Featuring Demian Dressler, DVM and Susan Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide.

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When to Avoid Chemo for Canine Mast Cell Tumors?

There has been much online talk these days about dogs with mast cell tumors (read, Palladia) which are the most common canine cancer.

So I thought I’d just add some fuel to the fire and give my readers some overall guidelines about mast cell tumors and chemotherapy.

As many already know, these cancers come in different grades (1, 2 and 3).  Grade 1 are almost always benign, grade 2 are intermediate (some benign and some malignant) and grade 3 are universally malignant.

Your vet will give you the grade following receipt of the biopsy report, which is completed by a path lab after submission of tissue from the tumor.

Wide excision (removal of a large swath of normal-appearing tissue around the tumor) cures many mast cell tumors.  Pretty much all grade 1, and about 90% or so of grade 2 mast cell tumors are gone permanently after wide excision.  Grade 3 mast cell tumors are candidates for chemo and possibly radiation and more as they will often come back and spread even after surgery.

The tricky guys are those grade 2 mast cell tumors.  Since some behave like benign tumors and some like real cancers, what are we supposed to do?

Well, the key is in getting more information about your dog’s individual tumor. There are a couple of bits of information that are valuable that can help you predict the behavior of your dog’s grade 2 mast cell tumor.

The single most important one is called the  mitotic index.  This is the number of cells that are actually dividing seen by the pathologist under the microscope.

The magical cut off is somewhere around 5.  This means that if the tumor has a mitotic index of less than 5, it usually will behave less aggressively and in my opinion do not require surgery, as long as you have clean margins on the removed tumor.

More than 5?  We need to now consider hitting these guys with the full spectrum approach (diet, supplements, chemo, and other strategies discussed in The Dog Cancer Survival Guide).

You may read about other markers (kit, AgNORs, Ki67) but these are much less useful than mitotic index.  If the mitotic index is around 5 though,  consider these other markers for more data.

By the way, not all vets may know about this stuff, so remember to be your dogs primary health care advocate and speak up!  You vet is the one who has to order this testing of the biopsy specimen from your dog.

The squeaky wheel gets the oil!

Best to all,

Dr D

About the Author: Demian Dressler, DVM


Dr. Demian Dressler, DVM is known as the "dog cancer vet" and is author of Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog's Life Quality and Longevity. Visit his blog and sign up free to get the latest information about canine cancer. Go to http://www.DogCancerBlog.com.

  • Colleen Sheehey

    Please help me…my 8 year old female lab has had 8 mast cells removed and 1 lymph node .
    I am at a loss – but no more surgery for her.
    When can chemo be helpful and what kind?

    Biopsies were done on liver, spleen and bone – they are clean.
    White cells are high and red are low.
    Her brother…is now showing just large bumps (noncancerous)
    What food do I change them too? Is pallidia an option?

    • Dr. Dressler

      Colleen, did your dog have a mast cell tumor removed recently?
      D

  • http://www.angeldogsfoundation.org Lisa

    Hi Dr. D,

    Palladia looks like it’s going to be an interesting drug. Wonder what the cost will be when it’s released.

    Some food for thought, and I’d like to open up a dialogue. I posted on an earlier blog about this….

    Why not treat dogs with mast cell inhibitors like ketotifen or rupatadine and H2 blockers (pepcid or zantac) in addition to low histamine/tryptase diets?

    For the dogs that have class one and two tumors, would it be possible to slow them down by mediating the mast cells that cause the tumors to proliferate?

    There is a human market in the US for both drugs (especially for ketotifen) for an orphan disease (rare disease), but no drug company interested in the profitability due to perceived competition from other popular antihistamines that do not possess mast cell inhibitor properties.

    If Ketotifen were marketed here for dogs, it would possibly save pet guardians thousands of dollars on treatment of MCTs in early stages. Studies would need to be done to prove the efficacy of the drug for MCTs, of course. And someone would need to get a manufacturer interested in a different on-label usage.

  • Carol

    Doctor, I recently filled out a survey and included a suggestion for your book, but was unable to finally ‘submit’ the survey because I am already a subscriber to your “Dog Cancer News” email service. No other option was offered.

  • http://www.petbehaviourscotland.co.uk lynn allardyce

    dear dr
    added complication of ADDISONS DISEASE
    my northern inuit male dog, broch, nearly 3 and half had his front leg amputated nearly three weeks ago due to a suspected osteosrcoma in his distral radius. he has recovered well from this but the biopsy have not been clear enough to say which type or grade of cancer he has. there was a lot of dead tissue, and the initial biopsy said the cells where not dividing very rapidly. initially the recommmended treatment was carbopalatin but now the oncologist is suggesting using a combination of two treatments instead. i have an appointment with the oncologist next week to discuss this and would really appreciate some advice from you as he has addisons disease too, i wondered if that creates any other issues to his treatment or recovery.

    thanks in advance

    Lynn Allardyce

  • MARIA

    Dr. how are you.
    My situation is the following. I have a poodle who in frebruary will be 13 years. A month ago was diagnosed with mass cell tumor behind his right shoulder. this is the first time something happen to him.
    Now. unfortunatelly my economic situation is not the best at this point. Besides it, I am as of today six months pregnant and live by myself. father of baby, mother father and family live in another country. So I don’t have anyone who can tace care of my dog but me. I was told by the oncolgyst at that time that we have to do a surgery which it will cost me 3,000. us. I ‘ve been looking for some help to pay for it and in the meantime I have my dog with a drug that help to reduce the tumor. I guess the name is prednisone, if I am not mistaken. this medicine was doing good on him, but when a finished, and I need more. it took me two days to get the appointment and the tumor grew up bigger in this two days. The oncologyst told meis too big for surgery now, and we need to do chimio asap. She told me about Palladia pills. But unfortunatelly because of my pregnancy I cannot handle them of clean after him. I am giving him right now the prednisone again. But I don’t know until when this medicine is gonna work.
    Another thing is that he has a little injury right on the tumor and I have to keep him with bandage because when they did thy test on the tumor he scratched himself and started bledding. So I have to cover the tumor for him not touch it. I was changeing the bandage every three days but the injury was getting worse. They said because it needs to be ventilate it and since is covered i am changing it every day. The vet was using nitrofurazone as onitment in his injury but again, because of my pregnancy a cannot use this ointment. I am putting on him neosporine instead. So I would like to have your opinion on what should I do and also if the neosporin will be a good replacement or which other antibacterial ointment could I used on him that is not bad for my current status.
    I haven’t had any final answer in the foundation I am trying to get help from. Other two they coulnd’t help me because of his age and other because is not doing any help for now.
    I really feel bad that because I cannot give him the medicine or clean him up right now, he might die. If it would be a hope for me that at least can give me three months once my mother come she might be able to help me. At that point I would have my baby born already….. Please if you can give me any advise I would really appreciate it. Thank you

