Making the toughest decision.

[Rubyfree]

7+ year old Great Dane, found a rather large (slightly smaller than a ping pong ball) growth on gum line of upper jaw last Friday. Vet tuesday, referred to oncology at Cornell, appointment Monday.

The growth is very obviously into the bone. It has displaced one incisor significantly. While the growth itself does not seem to be painful, it is obviously uncomfortable and due to the location it makes some dog life necessities difficult- many of his favorite toys are no longer appropriate as hard toys cause ulcerations. He is eating fine, but bolting his food a bit, presumably to get it past the growth.

It popped up very quickly. While it hasn’t grown noticeably since I found it last week, I expect it will continue to grow. There isn’t much room for it to get larger without causing real difficulties with eating and tooth configuration.

So here I am, attempting to plan for all possibilities. It’s a little early to get morbid, but I am short on people to discuss this with so please bear with me. YOU guys get it. :sadsmile:

He is very poorly bred and has had some vague low-grade neurological issues for YEARS. I am extremely wary of having him knocked out for anything- no experiences to cause this wariness, but he is the dog that will have complications, and he is no longer a young dog.

I am presuming that our options will be removing a section of the jaw completely and/or radiation. There is no way to remove the tumor without taking a section of the jaw. While we don’t know how far into things it is- I am not sure if I am comfortable having him knocked out for a CAT if I know I will not subject him to the removal. Cost is a factor here. I cannot imagine a surgery of that intensity at Cornell will be cheap. I am uncertain that a 5k+ surgery for a seven year old great dane is practical. My heart says of course, but my horsewoman head knows this is somewhat foolish.

On the other hand- he is very, very happy, active and strong. Other than those neuro issues and random nagging digestive issues that he has had all his life, he has no age-related problems. He runs and plays and acts, for all intents, just as goofy and full of life as he did at 8 weeks.

But that tumor will continue to grow, and happy or not, it will become a problem, probably sooner rather than later.

I don’t know what to do. Intellectually, I think I know what I WILL do- but I don’t want to think about it, y’know? :lol:

This dog was not my favorite animal when I brought him home- I had the pleasure of owning The World’s Best Dog ™ at the time and I was offended by his lack-of-her-ness. I wouldn’t have believed it then, but he has turned out to be a noble heir to TWBD’s throne. He is different, but he is wonderful, and he has been my rock through the last three years of my life, which have been VERY difficult.

Advice welcome, but I really just needed to commiserate and get it all out. The next few days are going to be heart-wrenching.

[oliverreed]

Oh man. I feel your pain. 7 IS fairly elderly for a Dane, isn’t it? I don’t really have any advice, just wanted to commiserate and sending TONS of support no matter what you decide.

[Alex_and_Bodie_s_Mom]

So sorry, and jingles for you and your dog. I had a Greyhound who had a large tumor pop up extremely quickly too; she was 14, though, and that decision was much easier. Hoping for good news from Cornell, though.

[SquishTheBunny]

Sorry you are having to deal with this

From my experience, maxillectomies are generally well tolerated by dogs. But yes, expensive and there is always a risk of complications and its not a “cure” if its neoplastic.

Assuming its an osteosarcoma, radiation and or chemotherapy can really slow the growth. Neither are comparable to humans, and dogs for the most part tolerate both extremely well. Goal is NOT to make them sick from treatment, but to give them just enough to slow the growth while maintiaing a high quality of life. Having a biopsy done would be helpful if you decide on medical management. For example, MCT’s can be treated with oral palladia, while osteosarcomas are really only responsive to injectable or radiation. Lymphomas can be responsive to prednisone. Hyperplasia needs nothing except debulking.

If you do decide on anesthetic, just make the doctors aware of the neurologic issue. I would think being a dane, it would be wobblers so bracing the neck is “routine” for most practices. You shouldn’t have further problems if the neck isn’t moved around too much.

7 is a hard age. Yes its mature for a Dane, so please don’t feel you let him down if you decide to do nothing. But at the same time, if you want to do something don’t feel you are putting him through treatment for no reason - dogs aren’t like people they don’t emotionally connect being sick with being sick. With the medicine we have access to these days, we can keep many pets comfortable throughout routine and invasive surgeries and can also offer excellent palliative drugs if that’s the route you wish to go as well.

Hugs to you

[csaper58]

So sorry I missed your post earlier. I have a thread on Pallitive Care for dogs with cancer, my girl(12yrs) has bone cancer. It was diagnosed in April, and she had a bone scan to see if there were any other tumors,(no) so she had one round of pallitive radiation (two treatments one week apart) and she has had three Pamidronate treatments. She is in very good spirits, knock on wood. Post on my thread if you have any ? I will try to answer ASAP

[Rubyfree]

Thank you for the jingles all, for directing me to your thread csaper, and for the very good info Squish. We had a biopsy performed monday. Depending on the results, we will likely have an ultrasound, CT and chest films shortly. If whatever it is has not spread, we have decided to go ahead and have the section of jaw removed.

