<p>Our dog has melanoma-the growth is in the mouth. He is 12 or 13, has several joint/hip problems but get around well after lots of medication adjustment. He does cough/gag, more so when upset (we leave or won’t give him people food). The vet says lab work is good with possible heart trouble. He is ready to do surgery. The little info I have found does not give a good prognosis. We were on vacation when we got the lab results. We are worried about the general anesthesia and the post op pain. He also has a “fatty tumor” that doesn’t bother him but will also be removed. We thought we were going to lose him last year and have enjoyed the extra time we have. </p>
<p>CC has helped us before, and any info would be so appreciated. Is it time for doggy hospice, or is being aggressive of benefit to our beloved old man?</p>
<p>In addition to being the mom of a graduating high school senior, I also am the author of Senior Dogs For Dummies (Wiley, 2004). An individual dog’s prognosis for melanoma depends greatly on the size of the tumor in question. is. If the tumor is small – and if the anesthesia for the surgery is adjusted to deal with any underlying conditions such as heart trouble – surgery and chemo could do the trick. </p>
<p>You might want to consider getting a second opinion, perhaps from a veterinary dermatologist.</p>
<p>Sooz obviously has more technical knowledge than I do, but let me go with the emotional stuff here:</p>
<p>The dog is old. He has numerous problems. This surgery will cost some significant money. Probably in a year, something else will come along that will make you send him to Doggie Hospice.</p>
<p>Consider how many financial resources you’re willing to devote to the dog, and whether spending that in exchange for another year of life will make you feel good over the long term.</p>
<p>As hard-hearted as this sounds, keep in mind that vets generally make more money on surgeries and geriatric care than they do on supportive care. </p>
<p>You need to ask a bunch of very hard questions: is there supportive care that’s appropriate? How much money can we afford to spend? How much money do we want to spend? Do we have the time, inclination, emotional support we’d need to do the treatment the vet suggests? Will the dog’s quality of life be better or worse if we do X treatment?</p>
<p>Last year I euthanized our 16 1/2 year old diabetic cat; the vet was in favor of twice-daily injections (which would have kept her reasonably healthy)… but I felt it would make the cat miserable, it would make me miserable, and no one would benefit. </p>
<p>It’s a hard decision and you have my sympathy.</p>
<p>I would find out if the melanoma in the mouth is the primary lesion, or if it has metastisized from elsewhere. That should also help in your decision making. Then they should be able to tell you what stage of melanoma your dog has, if it is graded in a similar way it is graded in humans ( I believe stage I-IV). I would also ask your vet for a prognosis with the treatment he recommends. Oh, and I agree with dmd about vets generally making more money on surgeries than palliative care.</p>
<p>Thank you all. I will try to get more info on the lesion to make a decision. Needles have never bothered our boy, but the blood draw for labs seemed to bother him quite a bit. My gut feeling is that perhaps this melanoma is contributing to the lumps, coughing, weakness etc he has been experiencing… I have worked with physicians who just won’t give up on a patient. I cannot tell if this is the case with the vet or if he is following the money making advice I read about in his vet journals.</p>
<p>Definitely consider the costs in money and dog discomfort. In people stage 1, not into the dermis, is cured with the excisional biopsy. Stage 2 is cured with a wide excision, including the “sentinal node” biopsy, with yearly followup for other melanomas or mets. Stage 4 still has a 50% mortality rate, the same as I learned in medical school over 25 years ago. No chemo or radiation, some other iffy treatments can be tried. I restudied this 4-5 years ago… I have an long ugly arm scar… I would also leave the lipoma alone if it isn’t bothersome.</p>
<p>My dog would get TLC and be allowed to die. People- PLEASE check yourselves for suspicious lesions, do not be conservative in getting them checked, ie don’t be sure all criteria are met (mine was in a hard to see spot and only differed in color, thank goodness I noticed one day and got it taken care of-unexpected diagnosis)- better to have many normal moles/nevi removed than let an undiagnosed cancer spread.</p>
<p>I believe that stage 4 is a bit more grim than a 50% mortality rate. Here is just one piece from one article:</p>
<p>Article
Medical management of stage IV malignant melanoma. Medical issues
Reginald C. S. Ho, M.D. *
Straub Clinic and Hospital, Honolulu, Hawaii</p>
<p>*Correspondence to Reginald C. S. Ho, Straub Clinic and Hospital, 888 South King Street, Honolulu, HI 96813</p>
<p>Abstract
Background. Stage IV melanoma is defined by TNM staging as any tumor, any node, and M1, the presence of distant metastasis. The prognosis of Stage IV melanoma is grim. The expectation for 5-year survival is less than 10%.</p>
<p>Having lost two out of 3 dogs to cancer, we regret the invasive surgery for bladder cancer that we subjected our dear, 14-year old Westie to in her final days. In hindsight, I can not imagine why the vet even recommended it. </p>
<p>The other dog we did nothing and eventually euthanized him - but, alas, we should have done that earlier too.</p>
<p>I switched after that to a much less aggressive, much less “fancy” vet and have been happier with his recommendations.</p>
<p>Either way, it’s heart wrenching and I feel for you. We just have to appreciate the good lives our pets have and the old saying, “Better to have loved and lost…” :(</p>
<p>Oops. Thanks for the stage 4 update, I hadn’t rechecked facts, just remember it’s bad… the reason to take care of those moles when you first notice them.</p>
<p>I’m glad to hear others are also not in favor of aggressive therapy for their dogs, quality of life counts.</p>