is nervous, such as when she knows she’s going to the vet (just like most dogs!) Due to her age and the breathing circumstance, the vet is a bit reluctant to perform the surgery.
She is approximately 59 pounds, was diagnosed with a thyroid condition approximately a year and a half ago and is on Thyroxine. She is also on allergy medication. We give her joint tablets and Pet Tabs on a daily basis. She is eating normally and very happy and playful. We had to have a satellite placed around her head because she was chewing at her paw and making it bleed. Our vet has placed her on Cephalexin to prevent infection in her paw.
We have been taking her to him on a weekly basis since we found out about the tumor just to have it checked out, have her bandages changed and make sure all is well otherwise. At her last visit, this past Saturday (January 7th), I asked our vet what he thought we should do and after being extremely rushed once again, he said that he thinks with all of her “conditions” we should put her down. My heart broke and I was sort of taken aback. I understand that she is an older dog but she still has so much life left in her. She is our best friend. She is not in any pain and just wants to play and give love. I cannot imagine not giving her a chance at a few more years of life and just taking that away from her. We are not trying to be selfish and do not want to do this for ourselves. We just would not be able to live with ourselves knowing we could have done more for her and just took an "easy" way out. However, what he is suggesting is far from easy to consider.
We have considered the surgery, but honestly, at this point in my heart I feel that our vet has already given up on her. I do not feel completely comfortable having him perform this surgery on her. I do not completely know what is involved because again, when we are at his office, we are extremely rushed and feel that he is just trying to get to the next patient as soon as possible to end the work day quicker. I know that sounds awful, but it is the way we truly feel. Our last visit was not even 5 minutes long and I had some questions for him and all he did was give me the euthanize remark and walked out of the room. I have been trying to do research myself online but truthfully, not even 100% sure what I am looking for. The vet informed us on Saturday that the tumor seems to be going into the bone in her paw and when he removed the bandage, there was an awful odor. He cleaned it up and bandaged her back up and put a larger satellite on her to prevent her from getting at the paw, as she was still trying to do. She has been fine at home and we are trying to keep an eye on the paw.
I am just seeking some additional advice from a professional so that we are a bit more confident that we are giving her the best chance. We are prepared for whatever decision needs to be made but want to make the best, most informed one for all involved – especially our dog. If you have any other suggestions we would appreciate some more expert advice.
I wish I had advice to offer, but I don't as I am by no means knowledgeable about your dog's condition, however others may well have more experience and be able to offer you more information.
From what you have said, it seems very strange for the vet to suggest euthanasia. The tumour is benign, but it would be better to have it removed, otherwise it will clearly either keep getting infected or become a constant annoyance to your dog who will continually gnaw at it. At the same time, there is a risk of your dog not surviving the surgery, particularly given her age and other health issues. I am also a bit surprised your vet hasn't given antibiotics, as it sounds like there may be an infection already present in the paw (hence the bad odour).
If I were in your shoes, I would absolutely go for a second opinion. You are clearly not happy about the way your vet seems to be rushing your consultations - which I imagine is very frustrating - and his suggestion of euthanasia just seems inappropriate, given her otherwise relative good health and contentment.
You have done an amazing job with her so far and I just hope another vet may offer you much better advice and more appropriate alternative suggestions for treatment. Tony
Thank you for your kind and thoughtful words Tony. I have contacted an animal hospital not too far from where we live who seem to have a very good reputation and experience in this area. I am hoping that they can offer some positive alternatives and will be willing to see us this week. She is actually on an antibiotic and has been since she was first diagnosed with the tumor. She is on a different, stronger antibiotic now. I do feel that his suggestion of euthanasia at this point was very off and really just want to do the right thing for our best friend. I really appreciate that you took the time to respond. Even just "talking" to someone else right now is helping. Thank you again!
Hello & welcome......This is not the expert forum, but you will be able to get very good information here.....Unfortunately, you must wait a long time for a response in the expert forum, so here's my opinion....
