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Oso Cancer Page

Oso was diagnosed with Multilobular thyroid follicular carcinoma (Thyroid cancer) when he was 9 1/2. There wasn't a whole lot to Oso's cancer. A few days of worry here and there, a fair outlay of money. There was one short period of serious risk. If a dog is going to have a cancer this has a better survival rate than most. This page is a series of emails between friends covering suspicion, diagnosis, treatment and a bit of follow-up.


From Diane Blackman
Date: Thu, 18 Jan 2001 19:09:54 -0800
Subject: Mystery lump

About a week ago I noticed a golf ball sized lump in Oso's neck - right next to the trachea just above his collar line. I kept feeling the other dogs and decided -"Yup its a lump that needs to be seen." So I made an appointment. No change in behavior, stool, eating, drinking etc. By the time of his appointment two days later the lump had gone down to about 1/2 its original size. Still clearly there just not a golf ball. So TED feels and feels and decides to aspirate. Given the location did an ultra sound. It is surrounded by blood vessels. It is not (or seems not to be) a lymph node. It is not solid. It has pockets of stuff. The fluid she withdrew was all blood. Neither she nor the lab could see anything but blood in the sample. His blood panel is normal - including thyroid. White count a little on the low side but nothing alarming. So we are going to try for another sample tomorrow.


From: Diane Blackman
Date: Wed, 24 Jan 2001 14:29:37 -0800 (PST)
Subject: Mystery lump

Hmmm, well the second attempts at an aspirate were inconclusive. 2nd vet is pretty certain it is throid, which is first choice logical. Next we are are going to take a trip to Pacifica to dose Oso with radioactive iodine, just a look see tomorrow - what we do afterward I suppose is a matter of what we find.

Note

:This visit was a low dose of radioactive iodine and a scan. The purpose was to confirm the tenative diagnosis, but more importantly to determine the extent of the problem. Choices if it was confined were different than if it had metastasized. The result showed no evidence of lung involvement, no evidence of problems beyond the thryroid itself. See this web page on on canine thyroid carcinomas.


 

From: Diane Blackman
Date: Thu, 25 Jan 2001 18:44:27 -0800 (PST)
Subject: Re: Mystery lump

So the mystery lump has been diagnosed as a thyroid tumour. The left half of his thyroid is about twice the size of the right. So for the next three weeks he is on an iodine (almost) free diet. Then he will be given some radioactive iodine. The part he will really hate is the 7 to 10 days in the hosptial. Prognosis is good. So far it appears that nothing else is involved.

It took about 40 minutes to drive to the clinic. It took an hour and a half to get home. Hard driving rain, snow, hail, thunder, lightening, an 50 MPH wind gusts made driving . . . interesting. Actually the snow was for the briefest of periods where I was driving, and the hail wasn't big enough to damage the van so it could have been worse. :-)

I can't say I was impressed with the doctor. I don't have anything BAD to say about her, but she was just too busy. She also has to live up to my former oncologist who was terrific with both the animals AND the people. As for her technical abilities - I'm putting my reliance on my regular vets to have done a good referral. THEM I trust as I know they keep up to date on lots of things, and they don't hesitate a second at getting second opinions or researching stuff.

The clinic sees more cats than dogs. They had several hospital cats around. And one chihuahua with a luxating patella. It was very Oso but must have seemed odd to them that Oso didn't give the cats any particular attention but I had to warn them not to let the Chi run up to Oso.

Today was just diagnostic. They inject him with radioactive iodine, very low dose.

After they gave him his injection and while we were waiting for it to circulate I sat in the waiting room reading with Oso on the sofa next to me. One of the cats came over, looked at Oso, walked right behind him on the top edge of the sofa, climbed on my chest and curled up purring. Oso sniffed a "Hi, cat" and put his head in the crook of my arm. :-)

Diane Blackman


From: Diane Blackman
Date: Thu, 25 Jan 2001 20:32:42 -0800 (PST)
Subject: Re: Mystery lump

On Thu, 25 Jan 2001, Ann wrote:

My mother had one of those! :) And she was fine after treatment. Why do they have to hospitalize him for this? is it to track the iodine?

