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Scans showed a tumour, where do we go from here?
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Member Since:
11 January 2022
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23 July 2022 - 5:58 pm
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Crush's back hasn't been improving (see my last thread) and last night he really screeched a few times when trying to lay down, so I took him to the emergency vet today and we did some x-rays to try and determine why he's in so much pain. The emergency vet (a new one) did note some narrowing between his vertebrae that she thinks is likely due to inflamed disc material.
However, she also saw a 3cm tumour in his right lung. It's high up, near his spine and she said she doesn't have the oncology experience to know if it could be contributing to the back pain. His lungs still look full of air, no fluid and he's breathing well. No other tumours noted though there was an area further down on his lungs she thought maybe looked suspicious, with potentially some small metastases but too small to really tell for sure.
I won't be able to talk to his regular vet until Tuesday at the earliest, so I'm hoping someone here can weigh in on the implications of the tumour. Could it be causing his pain? Do these lung mets hurt? How long do dogs usually survive with a tumour? The emergency vet said she dog with a similar tumour and only lived two weeks. Is that typical? I'm trying to understand if we're nearing the end here. Any input would be appreciated.
For now, we've just upped his gabapentin to keep him quiet and confined him to a pen like after surgery so he has to rest his back. 
Thanks

The Rainbow Bridge


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23 July 2022 - 8:44 pm
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Oh dang it I'm sorry! Is he the upped Gabapentin working OK? If he's up to it, some ice pack therapy for a few minutes at a time may help too.

It's good you took him in, at least you know more about what you might be dealing with. The tumour business is a heartbreaker! I also cannot say if a a tumor in that location is causing the back pain (by pressing on it, since lung mets do not technically hurt, they obstruct breathing by taking up space in the lungs). Hopefully Dr. Pam can give you more of an idea.

It's hard to say how long a dog will go beyond metastasis. Our Jerry lived seven months with two large lung mets, and he was very comfortable until the last couple of weeks. We have seen some dogs go further than that, even a couple of years! So try not to panic and think the worst. This may not be as bad as you are thinking. There is always a chance that he can get comfortable and continue being Crush. Try to focus on that for now OK? He is still Crush, he doens't know what the x-rays said and he just wants you and him to keep on keepin' on.

((((hugs))))

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23 July 2022 - 9:36 pm
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Thanks for the response. I'm really hopeful we can get his back pain under control and get him out and about having fun again, for as long as possible.
How big is big? I asked her to measure it for me but I don't even really know what the relative scale is. Is 3cm a medium one, a big one?

Virginia




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23 July 2022 - 10:18 pm
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Can only ditto everything  Jerry said.

Just throwing out some FWIW thoughts.  Assuming there isn't  something  wonky going on with a tumor causing this back pain, it certainly  makes sen that his spi e issue could be treated with rest, pain meds and an anti inflammatory.  Check with your regular  Vet about adding  somethong like Rimadyl, or maybe even a steroid like Prednisone .  And ig the met is causing  any inflammation in the lu g, the Pred could help with that too.

As far as the lung met, "timeframe", etc., as Jerry said many dogs live good extended  quality even with mets.   Obviously not a Vet, but to be told the "two week timeframe".when Crush has no fluid, is feeling good (except for the spine issue of course) just doesn li e up with what we've seen here.  As Jerry noted, many, many months or MORE is  definitely  is what is possible.  The Vet said my Happy Hannah had met "the size of a basseball".  It wasn't  until it got that large that she showed signs of tiring  easily, some off and on changes in breathing pattern, but basically no "pain " per se.  Not sure that it's not as much as the size or how many, but a lot depends  on the location.  Of course, there are some non invasive  paths uiu can take to help keep the met stable, or maybe even shrink it.

Anyway, just throwing  out so e things until our Vet chimes in.

In the meantime,  continue  to spoil, continue to stay present in the now, and make every moment t the best moment  ever!!!  If you can get the spine  issue resolved or at least better, Crush should be back to being Crush!!!

((((((Hugs))))))

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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23 July 2022 - 10:34 pm
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Thanks, I feel a bit better. It's been such a stressful week, it's still hard to wrap my head around how much has changed and how fast. He was doing so incredibly well until the incident last Friday! We'd been going for gentle hikes, visiting some of our favourite places we hadn't been to since last summer. He was coming to the office with me again and loving it. He was just doing so well. Of course the met was there but I had no idea and I'm sure Crush didn't either. 
I'm really hoping his back resolves soon, I just want him to enjoy his time and not be in pain. Steroids are a good idea, I will ask about that when I speak to the vet. Anything to bring down the inflammation in his back. He's pretty sad being cooped up, he can hardly walk but he still looks at me with these mournful eyes from his pen, he doesn't understand why he's locked up. But he has too much energy and this past week, every time he's started feeling slightly better he does a zoomie and then he can hardly walk again 5 minutes later, so I don't think there's anything else I can do but put him in a pen. I don't know how else he'll recover.


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24 July 2022 - 9:30 am
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I would agree that spinal disease is much more likely to cause pain than a small lung met. Sometimes the cancer can spread to the vertebral bones as well but the only way to evaluate for more lung/bone mets would be a CT scan. I also think that considering prednisone now would be a good idea although you would have to stop any NSAIDS. Upping the gabapentin is good and you can also consider amantadine.