  • KAT

    Aloha Dr. D~

    My 12 year-old Lhasa Apso recently had a MST surgically excised. The biopsy reported clean margins, a mitotic index of 3 (less than 5 yea!!!) but a not so fabulous, cryptic grade of 2/ borderline 3. Her vet suggested chemo as a precautionary measure to prevent other MST’s from developing…but I am hesitant to agree given the low MI and a few other factors. For example, I first discovered the tumor a little more than a year ago and brought her her to have it aspirated. I was told it was a little hematoma and not to worry…so I didn’t. I mention this because most of the research I’ve done on MST’s revealed that tumors which have been present for any great length of time are usually benign…so there’s the year-long time factor in our favor in addition to the low MI. The 2 / 3 grade is really the only thing worrying me and leaving me a bit perplexed as far as whether or not to further medicate my dog and would be grateful if you could please advise…

    I should also probably mention that–prior to surgery–her tumor suddenly started increasing in size from 2cm to 5cm in less than a month. We put her on a protocol of Prednisone & Benadryll 1 1/2 weeks prior to surgery to shrink the tumor which, by the way, had also ruptured and was seeping and turning necrotic before it started shrinking down.

    The sutures were removed today and she seems to be healing quite nicely. She is still taking the Prednisone (though a much lower dosage so it doesn’t interfere with her post-surgical healing) 2.5 mg every other day & 25mg Benadryll. I also have her on a grain-free diet…organic meats & veggies…broccoli sprouts, sardines, 1200mg Omega 3’s & a few alkalizing supplements. Ideally, I would like to ween her off the Prednisone and just stick to Benadryll & the specialized diet and hopefully avoid the other chemo protocols my vet suggested (Vinblastine, Palladia, etc.) entirely as I do not want to give her something I am not even sure she really needs…

    Mahalo for your time…and your wonderfully informative website!

    Sincerely,
    KAT

  • Bill

    Dear Dr. Dressler:

    I am so grateful to have found your website and hope you can be of some assistance.

    I have a 10 year old female beagle that up until now, has been a very healthy and active dog. She presented herself 3 months ago with what appeared to be an insect bite on her rear large pad. It took the 3 vets all of this time to finally diagnose her with a Mast Cell Tumor Grade 2 after biopsy. We also learned it had spread to the lymph node of the same leg. I have already spent over $3,500 dollars (more than I could afford) to finaly get this diagnosis. The last vet to see her was an oncologist who told me I had to do radiation, surgical removal of the pad(even though they cannot get clean margins), pad reconstruction, chemo, prednisone and weekly labs which she “guestimated” would cost be between 8 to 13 thousand dollars. I cannot aford this and I’ve become desperate. This dog means more to me than I can explain in this Email. She has been with me through thick and thin. I want to do everything within my means to save her.

    I have read nearly every blog on your website and searched the internet for hours hoping I could find something that would help me determine the correct course of action to take. She is currently on Prednisone 15mgs BID, Pepcid 10mg QD, and Benadryl 10mg TID. She’s been on these meds for 2 weeks now. I have not changed her food because I’m confused as to what best to give/prepare for her and have gotten no direction from my vet to do so.

    Is Chemo a way to go without doing radiation and tumor excision? What do you think her chances of survival would be based on doing these things alone. I cannot afford radiation, labs and surgery and if I were to find the money to do that, the vet gave me a 40% chance of remission/survival. Please help me. What would you advise I do and/or not do?

    Thank you very much,
    Bill and Bessie.

    • Dr. Dressler

      Bill
      Have your vet (or yourself, but that is second best) contact Dr. Albert Ahn at AB sciences in New Jersey. Have your vet tell Dr. Ahn I sent you.
      It is important to have your vet in on this. Have your vet tell Dr. Ahn you are interested in the compassionate use program for masitinib.
      Dr. Ahn will know what to do from there.
      Best,
      Dr D

  • Jeannie

    Hi Dr. Dressler. Our wonderful dog Lucky just had a MCT removed from his arm pit. The biopsy report indicated the miotic index was 14. We have seen an oncologist and he does not give him more than 2 years to live even if we put him on a new chemo therapy pill and continue with the Benadryl and Pepcid. Our regular vet is going in in a few days to remove the local lymph node and some muscle tissue that indicate cancer cells still remain there. The spleen and all other tests were fine. Our regular vet thinks we should try the Prednisone and maybe hold off on the Chemo treatment. I have heard of a lab in Michigan that can further test the tumor to determine what it is likely to do. Please advise us with your opinion, we would appreciate it so much. We so want to save Lucky and any discomfort, but like other people in these posts, we are confused.

    Thanks so much, Jeannie

    • Dr. Dressler

      Jeannie,
      the mitotic index, in this case, is more predictive than the tests you are talking about . The odds statistically are high that this is an aggressive cancer at this stage and the Michigan panel will likely not yield further useful data. All we have to look at are stats. You certainly should make sure that a wide excision was done in the first place, and if not a second surgery should be performed to remove as wide margin of tissue around the tumor area in the hopes of removing as many cancer cells as possible.
      You also need to read this post very carefully and then re-assess your situation:
      http://www.dogcancerblog.com/the-most-important-question-in-dog-cancer-care/
      The e-book I wrote may help as well.
      Best,
      Dr D

  • Jeannie

    Hi Dr Dressler, I forgot to provide some other details in my previous post. Lucky is only about 4 1/2 years old. I first felt the lump under his skin about 5 months ago, and it slowly came to the surface. I took him to the vet (saw a different Dr.) in September and it was diagnosed as a wart-mole. I was advised to watch it and if it changed or bothered the dog, I should have it removed. I did just that 2 weeks ago and that’s when they biopsied it and it came back as MCT. we are so upset about this, especially since he is incredibly healthy. Please let us know your opinion.

    Jeannie

  • Carla Benoist

    Hello Dr. Dressler, Thank you for being here.

