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Possible Nerve Sheath Tumor
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25 July 2017 - 2:37 pm
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Hi all, I'm new here, but am looking for some support and guidance. I apologize in advance for the long winded explanation.

My husband and I have a 7 year old beagle mix who started limping about 2 months ago on her right forelimb. The limping got progressively worse that week until she was no longer using her leg, so we took her to the vet early the next week. The vet did an x-ray and recommended that we see an orthopedic vet for arthritis and possible elbow displaysia. After the orthopedic vet examined her, he recommended that we take her to a neurologist as he suspected a neurogenic issue rather than orthopedic. We got her to the neurologist that week and had an MRI done. The neurologist said that she found a mass in the brachial plexus and performed a biopsy. Two days later the biopsy came back as just a lymph node, but she encouraged us to amputate anyways. I was a little uneasy about the decision without having a more definitive diagnosis, so we went back to our regular vet last week. He thought it might be best to get a second biopsy and sent us back to the orthopedic vet for that procedure as they're local and the neurologist is about an hour away. He also changed up her pain medication and she has started bearing nearly full weight on the effected leg since switching. We had the second biopsy completed yesterday and we're awaiting those results now. From what I'm reading in this forum and in medical case studies, I'm gathering that a lot of times nerve sheath tumors are difficult to diagnose. The surgeon that we saw yesterday told us to prepare for this biopsy to also come back as inconclusive, but that he would still recommend that we amputate her leg as clinical signs point to a nerve sheath tumor.

Has anyone else that has/had a dog with this type of tumor have the same difficulties with diagnosis? It's difficult for me to imagine making such a big decision when we don't have any concrete evidence of the type of mass. At the same time, in my research I'm realizing that these types of tumors are very difficult to diagnose and the prognosis is better the sooner you act. I would just hate to amputate and then send her leg off for histopathology and then have a clear result come back from that test, as well. Her pain seems well managed at this time, but she's on Tramadol, Amantadine, and Rovera. I want to do what's best for her, it's just difficult to know what that is with so little information.

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25 July 2017 - 3:23 pm
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wbransom said
I apologize in advance for the long winded explanation....Has anyone else that has/had a dog with this type of tumor...

No need to apologize! Long winded is what we're all about here...Best wishes for your pup, and the decisions you face. What is her name? Please keep us posted, your future forum posts will not require moderation.

While you wait for comments from others, use the Advanced Search above to refine your forum search results with specific phrases, and you're sure to find lots of helpful feedback.

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28 July 2017 - 8:06 am
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Her name is Molly. We just received the biopsy results yesterday and they, again, came back as a lymph node. We're going to try reducing her medication this weekend to see what happens as she appears to be recovering to some degree, but I think this may just be due to the various medications that she's on. Amputation is still the recommended treatment, but I'm having a really difficult time finding any case studies where amputation occurred without any pathological evidence of cancerous cells. It's hard for me to base this decision off of clinical signs alone, but it appears that I'm going to have to.

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28 July 2017 - 9:26 am
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Hi Whitney,

What a tough situation, I can't blame you for hesitating.

We have had many members who had to amputate despite not having a concrete diagnosis at first. Some got answers later after the bad leg was off, some did not. In all our history we have only seen a handful of members, maybe 1 or 2, whose dog's leg didn't need to be amputated after all. I don't know if that helps you in this situation but I thought I'd share that.

The signs your dog is giving say that she is in pain so something needs to be done right? Did your vets say the leg needs to come off regardless? Even if the tumor is another type, if it is infiltrating her limbs and causing her pain, amputation is usually the only way to help. If she is a candidate for radiation therapy, that can work too but I guess that's where knowing the exact type of tumor is needed in order to make it work.

You can ask your vet to take the pathology report and send it to another lab, like Colorado State or Texas A&M, if they haven't already. They are two of the best diagnostic labs in the nation if not the world and may be able to offer more insight.

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28 July 2017 - 10:04 am
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Good morning all! We here at Da Bear HQ have one of those cases of the one-two dogs who did not need to be amputated. So, we totally understand your reluctance to go with amputation based solely on clinical presentation. But also wanting to not wait should it be a NST ( which can be very difficult to diagnose EARLY but not necessarily by the time you are seeing signs of severe limping and/or pain.)