"he said that he thinks with all of her “conditions” we should put her down." I personally don't think she has ANY conditions that would warrant being put down! Nor do I see any that would effect the tumor being removed....(I would not use this Vet for the removal!)
Her thyroid condition is common & probably is non-existent anyway..
Her Allergy Issues are common & usually food related. What allergy med does she take?.....If it's steroids, it causes labored breathing...
You state her heart is good, no diagnosed heart condition.
The most important part would be blood work done to check her Kidney & Liver Values before her surgery.....This is common procedure before anthesetic (SP?) can be administered.....Has she had any recent blood tests that would show Liver & Kidney function?
IMO, You have a no win situation here....This foot is going to get worse & she's probably miserable living in a cone all the time.....If the infection travels to the bone, then you've got a dangerous situation setting up......The Paw is obviously already infected, thus the smell...I doubt that Cephalexin is strong enough, now.....
If she were mine, I'd find a Holistic Vet in your area.....Not only do they practice conventional medicine, they also practice natural methods....You get the best of both worlds, including a different protocol relating to Vaccines (Which should not be given yearly or ever to Senior dogs!)
If your interested, you can go to the AHVMA.org websight & do a search by state.....My Holistic Vet spends at least 45 minutes or more with me (Everytime)..It doesn't matter if he has other patients waiting or not!
Others here will be by with suggestions.....Until then, I wish you & your girl comfort........Karla
P.S. Be careful with the Pet Tabs, they get recalled frequently for toxins.....
It is so hard when they have a foot problem. I don't know why your Vet would say to put the dog to sleep as I am not really reading anything that isn't manageable. I would definitely get another opinion.
As a side note, a neighbor's dog (a bit older) has a history of cancer and had a lump come up on the back of the foot. The owners decided to have it removed although it needed a skin graft, quite involved and pricey. Different than your case but I mention this because the surgery was done, the foot kept wrapped and it healed up nicely. I would definitely get another opinion on this and try any treatment plan recommended.
Oh my goodness!! Change vets ASAP! Big red flag as far as I'm concerned!
The whole thing is very out of order.
Nervousness ALWAYS leads to laboured breathing. There are other criteria to consider before surgery besides nervousness. If her organs function well, and her heart is sound, and there doesn't appear to be any condition such as renal weakness, or clotting disorder, etc then it should work out OK.
My dog is also very nervous at the vet's...HATES the place with a vengeance, but sailed through surgery, even though she too is an older dog.
If the infection may have spread to the bone, then if antibiotic therapy doesn't seem to be working, partial amputation above the infected area may, possibly be the best cure. This may sound drastic, but may only involve one toe. When it heals, she will hardly notice it.
You do definitely need to see another vet as soon as you can. Good luck and I hope you can find someone who can give more time, attention and skill to this case.
I would definately find another vet, and even two if necessary. Your dog does not sound like she is in that bad of a shape, and for your vet to suggest putting her to sleep in my opinion is a joke. We have an almost 13 year old border collie/lab, and I would not hesitate to try surgery if there was a possible good prognosis. Even if she didn't make it through the surgery you have at least tried to help her, recovery after surgery might not be easy, but what your going through now isn't either. Good Luck.
I would change vets NOW. For whatever reason, your vet has obviously decided to basically wash his hands of this whole thing and nobody needs nor deserves to be treated that way when they take their pet to a vet.
I am in total agreement with Karla. The thyroid may or may not be an issue, but in any case it wouldn't be anything to cancel a surgery over. Her heart, liver and kidneys are good and THOSE are the main things you consider when looking at anesthetizing a pet. If it were not for the tumor on the paw, she would be a perfectly normal older dog with normal older dog issues. Certainly nothing to consider euthanization over.
PLEASE don't second guess yourself over this. You live with her. You see her every day. You know her habits. You know how she behaves when she is feeling well and how she behaves when she isn't feeling well. If you feel that she still has a good quality of life then she does! When it is time, you will know beyond a shadow of a doubt, no ifs, ands or buts.
