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Avatar universal

confused

Our old dog was mauled by a cow some weeks ago.  Some time after this we noticed a lump on one of her hind breasts.  We took her to the vet yesterday and the vet said she has cancer.
Mum and Dad think that if the cancer has spread and isn't contained to the one breast that she should be put down.  I disagree.  I think she still seems reasonably well and that it would be premature to put her down.
If she does have cancer and it has spread, does it make sense to put her down then while anesthetized?  I don't think so, but I want to make the best decision for the dog.  Her name is Speedy (because she was fast when she was younger).

Our dog also has other issues.  She has ongoing issues with her ears.  She had a ?Depps operation years ago.  She still scratches her ears occasionally, which are probably worse after she digs for rabbits, and is profoundly deaf.  She also has arthritis.  She was run over when she was a puppy.  Her back has fused.  She is relatively mobile although she does struggle with jumping (in and out of the car, etc) and walking up steps, etc especially if they are too high.  She is still relatively fit and often runs around with my sisters four year old dog (he's part lab, part something else).

Are you able to offer any advice regarding this situation?  It would be most appreciated.

Does it make sense to have her treated and then re-evaluate the situation on an ongoing basis?  I don't like the idea that her life is cheap and to have her put down when she still seems OK (considering her age, ears, arthritis, etc).

Many thanks.
J
20 Responses
Avatar universal
MEDICAL PROFESSIONAL
Dear Jaquta,

I'm sorry about your situation.  The bite may be a complete coincidence... or may not be.  First I would suggest getting a second opinion.

If they still think it's a tumor and not an abscess or poor healing, then I would take chest X-rays to see if it has spread (metastasis) to the lung (the most common place).

Then I would at least get a biopsy if your parents are so unsure.

Why? Because it's tough to diagnose cancer just by looking or feeling!  In a dog, there is a 50-50 chance that it is cancer vs. not cancer. And of course, it's could really be a result of the bite.

Call me biased (I'm a surgeon), but it is definitely possible to remove the mass, benign or malignant, with surgery.  Vets do that all the time!

I am assuming she is not spayed.  At the same time, I would suggest spaying her.  It doesn't protect against breast (mammary) cancer, but it eliminates the risk of a common, nasty and possibly deadly infection of the uterus, called a pyometra.

One more note: spaying BEFORE THE FIRST HEAT protects against breast (mammary) cancer with over 99.5% certainty!

I hope this helps.

Good luck.

Please keep us posted.

Phil Zeltzman, DVM, DACVS
Pet surgeon and author of a free, weekly newsletter for true pet lovers, available at DrPhilZeltzman.com
Avatar universal
Hi.  Thank you for your response.  The cow knocked her around a bit but she wasn't bitten.  (Unless our neighbors dog bit her.  They sometimes attack the dogs when I walk them).

50-50 sounds pretty promising.
The vet wasn't very assertive and wasn't able to give very much information (other than the fact she believed it was a tumor).  I was hoping she was much better with animals than with people.  I would have taken her to another clinic but this branch was closer to home and I trusted the vet wouldn't employ someone if they didn't think they had the necessary skills.  

You're allowed to be biased  (as long as removing the mass doesn't mean killing all the animals in the process).  I wasn't assuming you operated for fun though and didn't care about the outcome.  I think a lot of people working with animals do care.

No, she isn't spayed.  I hoped she would have a litter but it was unfair to do that once the extent of her arthritis was revealed.

Mum and Dad consented to her being operated on.  The vet is doing it now (removing the lump plus cleaning her ears and checking her teeth).  She said that alone would take 2 hours.

That's not a bad statistic.  I'll keep that in mind if we ever get another dog.  My sister's dog who we currently have has been de-sexed.

Thank you for all that info.  I wish some of these other options had been presented to us by the vet.  We queried something this morning and they said they don't have x-ray facilities.  If we had more time and information we probably would have asked to have her chest x-rayed.

I have recently been treated for breast cancer (partial mastectomy and radiation) so I think this is also raising a lot of emotional issues for people.


Thanks for your time and input
J
Avatar universal
MEDICAL PROFESSIONAL
Wow J, I'm sorry you went through that...

I'm thrilled that you elected to do surgery... Now I have to wonder if I made a difference in some small way!

Your post is a very important one, and I hope it will help a lot of other pet owners.

Hence one more piece of info: in cats, the odds of cancer vs. a benign mammary (breast) mass is 99%.

That's why we recommend spaying!

How many other cancers can we prevent that efficiently?

My advice when I do this kind of surgery (mastectomy as you know) is:
- to prevent licking/chewing at the incision with an E collar (plastic cone) until suture removal (10-14 days) and
- to keep the patient confined for 2-4 weeks. That depends on how extensive the surgery is.

