The Family

First, thanks to all for your concern. It is very appreciated.

The biopsy results came in today. I think I’ll be able to write about them; I’ve gone rather numb.

It is still possible that it is a fibrous sarcoma, which is what the vet had prepared me for. However, the lab results and, in retrospect, the physical presentation, point to the worse diagnosis of a hemangiosarcoma (subcutaneous). Here is a website, if you are interested:
http://www.marvistavet.com/html/body_hemangiosarcoma.html

And here is the summary.

The vet was hopeful that it could have been a liposarcoma, cancer in fat cells, as those are very localized and don’t metastasize or recur. That was very unlikely before, and pretty much scratched off the list after the surgery. At that point, we were hoping for a fibrous sarcoma, cancer of muscle cells. Those are very localized and don’t metastasize, though recurrence is common. This still might be what it is.

It is more likely, though, that this is a hemangio sarcoma, cancer of the blood vessels. It doesn’t metastasize, it just exists anywhere that there are blood vessels. This one seems to have manifested in the minor vasculature, but in dogs particularly it does move in to the organs, particularly the spleen and heart. That is, in a small word, bad.

Basically, if it grows back immediately we’ll figure it’s a hemangiosarcoma. There’s no other real clear diagnostic test. We could also run chest x-rays; if we see small tumors growing all over elsewhere it’s probably a hemangiosarcoma.

I’m opting for the x-rays as soon as Grail is recovered from the surgery; probably some time in January. I’d rather know.

Hemangiosarcomas don’t respond particularly well to radiation or chemo. If it does recur, which is likely if that is what this is, the clearest next option would be to do another surgery, but pull even more of the surrounding tissues. This would have to be done by a specialist, as they would probably have to remove or at least resculpt parts of the lower intestine, and it is probable that they would remove the leg (not that they’d have to remove the leg, but they’d be removing so much of the abdominal musculature that the leg would no longer function).

The vet delicately tried to tell me that there are no effective treatments for hemangiosarcomas. Median life expectancy after agressive surgery, which is what we just did, is about 6 months. Treatments may or may not do anything to prolong that.

And if I did radiation, which might help the cancer, the location – right near the kidneys – is problematic. One of those, ‘the good news is he won’t die of cancer’ kind of situations.

So. That’s where I am.

I am now, mercifully, numb. Whenever I think about it – in a real, non-clinical way – I fall to pieces. Loud, hysterical, sobbing pieces.

This is very hard.