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Mandy

Bear-Shaped Dog Update.

Posted on 2007.02.15 at 17:20
Tags: ,
Mandy had her follow-up appointment today.

Now, her paw had been getting swollen, but the vet and my wife both agreed it was likely due to the bandage, so we removed that bandage yesterday, intending to replace it with a more lightly-wrapped one... But my wife, who had planned to acquire bandaging supplies on her way from work had forgotten them. We didn't even have tape. So we made her a temporary bandage out of (I promise this is true!) half a sanitary pad and three socks. [the first two wrapped around like an ace bandage, the third on the dog and pulled up to her shoulder.]

Mandy had no objection whatsover to this, other than the tenderness when we handled the swollen footie. She never once, in my sight, tried to remove or chew the sock, the original bandage, or the wound.

When I got home, the "bandage" had come off. She was leaving her stitches alone, although one had come out, at the bottom, where the most flexing happens. Well, of course I freaked out, and tried to re-assemble the bandage, and we set off toward teh vet's for the follow up appointment. The bandage was back off -- not through her efforts, but just walking -- before we reached the car, and when I put it back in the car, again, by the time we got into the vet's office, it was off again.

I was trying to re-re-wrap it when the vet came by, and I braced myself for a scolding, but the vet said, "Never mind, the incision looks fine, the opening in the bottom is good for drainage. Just put the cone back on her if she goes after it."

What she had was a peripheral nerve-sheath tumor, low-grade. This is a canine soft tissue sarcoma. Yes, it's cancer.

The vet didn't have a "prognosis." He said he was going to send a copy of the report to the Oncologist for more information.

The report calls for "Surgical margins of at least three cm." The margins (this means the tissue removed around and along with the lump) on the lump he removed were less than 1 mm. So, because the location didn't allow for removal of as much tissue as the standards call for, she's at greater risk for recurrance.

The vet mentioned the possibility of letting the leg heal, and then removing more tissue to try to make up the surgical margins.

Now, the "Comments" section of the report says:

"Canine soft tissue sarcomas (STSS) are a diverse group of malignant neoplasms of mesenchymal (connective tissue) origin. This group of neoplasms includes soft tissue sarcoma of of peripheral nerve sheath origin (neurofibrosarcoma, malignant schwannoma), hemangiopericytoma, myxosarcoma, and fibrosarcoma."

So, if I read this correctly, because it's a peripheral nerve-sheath tumor, it is probably either neurofibrosarcoma or malignant schwannoma. I so wish hte word malignant weren't in there.

The comments say that in cases where adequate surgical margins are not attainable, ancillary radiation therapy has been shown to provide effective long-term control. The vet asked if I wanted that, and said, "Big bucks." I asked what the prognosis is with or whithout, and that's a question on the list for the Veterinary Oncologists.

So there's the news. The short answer is, although it's cancer, I don't know yet.

Comments:


mrsquizzical
mrsquizzical at 2007-02-15 23:47 (UTC) (Link)
*hugs you*
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 08:22 (UTC) (Link)
Thanks, Q!
zebraspots05
zebraspots05 at 2007-02-15 23:54 (UTC) (Link)
I didn't even know they had vetrinary oncologists?!?
Sorry the news isn't the best; I am struck by reading your account, that we (at least I do) always expect an answer to be easy...either yes or no...but it sounds like there are even more questions than you had yesterday. Now that you know WHAT it is, how do you deal with it? that is going to be the tough part.
Fingers crossed that you get some more answers soon
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 08:31 (UTC) (Link)
I didn't even know they had vetrinary oncologists?!?

Yeah, that knocked me for a loop, too!

Now that you know WHAT it is, how do you deal with it? that is going to be the tough part.

Well, I'm not really sure I do know what it is. What I've been able to find thus far is more re-assuring than not. Peripheral nerve-sheath tumors apparently come in "low-grade" adn "high-grade" varieties, and this seems to be a "low-grade" one. Which means that, espeially with the low surgical margins it's somewhat more likely to grow back, but not terribly likely to metastisize. (If I'm reading my research right!)

