Hi again Joyce,
Since I didn’t hear back from you regarding chest x-rays and need to pop away for a wee bit (I will be back within an hour or so), I do want to leave my thoughts for your lass’s situation. So, do let me know if they did take chest x-rays and if you have any other questions.
First, as I am sure you can appreciate, medical management for any growth will be of limited value for a progressively enlarging mass. In cases where the mass is growing rapidly, the only non-surgical options would be palliative care. Specifically, this would include the use of antibiotics to address any bacterial infection that could arise with splitting/ulceration of the skin. As well, we often will use steroids as they are an anti-inflammatory with some anti-cancer effects. They are used to try to shrink tumor size and reduce the associated inflammation. Further to this, our only other treatment options would be pain relief (ie Tramadol, Bupenorphine, etc) to ease any discomfort and suffering she may have with this.
Now as you can see, you are already treating her palliatively. Further to this, we would be in a situation where we’d need to know what kind of mass this is (if its cancerous and if so what kind of cancer) to decide which further treatment options would be practical. This is especially important since some cancers will respond well to chemotherapy or radiation therapy, where others only respond to surgery. As well, knowing what mass is present will give you an idea to whether this has likely spread internally and into her lungs. Or whether this is a tumor that only spreads locally.
Now if the suspect mass is in the bone, then we do have a few considerations. We can see osteosarcomas, chondrosarcomas, bone cysts, and even severe osteomyelitis (that can be mistaken for cancer). In a situation like this, without a biopsy we can only speculate and just do not know the nature of the mass. And if we do not know, we cannot say whether surgery wouldn’t be curative nor can we determine if her mass would be a good candidate for radiation therapy with chemo (as we will use for palliation with some osteosarcomas). So, at this stage, we can only speculate and cannot truly assign a poor prognosis with or without surgery for her.
Therefore, with all of this in mind, I do appreciate that your veterinary surgeon is not keen to operate. Still, in this instance, you may want to consider a second opinion with another veterinary surgeon or seeking referral to a veterinary cancer specialist (who will be more familiar with treatment options for her) or surgical specialist (who will be more experienced with surgical removal of difficult masses). These other vet will be able to give you an idea if there are practical treatment options for her individual mass. If their testing yields an infection based osteomyelitis, then they can culture samples to find the antibiotic that will address it for her. Otherwise, if they do diagnose cancer, then depending on the mass type and extent, they may be able to remove it fully, debulk the tumor to at least reduce its size, or even amputate the leg. If they diagnose an oseteosarcoma or chondrosarcomas but find it has spread to the lungs, then chemotherarpy may be an option for her. But of course, just as in people, knowing which option is best does totally depend on the mass type present.
Therefore, if we have a mass in the bone, we do have some serious concerns. You are already treating as palliatively as possible for the situation at hand but it sounds to not be enough for her. Therefore, at this stage, a second opinion or ideally a referral to a veterinary cancer specialist may be indicated here so that you can get a clear idea of what this mass may be, what treatment options there are for her, and what you can do to address this for her.
I hope this information is helpful.
If you need any additional information, do not hesitate to ask!
All the best,
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