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elanya at 07:41pm on 24/01/2019 under jola, life, pet health, tumblr crosspost, twitter crosspost
elanya at 07:41pm on 24/01/2019 under jola, life, pet health, tumblr crosspost, twitter crosspostSo, Back in November - on Woolfenoot, to be precise - I noticed that my dog, Jola, had developed what seemed to be a large swelling on her right chest. I took her to the emergency vet, thinking she'd hurt herself some how and was just swollen, or that it was a fluid edema, or something. It was not.
At my home vet, they did a fine needle aspiration, then a real punch biopsy, and blood tests, none of which were at all conclusive. They did radiography, x-rays to start, where they thought it was maybe her heart (though I am still not clear why they were looking there...), and then a CT scan which showed the large mass to probably be a sarcoma. Well encapsulated towards her head, but with "stranding" where it led further back towards her tail. They didn't see any metastasizing in her lungs at least. The differential diagnosis from the CT scan, from the radiologist was a sarcoma.
Today I went to the Animal Cancer Center at the University of Guelph to meet with member of their oncology team, to talk about where we are, what is left to learn, and options on where to go next.
Thy think it is probably a sarcoma, but can't confirm that without further tests - specifically it would require another histology test from a biopsy taken with ultrasound (to make sure they are getting a good sample) to determine what kind/level of aggressiveness. They would also want to do an ultrasound of her abdomen to make sure that she doesn't have another issue already that would make treatment of this mass pointless. I think the CT scan actually covers all the area they'd want to look at, but they hadn't received it before the appointment because of some communication issues with my vet (they don't have the CT, they don't have the software to look at it, so they sent the Cancer Clinic to the radiology peeps). I actually have the CT scan, because we have the MicroCT at work (at least physically) and very definitely do have the software to look at DICOM stacks, so I have some images, and was able to show them to the resident on my phone at least. I am not going to pay $1300 for radiography and not insist on a copy :p
Anyway. Those tests (plus a urine tests to make sure her kidneys are okay for NSAIDS) are the very next steps they would do, to identify the sarcoma, and then it would be surgery, and then a regimen of radiation therapy. All of this would need to happen at Guelph. It would be a major surgery and she might lose her leg. She would have to be sedate for every treatment, and complications could arise from it and she would be very sick, and it would have to cover a large area. I would have to take time away from work to get someone else to drive me and her to a city an hour and a half away for each treatment and test. And then at best she'd go into remission, Oh and also it would run around $10,000 for the surgery and radiation. One without the other would not be effective - without radiation it would come back, and considering how quickly it has grown this time, it could happen very quickly, and she would have gone through a very complicated major surgery for nothing.
So, I am not doing any of that. I decided that at this point, I will do my best to manage her quality of life. I will keep her on pain killers (and do the urine test to see if I can add NSAIDS to the mix), and be careful with her, and monitor her behaviour and activities and general health to try and track her quality of life as best I can, until I feel like she is suffering too much.
I think this is the right decision, I think I have done everything within reason and possibly beyond, but I'm still really really upset. She's 11, which is and isn't old for a dog her size. She'd been very healthy all of her life. She's still eating and everything else about as well as she ever has, she's still a complete and utter sweetheart. I love her very much.
I bought her a very big bone when we got back to town.
( CT scan images under the cut )
At my home vet, they did a fine needle aspiration, then a real punch biopsy, and blood tests, none of which were at all conclusive. They did radiography, x-rays to start, where they thought it was maybe her heart (though I am still not clear why they were looking there...), and then a CT scan which showed the large mass to probably be a sarcoma. Well encapsulated towards her head, but with "stranding" where it led further back towards her tail. They didn't see any metastasizing in her lungs at least. The differential diagnosis from the CT scan, from the radiologist was a sarcoma.
Today I went to the Animal Cancer Center at the University of Guelph to meet with member of their oncology team, to talk about where we are, what is left to learn, and options on where to go next.
Thy think it is probably a sarcoma, but can't confirm that without further tests - specifically it would require another histology test from a biopsy taken with ultrasound (to make sure they are getting a good sample) to determine what kind/level of aggressiveness. They would also want to do an ultrasound of her abdomen to make sure that she doesn't have another issue already that would make treatment of this mass pointless. I think the CT scan actually covers all the area they'd want to look at, but they hadn't received it before the appointment because of some communication issues with my vet (they don't have the CT, they don't have the software to look at it, so they sent the Cancer Clinic to the radiology peeps). I actually have the CT scan, because we have the MicroCT at work (at least physically) and very definitely do have the software to look at DICOM stacks, so I have some images, and was able to show them to the resident on my phone at least. I am not going to pay $1300 for radiography and not insist on a copy :p
Anyway. Those tests (plus a urine tests to make sure her kidneys are okay for NSAIDS) are the very next steps they would do, to identify the sarcoma, and then it would be surgery, and then a regimen of radiation therapy. All of this would need to happen at Guelph. It would be a major surgery and she might lose her leg. She would have to be sedate for every treatment, and complications could arise from it and she would be very sick, and it would have to cover a large area. I would have to take time away from work to get someone else to drive me and her to a city an hour and a half away for each treatment and test. And then at best she'd go into remission, Oh and also it would run around $10,000 for the surgery and radiation. One without the other would not be effective - without radiation it would come back, and considering how quickly it has grown this time, it could happen very quickly, and she would have gone through a very complicated major surgery for nothing.
So, I am not doing any of that. I decided that at this point, I will do my best to manage her quality of life. I will keep her on pain killers (and do the urine test to see if I can add NSAIDS to the mix), and be careful with her, and monitor her behaviour and activities and general health to try and track her quality of life as best I can, until I feel like she is suffering too much.
I think this is the right decision, I think I have done everything within reason and possibly beyond, but I'm still really really upset. She's 11, which is and isn't old for a dog her size. She'd been very healthy all of her life. She's still eating and everything else about as well as she ever has, she's still a complete and utter sweetheart. I love her very much.
I bought her a very big bone when we got back to town.
( CT scan images under the cut )
sad
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calm