"What I'll do" is the easy part, though. I'll learn as much as I can about the options, and weigh the potential benefits of treatment against the potential discomfort and -- and I feel like a heel for saying it -- the cost. I love my bear-shaped girl more than life itself, but that doesn't mean I can produce money in unlimited amounts to treat her, and vets, unlike doctors for humans, have no obligation to treat whether they are paid or not. And then I'll make my decision based on my best judgment as to which of the options available to me will give her hte longest period of the most comfortable, happiest life.
herrbgone
herrbgone at 2007-02-15 23:57 (UTC) (Link)
To quote Mum “I’m crossing my fingers and toes and everything else.” Which, as has been pointed out already, does make typing difficult.

Best of luck to the both of you.
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 08:35 (UTC) (Link)
Thanks, Dave.
elfwhistletree
elfwhistletree at 2007-02-16 00:34 (UTC) (Link)
I'm not a vet - I don't know what all the words mean - I'm afraid you just have to wait for the report ;-(

So we just have to hope for the best - I know you and tour wife will take good care of Mandy.

*hugs*
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 08:35 (UTC) (Link)
Thanks, my friend!
Gummo Bergman's "Silent Strawberries"
marginaliana at 2007-02-16 00:57 (UTC) (Link)
*hugs*
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 08:36 (UTC) (Link)
Thanks, Jessie.
jo
jo_ron at 2007-02-16 01:53 (UTC) (Link)
*hugs to you, your wife and mandy*

and stop reading! You're going to end up worrying and fretting and that's not going to do mandy and good. Okay, I would keep reading too.

I'm sorry that that word malignant is in there, I wish I could take it out.
Spoil her, hug her and love her to bits...you already do that...so it should be too hard.
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 08:37 (UTC) (Link)
Thanks, Jo.

I've gotta keep reading. It's not fun, but it's the only thing that can arm me to fight this battle.

And, yeah, I'll continue to spoil her rotten.
shygryf
shygryf at 2007-02-16 03:52 (UTC) (Link)
*hugs*

before paying for any radiation I would recomend getting mandy checked for more tumors.

Mandy and you are in my prayers.

*hands over wrung out hankie*
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 08:43 (UTC) (Link)
Thanks, Gryf. I'm pretty confident that the one we got was a loner. Given the type, and its low likelihood of metastasis, and its "typical" location, that seems pretty likely, and I've not felt any other mysterious lumps.

In any case, I'm going to have to know that radiation will greatly improve her long-term chances for survival with fairly minimal discomfort before I'll even consider it. I have no desire to subject her to a long, drawn-out torture.
Mrs Salazar - two million years old
cantabile at 2007-02-16 06:44 (UTC) (Link)

There is a sort of a "health warning" about reading the end of this.

First of all, like the others *hugs * to Mandy and her human parents. How brave she is being and how lucky to have you to take such good care of her.

Now the business, if it helps at all. For seven years I did the office management of a very busy veterinary surgery. During that time I saw lots of cases of dogs who had terminal diseases diagnosed. Some "parents" decided to go for some ongoing, costly, and debilitating (usually) treatment with the hope (not a promise) that it would extend their loved doggy's life by some time. Others opted not to, but to give palliative care when the time came. My experience was that the first lot, taking the oncology treatment, were pioneers and brave in their own right, but that their animals probably didn't live any longer (a few days perhaps at best) and had to put up with lots of trips to the surgery, being handled in ways they dind't need. Some had lots of chemo and felt very subdued and depressed - definitely not themsleves - while they were suffering the side effects. I promised myself that if one of mine was diangosed with something similar I'd do what the other half did, the palliative care. I hoped that it would never happen. In June it did. Sadly our old lady, Polly, had a very destructive and fast moving type of cancer and there would have been no time anyway for ongoing treatment.