I am still struggling with this mentally as I tend towards the practical and logical side of animal care, but that’s fighting me a bit in this case. What’s killing me is the number 7; if this had arisen a year and a half ago or a year and a half from now, there would be no great discussions regarding what to do. He is a very happy, seemingly healthy dog and before discovering the growth I had very little idea anything was wrong- he wasn’t acting “off” at all.

Now is just time to wait and enjoy our time. Next week, when we have a clearer picture of what we’re dealing with, we’ll make more decisions.

[SquishTheBunny]

Not an easy decision - but sounds like you are making an educated one. Staging is important, if everything is clean then you know you “likely” will have a good amount of time after the surgery. If there are mets in the abdomen or chest, then you will know palliative treatment is best. None of these procedures are invasive and wont hurt your dog at all. With a clear picture, you will have an idea on moving forward or not. This also isn’t “selfish” at all, you are doing what you can to provide your dog with a good quality life.

If all is clear…you will be amazed how well dogs do with missing body parts!! And FWIW, we just saw a 13 year old dane today, and a dog with cancer in his jaw/nose (squamous cell) in 2009 come in for a recheck - cancer free

[csaper58]

Hi Rubyfree, I answered on the Pallitive Care thread, some info on Cyber Knife that Squish and Simke gave me. Also called Limb Spare Laser I think. There is a place in in Yonkers N.Y. that does it.
Hope you get really good news, and don’t need any of these options! Let us know if you need help, or info., or if it is all OK. JING JING JINGLE.

[lovey1121]

[QUOTE=Rubyfree;7134223]
Thank you for the jingles all, for directing me to your thread csaper, and for the very good info Squish. We had a biopsy performed monday. Depending on the results, we will likely have an ultrasound, CT and chest films shortly. If whatever it is has not spread, we have decided to go ahead and have the section of jaw removed.

I am still struggling with this mentally as I tend towards the practical and logical side of animal care, but that’s fighting me a bit in this case. What’s killing me is the number 7; if this had arisen a year and a half ago or a year and a half from now, there would be no great discussions regarding what to do. He is a very happy, seemingly healthy dog and before discovering the growth I had very little idea anything was wrong- he wasn’t acting “off” at all.

Now is just time to wait and enjoy our time. Next week, when we have a clearer picture of what we’re dealing with, we’ll make more decisions.[/QUOTE]

I’ve been through this, though it was in the mid-80s. I found an approx. 11 y o intact GSD in the woods and brought him home, neutered him, and he became one of the family.

He had a growth on his lower jaw, and I hit the Animal Medical Center in NYC to see what to do. They removed a 2+ inch section of the jaw, and pronounced margins clear (I cannot remember specifics though - it was many yrs and animals ago )

He never looked back. He was understandably a messy eater and drinker and his tongue would stick out of the side but he thrived for another couple of yrs before I lost him to degenerative myelopathy.

I thought maybe this might be of some use to you. I don’t recall it being a fortune, though I’m certain my Mom helped me out with it, as at the time, I was living at home.

[Rubyfree]

We got great news tonight- the growth is benign. Unfortunately it’s also locally invasive, so the jaw will go. There’s a long road ahead still- the vet felt strongly that staging, while not completely necessary due to the nature of the growth, was a good idea due to his age & breed, so Tuesday we go for the works. CT scan a weekish after if all that is clear, and hopefully surgery about a week after that.

We no longer have any qualms about what to do. If it had been cancer, we may have wavered, but knowing that it’s just a nasty aggressive little bastard in my pup’s face who is diminishing his joy in playing and eating makes the decision easy. We’re just going to chop that sucker right off :lol:

Lovey, thanks- everything I’ve read indicates that they tolerate this sort of surgery VERY well, and it’s heartening to hear of other aged dogs who have come through just fine. He already drools a ton, he’s already a messy eater, and he already has a goofy face. This won’t change a darned thing.

[GraceLikeRain]

@Rubyfree;7134223

I am still struggling with this mentally as I tend towards the practical and logical side of animal care, but that’s fighting me a bit in this case. What’s killing me is the number 7; if this had arisen a year and a half ago or a year and a half from now, there would be no great discussions regarding what to do. He is a very happy, seemingly healthy dog and before discovering the growth I had very little idea anything was wrong- he wasn’t acting “off” at all.

Your dog doesn’t know his age. Set aside the numbers if you can. Make the decision that is best for him even though it is likely going to be the hardest for you. I think people rarely regret letting them go when they are happy and seemingly healthy. A lot of people on here have admitted to carrying the grief and burden of waiting too late.

Just saw your update. Best of luck.