Please let us know how everything goes.

Take care of yourself.

Phil Zeltzman, DVM, DACVS
Pet surgeon and author of a free, weekly newsletter for true pet lovers, available at DrPhilZeltzman.com
Avatar universal
Dear Dr Zeltzman

Thank you for your kind words.
For me personally, I was fortunate to have had symptoms (a bloody nipple discharge), as I was told that this saved my life.  Without the bleeding it is unlikely that the cancer would have been detected until much later.  The surgeon said this type of cancer was rare in someone my age.

I wish I had been more observant with what was going on with Speed and had of acted sooner.  I wish I had of trusted my instincts and not given in to placate my family.

Speedy is doing better today.  She was a bit groggy yesterday after surgery.  The surgery lasted in excess of three hours so I expect that knocked her around a bit.  I am really ashamed to say this but speed had three teeth extracted.  She had abscesses in two of her back teeth and an exposed nerve and receding gum in the front.  I can't believe we missed something that major in her.  She occasionally had some lumps come up near her jaw but we just presumed it was from the bones she eats.  This past week her breath was smelling but she's a dog and has been eating calf poo.  In hindsight, she did occasionally drop her biscuits when I hand fed her.

Her ears were also a mess.  The vet said she's never seen anything like what she saw with Speed.  Apparently there was a lot of hair and debris and wax in her ear canal.  The vet thought her ear operations may have contributed to this.  Almost like her ears are filtering this stuff into her ear canal.  I don't know if she can hear better but the ears definitely aren't as thick.

The lump was also cut off and she apparently has layers of stitches there.  The vet thought the lump was pretty much contained and didn't think it had spread.  She also found another lump on Speed's brisket but she thought that that was just fatty stuff.
Mum is reluctant to get the lump tested due to expense.  I feel that this would give us peace of mind though and let us know what we're dealing with.
Mum and Dad will pay the initial cost but I'll end up paying for her treatment.

I think I would have got Speed seen too but I think your post helped get mum and dad on board which was really important.  Thank you.

Our vet said she did some reading and said that most lumps in dogs have a 30-50% chance of being cancerous.  You already said 50-50.  I guess that risk alone would warrant intervention.

That's extremely high in cats!  I would hope that the likelihood of cats getting any mass would be extremely low to counter those odds.  Those odds would be extremely concerning for any cat lover.
I personally feel uncomfortable about spaying but I can see it most definitely has advantages.  Not just for preventing cancer but for population control, etc.
I wouldn't think too many cancers could be prevented that easily.

Does that spaying before the first heat apply for cats as well as dogs?
I'm assuming it does.

We were told to give her pain relief for the next four days and antibiotics for the next 12 (for her teeth).  We were told to feed her soft food for her teeth for the next few days and also keep her calm for the next two so she didn't burst her stitches which are said to be tight.  And to take her back in two weeks to have the stitches removed.

She has already been licking at the dressing over her incision and it is loose.  Mum thought that was also partly due to the swelling going down.
I had a breast abscess following surgery which required iv antibiotics and took four weeks to heal.  I don't want speed getting an infection.  Not if we can help it.

2-4 weeks.  While I was out feeding the animals mum said speed was running around.  And when I came back I forgot to close the door and she was rolling around on the lawn.

I can tell the next little while is going to be fun.

Thank you so much for all your time, support and concern.  It has been much appreciated.

I'll let you know the pathology results when we get them back.

Thanks again for everything.

J

p.s.  I forgot to thank you all for the forum and the opportunity to access all your expertize.  Thanks heaps!!
Avatar universal
MEDICAL PROFESSIONAL
Hi J,

Let me try to answer 1 by 1:
. "She had abscesses in two of her back teeth and an exposed nerve and receding gum in the front"
No need to be embarrassed.  Think about how our teeth and gums would look if we hadn't brushed our teeth or had (bi)yearly teeth cleanings for 14 years!!!  That's exactly why vets recommend that!

. "the bones she eats"
That's also why vets usualy don't recommend giving bones to pets. It makes some people angry. Well, guess what, believe it or not but yesterday our ER doctor removed a bone stuck in the small intestine of a Bassett Hound on Friday (yesterday, Aug 20, 2009).  That's one expensive bone!

. "I would hope that the likelihood of cats getting any mass would be extremely low to counter those odds"
Well... that's not how Mother Nature works!  The risk is high in an unpayed female, period.


. "Those odds would be extremely concerning for any cat lover"
... which is why I'm convinced that if more people knew the truth, based on science, instead of relying on urban legends and advice from their neighbor or brother in law, they would do things slightly differently.

