Mast Cells - Need Advice

[jamesanddean]

In Oct last year I found a small lump on the side of our then 5 3/4 year old male Hunter and I booked him in to the vet to have it checked the next day. When it came time to go to the vet the next day the lump had disappeared and we couldn't find it! We went to the vet anyway and while I was holding him as she examined him I found another lump under his neck. She aspirated the lump and came back and advised it contained mast cells and needed to come off. We booked him in for surgery to take place 2 days later and I went home to research in more detail what mast cells were and the implications for our boy. The morning of his surgery the original lump on his side reappeared which was a blessing as they were able to test it and also remove it at the same time as it too contained mast cells. I was totally shocked when I picked him up from the vet that night to see how significant his wounds were and I felt terrible for putting him through it but it was for the best for him. The pathology results came back a few days later and fortunately it was a benign stage 1 with only a 10% chance or metastasis. We were ecstatic and have enjoyed the last few months with a different perspective on how fragile and volatile their health can be.

On Saturday night I was patting him and I found a large lump on his right hind leg thigh. I was immediately nervous about what it may mean and took him to the vet on Sunday morning to have it checked. She checked him over and also aspirated the lump and after checking under the microscope she advised it did contain some mast cells but also had more other non dangerous cells. She gave him an antihistamine injection and advised us to give him an antihistamine tablet each day and monitor the lump. If it didnt go away it would most likely need to be removed.

It has now been 4 days and although the lump has reduced in size it is still there although relativey small (less than half the size of a 5c piece). I don't want to have to put Hunter through more surgery to remove the lump if not necessry as it is not in a place where it can easily be moved and his skin stretched, but I also don't want to risk it metastasizing and causing something worse down the track. The fact he has had another incident with mast cells less than a year after the first time worries me about what lies ahead in future. Will this be an annual thing?

My question to those who have also had experience with lumps and mast cells is when do you make the call to remove the lump? Should I wait and have it aspirated again in a week or 2 to see what is happening? I don't want to jump in too soon and put him through surgery if it is not necessary, but don't want to risk his long term health either. The vet just says if it hangs around we should remove it but how long do we wait before we do something if at all?

If anyone has had experience with this I wold appreciate your feedback and advice.

[Ivory & Beau]

I'm sorry to hear about Hunter. I know the horror of having lumps removed. Ivy just had her second major lump removal 36 hours ago but thankfully they are just Lipomas [though the second lot wasn't tested]. If they do grow back again, I will go down the path of tests etc but at the moment, we are just thankful she came through the operation [which was really big and $$$].

Ivy and I give you and Hunter our love xx

[cavNrott]

Send a PM to Staffyluv. Her lovely old dog Ollie had a number of mast cell tumours. Staffyluv has a wealth of experience and information about mast cell tumours that I'm sure she will be prepared to share with you.

[Staffyluv]

Jebus, I wish vets would warn owners of the incisions required to get clear margins.

I am sorry about your boy. MCT is often not as bad as it sounds.

Mast cell tumours release histamine - get your dog onto an antihistamine once a day. Ollie was about 22kg and took one polarmine tablet a day for the rest of his life.

What grade were the tumours removed?

Has the vet suggested chemo?, radiation?, or a wait and see approach?

Ollie was grade 2 MCT, with no clear margins on the excision of his biggest tumour. They took lymph nodes near the main tumour site (he had 4 tumour sites the first surgery) and the lymph nodes contained mast cells - he was already systemic. So we chose to do 6 months of chemo (vinblastin and ?? can't remember off the top of my head but it is all in his thread here in this part of the forum).

While he was having chemo and for many years after, we also treated holistically - high doses of vitamin C (1000mg a day), five mushroom drops, lymphodran, anti-ox and a couple of other supplements as well as chinese herbs (the things we do for our dogs hey!)

We made the decision to stop doing surgery when he was 11 years old. He had a toe removed as it showed another type of malignant tumour. He didn't recover from this surgery very well and we decided then, that he wouldn't have any more surgeries, no matter how many lumps and bumps we found. He did have 4 surgeries to remove MCTs over the years.

Ollie's prognosis wasn't very good - his initial prognosis was 12-18 months with chemo.

He lived over 6 years - had a good life and was loved right to the very end.. He was given his wings at the ripe age of 14.5 years old.

[RobynH]

Hi, would like to give you my own experiences of MCT. I've lost 2 boxers to MCT, one dog was aged 9 the other 10. Boxers and Staffy's are both very prone to these it seems which is such a shame as they are both wonderful breeds.

