Had the vet look at Isabeau's growth...

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Had the vet look at Isabeau's growth...

Postby RescueAPBT » Wed Jan 19, 2011 4:25 pm

It's technically on her hip, an inch or two from the base of her tail. I just took this pic with my phone a couple minutes ago, it's the best I could get:

Image


It's been there for a few months. Recently, Isabeau has started licking the area a lot, acting like it bothers her. After reading about other member's experiences with Mast Cell Tumors, I realized I should get the vet to take a look at it.

The vet said it was kind of an odd looking growth. It's pea-sized, round, flat, and hard. She tried to aspirate it to get a sample for cytology, but couldn't really get anything. All she did was manage to make it bleed and turn red (and make Isabeau super-nervous, so she released her anal glands :wow ) .

She gave me anti-inflammatory/pain pills, and told me to up Isabeau's benedryl for the next few days. She wants to see if it will shrink. If it doesn't shrink in a week, she said she would definitely have it removed and sent to the lab. She said she wasn't sure what it is, it could be anything. She would not rule out MCT, but said it also didn't look like most MCT's she's seen. She said Isabeau needed a dental anyway, so she recommended we just go ahead and "kill two birds with one stone", which is fine by me.

When I checked out at the front desk, they gave me a print out of the estimate for everything. I noticed they just called it a "growth removal- small" and it was listed as only $30 extra. Call me crazy, but it doesn't sound like she's planning to treat it like it IS a MCT, since I would imagine taking out 3cm margins all the way around the growth would be a bit more involved and cost a lot more than $30. So do you guys think I should ask her to treat it as if it WERE a MCT??? Or should I trust her judgement and let her do what she thinks is best?
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Re: Had the vet look at Isabeau's growth...

Postby PITtsburgher » Wed Jan 19, 2011 7:57 pm

Not sure about the removal margins, but definitely make sure it gets sent out for histopath so you know what it is. Usually they can't tell by just looking at it and need to have it examined in a lab.
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Re: Had the vet look at Isabeau's growth...

Postby RescueAPBT » Thu Jan 20, 2011 10:56 am

Yeah, I'm most definitely having it sent out to the lab. I'm supposed to call the vet back on tuesday, so I guess I'll ask her then about the margins.
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Re: Had the vet look at Isabeau's growth...

Postby Misskiwi67 » Thu Jan 20, 2011 12:40 pm

Mast cell tumors are very easy to diagnose by aspirate which makes me think this is less likely to be mct, however, very few tumors get irritated after an aspirate other than a mast cell tumor. If this was my case I would do 3cm margins if it were easy and a minimum of 2cm margins if it were not. With mast cell especially the first surgery is often your only chance for a cure and it's much better to take huge margins on a benign cyst than small margins on a mast cell.

I would just make sure to discuss with your vet the day of surgery that you would prefer she treated it like mast cell and you understand this may incur additional costs.
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Re: Had the vet look at Isabeau's growth...

Postby RescueAPBT » Thu Jan 20, 2011 9:10 pm

Misskiwi67 wrote:Mast cell tumors are very easy to diagnose by aspirate which makes me think this is less likely to be mct, however, very few tumors get irritated after an aspirate other than a mast cell tumor. If this was my case I would do 3cm margins if it were easy and a minimum of 2cm margins if it were not. With mast cell especially the first surgery is often your only chance for a cure and it's much better to take huge margins on a benign cyst than small margins on a mast cell.

I would just make sure to discuss with your vet the day of surgery that you would prefer she treated it like mast cell and you understand this may incur additional costs.



Thank you! :)
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Re: Had the vet look at Isabeau's growth...

Postby RescueAPBT » Tue Feb 01, 2011 9:49 am

Isabeau had her surgery yesterday. I had pre-anesthetic bloodwork done last week, and everything was normal. The surgery went well. The vet took a good chunk out around the growth, and sent it off to the lab. I should hear something back in about 10 business days. She seems to be feeling just fine. She's not too thrilled about the elizabethan collar, lol. I don't trust her without it on though, since she was already licking and chewing that area before the surgery. I'll update when I get the results back. (fingers and toes are all crossed until then!)
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Re: Had the vet look at Isabeau's growth...

Postby HappyPuppy » Tue Feb 01, 2011 11:34 am

Fingers crossed! At least it is off of there now -- here's to clean margins!!
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Re: Had the vet look at Isabeau's growth...

Postby RescueAPBT » Fri Feb 04, 2011 10:14 am

Well, the vet just called. It was a Mast Cell Tumor. Grade 2. CLEAN MARGINS!!!! Thank GOD!!! I still got really upset and burst out in tears as soon as I hung up the phone. Vet said to just keep an eye out for any new growths, especially because of the area that her MCT was in (apparently they tend to be more aggressive when near the genital area). He also told me to keep an eye on her lymphnodes back behind her knees. I am relieved to finally know what it was, and to know that they got clean margins. I am still very upset and worried it will come back. :(
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Re: Had the vet look at Isabeau's growth...