I guess my questions would be:
1) Are you near a Vet School where a group of specialty doctors can consult each other rather than you going to individual practices/specialties? Sometimes this helps with the bigger picture and often specialities truly do base their protocols off of past experiences. There may be some differential diagnosis that would be considered by a group/panel AND Vet Schools do have the benefit of generally seeing the most complex cases. Plus, you don't get charged for all the consultations...
2) Have any of the vets done an EEG to see if there is nerve damage ( which is kind of a hallmark of NST).
3) I'm confused as to what you mean by the biopsy result coming back as " lymph node". And the MRI showing a mass in the brachial plexus also coming back as " lymph node". Are they saying the mass IS the lymph node and that for some reason it is infiltrating or inflamed? Or are they saying the biopsy results are consistent with the lymph node? Sorry for my confusion on this. However, as Jerry shared and as you have read, biopsy results can be very inconsistent so based on biopsy alone in this case...dunno.
4)What is the pain med protocol again? Gabapentin is generally the first line of defense for any actual ( or perceived) nerve pain. I am not familiar with Rovera. Is it similar?

Again, Charlie Bear has a VERY unique case so if you would like to know more or have ANY questions, please PM us ( as his story has been told lots on this site already;) He was an almost amp but, after much consulting, he is simply on a pain management protocol and has been since last Thanskgiving. On the other hand, Lisa ( User name " Hester") and her courageous now Angel Pofi also have a wealth of information/knowledge regarding NSTs and the opposite experience of ours. There are many others as well.

Best wishes, huge hugs, and PyrPaws all around!

Whitney
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28 July 2017 - 12:12 pm
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jerry said

The signs your dog is giving say that she is in pain so something needs to be done right? Did your vets say the leg needs to come off regardless? Even if the tumor is another type, if it is infiltrating her limbs and causing her pain, amputation is usually the only way to help. If she is a candidate for radiation therapy, that can work too but I guess that's where knowing the exact type of tumor is needed in order to make it work.

You can ask your vet to take the pathology report and send it to another lab, like Colorado State or Texas A&M, if they haven't already. They are two of the best diagnostic labs in the nation if not the world and may be able to offer more insight.  

charliebear said

I guess my questions would be:
1) Are you near a Vet School where a group of specialty doctors can consult each other rather than you going to individual practices/specialties? Sometimes this helps with the bigger picture and often specialities truly do base their protocols off of past experiences. There may be some differential diagnosis that would be considered by a group/panel AND Vet Schools do have the benefit of generally seeing the most complex cases. Plus, you don't get charged for all the consultations...
2) Have any of the vets done an EEG to see if there is nerve damage ( which is kind of a hallmark of NST).
3) I'm confused as to what you mean by the biopsy result coming back as " lymph node". And the MRI showing a mass in the brachial plexus also coming back as " lymph node". Are they saying the mass IS the lymph node and that for some reason it is infiltrating or inflamed? Or are they saying the biopsy results are consistent with the lymph node? Sorry for my confusion on this. However, as Jerry shared and as you have read, biopsy results can be very inconsistent so based on biopsy alone in this case...dunno.
4)What is the pain med protocol again? Gabapentin is generally the first line of defense for any actual ( or perceived) nerve pain. I am not familiar with Rovera. Is it similar?

Thank you all for the responses! It is a complicated situation, but I'm trying to research as much as possible, so that I can make an informed decision, so I appreciate any and all insights.

As far as medications and pain:

When we first took her to the vet she wasn't bearing any weight on her right forelimb, so they started her on Tramadol and Rovera (which is for inflammation typically associated with osteoarthritis). We didn't really see any improvement with these two medications. She would yelp when jumping off the couch and sometimes even yelp at night if she rolled over the wrong way. There was no change by the time we took her to see the surgeon (a week later). Once he suspected a nerve issue he prescribed Gabapentin and discontinued the Rovera. Over the next week/week and a half, we noticed slight improvement. She went from not using her leg at all to using it around 20% of the time. We then went back to our regular vet and he discontinued the Gabapentin, restarted the Rovera, and also added Amantadine. The week following that medication change, she showed quite a bit of improvement and started using her leg 80% of the time, but does still limp and holds her leg up after laying down for long periods of time. I haven't seen any signs of pain in the past 1-2 weeks after the medication change, but I fear that we're just masking the symptoms, which is why we plan to reduce the medication this weekend and monitor the effects.

Aside from our primary vet, we've been taking her to Med Vet. We've been to a couple of different locations and they have a variety of specialists that have been collaborating on her case. I will definitely look into some vet schools, though! We're in Lexington, KY and I don't see any nearby on the list provided on this site, but I'll do some digging.

We have not tried an EEG or EMG, which I was reading about earlier today, so I may bring that up with the surgeon when I speak with him on Monday.