    You said ”
    Bill
    Have your vet (or yourself, but that is second best) contact Dr. Albert Ahn at AB sciences in New Jersey. Have your vet tell Dr. Ahn I sent you.
    It is important to have your vet in on this. Have your vet tell Dr. Ahn you are interested in the compassionate use program for masitinib.
    Dr. Ahn will know what to do from there.
    Best,
    Dr D”

    Is Dr. Ahn a specialist for masitinib (now I have to look that up, new information)? for MC cancer? Do you know about Dr. Mauricio Couto’s work in the Greyhound Wellness and Oncology program at Ohio State University? My 2 vets have been consulting with him (at my request). I’ll keep this short. Thank you.

    • Dr. Dressler

      Dr Ahn is president of AB Sciences, located in New Jersey. AB Sciences is a pharmaceutical corporation. The are waiting for the FDA approval of masitinib. AB Sciences will sell it in the USA after FDA approval. Dr Ahn is the one who supervises the importation of masitinib from France under the auspices of the compassionate use program. Get your vet involved in this by having him/her contact Dr Ahn.
      Dr D

  • hitaloyappy

    Thanks for the informative information – I enjoyed reading it! I always enjoy this blog. :) Cheers,

  • Gary

    Dr. Dressler, I just found out that my English Bulldog, 7 years old, has a poorly differentiated Grade III mast cell tumor. The biopsy report said the “mast cell tumor appears completely excised.” However, it says her mitotic index is 6/10. How bad is that number? Thank you very much.

    Gary

    • Dr. Dressler

      Dear Gary,
      you need to understand this is a very serious cancer. The statistics are rather dreadful: less than 2 month survival time for a grade 3 mast cell tumor with a mitotic index of greater than 5. I would consider the whole arsenal in a 7 year old Eglish Bulldog, depending on what type of person you are (how risk averse). I would utilize the full range of surgery, chemo, possibly radiation (the latter two under oncologist supervision), as well diet, supplements, life quality measures etc. that I describe in the Dog Cancer Survival Guide. You should also pay close attention to the treatment plan analysis portion of the book due to the grim numbers involved in cases like your dog’s, to make sure that what you do makes sense to you and feels right from an ethical standpoint.
      Dr D

  • Jonny White

    Dr. D,

    Our 5yr old Great Dane/Lab mix recently had a tumor roughly the size of a walnut removed from the back of her leg. The pathology came back as Grade I mast cell tumor, with a mitotic index of 0-1. However she has 3 other smaller growths the size of a pea in other surgically aceptable areas.

    My question is are we likely to have ongoing tumors appear and what is the prognosis if we continue to see new tumors. Can we expect to have all of these sucessfully removed thru surgury given her pathology or is her outlook likely to deteriorate over time.

    My vet seams optomistic but we don’t want to be caught of guard given this may not be the only malignant tumor.

  • mike

    fyi..i just purchase paladia from my vet for $220 for 30 pills for my schnauzer

  • http://www.eventphototampa.com Todd Gilman

    Hi Dr. D,

    I just read this article and was hoping you could comment. My dog’s mast cell tumor had a mitotic rate of 0-1 when staged back in Sept. It was excised, with narrow margins the first time and came back in 2 weeks, so the vet did it again and got wide margins, again with 0-1 MR. The tumor came back again and we were referred to http://www.fvs.com They have given him every chemo drug in the book(vinblastine, palladia, lumostine) and he has not responded at all. His lymph node was the size of a tennis ball. The oncologist gave us a drug from Europe(I don’t remember the name). It shrunk the lymph node by half but that was all.

    I was hoping you could comment on how this tumor is so aggressive with a mitotic rate of 0-1. Nothing we do works. Also, if you have any advice on any other options, it would be greatly appreciated. For your info, Kramer is a 11 y.o. Weim/Greyhound mix.

    BTW, Got the book and thought it is very well done.

    Thank you very much for your time.

    • Dr. Dressler

      Dear Todd,
      the Grade of the mast cell tumor is the first thing that predicts behavior. Mitotic index is a second level predictor once the grade is established and is most useful for Grade 2 (intermediate grade) mast cell tumors where you don’t know if it will behave aggressively or not. Then we look at mitotic index and some other things to try to predict behavior.
      I hope this helps
      Dr D

  • Russ

    Dear Dr. Dressler

    Lola, my four-legged companion has had over 50 tumors removed since September of last year. Lola has been with me for nine years at the end of April. I assume Lola to be at least eleven or twelve years of age since she was a stray.

    When I brought Lola into my home, she had two bumps on her. The dermatology vet hospital where I took Lola, told me to ignore the bumps because the bumps were nothing more than fat tumors. The dermatology clinic owners have a monopoly of dermatologists in southern California, Hawaii and other locations. So, getting a second opinion is impossible. Instead they put Lola through all kinds of allergy tests because she had terrible allergy problems. Not once did they mention the use of Benadryl.

    Three and half years later, one of the two bumps changed colors. I knew something wasn’t right. I took her to a vet hospital to it aspirated. The bump Came back positive and the two tumors plus a third were removed. All grade 2, level 1. Had the dermatology clinic performed their job as they should have, I would’ve taken a complete different path for Lola’s health.

    First of all, I wouldn’t have allowed all those various vaccines to be given to her. It wasn’t until after the fact that I learned all those vaccines are not good because of the potential diseases they can produce. I would’ve taken a more holistic approach to her diet as I now do, and eliminated many of the drugs I believe have caused her immune system to be challenged.

    Recently, six active tumors were injected with a very small dose of steroid. Since Lola’s system is very sensitive, the oncologist said the amount given is far below what is normal for a dog her size and weight. Lola does react well to the small dosages.

    Now I am at a cross roads of what to do. The oncologist suggested a chemo drug (the generic version) as a pill to give her. I’ve resisted this because I am frightened by the potential side affects. What do you think?

    Sincerely,
    Russ

  • Russ

    Oops! I should have said — over 50 tumors removed since September of 2005.

    Thanks

  • Russ

    Dear Dr. Dressler,
    Thank you for your reply. When it comes to fish, is it ok to use fish oil in her diet?
    thanks
    Russ

  • Gary

    Dr. Dressler,

    Hi. Thank you for your very informative site.
    We have a 8 year old previously healthy Basenji who was diagnosed w/ grade 2 MCT, low mitotic index in the proximal aspect of her upper limb (FR leg). No mets. Resecetion was done: grossly normal margins but ditry margins microscopically and given the location, the surgeon felt they couldnt go wider.
    Our vet discussed RT, which is not done in our state (UT) but could be done in CO. We met w/ an oncologists who felt we’d have very good odds w/ Masitinib as a first line thereapy post-op.
    What do you think? They inidcated a better than even chance of no recurrance and in the case of a local recurrance, the option of RT would still be feasible (though Ive read those recurrant tumors can change grade and be more malignant and aggressive)
    Ive had a hard time getting numbers for mastinib in this type of case (limb, resection w/ microscopic dirty margins Grade 2).

