Large Abdominal Mass
 

I wasn't expecting this today. My nine-year-old yorkie Turner has been vomiting foam every once in a while for a while now, and recently it became more frequent and was pink, mostly in the mornings. Took him to the vet. The vet did blood work--the CA and Lip were a little elevated--she gave him Metronidazole, Cerenia, and probiotics for a week. The vomiting stopped completely--until the day after we stopped. I called the vet and they said I could put him back on Metronidazole for a few days. As soon as he was back on it, the vomiting stopped. Then the vomiting resumed the day after the Metronidazole was gone.

At this point the vet recommended an X-ray, two views, to rule out some obstruction. We did a more extensive blood work up, which showed him becoming slightly anemic. Specifically: Elevated MCH, Low lymphocites- stress response. Low normal- HCT/PCV- could be anemia from chronic disease.

Then she did the X-ray, and I knew when she called me to look at them that something looked amiss. She showed me that his stomach looked empty but the lining--or walls?--looked to be thickened. And his--I think it was--small intestines--was not where it should be. Too low or too high. She also pointed out that he had lots of gas in his GI tract.

We decided to to an ultrasound. She called me in and the look on her face told me it was going to be bad. She showed me the ultrasound which shows me nothing, but she said this was all a mass and said pit was probably--she through out a couple of cancer terms I'd heard before ending in oma. She shook her head and said that even radiation wouln't help. I assumed because of the size. I wasn't really hearing her completely; I was too stunned.

She said she tried to see if she could tell if it was connected to an organ but he was so uncomfortable that she just stopped, didn't want to put him through it.

At this point the waterworks started and she then told a story about a dog that had a large mass and they opened him up and it was a testicle that hadn't descended. (Turner's been neutered so that's not it.)

She said we could take him to a veterinary college not far from here and they can do an exploratory but if they find it's cancer they will not want to wake him up from surgery. Also, I think if it's a laparoscopy, that's not so bad, but if it's abdominal surgery, that's harder to recover from. (I've had both.)

He still plays. She said the ultrasound was causing him pain but I have not seen any indication of his being in pain.

I want to do what's best for him. It's just really hard to know. She also said, kind of thinking out loud, "Well, I don't have to worry about cost. I'm a vet so I could just open my dog up and look." So that sounds as if she was thinking that if it were her dog she'd do the exploratory.

Any thoughts? I'm going in circles.

Oh my gosh - I'm so very sorry about this news :(. How heartbreaking for you - I'd just be an absolute wreck.

Was this your regular vet or was this an Internist? It may be well worth it to spend the $ on an office call and see an Internist before making any other decision. They will really know *far* more about your situation than a generalist vet.

If there *is* a chance for surgical removal of the tumor and good survival following removal - then I'd want to explore that further, if it were me.

Please keep us posted and I'll be thinking of you both :love:!

Sending along thoughts and prayers for you and Turner.

You wrote, "She said we could take him to a veterinary college not far from here and they can do an exploratory but if they find it's cancer they will not want to wake him up from surgery. Also, I think if it's a laparoscopy, that's not so bad, but if it's abdominal surgery, that's harder to recover from. (I've had both.)"

Wylie's mom wrote, "Was this your regular vet or was this an Internist? It may be well worth it to spend the $ on an office call and see an Internist before making any other decision."

So hope the consult and visit with Internist is in the cards for you.

Thank you for responding
 

This was not his regular vet. When we got Turner, I chose our regular vet, which is located in another town, because they seemed to be rated so well. My husband and I are now both retired and on a fixed income with high medical bills of our own, so we took Turner to a vet we've used before for teeth cleaning, spaying and neutering, heart worm blood checkups, things we consider routine. It's run as a rescue and to provide vet services for people who are having trouble paying for their pets need medically.

They're very caring, rescue dogs from puppy mills from all over and, as I said, charge less. They're competent vets, just not as upscale as our regular vet.

I really thought this would just be routine X-rays, which I really didn't expect to show anything or certainly nothing major. It seemed to me if antibiotics kept him from throwing up, it was probably something related to a type of infection. The two-view X-rays are $300 at our regular vet and cost $60 at the vet yesterday. We spent around $350 there yesterday and it would have easily been over a thousand at our regular vet.

It's sad when money has to figure in with our Turner's care. It really is. We will spend more than we can afford, but it's not unlimited, though I wish it were.

There are internists at the veterinary college this vet said we could try. I would imagine they will examine him and give us their opinion before doing any surgery.

