Tazzie’s lab results came back, but I did not see that the vet left that message until today (Saturday). She hadn’t expected them until next week. A different vet read the results to me today, so I have some but not all the information.

The biopsy, which was presumably a needle biopsy, showed the new lump to be a sarcoma. Given his history of OSA and neoplastic cells that appeared similar to osteoblasts, it seems most likely that it is a OS metastasis. However, there is lots of fat cells in the background. So if he did not have the OSA history, the pathologist might think it was a liposarcoma and would require a full biopsy of the lump to get more information on the structure of the sarcoma.

My vet spoke to the oncologist who said that soft tissue mets of OSA are extremely rare. However, the oncologist said that when soft tissue mets show up there are usually lots of others that are present, so the prognosis is poor (I guess that means really really poor). They talked over options for chemotherapy at this point, but I won’t get that information until I call her on Monday. So, the main information I cannot provide here is the oncologist’s suggestions for treatment (or advice to treat or not to treat).

For what it is worth, I would not mind hearing anyone’s thoughts (especially Pam’s) on what options may be:

1. Do surgery to remove the lump to get more information and just to remove it? It seems close to the surface, but I suspect would still require anesthetic. (I am guessing they can't do surgery this week, because his cell counts will be at their lowest post-chemo.)
2. Stop chemo and start metronomics?

3. Is it appropriate to consider bisphosphonates, or are those specifically for boney tumours and mets?

4. Any other ideas????

Tazzie still seems to be feeling good. Well, he is kind of dog-tired right now but he had his longest and most active post-amp walk and swim yet at the doggy park this morning, plus he is getting to the point post-chemo (adriamycin) when we would expect him to be tired due to cell counts. In other words, he is doing great – make that, he ACTS as though he is doing great. Obviously, he has not been reading the lab reports.

I am starting to wonder which saying to live by: Knowledge is power or Ignorance is bliss?

Susan

Pam

Thanks for the insight. That all sounds reasonable. I am guessing we will face the continued chemo vs. metronomics decision this week, or if/when the lump is removed. I doubt his WBC will be normal for another week – based on today's behaviour and appetite, they seem to be dropping, which is to be expected. He was SO perky all day yesterday and evening.

To our knowledge, the lungs are clear. This is from x-rays just 3 weeks ago plus the ultrasound person heard/saw nothing consistent with masses in the area he can view.

I have not followed the recent Palladia discussions. Is that something else I should consider or ask the oncologist about if this is a met?

Susan

I spoke with the vet, but unfortunately have little time to act right now. Probably does not matter since his cell counts would be low due to last week's chemo. Might have been wise to delay that chemo while we checked this out.

Basically we will look for other lumps via abdominal ultrasound and another chest xray. For that his abdomen will be shaved. The oncologist expects to find more lumps (oh joy).

If we don't find any, and perhaps if we do (?), we will remove the lump, once his blood counts get high enough. For that, a chunk of fur not yet touched over his right hip will be shaved. In otherwords, my furball mutt will be getting pretty darn close to being naked and it ain't growing back thanks to the chemo. The vet says he could be slow to recover from surgery, given he is on chemo.

The vet is considering a different drug for chemo, since Adriamycin and Carbo do not seem to work given this met showed up while he was on chemo. I am not sure that is a fair conclusion. It might have been too large to be affected by the chemo before we started. The drug mentioned began with an "M" and is in the same family as Adiamycin (supposedly less toxic on heart), but turns things like the white of the eyes blue.

Personally, I will check out the metronomics possibility, unless this is an isolated lump in which case I think we would continue as usual.

We will do these exams later this week (probably no rush given blood counts). Tazzie was a bit more lethargic yesterday and today, as expected due to last week's chemo, but basically in fine shape. My neighbours showered attention on him yesterday (took him to their house, to the park and visiting to their friend's house). It is sooo nice of them.

I wish I could follow Tazzie's lead and devote more attention to him, but I have to reserve a bit for my students.

Emily – I'm sure your biopsy will be fine. It just sounds different. This was bone hard – it felt like a bone met.

Susan