Oncology visit..Cami=KUJO!

[Tuff Love]

Haha.. your story gave me a little chuckle. Poor Cami girl... I agree though- what did they expect? Dogs, like humans HAVE LIMITS. And that is one hell of a sensitive area to be testing limits! I hope your PB idea works, but judging by how strongly she reacted, do you really think a little PB will calm her down? Lol. Good luck! Either way, I hope you and the oncologist have luck treating it so you can be through worrying about it. I hope the nose bleed was a freak incident and nothing serious is wrong Your girl is such a trooper.

 

[bayleighmom]

Poor Cami! She's been such a good girl through all this. Keeping my fingers crossed that the ointment does the job and her "space" won't have to be invaded.

 

[baxtercruz]

I don't blame Cami either... that would piss me right off! And I bet it didn't feel good either.

Baxter embarrassed me at the vet when they were just trying to take a print on a slide from between his toes to see if it was a yeast infection... HE HATES HIS FEET BEING TOUCHED. And he will let me do a lot of things to him if I talk to him and coax him through it, but he's not about to let anyone else mess with him (except my mom ). His vet wouldn't let me assist, and before they even did anything, just him and the assistant restraining him made Baxter wail. I kept telling the vet that it would be better if I could hold him, that Baxter would cooperate, but instead they took him into the back, which really set him off, and ended up muzzling him, and holding him down.... just to take a print from between his toes!! I was really upset, because such a simple thing ended up being really traumatic for him and me- I understand they probably have rules about it, but I know my baby and he proved me right! And I think the muzzle made it even worse- him being fully restrained, and pulled away from me... makes me sad for him even now. I was embarrassed that he made such a big deal, but then I was like, "well, that's what you get if you're going to handle him that way, and not listen to me".

Your poor girl has been through a lot- more than she should have to handle. I really hope this cream is a miracle worker so she can get a break!

-Kim

 

[Boxer Babies]

Oh your poor baby! But yes I agree, I wouldnt be too happy with anyone going there either. Look on the bright side, she could have farted on the vet....hehe.

Seriously though, I do hope all goes well for you both. We will be thinking of you all

 

[AmeliaH]

I hope this post find you and Cami well. Although Cami's situation is not funny, I did have to chuckle a bit. I'd be unhappy with a needle near my whoo-ha too!

I'm new to the site and haven't quite figured out how to post a new thread. However, in reading the MCT posts, it seems that you unfortunatly have a tremendous amount of experience. Would you mind if I ask your opinion?

Bella is a 2 1/2 year old white boxer. A few months ago I noticed a small nodule (~3mm) on her left ear. It wasn't really growing, so I waited 1-2 months until I brought her in. My local vet (I live in Northern Vermont) said "She's a boxer; I should remove it." She did, and it was a grade I MCT with clean margins (albeit small because it was on her ear) and low mitotic index (<1). She said that if I wanted to be extra cautious, I could go and see an ocologist in Boston (~4 hours south). I made an appointment right away. However, in less than a week, she had two more small bumbs pop up. One was near the healing site and one was on her other ear. I already had the appointment with the oncologist scheduled, but put some topical triamcinolone on the tumors in the mean time. In just a few days, one went away almost completely, and the other was reduced in size.

The oncologist said that MCTs on the ears tend to be aggressive. She gave me many options including removing both ears, complete staging, or just treating with chemo. Bella really does not do well with anesthesia. Given that the chemo (vinblastine, prednisone, and CCNU) has a fairly low toxicity, I opted not to fully stage her nor remove her ears. My thought is that either it is going to be really aggressive in which case, I don't want to put her through too much, or it will respond to chemo. I really want to focus on good quality of life for her. For some reason, cutting off her ears just seems wrong, especially if given her age, she's going to get more anyway.

So, she's about two weeks into therapy. She's been a little cranky (and thirsty, and peeing) with the the prednisone, but otherwise seems well. The other lumps are completely gone.

I emailed Cheryl London (who seems incredibly nice!). I may be able to have her do a consult as she is in the Northeast for a bit this summer.