Dogs only know today, they don't know about tomorrow. They don't have a wedding, a birth, a graduation, or a holiday to look forward to because they don't know about those things, they don't look forward. I think that their now has to be quality, and that their yesterday was too. I'm going on a bit I know, an dperhaps you're thinking that you wish I'd have left this. Please feel free to delete the ocmment.
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 08:46 (UTC) (Link)

Re: There is a sort of a "health warning" about reading the end of this.

Thanks, so very much.

My first words to the vet when he asked about Radiation was to ask about prognisis with and without. I told him point-blank that I'm only interested if its benefits are significant, and discomfort minimal. I want my dog with me a long time, but I want her happy to be here, not to torture her for a few extra months of pain.
alloy_
alloy_ at 2007-02-16 07:39 (UTC) (Link)
I sense your growing frustration.

Hang tight.
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 08:48 (UTC) (Link)
No, I'm not really frustrated, although I'd rather have some answers and a course of action I can sink my teeth into.

I knew when I met ehr at the animal shelter two and a half years ago that we were in this for the long haul. I won't be hanging in there any the less now.
harrysmom
harrysmom at 2007-02-16 11:56 (UTC) (Link)
Oh Jon, that sucks. I hope it all works out and that Mandy is not in pain.
*hugs you*
*hugs Mandy*
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 12:07 (UTC) (Link)
Oh, she doesn't show any sign of being in any pain, other than that Daddy's a pain in the neck for telling her not to lick the thingie on her front leg.

I have a feeling this is going to be OK. It seems like it's a kind of cancer that's not likely to metastasize, so it's likely to just mean thata she'll grow more lumps in the same place -- unless I'm completely misreading the on-line literature.

Optimistic, that's me.
louhq at 2007-02-16 16:21 (UTC) (Link)
more scritches behind the ears for Mandy girl and a big hug for Jonathan.
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 16:53 (UTC) (Link)
THanks, Lou, from both of us!
B00
i_m_b00 at 2007-02-16 16:24 (UTC) (Link)
I so want to give you words of comfort or at the very least answers and guidance. Just know that I care.

*hugs you*
*hugs Mandy* *gives Mandy a treat*
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 16:55 (UTC) (Link)
I appreciate it, b00, and so does Mandy. Especially the treat! She's been getting lots of treats, because she's on Amoxycillin, capsules that would choke a hippogriff, and I've been inserting them into cocktail wieners, and she's been just loving medication time!
xedra
xedra at 2007-02-16 17:42 (UTC) (Link)
*big hug for the bear-shaped dog and her person*
Jonathan Andrew Sheen
leviathan0999 at 2007-02-16 18:15 (UTC) (Link)
I thank you for my hug, and will pass Mandy's on to her this evening.

And I offer you one more of your own. I was so sorry to hear your awful news.
Risie
risiepookie at 2007-02-17 00:49 (UTC) (Link)
Oh, gosh, my love. I am sending so many hugs and positive thoughts for you, Mandy, and Cathy! Keep us updated!

::hugs and kisses::
Jonathan Andrew Sheen
leviathan0999 at 2007-02-17 02:16 (UTC) (Link)
Cathy? ;)

Mandy, Cindy and I all appreciate your support and good thoughts. As I've said, we're feeling very optimistic at this point.
Risie
risiepookie at 2007-02-18 18:36 (UTC) (Link)
::risie smacks self upside the head::

This is why I should NEVER multi-task. I was talking to one of my best friends (KATHY!) on the phone while trying to respond to your post. hehe. My mind must have been trying to reconcile the two names, because I used a "C" as the first letter. ::shrugs::

At any rate, I'm glad you're feeling optimistic! ::big hugs to all::

Photobucket - Video and Image Hosting
Jonathan Andrew Sheen
leviathan0999 at 2007-02-18 19:58 (UTC) (Link)
Tee-hee! I, too am a dreadful multi-tasker! I feel your pain.
triomakesmehot
triomakesmehot at 2007-02-17 05:35 (UTC) (Link)

Worried about you!

