Cancer or infection?

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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