On Thu, 25 Jan 2001, Lynda wrote:

Radiation safety. People can be told to only eliminate in the toilet, but dogs aren't quite that ... reliable. It's my understanding that all waste products are considered radioactive for a certain period of time, and until the radiation has decayed to the point that it's below some maximum level, dogs are kept in quarantine. Handling of their bedding, bowls, and waste products is pretty clearly defined and regulated.

Yup. I was warned that anything I brought would not be returned. He doesn't really have a "his bed" but I'm going to put an old blanket on our bed so he can have it.

I figured I'd ask about the visitation rules later - any hints on what I should expect?

Diane Blackman


From Diane Blackman
Date: Mon, 19 Feb 2001 21:16:08 -0800
Subject: Right about now

I figure that right about now Oso is starting to panic. I dropped him off for his radioactive iodine treatment this morning. He's been day boarded before but never been left at night. The one time he was left there at closing he was in a panic when I showed up just in time to get him. *sigh* Other than spending the money to board him regularly there isn't much else I could do to prepare him. I've made sure he got a wide variety of experiences in other ways - but he is one very specific doggy.

I have some concerns that the clinic may be just a little too used to cats and not enough used to dogs. There was a cattle dog kenneled two runs over - that was it for dogs. The kennel gate had one of those u-shaped latches. I told them to put a pin or clip on it otherwise there was a risk he was just going to knock the latch open. Mostly I'm concerned that they may take his apparently placid temperament for granted and not take adequate precautions with regard to other dogs. I have warned them but he is just so specific about what will trigger him that I'm not sure they will believe it.


Date: Tue, 20 Feb 2001 20:09:50 -0800 (PST)
From: Diane Blackman
Subject: Re: My poor kids :-(

Oso had big diarrhea last night. I figure its a combination of stress and something they ate as Tsuki's pretty loose too. However Oso ate all his dinner and had soft stool so I suppose it will be fine. They didn't report any behavior problems. They got "too busy" to update his mail box and that did not make me happy. What they do is provide a phone mail box where they update the dog's condition. You can talk to a person, but I found from calling them earlier that at least half the time you have to leave a message and wait for a call back.


Date: Wed, 28 Feb 2001 22:12:19 -0800 (PST)
From: Diane Blackman
Subject: I got my leash back.

I thought I might not, but I did.

Diane Blackman (being deliberately obscure)


Date: Thu, 1 Mar 2001 09:40:43 -0800 (PST)
From: Diane Blackman
Subject: Re: I got my leash back.

On Thu, 1 Mar 2001 april wrote:

< I thought I might not, but I did.

:-)

And was Oso happy to come home on the other end of it?

April

Yes! He was very very happy to come home. They got him all shiny clean. He looked beautiful. whatever they used on him smelled like sandlewood 8-P Anyway a month from now we arrange surgery.

When we first made the arrangements they told me I wouldn't get back anything I left for him. So I brought stuff I wouldn't mind losing - except that when I left him I also left my six foot perfectly broken in leather leash. Eeeeeek If I had been thinking I would have brought him in on a trashy leash. Anyway, I wasn't sure whether I would get the leash back, but I did.

Oso slept very soundly. He is a little hoarse from constant howling.


From Diane Blackman
Date: Fri, 30 Mar 2001 06:53:19 -0800
Subject: Oso's thyroid report

The staples in his throat make him look like he has had a zipper installed. So far he only tried to remove them once - and that was more a side effect of scratching the itchy skin than aiming for the staples. A neckerchief took care of the problem.

For those who like medi-babble here is the report:

Multiple sections of a partially necrotic hemorrhagic partially cavitated expansile encapsulated neoplasm from the thyroid glad are examined. The neoplasm is composed of a moderately pleomorphic population of thyroid follicular epithelial cells. These have an ovoid uniformly stippled nucleus with single nucleolus and relatively abundant eosinophilic slightly vacuolated pale cytoplasm. Mitotic figures are present in very small numbers (less than one per high power filed). In many areas these cells proliferate to form solid lobules separated by delicate fibrovascualar septa. In limited areas the cells proliferate to form distorted follicles. There is some invasive growth by the neoplasm to involve the fibrous capsule and some of these invasive cells are seen within irregular vascular channels in the fibrous capsule.

