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Excerpt from our July
newsletter
by
Chiclet T. Dog
I’m
going to break with tradition and let you read my diary,
an act usually punishable by a slow, painful licking to
death. Something scary is happening to my boyfriend
Jiggy, but it taught Mom and me so much we wanted to
share it with you. You may think it doesn’t pertain to
you. We didn’t think it pertained to us either—until it
did. It’s about cancer, something afflicting half of all
older dogs who die of disease—and lots of younger dogs,
too. Please read on and find out what we’ve learned. It
could help you with any major medical situation.
June 13. Jiggy’s latest blood test
reports that his liver enzymes, which have been behaving
themselves for several years now, have mysteriously
risen. Dogs can look
and feel terrific (Jiggy did) and still have an
underlying disease process. That’s why your dog needs a
yearly checkup and blood test. (Dogs over six
should get two checkups yearly.) 
Anyway, Mom decided to have his teeth cleaned because
bacteria lurking in his
gums could be causing, or at least, exacerbating the
problem. His liver disease makes anesthesia
problematic so we opted for anesthesia-free cleaning by
someone who works with our vet and who actually does
sonar cleaning up under the gums. But that’s another
story.
July 3.
During cleaning, the dental tech found a lesion on
Jiggy’s throat. You have to pull his tongue aside to see
it unless you’re my size and are faced with it he yawns.
It looks like a thin slice of pencil eraser (the tasty
kind), except it’s oval. It’s rough and red in the
center, smooth and pink around the edges. Even though
Mom brushes our teeth daily, and checks around our gums,
she never would have
found this lesion herself.
Dr. Brook Niemiec, a board certified veterinary
dentist, told us he finds tumors all the time during
cleaning—often when they’re small enough to be
removed for a complete cure. Unfortunately, if we
wait for our moms and dads to find them, tumors tend
to be the size of golf balls. You Humans just aren’t
very observant.
When was the last time you inspected your dog’s
whole mouth? (Depending on the dog’s temper
and tooth size, this job is often best left to brave
professionals. Getting your dog to that professional
regularly is your responsibility.)
July 5. A world-famous oncologist checked
Jiggy’s throat and said that if Jiggy were a pup, or
chewed bones or sticks (which he doesn’t), he’d presume
that the “spot” was just an injury. Pressed by Mom, he
guessed that, in Jiggy’s case, there was maybe a 50%
chance it was cancer. I could tell the news wasn’t good
because Mom started crying. She made herself stop when
Jiggy looked up at her with concern.
It’s important not to
stress the doggy patient.
The oncologist suggested an immediate x-ray, CT scan,
blood test and biopsy. You need an empty stomach for
some blood tests and for anesthesia, and Jiggy was
brought in fasting. She almost handed Jigs over for the
tests—she was so anxious and scared—until I gave her
that “get a grip” look I have to give her sometimes.
I know she always
advises people to take a breath and take a break.
She needed to think things through before letting
anyone cut on my Jiggy, so she rescheduled for tomorrow.
We
took Jiggy home and Mom called out our holistic vet. He
told her to get the biopsy. My worry-wart Mom would have
to know what was happening. He also said to have them
remove the entire lesion rather than take just a small
piece to test—if they could do so safely and without too
much trauma. Why?
-
It
is not uncommon for biopsies to have to be repeated
because they yield inconclusive results.
-
-
You may have to pay for everything again to take
another sample or to remove the lesion/tumor.
-
-
Your want to avoid
the risk of administering anesthesia again.
Of course, if the mass
can’t be easily and safely removed, that’s a
different matter.
Mom decided to consult
the vet who helps with Jiggy’s liver about the
advisability of giving him anesthesia even once. She
made an appointment for a phone consult the morning of
the 7th and postponed the biopsy again.
July 6. Waiting
for the consultation gave Mom time to think and make
plans:
1) She had time to
line up experts.
She contacted her surgeon of choice, because her
oncologist wasn’t a surgeon. The first vets to see
potential cancers usually aren’t even oncologists. The
person who does the biopsy can determine much of the
success, or failure, of the entire treatment. Don’t
leave this decision to chance.
2)
She remembered that Jiggy had a loose tooth that could
probably be slipped out during the biopsy. He had been
on antibiotics for the teeth cleaning so infection
shouldn’t be a problem. (Otherwise, it might.) They
could do this simple procedure inexpensively without
further danger to Jiggy.
3)
She remembered that Jiggy was on herbs; something the
surgeon and anesthetist should know. She had time to
stop them.
4)
She could get our
Arnica Montana (available at your health food
store or holistic vet) to help limit bruising and
bleeding—and thus speed healing. Our vet recommends it
before and after surgery.
5)
She could give Jiggy
some Rescue Remedy before leaving him at the vet to help
keep him calm.
6) She could prepare
his favorite carrier for him to stay in at the vet.