    Seems hard to predict those grade 2’s, but is this a a reonabale approach? Try Mastinib and if any recurrance, go to RT (assuming we have the option). Or is it too risky and RT a better option by far (which my wife is less enthusiastic about).

    Thank you.
    Gary

  • Jan

    Dr. Dressler,
    Thank you for this informative site, I will be looking to purchase the survival guide. My 4 year old mini dachshund developed a lump on the top of her left front paw, it seemed like the area arose overnight. I brush her regularly and she goes to a groomer and neither of us had noticed it. Our local vet was unable to draw any fluid from the growth and surgically removed it. We were called last night and told it is a Grade 2 mast cell tumor, with “low mitotic index” – no number given.
    The neoplastic cells extend to the margin per the phone report. I plan to get a copy of the report. We have an appointment next week with an oncologist. Our local doctor did not recommend anything in the mean time. What are your overall thoughts? Thank you so much.

    • Dr. Dressler

      Dear Jan,
      Get a wide excision scheduled as soon as possible. Although spread is not hugely likely, try to get complete blood work, a urine test, and an ultrasound of the abdomen done before this to make sure there is not obvious spread before putting your dog through another surgery. Change to the dog cancer diet in the Guide (and the rest of the plan) and get your Apocaps to start 10 days post op.
      Best of luck,
      Dr D

  • Rebecca Cowan

    Hi Dr. Dressler,
    I just stumbled across your site after searching for information on canine mast cell tumors. My 10 yr old whippet/lab/terrier mix Keko was diagnosed this week (via aspirate) with a mast cell tumor on his right front leg, a couple inches below the elbow joint. We have done radiographs of the chest and abdomen and an abdominal US, all came back clean.

    Due to the location of the tumor on my dog’s very thin front arm (approx 7 cm in diameter at the location of the tumor), it seems highly unlikely that an excision could be accomplished that will yield clean margins without resorting to an amputation. My vet and one oncologist who has been consulted are also reluctant to do a punch biopsy because of the risk of dumping all those angry cells into Keko’s system. We are therefore looking at amputation of the front limb as one option for treatment; however it seems we would be taking this (drastic) measure without being able to grade/stage the tumor or determine the mitotic index. Am I thinking of this correctly? Are there other ways to get this information (like from another aspirate – and would that pose risk similar to a punch biopsy)? Any other data we could use to help us know how aggressive this tumor is?

    It would seem a shame to remove Keko’s leg for what might turn out to be only a Grade/Stage 1 tumor.
    Many thanks,
    Keko’s family in Hawaii

  • DIANA

    DEAR DR. DRESSLER,

    MY FOUR YEAR EIGHT MONTHS OLD TOY MANCHASTER TERRIER GOT A SMALL WART REMOVED THAT HE HAD FOR 1 -2 YEARS. THERE WAS NO CHANGE IN SIZE OR COLOR AND EVERYONE THOUGHT IT IS JUST A WART AND HARMLESS.

    MY INSTINCT TOLD ME TO HAVE IT REMOVED LAST WEEK, WITHOUT ANY DIRECT REASON. THE DOG WAS NOT LOSING WEIGHT. HE IS AN INCREDIBLE EATER AND RUNS 2-4 HOURS A DAY. HE ACTUALLY GAINED 1,5 POUNDS, WHICH WORRIED ME (HE IS 13,6 POUNDS). WE FEED HIM A RAW DIET, HE GETS CHINESE SUPPLEMENTS AND VITAMINS AND MINERALS AS WELL AS LIQUID SHARK CARTLIDGE. HE IS VERY ACTIVE AND WE ARE DOING A COMPLETE BLOOD CHECK WITH TITERS ONCE A YEAR (WAS JUST DONE 6 MONTHS AGO).

    THE BIOPSY HOWEVER CAME BACK AS A GRADE ONE MAST CELL TUMOR AND I AM DEVASTATED. WE HAVE AN APPOINTMENT WITH AN ONCOLOGIST ON MONDAY I AM TRYING TO FIND SOME SPECIALTY LABS IN THE LOS ANGELES AREA TO HAVE THE NODULE REEXAMINED IN DIFFERENT LABS, AS I DON’T REALLY TRUST THE PLACE THAT HAS DONE THE BIOPSY IN ARIZONA.

    HERE IS HOW THE REPORT READS:

    EPIDERMIS SHOWS MILD ACANTHOSIS, MILD PIGMENTATION, MODERATE LOOSE ORTHOKERATOSIS. HAIR FOLLICES ARE MIXED ANAGEN AND HAIRED TELOGEN WITH MILD LUMINAL KERATOSIS. SEBACEOUS GLANDS ARE NORMAL. DERMIS CONTAINS SMALL SLIGHTY RAISED AND MILDLY CIRCUMSCRIBED SUPERFICIAL PROLIFERATION OF SMALL MODERATELY WELL DIFFERENTIATED NEOPLASTIC MAST CELLS, MIXED WITH SCATTERED EOSINOPHILS SURROUNDING A FEW ADNEXA. SURROUNDING DERMIS HAS MILD PIGMENT INCONTINENCE AROUND THE BULBS OF A FEW FOLLICLES.

    TUMOR IS SUPERFICIAL AN APPEARS TO BE ADEQUATELY EXCISED. PROGNOSIS IS CONSIDERED FAVORABLE, FOOLO UP AND REEAMS ARE RECOMMENDED

    PLEASE LET ME KNOW WHAT I CAN DO TO PREVENT ANY FURTHER MAST CELL GROWTH. I STILL DON’T UNDERSTAND HOW ALLERGIES OR INFECTIONS ARE RELATED TO A GROWTH OF A MAST CELL TUMOR. IS HIS IMMUNE SYSTEM TOO WEAK OR TOO STRONG TO ALOW THAT. HE NEVER HAD ALLERGIES OR ANY INFECTIONS I KNOW OF. PLEASE DOC LET ME KNOW HOW SERIS THIS IS. THE LITTLE BOY IS MY LIFE AND I AM HAVING A NERVOUS BREAK DOWN.