Sorry, my wording on the pathology results is confusing only because I'm slightly confused myself! The MRI showed a mass in the brachial plexus, but both aspirations of the mass have come back as reactive and consistent with lymph node. I plan to get more clarity on whether they think it's just her lymph node showing up or if it's a mass not related to her lymph node, as I'm still unclear. 

I will be sure to check our Charlie Bear's story! Thanks again for the support!

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28 July 2017 - 3:34 pm
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Hi Whitney!  It is a difficult decision and I can empathize with you!!  We didn't have concrete answers with our dog Toddy (also 7 years old).  He has had cervical issues that caused nerve damage for the last 2 years in his right front leg.  Has been on an anti-inflammatory and 2 pain meds ever since.(gabapentin, tramadol and previcox)  He then showed up with a tumor in the brachial plexus. He already had knuckling of his right limb and has pretty much stopped using it.  Our vet recommended amputation due to location of the tumor and thad his tumor would only continue to grow.  Toddy was in tremendous pain and had the surgery 7/18.  We don't have pathology back yet to let us know if it was benign or malignant .  Once removed , the tumor was roughly the size of the palm of your hand.  Our vet never did a biopsy.  He said due to location it would be difficult to aspirate and due to Toddy's pain he recommended the amputation. Because of Toddy's IVDD and the tumor we didn't have any testing except x-rays to make sure there were no tumors in the bone or lungs. 

That's great that they are able to manage her pain!  It seems that none of the tumors in the brachial plexus are "text book".  Hopefully you can get more answers from the surgeon on Monday! Wishing you the best and praying for a good outcome.

Heather and Toddy

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28 July 2017 - 4:49 pm
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Charlie Bear is now on Previcox, Gabapentin, Amantadine, and Tramadol. He would not be able to use his leg without and we have spent months tweaking the meds so that he is still very much Da Bear. One thing to keep in mind is that some of these meds have greater efficacy when used together and some take awhile to build up to a therapeutic dosage. When Charlie Bear consistently takes his meds, he uses his leg @90% of the time although he does have occasional bad days and some knuckling over at this point. He can stay on these meds at these doses indefinitely without harm according to his vets (UGA Vet School).

When he first presented, Head of Surgery recommended very invasive thorax cracking surgery. Head of Oncology said no way. And, finally, Head of Neurology made the best argument: what happens if you amputate but it does not take the pain away? How will we know he is in pain (which he could very well continue to be) but now the leg is gone...

Now, these cases are unique and Da Bear had a legendary infiltrative lipoma near the compromised area surgically removed several years prior. So we knew it would grow back and when we had the MRI and the CT don last fall the consensus was that perhaps the new growth was compromising the nerves by putting pressure on them: but the Head of Neurology and Head of Radiology said they just could not see why that was happening as the lipoma is "squishy" and should not be causing the "likely" compression. The EEG came back showing no loss of nerve function.

I am not at all against amputation (was once blessed with an OSA tripawd-well twopawd;) but also would want to be darn certain that amputation is absolutely necessary before proceeding. On the other hand, amputation does tend to remove the source of pain and/or disease, and whether it is a benign or malignant mass, it is often the gold standard of care. But as the Head of Neuro posed to me, "What if we amputate but the pain is still there? How will we know?" We at Da Bear HQ thought... that is a very interesting question.

Again, best wishes during this confusing time! Molly is sooooooo lucky to have you as an advocate for her!!! We hope you get answers soon and , in the meantime, as Sally would say, EAT MORE CHOCOLATE and spoil Molly (she is GORGEOUS!!!) ROTTEN!

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29 July 2017 - 7:22 pm
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If the MRI showed  a tumor of some sort in the brachial plexus then I would amputate since they should be able to remove all of it.  If the tumor invades towards the spine on the MRI then a complete excision is not guaranteed with amputation but should give her immediate pain relief.

Pam

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31 July 2017 - 11:34 am
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Heather said
Hi Whitney!  It is a difficult decision and I can empathize with you!!  We didn't have concrete answers with our dog Toddy (also 7 years old).  He has had cervical issues that caused nerve damage for the last 2 years in his right front leg.  Has been on an anti-inflammatory and 2 pain meds ever since.(gabapentin, tramadol and previcox)  He then showed up with a tumor in the brachial plexus. He already had knuckling of his right limb and has pretty much stopped using it.  Our vet recommended amputation due to location of the tumor and thad his tumor would only continue to grow.  Toddy was in tremendous pain and had the surgery 7/18.  We don't have pathology back yet to let us know if it was benign or malignant .  Once removed , the tumor was roughly the size of the palm of your hand.  Our vet never did a biopsy.  He said due to location it would be difficult to aspirate and due to Toddy's pain he recommended the amputation. Because of Toddy's IVDD and the tumor we didn't have any testing except x-rays to make sure there were no tumors in the bone or lungs. 