Hi there!

I hadn't heard from you in a couple days, and I wondered why since I posted my next chapter. Thought I'd peek in here, and I saw the news about Mandy, and I can't tell you how sorry I am!!!

I'm a dog fanatic myself (my 4 are right up there with my Potter addiction), and my heart just breaks for you. I will keep Mandy, as well as you and your wife, in my prayers for her to have the best possible prognosis. I wish there were more I could do.

~Jamie~
Jonathan Andrew Sheen
leviathan0999 at 2007-02-17 10:15 (UTC) (Link)

Re: Worried about you!

Oh, Jamie, I'm sorry. I've actually sort of blown off reviewing that chapter for a couple of days because the "pairing" pushed my comfort zones a bit, so I wanted to sort out my feelings on that score before reviewing.
Isha
isha_libran at 2007-02-17 19:02 (UTC) (Link)
Aw, you poor thing. I have a dog, too, and I know how bad you feel when he/she is in pain and you're helpless to do anything. *hugs* I hope things get better soon.
Jonathan Andrew Sheen
leviathan0999 at 2007-02-17 20:06 (UTC) (Link)
Thanks, Isha!

I'm actually very optimistic, at this point. Based on my research, this is a cancer that has a very low rate of metastasis. If the Vet had been able to achieve the kinds of margins the standards call for -- if I've read this correctly -- we'd be all done now. On a limb, gettig those margins is damned near impossible, but I think all it means is that the same soret of tumor is likely to grow back.

Radiation is, I'm told, quite expensive, and I may be unable to afford it. But it looks to me like a worst-case scenario is amputation, and while I'm certainly not going to claim that that would be a good thing, I've known lots of thoroughly happy tripod dogs.
Isha
isha_libran at 2007-02-17 21:10 (UTC) (Link)
I'm glad you're so optimistic! I'm sure everything will work out. =)
Jonathan Andrew Sheen
leviathan0999 at 2007-02-18 00:57 (UTC) (Link)
I tend to believe Albert Camus: "Happiness, too, is inevitable."
sarahenany
sarahenany at 2007-02-18 08:45 (UTC) (Link)

Oh, sweetie!

I guess you've gone to bed. I am trying to access my Hotmail, and it's shut down - I think the problem is from their end, as both IE and Opera won't open it. I know you did tell me where you live, but I can't remember right now... am frantically searching your website. So if you read this, please reply right here, just city and state, pretty please?

Plus - having read this, yeah, I support your optimism. Back in 1993, my dad had a local carcinoma in his tongue - malignant and all - and it was pretty darn big, too, over 2.5 cm - and he had it out and a bit of radiotherapy, but anyhow, it didn't metastize,even though it had been there for seven months. And he's still alive and well today, no recurrence or anything (touch wood). The doc said that the type of carcinoma that's local *really* doesn't metastize unless you ignore it for years and years.

So, a dose of realistic optimism there.

And, um? "I knew when I met ehr at the animal shelter two and a half years ago that we were in this for the long haul. I won't be hanging in there any the less now."

Awwwwwwww!
Jonathan Andrew Sheen
leviathan0999 at 2007-02-18 08:53 (UTC) (Link)

Re: Oh, sweetie!

I guess you've gone to bed.

And gotten back up again!

I live in Pepperell, Massachusetts.

(And, please take a look at that listing to see the postage, BTW!)

Thanks so much for the good thoughts about Mandy. She's such a joy to me -- although she's, you should pardon the expression, in teh dog-house right now, for removing her bandages and licking her incision. I had to put her back in the cone! Aaaargh!
Isha
isha_libran at 2007-02-18 10:50 (UTC) (Link)
=)
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