Lung mets can stay small for a long time so the main factor here is what is causing his spinal disease and can we control that pain.

Pam

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24 July 2022 - 1:22 pm
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Thank you for the insight, I'm glad to know that it's unlikely the tumour causing his discomfort. He already seems much better today, whether that's the extra gabapentin or the rest I'm not sure, but he looked quite comfortable this morning when he hopped outside to go potty and he was able to squat down for that without seeming to struggle like before. I don't think a CT is an option as there isn't a veterinary machine in town, but if his pain doesn't improve perhaps we'll have to start investigating what further diagnostics can be done. I guess we'll have to see how he does. I'll contact his vet first thing Tuesday to ask about adjusting the meds to add the steroids etc. I'll think I'll call the rehab vet again too to see if she has any suggestions about how to get him comfy and mobile.
Thanks for weighing in everyone, I feel better now that it seems the two weeks left comment from the vet may have been a bit pessimistic.

The Rainbow Bridge


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24 July 2022 - 1:33 pm
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I believe Jerry's got to 10 cm when we found it. I don't know how large it got by the time we decided to set him free, since we stopped x-raying. As Dr. Pam suggested, during his last few weeks he was also on Pred for a bit to decrease inflammation.

I'm SO glad he already seems better! Good idea to call the rehab vet. There are quite a few pain management modalities you can try if he shows more discomfort. You are such a great advocate for him. We are keeping our paws crossed that the relief continues.

Thank you for your feedback Dr. Pam. You rock, as always.

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24 July 2022 - 5:36 pm
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That's good to know. Baseballs and 10cm are bigger than 3cm, so hopefully we have more time left. I was super concerned that if he needs two weeks of bed rest and his life expectancy is only two weeks, that it'll be two weeks of being miserable and maybe it's not fair to him. I'm feeling more hopeful now, I'll be calling the vets asap though this week to see what we can do to facilitate his healing.

Crush trying to relax.

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The Rainbow Bridge


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25 July 2022 - 10:33 am
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Awww sweet boy! We love seeing him.

Let us know what the vet says OK? Stay pawsitive!

Virginia




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25 July 2022 - 3:39 pm
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Awww Crush, you sure do have a monopoly  on CUTENESS.  Is that a shark you are holding so gently  in your mouth for 'Shark Week"?👍

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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25 July 2022 - 6:58 pm
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It's actually a duck, but maybe he needs a shark for shark week! He tends to get new toys when he's hurt because I have no self control when I feel bad for him lol.
Talked to his vet today, she wasn't keen on steroids, he's already on metacam, gaba, and trammadol and she doesn't think steroids will be better than the metacam as an anti inflammatory. But in addition to the upped gabapentin, he's going back on the muscle relaxants, double dose, she says she's found that helpful for disc pain in the past. It was the end of the day when she got the scans, so I'll call Dr Edwards the rehab vet tomorrow to see if she has any additional suggestions, physio or otherwise.
We've also requested an oncology consult for his scans, to see if oral metronomics could be helpful for him. I'll report back on how that goes.
Crush's pain does seem better today though. Yesterday, he had a few little yelps when bending down and was still hopping a bit slowly. Today, no yelps yet and he is moving pretty much normal. So that's improvement. His vet recommended rechecking him after 2 weeks of bedrest, so we'll do that. I hope he's able to start having some activity again at that point.

The Rainbow Bridge


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26 July 2022 - 11:31 am
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He totally needs a shark! Yay for hoomans with no self control in the toy aisle!

So makes sense about the reluctance to treat with 'roids. Our own vet mentioned that Metacam can do as good a job sometimes as an anti inflammatory. The muscle relaxer should definitely help too. Hope he's having a good day without any pain. I'm glad that yesterday was overall pretty good. The bed rest and spoiling is also great medicine!

Any word from the physio?

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26 July 2022 - 12:16 pm
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So it looks like it'll be a wait for the rehab vet, when I called the tech who answered said I need a new referral since it's a new injury, and she's booking into late august. So I started the process but it'll be a while before I can talk to her it sounds like. I'm glad his regular vet is willing to talk to me on the phone without needing to wait for an appointment.
Does anyone know anything about CBD for dogs? One of my coworkers has a brother who makes CBD treats and supplements for pain management (not like in his garage, it's a brand sold in pet stores but I can't remember the name) He offered me some to try. Do you think this is a good or bad idea?
Crush was pretty anxious and restless this morning, it was hard to keep him quiet. He keeps trying to get out of his pen when I go in and just crying a lot wanting out. I assume he's feeling better.. But he has a lot of bedrest left so it's gonna be tough keeping him settled.

The Rainbow Bridge


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26 July 2022 - 12:27 pm
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Oh that's a long time to wait, I'm so sorry! Yes your current vet is awesome!

Can I ask you a huge favor? Please start a new topic here about the CBD question, so that Dr. Pam doesn't need to sift through all the back and forth not related to the original post. Thank you! I'd love to address it in the other forum discussion area. 

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