. "I personally feel uncomfortable about spaying but I can see it most definitely has advantages.  Not just for preventing cancer but for population control, etc.
I wouldn't think too many cancers could be prevented that easily."

That's interesting.  Spaying and neutering are 2 very well established operations.  Done well, they have very few complications.  But the benefits are countless, both for the patient in particular, and the population in general.  And with proper pain management, pets recover quickly.

. "Does that spaying before the first heat apply for cats as well as dogs?
I'm assuming it does."

Absolutely, they do.  However, I don't think those numbers apply to cats, they're based on studies in dogs.  I can't imagine that they're that different... The key is to spay BEFORE the 1st heat cycle.  It's hard to predict precisely, which is why most vets recommend it before the age of 6 months.

. "She has already been licking at the dressing over her incision and it is loose. "

That's just the beginning, the next step is licking/chewing at the stitches.  Please use an E collar (plastic cone)!  It's a cheap insurance policy!

. "2-4 weeks.  While I was out feeding the animals mum said speed was running around.  And when I came back I forgot to close the door and she was rolling around on the lawn."

Yep, the whole family needs to understand that things need to change and be strict (in my mind) for the next 2-4 weeks. Again, the duration depends on what your vet did.  If all they removed is "soft tissue" then 2 weeks may be enough.  If muscle was removed (which I doubt but you should ask) then 4 weeks are more reasonable.

. We're all waiting for the pathology results.

Keep us posted.

Thanks

Phil Zeltzman, DVM, DACVS
Pet surgeon and author of a free, weekly newsletter for true pet lovers, available at DrPhilZeltzman.com
Avatar universal
MEDICAL PROFESSIONAL
One more question, -personal-, if I may.

I'm curious: where are you located?

Just the State is enough!  Don't provide too much personal info!

Thanks

Phil Zeltzman, DVM, DACVS
Pet surgeon and author of a free, weekly newsletter for true pet lovers, available at DrPhilZeltzman.com
Avatar universal
Wow!  I feel like I've had a thorough vet consult -and free of charge.  Thank you for your time and expertize.

I read that 80% of dogs have dental issues.  I guess I went about this the wrong way.  Instead of buying enzymatic toothpaste or dental sticks I should have done the obvious thing and taken her to the vet.  We'll need to take Scruff (that's my sister's dog.  I don't think he'll take too kindly to that -he had rumensen poisoning when he was a puppy).

I had heard that cooked bones were bad as they splintered easily.  Surely dogs would have eaten bones in the wild though.  I'm sorry if this makes people angry.
That's true and I don't expect that dog will get too many more bones.
That's kind of interesting.  Almost like humans where x-rays have shown some people to have forks, keys, rings, etc inside them.
I hope the dog is OK and that the bone didn't cause too much damage.

To be honest, I've never heard any person talk about mammary lumps, etc in cats.  Until now that is.

I think many people think and feel they're doing their best for their animal or pet.
I know my family try but we seem to be incredibly ignorant.

I'm not concerned about complications from surgery, etc.  I guess I am more traditional and feel like they should be given the opportunity to have offspring.
I know this can cause more issues.
We have been overrun by cats at times and the outcome can be tragic.
(I did tell my brother to leave that stray cat over the paddock).  With the cats it is more a question of expense than anything else.  Which if we didn't feed the kittens we would probably be right.

I was surprised the vet didn't give us one.  I had made a comment to mum before the operation that she would come home with one.

She's been running around barking at the cows (which are near the house).
If she gets excited we don't let her out.  She has to go out to pee though.  Perhaps we need to use her lead.

It's hard for me to take responsibility.  I've been so traumatized by things I've seen animals go through that I now distance myself and try not to get emotionally involved.  Hard not to around animals though.

Sure!  I almost feel like I've done something wrong.  By accessing advice from an expert in another country.  We'll try country.  I live in New Zealand.
I don't know the motivation behind the question but we use an animal health service for our large animals (cows, bulls, etc) and a vet clinic for our small animals (cats, dogs).  The vet clinic has recently expanded to open another clinic about 20 minutes drive away from where we live.  Plus they're extending their main clinic to encompass quite a large animal hospital.
I think my family have made the decision that if we need to take speed or scruff, etc to the vet we'll take them to the larger one in future.  I'm familiar with the owner and have a good rapport with him and he is infinitely more qualified.
Although I did go into the local one the other day and the vet on at the time seemed OK.  Spoke about removing a 22 g tumor from a 30 g mouse.

Thanks again for all your time and input.
I'll keep you posted about the results.  They won't send them off till this Monday so they may take a little while.

J
J
Avatar universal
MEDICAL PROFESSIONAL
Hi J,

Wow, New Zealand!  And I thought you were in the US!  How incredible the Internet is, eh?