With my first experience, when my dog Chopper was 7 I noticed a small lump on his scrotum. I took him to the vet. He didn't like the look of it and suggested removal. As he was desexed there was lots of skin there so margins were easy. While he was under though he found a smaller lump in his right groin, which he also removed. These were tested and proved to be grade 2 MCT's. His prognosis was still good, I read a lot and convinced myself that was the end of it, even though I read that MCT's on the back end of a dog are statistically more serious. About 8 months later, when he was rolling around on the grass one day, I noticed another lump in his groin, on the other side. Unlike the last one this one was the size of a small hens egg and deep under the skin and it had come up quickly. I took him to the vet again and he wanted to remove it, just to see what it was. I didn't think it was that straight forward. It would be a big surgery given the location of the tumour and I felt that the decision had to be made in the best interest of my dog, not in the professional curiosity of the vet so I went home and discussed it with my husband. Our thoughts were that this was likely to be the cancer spreading. This was not a new cancer, especially as it was in his groin again where all the lymph nodes would be. We could keep operating and hope no more lumps happened but if it was in his lymph nodes it would be circulating through his system and no amount of surgery was going to stop it. We decided to treat him holistically and with love and care and take what we got. For about a year things went ok but then the tumour started growing like mad. We had him put down almost 2 years to the day from the date of the first surgery. As I said he was 9 years old. The tumour was then the size of a grapefruit and the skin was stretched over it so tight we risked it splitting. He still seemed 'ok' in himself but we knew it was time. I somewhat regret not having that tumour removed in hindsight, not because it would have saved him but because it caused him so much discomfort at the end. Perhaps other tumours in other organs would not have been so uncomfortable but maybe they would have been more painful. I don't know.

My second experience was a little different. Bella was 9 when we noticed 2 lumps on her neck. We had them both removed straight away and tested. One was a grade 2 MCT, just like the last dog, and one was harmless. We took on our approach of wait, watch, love and care again and this time no more lumps appeared but after about 18 months, I started noticing changes in her. Her appetite was sometimes off and she wouldn't eat for a day. Her stools were very thin and she seemed to struggle to pass them. Some days she seemed to have abdominal pain. We took her to the vet a number of times (new location, new vet unfortunately)and they kept telling me she was fine. Her blood work was fine, her coat was shiny, she was bright and eating. They gave her some medications for pancreatitis but generally seemed unconcerned.

In Jan of last year we moved overseas where my husband was going to work for a while. Our daughter took Bella but I had grave reservations. I knew something wasn't right but I couldn't get anyone to believe me. Our daughter lived in another town so again another vet. I told her my concerns and my gut feeling that we should perhaps do the inevitable before we left, saving our daughter the prospect of going through some sort of crisis without us. She did the bloods again, they were ok, she looked good and with the vet's reassurance and scheduled follow ups every couple of weeks, we left. First follow up after 2 weeks went fine, second one after another 2 weeks the same and the vet decided to make the next follow up should be 6 weeks, because she looked so good. A few days later our daughter found her under the house in obvious pain and distress and rushed her to the vet. Again the vet thought it was unlikely to be serious but told her to go home, they would do an ultrasound to be sure but come back after work. She didn't even get home before she got the call to come back. Bella had a massive mass inside and would not survive. She was sedated and our daughter took her home for one night so that others could say goodbye and the next morning she was quietly put down. Again this was almost exactly 2 years from first lump surgery and only a few weeks from the point where my gut suggested I should make the hard decision before we left.

We are now going through it again with our third boxer (who we bought overseas with us). Lana is now 7 and has had a lump removed from the inside of her front leg about 18 months ago. This one had aspirations done on it twice, no mast cells (thank goodness) and I was told both times it was a histiocytoma and would go away. It didn't. Just before we left for overseas it was suggested by the QAS vet that it be removed. It was tested and found to be a grade 2 spindle cell tumour but we couldn't get clear margins as there is simply no spare skin there. At least with this prognosis I didn't instantly panic. It was not an MCT. That was all I cared about. This tumour had also first appeared when she was only 4 years old so I had every confidence that the path we were on with this one was different. Now, 18 months and 2 countries later, we are living in India. In the last 6 weeks new lumps have appeared, 2 small ones on the inside of her front legs, one on each side (spindle cell likely) and one very MCT looking one on the back of her right back leg. Chemo etc will not be an option here, I'm not even confident about surgery. Dogs are not treated the same here as they are in Australia. There are thousands of street dogs and most people fear dogs in general, especially my boxer who they think looks like a fighting dog. So far I have not had the lumps checked out. She had a gastro bug some weeks ago and I took her to a recommended vet and found a small shop about 2 meters by 3 meters with 2 surgery tables inside and 4 more surgery tables outside on the footpath and in the car park, treating numerous small dogs, going straight from one to another with no wipedown etc. I'm not sure what I will do as yet.

