[Dailydrool] No surgery today

[surferdogs at comcast.net]

Mango saw the surgeon, but no surgery today. The surgeon was worried that we were dealing with grade 3 mast cell tumors (systemic) which require chemo first. If you try to remove them, apparently they can bleed for days and the skin won't heal so you get a giant, nasty, open wound. Not good. So we had to do staging including ultrasounds of abdomen and heart and fine needle aspirations of an enlarged lymph node by her left shoulder (above the mass) and her spleen. 

The ultrasound showed normal liver/spleen/kidneys. Her stomach is thickened, probably generalized gastritis which caused the GI bleed but no tumors or lesions. Meaning it is likely this is a response to all the cytokines, histamine, heparin, etc, secreted from the mast cells. The FNA showed probable mast cells in the left supraclavicular lymph node, other LN seem normal - official cytology from the LN, liver and spleen aspirates should be back in a couple of days but everything appears grossly normal except for the one lymph node. She does have a bad mitral valve in her heart, with mild pulmonary hypertension and right heart enlargement. The two options are no treatment, or Viagra (at $10/pill) three times a day. So, no treatment for that. 

Meaning, she is on gastro-protective meds (Zantac, benadryl, carafate) and is starting prednisone. The prednisone may help shrink the tumors, and will stablize the mast cells. Prednisone also tears up the stomach, so really need to watch for more bleeding. The surgery is scheduled for next Tues, after a week on the steroids. Since it appears to be grade 2, not grade 3, after a run of the steriods, she wants to preceed with surgery. She will have the tumors and the positive lymph node removed. Her stomach won't heal until the tumors are removed. Same for the infections in the tumors - the have necrotic centers and will continue to drain unless removed. She can get a recurrence down the road, if they don't get clean margins, and they won't know the actual grade until the actual pathology report, but this is based on the clinical findings so far. She will stay at the vet 24-36 hrs post op to watch for bleeding but if all goes well immediately post op, she should heal well. 

She won't get well without the surgery, and had a good chance at quality time with it. I will continue the meds as prescribed and have the appt for the surgery on Tues at this point. I am waiting to hear back from NEBHR. The money left in her firstgiving account covered today's work up and will do about 1/3 of the surgical costs. The specialty vet gives a 20% rescue discount, but it is still going to be quite expensive. Mango is happy to be home, though she was a very good patient and didn't need sedation for any of the procedures today. She did have an IV just in case, but it wasn't used and came out when she came home. 

So, I'll just keep giving her belly rubs and good food and get her ready for next week... 

Synthia, so many bellies to rub, so little time 
Bud, Barney, Zuma, Kahuna, Pearl, Mango, in transit Bodhi 
Ace, Maya, Sage, Kirby 
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