Dear Visitors:

I am not a vet. I don't even play one on TV. What follows here are my personal observations and experiences with a hemangiopericytoma tumor in our dog. I'm telling my story to help anyone who happens to find our site. I can in no way guarantee that you will have the same experience. And there is no way that what I've included here is a replacement for what you hear from your vet. I just wanted to include a real story in the hopes that it will help alleviate the fear I felt the night I got the diagnosis.

Please feel free to e-mail me personally if you have any questions about our experience. annenoe@aol.com

We noticed a small (golf ball size) lump on Mickey's back right leg. We had assumed (big mistake!!) that it was nothing more than a fatty deposit so did not rush to the vet. After some months, we finally had the vet take a look. She did a quick needle aspiration and confirmed that it was not fat. Apparently, they can tell very quickly whether it's fat, but not whether it's cancer. Since it was not fat, she recommended surgery which was performed on November 16, 2001.

After removal of the lump and a biopsy, it came back as a tumor known as hemangiopericytoma. Not a bad cancer, but cancer nonetheless. It has a low rate of metastasis, i.e., its tendency to spread to distant tissues like lungs or liver. However, without aggressive treatment, it has a high recurrence rate, i.e., its tendency to return to the same spot. Each time it returns, it would mean additional surgery and more and more muscle tissue would have to be removed. Sooner or later, Mickey could lose enough muscle mass to render him lame.

Because of its high success rate, we have opted for radiation treatments. Mickey will undergo a series of 12 treatments, M/W/F of each week for 4 weeks. Our oncologist has assured us that the chances for full recovery is 85%, i.e., the chance that there will be no recurrence of the tumor.

Obviously, this will be very hard on both parents and dog. For Mickey, while there is no real pain or major side-effects, he will have to be taken on a 1-hour drive, be placed under anesthesia, get the short treatment, stay at the vet until he is fully conscious, then take the 1-hour return drive. And repeat this 3 times a week for 4 weeks. To add insult to injury, to ensure a rapid and healthy recovery, the vet says that we must, under all circumstances, keep him from licking the radiation site, which will become more and more irritated as the treatments progress. So, he will be required to wear one of those "space-station" collars, which he absolutely hates. And, while he is suffering through all of this, we will have to stay with him 24x7. I am not at all comfortable leaving him alone with that dreaded collar on for fear that he will do himself a mischief. So, we're expecting it will be hard but also expecting complete recovery.

I will post updates here on our experience. I hope it might help someone else who will have to go through this with their dog. Please feel free to e-mail me if you have questions.

 

We started treatments on January 22 and finished on Monday February 18th. It turned out we needed 13 instead of 12.

Final cost for the radiation alone was $2690. Each session cost $95 for the treatment (ours was considered simple) + $95 for "Anesthesia Less than 50 lbs." for a total of $2470 (13 x $190). In addition, there was an initial charge of $220 on the first day that had to do with making sure the radiation was directly exactly where it was supposed to go. The entire cost includes $150 for the initial visit during which they aspirated the lump and $700 for the removal of the tumor, both done at Adobe Animal Hospital. Once the diagnosis came back positive for cancer, we had consultation with Dr. Linda Fineman of Pacific Vet Specialists (in Capitola). At that time, we opted for an x-ray of his heart and lungs to determine if the cancer had metastasized (which it had not!!). That visit cost $250. We will have one more final visit with Dr. Fineman next week to make sure everything is going well. I expect that visit will be another $150. So, all told, it will be around $3800 for the entire process. Yes, it's a lot. And I can only be thankful that we had the money. Though I will thank Uncle Sam since our refund from the IRS this year will cover the whole thing. Good karma I guess.

Initial visit	$ 150
Surgery	$ 700
Oncology consult	$ 250
Initial radiation set up	$ 220
13 "simple" radiation treatments @ $190	$ 2470

Our treatment were performed at the Veterinary Tumor Institute in Santa Cruz, CA. Our specialist was Dr. Geri Carlson. In our case, each treatment took approximately 2 hours, sometimes an hour and a half. Our drive "over the hill" (as we say here when you drive from Santa Clara Valley over Highway 17 to Santa Cruz), turned out to only take 35 minutes thanks to good weather (thank you weather gods!!) and an appointment time that put us outside the heavy commute window. By the time we picked him up, he was a bit groggy. Just enough that he would sleep most of the way home. But the effects of the anesthesia was minor.

First of all, I can't say enough about the staff at VTI. They were wonderful. So wonderful in fact, that after the first few treatments, Mickey would trot into the back without a care in the world. Now, I certainly can tell you that if he was frightened or upset in any way, he would not have been so eager to go with the techs. They are all wonderful, kind and gentle folks.

As for the actual treatments, they have been relatively easy. We noticed no change in Mickey's behavior or overall health. No pain, eating just fine, full of energy. In fact, he did not really need the collar until last week. However, as we came to understand, should the skin become irritated due to licking, it could mean having to suspend the treatments, i.e., they can't continue radiation on skin that is not intact. For that reason, we never left him alone without the collar. When we were with him and could watch him, we left it off.