OMG, of course, I should have mentionned that she should be walk outside to pee and poop ON A LEASH (aka lead)! Otherwise, it defeats the purpose of confinement inside!

As for feeling bad, you really shouldn't.  You made the right decision by getting advice.

Take care.

Phil Zeltzman, DVM, DACVS
Pet surgeon and author of a free, weekly newsletter for true pet lovers, available at DrPhilZeltzman.com
Avatar universal
Hi.  Yes, the internet is an amazing thing.  NZ seems a whole world away from the States and just about everywhere so being able to access such educated and talented individuals is truly amazing.
The internet is a great educational and research resource.  Not to mention support.
I like NZ though (which is easy to say now with spring coming up.  Winter was absolutely freezing -the coldest in nearly 30 years).

Speed seems to be doing OK.  I feel she has declined a bit over the past few days but she still seems OK.
The vet rang up two nights ago with the results.  (Sorry for not writing back sooner.  I've become quite depressed and I'm struggling just trying to manage my parents farm.  I feel absolutely shattered.  It's a lame excuse I know but stuff is going on).
The vet said, according to mum who answered the phone, that Speed had two benign cancerous lumps.  It sounded like it was pretty much contained and that there was no lymph node involvement, etc.  I was wanting a copy of the pathology report before writing back but that won't be available for another few days.
It sounds like great news for Speed and the rest of the family.

Thanks a lot for your support and advice.

Jackie
Avatar universal
MEDICAL PROFESSIONAL
Hi Jackie,

Well that's interesting... as there is no such thing as "benign cancerous lumps."  Benign and cancerous are mutually exclusive.

A mass can be benign, ie non cancerous, ie good.

Or it can be malignant, or cancerous, ie bad.

Getting a copy of the biopsy report would obviously be highly interesting.

Please try to let us know what it ways, even very briefly.

Thanks.

Phil Zeltzman, DVM, DACVS
Pet surgeon and author of a free, weekly newsletter for true pet lovers, available at DrPhilZeltzman.com
Avatar universal
Dear Dr Zeltzman

As I client I feel the vet doesn't have the greatest communication skills.  It's almost as though she fears asserting herself and therefore doesn't really define boundaries or needs.  When I go to the vet I want to know what's wrong, what can be done and if there needs to be vet intervention, how much will it cost.  Plus other questions of course.
I don't expect to leave a vet consult feeling confused and having more questions than answers.  Maybe I am just a difficult client??  

I didn't push my mother too much regarding what the vet said.  My mother was a nurse so understands the terminology.  It's just easier to wait for the results -they often speak for themselves.

For me, my cancer/ non-cancer was caught early.  Some people say it's cancer while others say it's not.  It's strange having aggressive cancer treatment for a non-cancer.
I expect that is what has probably happened with speed.  She has had surgery to prevent what was probably benign from spreading.  (Do benign growths grow and spread?  I guess there must be potential for that.  Maybe benign, as defined by a pathology report, at that point in time -which doesn't exclude it from becoming malignant later.)

I wonder how owners, and people, manage that unknown quantity.  Will it spread and will they die from it?

I think I'm about as confused as our vet now.  Is cancer really that black and white or does it exist on a continuum (going from low grade to high grade, from ?dcis to invasive)??

I'll let you know the results once we get a copy of the report.  I expect it would be grossly unfair to leave you hanging like that.  It's always nice to get closure on something you've followed and been involved in.

Thanks for the interest in the health and well-being of our pet.

Jackie
Avatar universal
MEDICAL PROFESSIONAL
Sorry, let me try again.

Benign and cancerous are mutually exclusive.

A mass can be benign, ie non cancerous, ie good, ie it will not spread.

Or it can be malignant, or cancerous, ie bad, ie it MAY spread.  

Some cancerous masses are known to spread slowly or rarely. Ex: a nerve sheath tumor or hemangiopericytoma or fibrosarcoma are typically "locally invasive," ie they invade the area where they started, sometimes in an evil way. But they spread maybe in 15-20% of the cases.

Other cancerous masses are known to spread quickly or frequently to distant places. Ex: osteosarcoma, or bone cancer, probably spreads in 100% of the cases, most often to the lungs.

Mammary (breast) cancer is known to spread to other places, most often to lymph nodes and the lungs.

And that's why vets routinely take chest X-rays whenever they suspect that a mass is cancerous.  Doing surgery on a pet with lung metastasis (spreading of cancer to the lungs) is hard to justify!

Phil Zeltzman, DVM, DACVS
Pet surgeon and author of a free, weekly newsletter for true pet lovers, available at DrPhilZeltzman.com
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