That's great that they are able to manage her pain!  It seems that none of the tumors in the brachial plexus are "text book".  Hopefully you can get more answers from the surgeon on Monday! Wishing you the best and praying for a good outcome.

Heather and Toddy  

I'm sorry to hear about Toddy! Hopefully the amputation provides him some relief and you can get some answers. How is he doing after the surgery? My husband and I discussed it over the weekend and I think we're leaning towards amputation. We tried reducing her pain medication over the weekend to see if she was truly getting better, but she started limping more and her leg was shaking after 24 hours. We already increased her doses again, but I think amputation is going to be the only option for long term pain relief.

charliebear said
Charlie Bear is now on Previcox, Gabapentin, Amantadine, and Tramadol. He would not be able to use his leg without and we have spent months tweaking the meds so that he is still very much Da Bear. One thing to keep in mind is that some of these meds have greater efficacy when used together and some take awhile to build up to a therapeutic dosage. When Charlie Bear consistently takes his meds, he uses his leg @90% of the time although he does have occasional bad days and some knuckling over at this point. He can stay on these meds at these doses indefinitely without harm according to his vets (UGA Vet School).

When he first presented, Head of Surgery recommended very invasive thorax cracking surgery. Head of Oncology said no way. And, finally, Head of Neurology made the best argument: what happens if you amputate but it does not take the pain away? How will we know he is in pain (which he could very well continue to be) but now the leg is gone...

Now, these cases are unique and Da Bear had a legendary infiltrative lipoma near the compromised area surgically removed several years prior. So we knew it would grow back and when we had the MRI and the CT don last fall the consensus was that perhaps the new growth was compromising the nerves by putting pressure on them: but the Head of Neurology and Head of Radiology said they just could not see why that was happening as the lipoma is "squishy" and should not be causing the "likely" compression. The EEG came back showing no loss of nerve function.

I am not at all against amputation (was once blessed with an OSA tripawd-well twopawd;) but also would want to be darn certain that amputation is absolutely necessary before proceeding. On the other hand, amputation does tend to remove the source of pain and/or disease, and whether it is a benign or malignant mass, it is often the gold standard of care. But as the Head of Neuro posed to me, "What if we amputate but the pain is still there? How will we know?" We at Da Bear HQ thought... that is a very interesting question.

Again, best wishes during this confusing time! Molly is sooooooo lucky to have you as an advocate for her!!! We hope you get answers soon and , in the meantime, as Sally would say, EAT MORE CHOCOLATE and spoil Molly (she is GORGEOUS!!!) ROTTEN!  

Thank you for the encouraging words! I'm so glad to have found this site and know that I'm not alone in this complicated time. I will definitely address some of the same questions that you've faced when I chat with the surgeon this afternoon. Charlie Bear is lucky to have a pet parent as vigilant as yourself.

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31 July 2017 - 1:31 pm
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Whitney,

Toddy is doing amazingly well. He is able to move around so much better and wants to bounce around. He will be 2 weeks post op tomorrow.  He had his stitches removed today and we did find out it is soft tissue sarcoma.  Our vet said pathology report could not confirm if all the margins were clear due to the way he had to remove.  He said with the naked eye the tumor was contained and he felt he had really good margins.  Pathology could not confirm if it was a nerve sheath tumor.  Toddy is pain free.  He has a bounce to his step, even with only 3 legs, that he hasn't had in awhile.  He was in SEVERE pain prior and now is off all of his pain meds.  Keep us posted on how the visit goes today and what you decide!  This site has helped us tremendously!

Heather & Toddy

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31 July 2017 - 4:15 pm
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My Jake had a nerve sheath tumor just behind his shoulder blade. It was biopsied and misdiagnosed as a fatty tumor. The vet said no need to remove it if it's not bothering him. Fast forward four years, it grew seemingly out of nowhere and he started limping. Next thing I know the surgeon is calling me telling me they had to amputate during surgery because the fingers of the tumor were stretching down his leg. Our cancer vet said it wasn't uncommon for them to be misdiagnosed. I understand the hard time you are having. I didn't want to have the small lump removed on Jake either if it "wasn't necessary" like the vet said. Do you have a specialist vet you can get a second opinion from, one maybe more familiar with this? Sending you lots of hugs and positive thoughts! 