Did Cami have any tumors on her head or neck? I know the ones on the perineum are also supposed to be considered more aggressive.

I hope you don't mind me picking your brain....do you have any thoughts?

Thanks in advance. Amelia and Bella

 

[Cami]

Dr. London is VERY nice, easy to talk to and more importantly a walking encyclopedia when it comes to mast cell tumors. She is currently on maternity leave! She adopted a baby girl over Christmas last year. She is in her hometown at least through August.

I am thrilled with joy to hear that the topical triamcinolone worked for your baby. I am presently applying it three times a day to Cami's bum/hoo-haw (much to her dismay). In realty she quite enjoys the peanut butter smothered biscuit that she gets before I head "back there". I keep saying to hubby (wanting him to agree/confirm) that her tumor is getting smaller with its application but more possibly I just want to see it getting smaller.

I can only give you an opinion based on my experience and constant questioning/pestering of multiple oncologists, including Dr. London.

Chemo does not have a very good track record for treating MCT's (on the skin). Once they have metastasized, then that is another story. I believe that the "cure rate" for treating MCT's with the specific protocol you mentioned is about 20%. Triamcinolone on the other hand has a 50% success rate when it is injected into the tumors directly. I like to say that in Cami's case it had a 100% success rate on FOUR tumors. I didn't break down the percentage with the total of 6 that were treated initially (far from a math wiz!!). But if someone did they would find it was OVER 50%. I like those numbers.

What the chemo is more gauged towards (to be honest) is keeping the body from developing additional tumors while on the drugs and keeping present tumors from getting larger. If no new tumors develop while on the 4-6 months (or however long protocol) then you stop treatment. Sadly, WHEN, not usually IF (with regards to Boxers) a new tumor rears its ugly head then you start the chemo up again in the hopes that you at least get that tumor to stop getting bigger and again try to avoid new ones while also making an attempt to keep them from heading to internal organs or even lymph node bound.

It's a vicious cycle. It is seared into our heads that cancer equals chemo. Unfortunately it is not always the magic pill and its use with MCT's just doesn't have a very good track record.
I had an oncologist look me straight in the face and say... "Cami needs to go on chemo". "It probably won't get rid of these tumors (6 at the time) but it might stop new ones from presenting". Well that wasn't enough for me or my girl.

The oncologist said that MCTs on the ears tend to be aggressive.

Can't get fully on board with this statement.
The head itself, including ears are not "common/typical" places for MCT's to show up so when they do one needs to pay them some close attention (do what you can to get rid of them). That being said.....a grade 1 with a low mitotic index on the ear is pretty much the same as having that same tumor on a leg or anywhere else. Just because it is on the ear doesn't automatically make it a worse MCT. It WILL make it harder to remove and achieve clean margins but like in your girls case, not impossible. Same would go for another location that has far less skin to deal with surgically.

I am totally in agreement about the ear removal. Just as I would be to do an amputation of a limb for this type of cancer in a Boxer. The younger they are when one first appears is a pretty good indicator of what their future holds (additional tumors). My thought process is if I needed to remove one leg that another tumor would appear on a remaining leg. A tripod can do quite well but a dog with only two legs will have a much tougher time. Of course this is just my opinion and I wouldn't fault anyone who made a different decision for their own pets situation.

So far Cami has not had any MCT's on her head. She does have something going on with one of her ears however I do not think it is a MCT since she had something quite similar in the past (different ear) and it self resolved. Although I a firm believer that miracles DO happen and for all I know it could have been a MCT that had some "special help" and is now gone.

The current tumor on her "privates" is I am assuming the perineum?? Between her anus and vagina. It has been present for at least a year. Probably closer to two if I were to really think about it. It appeared one day and never changed for the longest time. Then it started to change ever so slightly. Then Dr. London made it MAD and it got angry looking. It is now THANK GOD back to looking like its old self with the med being applied to it. That is a step in the right direction.

