Did I make a mistake?

[tilerspop]

As I posted back in mid -October, Tiler was diagonsed with a cancerous tumor on his zygomatic arch. My vet said that if he made Thanksgiving he would be doing good, Christmas would be an absolute miracle. The oncologist agreed with that diagnosis. Both thought that since this was a classic presentation there was really no point in doing a biopsy, it would be purely academic.

Here we are after Christmas, and Tiler is still going, not strong but hanging in there.

The tumor has not grown substantially ( at least where we can see it). It is now the size of about half a good sized chicken egg.

The droopy eye has not returned, nor has the droopy lip. He takes treats and chomps them right down. He is not head shy. He eats all his dry kibble just as before the illness. These are all things that were going on at the time of diagonsis.

He is currently taking 30mg of prednisone daily. He is eating everything in sight and drinking alot. He does pant quite a bit.

He still trots out to meet me at the door, still wants to go as much as he can, still likes to go for walks, etc. You get the picture. In short I'm not seeing the disease progression that I've been led to expect from bone cancer.

He has become weak from loss of muscle mass. I can see the losses. He can not get into the truck by himself or get up on the bed. His walks are much shorter.

The questions are. Did I make a mistake by not having the biopsy performed? Is there another anti-inflamatory drug that will do the same job as prednisone w/o the side effects? Are there other things that can cause tumors that aren't cancer? If the above are in the affirmative, can we recover the lost muscle mass?

Or maybe the bigger question is am I just whistling as I walk past the haunted house?

My plan of action is to get back into the vet and have a chest x-ray. If it is cancer I would think that it would have spread there by now and we are in end stage. If the lungs show clear then we will consider a biopsy. My wife seems to think this will cost about $1500, but we don't know where she got that figure. Then we go with the new information and diagnosis if there is one.

Your thoughts and opinions are appreciated.

[Rottlva]

I've had many x-rays done on my dogs from hips/elbows to abdominals in my cocker-x who bloated. They were all around 50-80/picture, and after the second or third, the price lowered to 40 or so. That being said, why did they not biopsy it to begin with??? Did they x-ray it and see the obvious bone changes??? Usually when they see the cancer on the x-ray they will biopsy to see how aggressive a cancer it is.

I would want the biopsy first. Find out what it is. Then go from there.

[szky]

First, I'm glad to hear that Tiler is still doing well. The questions you've asked are all good questions for your Vet and the oncologist. Is Tiler coughing (like kennel cough)? The reason I ask is Buster had a persistant cough (3 months), that ultimately turned out to be Osteaosarcoma in the lower lung lobe. There was no underlying tumor anywhere.

A biopsy would show where Tiler is at and what treatments may be available. Hopefully, other people here on RND can give you some good info.

Thinking good thoughts and prayers for Tiler's continuted good health.

[chivas]

Biopsies usually run about $65 per sample. Yes, there are many things that can minic cancer and not be cancer. Id do the chest xrays, if clear - i would do a biopsy since you arent seeing much progression (OS is EXTREMEMLY agressive). Oh, and some people (me included) dont like to do a biopsy off the get go - some of us are in the thinking that messing with a primary tumor throws "seeds" throughout the body but in your case - as long as the lungs are clear - I would be curious to see if it really IS OS.

[frontierrots]

My male Tune had a lump appear above his right eye the beginning of the year. (this was after a month of whining if patted on top of the head) Took him in for an xray and nothing showed up so the vets assumed it was a cyst or something benign and that we should just watch it

Instead of resolving it grew. When it became golf ball sized we xrayed again and again it looked like nothing as in you could NOT even see it on the xray. The vets did not want to operate because it was a hard firm mass and that it would be a very looong surgery and he did not do anesthesia well and was an old dog

Finally this fall it had grown to large egg size in height and had spread to cover from about even with the center of his eye to just past the centerline of the skull. It was making his right eye not open as much as the left and it was obvious that the weight bothered him, although it was no longer sensitive to the touch. Took another xray and you could finally see the mass firmly attached to the skull. The prognosis was that it would continue to grow, no one wanted to operate for the above reasons and because it was on the skull, I did not want it to progress to his brain and cause a behavior problem like I had seen in many other dogs with skull tumors (not my own)

So we put him down. Should we have operated in spite of the vets protests (3 different vets at 2 practices)? No I think we did the right thing in gving him a fun filled and loving summer and end life when things got worse.

