Brisbane's Cancer Treatment

On Wednesday, Brisbane's tumor went from annoying to serious. The outside lump grew an entire centimeter in one week. Inside his mouth, the mass got even bigger. It started getting in the way of his teeth, got infected, and on Wednesday started bleeding a whole lot. Did this bother Brisbane? Not particularly.

I've always said I wouldn't do tons of unpleasant treatment to try to keep a suffering animal alive, but Brisbane isn't suffering. I had thought the tumor would be painful, but it clearly isn't bothering him much because he happily chews bully sticks with great enthusiasm even when he's bleeding everywhere.

So we're doing palliative surgery to remove as much of the mass as possible. This definitely won't be a cure, this type of cancer is very invasive locally and makes a mess of things, with tendrils all over the place. There may be some nerve involvement, and he could lose some facial control on that side. He will definitely be losing at least one tooth in the process, and that's just fine. Heck, he could lose that eye and it would be fine.

This surgery is all about balancing cancer removal with recovery difficulty. The goal is quality of life rather than cancer eradication, so the vet won't be trying to get good margins. Only as much as can be removed with a short and easy recovery.

I spent a lot of time this week worried that this was the end, that Brisbane's quality of life would get so bad so fast that I would have to say goodbye way too soon. I don't want to put him through painful treatments and make him miserable in order to prolong his life. I just want him to be happy and comfortable.

Is Brisbane happy right now? Hell yes! He is the happiest dog. On Tuesday we went to our first Barn Hunt class and he got to search piled up bales on hay for rats safely hidden in plastic tubes. Most of the dogs there found the rats because they expected to get a food reward for their efforts. Brisbane's reward was finding the rats, each time he located one he would pounce on the tube with glee and ignore food entirely. A few days before that we went out to practice herding and he screamed with delight at the sight of the sheep. A couple of weeks ago we went lure coursing and he ran as fast as ever.  His appetite is great, he loves doing tricks, and aside from the tumor he is a very healthy dog.

So now we're going to fight the cancer in order to keep him happy. He will be hospitalized for a few days so the vet can monitor his recovery and better tailor the treatment plan. We're trying high-dose vitamin C because there are apparently some promising studies, it's inexpensive, and won't make him feel sick or hurt him if it doesn't work. The vet has also been reading studies on experimental treatments involving injecting the tumor itself with chemotherapy drugs. We are hoping that this type of treatment will help slow the cancer down for a while without making Brisbane feel sick.

Keeping him happy is the entire point, and when he can no longer be kept happy I'll know he's ready to leave me. In the meantime, we have a GoFundMe set up to help with his vet bills. We're getting donated chemo meds so the bills aren't going to be crazy. We would appreciate as many shares as we can get, please help Brisbane keep being awesome if you can!

Yup, It's Cancer.

Well, Brisbane's suspected carnassial tooth abscess did not respond to antibiotics at all. In fact, it may have gotten bigger. The vet numbed his face down and stuck the bump with needles and sent whatever she got out to the cytology lab.  We were expecting results back within a few days, but I was told that the initial report was not particularly detailed or helpful. Our wonderful vet spent the next two weeks chasing down the pathologist who did the report and shaking them down for answers. Here's what we learned:

It's Definitely a Mesenchymal Cell Tumor.

Mesenchymal cells are undifferentiated stem cells that can turn into all sorts of things. Sometimes they get a bit messed up and start turning into the wrong things. This is a very big category of tumors though, and encompasses the entire group of soft tissue sarcomas. I believe this was all that came back on the original cytology report

It's a Soft Tissue Sarcoma.

Again, this is a great big group that encompasses things as benign as those fatty lipoma lumps old Labradors tend to grow, and as horrific as the deadly and aggressive hemangiosarcoma. That's basically the entire range of severity when it comes to bumps on dogs. Could be something completely harmless and painless, could be acutely fatal cancer-of-the-everything that's undetectable until it's in the late stages. Again, not that helpful an answer.

It's Likely a Hemangiopericytoma.

This is a type of peripheral nerve sheath tumor. Without doing a major surgical biopsy we can't be sure, but the pathologist said there is a very good chance that's what we're dealing with. These tumors are usually localized, but also aggressive. They don't spread to other parts of the body or hostilely take over the lungs most of the time, but they do tend to grow and bother the structures around them. Typically these are treated by removing them surgically and then using radiation to make sure they're really gone. If not completely obliterated, they tend to grow back even more aggressively.

The Good News.

Brisbane has a low-grade tumor, the type that is least likely to metastasize to other parts of the body. He doesn't appear to be in any pain from the tumor, he is still behaving normally and gnawing bones and bully sticks with that side of his mouth.

Not exactly devastating, but not great either.

The Bad News.

The location means it is unlikely the tumor could be removed completely enough to prevent regrowth. Surgery and radiation treatment would be a long, painful process that would ultimately do very little for Briz besides make him miserable. 

Where We Go From Here.

So, at the recommendation of my vet, I am doing nothing about Brisbane's tumor. Well, actually I'm monitoring and measuring it and researching stuff and my vet is also casting far and wide for other treatment options. Mostly I'm just not going to put him through surgery. There is the possibility that the vet can inject the tumor with something to help shrink it whenever it finally starts to bug him. I first noticed the tumor a little over a month ago and in that time it has grown to 4x3.5 cm as of Saturday. It might keep growing steadily until it impacts his quality of life, or it might not even shorten his lifespan. For now he is a happy dog with a full and joyful life, and I'm going to enjoy him for as long as I have him. We have a sheep herding trial coming up in a couple of weeks, and we're ready to get his next Trick Dog Title and start looking into Dog Parkour and Cyber Rally. 

Vet Time: My Dog Has a Bump On His Cheek

Brisbane has a big bump on his cheek, and it's probably an abscessed tooth. Poor Briz! At first I was worried it could be cancer, but several of my internet friends have suggested that it looks like an abscessed carnassial tooth. Those are the biggest back teeth in the upper jaw. Of course we're going to the vet later today. I noticed the bump on Friday night, when all veterinary issues arise around here, but Brisbane's doctor doesn't think this is an emergency situation so we're waiting for an available appointment.

What are the Symptoms?

The bump on Brisbane's face is very hard, it feels just like the other side of his face except for the shape. It doesn't feel warm to the touch, and he doesn't mind me poking at it so it doesn't seem to be causing him pain. He is still gnawing bully sticks happily on both sides of his mouth and basically acts like he is fine.

The bump has actually been there for about two weeks, but it has been slowly growing and wasn't big enough for me to really identify it as a problem until Friday. I didn't think it was an abscess at first because it isn't hot or painful. Brisbane actually has beautiful clean teeth, another reason I didn't suspect an abscess.

Is this an Emergency?

According to my vet, the probable-abscess is an urgent problem, but not an actual emergency. As long as Brisbane is eating normally, drinking normally, and breathing normally, he can wait a few days for an appointment with his regular vet. Given his various health issues, I'm comfortable waiting to see the doctor who knows him best. I did call the clinic that did Ru's dental a few months ago, but they were unable to see Briz before today either.