Aa
looking for some closure
my peke went in for teeth extractions and afterwards developed pneumonia. after her surgery she didn't want to eat so i thought it was due to her surgery.took her back to the vet for her check-up and was told that her mouth was healing up nice.that was dec.14th of 2011. she kept acting like her mouth was bothering her, so i took her back and they did x-rays of her mouth and said she had a grade2 soft tissue sarcoma and it was malignant. unfortunately she passed march22, 2012. what i don't understand is why didn't they see the tumor in her mouth when the dental surgery on her teeth was done.i've lost 2 sisters (pekingnese) in 4 months due to something happening after surgeries.what your opinion?
The amount of time that it takes for a tumor to reach a certain grade all depends on the individual case. The grade is not the size of the tumor, it's the based on how great the likelihood is that a tumor will spread.
The grade used to be based on how normal the cells of the tumor looked under a microscope. Over time and as newer and better diagnostic methods became available, that proved to not be the best system, so a new system called the French (or FNCLCC) system was developed. It is based on three factors; differentiation, mitotic count and tumor necrosis.
Differentiation is used to distinguish how many cells look normal as opposed to how many cells look abnormal. The cells are scored 1 to 3, with 1 being mostly normal and 3 being mostly abnormal.
Mitotic count takes into consideration how many cancer cells are seen visibly dividing under the microscope. Again, these are scored 1 to 3, with 1 being the fewest cells dividing and 3 being the most cells dividing.
Tumor necrosis defines how much of the tumor is made up of dying tissue. It is scored from 0 to 2, with 0 signifying less dying tissue and 2 signifying the largest amount of dying tissue.
The three areas are assessed by a pathologist, who then determines, based on the scores, whether a tumor is a low grade cancer or a high grade cancer. High grade cancers are more aggressive and spread faster than low grade cancers.
A tumor is graded GX when the grade cannot be determined because there is inadequate or incomplete information.
A Grade 1 (G1) has a total score of 2 or 3.
A Grade 2 (G2) has a total score of 4 or 5.
A Grade 3 (G3) has a total score of 6 or higher.
There are several other things that are taken into consideration before determining the prognosis for a cancer patient. The tumor itself is evaluated as to whether it is considered to be superficial or deep in the tissue, and the size is measured. It is then determined whether or not there is lymph node involvement. Finally, it is determined whether or not there is any metastases (metastasis being when cancers spread from one organ or body system to another).
All of these criteria are then combined to assign a stage to the cancer. The different stages (I won't go into what determines these, it will be too lengthy) are Stage IA, Stage IIA, Stage IB, Stage IIB, Stage III and Stage IV. All of the A and B stages involve no spreading to the lymph nodes or more distant organs, Stage III involves spreading to the lymph nodes but not to any other sites, and Stage IV involves both spread to lymph nodes AND other sites.
I hope I have explained this in a way that is easily understood. If you need any clarification, I will do my best to clarify whatever you are confused on.
Ghilly
The grade used to be based on how normal the cells of the tumor looked under a microscope. Over time and as newer and better diagnostic methods became available, that proved to not be the best system, so a new system called the French (or FNCLCC) system was developed. It is based on three factors; differentiation, mitotic count and tumor necrosis.
Differentiation is used to distinguish how many cells look normal as opposed to how many cells look abnormal. The cells are scored 1 to 3, with 1 being mostly normal and 3 being mostly abnormal.
Mitotic count takes into consideration how many cancer cells are seen visibly dividing under the microscope. Again, these are scored 1 to 3, with 1 being the fewest cells dividing and 3 being the most cells dividing.
Tumor necrosis defines how much of the tumor is made up of dying tissue. It is scored from 0 to 2, with 0 signifying less dying tissue and 2 signifying the largest amount of dying tissue.
The three areas are assessed by a pathologist, who then determines, based on the scores, whether a tumor is a low grade cancer or a high grade cancer. High grade cancers are more aggressive and spread faster than low grade cancers.
A tumor is graded GX when the grade cannot be determined because there is inadequate or incomplete information.
A Grade 1 (G1) has a total score of 2 or 3.
A Grade 2 (G2) has a total score of 4 or 5.
A Grade 3 (G3) has a total score of 6 or higher.