I am also with chivas on this, I don't do biopsies for the same reasons she mentioned. And in the case of bladder cancer doing a biopsy is contra indicated as it is proven to cause the tumor to seed to why not ther types as well?

[BostonRott]

Not all cancers progress as predicted. I have a friend whose Golden outlived the dx by 3.5yrs (and still going). You do mention significant change in teh dog, especially with regard to muscle mass. There is definitely something cooking. Did your vet tell you "osteosarcoma" or is that just what people here are guessing? Was it another type of tumor, or without the biopsy were they not willing to comment on type?

I personally agree with your course of treatment. I think it's a little late now to be wondering about biopsy and other treatments. While he may not be as bad off as predicted, he also does not sound like a healthy animal with a simple fix waiting just around the corner. Not trying to be heartless, just honest.

Enjoy him while you can, be thankful you didn't lose him yet and keep him comfortable.

[tilerspop]

Sorry I haven't responded earlier, we lost the internet connection at home again.

Rottlva, yes the skull x-ray did show bone changes and according to the vet and oncologist this was a "classic" presentation. We didn't do a biopsy ecause both felt that it would be a purely academic exercise and painful to the dog.

Szky - no cough or any other obvious lung involvement. I listened with a stethascope and the lungs sound clear.

fr - I agree, the sugical option was offered at first and we turned it down due to the type of surgery and prognosis for a better outcome, much the same as you. I have not noticed any behavioral changes (I've been looking for them) other than being inordinately tired. If I were to see any changes in behavior the last trip to the vet would be immediate.

Boston - The vet and the oncologist both said cancer. The oncologist would not be more specific w/o a biopsy, but she is the one who said it was purely an academic exercise. So no, we really don't know if it' osteo or some other carcinoma, if it is cancer at all.

I realize that he is not healthy and we are spoiling him. I thank God for every additional day I have him and pray that I make the right decisions for him as this progresses.

At this time, Other than the weakness, he is living a good life. He does not seem to be in any pain and still enjoys the things he always has. Out of the three things I decided I would use as indicators there is only one that he can no longer do and that's get in the truck by himself. He still loves to go but he needs assistance to get up in the vehicle.

[BostonRott]

Sounds to me like you're doing the very best that you can and also doing what is best for him. And the fact that he's still comfortable enough to ride in the truck..... that's great!! I wouldn't cross that one off the list yet! When he's too uncomfortable bouncing and bumping along in the truck, THEN you can cross it off. You still have a "list of 3," and that's great!! Keep your chin up and give that boy some love!

[warrior1]

Hi. I am new here but I have to respond to this situation. I have a 9 1/2yr. old Rottie. I am sure I don't need to carry on how much my boy means to me. By reading this forum, I see we all feel the same about our babies. Anyhow, one day at the end of May of 2005, my dog started severly limping(front left paw)He is older, I thought maybe arthritis. Next day, he could not move. LAME!! A few hours later, a bumb appeared on the joint. I quickly called his Vet. They took him right in. (not fun being 5'2 getting a 130 lb dog into a car alone) Long story short, x-ray showed ostosarcoma (99% chance w/o biopsy).I was in the room and saw the ugliness of the x-ray. I was devastated. I too refused the biopsy.My boy was put on rimadyl but just as a trial (they didn't think at this point it would do any good) He had a very short time due to the disease progression and he was already unable to walk. I cried my heart out knowing what I had to do. 6 days pass, Day 7, we are walking, with a limp but walking. 4mts pass, no limp, running, playing ect. I call to order more meds. and the vet wants to see him ASAP.Why wasn't he failing? He was re x-rayed. Lump was still there but the x-ray was clear!! NO CANCER just a lg bone cyst on the joint and a fracture. The lump is ugly and at times it does bother him but overall we are doing fine. The Dr.(after his speech returned) said he has never in 26 years seen the 1% chance that it wasn't cancer. It is 8mts later and he is fine. Don't get me wrong, he definatly has his senior problems but he is still with me and not in pain!!
Point is, we can all hope for miracles when it comes to our dogs and I truly feel I got one. Don't count your dog out just yet, you never know what will happen. Sorry this is so long, I just thought I could put a little bit of hope out there for someone who might need it!

[Nina&Bill]

Oh Mike I feel for you and your boy!

