Caring for a Three Legged Dog or Cat
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Hi, our approximately 7 year old pittie recently developed a subcutaneous (under the skin) growth on the lower part of her right hind leg. We had a cytology test performed and it came back as a mast cell tumor. Our vet referred us to a local oncologist but the earliest available appt is the end of Oct -- almost six weeks away. We are trying to figure out next steps and if anything else should be done in the meantime. Our vet did not present any treatment options other than referral to the oncologist or amputation of the leg. The cytology test recommended further testing called a histopathology -- any opinions on if that is worthwhile and how hard it might be for a tumor that is under the skin? Another concern is if we even have time to wait six weeks to see the oncologist to decide if amputation is the right choice -- we are worried about metastasis. So far we haven't particularly noticed an increase in size of the tumor but it's also hard to know. Thanks all for your thoughts.
Hi and welcome to you and your pup! Your future posts won't need to wait for approval so post away.
What's your pup's name?
It's super smart that your vet referred you to an oncologist. They can do all of the diagnostics to make sure you know what you're dealing with, including the histopathology. This will also tell you about the odds of metastasis happening. But six weeks is a long time to wait. Did they put you on a cancellation list? And is there anywhere you are willing to drive to that might be able to see your pup sooner? I would look around to other oncology clinics and see if they can take you before then.
Hello and welcome.
My Pug Maggie lost a rear leg to a MCT in her knee. A couple of thoughts:
When ever we were dealing with a MCT, especially if the tumor was manipulated in any way, the dogs were put on benadryl and an antacid like pepcid. Oh- I say dogs be cause Maggie's little sis Tani had multiple MCTs during her life but none on her legs. Benadryl helps control the histamines that mast cell releases and the pepcid helps protect the stomach.
Six weeks seems like a long time to wait- but unfortunately it seems the norm these days with vet care. To be honest I have no idea how long the tumor was in Mag's knee- it could easily have been 6 weeks or more.
Mast cell is notoriously unpredictable. At low grade it tends to be very treatable, but there is no way to know the grade without a biopsy. Tumors can grow or shrink quickly. It's important to keep an eye on the tumor and if it seems to grow quickly or worst case ulcerates take your girl to the emergency vet. Sometimes when things become an emergency you can get a referral and into a specialist sooner.
Because of the location of the tumor in Maggie's knee I was told that removing the tumor with acceptable margins was probably impossible. My oncologist told me that a MCT is like an egg. The yoke is the tumor you can see or feel, the white part spreads out but you can't see it. That is why when MCTs are removed a very large margin is recommended.
Karen and the Spirit Pug Girls and Boy
Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.
1999 to 2010
jerry said
Hi and welcome to you and your pup! Your future posts won't need to wait for approval so post away.What's your pup's name?
It's super smart that your vet referred you to an oncologist. They can do all of the diagnostics to make sure you know what you're dealing with, including the histopathology. This will also tell you about the odds of metastasis happening. But six weeks is a long time to wait. Did they put you on a cancellation list? And is there anywhere you are willing to drive to that might be able to see your pup sooner? I would look around to other oncology clinics and see if they can take you before then.
Hi Jerry,
our pup's name is Pennie. Yes we did ask to be put on a cancellation list and are calling back a couple times a week to see if there are any cancellations. We live in Tucson and haven't been able to find another option with sooner availability so far -- vet oncologists in Phoenix seem to be booked out several weeks as well.
krun15 said
Hello and welcome.My Pug Maggie lost a rear leg to a MCT in her knee. A couple of thoughts:
When ever we were dealing with a MCT, especially if the tumor was manipulated in any way, the dogs were put on benadryl and an antacid like pepcid. Oh- I say dogs be cause Maggie's little sis Tani had multiple MCTs during her life but none on her legs. Benadryl helps control the histamines that mast cell releases and the pepcid helps protect the stomach.
Six weeks seems like a long time to wait- but unfortunately it seems the norm these days with vet care. To be honest I have no idea how long the tumor was in Mag's knee- it could easily have been 6 weeks or more.