Mom to Tripawd Angels Jake (2001-2014) and Rosco (2012-2015) and Tripawd Tanner. “Whatever happens tomorrow, we had today; and I'll always remember it”  

      

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31 July 2017 - 10:41 pm
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Hi - I'm another of parent of a dog who had soft tissue sarcoma nerve sheath tumor and have just seen this, but am a bit too tired to give you any good info at the moment.  I will be back tomorrow when my head is clearer.

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His Daddy and I miss him terribly along with his canine sister, Mia, and two feline siblings, Lucia and Cliff.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation

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Hello, again, Whitney.  I am so sorry you find yourself here and sorrier still that your Molly may have that difficult to diagnose peripheral nerve sheath tumor soft tissue sarcoma in the brachial plexus.  This is exactly what my boy had and to my continuing despair, yes, it is difficult to diagnose.   Amputation surgery is typically "presumptive" with the very strong indicators of not wanting to bear weight on a front limb (but this may be intermittent at first and may seem better with pain meds), atrophy of the muscles in the leg and an MRI indicating a mass in soft tissue. My own vet, once we thought we had the diagnosis, told me about times early in his career when they had to amputate with no diagnostic imaging and just hope they were removing enough tissue to get it.

Pofi's took a long, long time to diagnose despite multiple consults with my own vets, emergency vets and multiple consults with all the major veterinary disciplines in a major university vet school hospital.  Earliest signs of the issue were in April and May of 2015 and we had multiple red herring diagnoses (including a toe amputation) and missed diagnoses and clean bills of health until mid April 2016.  Unfortunately for us, that meant the normally slow growing cancer was now anything but and had grown very large.  My enduring regret is that we did not amputate sooner.  

I don't know how much detail to give you and how much you want to hear.  A nerve sheath tumor is painful, but some dogs are astonishingly stoic.  Pofi clearly was. The muscle atrophy in his forelimb was remarked upon as early as July of 2015 and yet that was the sames symptom that seemed to finally yield a proper diagnosis from a surgeon who had been in charge of / overseeing clinical assessments conducted by the residents on that August day when we had our first referring consult. Why she seemed to see the problem immediately in April when the resident and other doctors including a neurologist did not make the connection in August is unclear, but we all now know it was the same issue.

Has muscle atrophy been remarked upon in that leg - does it seem less muscular than in Molly's other forelimb? And if it were not cancer somehow, does that really change the prognosis on the leg or the fact there is pain that would likely be alleviated by amputation?  

I know it is shocking to think about, but they adapt so much better than we ever anticipate, typically.  And when the have really stopped using that leg, frankly, they often do even better because they have been virtual Tripawds. Pofi's recovery was one for the record books - absolutely remarkable how well he got around and how quickly.

One thing I feel I should tell you it that Pofi's tumor had expanded to the point of "destroying" a lymph node and also wrapping around a rib - that was all removed during surgery.  A nerve sheath tumor in that location can also have impact on the functioning of the diaphragm muscles - Pofi's left lung/diaphragm was not working as well as right side - not contracting/expanding as well. Another reason I wish his surgery had been sooner.  

What else would you like to know from me?

Molly, btw, is adorable.  heart

Lisa, Minneapolis

On October 27, 2016, nearly 6 months after amputation, and 18 months since his cancer likely started, we lost Pofi to a recurrence of Soft Tissue Sarcoma in his spine quite suddenly.  His Daddy and I miss him terribly along with his canine sister, Mia, and two feline siblings, Lucia and Cliff.

Blog: Pofi, Peripheral Nerve Sheath Tumor Amputation

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Heather said
Whitney,

Toddy is doing amazingly well. He is able to move around so much better and wants to bounce around. He will be 2 weeks post op tomorrow.  He had his stitches removed today and we did find out it is soft tissue sarcoma.  Our vet said pathology report could not confirm if all the margins were clear due to the way he had to remove.  He said with the naked eye the tumor was contained and he felt he had really good margins.  Pathology could not confirm if it was a nerve sheath tumor.  Toddy is pain free.  He has a bounce to his step, even with only 3 legs, that he hasn't had in awhile.  He was in SEVERE pain prior and now is off all of his pain meds.  Keep us posted on how the visit goes today and what you decide!  This site has helped us tremendously!