I don't know if I answered your questions! I can talk MCT's all day. How sad is that?? LOL

 

[AmeliaH]

Thank you so much! I'm glad to hear you agree about not doing "pinnectomies" (aka- lop her ears off!)- which doesn't sound nice even then they use the anatomic term.

In terms of the chemo, I am now sick just thinking about it. I'm only in week 3 of 16. Dr. London thought she might be able to see Bella at the end of August. I will try to take her up on that! Has she been the primary oncologist to deal with Cami?

If the injections work, perhaps I can get my local vet on board (she's great!). Have you ever tried EMLA cream prior to Cami's visits? It's a topical anesthetic we use with kids. If you put it on about an hour before the procedure with an occlusive dressing (called a tegaderm), it will numb the area. I don't know if you could get it on her back side...but any flat spot might work.

Given the wide range of disease with MCT, I realize I can't assume that our girls' diseases are similar enough to make predictions, but hearing that Cami has already had four years (and hopefully many more) after initial diagnosis is giving me some hope. The oncologist told me 6 months if I did nothing, and start with hoping for 1-2 years if I opted for chemo.

THANK YOU AGAIN for your time and thoughts!!!! I will keep up on the threads and send good vibes your way.
Amelia and Bella

 

[Cami]

Have you ever tried EMLA cream prior to Cami's visits?

I have not tried that however Dr. London did apply some topical lidocaine prior to attempting the injection. Cami just has issues with her bottom being "inspected". She also has issues with being restrained and she had three people on her at the time.

Dr. London is Cami's primary oncologist but she has seen other oncologists on various visits at OSU when Dr. London isn't on clinic on any particular day. She knows Cami well plus one of my best friends cares for George (Dr. London's dog). I also own a pet sitting/dog waking company hence that connection. I've got the inside scoop on Dr. London's schedule by asking my friend if she is seeing George on any particular day!

Regarding what your oncologist said about 6 months.....
HUH?????????????????????
Based on what you have said about one tumor being gone via surgery (albeit without clean margins) and the others being small (or getting smaller) that statement is just mind boggling.
If a Boxer must have ANY form of cancer then a MCT is the preferred one. Not that you would want cancer at all but I'm just sayin.
Boxers tend to have a more benign form of the disease. Meaning that they can present with multiple tumors over their lifetime and with various forms of therapy available that are proven to work this type of cancer is more "manageable". **Of course some Boxers have more serious, higher grade MCT's and or metastases and those can or do become life threatening. At any rate cancer is still cancer no matter the grade and it is all serious.

I do hope that you can visit with Dr. London. She is open to being asked all sorts of questions (at least she was with me). I literally had a list a mile long of various treatments I had found online from injecting tumors with deionized water all the way up to different chemo protocols and she gave her opinion on each one. It was only when I mentioned the Vetalog injections that I got excited by her responses! She said she used it with great success and would be more than happy to try it with my girl. Glad I spotted what little info there was and she was up for it. Not ONE oncologist that I had met with prior had ever even mentioned it.
I SOOOO wish I had known about its use prior to seven previous surgeries. I might have been able to save my girl from some of them.

 

[AmeliaH]

Thanks once again for your encouraging words! I have really just been a wreck since finding out and reading about MCTs- especially knowing she had three so quickly at such a young age. However, I am encouraged both by Cami's story and by your feedback.

Am I reading the literature right? It seems like resection with a 2cm margin is important and that adjuvant chemo and/or radiation may help some with dirty margins. I've also seen the articles that chemo alone doesn't seem to help large, non-resectable tumors nor diffusely metastatic disease. Is there literature and/or what is your knowledge about chemo for multiple small tumors? You said that chemo doesn't seem to help, but I can't seem to find that documented. Bella's two small tumors melted away in less than a week. Is is just that it won't last? I'm wondering if I should even keep going with the chemo, although she is tolerating it just fine thus far. I wonder if they recommended chemo like Midas recommends a new muffler. Has Cami received any chemo?

I will definitely try to go see Dr. London!

Thanks, thanks, thanks again and (as always) good luck with the topical triamcinolone administration. I'm glad the peanut butter provides good distraction!