    THANKS,

    DIANA

  • DIANA

    DR. DRESSLER,

    I FORGOT TO MENTION THAT THE NODULE WAS REMOVED FROM THE TAIL, ABOUT UPPER MID SECTION.

    DIANA

  • Randi

    I have a 18-month old Chihuahua-Labrador mix. About 6 weeks ago a 2 cm tumor appeared out of the blue on her right front leg. It was removed but the vet was not able to get much margin because of the location of the tumor. The tumor was not encapsulated and there were mast cells in the margins they were able to remove. It was diagnosed as MCT Grade II with a mitotic index of 2 and I was referred to an oncologist. She presented me with 4 options: watch and wait, conventional chemo (Vinblastine and Lomustine), Masitinib and radiation. I’m in a complete quandry on what to do.

  • Jaime

    Hi Dr.,

    My pit bull/rotti mix just had a MCT on her front limb removed. It came back as a grade 2 and the vet says that because of location, they were not able to get a good amount of margins around the tumor. All blood tests, x rays, and buffy coat came back clear. She is 11 years old and the MCT was removed about 1 week after I noticed her licking at her leg and noticed the tumor. Is radiation the answer? Or are medications a better choice? The vet told me radiation will cost me about $10,000 and I can try to do something to get that money but as of right now I do not have it. My dog is my best friend and I will do whatever is necessary, someway somehow. Thanks in advance.
    Jaime

    • http://DogCancerBlog.com DemianDressler

      Dear Jamie,
      first you need to find out the mitotic index. This tells you how aggressive these gray zone cancers are. Read this post. Ultrasound is the imaging of choice if you were to pick one to assess spread of mast cell tumors. You might want to get an oncologist involved here! If no spread and regrowth is occurring as a last resort, ranother option is removal of the affected limb. Here is more info on that, (focusing on bone cancer but the gist is the same). Other steps I would be taking here are Apocaps, diet change, supplements to help slow metastasis, benadryl, cimetidine, consideration of masitinib (check into the compassionate use program at AB Sciences in New Jersey), brain chemistry modulation to a cancer fighting state, and more. Please take some time to get and read the Guide- I think it will help you. Remember to have all steps supervised by your vet/oncologist.
      Best,
      D

  • Ann

    Is the wide excision surgery ALWAYS advisable? My dog Wally just had a mast cell tumor removed from a few inches above his penis. It is Grade 2. Wally is approximately 11-12 years old. I do not yet know what the mitotic index indicates, but if it shows below 5, for quality-of-life reasons, would you endorse not doing the wide excision? It seems that if the index is low, the likelihood of spread is low, so why put the dog through that second surgery. If the index is high, again, why put the dog through it? Thank you for any advice.

  • Matt

    My 8 year old Rhodesian Ridgeback just had an MCT removed from an area just behind is right front armpit. The biopsy came back as Grade III with MI of 18. Chest X-rays and abdominal ultrasound show no organ tumors at this time. The vet has advised a course of Vinblastine and Prednisone.

    Based on my research, the avg life expectancy for a Grade 3 / MI 18 tumor is three months even though he shows no other symptoms at this point. Would you still recommend proceeding with the chemo? Not knowing much about the mastineb, would this be a better approach?

    I have just purchased your book and looking forward to learning more. Thank you.

  • steve

    Our 5 year old golden retriever had a 1cm mast cell tumor removed from his left hip area two weeks ago. The lump had been there for two months but had not changed in size at all in that time and he had no systemic symptoms. The bad news was that the tumor was a grade 2 but the good news was that the mitotic index was 0 and there were 7 mm clean margins all around the mass (10mm might have been better but 7mm wasn’t bad). We were actually feeling pretty good about the prospects of a surgical cure until a spleen ultrasound yesterday showed a 2cm hypoechoic mass in his spleen. The question I guess is whether this is a metastatic lesion from the mast cell tumor, a new and different primary malignancy, or a coincidental benign tumor. (I almost wish now we stopped at the Mitotic Index of 0 and hadn’t done the ultrasound.) So my question is this…what next? Do we watch the mass and just re-image it in 4 weeks, do we needle biopsy it and run the risk of associated bleeding and a possible second anesthesia to remove the spleen if the biopsy is bad, or do we just bite the bullet now and remove the spleen without a biopsy beforehand. He’s only 5!!! (I’m a pediatrician myself so I am medically sophisticated in the human world.)

    • http://DogCancerBlog.com DemianDressler

      Dear Dr Steve,
      As you know we don’t know the nature of the mass without cytology or biopsy. Statistics these days point to 75% of Goldens ending up with cancer. If this were my dog I’d explore the abdomen and biopsy. Yes, could be benign, or a hematoma, or something else, but assuming all other testing is normal we just don’t know, and mast cell tumors sometimes don’t read the book. I’d rather have a diagnostic surgery than do nothing. My two cents…
      D

  • steve

    We took the spleen out two days ago on the theory that if the mass were malignant (MCT or otherwize), it needed to come out; and if it were benign, well then at least we would know that and wouldn’t have to worry…and who knows, maybe by taking his spleen at 5 we will prevent him from getting a hemangiosarcoma at 8. (We lost another Golden 3 years ago to that nightmare.)

    The path report came back today as benign nodular hyperplasia, so needless to say we are delighted!!! Some might argue we took his spleen out unnecessarily, but I would not be one of them.

    With the risk to Goldens being as high as it is, especially for hemangiosarcoma, I almost wonder if a preventative splenectomy at age 5 wouldn’t be a good idea. (Unfortunately, many might not be able to afford it.) Thanks for your input.

