Caring for a Three Legged Dog or Cat
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Hi wanted to share this experience. We have an 8 year old lab pit mix (w several other breeds in there too) Our very sweet and gentle boy developed a lump on his left front “wrist”. It was determined to be a mast cell tumor and we were referred to a specialist surgeon 300 miles from our rural home in northern Maine.
The surgeon told us that the tumor was inoperable due to its location. Mast cell surgery requires a significant patch of surrounding tissue to be removed to assure “clean margins” and that could not be accomplished due to the tumors location and shape- which wrapped around his “wrist”. The surgeon told us that taking the leg off was best way to try and assure it’s containment- depending on what our goals were.
We returned home fairly dejected. The vets were not able to determine the grade of the tumor, but his spleen biopsy came back clean. I don’t really understand but I think there was reticence to fully biopsy the tumor based on concerns it could cause the tumor to “granulate” and possibly send the disease into other areas of his body. We made an appointment to return in a couple of weeks to get the leg amputated in case we wanted to do that.
After much agonizing we were very concerned that amputation would not be appropriate for our dog given his age, body type and our ability to deal with a dog we already have to coax outside during our long very cold winters as he has no undercoat and hates the cold.(I am not categorically opposed to amputation and had to have my cat’s front leg amputated - I had found him suffering in a barn with a horribly mangled leg- he did amazingly well on three legs.) Accordingly, we asked the surgeon to refer us to an oncologist in the same vet practice on the morning before the surgery was scheduled.
While we were waiting to head back down we went though every picture we had of our dog over the past two years. In doing so we were able to begin to notice the wrist lump forming almost a year prior.The oncologist we met with offered us several treatment options, and opined based on the information she had -but did not guarantee - that there it likely a low grade mast cell tumor. I don’t fully understand this either, but I think that mast cell tumors don’t change grades.
In any event we chose a plan for three Triamcinolone steroid injections directly into the tumor -spaced out over a month and a half. It was the least invasive option offered to us, and we decided to start with that on that day. We just got back from our fourth visit which was just a check up and were told the area no longer has a palpable mass. So we will wait and watch and hope for the best. I am grateful we had the opportunity to speak with an oncology specialist before we made the final choice on amputation.
Hi Sarah, thanks for registering and sharing your boy's story. He's so lucky to have such great people looking out for him!
Amputation isn't always the choice people make and we understand completely. So sharing your dog's amputation alternative story is super helpful, thank you.
At first I thought you were talking about Stelfonta, the new MCT therapy that gets rid of certain tumors. Then I looked up Triamcinolone and see that it's used to reduce inflammation. So it sounds like a palliative therapy? That's awesome it's working to bring down the mass on him. If it stops being effective, I would ask about Stelfonta, or even electrochemotherapy or intralesional chemotherapy . It might be hard to find a provider of any of those therapies where you are located, but I thought I'd throw them out there.
I hope the treatment he's being given continues to work! That's awesome. I'll bet you are looking forward to the snow melt and a really fun spring/summer together! Keep us posted OK?
WOW! Three hundred miles! Clear
Your sweet gentle boy os adored....and I'm sure he knows it!
Thank you so much for taking the time to provide so many details on your journey so far. We definitely are interested in alternative options and look forward to hearing more updates when you can.
You've done your research to get to this point and have had very informative feedback from your vets. Absolutely thrilled to hear that that old tumor has been reduced! Such good news! We are continuing to cheer for your pup. What's his name?
Hugs
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie!
PS. FWIW, one of our me,bers here, if I recall correctly, had mast cell and passed away four years later from another kind and old age.
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!
I am going through a very similar situation. I have an 8 year old mix who had her MCT removed from her hind leg wrist/paw area a couple weeks ago. Basically it looked like she had an extra knuckle. I also looked back at photos and noticed it appearing a year ago! Feels horrible to know it's been sitting with her as long as it has and I never noticed. She'd been to multiple vet visits, a nail trim, surgery for other lump removals, and no one noticed it despite it being the size of a grape for a year. It's frustrating, but I'm with her more than any vet is and I didn't notice it either. So I can't blame anyone but myself. I am hyper aware of all of her other lumps, but never took the time to notice her paws until I happened to just glance at them the right way one day and see that odd grape.
You mentioned your surgeon suggested removal is not possible due to its location. My vet did remove my girl's (she said it would take a while to heal, but other than that, gave me no indication of how risky/poor of an idea it is to operate in this area - I sure wish I'd done my own research here). My dog's wound is only beginning to heal after its dehiscence and requires punch graft surgery to aid in the healing. So, while it's apparently possible to remove an MCT from this location, your surgeon sounds like he's saved you a lot of complications. You're already doing the right thing seeing specialists. I regret trusting my vet without seeking other opinions.
Your oncologist may have been looking at your boy's cytology report (was the tumor aspirated?) when they suggested it is likely low grade. There are certain factors visible in the slides taken from a fine needle aspirate - well vs poorly granulated cells, single nuclei vs multi, shape uniformity of cells, etc. These contribute to its classification as low vs high grade. I believe classifications gleaned from cytologic information tend to coincide with what is discovered from a biopsy. However, it's not always the case and various locations within the tumor might yield different sampling results so a biopsy is definitely preferred. https://todaysv.....l-animals/
Once I met with an oncology specialist, she explained that a MCT's size doesn't necessarily ever get smaller. It's more that the agitation of the tissue surrounding the tumor can lessen as can the swelling, resulting in the visible lump getting smaller. This is why my vet prescribed Benadryl prior to my girl's surgery in order to reduce irritation and lessen the path to the tumor. I think steroids have a similar goal to this but I could definitely be wrong here. Haven't heard any mention of steroids from any specialists I've seen just yet.
I agree with Jerry above. Your boy's tumor may be a candidate for Stelfonta. I think it can be difficult to find a specialist to administer it but, as far as I understand, it eliminates the tumor. The dog is left with an open wound that does heal. Something like an 85-90% success rate. If I were to do it all over, knowing what I know now, I would have either done Stelfonta followed by radiation to the leg or full amputation. Obviously, I'm just a person who has been immersed in this MCT world over the past few weeks, so your specialists certainly know more. Maybe there is no nearby Stelfonta administration availabie or maybe your boy's tumor size doesn't fit candidacy for Stelfonta so they didn't bother mentioning it as an option. But you may want to inquire at your next appointment if it sounds to you like Stelfonta might be an option for your guy.
Regarding amputation, I bet your boy would do better than you think! Or he would likely be just as stubborn about going into the cold as he is now. As far as I know, life on three legs isn't much different than it is with four. It's just a horrible decision to have to make. But your guy isn't ancient. He still sounds like he'd have great potential to adjust without much issue, as it sounds like your cat was also able! Maybe a fleece onesie would help on those cold days? 
I'm so sorry you're going through this. It sucks when there isn't much clarity and involves beloved family members. If I rambled or went on about my own situation too much, I apologize. I was just surprised at how similar our pups' circumstances were and am still processing my own girl's situation. Just throwing out whatever information I've gathered over the past couple weeks to see if it helps at all.
Lastly, I bet your guy loves you to the ends of the earth for giving him a loving life in rural, northern Maine. What a beautiful area.
annhou said
I am going through a very similar situation.
Ann that is sooo nice of you to offer such great input. Thank you!
Your post is now approved and I tossed in some feedback, but I see you are very educated on this topic and hope that you'll continue to stay active here and let us now how things are going.
Feeling a little silly at my lengthy response now that I see this post two months old! Hoping everything turned out as well as it can for you and your guy
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