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Dog with colonic tumor.

Species: Dog
Breed: Labrador Retriever
Age: 8-11 years
Hi -
Our nearly 11 year old male yellow lab has had quite a week. He has been very healthy until now.
We brought him to our regular vet a week ago for lameness in rear left leg. We did xrays and our vet concluded that he has a torn cruciate ligament. Additionally, they noted spinal arthritis. They used a mild sedative during the xray procedures and sent us home with vetprofin. 3 days later Vedder began having stomach issues which escalated into diarreah, then vomiting almost 24 hours later. About 12 hours later there was blood in the diarreah and then blood in the vomit soon thereafter. We brought him to a local 24 hr hospital. They ran bloodwork...which all came back normal (aside from the expected signs of blood loss and dehydration). They administered fluids and anti-nausea shot. His condition improved and he was eating small dose of bland food by that evening...and almost back to 100% after another 24 hours. At the hospital that day, we also had an ultrasound taken to look for tear or other GI issues that could have caused the bleeding. Nothing was found. However a "large" mass in his ascending colon was found during the ultrasound (near the ascending/transverse corner of the colon). Everything else on the ultrasound looked perceived cancer/metastasis in the liver, spleen or anywhere else. Chest xrays showed no signs of cancer/metastasis in his lungs. The opinion seems to be that the diarreah and vomiting episode (as well as blood in both) was not related to the mass...that the mass is a completely incidental finding. A needle biopsy was taken, and the results are inconclusive...but "there is no overabundance of malignancy within the observed population". They seemed to think they could rule out lymphosarcoma, however that the tumor could be adenoma, adenocarcinoma, leiomyosarcoma or leiomyoma. We are faced now with the decision of whether to proceed with surgery to have the mass removed. What is your opinion? I understand that adenocarcinoma is much more common than leiomyosarcoma...and that the former typically has much worse prognosis. Do you think it is likely or unlikely that the diarreah/vomiting/blood are related to the mass or potential cancer? What is the likelihood that the tumor could be benign? If the tumor is benign, what is the likelihood it would become cancerous? What is the likelihood it would continue to grow and cause other major problems for Vedder?
Thank you so much in advance for your time and opinion.

Online vet, Dr. Marie

Dr. Marie replied:

Oh, you and Vedder have indeed had a tough week!

It sounds like you have a very thorough vet.

It's going to be hard for me to comment on the mass without seeing your boy, but I can give you my thoughts.

From what you have described, if this were my case I would be advising an exploratory surgery to see if we can remove the mass. The only way to know for sure if it is cancerous or not is to open him up and take some biopsies (or hopefully remove the whole mass) to send to the pathologist.

The fact that there were no obvious malignant cells is encouraging. The most common type of intestinal mass is lymphoma. However, lymphoma is usually relatively simple to diagnose with a fine needle aspirate, so this is unlikely. If it's not lymphoma then either leiomyosarcoma or adenocarcinoma are the next likely. (I could not find any stats to say that one was more common than the other.) The good news is that for either of these tumors, if we can remove them before they metastasize then there is a really good chance of curing him with surgery.

Adenocarcinoma tends to spread to lymph nodes in the abdomen and leiomyosarcoma tends to spread to the liver. Most likely, if there was spread of tumor then there would have been some evidence on the ultrasound (although we can never be 100% sure.)

So, what I am trying to say is that if there is a mass here, it is either benign, or if it is malignant it is likely early in the stages of malignancy. In either case, removal now would likely be extremely helpful.

We could theorize that if it was a benign mass we could do nothing. However, even a benign mass can grow to a large enough size that it causes an intestinal obstruction, or even rupture open and cause intestinal perforation and so I would likely opt for removing it now.

It's hard to say whether the vomiting, diarrhea and blood are related or not. The ketoprofen (NSAID) can sometimes cause stomach ulceration and bleeding and vomiting. However, one study states that 33% of dogs with intestinal tumors present with anemia, so it certainly could be because of the tumor. It is also possible that it was a combination of the two.

I don't envy you this decision. However, I would agree with your vet that an exploratory surgery is likely the best idea.

I hope everything goes ok!

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. 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.