    • http://DogCancerBlog.com DemianDressler

      Great news doc!
      Stay in touch
      Best,
      D

  • Judy

    I have a 16 year old cocker who had been diagnosed most recently with kidney failure in march 2010. She also had a nasty e coli infection that kept muating through several drugs and we finally conquered it with sub q injections of meripenem, which she is still on. She has a hx of bladder stones, IMTP, and chronic IND – she has also had pancreatitis in the past as well as vestibular. She is a very spunky girl. Two weeks ago she awoke with a huge lump just above her anal gland. it was purple. I took her to the regular vet and they tried to express the anal glans, which made it worse. Then they did a needle aspirate and she bled for two days. I took her into the specialist who had been seeing her for the kidneys and he diagnosed a mast cell from a bood sample. Due to her age and condition her recommended tricolsane (sp?) injections – she was put under for a couple of minutes. The first treament resulted in the tumor shrinking and she was up and about and a little piggy. The second treatment a week ago seemed to leave her very lethargic and her rear legs are very weak – weaker than they were before. She walks for a short distance and then she slowly sinks to a sitting position. Her appetite is still good but she tires very easily.The specialist wants to put her on Paladia but my gut feeling is it will do more harm than good – she has always had chronic IBD – so much so that if you change her food at all, even to a bland chicken and rice mix she gets bloody diarhea with frank blood for days. Right now she is on Royal Canin canned Renal LP modified mixed with cream of wheat, baby sweet potato, baby turkey and Cranimal powder, Do you have any stats or research on Paladia and kidney dogs or dogs with IBD. She takes 1 mg pred 2 x a day (has for years for her immune issues), 1 mg thyroxine 2x day, 1 pepcid 2x a day, a meripenem injection 2x a day, 100-200 ml lactated ringers sub q per day and 4 ml aluminum hydroxide liquid after each meal. She is also on 1/2 benadryl 2x a day. She weighe 20 lbs. She is my family and the light of my life. I rescued her on new years eve 2004 – they said she was 10 years old and she was blind and partially deaf. What supplements can I give her with the kidney issue and how can I slowly adjust her diet to help with the cancer?

    • http://DogCancerBlog.com DemianDressler

      Dear Judy,
      this sounds very hard for everyone. Tricky stuff here. No stats I know of to answer this question. I’d have your oncologist contact Dr. Ahn at AB Science to see if you can get Masitinib under the compassionate use program.
      Yes, lots of supplements. Have you read the Guide? An easy read and I believe you will find a lot of useful information. As to the kidneys themselves, I’d be using Azodyl as a minimum, of course all under veterinary supervision.
      Hope this helps,
      D

  • Deborah

    Hi Dr. Dressler, We found out two days ago our 2yr old female boxer “Roxy” has MCT. She had 4 lumps that I saw so I took her to the vet. One on her nipple two on her neck and one on her rt hip they looked pretty small.The vet wanted to do surg asap so the nexxt morning she went in. The ultrasound was negitive. When Roxy was in surg. the vet discovered one more lump on her ear and removed it as well. All 5 are MCT. The vet said they look like 2or3’s. Roxy is so young what are the chances of her getting more of these or it matasticing? Please help me understand this?. Thanks Debbi

  • Renee

    Hi Dr. D.
    I have a 10 yr old Lab/sheppard mix girl named Almond! She had surgery 12/6/10 to remove a mast cell tumor. Results came back as a Grade 2 with clean margins and her mitotic index was low like 1 (cant remember the wording). I brought her last week to an oncologist and now Im so confused on what to do. The doctor said that there is alot of positives on my baby’s side. But the only thing was the size that she questions. The size was alittle under the size of a nickel. It would go down and come back but never got bigger. I had noticed it in August,2010 and the vet at the time said to watch it. Not knowing that the fact that it was getting smaller and coming back was a sign. I thought if it got bigger than to worry! Anyway the problem I have now is deciding on what to do. She said I could wait and see just keep having her checked or I could do Chemo & the drug Palladia. Can you please advise what you think? Im so scared to make the wrong decision. If I do the drugs she could have a side effect and if I dont she could have the cancer spread. She says her chances without Chemo are 70% and with 90% but there is a 10% side effect with the drugs. Please help me! I want to do the best for my dog! I Love her sooo much! Thank you in advance!

    • http://DogCancerBlog.com DemianDressler

      Dear Renee,
      This is a great question for a blog post. I will answer in the next general post!
      Best,
      Dr D

  • Jeannine Sovet

    Dear Dr. Dressler,
    My 12 yo Bichon Stella was diagnosed with Mast cell on her (L) hind leg in Aug. 20, 2010. She had a wide margin excision on 09/2/10 which came back as grade III with dirty margins and lymph node involvement. I found your website and ordered your survival guide. I started her on your cancer diet right away. I also started her on K9 immunity plus, milk thistle, a multivitamin, benedryl(25mg) tid, Cimetidine(200gm) bid , and 1000mg fish oil tid. I got her into an oncologist and he started her on masitinib on 9/23/10. Her tumor was already starting to grow back at this time. Two weeks after starting her on Masitinib her enzyme levels in her liver started to elevate so we discontinued treatment and the following week when I took her in to see the oncologist we started her on the triamcinolone injections which she has been getting every two weeks since then. Now it Jan.22, 2011 and it looks like the injections may not be working anymore.. Twelve days from her last injection her tumor grew so large and looked so mean and she was in pain and I thought it was going to burst so I rushed her to the vets… The oncologist said we would probably have to start thinking about what are next options are for my little girl… The injection brought it down to about 50% it usually brings it down 75%. It still looks very angry but it is not bothering her at all, but now she has blood in her feces (which she never had before). She is still a very happy, energetic dog, still full of life and still getting into trouble(Stella’s usual). I’m scrapping the bottom of the barrel to pay for her vet bills. Is their anything else you can recommend we try. If the injections are not going to work to keep her tumor at bay and it gets any bigger then it did the last time I fear I will have to put her down due to the pain it is causing her.( it doesn’t seem to bother her at all when it The thought that I will have to put her down while she still has so much life in her just kills me. I would do anything for my little girl but i will not let her suffer in pain… Please Help..

    Sincerely,
    Jeannine and Stella

  • Jen

    Hello Dr. Dressler,

    I wanted to follow up on an earlier post. I have heard about mast cell stabilizers used successfully in humans and, through a search, found this thread and an earlier question about whether these could be used to treat canine MCT. My 11-year old Lab has had 8 MCTs removed over the past 8 years – all grade 2 (so, about 1 surgery per year). He’s been through a lot of surgeries. He’s getting older and doesn’t bounce back quite as well from them now.

    I would love to find something that may have a chance of preventing tumor growth. Do you see any potential for mast cell stabilizers, such as Ketotifen? Or, maybe quercetin would have a similar effect. Have there been any studies on this to your knowledge?