Postby nsbullylover » Fri Feb 04, 2011 12:01 pm

RescueAPBT wrote:Well, the vet just called. It was a Mast Cell Tumor. Grade 2. CLEAN MARGINS!!!! Thank GOD!!! I still got really upset and burst out in tears as soon as I hung up the phone. Vet said to just keep an eye out for any new growths, especially because of the area that her MCT was in (apparently they tend to be more aggressive when near the genital area). He also told me to keep an eye on her lymphnodes back behind her knees. I am relieved to finally know what it was, and to know that they got clean margins. I am still very upset and worried it will come back. :(


That is great news!

I have no experience with Mast Cell Tumors and have never heard the term "clean margins" before. Does this mean that they were able to remove all of the tumor?
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Re: Had the vet look at Isabeau's growth...

Postby RescueAPBT » Fri Feb 04, 2011 12:07 pm

Yep, clean margins means they removed all of it. So that's definitely good news. :)
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Re: Had the vet look at Isabeau's growth...

Postby PitBull-Lady » Fri Feb 04, 2011 12:10 pm

That is GREAT news. Clean margins are what you want to hear. :yipee:
I'm still holding my breath as Jasmine's margins were ok everywhere on her leg EXCEPT the area right by a major nerve.

I think you can breathe easy now :) by always stay vigilant.



(Doctors use the term "margins" or "margins of resection" to refer to the distance between the tumor and the edge of the tissue. You can think of this as the margin of white space on a printed page that separates words from the edge of the paper. The margins are measured on all six sides: front and back, top and bottom, left and right.

Seeing how close cancer cells are to the edge of the removed tissue helps your doctor make the right treatment decisions. This is particularly important if a decision has to be made about additional surgery—re-excision before radiation versus mastectomy.

The information your doctor gathers about a tumor's margins is important for treatment but does not usually influence your prognosis (likelihood of recovery without metastasis or recurrence)
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Re: Had the vet look at Isabeau's growth...

Postby tiva » Tue Feb 08, 2011 12:23 am

I'm glad you had clean margins, but 1/2 cm margins are not great news. What's the mitotic index?

Watchful waiting is certainly an option. But since your vet couldn't get the usual margins, I personally would talk with a board-certified oncologist, if that vet wasn't one.

You may have run across our Tiva's MCT experience. She also had a bump at the base of her tail, and we also ignored it for a while because our old vet wasn't concerned. When we switched to a new vet, she aspirated the lump and found mast cells. She did surgery, couldn't get 2 cm margins, and the tumor was grade 2, mitotic index of 0. We opted for tail amputation, after consulting with the veterinary oncologist at the university. Amputation was EASY for Tiva, and she spent another 3 years without any recurrence. It worked.

Now she's 15, maybe almost 16, and she just developed another MCT, this time on her leg, above her elbow--a big one, hard to remove. We took her to the university, and she had surgery last week. Because of the location, they could not get clean margins (which we knew would be the case going in), but it too was a grade 2 with a low mitotic index (1). Normally, the vet school would recommend radiation or chemo (prednisone plus vinblastine, or possibly palladia or masitinib.) Most chemo protocols and radiation are VERy expensive ($thousands each), but effective, with usually quite moderate side effects. But for a 15 year old dog, we're not yet sure what to do.

Anyway, the point of all this is--Go to an oncologist, if you are uncertain, as you sounded in the dog cancer forum. You might consult with a board-certified surgeon about tail amputation as a possibility, depending on the location. Margins of 1/2 cm are not typically considered sufficient. You mentioned elsewhere that this vet said there was nothing more that you could do, which may be true within his practice, but it's not true for a specialist.

Here are some options that a specialist could discuss with you:
1. possibly amputate her tail, depending on where the MCT was.
2. chemo
3. radiation
4. wait and see--it is certainly an option, but it's important to realize it's not the only option.

Good luck. Tiva got 3 great, pain free years, after her MCT in her tail. I hope your pittie gets at least the same!
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Re: Had the vet look at Isabeau's growth...

Postby tiva » Tue Feb 08, 2011 12:25 am

Sorry--I just looked at your picture and realized that your pup's MCT is technically on her hip, so forget what I wrote about amputation.
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Re: Had the vet look at Isabeau's growth...

Postby RescueAPBT » Tue Feb 08, 2011 9:35 am

tiva wrote:Sorry--I just looked at your picture and realized that your pup's MCT is technically on her hip, so forget what I wrote about amputation.


I just replied to your post on cancer forum, lol. I believe I am going to go to my vet and ask for a copy of her pathology report, and then make an appointment to get a second opinion from a vet I used to work for. Since money is tight for me, I'm going to hold off on the oncologist for the time being. I really appreciate you taking the time to tell me about Tiva and confirm that I should get a second opinion. Thank you. :)
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Re: Had the vet look at Isabeau's growth...

Postby tiva » Tue Feb 08, 2011 10:14 am

Good luck! There are inexpensive chemo options, if your second vet thinks chemo might be appropriate. Some chemo is very expensive because it needs to be administered intravenously. Other chemo can be given by pill, and while you still need to monitor blood counts, it's not expensive. For example, one chemo protocol our vet is discussing with us is prednisone + leukeran. Both are pills we could buy at the Costco pharmacy for a reasonable amount, and we could work with our own vet on the blood monitoring. Another protocol, using prednisone + vinblastin, would cost several thousand dollars.

I'm very glad that the margins were clean for your dog.
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