Find another vet ASAP. Let him or her evaluate the paw and see what they say about the surgery. Have them do the complete battery of pre-anesthetic testing, most importantly the bloodwork. Have them do a BUN and creatinine test to make sure the kidneys are good. Have them do ALT, AP, bilirubin and cholesterol tests to check out the liver, and glucose and total blood proteins to make sure diabetes isn't an issue, an EKG to check the heart and a total white cell count, hematocrit and a differential. If all of these tests come back OK, you have nothing to worry about when it comes to anesthesia but even less to worry about if you're going to go the local-only route, which CAN be done. Ask them about doing the surgery without using a general anesthesia. Ask if they can give a shot of Xylazine (sometimes mixed with Telazol). Xylazine is what is known as a disassociative agent. Animals who have a shot of this do not appear to be sleeping, it looks like they're in a trance. It's kind of disconcerting because they lay on the table with their eyes wide open, but they have no idea what is going on around them. Salve should be placed in the eyes so that they don't dry out during this time because the dog won't blink. A disassociative agent kind of, for lack of a better explanation, de-links certain parts of the brain from each other so they're not communicating. When these disassociative agents are used, another drug, Yobine, can be given as soon as the surgery is over to reverse the effects of the Xylazine immediately. This way, the doctor has complete control over the length of time the dog is not aware of what is going on, and the dog is never unconscious and its body isn't dealing with the rigors of anesthesia. I used to work for a vet who used Ketamine as a disassociative agent but the Xylazine is better because it can be reversed so quickly with the Yobine. The best part about doing this is that if anything happens during the surgery that seems amiss, the dog can be awakened IMMEDIATELY and doesn't have the risk of waiting for the anesthesia to wear off.
So DEFINITELY look into having the tumor removed from her foot, because when it comes to doing surgery on older or higher-risk animals, there ARE options to look into that can give your older girl the safety she needs during the surgery. Otherwise that tumor WILL just keep opening and bleeding and getting more and more infected and it COULD become a very serious matter, possibly even life threatening if the infection becomes bad enough and goes systemic. PLEASE let us know what your second opinion vet says.
Wow, logging in today I am so utterly and totally overwhelmed with gratitude to each and every one of you who responded with your kind, thoughtful words and wonderful advice. I really mean this. I am so very touched by your kindness and thank you so very much for taking the time to respond to me.
After some serious research, we have found an animal hospital with an excellent reputation and wonderful reviews. The vets at this animal hospital really seem to care and know what they are doing. I explained the entire situation to them and they gave us an appointment without hesitation and even apologized to us for having to go through any of this with another vet. We are taking her there in a few days and for right now, just keeping an eye on the paw, cleaning it up, checking the bandages and giving her the Cephalexin antibiotic. She is in great spirits (even with the dreadful cone! :-) )
I just knew in my heart that something was not right but kept trying to tell myself that this vet cared so much in the past and took his time with us before. This last visit was the last straw for me. After going online and reading some reviews about him, I was not surprised to see that other patients are complaining about the same things we are. They feel like he no longer cares and is just going through the motions. It's very sad because he used to be so good. We have known this vet since our little girl was a puppy and he's always seemed to give her the best care possible. I think he is just very overwhelmed and could use a bit more help in his office. There is always so much chaos and he never takes any time with us anymore and from what I've read, we are certainly not the only ones. I feel like I have to chase him around the room to talk to him. That's not fair to our girl at all.
I am very confident that we are doing the right thing in getting a second opinion and really do hope that this new facility can come up with a better approach.
The allergy medication she is taking is called Chlorpheniramine. She has been on this medication for approximately one year. She is also on a steroid ( a half pill every other day) - this would make perfect sense regarding the breathing issues but she honestly only breathes this way when she is in distress. Otherwise, aside from the thyroid issue, I know she is in very good health and he did do bloodwork which he said all came up good and took x-rays which showed no other signs of anything else to be alarmed about.
