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Caring for a Three Legged Dog or Cat

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Amputation, chemo or watchful waiting for COSMO with MCT
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Member Since:
19 April 2016
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27 April 2016 - 5:16 am
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I have an energetic Maltese with mct between Cosmo's two back toes. Had it taken off, could not get clean margins. Has an mitotic index of 2. For various reasons, radiation is off the table. You've been told by Onco and regular Vet you could "wait and see" as it may, or may not come back. You've also been told you could amputate, but it could still come back. In both cases you were told if it came back it would be more aggressive than before.

He has had X-rays to check and see if it has spread but hasn't had ultrasound or lymph node as aspirations. Sould I get those done as well?

The tumor was removed April 5 and three days later came back as a low grade Mct. Mitotic level 2.

Realizing there are no guarantees, would amputation give Cosmo the "best" chance of it not coming back? Would follow up chemo be necessary to ensure a little extra edge? Which is best?

If I "wait and see" and don't ampute, Is it a forgone conclusion that, if it comes back it will be more aggressive? Would amputation at that point still be an option of value?

very confused and felt like I havnt had any answers. Please help!!!


Member Since:
22 August 2008
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27 April 2016 - 5:27 pm
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The best option is to do a fine needle aspirate of the lymph node to see if there are mast cells there.  If so then I would amputate ASAP and consult an oncologist.  If there aren't any mast cells  I would probably wait and see what happens since a mitotic index of 2 is quite low and the tumor may never recur.

Pam

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19 April 2016
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27 April 2016 - 6:08 pm
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Pam I ask my vet to fine needle aspirate the lymph node and he told me u have to hit the spot where the cancer cells are to really know if it has spread. That it would be better to have the actual lymph node to send in for more accurate results, if we amputated . Should I demand one or ask another vet to do so? I also have gotten in touch with another vet that is supposed to do a ultrasound of his organs, should I ask him to do the aspirate as well. Also will he need the ultra sound? He had X-rays which look good.

comso has neck problems due to something unknown really, would he still do okay with an amputation? Thanks so much for your reply. It has cleared up so much for me. Finally got some answers..

Another thing. I've noticed just since his last onocology app which was two weeks ago I had her look at a spot on him and she said it looked like pigmented skin but watch it and make sure it doesn't raise. Since then he has all kinds of light brown patchs on his little pink skin??  Maybe I'm just a worried parent that thinks everything is cancer related. Or is it some other kind of disease..


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22 August 2008
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28 April 2016 - 11:49 am
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It is true that a biopsy is more accurate than an aspirate but it requires anesthesia and mast cells usually stain really well on an aspirate so I would do that first.

I can't really comment on the darker masses without seeing them but in general mast cells are not pigmented.

Pam

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