It's very easy to second guess yourself & wonder if you've made a mistake but do NOT do that. A biopsy will change nothing & will disturb the mass. Continue doing what you're doing & spoil Tiler rotten.

We ended up building a ramp on the stairs for Smidgen (that the goober was too afraid to use...if I had only known about agility 12 years ago!) and taking her for rides in the pickup truck since it had the extended cab & 3rd door so she could simply step right in. Tiler will let you know when it's not fun anymore.

I'm so sorry.

Nina

[tilerspop]

Thanks for the good thoughts and the hope given. I'm sorry I haven't reponded earlier but I couldn't get on the site for the last couple days.

We have a vet appt. this afternoon for a check up and possibly some x-rays. Whatever the vet thinks is needed. After reading here, I'm not going to order a biopsy. It just doesn't make sense to do it now, especially with the negative side effects of disturbing the mass.

Tiler won't like going to the vet but he will like the car ride, and of course the treats after. He's still doing well and seems to be getting a little better with additional exercise. I'll post the results of the vet visit this evening.

Thanks again.

[tilerspop]

Doc said we're doing pretty good. He was very surprised to see us. We didn't do any additional x-rays as he thought they were not necessary. Tiler checked out OK and he said keep doing what we're doing bc it seems to be working. We do need to exercise more to keep his muscle strength up, so we will now go for short walks at least twice a day. If his stamina builds we will lengthen the walks as much as he can tolerate.

Again, thank you all for your support.

[jessicajcl]

Oh, I wish I had seen this topic sooner. I am glad you didn't do the biopsy. I have to tell you, I believe my dog is suffering more now because of it. She started with the on and off limp. The vet tried treating for arthirits first. She still limped. Vet said it could be cancer and did an x-ray. The x-ray showed the classic signs ofosteosarcoma on the small bone of her front right leg. The doctor was 99% sure that's what it was. She wanted to do a biopsy to be sure. So she did a needly biopsy (on a 118lb rotty she attempts a biopsy with a small needle-duh). Of course it came back inconclusive. It was painful for the dog for no reason because we basically knew what it was anyway. The vet insisted on doing it again - even though she screwed it up they wanted to charge me again! My husband begged me not to take the dog back there but STUPID me did, this time they made two incissions and extracted bone samples. This time they got a positive result. Since that day, December 1, 2005, my poor girl has not recovered from that procedure. The vet didn't stitch her, they used glue. They didn't even send her home with an antibiotic. So of course the tumor more than doubled it's original size in a matter of days (plus there was fluid form the procedure), the skin split, and now the wound has opened wider and she has to have her leg wrapped at all times for the rest of what little time she has left with us. Needless to say we don't go to that vet anymore. They were looking to make money. They kept pushing me to spend $5,000.00 plus on amputation and chemo and if you ask me, they really believed I would do it so they were sloppy with the biopsy. I am so mad at myself for letting them take the second biopsy. I truly believe it's better to leave it alone. It grew so much faster after they went in. Plus, a good vet and any pet owner who has been through it knows the classic signs of cancer on an x-ray. It might be important to get a biopsy with other types of cancer especially if you're going to go through the treatments but in my opinion, in an older dog (mine's 8 1/2) with something like osteosarcoma where you know you are not going to put the dog through something like amputation, do not bother with the invasive biopsy when it's clear on the x-ray. Just my opinion though. Like I said, there are other types of cancer that are not as devastating as osteosarcoma and are treateable. Yes, in that case, ok, but it was a MISTAKE in my case and I would urge anyone in the same situation as mine not to do it.

[tilerspop]

While we were at the vet we discussed the biopsy. He basicly said the same thing as chivas. Biopsy cause tumors to throw seeds and make the situation much worse. So everyone was in agreement, not a worthwhile procedure in this case.

[jessicajcl]

Oh, I forgot to mention...you had asked a while back if there was any other good anti-inflamatory with less side effects. The one my Sydeny is on which works WONDERS is Metacam. I don't know how it works on the site where Tiler's tumor is but it worked great on her leg - she even stopped limping entirely. I have the predisone but am holding off 'til it's absolutely necessary. Since your dog is already on it, I don't know how good it would be to go back to something less powerful but definitely ask your vet about Metacam. It's non-steroid so it doesn't come with all the nast side effects of cortisone/prednisone.