Heather & Toddy  

So happy to hear that he's doing well! In speaking with the vet today, we decided to proceed with amputation on Thursday. He said that it's relatively common for the pathology to still be inconclusive after amputation because those types of tumors are so hard to diagnose. At this point I'm just hoping that we can help her live a happy, pain free life. Thank you for sharing your story! It definitely helped us in our decision. If you have an tips for post-op care, I'm all ears!

elizabeth said
My Jake had a nerve sheath tumor just behind his shoulder blade. It was biopsied and misdiagnosed as a fatty tumor. The vet said no need to remove it if it's not bothering him. Fast forward four years, it grew seemingly out of nowhere and he started limping. Next thing I know the surgeon is calling me telling me they had to amputate during surgery because the fingers of the tumor were stretching down his leg. Our cancer vet said it wasn't uncommon for them to be misdiagnosed. I understand the hard time you are having. I didn't want to have the small lump removed on Jake either if it "wasn't necessary" like the vet said. Do you have a specialist vet you can get a second opinion from, one maybe more familiar with this? Sending you lots of hugs and positive thoughts!   

We've consulted with a few different specialists and they're all coming to the same conclusion. Based on clinical signs, they're thinking it's a nerve sheath tumor and they said that it's common for them to not show up in pathology. They think that amputation will relieve her pain, so we went ahead and scheduled her for amputation on Thursday. Thank you for sharing your story! This site has definitely helped make the decision a little easier. If you have any post-op tips, I would love to hear them!

hester said
Hello, again, Whitney.  I am so sorry you find yourself here and sorrier still that your Molly may have that difficult to diagnose peripheral nerve sheath tumor soft tissue sarcoma in the brachial plexus.  This is exactly what my boy had and to my continuing despair, yes, it is difficult to diagnose.   Amputation surgery is typically "presumptive" with the very strong indicators of not wanting to bear weight on a front limb (but this may be intermittent at first and may seem better with pain meds), atrophy of the muscles in the leg and an MRI indicating a mass in soft tissue. My own vet, once we thought we had the diagnosis, told me about times early in his career when they had to amputate with no diagnostic imaging and just hope they were removing enough tissue to get it.

Pofi's took a long, long time to diagnose despite multiple consults with my own vets, emergency vets and multiple consults with all the major veterinary disciplines in a major university vet school hospital.  Earliest signs of the issue were in April and May of 2015 and we had multiple red herring diagnoses (including a toe amputation) and missed diagnoses and clean bills of health until mid April 2016.  Unfortunately for us, that meant the normally slow growing cancer was now anything but and had grown very large.  My enduring regret is that we did not amputate sooner.  

I don't know how much detail to give you and how much you want to hear.  A nerve sheath tumor is painful, but some dogs are astonishingly stoic.  Pofi clearly was. The muscle atrophy in his forelimb was remarked upon as early as July of 2015 and yet that was the sames symptom that seemed to finally yield a proper diagnosis from a surgeon who had been in charge of / overseeing clinical assessments conducted by the residents on that August day when we had our first referring consult. Why she seemed to see the problem immediately in April when the resident and other doctors including a neurologist did not make the connection in August is unclear, but we all now know it was the same issue.

Has muscle atrophy been remarked upon in that leg - does it seem less muscular than in Molly's other forelimb? And if it were not cancer somehow, does that really change the prognosis on the leg or the fact there is pain that would likely be alleviated by amputation?  

I know it is shocking to think about, but they adapt so much better than we ever anticipate, typically.  And when the have really stopped using that leg, frankly, they often do even better because they have been virtual Tripawds. Pofi's recovery was one for the record books - absolutely remarkable how well he got around and how quickly.

One thing I feel I should tell you it that Pofi's tumor had expanded to the point of "destroying" a lymph node and also wrapping around a rib - that was all removed during surgery.  A nerve sheath tumor in that location can also have impact on the functioning of the diaphragm muscles - Pofi's left lung/diaphragm was not working as well as right side - not contracting/expanding as well. Another reason I wish his surgery had been sooner.  

What else would you like to know from me?

Molly, btw, is adorable.  heart  

She has quite a bit of muscle atrophy in that leg. That was the first clinical sign of a nerve sheath tumor because it happened very quickly (within a couple of weeks). After speaking with the surgeon today and going through all that we know, we went ahead and scheduled her amputation for Thursday. I really appreciate you sharing your story! It helped make our decision a little easier. I just want her to be happy and pain free. If you have any post-op tips, they would be greatly appreciated! This is all happening so fast, that I don't feel like I have much time to sufficiently prepare.

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