Smaller nodules of neoplastic tissue lie within cavernous vascular channels within the loose connective tissue adjacent to the main neoplastic mass. The neoplasm does not extend to the multiple surgical margins examined.

Diagnosis - Multilobular thyroid follicular carcinoma


From Diane Blackman
Date: Fri, 30 Mar 2001 07:44:25 -0800
Subject: Re: Oso's thyroid report

On Fri, 30 Mar 2001, Ann wrote:

So it's a cancer that has a few pieces that have not metastised? one that has different lobes?

What symptoms did he show that made you do the testing?

Ann

I think it was back in January I was giving Oso a neck scratch and noticed a lump in his throat. I took him in two days later. We did an ultrasound that confirmed the mass was unlikely to be lymph, but two biopsies were inconclusive. So I ended up taking him for diagnosis via radioactive iodine that confirmed the presence of a malignant tumor. 3 weeks of iodine free diet then a dose of much more radioactive iodine to kill the tumour and cause surrounding blood vessels to shrink away. This week surgery to remove the tumour itself. The radioactive iodine succeeded in shrinking away the bolld vessels from the top half, but not the bottom half. They sent it in to make sure they got it all. The report says that there is some degree of metasitization, but not much, and the margins of the tumour are clean so basically they got it all. Some possiblity of malignant cells elsewhere but the oncologist says she thinks the radioactive treatment probably got all of them. Basic prognosis is excellent - assuming no evil guys are lurking somewhere else.

I asked how long the lump was there before I noticed it and the answer was "not long" because there were no other symptoms.


From Diane Blackman
Date: Mon, 11 Feb 2002 19:29:04 +0000
Subject: Oso

Oso is staying the day at the vets getting xrayed and blood drawn etc. He suddenly turned into an "old dog" in the space of about two weeks. Lately I notice he seemed uncoordinated and spacey so I took him with me this week-end to watch him. Without going into all the symptoms he was showing signs of neurological problems. The vet agrees - maybe pressure on cervical nerves but more likely something going on in his brain. Likely we will be referred to a neurologist. But I had a bad feeling when I took him in for his throat lump and I was right and I have a bad feeling about this one. He is 10 1/2.


From Diane Blackman
Date: Tue, 12 Feb 2002 03:58:50 +0000
Subject: Re: Oso

Whew - at least for the moment crossed fingers seems to be working. Scared the be jabbers out of the vet though. She had just finished drawing blood when he had a seizure. Blood panel showed very low calcium level 5.1 (normal range being 7 something to 12 something). So they've been giving him iv calcium all day. He got to come home but he goes back tomorrow for more. One of his symptoms, rubbing his face, is apparently classic.

The probable cause is that his radiation treatment (for the thyroid tumour) destroyed the parathyroid which is needed to make the vitamin D to process the calcium. So apparently he has been living on calcium reserves for the last six months or so and they ran out.

He kind of fooled them because this whole thyroid problem is much more common in cats, and in cats the calcium problem usually shows up within weeks - not months. And that was why they didn't think of it the last two times I brought him in with the rather vague "he's not quite right" and he's losing weight. I really couldn't pin point it what the "not quite right" was so we had figured the thyroid was just a touch too high and adjusted it.

Anyway - he is obviously feeling better than when I took him in this morning, although still pretty wobbly. He'll get four days of monitoring - and calcitriol - and then we shall see how to stabalize him at the right levels. Hopefully that will be all there is too it.


From Lynda
Date: Mon, 11 Feb 2002 23:16:00 -0500
Subject: Re: Oso

Gack. Poor Oso.

IV Calcium is almost as scary as low calcium! I hate giving it IV -- I have given a lot of it SQ. But if his calcium was low enough to cause a seizure, he needed it IV. I assume he's already on oral supplementation also?

Weeks heck -- DAYS. And usually it's a lot more obvious. I've seen a cat who had hypocalcemia secondary to a thyroidectomy ... not pleasant, although with some IV calcium and some SQ calcium, he was good to go home the next morning.

Did they check his thyroid levels?

Pshew. This is WAY better than a brain tumor. Calcium is managable. I'm fairly certain you can actually feed Tums ... don't know the dosage off the top of my head, but this is most definitely better than the alternative.

