Hi Dr. Dressler,

My dog was recently diagnosed with Mast Cell Tumor Grade III. My vet said to just wait and see. After much research on-line I chose to contact Cornell University to schedule an appointment with an oncologist for further testing. The tumor which was located on the perineal groin (just a little to the left of her tail) was completely removed by my vet on Oct 22nd and I just went for the oncology appt on Monday Nov 24.

The tumor was a clean removal (7mm margin with no cancer cells along the outside of the mass) and the testing (blood work, urine, ultrasounds, bone marrow, lymph nodes) all came back clean with no signs of metastisis (spreading). There was a concern with a mildly enlarged left inguinal lymph node but upon aspiration there was an insufficient amount of sampling and with two hypoechoic nodules on the spleen but they were non characteristic of Mast Cell and they were aspirated and showed no signs of Mast Cells. According to these results this would be a stage 1 - 1 tumor in the skin with no lymph node involvement (which is a very good thing however it was classified as a Grade III which is considered a very aggressive form.) I’m assuming that this would be the stage as I had to specifically ask ‘does this mean it would be a stage 1′ and the dr had to look over some information to determine if that is correct.

My dog is showing no signs of having a disease. She is eating normal, maintains a normal level of activity, doesn’t have any stomach issues and is eliminating feces without any problems (color & texture is fine).

The doctor at Cornell put her on Pepcid AC (famotidine 10mg) 1 tablet per day and Benadryl (diphenhydramine 25mg) 2 tablets per day. She suggested that we start Chemo with lomustine (CCNU) orally and 21 days later vinblastine an injection. I questioned about prednisolone as I have read that vets often prescribe this steroid even before they perform surgery. The doctor added this to the protocol - Prednisolone 20 mg 2 per day for 2 weeks, 1 per day for 2 weeks and then 1 every other day. I have started the Pepcid, Benadryl, and the Pred for the last week.

The next day (Nov 25th) on the phone when I received more results she told me she made a mistake about the dosage for the Benadryl & it should be 2-25mg tablets 3 times per day (total of 150 mg per day). I was worried about once a day. I don’t want her to be tired all day long. I still haven’t started doing 3 doses of Benadryl only the orginal once a day at bedtime. I asked the Dr. yesterday (Dec 1st) about Loratadine (Claritin) instead of Benadryl as it is non drowsy but she put me on hold and looked up in her books and told me she could not find that drug as being approved for animals.

The Prognosis, according to the doctor, is without treatment median survival is 6 months or less and with the Chemo protocol approximately 50-60% for dogs with respond and median survival is 6-12 months. I’m having a hard time understanding why I should start Chemo when there are no systemic signs of the cancer and the margins were clean. It seems like the protocol was the same regardless of the stage.

I asked yesterday (Dec 1st) about the original biopsy report to find out the Mitotic Index because the information I researched suggested that this could play a role in the prognosis. She did not have that report but said she thought she remembered it being high and that she thought she remembered that the features of the biopsy were not characteristic of mast cells which was why it was grade III. I tried to get a copy from my vet today but their copier was down and they would not let the original leave the building. From everything I’ve read the Grade can be somewhat subjective. I don’t have the scientific background to understand everything but I’d like to make sense of what I can.

I’ve asked at Cornell about changing my dog’s diet and immunotherapy but the dr. claimed that this does not apply to Mast Cell Tumor but to other types of cancers. She agreed that my dog should take an omega 3 fish oil but no other supplements. Does this sound right to you? I really have no clue how much to give to a 42 lb dog. Does it have to be for animals or can it be for humans? I found a holistic vet about an hours away that I plan to try to contact again tomorrow. I want to do everything and anything to fight this!

Now I have to make a decision as to whether to do chemo or not. My brain is hurting from all the thinking I’ve been doing. I want to make the best educated decision for my dog. One minute I think I have to do it and the next minute I think she seems fine and why make a healthy dog sick. I need more advise and I’m not sure who to turn to.

I’d really appreciate hearing from you!!!

Thanks,
Kathi

Hello Dr. Dressler,

My 4 1/2 year old Border Collie was diagnosed with High grade malignant lymphoma in June of ‘08. I believe it was stage two. She is on chemotherapy, Madison-Wisconsin protocol and is responding really well, with no signs of any tumors. She did not undergo surgury because, as the Vet said, her abdominal cavity was too invaded to successfully remove it all. None of her vital organs were invaded, not even, surprisingly enough, her lymph nodes! I’m just wondering, with her apparent success with chemo., what are the chances she will continue to be in remission, and for how long? Her final treatment is next week, and her energy, attitude and strength are about 85% of normal.

By the way, the reason we found the tumors in the first place was because her B.M.s had a tiny bit of blood in them and there was a slight ribbony effect to them. It just seemed like there had to be “something in there” to cause that, so I think we were lucky to have caught it so quickly. Although the vet that did the surgery actually recommended euthanasia on the table because the tumors were so invasive.
We’re sure glad we didn’t go that route!

Hi Gwen,
nobody can give you a truly accurate prediction on what to expect in the future, I am sorry. I must say that usually lymphoma is a widespread disease, in spite of the fact that it might be localized to one area. So removal most often is quite a challenge.
If I were to make a guess, and it is a guess only, nothing more, one would be thinking along the lines of perhaps 4-6 months with that description? But I do not want to put a limiting belief in your brain, so please disregard that number!!
I hope that your loved dog is on a special food (ND should be discussed with your vet), along with omega-3 fatty acids, and the other supplements in other blog posts…I hope your BC lives long!!
D

Hi Dr Dressler,
My 11 1/2 yr old black lab just had a mast cell tumor removed from her hind leg last week. We treated her with a dose of Lomustine and Prednisone prior to surgery to shrink it. I take her back this week to see if stiches are healed enough to come out. My vet said it is a stage 11 tumor and she would like to continue ~ 5 doses of chemo. I want to give her the best chance but feel with her age she may only live 6 months anyway. She is diabetic and arthritic and I want her last days to be happy ones. She is active, happy, eats well, plays with her toys etc. I now check her blood sugar everyday. She was well controlled until the steroids. We are weaning her from them now. She did handle the 1st dose of chemo very well, no real side effects other than the myelosuppression. Do you feel she has a chance of doing ok for the reminder of her life with out giving chemo. I don’t want what we have done so far to be all in vain either. I felt maybe we would give her another dose and then call it quits. Would just giving a dose or 2 be of any benefit if I choose not to go for 5 months worth? THanks for your time and opinion.