[csaper58]

Such wonderful news! Good wishes for a speedy recovery from the surgery.

[lovey1121]

Rubyfree, great news! Looking forward to your updates

[Rubyfree]

Just wanted to update for those playing along at home.

We went in Tuesday for chest films/abdominal Ultrasound etc. He’s healthy as can be outside of the stupid growth. We scheduled the CT for this coming tuesday, but a couple of hours after we got home we got a call from the Doc we’ve been working with. She had showed Arlo’s case to the head dental surgeon, and he was very excited & optimistic about the procedure. He strongly recommended that we do the CT and surgery all at once and he wanted to do it all on Tuesday. It makes sense- then the pup only has to be knocked out & make the trip once, and long term the cost will be less, but that still took us from 2-3 weeks to accrue funds down to (gulp) one. Regardless, we scheduled it and we’re making the money happen. It’s been a busy, chaotic week but friends near & far have come out in support of the dog and we are moved beyond words by the love we’ve gotten from all around.

It’s the right time to do it, I think- the growth is nasty and now causing him significant pain, and at this rate he might not be able to eat for much longer.

Think good healing thoughts for Arlo on Tuesday, and hopefully my next update will be pics of a healthy dane with slightly less jaw!

[csaper58]

Tuesday shall be Arlo Jingle Day! A Dane with a lopsided smile…

[Rubyfree]

Arlo came home today from Cornell. He is tired but otherwise absolutely fine. The vets felt very good about the surgery and he made many friends during his stay. The next two weeks will be trying considering we have to keep him from rubbing his face on everything (he really really loves rubbing his face on stuff) & thusly destroying the suture site, but overall- if anyone is on the fence about having a maxillectomy performed, I’m going to go ahead and say go for it. His discomfort level seems very minimal, his appearance is almost unchanged, and he was ready to go home in 24 hours.

The biggest battle will be finding SOME variety of e-collar he will wear. Related, he came home with the biggest freakin’ e-collar I have ever seen. :lol:

Thank you everyone for the good thoughts and info!

[crosscreeksh]

[QUOTE=Rubyfree;7157577]
Arlo came home today from Cornell. He is tired but otherwise absolutely fine. The vets felt very good about the surgery and he made many friends during his stay. The next two weeks will be trying considering we have to keep him from rubbing his face on everything (he really really loves rubbing his face on stuff) & thusly destroying the suture site, but overall- if anyone is on the fence about having a maxillectomy performed, I’m going to go ahead and say go for it. His discomfort level seems very minimal, his appearance is almost unchanged, and he was ready to go home in 24 hours.

The biggest battle will be finding SOME variety of e-collar he will wear. Related, he came home with the biggest freakin’ e-collar I have ever seen. :lol:

Thank you everyone for the good thoughts and info![/QUOTE]

Is he able to eat okay?? I had a similar situation with an old Border/Jack of ours, but on the lower jaw. It was surgically removed 3 times in 2 years, but now seems to have given up the battle. Because part of her lower, front jaw was removed she found it hard to “shovel” her food out of a bowl. For months I fed her a mixture I concocked - often with a 60cc dose syringe. I fixed instant oatmeal using weak beef bouillion mixed with cooked hamburger, one cup of vegetable oil, and a large glob of canned, chopped chicken dog food. I never forced her to eat, but could gently squirt the mush in the side of her mouth away from the tumor site. Now, she is fully recovered and eating on her own again. Good luck with you fellow.

[csaper58]

Glad surgery went so well, jingles for a speedy recovery. Have no ideas regarding e-collars, but when my girl was hit by a car and needed to be as still as possible to heal (6 month old aussie) we kept her lightly sedated as needed.

[Rubyfree]

[QUOTE=crosscreeksh;7159541]
Is he able to eat okay?? I had a similar situation with an old Border/Jack of ours, but on the lower jaw. It was surgically removed 3 times in 2 years, but now seems to have given up the battle. Because part of her lower, front jaw was removed she found it hard to “shovel” her food out of a bowl. For months I fed her a mixture I concocked - often with a 60cc dose syringe. I fixed instant oatmeal using weak beef bouillion mixed with cooked hamburger, one cup of vegetable oil, and a large glob of canned, chopped chicken dog food. I never forced her to eat, but could gently squirt the mush in the side of her mouth away from the tumor site. Now, she is fully recovered and eating on her own again. Good luck with you fellow.[/QUOTE]

For the moment he is getting a fancy-schmancy concoction of mush consisting of boiled chicken, rice, carrots, canned Merrick, probiotics and whatever else I have laying around blended up- he cannot have hard food for two weeks at least. He is eating that fine, mostly ingesting via licking it to death.

Theoretically once he is healed up he should have no problems going back to kibble; in his case, the teeth removed were all in the front of the mouth, so his molars are fine and chewing shouldn’t be a problem.