Post-operative chemotherapy in subcutaneous MCT

RE: Post-operative chemotherapy in subcutaneous MCT

Anthony Dennison — Thu, 11 Jul 2019 09:43:24 GMT

[quote user="robloxley"]would it? maybe if you had awful liver function you'd avoid lomustine[/quote]

I normally use vinblastine and prednisolone to mop up any possible micrometastatic disease. However, if there is gross metastatic lesions this is less effective so may have to look at using palladia. That was my thought process.

[quote user="Beats"]

Thus I'd consider carefully the pros of potential increased life-expectancy (which remains speculative in the case of a subcutaneous mast cell tumour treated with preds/vinblastine in my opinion) with the cons of the drugs and their administration on the patients quality of life.

In the quality versus quantity debate, the drugs can't really help the quality, only the quantity, so it comes down to whether there is likely significant detriment to the quality from their use. In a pug of this age with chronic issues with hindlimbs, I'd be focusing on quality above quantity and would have concerns particularly re drug effects, but I accept it's an open question.

[/quote]

This is a good point - the dog isn't completely incontinent to the point he dribbles, but will squirt a bit of urine when examined. It will be tough conveying that to the owners though, will see what they think.

[quote user="Beats"]PS - how big was the SC mast cell tumour and in what location and how quickly had it grown or any other interesting facts?[/quote]

It was in the right axillae, main mass was approximately 3cm diameter and there was a small satellite lesion with it. Owner says it had been there a while then suddenly grown quickly (which I have head in previous cases) but I didn't feel it when I examined the dog about 3 months ago.

RE: Post-operative chemotherapy in subcutaneous MCT

Beats — Mon, 08 Jul 2019 21:54:13 GMT

I find subcut mast cell tumours fascinating (as in I'd like to know more about them!). My most memorable case after a lot of umming and aahhing got mastinib alone (no excision) and promptly went diabetic to my surprise - if it had had a whiff of steroids I'd have blamed them for sure.

Does your pug have any urinary incontinence? If some lack of nerve function in back end, then preds may tip it over the edge. Also preds and vinblastine/chlorambucil/whatever might increase chances of UTI in addition to more obvious side effects / risks.

Overall, I'd bet that this dog doesn't get euthanased due to recurrence / metastasis of its excised/debulked subcutaneous mast cell tumour - it might, but I bet it doesn't.

PS - how big was the SC mast cell tumour and in what location and how quickly had it grown or any other interesting facts?

RE: Post-operative chemotherapy in subcutaneous MCT

Rob Loxley — Mon, 08 Jul 2019 20:50:57 GMT

Thompson et al., (Vet Path 2011) reported a much worse outcome (recurrence and metastasis) for dogs with subcut MCTs with a MI over 4 per 10HPF, so your thoughts on adjunctive treatment seem sensible

[quote user="Anthony Dennison"] if these are present it would probably require a different chemo protocol[/quote]

would it? maybe if you had awful liver function you'd avoid lomustine