Mast cell is notoriously unpredictable. At low grade it tends to be very treatable, but there is no way to know the grade without a biopsy. Tumors can grow or shrink quickly. It's important to keep an eye on the tumor and if it seems to grow quickly or worst case ulcerates take your girl to the emergency vet. Sometimes when things become an emergency you can get a referral and into a specialist sooner.
Because of the location of the tumor in Maggie's knee I was told that removing the tumor with acceptable margins was probably impossible. My oncologist told me that a MCT is like an egg. The yoke is the tumor you can see or feel, the white part spreads out but you can't see it. That is why when MCTs are removed a very large margin is recommended.
Karen and the Spirit Pug Girls and Boy
Thanks for sharing your story. It's good to know that others have been through this as well. I think Pennie's tumor is probably inoperable due to size and location and the fact that it is not well defined. We do have her on Benadryl twice a day which hopefully is helping a bit. Amputation may be the best option but we'll see what the oncologist says next month. How did your dog Maggie do with the loss of her back leg?
A lot of time the SQ mast cell tumors behave in a more benign way. Is there any redness or skin involvement at all or is it truly under the skin only (freely moveable)? I do not know that I would jump to amputation right off the bat. I had a female Pittie who had mast cell tumors for most of her life including SQ masses and they always behaved in a benign manner. How large is this mass? Can you send a photo? There is also a new injectable medication that you can use as an alternative to surgery for growths where complete surgical removal is not possible; it allows the mass to slough off after injection but this may be only helpful for skin (dermal) masses. If the mass is not growing quickly I would wait for the oncology appointment; it is also reasonable to ask your vet about giving Benadryl until then. Another option is to give the dog prednisone to try to shrink the mass so that it can then be surgically removed.
Pam
Ohhh yeah, Tucson is great but yeah, a limited supply of specialty vet care. Definitely keep calling.
Dr. Pam your experience is invaluable, thank you. Duh I forgot to mention Stelfonta as an amputation alternative! Thanks for the reminder. I also didn't know that about SQ tumors behaving that way, good to know!
Hi Dr. Pam,
thanks for sharing your thoughts. There is no redness or skin involvement that I can tell. It just feels kind of soft and squishy. We've had her on Prednisone for about a week and it seems to have gone down in size slightly. Before we had the cytology result we tried her on a NSAID (carprofen) and antibiotic but those didn't make any difference. She is currently on Benadryl (50 mg) twice a day and Predisone (20 mg once a day).
We researched Stelfonta -- it sounds like an amazing breakthrough drug. Our vet had heard of it but has no experience with it and didn't think it would work since the mass is not well defined. We took Pennie to a different vet who has (limited) experience with Stelfonta (she's only used it twice), but she also thought it was not a good candidate due to the size, location and lack of firmness of the mass. It's hard to say the exact size -- I'm guessing about 1.5-2" tall, maybe 3/4" wide and 1/2" deep but that's just a very rough estimate. Again, it's not firm so it's hard to tell the size especially since it's under the skin.
Here's a picture after a week on Prednisone:
Oh now I see it is in an odd location more along the foot. I would wait for the oncology consult prior to any surgery and keep up the prednisone. They might also talk to you about Palladia.
Pam
I have had several dogs do well on it including a Pittie with Grade III mast cell tumor; main side effects are on the GI tract although some dogs can get a low white count. There used to be other brands of medication targeted towards mast cells but I am not sure what is available right now; these meds typically need to be prescribed by an oncologist.
Pam
How to know when to begin treatment of a MCT? So far we are taking a "close monitoring" approach and just checking in with our oncologist every 1-2 months to see how things develop. I do think Pennie's tumor has gotten a bigger in the past month, though there's still no redness or itching.
That's a great question. If Dr. Pam doesn't see it here you might want to post in Ask a Vet.
My own feeling is that if something is telling you the tumor is bigger, then you should give the oncologist a call to discuss now instead of waiting.
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