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Ask Dr. Kara Your Own Question
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My black, 12 year old Lab/Springer spaniel cross has developed
My black, 12 year old Lab/Springer spaniel cross has developed a tumour in the lower half of her mouth and lower jaw bone. The lump is hard, extends along her jaw about 2" long and >1" wide. This was discovered 3 days ago and it really does seem to be growing by the day since, as it is clearly visible now. It was a complete shock, I hadn't noticed anything wrong (apart from smelly breath the day before) until she slobbered mucky discharge all over her bed and I had a look in her mouth. The (OOH) vet took a biopsy 3 days ago and prescribed antibiotics for an infection at the site, and Prednisilone to shrink the growth. We will have to wait up to 7 more days for the result due to Easter bank holidays. Very unfortunately we are leaving to go to Australia for 3 weeks, in 8 days' time.
21 months ago she had major reconstructive surgery on both back knees due to cruciate ligament damage. She has increasing numbers and sizes of lipomas all over her body. 3 months ago she suddenly developed what looked like a large cyst on the side of her big toe. The vet treated this with antibiotics as it was inflamed and angry looking. This reduced the sore look of it but it remains. We have no pet insurance.
I suppose I am looking for answers that you probably can't give, as we do not know yet what type of cancer it is (the vet's clinical opinion was that it is not benign) or if there are metastases - I am now wondering if the growth on the toe is cancer also; perhaps she has bone cancer? She has certainly been getting markedly stiffer and less willing to move, and has less stamina over the last few months - I had put this down to her age and stiffness in her back legs.
Like everyone else who has a pet my priority is her comfort and quality of life. I would appreciate any input you might have, all things considered, about whether keeping her comfortable with palliative care might not be kinder than putting her through an op and possibly radiation and/or chemo, at her age. From all I have read on-line, the best-case scenarios, even with no spread, still seem to point towards the disease taking the dog within a year or just a little more.
Would it be kinder to her for us to accept the situation and to care for her with minimal invasive/uncomfortable treatments, until her pain can no longer be controlled?
And will she still be here when we return from Australia? (I suppose no-one can answer this as we don't yet know what we're dealing with).
Even if you can't answer my questions fully - which I know you can't - any feedback would be very much appreciated. She is a great girl, the brightest, gentlest, best dog I have ever had. I just want to do what's best for her.
3 years ago.
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replied 3 years ago.
Hello, my name isXXXXX and I have over 20 years of experience as a veterinarian. I'm sorry to hear that Bella has a tumor in her mouth, and I understand given all of her other troubles and her age you are wondering how aggressively to treat this tumor.
I do not think that the mass on her toe is related to the one on her jaw/mouth. It may be an aggressive tumor, but tumors on the feet spread to local lymph nodes or other filter organs like the lungs, spleen or liver, not the jaw.
The most common types of fast growing oral tumors in dogs are malignant melanoma, squamous cell carcinoma, osteosarcoma, and fibrosarcoma. These tumors are all very locally aggressive, meaning that they infiltrate deep into local tissues and they can metastasize (spread) to distant tissues, including the local lymph nodes and the lungs. They have often already spread by the time they are discovered.
Because these are aggressive tumors treatment must be aggressive as well and often includes hemi-mandibulectomy (removal of half of her lower jaw) or a mandibulectomy (removal of the lower jaw) and recovery from that surgery isn't easy. Long term if we can get the entire tumor and there are no metastases then this can affect a cure. But in most cases, because we already have metastases, it is only a short term treatment.
I would not recommend putting her through this sort of surgery if she has metastases.
And at her age I would have to strongly weigh her overall health before putting her through an aggressive surgery such as a hemi-mandibulectomy or a mandibulectomy knowing that this is a difficult surgery to recover from and at her other health concerns may crop up. I probably would not put my old dog through that sort of surgery unless she were completely healthy otherwise.
Palliative treatments could include debulking the tumor and radiation treatment to slow tumor growth as well as antibiotics and the nonsteroidal anti-inflammatory called Piroxicam which has anti-tumor effects as well as anti-inflammatory effects.
Radiation treatment may be difficult for you to do for her given that you are leaving for vacation soon as it is usually done by giving low levels daily for several weeks.
If this is a malignant melanoma then this may progress very, very quickly and she may need to be humanely euthanized before you are back home. The other tumors I mentioned are a little less aggressive and she will likely be able to be kept fairly comfortable until you come home.
Please let me know if you have any further questions.
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