She taped his photo (left) to the carrier so they’d know
who Jiggy was and whose carrier it was. (They leave it
open inside his cubicle.) She could also spray the
carrier with D.A.P. for a little extra emotional comfort
and tuck in his favorite stuffed toy. Otherwise, he’d
have to wait a long time in a hard metal cage with
nothing to do but go berserk.
7)
The surgeon and oncologist both recommended a CT Scan
immediately before the biopsy. Mom’s first instinct was
to say no. We didn’t want him under anesthesia any
longer than necessary. Both doctors insisted that the
scan was necessary to determine the size and depth of
the lesion, and to determine where to take the biopsy.
Mom had time to do some investigation and reluctantly
agreed that was the best course of action.
July 7. Mom talked to our
consulting holistic vet this morning. Mom described the
lesion and answered a lot of questions. They decided we
should watch the lesion for a week or so to see if it
healed. No one wanted Jiggy to be traumatized
unnecessarily while his liver was misbehaving. (Some
cancers are aggressive and need immediate attention; we
had already determined that Jiggy’s lesion didn’t appear
very aggressive—we hoped.)
Mom canceled today’s biopsy but wanted the oncologist to
look at the lesion again. Our onco-doc wasn’t working
that day so she scheduled a recheck with his partner.
Second opinions are
always a good idea, even when your vet is a
friend or top expert.
The new vet introduced himself as the only guy in the
practice who had never treated Jiggy (only a slight
exaggeration). He looked down his throat and said it
looked like an injury that was healing. Yeah! Then
Jiggy’s surgeon wandered by and took a peak. He thought
it looked like a chemical burn.
If
this lesion were on trial for being cancer, we clearly
had reasonable doubt.
The new doc gave Jigs a blood test at Mom’s request. The
results came back immediately from their in-house lab.
Jiggy’s liver enzymes were completely wacko. If they had
used our regular lab the results might have been
different, so they stuck poor Jiggy again and stole more
blood. Mom hopes you’ll remember this when checking your
own dog’s progress from an illness.
Different labs yield
different results. Save yourself some money and grief by
using your usual lab whenever possible.
July 10. The results from our regular
lab showed a much less dramatic rise in the liver
enzymes but there’s clearly work to do.
July 13. Jiggy’s regular vet sees Jiggy’s
throat and says he “doesn’t like the look of it.” We get
scared again.
July 19. Mom and I left Jigs this morning
for another blood test, a chest x-ray, CT scan and
biopsy. We think the lesion looks smaller but because
mouth injuries usually heal quickly because of good
blood supply, and this one hasn’t, we’re going for the
biopsy. At 3:00 PM they called and said to come get
Jiggy. The CT scanner wasn’t functioning and we’d have
to postpone. Both Mom and I screamed. Jiggy was just
thrilled that he could eat.
Mom considered taking Jiggy elsewhere
but not all practices
have a CT scan, a board-certified surgeon skilled in
operating on small dogs, anesthetists skilled in
administering anesthesia to small dogs (so important!)
and an oncologist on staff. And no one else knows
about Jiggy and his liver or knows that he’s a perfect
dog.
July 24. The CT is up and
running and so we left Jiggy at the vet’s. Our surgeon
and Mom agreed to proceed conservatively—to do a blood
test then tranquilize Jiggy enough for the surgeon and
oncologist to really look at Jiggy’s throat and poke at
it with their fingers to determine what it felt like. If
they thought the lesion looked like it was healing, we’d
postpone again. Otherwise, we’d go ahead with the
procedures.
A
few hours later we got a call. Jiggy’s liver enzymes are
way down! Also, both vets agreed that the lesion looked
better and recommended that we should just keep and eye
on it and wait. Please keep your fingers and paws
crossed for my dear friend and think good thoughts. And
give your own dog a hug for us.
August 15.
Jiggy's throat lesion completely disappeared. Several
weeks later, it was back in a different spot--then
disappeared again. It appears to have been, for the want
of a better term, a "reverse freckle" on his pink and
black palate. As far as I know, it may have been
changing since he was born.
November 20. Jiggy has a new, larger
"reverse freckle." We'll continue to watch it and see
what happens.
Summary.
Taking the conservative approach not only saved Jiggy an
unnecessary surgery and anesthesia (at least we hope it
has), it was about 1/10 the cost of a more aggressive
approach. Even if we had decided to take the aggressive
route, the delay would have allowed us to make Jig’s
ordeal much more comfortable and safe. When it’s
not an emergency, there
are many benefits to proceeding with caution.
Absent proof positive, even the best vets (and doctors)
are just making educated guesses, and even great minds
differ. It’s up to you to advocate for your dog, make
the best decision you can, and then, for heavens sake,
relax! You humans can drive us crazy with that annoying
crying.
Disclaimer: We are not veterinarians. If you spot any
unusual lesion or any other signs of cancer, please see
your veterinarian--or better yet, a veterinary
oncologist. If your dog has been diagnosed with
cancer, please check out our chapters on major medical
problems and the links on our link page.
