Caring for a Three Legged Dog or Cat
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Good morning,
I have a question about the margins after surgery. My dog Odin is a 7year old lab who was diagnosed with a nerve sheath tumor in his brachial plexus, apparently the margins were only 1mm. The doctor said that during surgery it had not gone to his spine for what he could see but isn’t 1mm extremely small? Can we even state that it was all gotten? My question really is does it matter the amount of clean margin as long as some of it it clean or can cancer jump 1mm and be after that margin. I hope my question is making sense. Thank you for any advice no matter what it is. I usually see people stating 2cm or 3cm clean margin mine being 1mm worries me a little bit.
This is a great question. We'll wait for Dr. Pam to reply with her own feedback, but in the meanwhile here is some great info from Drs. Dressler & Ettinger, authors of the Dog Cancer Survival Guide :
From the video transcript:
it’s just important for the tumor type for malignant cancers are somewhere 1-2cm margins is considered the gold standard and adequate, but there are some cancers where you may need some soft tissue sarcomas where, it maybe 3, 4cm margins, and so if it’s just clean, and then you find out that it was only a half centimeter margin, it puts your dog at risk for reccurrence, and if you know that earlier, then you can do something like either scar revision where they’re gonna go back and get more tissue if it’s on a part of your dog’s body where that’s an option, or maybe you’re gonna look towards radiation therapy to prevent reoccurrence.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
It really depends on the type of tumor. Nerve sheath tumors tend to be locally aggressive and the most important margin is the deep margin. I have often seen these tumors recur in the exact same place because it is hard to completely excise the deepest part of the tumor. Many of these are slow growing so sometimes take a while to grow back. Did your vet take off the entire leg? If so then there is less chance of recurrence.
Pam
Thanks for your expertise Dr. Pam!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Thank you so much Dr. Pam and Jerry for the video. To answer your question he took the leg and the shoulder. Thank you for your wisdom and knowledge.
Hello Puffer (and Odin - what a cute boy) - it's Lisa again. Dr. Pam said it very well. Locally aggressive and can often recur in same location. I think you have read my old blog now and although our surgeon thought she had 4 mm margin to the spine so that she could excise with the clean 2 to 3 mm, the post amp pathology came back not showing clean margins in a few locations tested. But Pofi's tumor was very, very large, messy, diffuse, "not well encapsulated" and graded as a 3 of 3 because of lymph node involvement and the way it was wrapped around a rib (which also had to be removed). Maybe Odin's was not as advanced and spreading out with the tentacles that are typical with later stages.
How is Odin getting around? Pofi seemed relieved to be rid of both the pain and the encumbrance of a leg that had ceased to be very useful.
Please let me know anything I can tell you or help with.
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 canine sister also succumbed to cancer on March 1, 2019 - we lavished her with our love in the interim, but life was never quite the same without her only real canine friend. Cliff kitty had to leave us, too, suddenly, in August 2019. Lucia kitty grieved all these losses, but helped us welcome two new Lurchers into our home and our lives, Shae and Barley.
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