Today I noticed that Turner did not want to play, which we do every morning as soon as we are awake. He became interested when our other yorkie Annabelle started playing fetch and chased his toy a few times and then on the last throw just stared at the toy in the distance and didn't offer to get it. I also noticed that he spent the whole night sleeping on the floor and not in the bed with us as he usually does. He has been isolating himself more, which I guess I've been in denial about. Other than throwing up he seemed to feel fine. But then dogs are so brave.

When I had to have another beloved yorkie put down in 2006, the worst pain of course was losing him, but the second pain was wondering if I had kept him alive too long because I couldn't bear the thought of losing him. i swore I wouldn't do that with another dog.

Thank you all for taking the time to respond. I've always known this board to have such caring people, and I know that each of you understands how much I love my pups. My husband and I got married late in life and these are, indeed, our children.

I’m so sorry. I think I would get a consult with an internist and make sure to have the cd with the X-rays on it and if you can images of the sonogram so they can look at those and not have to re do those tests.

Thank you. That's a good suggestion. I was told that the veterinary college has a better ultrasound machine but maybe they can tell enough from the one we already have. The vet who looked at the current one seemed aghast; apparently it's large. But she wasn't able to determine if it was attached and felt she needed to quit because it was making Turner so uncomfortable.

I imagine it probably does hurt to be pushed on. If they have to do a sonogram they may have to sedate or put him under anesthesia. Specialist really know their stuff though so they might be able to know what it is and everything with out doing that.

Yes, I'm looking forward to getting more definitive and/or clarifying information. Still don't know why antibiotics stop his vomiting but, again, they have.

update May 7
 

I called the director of the community vet we took Turner to in order to get a referral for the veterinary college out of town, not knowing how we were possibly going to get Turner in there in a timely matter, given that it's a teaching college and they perform certain procedures according to their time schedule, and given that my husband is in dialysis three times a week and has an abdominal catheter flush on the fourth day of every week. That leaves Tuesdays, and how long would it take to get him in specifically on that day?

Before I got into that she asked if I had been warned how expensive it would be for Turner to be seen there: $500 just to walk in the door and anything else they had to do would be a lot more. I told her we were prepared to use credit cards if we had to.

She said they have a surgeon here who does exploratory surgery all the time and, given my schedule problems, the distance, and the money, would I like for him to take a look at Turner's case, and see what he thought, and she added that they could send a biopsy to a lab here.

Regardless of who looks at his records and information, I would like for Turner's mass to be biopsied. Even if an internist looked at the mass on the sonogram, I don't think he/she could say for certain what it is without a biopsy. And even it if is cancer, I still want more information. What kind of cancer is it? Is it an aggressive kind? Likely to metastasize? What's the prognosis?

So at this point I hope the local surgeon will go in (laparoscopy hopefully) and take a biopsy and give us more information.

Turner's been on the Metronidazole, Cerenia, and Sucrate for 24 hours now and he's much more lively, wanting to play, even trying to take his sister's toy away. He played long enough to make me tired. He doesn't seem sick at all. He has even gotten the same good results from when he took the antibiotic alone. If its cancer that's causing him to vomit foam, why does an antibiotic stop the vomiting and make him feel so much better? Such a mystery to me. I guess it could be more than one thing going on.

Bless you, P Hudson, and Turner, too.

Thank you. :rose:

I do hope it turns out to be some freak thing or a cancer easily removed if it is cancer. Please continue to keep us updated. Hoping and praying for good news.

I have no idea where that person got her information but there is NO vet specialist that charges $500 to walk in the door. That said, yes, if you have diagnostics it can be costly so maybe that is why she said it since she realizes money is an issue here. Just please don't believe that story because it is patently untrue. Trust me, I have seen enough specialists and have friends all over the country...no way, no how! You might want to just call them and ask them for an estimate...they are usually pretty good about telling people what to expect.

I am very sorry your pup is so sick and will pray that all goes well.

Thank you. I will.

She may have meant, or even said, that it would be $500 for their exam and maybe work up. I had just woken up when I called her. She then said it would be $500 more if they did surgery. I read somewhere that this kind of exploratory surgery was around $850 - $1000. I just want somebody to tell me for certain what it is. Given our schedule and medical issues of our own, if someone local can do the exploratory and the biopsy and send it to a lab, that would be more manageable.

I looked online and saw that there are also local internists, so I don't know why the college was even suggested. Maybe they'd have more or newer equipment or something.

Turner seems to feel good today and that makes me feel better--even if it doesn't last, it's good to see.

Again, thank everyone again for being so supportive.