This is a long post and not a particularly happy one. I know there are some good outcomes for some dogs but for me, much as I love them, I will never get another boxer. I just can't bear to lose another one this way.

Hope this helps.

[Staffyluv]

MCTs seem to show up in dogs that have a history of allergies as well - especially skin allergies.

The body releases histamine in response to an allergy - so do MCTs.. There has been quite a bit of study done on the link.

Back when Ollie had MCT his prognosis was 12-18 months (grade 2, multiple tumour sites, no clear margins).

2 years from dx seems to be a very interesting point in time - it seems so many pass around that time (I was very lucky).

I am sorry for your loss RobynH, it really is an insidious disease but it can be managed to a degree.

Removing the instance of histamine releases by giving anti histamines daily is one thing. A good vet and a good holistic vet that work with the canine oncologist is how we managed to keep Ol well for so long.

[jamesanddean]

Thanks all for your responses. Staffyluv and RobynH you have both had a lot of experience in this topic unfortunately. With Hunter's first round in Oct when he had 2 lumps removed in Oct last year they came back as grade 1 and benign with clean margins. I wasn't sure you could be benign if they were mast cell tumours but am happy to take it if that's what it was! The lump we found last Sat night has now gone down as any insect bite or mast cell tumours can, and it makes you wonder if he has had others we may have missed. My concern is about missing them and what they could be doing internally so I want to take as many precautions as we can.

When he was sick in Oct I did some research about holistic vets and oncologists but never did anything further. Now I would like to talk to one or both before it gets too late and we regret not doing it. I may be worrying too much as Hunter's initial MCT were grade 1, whereas RobynH and Staffyluv's experience has been with grade 2 but I wold rather take preventative action now.

Do you have a view on either holistic vets or oncology vets? I would like to discuss diet and other lifestyle info eg whether to vaccinate again with someone who know something about this subject. Our vet is good but can't really give any specific info or advice. We have him on a claratyne tablet daily at the advice of the vet and we will continue this if that will help.

Do you know any politic vets or oncology vets that you can recommend in Sydney?

Thanks for responding and sharing your experiences, it is much appreciated

[~Anne~]

I am also battling MCTs with one of my pugs, Boofy. I've now decided I will not operate on any further lumps. They just keep coming and 6 major surgeries to remove tumours that were all low and one mid grade, plus having his spleen removed, we've decided enough is enough.

He's now 11. His first came up when he was around 8. We had no more until the last 18 months when they came on thick and fast.

I know what you mean by major wounds. His last surgery before his spleen was removed was to remove lump in his neck. He has a thread here in this section which shows some pics. That particularly surgery seemed more painful for him, as did the spleen. His spleen turned out to be a different cancer, not MCT.

I've decided no more surgery. He doesn't understand why he is going through the whole process. It causes him stress and pain. All of his tumours have been low grade. My vet and the oncologist also decided against any sort of chemo as it wouldn't stop future tumours.

We tried a holistic vet in Sydney, but I was disappointed with the results. There is more info in the thread about Boof and his splenectomy, including loads of advice from Staffyluv and others that may also be of help to you.

Of you feel like reading, here it is;

http://www.dolforums.com.au/topic/244967-boofys-splenectomy/

Edited June 28, 2014 by ~Anne~

[Staffyluv]

I am in Canberra and we used Rod Straw in Brisbane as our oncologist - he is one of the leading canine oncologists in Australia. My link

Our holistic vet was Barbara at All Natural Vet Care in Sydney.My link

Note there are different holistic vets there now compared to when I used them.

Our regular vet was wonderful and used to liaise with both of these vets, for the best care all round.

We used both holistic and main stream veterinary services. Our vet administered the treatments recommended by the oncologist, all test results were sent to both the oncologist and the holistic vet and the holistic vet used to do phone conferences with me to discuss Ol's progress, set backs and what to do next.

His chemo went for 6 months and we used to update the oncologist each year - he was amazed that Ollie lived so long.