I didn't realize the Pet Tabs had been recalled. Truthfully, since we started giving them to her over a year ago, she has had more energy and we did notice a very positive difference in her overall well-being.
I want to thank each of you again and will certainly keep you posted on how things go. Please keep our little Maxie in your thoughts and prayers. She sends a big hug to each and every one of you.
Yeaaaahhh! I am so pleased for you and Maxie. I really do think the 2nd opinion you get will be much more positive. While I realise the vet you were using was good once, there is still no excuse whatsoever for the kind of service being given now, particularly when it is at the expense of a dog who may have some health issues, but is otherwise happy, contented and so much loved by his family. If Maxie could talk, I'm sure he would thank you for caring so much and for finding a more amenable vet. Keep us posted on how things go. In the meantime, keep doing what you are doing. Big hugs from the UK, Tony
Your dog has a benign tumor, thyroid condition and allergies, and your vet suggests euthanasia...?
Wow....I am so happy to read that you are getting a second opinion for your dog.
You are certainly doing the right thing.
Don't forget, no matter how many opinions you get....You know your dog best, and it is your opinion that matters the most.
Well, I am back with an update. Took Maxie to the new vet, what a TREMENDOUS difference!!! The new vet and the assistants were shocked to hear of our other vet's recommendation to "put her down". They examined her and were playing with her and one of the assistants actually teared up saying how beautiful and full of life she is. They were actually as upset as we have been. The new vet said they can do the surgery with no problem and we just need to be sure all of her tests come back okay. She told us that they just did a similar surgery on a 14 year old dog who came out of it with flying colors! The other vet wanted her to be put down and told us surgery could kill her.
They ran all of the tests on her and did a cytology on her paw and we are awaiting those results. However, the new vet called me this afternoon to let us know that from the tests that have come back in, Maxie is being overdosed on her thyroid medication and asked us to please only give her half as that is all she needs. I was again very very troubled by this. She also said that the steroid medication Maxie is on is uncesessary and actually discarded it while we were at the office! The other vet just did a whole series of tests on her and told us none of this. She said the steroid medicine is actually going to slow the healing process. She also asked us to keep the bandage off (since Maxie has a larger cone now, she cannot get to it to chew at it) and let the air hit it.
I am all at once shocked, upset and happy because we finally got her to a good place but am upset because of all this new information. Had we not gone for the second opinion, we would have never known any of this. In essence, if she had gone under surgery with these high levels, she surely would not have made it and we would have gotten the "I told you so" speech from the old vet thinking it was because of her age.
We are still waiting to hear the rest of the test results but for now, we are being extremely positive and just loving our girl and making her as happy as possible. Thank you all again for your continued support!!! We will keep you posted.
Very happy for you and Maxie, thank goodness you didn't give up on her! Your research really paid off, and Maxie now has a vet that cares, which is how it should have been before. She sounds like a tough girl, and I'm sure she'll pull through great. After shes all healed, it wouldn't hurt to let the old vet know how well shes doing.
This is GREAT news!!! I'm glad to hear it, I can imagine you must be over the MOON to know that your Maxie is not nearly as bad off as your old vet led you to believe she is! It's just wonderful that you got a second opinion from a vet who can help you and that you listened to your heart and gut and didn't just take the word of this person because they have a veterinary degree. Remember, not all vets graduated at the top of their class. Some of them just managed to squeak by and still graduate.
I eagerly await your update following Maxie's surgery. Best of luck to you AND Maxie and you both will be in my thoughts. :)
Fantastic news. Thank you for updating. There are many times we cry on this forum, knowing the news is not good - but the first vet's advice just never felt right, even from the outset. I am so relieved for you - and for Maxie. Things have really worked out as well as anyone could hope for. Even better, because now you have a new vet you can trust for years to come. Huge cyber hugs to you and Maxie. I can retire to my bed tonight with a smile. Tony x
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