Transitional Cell Carcinoma

Well, the mass found in Lucy’s bladder has been diagnosed as transitional cell carcinoma, unrelated to the cancer that she already has in her leg.  Our vet is consulting with the oncologists at NCSU to see what palliative treatment they recommend.  We decided against more chemo and I’m really hoping that’s the right decision for Lucy – she’s been through so much of that already and I don’t want to keep putting her through it.  She will most likely be started on Peroxicam.  The vet told me that the prognosis for dogs with TCC is 4-6 months without treatment and 6-12 months with treatment.  That is scary and heartbreaking but I try to keep in mind that Lucy was given 6 months at the beginning of  her histiocytic sarcoma diagnosis and that was 3 years ago; so we know Lucy lives by her own timeline.  She’s always been a bit stubborn!

In the meantime, Lucy is getting spoiled rotten.  She has enjoyed steak with her dinner, morning walks with her little sister Kona, and we’re planning a trip to the coast so she can spend time running on the beach and chasing seagulls.  She seems to be doing well, just taking her walks a little more slowly than she used to.  My goal is to keep her happy and pain free for as long as possible.

 

Out for a walk

 

Found something smelly to roll in

 

Bad news from ultrasound

Lucy had an appointment for her abdominal ultrasound today.  This was the last step before scheduling her surgery for amputation.  Unfortunately, the ultrasound revealed a mass on her bladder.  The vet took a urine cytology to be sent to NCSU so hopefully we’ll have the results of that by the end of the week.  Either it will come back as the same kind of sarcoma that she has already been diagnosed with, or it could be a different type of cancer all together.  Luckily Lucy isn’t showing any symptoms of having any issues but that’s also why this came as such a shock.  However, with this new development, the vet said that she didn’t see a reason to go ahead with the amputation.  So now we wait…

It’s a weird feeling to be disappointed about not amputating your dog’s leg.  As much as I wasn’t looking forward to it, I felt that it was Lucy’s chance to finally be cancer free.  I’m not really sure where to go from here.

How we got to this point

Lucy Pre-Diagnosis

It’s news that no one wants to hear: your beloved pet has just been diagnosed with cancer.  After waiting a couple days for a biopsy result, that was the news I was given in January of 2014.  Lucy had a histiocytic sarcoma on her right front leg right near her carpal joint.  I couldn’t help myself and immediately began a Google search to find out what I could and what this diagnosis meant for my little girl.  Unfortunately, what I found didn’t reassure me.

Because of the location of the mass, surgery at that point was not an option.  There just wasn’t enough tissue in the area to get clean margins.  Amputation was briefly mentioned but we were referred to a veterinary oncologist to go over other options.  That was the start of our 3 years of cancer treatments.  First, Lucy was started on chemo until the mass shank enough to be surgically de-bulked.  Her surgery went well and although they were still unable to get completely clean margins, Lucy was considered to be in clinical remission.  Everything was great for about a year with Lucy going to see the oncologist every 3 months and told everything was great.  Until it wasn’t.

In December of 2015, the mass on Lucy’s leg began to grow back.  I took her in to be examined and she was started on another few rounds of chemo and some oral chemo meds as well. The tumor was stable for most of 2016 – not really growing and not bothering Lucy in the slightest.  In November of 2016, the oncologist suggested a nanoparticle treatment with laser therapy that she was starting to use on her other patients.  She said one of two things could happen: either the mass wouldn’t show any response or the tumor would respond and either begin to shrink or completely die and fall off.  At first, it looked like Lucy’s cancer was responding well to the treatment.  Her tumor, while not noticeably smaller, did start to measure slightly smaller at each visit before settling at a stable size.

2017 came and Lucy’s mass began to grow… and grow.  Between April and May it grew a whole centimenter and is now measuring 4cmx4cm and continues to grow. We were faced with a choice: 1) continue on chemo, 2) do another de-bulking surgery, or 3) amputation.  I knew we didn’t want anymore chemo.  It was hard on Lucy: the pills would make her nauseous and honestly, the cost was seriously adding up.  Before making a final decision, we wanted to know more.  Lucy went last week for chest x-rays and a fine needle aspirate of the nearest lymph node since it was slightly enlarged.  Everything came back clear.  The next step is an abdominal ultrasound.  If that also looks clear, we decided to move on to amputation of the right front leg.  I still can’t really wrap my head around it.  I definitely didn’t come to the decision lightly and there was much back and forth over what would be the right thing to do.  Ultimately amputation seemed the right way to go and our veterinarian agreed with us.

Lucy’s ultrasound appointment is tomorrow morning.  Here’s hoping everything looks good and we’ll be able to schedule her surgery.  I am still very worried about whether I am making the right decision and concerned about how Lucy will recover.  She’s 12 years old and surgery comes with its risks.  But during one sleepless night, I stumbled upon this website.  I poured over all the articles, and blogs, and forums.  I haven’t yet gotten through all the reading and still have questions, but I am already feeling reassured.  At least I know that Lucy is in good company.  I’m sure I’ll be spending a lot of time here in the next week preparing for Lucy’s surgery and learning everything I can.  Thanks to this site for its amazing support and resources.  It has already been invaluable.