Liver cancer questions.

Dr. Marie replied:

Oh dear. It sounds like Penny (and you) have been through a lot!

Those liver enzymes have me very concerned as most of them are quite high. The ultrasound results have me worried as well. I'll explain some of the "medical speak" for you.

Regarding the liver they are seeing a large 12cm area that is much more dense than the rest of the liver. This almost always means cancer, unfortunately. The mottling on the rest of liver may mean that there are other smaller cancerous areas as well. Or, it can mean that there is inflammation in the liver, but then the question is why.

You're right in mentioning that the medicines she is on are expensive. As well, there is a concern because Rimadyl is processed through the liver. So, if the liver is struggling (i.e. because of cancer) this can make things worse. But, as you mentioned, without the Rimadyl, she is in pain.

It's really hard to advise you on the canine tooth, especially considering that you have two different opinions from two different vets. If a canine tooth is fractured, it's often hard to no whether or not the tooth is painful to the dog. Dogs aren't wimpy like people. They really don't do anything to show us pain. With that being said, if the vet feels the tooth is painful at the end, then there likely is some discomfort there.

Removing a fractured canine tooth is a major surgery. It usually takes a good amount of time and as you are likely aware, can be expensive.

It is really hard to advise you on what to do here! Let me lay out the pros and cons of removing the tooth and hopefully that will help with your decision.

Pros:

• She won't have dental pain during the time she has left with us.

Cons:

• Expensive


• The anesthetic could be a risk. Most drugs have to be processed through the liver and we know that the liver is diseased.


• We don't know how much time she has left. It is possible that we do the surgery, spend the money and remove the tooth all very successfully, and she could possibly succumb to liver cancer a week later.

Now, keep in mind that it is hard for me to advise without being able to examine Penny. But, if one of the vets is saying that it may be ok to leave the tooth then I would tend to agree that this would be the better decision.

If there is liver cancer (which it really sounds like there is), there is a chance that we do not have much time left with Penny.

I hope that helps with your decision. Let me know if you have more questions.


Do you have a pet website? Interested in learning more about SEO for Wix?

---

Check out our dog age calculator and cat age calculator.

Dr. Marie replied:

I face tough decisions like this every day. It is so hard to determine how long an animal has. And you're right...if we could tell how long she was going to live, then it would be so much easier to make decisions like this.

Has your vet talked at all about doing a biopsy of the liver mass? If we knew what type of cancer was present then this could give us more information on how much time we had left. Most of the time a biopsy can be done with mild sedation.

I don't think the liver cancer is because of either the Rimadyl or the cushing's. While both Rimadyl and cushing's can cause an increase in liver enzymes, neither of them would cause a mass in the liver. Usually we don't know the cause of liver cancer. It's just one of those things that just happens.

I would definitely recommend to stay on the liver drugs. At this point, they can only help. The blood tells us that we have a significantly injured liver and so, anything we can do to support the liver is good.

Dr. Marie replied:

My experience with liver cancer is that animals do extremely well (and owners have a hard time believing the diagnosis). And then, one day they eat a little less than normal and are a little quiet. And then within the next few days things progress quickly. At this point it becomes obvious that the time for euthanasia has arrived.

Most of the time I find that most pet owners know quite easily when the time has come.

The problem is that no one can tell you how much time to expect. From what you have told me I think 6 months would be very optimistic.