Sofie’s Oncology Appointment

 This week, on Wednesday, Sofie went to her first appointment with the oncology vet.  A week out from her surgery to remove the melanoma from her lip, we trekked all the way to Seattle to Animal Cancer Specialists.  We met with Dr. Gillings who is a vet of 6 years who returned to school to specialize in oncology.  She is a tiny matter-of-fact woman who was very easy to talk with.  She’d already reviewed Sofie’s pathology report on the oral melanoma tumor, and spoke with me as if I were her peer as we discussed the likely prognosis and treatment options.  I’d read about the melanoma immunization (see the melanoma link above) and had just about decided that Sofie would get it.

But earlier in the week I’d noticed a weird lump on Sofie’s hip and so Dr. Gillings did a needle biopsy of that along with her neck lymph nodes.  Just to be on the safe side (needle biopsies aren’t the most fun thing to have done), Sofie got to wear a lovely basket muzzle.  She was thrilled, as you can see by her face in this picture.  She was tense, but cooperative.  After two needle biopsies of each lymph node and the bump on her hip, she was taken back for chest x-rays.  These were all done to look for metastases.

After the x-rays and biopsies, Dr. Gillings returned to the exam room and told me her findings with the caveat that a radiologist would review the films, and a pathologist would review the biopsies.  Her impression of the bump was that it likely was a mast cell tumor.   Just the act of examining the bump and poking it with the needle for biopsy caused it to release histamine and swell.  That made it seem more likely her impression was correct.  This is what makes these tumors so dangerous.  Sofie got an injection of Benadryl for the trip home.  In the picture, she looks a little stoned from her Benadryl shot.

It took until Friday to hear the pathology & radiology results.  Dr. Gillings called me just as I was leaving work. The bump is a mast cell tumor.  The x-ray shows a shadow in the lung.  The melanoma tumor in the mouth is Grade 1 probably as it was small and the nodes were ok.

Meanwhile, I set Sofie up with Dr. Patti Schaefer of Canisport.  Dr. Patti is a holistic vet that does acupuncture, advises on diet and supplements, and does chiropractic work with animals.  Here’s Sofie enjoying her acupuncture treatment.

So, what now?  Today, we took Sofie to our vet, Dr. Mark Peterson at Animal Hospital of Parkland.  I needed to talk to him as I  was starting to feel a bit overwhelmed by the choices that needed to be made.  Dr. Mark helped us (Dale and me) sort out what the heck to do next. 

Obviously the mast cell tumor must be removed.  In fact, it has to be removed with huge margins to be sure that it is completely gone.  That’s happening next Tuesday.  That tumor and surrounding tissue will be sent to pathology for confirmation of cell type and identification of it’s stage (how fast it is reproducing and likelihood it has spread.)  Dr. Mark will also do some more x-rays to see if that shadow in the lungs is just a shadow, or if it’s another tumor of some sort.  Based on that information, we can decide how to proceed.  If the shadow is a tumor, it’s potentially melanoma.  It’s unlikely to be mast cell (they rarely go to the lungs).  We could monitor it, and if it begins to grow, and if we don’t have to worry about spreading mast cell cancer,  then the melanoma immunization would be the way to go.  

But if the mast cell cancer is widespread, it would not make sense to do the melanoma immunization.  In that situation, keeping Sofie feeling happy and pain-free would be the game plan.  

So, that’s where we are in the dog pack scheme of things.  Sofie’s eating a cancer-dog diet with low grains.  She gets pre & probiotics, vitamins, and other supplements to help her fight the cancer and maintain her health as much as possible.  She’s not getting any more immunizations (except maybe the melanoma one).  She gets quercetin, organic apples, blueberries, and wild salmon oil.  And she’s getting 50 mg Benadryl three times a day.  She gets to play, swim, go on walks and chew on bones and every other dog joy that is available.  And we’re going to love her as long as we have her to love.