News on Katie's Nose

[Stacy]

Because I hate it when people say something and then never come back to update... 

I took Katie in for a biopsy a week ago Thursday and just got results this last Friday. The vet was intitally very encouraging and thought it would be something innocuous - she actually thought it was TVT, which is a transmissible venereal tumor, but when she called on Friday the pathology report said suspicious for well differentiated adenocarcinoma, but correlate with clinical findings. Not at all what I wanted to hear. So Katie is scheduled for a head CT tomorrow morning. We should have a better idea of what we are dealing with at that point. 

The proposed treatment, dependent on the CT results are stereotactic radiation at Colorado State which is supposed to be very precise and only take a week (good because it's a long way from home) or potentially palladia, which is an oral chemo. Neither option is without side effects. Neither option is inexpensive. But how do you put a price on a life? Right now I'm just trying to take it one step at a time and go from there. I have this very tiny hope that the CT will show us something different than the biopsy did. 

The vet also said that Katie is an outlier. She's too young for this disease. She's too healthy. And almost never can you see the tumor inside the nostril. So yay, we're special? 

If anyone is curious, I'll let you know about the CT results.

Stacy

[Karen, Jasper and Jackdoodle]

You know I am keeping you and Katie in my thoughts and hoping for the best possible outcome. Hugs to you both. 

[Stacy]

And I appreciate it! It's important to have people who really understand that it's not "just a dog." She's family. You can't just replace her like a new car. She's a living, breathing, feeling creature with a heart. And she knows all of my secrets better than anyone else in the world. She's my kid.

[Karen, Jasper and Jackdoodle]

Yep. 

[F, Calla & Luca]

Of course I am curious. I am hoping this well differentiated adenocarcinoma turns out to be a benign adenomatous polyp after all. Suspicious doesn't sound definitive to be and I would certainly ask for a second opinion on the slides.

[Stacy]

I have the pathology report from IDEXX laboratories.

The microscopic description says: The submucosa is expanded by a well differentiated and mildly disorganized proliferation of atypical epithelial cells arranged in tubuloacinar structures. Atypical epithelial cells have variably distinct borders and polygonal nuclei. There is mild anisokaryosis with 5 mitotic figures per ten 400X fields. 

The microscopic interpretation says: Atypical submucosal epithelial proliferation, suspect well differentiated adenocarcinoma. 

When I spoke with the vet I very much got the impression that she didn't feel that the pathology was definitive either. 

So, of course we're going with the CT. But I think you have a good point about asking for a second opinion on the slides. Sometimes people come in with their CT scans and our radiologists over-read them (and often have a different opinion than the radiologist at an outlying and non-pediatric hospital.) But I have no idea how you would get the tissue over-read. Do you think I could have them send the slides to another lab for interpretation? I really like the idea of them just being wrong.

[F, Calla & Luca]

Talk to your vet. She might suggest how to go about another opinion. A pathology specialist at a veterinary school would be ideal I think. Even in the worst case a well differentiated tumor sounds better and might be amenable to surgical removal. Was this a needle biopsy or an excision also biopsy?

[Stacy]

She said she was taking a cup biopsy with her endoscope. A vet school is actually a great suggestion. She did say that after we do the CT we could send all everything to Colorado State for review. Maybe they will get the actual images of the biopsy and not just the report and that will help give a more definitive diagnosis.

[Jersey, Jasmine, Jypsy and Diane]

So sorry you are all going through this. Keeping you all in my thoughts and prayers. Please keep up updated. 

[Stacy]

Thank you! I will keep everyone updated. I really hope that I don't have to wait another week for the results of the CT.

[Laurie, Wally & Charlotte]

Hi Stacy, I agree with you in feeling lucky to be a part of a like-minded community of people who understand how much we love our dogs and think of them as family members. I am sorry to hear about Katie and the worrying you are doing as you wait for a definitive diagnosis and treatment plan. With my own dog and a similar situation of waiting for a week for biopsy results, I can sympathize with you. Also, a have a close (human) family member who has been treated successfully with stereotactic radiation. Hugs. 

[Laurie, Wally & Charlotte]

P.S.: Thanks for your kind words on my discussion about Wally's surgery. 

[Stacy]

Waiting is absolutely the hardest part! I thought I would have results on Tuesday and I didn't get them until Friday. When I called on Tuesday to check and they told me they didn't have them it was all I could do not to throw a huge fit. I had to take a deep breath and think about my own job and tell myself that I cannot scream at a person who has absolutely no control over this. But I suddenly saw how easily that could happen.

I saw Wally came out of surgery well. I'm hoping for very uneventful biopsy results for you.