Did you look here? A lot of people assume people should go to vet schools...that is totally not necessary. You just want to look for boarded specialists. www.acvs.org

So glad he is doing ok. :)

Thank you. I'll check it out. And, yes, I would think a competent specialist in private practice would be fine. I actually think it's strange that a teaching college would cost more when, in addition to them helping their patients, those patients provide the school and its students with the benefit of a teaching experience. Seems like it should cost less. But what do I know?

A lot of people think they are less expensive, but they are not. I agree it seems a bit odd, but I guess like any other place, they have an overhead.

I have actually found that the specialists here in the Houston area sometimes charge less than Texas A&M for certain things. I honestly prefer private practices because then I have a choice which vet I am getting. Not all vets are equal and I don't just look at the facility....I look at the individual vet. You don't choose your vet at a school.

And of course with a teaching hospital, even though they are supervised, students have to get hands-on experience. I'd prefer the surgeon cutting on Turner already have experience, especially when it comes to something this critical.

Sadly, we had to let Turner go today. The vet told us that his mass was inoperable. It was extensive, had wrapped itself around his pancreas, spleen, stomach (and other things I can't remember now), and she believed it was cancer. At any rate it could not be removed. His prognosis was not good. She said that often when cancer is exposed it grows even faster, and that it was going to strangulate his organs, which would lose their blood supply and die, which was not a pleasant way to go. We decided to let him go then rather than have him wake up to not only the pain of a large abdominal incision but the impending strangulation of his organs. He was a sweet dog--the sweetest I have ever known--and we miss him terribly. But we felt that letting him go now was best for him. It's hard for me to understand how this mass had become so extensive when he got his last annual wellness check less than a year ago and his organs were palpated. The vet said sometimes they grow really quickly. Our other pup is very subdued today, which is about as far from her personality as you can get. Yesterday she sniffed him at a distance and backed away. I think she knew. Later that night, Turner lay down right against her for a while, which they usually don't do. Thank you all for your support during this crisis.

Oh, I am SO very sorry. :( Sadly, many of these tumors are like this...they just seem to pop up out of no where. I have had it happen twice...once with a foster and once with one of mine. You did what was best for him ... I wouldn't want a pup to have to experience the pain of surgery only to end up being in pain again. I know how hard those decisions are....sadly we have to do for them what is the most painful for us.
I hope that very soon your good memories will help to heal this pain of losing your sweet boy.

Thank you. It's comforting for me to have the knowledge that these tumors can come up quickly, because occasionally I have had the thought that I could have saved him if I had been more aware or vigilant.

I am in pain and will be for a while, but he gave us years of joy and unconditional love. And I am grateful for that.

I too am so very sorry about this.

Prayers your way--bless you for the love and care you shared with Turner.

Thank you. So kind.

Ohhh please don't do that to yourself. My foster who I mentioned had been to the vet a couple of times in a two week period for some neck issues he was having. He got up one day and was really acting odd...I took him in and they did xrays and found a massive tumor in his abdomen. We were all stunned. So, yeah, it does happen.

One of my favorite sayings......"Death leaves a heartache no one can heal, love leaves a memory no one can steal."

I'm so sorry. My thoughts and prayers are with you.

Thanks so much. I love that quote. I just read it aloud to my husband.

I might have taken him to the vet sooner if not for the fact that both he and his sister both have sensitive stomachs, and we've had them on Royal Canin Intestinal Low Fat as Annabelle got pancreatitis a couple of times and Turner, maybe once.

Turner was one of those dogs who picked up things off the ground and ate them. The funny thing is, they gave him the antibiotic Metronidazole about three weeks ago after doing blood work to try to diagnose the then daily vomiting, and as long as he was on it, the vomiting foam each morning stopped. It could have been an entirely different issue that led us to discover the tumor. If so I'm grateful for it because I wouldn't want him to get to the point where the tumor had strangulated his organs. He played yesterday so I know he felt at least that good before he died and seemed to feel at least okay today.

Thank you so much. We appreciate that.

It does sound like it was just an incidental finding...thank goodness because he would have really been in pain at some point.

Oh and yes, when you look back you will realize that it was a gift that it happened this way and that he didn't suffer and that he was happy up until it was time to go. I know it is terribly painful now, but it will get better...although we never totally get past it. I just hold on to the thought that one day I will see my babies again.

I am so sorry to read about your dear Turner. I am in tears reading this and just brings back memories of losing my Keally. You did the right thing and I hope Turner meets my little Keally over the Rainbow Bridge. It is sad your baby had to get that tumor and it is hard for all of us why these things happen. Anyways Turner knew you loved him and had a wonderful home. Cherish those good memories and take one day at a time. Sending a hug from me and my little Kinder. Susan