The SECOND hardest thing…

It was just a little lump between Fluffy’s toes.  I mean, it was tiny, but in three weeks it had grown and was about 3/8 of an inch.  Her owner wasn’t too worried, but she wanted it "looked at".  I tried to aspirate it (suck some cells out through a small needle) for a cytology exam(looking at the cells under the microscope), but couldn’t get much out of it.  So, we set her up to remove the lump surgically.  Not to worry, it’s just a tiny little lump.

Unfortunately, when we cut into the skin, the lump didn’t have a nice distinct border.  It just sort of went everywhere in and around the toes and tendons.  I had to remove it piece-meal.  There was no way to be sure that I really had it all;  I just kept snipping away things that didn’t look like dog until I got everything that I could.  Well, hey, it could just be an inflammatory reaction — maybe there was a little splinter or something in there.  We sent the crumbs of lump to the pathologist for evaluation.

Bad news: the lump is Mast Cell Tumor , Grade II.  If I could have removed it all with clean margins, I’d be feeling pretty good, since I’ve had such good luck with chemotherapy on these in the past.  Unfortunately, I couldn’t remove it all and I know there is still tumor left in the foot.  I talked to the oncologist (the cancer specialist) and all of our options stink.

Fluffy’s best choice for long-term survival is radiation therapy.  If you can take your dog to the University of Missouri (six hours away) and leave her for weeks, and spend about $2,000.00, the outlook is rosy.  Her owners can’t do that.

If she doesn’t have any spread of tumor to other parts of her body (metastasis) , we can get all of this tumor by the simple expedient of amputating her leg.  Good thing it wasn’t on her nose.  Unfortunately, to do our best job of finding evidence of spread, or lack of spread ("Staging" the cancer), we need to spend about $400 in testing (and it will be about double that if she goes to the nearest specialist).

If it has spread already, then our third best choice is chemotherapy, eight treatments over twelve weeks.  It usually doesn’t make them feel bad, but with tumor already spreading, the odds are we’ll only get about eighteen more months for our patient.  The total cost would be between five and six hundred dollars for this little gal.  That’s pretty cheap for chemo, but it’s some significant money.

It’s really hard to have to tell someone that they’ve got a bad disease and their treatment options are all expensive and may not work.  You can hold their hand and answer their questions, but you really don’t have the answers they want.  I like solving problems and giving people good news, and this time that’s going to be hard to do.

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