Now, as for his recovery. As we had been warned, the effects of the radiation did not show up right away. In fact, we did not notice any real irritation until last week (after treatment 11). It has been a little over a week since we began to see a change. In that time, the skin has gotten very red and flaky. In fact, it looks like a bad sunburn. Mickey is obviously uncomfortable. He doesn't like to lay on that side, it's tender to the touch (so we don't touch it much), and he is definitely favoring the leg when he walks. He sometimes holds weight off it when he stands. We are using a pure aloe spray we got from the vet but that's the extent of medication and we are limiting his exercise (no 6 mile walks until he is feeling better).

All in all, it was not as bad as we thought. More importantly, there have been only minor ill effects on Mickey. We're seeing it now, but expect he should be back to normal soon.

Do I recommend it? Well, in our case, the money was available and our dog is young (he'll be 7 next month). We felt we had to give him a chance. A couple of weeks of inconvenience and minor discomfort are well worth what we hope will be a very long life. Only time will tell if he is completely recovered.

I'll continue to update his story with any news of significance.

April 11th. Well, it's been a month and a half or so since we finished. I wish I could say it's completely healed but Mickey is still showing irritation. It's slowly getting better. We still have to put him in the collar when we leave him but he's showing less tendency to scratch and bite. Unfortunately, the site is still very ugly, discolored and the hair is only just beginning to grow back. Our main concern now is how much scarring we will see. But, I think we're finally beginning to see the light at this very long tunnel.

We had a follow-up visit with the oncologist at 2 weeks after the last treatment. The plan is to continue to have follow-up visits at longer and longer intervals. The next one is scheduled for 2 months after that last treatment. Then we will continue to follow-up with her. We don't know yet when we will be able to say he is "cancer-free".

That's the latest. I'll post next when the site is completely healed (with pictures of course!)

April 27th. I've added the latest picture of the site. It's really nasty looking - very black. The hair has still not come in. He has finally stopped chewing at it so we have some peace and quiet. I'm still not very hopeful about how much scarring there will be. Against his white coat, I think he will always carry an ugly black patch. I guess it's a small price to pay for his health.

 

April 8th - 2 years later.

Good news - no recurrence of the tumor!!!

The leg still carries the bald spot - the hair did not grow back completely. A very small price to pay.

The only question left in our minds is something that came up just after he recovered from the radiation. We noticed that he was favoring that leg - he was not limping or showing any obvious signs of pain, but we did notice that when he was standing, he would either pick up and replace the foot repeatedly, or, would simply not put weight on that leg. It clearly bothered him. We saw our regular vet, and got a second opinion with Dr. Gary Brown (very well-known orthopod located in Fremont, CA). At the time, they were not positive but suggested a partially torn ACL. Surgery is an option, but considering Mickey had just recovered from the tumor, we decided to take a "wait and see" approach and give the poor little guy a breather.

In the two years since, the situation has continued to deteriorate. He now has regular (several times a day) bouts of obvious pain and he is clearly favoring that leg. We are on our third, fourth and fifth opinions. Because this is clearly some sort of soft tissue problem, no one can be absolutely positive, but the diagnosis has now switched to luxating patella, a condition, common in Fox Terriers, in which the knee cap will not stay "seated". In other words, his knee pops out. All the symptoms point to that. The leg actually looks wobbly (it's hard to describe), sometimes he sticks it straight out - either behind or to the side - sometimes the leg is just "off-kilter", sort of sticking out at an angle, sometimes he pulls the leg up completely, close to his belly, and hops around for a minute or two. Then, as suddenly as it happens, it seems to be fine and he's his normal self. This is clearly not symptomatic of something like a tear that would be constant - it is episodic.

Our theory at this point is that during radiation, while Mickey was under anesthesia and they were getting the leg into position, that somehow the ligaments that surround the knee were compromised, stretched a bit too far. Obviously, Mickey could not register a complaint - he was out cold. Whether Mickey was predisposed to this (as I mentioned above, this is a common condition in SFTs) and the condition was aggravated by the manipulation of the leg, or whether is was a direct result of the radiation, or whether it was all just coincidence, we'll never know for sure - but we lean towards this being a result of the radiation. I have repeated this to our vet and she agreed that it could have been caused by the radiation treatments.

So, I guess the only take-away here is that depending on the location of your dog's tumor, there may, and I repeat may, be some chance that manipulation of the leg could result in a secondary problem. But, I really must stress that we have no proof, and more importantly, we harbor no grudge. We would not do anything differently. In hindsight, I only wish we would have known the condition of the knee before radiation started. Our vets have been able to manipulate the leg and "feel" the looseness of that joint (this is how they have come to believe the problem is a loose knee joint, not a torn ACL). We will just never know if the condition existed before the treatments, and we just did not notice it until our observations were heightened as we watched him recover. My best advice at this point is if your dog's tumor is located on the leg, you might repeat this story to your vet and just have them check the health of the joints before you start. Knowing there may be a problem might be good information for the radiation techs before they start.

And lastly, if you get this far, we can only offer our sincerest best wishes for the full recovery of your "baby". Since I put this site up 2 years ago, I have heard from a number of owners going through the same thing. So I repeat, please don't hesitate to email me if you have any other questions. I will offer whatever information I can.

Cheers,

Anne