    Thank you in advance for any comments or insight you could offer.
    Jen

  • Cristina

    Hello Dr. Dressler,
    my dog American Staffordshire Terrier 6 year old has a mast cell tumor on the hind leg, just above the hock. Current size 3cm x 4 cm.
    It is became visible as an insect bite at the beginning of December, believing that I was not worried. As a result of having grown up in January I brought him to my vet. After a week of antibiotic has been done fine-needle aspiration and further the tumor is ulcerated, swollen and raised. 1 week after the analysis has formed another small nodule (3-4 mm) and analyzed by our oncologist considered as “compatible with metastases”. It could have been formed because of fine-needle aspiration.
    Oncologist said me: first staging, afer surgery.
    We have completed staging: chest x-ray, abdominal ultrasound with fine needle aspiration liver and spleen, there are no metastases and all analysis are normal. Prednisone caused diarrhea by a week. Now, the oncologist, becouse of the second nodule, want to do a cycle of chemotherapy (2 or 4 therapy sessions) – for cytoreduction and operating margins as clean as possible – before surgery.
    Personally, this change of direction gave birth in my mind to many questions about how to intervene, especially as it is not certain that the chemo ensure what the doctor is hoping (clean margins). Like any pet-owner I want give him the best, Can you let me know your approach in similar situations to evaluate other opportunities to better treat my dog. Sorry for my english..
    Thanking you in advance, best regards
    Cristina

    • http://DogCancerBlog.com DemianDressler

      Dear Christina,
      as far as conventional oncology goes, this plan sounds very much according to standards. Don’t forget the diet, supplements (apocaps, omega-3, K-9 immunity, artemisinin, etc) discussed in the Guide.
      If surgery is not an option, one could consider Neoplasene, but be prepared to deal with an open wound for what may be a long time. Hopefully famotidine and benadryl are being used too..
      Of course, be sure to make any changes with veterinary supervision.
      Best,
      Dr D

  • jess

    Dear Dr. Dressler:

    I have written to you before and purchased your book and have read everything I could possibly find on mass cell. My Boxer Scarlet is currently on CEENU (Lomustine) she was on the protocol vanbalastin before but, the cancer started growing again and their is lympe involvement, Palladia was considered but, the Ceenu seemed to have the best trials. The tumor looks as if it has stayed the same size on the surface but, the last X-Rays showed it had gone deeper. Is compassionate program with Dr. Albert Ahn regarding the drug Masitinib an option if my oncologist request it. Scarlet also on predisone, benedry and Cimetidine, Apocaps. We also have her on Reishi mushrooms. My Oncologist is aware of all we are giving her and has been as helpful as she can be. She is not a canidate for surgury and is stage 3 mct.
    We, are trying to prolong her life and her comfort but, we are getting short of funds and I want to have an answer if this drug must be stopped because it has stopped working. I want her to be well, but I know I must do what right for her. I have noticed in the last day or so that her breathing has been more labored but, it hard to tell if the predisone side effects or it’s because the lymp mass cell has gone deeper. I am taking her to my vet tomorrow – I look forward to your response and appreciate any advice you could give.

    Regards,
    Jess

    • http://DogCancerBlog.com DemianDressler

      Dear Jess,
      Sorry to hear this- sounds very hard.
      if the drug is not working discuss discontinuing it with your oncologist. You might also consider Neoplasene at this stage. I hope this helps,
      Best,
      Dr D

  • Jenifer McClellan

    Dear Dr. Dressler:

    I recently adopted a 7 year old rescue dog (Wiemeraner/Lab mix) with Diabetes and Thyroid Desease, both are now under control with proper exercise and diet and medication. I discovered a swelling on her front leg and a smaller swelling on the back thigh, they looked completely different from each other. I took her to my vet, he said it wasn’t swollen and no idea what it was. A few weeks later it happened again in both area’s and I took her to another vet who said they were Mast Cell tumors. I called the rescue group and found she had a grade 2 tumor removed 8 month’s ago on the front leg and this was a recurrence, and another removed from her belly which now has also recurred plus the new one on her thigh, and since have found numerous more small ones. I had some asperated and 1 out of 3 came back positive, so my vet sent me to an Oncologist. The Oncolgist has diagnosed her with Cutaneous Mastocytosis and said she has 3 to 6 months to live. She does not recommend surgery as there are so many tumors and the larger recurrence on her front leg removed last year and could only get 1mm margins (clean) but there is not enough tissue to work with and the muscle would be very damaged trying to remove it again, the leg would be useless. So Chemo has been recommended 8 treatments and then inhibtors there after. My question is, is this a reasonable thing to do for her. She is not in pain, has been on Benedryl and Pepcid 2 weeks now (ordered by our vet) but with her Diabetes and other heath issues I am unsure of what is the best course of action for her??? Any advice would be appreciated. Jen

    • http://DogCancerBlog.com DemianDressler

      Dear Jennifer,
      you need to do a treatment plan analysis as is discussed in the Guide. Get an idea of side effect frequency, side effect severity, what the life quality negatives are with treatment, what are the odds of a response given the recommended treatment, and what is the added life expectancy (median, like an average) with the treatment. Once you obtain this specific information from your oncologist your decision will clarify.
      Best,
      Dr D

  • Clarissa S

    Dear Dr. D,
    I have a 4 year old Boston that just recently had two mast cell tumors removed from his hind leg. They were fairly small and close to each other so only one incision. One of the tumors came back after biopsy as a Grade I, the other was diagnosed as a Grade 2. In reading the reports of the biopsy, the findings say similar things for both “Nulcie are pleomorphic with scattered chromatin and a low (<1 mitotic figure per 10 hpf) mitotic index". The comments on the Grade 2 tumor are more extensive. I'm wondering is it possible for a Grade 1 and 2 tumor to have similar mitotic figures? The recommendation from my vet was to see an oncologist. Should I have cause for concern?

    • http://DogCancerBlog.com DemianDressler

      Dear Clarrisa,
      i too would see an oncologist, especially if your vet is recommending it. This tells you that your vet is suggesting more expert advice, and if your vet is telling you this, I feel it is sensible wisdom. There are more aspects of a pathology report than mitotic figures, and there are other determinants of tumor behavior as well. However, right off the bat, I have cautious optimism that things will be okay. But it is important to follow your vet’s advice. I hope you are also using the other steps to help your dog? Diet, apoptogens, immune support, and the rest of the steps in the Guide??
      Best,
      Dr D

  • Julia

    Hi Dr. Dressler,

    My 8 1/2 year old mixed breed dog had a stage 2 mast cell tumor removed from his hind leg about two months ago. The incision site took several weeks to heal; it kept ripping open and having to be re-stitched. The lab said the removal had incomplete margins. My vet sent me to an oncologist and we had a tumor marker test done that came back with a 65 reading (I’m not sure what this means exactly, but apparently over 54 is likely to metastasize). The oncologist is recommending localized radiation as well as chemotherapy asap.

