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Cancer or infection?

Species: Dog
Breed: Germain Shorthair Po
Age: 11-15 years
My dog recently completed radiation therapy for a brain tumor and he handled the anesthia very well and they said his lung xray looked fine. Now my dog has a swollen toe. The vet thinks the x-ray shows a bone tumor and the radiologist thinks it could be an infection. They took an xray of his lungs and they appeared much lighter in color than expected on the xray. The vet thought the cancer metastized to his lungs and the radiologist thinks he could have dirty lungs as he is eleven and has had kennel cough in the past. The xray of his abdomen showed a large mass and the vet thought it was cancer but the radiologist thinks it may be a swollen liver because of the predisone (2 at 20mg per day)that he is still one. They have given him some antibodics to see if the toe gets better. I don't understand why there could be such difference of opinion in what is in the xrays. What is this? I don't want my dog to suffer after all he has been through with the radiation therapy, but I don't want to put him to sleep if he can have a good quality of life. Please help


Online vet, Dr. Marie

Dr. Marie replied:

I'm sorry to hear that you and Rufus are going through these difficult times. Often radiographs can be difficult to interpret.

Regarding the toe, I just recently got asked a similar question:

Toe tumor or infection on a dog?

An infection and a tumor can look very similar on xrays. In my experience, bone infection is not as common as a bone tumor. Unfortunately the only way to really tell the difference would be to do a biopsy of the bone which is not an easy matter. What we usually do is exactly what your vet is doing - give antibiotics and see if there is any improvement. Then we take an xray a few weeks later and see if it looks better or worse.

Lung xrays can be really difficult to interpret. I wouldn't say that a lighter color usually means cancer. But, it's possible that the "lighter color" is actually some fluid in the chest. Fluid in the chest can be because of cancer. But, if the radiologist thinks that there is no tumor they are probably correct.

Regarding the abdominal issues it's possible that an ultrasound could tell you if there was a cancer there. But, I can understand if you don't want to go doing a bunch more diagnostic work.

Unfortunately cases like this can be very common. We do our best to interpret the tests but often the decision making has to hinge on our experience and how the patient responds to treatment. If this were a human patient then likely additional tests would be done such as an MRI or CT scan or ultrasounds but with pets often finances limit us from doing those.

In a case like this I would likely be recommending to keep doing what we are doing and then see how Rufus improves. You will know if he is not doing well. Some signs of him not doing well that would make me want to start considering whether it is time for euthanasia would include a lack of appetite, and reluctance to move very much. I do find that most of my clients seem to just "know" when it is time for euthanasia.

Doing some further xrays in a few weeks is not a bad idea as well. If there is cancer then it really should be more evident in a few weeks.

I do hope things improve though.

Dr. Marie.



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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.