Suspected sarcoma in gastrocnemius

RE: Suspected sarcoma in gastrocnemius

Lindsey Edwards — Fri, 16 Feb 2018 21:17:14 GMT

Lymphoedema in humans is reportedly extremely and intractably painful, the patient seems to have metastatic disease and the owners are unwilling to consent for a biopsy for a definitive diagnosis? Especially given the very limited options if it is indeed a sarcoma and the lack of consent to prove otherwise I would be recommending euthanasia and any attempt at palliation is delaying the inevitable whilst the dog continues to decline and suffer

RE: Suspected sarcoma in gastrocnemius

Karen Eggleton — Wed, 14 Feb 2018 09:46:30 GMT

Have a great day David! (And you can call me dear and old fruit as much as you want-I find it quite endearing)

RE: Suspected sarcoma in gastrocnemius

Karen Eggleton — Wed, 14 Feb 2018 09:44:59 GMT

Thanks again Gerry for your advice and taking your time to offer it. Much appreciated!

RE: Suspected sarcoma in gastrocnemius

Gerry Polton — Wed, 14 Feb 2018 09:11:22 GMT

Morning!

Oedema develops due to Starling forces. Unless we are talking about a mast cell tumour, that generally means we are dealing with a lymphatic obstruction causing elevated hydrostatic pressure downstream from the visible/palpable oedema. In order to reduce the hydrostatic pressure we have to reduce the pressure in the lymph vessels if inflamed or the lymph gland(s) if enlarged and where the obstruction is occurring (or, in theory, we could redirect or drain lymph - doesn't happen in veterinary practice that I know of but does happen in human medical practice). Then all we have to do is to think of a way of doing that... basically the swelling/tumour has to shrink. One could wonder about the role of lymphadenectomy but this should only remove an already obstructed lymph drainage route and therefore shouldn't improve drainage elsewhere, and who in their right mind would do that anyway just to relieve oedema in what is presumed to be a terminally ill patient? (Hopefully you all will know this was a rhetorical question).

If we know the nature of the presumed cancer, we can consider our non-surgical treatment options. Without a diagnosis, we can only offer physical therapies and non-specific analgesia/anti-inflammatory therapy.

So, the short answer, and thank you for your patience reading this far, we need a diagnosis. How very old-fashioned! Wouldn't it be fun if it was a fungal infection???

Gerry

RE: Suspected sarcoma in gastrocnemius

David Mills — Wed, 14 Feb 2018 08:46:58 GMT

[quote user="nobbygonzo"]Everyone has manners on there and doesn't have anger issues . [/quote]

I suspect the irony of this response is lost on you, old fruit. Not to worry.

[quote user="nobbygonzo"]And my clients are shared with a hospital practice for work up as you have obviously worked out that we are a non traditional practice and don't like it.[/quote]

What do they say about "to assume"? Why are you so defensive? Very very odd behaviour from someone who waxes lyrical about [quote user="nobbygonzo"]manners on there and doesn't have anger issues[/quote]

I hope you find what you are looking for dear.

RE: Suspected sarcoma in gastrocnemius

Karen Eggleton — Wed, 14 Feb 2018 07:47:14 GMT

Oh David, Have you had a bad day? This is why I much prefer SPVS forum. Everyone has manners on there and doesn't have anger issues . All advice. And my clients are shared with a hospital practice for work up as you have obviously worked out that we are a non traditional practice and don't like it. Oh, and I once used to study homeopathy if it helps (no longer practice though, haven't got the time) x

RE: Suspected sarcoma in gastrocnemius

Karen Eggleton — Wed, 14 Feb 2018 07:41:01 GMT

Hi Michael, Yes I do have permission (ahead of May). And this is a space occupying lesion that was surrounded by excessive swelling. 3 vets have examined and failed to locate with clinical examination,radiography and ultrasound. We just had a very swollen leg to go on. Hence the CT scan. Owner has been offered referral for biopsy to the oncology department at Cave and has declined. Hence looking for palliation whilst appropriate for the dog (which it currently is) and the owner digests the prognosis.

RE: Suspected sarcoma in gastrocnemius

Michael Woodhouse — Wed, 14 Feb 2018 01:31:46 GMT

I hope you have permission from the owner to put their name and the dogs name on the internet for all to see?

I don't think I've ever met an owner who'd go for a CT but not a biopsy, the cost of that would be vastly less, even an attempt at removal/debulking might make the dog happier and let you find out what you are dealing with.

You have a report saying there's a lump and they don't know what it is. Suggesting palliation (other than euthanasia) is pretty mush impossible.

RE: Suspected sarcoma in gastrocnemius

David Mills — Wed, 14 Feb 2018 00:10:26 GMT

Are you after all advice this time or just stuff you'd like to hear?

Just out of interest are these cases all yours as first opinion or did they come to you for a second opinion?

RE: Suspected sarcoma in gastrocnemius

Karen Eggleton — Tue, 13 Feb 2018 23:30:26 GMT

CT report