Lynda


From Diane Blackman
Date: Tue, 12 Feb 2002 04:58:14 +0000
Subject: Re: Oso

On Mon, 11 Feb 2002, Lynda wrote:

IV Calcium is almost as scary as low calcium! I hate giving it IV -- I have given a lot of it SQ. But if his calcium was low enough to cause a seizure, he needed it IV. I assume he's already on oral supplementation also?

Yes, they mentioned that its a touchy deal. After the first bit they rest was given SQ. Tomorrow is SQ - and monitoring. Probably for the next four days.

< < < He kind of fooled them because this whole thyroid problem is much more
< < common in cats, and in cats the calcium problem usually shows up within
< < weeks - not months.
<
< Weeks heck -- DAYS. And usually it's a lot more obvious. I've seen a cat
< who had hypocalcemia secondary to a thyroidectomy ... not pleasant,
< although with some IV calcium and some SQ calcium, he was good to go home
< the next morning.

My vet said they stiffen up - turn into cement cats. :-)

< < And that was why they didn't think of it the last two
< < times I brought him in with the rather vague "he's not quite right" and
< < he's losing weight. I really couldn't pin point it what the "not quite
< < right" was so we had figured the thyroid was just a touch too high and
< < adjusted it.
<
< Did they check his thyroid levels?

Then, yes. It was a touch high. Not high enough they would have usually bothered with adjustment. Rechecked today.

< < Anyway - he is obviously feeling better than when I took him in this
< < morning, although still pretty wobbly. He'll get four days of monitoring -
< < and calcitriol - and then we shall see how to stabalize him at the right
< < levels. Hopefully that will be all there is too it.
<
< Pshew. This is WAY better than a brain tumor. Calcium is managable. I'm
< fairly certain you can actually feed Tums ... don't know the dosage off the
< top of my head, but this is most definitely better than the alternative.

A small handful - up to 10 a day. Of course first we have to make sure we can get him to metabolise oral calcium.


From Diane Blackman
Date: Wed, 20 Feb 2002 06:34:01 +0000
Subject: Re: Perry Update

Oso Is far from done with his own problems. We discontinued calcium supplementation Wednesday and checked again on Thursday and Saturday to be sure we weren't losing ground. Everything looked great. Sunday afternoon I noticed him being unsteady, talked to his vet on Monday and this morning decided he was just too damned wobbly. Yikes - somehow we overshot. They had him on IVs all day trying to get the calcium levels back down into the normal range. I take him back tomorrow morning. I've got all three doctors in the practice involved, plus his oncologist and surgeon.


From Diane Blackman
Date: Tue, 26 Mar 2002 19:22:38 +0000
Subject: Re: Twzl Update...

On Tue, 26 Mar 2002, Ann wrote:

< < From: Diane Blackman
< <
< < Yes. Just a few short months ago I watched as Oso suddenly turned into an
< < old dog. He'll be 11 in June and certainly nothing in him is long lived.
< < Initial vet lookover didn't sound good. Then we found the problem was
< < actually treatable, though its been a royal pain to figure out the right
< <
< <
< What did you find to be wrong with Oso?

Idiopathic hypoparathyroidism Which means his parathyroid gland(s) quit for reasons unknown and thus he could not metabolize calcium. Calcium is not only necessary for bones but blood clotting, muscle contraction, enzyme reactions, cellular communication and skin differentiation.

We have him on "calcitriol" to substitute for the missing hormone. It's really sensitive. A smidge too much and his calcium levels get too high - a smidge too little and we can't keep them up high enough. Not quite as sensitve as insulin levels so I'm lucky there.


On January 24, 2004 Oso left us and his pain behind. See Oso's last story.

You may find these resources to be useful

Pets Living With Cancer by Robin Downing
Help Your Dog Fight Cancer - An Overview Of Home Care Options by Laurie Kaplan
Home Prepared Dog and Cat Diets by Patricia Schenck
Ultimate Diet: Natural Nutrition For Dogs And Cats by Kymythy Schultze

                 

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Copyright © 2003, Diane Blackman     Created: April 4, 2003     Updated November 12, 2007

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