    I’m not sure yet what myself, my wallet, and most importantly my dog can handle. While I understand nothing is 100%, I am trying to weigh the potential of a successful outcome with the negatives.

    What I cannot seem to understand is this: Since the radiation will have been delayed so long due to the difficult healing, is it still nearly as effective?
    Also, how much should I take the tumor marker results to heart?

    Thank you for any input in this confusing time,
    Julia

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  • Catherine

    I have a 11 year old German Shepard mix with mast cell cancer :( she had a tumour on the upside of her index finger removed, it was a nasty surgery. After 5 1/2 weeks the wound is still open and bleeding a little. Is this normal?. Also, we soak her foot in water with a small amount of Epsom salt and then use neosporin and wrap it. My question, is this the correct protocol ?
    Thanks

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  • pam

    Our 12 year old Mini Schnauzer was diagnosed with a low grade malignant tumor after many invasive procedures to determine this diagnosis. Long story, but our wonderful Vet, of 30 years, removed a malignant tumor from her armpit and got “clean margins” of 1 millimeter. Another long story short, our home town vet hospital recently sold out to a corporation “VCA” as the original doctors are about to retire. Fortunately, our Dr. is still on the same page as us, and told us “if it were his dog, he would not pursue the radiation therapy” that the VCA corporation suggests.

    I have come to realize that we put our pets through these invasive medical procedures, not for them, but for ourselves!! If our pets (dogs, cats) could talk, and we asked them if they wanted to go through surgeries, do you think they would say YES?? Of course they would not!!!!!!!! Animals instinctively mask pain as a right of survival. They know that they need to be strong to survive!!

    I hope my words will convince pet owner’s to think of their pet’s rather than themselves when it comes to pain and their beloved pet’s tolerance for pain.. they will mask it for you as they love you sooo much!!

  • JD

    My dog was diagnosed with mast cell cancer almost 5 years ago. I took her to a new vet for her regular exam and shots. The vet noticed that my dog had a small lump on her belly about the size of a nickel. I didn’t want it biopsied because I knew I couldn’t afford to have it treated and besides, she’d had the lump for about 2 – 3 years already and it really hadn’t changed much since I first noticed it. Well, the vet went ahead and stuck a needle in it anyway and then charged me 89 bucks for the test… well within 2 months of that test the tumor had grown to the size of a small orange, and was softball sized within the next 18 months. I was a little more financially stable by this time, so I had the tumor removed, but I still unable to afford ‘treatment’. I’ve been giving her 100 mg Benadryl daily for about 5 years. We are now 7 – 8 years post initial tumor, 5 years post dx. She has several more small tumors and lymph nodes are all enlarged, but she is fat and happy. She eats, has full bowel and bladder control, runs, plays and enjoys her life. She is now 13 and is almost at her life expectancy. I am not so sure that all this treatment for cancer is necessary or beneficial. I am glad I never subjected her to the Side effects of chemo. I think that the assault to the tumor during the biopsy sped its growth. The vet initially told me my dog would die within 2 years w/o treatment… that was 5 years ago. Could it be that the treatment is worse than the disease?

  • Jennifer

    Hi,
    Our American Bulldog was just diagnosed with a grade II mast cell tumor. The report says the tumor extends to the deep surgical cut margin. It was located on the back of his right rear leg and our vet said he cut all the way to the muscle. Does that mean that it’s in his muscle also? Also on the report it states: “The skin specimen from right caudal thigh contains an infiltrative neoplasm composed of atypical mast cells and eosinophils. Mitotic figures are not seen in 10 HPFs.” what does all this mean? Thank you do much

  • Jennifer

    Dr. Sue,
    Thank you for the information! I took Big Boy to a veterinarian oncologist last Wednesday and was given two options, chemo or amputation. Since chemo isn’t something we can financially afford we are going to go the other route. The oncologist didn’t say anything about scar revision but she said its very difficult to remove a tumor completely from that area. What are your thoughts?

  • Jeannie G.

    Hi Dr.: We removed MCT, Grade 1, on my 13 year old dog, and another mass has just returned in the same general area (spine/back). Organs were CAT scanned and nothing else found. Margins were clean on the first MCT, and it presented differently than this new one (which is more like fatty tumor but firmer). We’re going for a biopsy on the new mass, so I wanted to just clarify your comment: ” …if the tumor has a mitotic index of less than 5, it usually will behave less aggressively and in my opinion do not require surgery, as long as you have clean margins on the removed tumor.”

    To clarify, if the mitotic index from the second mass is benign or less than 5, removal of the second mass may not be necessary in your opinion? (knowing this is not a diagnosis by you). If not, what surgery is not necessary?

    Thank you in advance!

    • DrSueCancerVet

      Jeannie,
      Dr Sue here! =) All MCT should be removed, even if the mitotic index is low. I have written a series on MCT discussing grading, staging, surgery, chemo etc. In addition to mitotic index there are other important predictors. Please check out the series: You can start here:
      http://www.dogcancerblog.com/the-oncologists-thoughts-on-mast-cell-tumors/#.UkjXwee9KSM
      If the tumor cannot be removed, you could consider radiation or chemo. Another situation where I might not recommend surgery – multiple tumors at one time, like the dog I managed with greater than 10 MCT. She went on chemo.
      Good luck! All my best, Dr Sue

  • Jason

    Hi Dr., My 11 year old dog recently had a mast cell tumor removed that the pathologist described as a Grade 2 MCT with a mitotic index of 0 and clean margins. This seems to carry a fairly hopeful prognosis, but I wanted to ask whether preoperative prednisone could distort the mitotic index. Our dog had been on a low dose of prednisone for 10 days, ending 4 days before surgery (and 5-6 days before the pathology report was compiled). Is this mitotic index still a reliable measure?

  • onevoice1914

    It gave me comfort to read your story. I am in the exact same situation with my boxer, he is 13 and has 2 -MCT on his side, eating well, still wants to play. It seemed more cruel to put him though all that during his last years. And actually thought it would do more damage at his age and speed up the process of the unenviable.

  • Dr. Demian Dressler

    Dear Farokh
    I am sorry to hear about this.
    You need to get the biopsy report back before surgery. There is risk of spread, and the type of cancer helps tell us where to look for the spread before doing major surgery. This is not your question, but is your next step nonetheless. The ulnar resection is possible but the problem is you will not likely remove the cancer cells with it. Thus you would need to diet your dog and help your Buddy up the stairs…not an easy answer I am afraid but it is doable.
    I hope this helps
    D