Caring for a Three Legged Dog or Cat
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My Boxer Rosie had bone cancer (undefined sarcoma - probably osteo or angio), a primary lung tumor, and a mast cell diagnosed in May of this year. Yes, that's three different cancers! We recently celebrated her 5 month ampuversary.
She had been doing great after her amputation and removal of the mast cell in May (started carboplatin - stopped the lung tumor from growing) until her check up in late September. She developed breathing problems two days before the check up appt. and they discovered fluid in her chest cavity. They drained the fluids out (thoracocentesis) and started her on vinorelbine but the fluid returned 10 days later. They drained the fluids again and it returned 4 days later. After this last thoracocentesis Rosie developed pneumothorax (leaking lung) on the left side and then while the left was healing, the right side started to leak. Ugh. She spent two nights at the hospital. It appears that the lungs are healing on their own but I'm worried that the fluid will return and then what? The fluid is serosanguineous.
While she was in the hospital last we started carboplatin again. It seemed to work last time.
She's home now and breathing normally but she does not tolerate much exercise (a little bit of hopping around and she's wiped out). She's been eating well. Oncologist instructed me to limit her exercise and keep an eye on her breathing.
The fluid seems to build up quickly and the thoracocentesis procedure is the likely culprit for the leaks in her lungs (due to compromised tissue). Now I'm stuck with the decision, if the carboplatin does not control the pleural effusion, to go through another thoracocentesis if the fluid returns and risk damage to the lungs again? I'm not sure I want to put her through pneumothorax again.
Has any had experience with this? Pleural effusion? Thorococentesis? Pneumothorax?
Wow Rosie, you are one tough cookie! Hoppy Ampuversary!
Darn I wish I knew something about this topic but unfortunately I do not. I'm sure one of our vet experts here will be able to help you with some input that can help you decide.
I hope you feel better soon Rosie. Please keep us posted and thanks for joining us! You future posts won't require moderation.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Did they do cytology on the pleural fluid?
Right hind limb amputated 7/3/12 for OSA, started on alternating cycles of Carboplatin and Doxorubicin and oral Palladia. Single lung met 9/1. Met in the neck muscle removed 9/30. Large mass in sublumbar lymph node 10/2. Rescue chemo with ifosfamide 10/6. Mets to the rib and axillary lymph node 10/21. Started Leukeran and Pred 10/25. Wookie left this Earth for a far better place on 12/4/12. I miss you, Boo, you were my heart.
wookie524 said
Did they do cytology on the pleural fluid?
Yes, unfortunately it was diagnosed as a neoplastic pleural effusion - carcinomatosis.
Rosie is definitely a tough cookie! She amazes me everyday.
roandro said
The fluid seems to build up quickly and the thoracocentesis procedure is the likely culprit for the leaks in her lungs (due to compromised tissue). Now I'm stuck with the decision, if the carboplatin does not control the pleural effusion, to go through another thoracocentesis if the fluid returns and risk damage to the lungs again? I'm not sure I want to put her through pneumothorax again.
Has any had experience with this? Pleural effusion? Thorococentesis? Pneumothorax?
Sorry to hear about the difficulties you are having. It is certainly not common to get a pneumothorax after a thoracocentesis, but is understandable giving her underlying pulmonary disease. They can also develop pulmonary bullae which are like blisters in the diseased lung that can spontaneously rupture and cause a pneumothorax. Unfortunately, if Rosie develops a significant pleural effusion and it is not drained off, she's going to feel like she is suffocating, certainly not what anyone wants.
Other options may be to put in a chest tube that stays in so that repeated drainage of the pleural fluid can be performed. There are also shunts that can be placed that shunt the pleural fluid into the abdomen where it can be more readily absorbed, although if she has carinomatosis, you don't necessarily want to shunt that fluid into another body cavity. Unfortunately these are only temporary measures.
I really hope the carboplatin helps to decrease the pleural fluid. If not, your only other recourse is repeated thoracocenteses and dealing with the pneumothorax if it happens.
When is enough, enough? That's often the hardest question. Usually you know it in your heart, or maybe Rosie will look into your eyes and tell you.
Hoping for the very best for you both.
Right hind limb amputated 7/3/12 for OSA, started on alternating cycles of Carboplatin and Doxorubicin and oral Palladia. Single lung met 9/1. Met in the neck muscle removed 9/30. Large mass in sublumbar lymph node 10/2. Rescue chemo with ifosfamide 10/6. Mets to the rib and axillary lymph node 10/21. Started Leukeran and Pred 10/25. Wookie left this Earth for a far better place on 12/4/12. I miss you, Boo, you were my heart.
Chubby suffered and is suffering Pleural Effusion too, I think Prednisone/ Prednisolone help a lot at first, but it comes back again, you can try Prednisone.
And Pleural Effusion can cause anemia (RBC drop down), Chubby becomes weak.....
So my suggestion is Prednisone and start to prevent anemia with supplement.
And not to do intense exercise and be too excited, I found out it will cause Pleural Effusion too......
just for your reference,
Patty
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