There are several other things that are taken into consideration before determining the prognosis for a cancer patient. The tumor itself is evaluated as to whether it is considered to be superficial or deep in the tissue, and the size is measured. It is then determined whether or not there is lymph node involvement. Finally, it is determined whether or not there is any metastases (metastasis being when cancers spread from one organ or body system to another).
All of these criteria are then combined to assign a stage to the cancer. The different stages (I won't go into what determines these, it will be too lengthy) are Stage IA, Stage IIA, Stage IB, Stage IIB, Stage III and Stage IV. All of the A and B stages involve no spreading to the lymph nodes or more distant organs, Stage III involves spreading to the lymph nodes but not to any other sites, and Stage IV involves both spread to lymph nodes AND other sites.
I hope I have explained this in a way that is easily understood. If you need any clarification, I will do my best to clarify whatever you are confused on.
Ghilly
the tumor was on the left lower jaw and the surgery was on the right lower jaw.when they did the x-ray the tumor in feb. the tumor was the size of the tip of your thumb. unbeleiveable.thanks for your condolences.
I am very sorry for your loss. Sadly, it may not have been possible for the vet to see the sarcoma prior to or during the surgery, partly because they simply weren't looking for it. Much of course depends on where the sarcoma was sited and the extent of it. It often seems obvious with hindsight - and as owners we tend to blame ourselves for not appreciating the importance of the early signs of illness - but it is also true that sometimes our best friends become ill and pass away, just as humans do. Even if the sarcoma had been spotted earlier (at the time of the surgery), there may not have been anything the vet could have done, so try not to dwell on it too much. My heart goes out to you. Tony
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Within the category of sarcomas there are different types of tumors. Some grow slowly and some just grow unbelievably quickly, and the ones that grow that quickly it also seems to follow that the cancer is extremely aggressive. In all likelihood the tumor either was not yet there or was so small as to not even be visible yet when she had her surgery. Perhaps it will be of some small comfort to you to know that even if you had known about the tumor back in December, chances are good that the doctor would not have been able to stop it or remove all of it. Because they grow so quickly, there would have had to have been the removal of so much tissue to be able to leave the area clean that it would be so disfiguring as to leave your poor girl unable to survive.
Unfortunately, brachycephalic breeds often have a difficult time with surgeries because of the construction of their airways. There is something called the Brachycephalic Syndrome. Not all brachycephalic dogs are affected by the entire syndrome, but they all have SOME parts of it going on, which makes anesthesia of these breeds extremely risky. Brachycephalic Syndrome causes an elongated soft palate, stenotic nares (small, pinched-in nostrils that collapse during inhaling, making it very difficult for the dog to breathe through its nose) and everted laryngeal saccules, which refers to excess tissue in front of the vocal cords that is pulled into the trachea during breathing, partially obstructing the windpipe. If the dog is obese, it makes all three of these problems even worse. As I said, not all brachycephalic breeds have all of these issues, but they all have at least one or two of them and many DO have the full-on syndrome.
Surgery can be performed to resect the soft palate, widen and straighten the nares (nostrils) and remove the saccules so they cannot obscure the airway, however it's usually only totally successful in young animals who have not yet been fully affected by the syndrome. Once the animal has had to deal with the effects of not getting in enough air for a year or more of its life, its chances of being able to have these conditions corrected via surgery lessen with passing time.
Brachycephalic dogs (Pekingese are THE breed that is number one for individuals having all the aspects of the syndrome and not just individual aspects) have difficulty getting in enough oxygen which puts a HUGE strain on their hearts. In the hot weather they are unable to adequately cool themselves because of the airway being cut off by the everted laryngeal saccules, thereby placing a strain on their whole body. When all of these things are added together, it makes anesthetizing these breeds EXTREMELY risky, and any surgeries on these breeds should ideally only be performed by vets who have experience with them since there ARE so many chances for post-operative problems to arise.
I know that none of this will be very comforting to you, I wish I knew of something to say that would make things easier for you to bear. For that, I apologize. There is, in all likelihood, nothing that could have been done in either of your dogs' cases that would have helped them. Their own physiology was against them in terms of being able to withstand anesthesia and the rigors it places on the body's various systems.
Again, my most sincere condolences on your losses.
Ghilly