Chemo doesn't affect dogs like it does humans - they sometimes get a bit flat a day or so after for maybe a day or so but that is about it.

Ollie had a 3 week chemo protocol. One week he had Vinblastin, the next week he had Lomustine (spelling not sure of it) and the third week was rest week.

Then back to the vets for bloods to see if we could go again.

Sometimes his blood count wasn't high enough to do chemo, so we would wait that week out and go again the next week.

It is expensive and draining - the emotional roller coaster of a terminally ill dog is hard on everyone. We knew we were only buying Ollie time but it was worth it.

After the chemo finished we had the option to go again but chose not to.

He was holistically treated for the next few years and then we just let him be - he still lived a couple of years after this.

If I had to do it again - I would...

[Dave73]

Had my Rhodesian Ridgeback diagnosed with a grade 1 MCT just above his eye it was tiny 2 mm in size. He also has terrible skin issues and we have to keep an eye on all these skin tags as our oncologists calls them, but thankfully the skilled surgeons at SASH got clear margins on it so no need for chemo. He had a full scan and xrays and he was free of any other cancers.

[~Anne~]

He's free for now. I know this sounds negative but I'm not sure there are many dogs who only develop one tumour if it's a mast cell.

[RobynH]

That sounds like an awful lot of treatment and an awful lot of expense Dave73 for a 2mm tumour??? My girl as about 7 lumps, the largest about the size of a marble and have just had an ultrasound to confirm there are no internal masses, which there aren't at this stage, thank goodness. I would like to hope vets don't take advantage of our love for our pets and overservice to extract more dollars. I don't know all the story Dave73 so I may be wrong, but that was my first reaction reading your post.

[~Anne~]

Are the 7 'lumps' all mast cell tumours? Have they been graded?

[RobynH]

Are the 7 'lumps' all mast cell tumours? Have they been graded?

Not yet Deve73 but as I've lost a couple of boxers this way (plus she is a Boxer, one that has already had spindle cell tumour at aged 4), I am pretty sure. If I was back in Australia it would be easy to have them biopsied and graded. Here in India, things are not that simple. But I do know from experience with my other boxers with Mast cell tumours, each time about the size of a 5 cent piece, I had them removed and graded, each time showing they were grade II but there was never a suggestion of full xrays and scans afterwards. We had clear margins each time and was recommended a wait and see approach but it didn't prevent them losing their lives to them within 2 years. I don't think xrays or scans at the time of removal would have shown anything at all. The problems start after removal. In fact I have a feeling removal contributes to a process that starts them spreading. Just a gut feeling.

[Jumabaar]

That sounds like an awful lot of treatment and an awful lot of expense Dave73 for a 2mm tumour??? My girl as about 7 lumps, the largest about the size of a marble and have just had an ultrasound to confirm there are no internal masses, which there aren't at this stage, thank goodness. I would like to hope vets don't take advantage of our love for our pets and overservice to extract more dollars. I don't know all the story Dave73 so I may be wrong, but that was my first reaction reading your post.

Better to remove at 2mm when you might need 1cm margins particularly in such a difficult place! If you waited till it were 1cm then what might happened to the eyelid and thus the eye had they waited! The smaller the lump the smaller the surgery.

Also offering Gold standard standard service is not over servicing- its giving owners the options and choices to make decisions about their pets care rather than dictating.

I hope Hunter is feeling bright and bubbly! I also use Barbra at all natural vet care (she works tues and wed).

Edited July 15, 2014 by Jumabaar

[~Anne~]

The difficulty with mast cell tumours is that there is no defined appearance. They can look anything from mole like to a sore and they can be very different in size.

I'm not sure that you could claim with any certainty that they are mast cell tumours just by looking at them.

In my personal experience with my dog, they've all been different looking, different in size and located in very different locations. Most on the outer dermis layer and one under. He has also had two other tumours that were not mast cell and he has a lipoma. I could have assumed all of them were mast cell but they obviously weren't.

We only decided on an ultrasound after my vet became concerned about the progression of the mast cells. The scan showed a tumour on his spleen. We monitored it for sometime before opting to remove the spleen when the tumour grew quite large in a short space of time. We thought it would be a mast cell. It wasn't. If not for the scans he would be dead now from the splenic tumour.

It must be hard living in a country where quality veterinary services are not easy to obtain. I know my vets aren't misleading me. I trust them and I value their knowledge and expertise.

Edited July 17, 2014 by ~Anne~