This looks like a pretty good layperson’s overview. I’ve been kind of hampered in trying to do a little quick research, by not even knowing yet what type of mass they found. Not surprisingly, the prognosis varies a lot depending on what exactly is going on. But, the vet called yesterday evening, and I’ve got a little more info to work from than “he had surgery”.
I am at least hoping that it’s a primary liver tumor limited to one lobe, suggested by the fact that they did remove a large discrete mass and one lobe. (Plus the gallbladder, which is a bit worrying, but they’re squashed right together and it was apparently a very large mass—so it’s not necessarily the usual kind of multiple organ situation, as such.) And if it’s metastatic from somewhere else, usually that would be obvious by the time they’re doing endoscopy and then deciding to go ahead and remove the tumor. If he had been eaten up with metastatic growths like our poor Punkin kitty, they probably would not have tried removing the gallbladder and part of the liver, because there really would not be any point. At this point, I am more concerned about its having not so obviously yet metastasized elsewhere. But, there is obviously no way to know.
Apparently, the suddenness of its becoming obvious that there was a problem was not unusual at all with many types of liver masses in dogs. “Because of this [blood supply], the tumor can rupture, leading to sudden and severe hemorrhage, collapse, and rapid death. Often, owners do not realize their dog is affected until the sudden hemorrhage or collapse.” That was specifically referring to hemangiosarcomas (which I hope this is not), but that also happens with some other types.
You may get some often mildish nonspecific symptoms related to liver function. Max’s enzyme panels were slightly elevated, but just to a point that they wanted to keep a watch on it and continue his NSAID treatment for arthritis, and they were also keeping a watch on his looking a little more potbellied than they would have expected. That could come from a number of things in older dogs; they were wondering about Cushing’s. He was also having some not too serious GI symptoms periodically, which were not far off what I get from even the couple of NSAIDs I tolerate well enough to be able to take. That was all. I still have no idea how much of his obvious pain and tiring easily on walks has been the arthritis and deconditioning, and how much from this. I was less inclined to put it off on the generic “he’s getting old”, since that has mostly been a gradually worsening problem over the past year or so. And “probably arthritis + meds” != “getting old”. :-|
But you don’t necessarily notice much of a problem until the mass gets large, and ruptures to cause internal bleeding. The vet also said that whatever type Max’s was, is prone to sudden quick growth. His collapse Monday morning was indeed from bleeding into his chest/abdomen, and honestly he’s a really tough dog to have survived until the office opened and we could get him there.
But, there really is no need to blame ourselves over missing that something was seriously wrong earlier. We’ve been using that vet practice for over 10 years now, with Dr. Arciniega who is handling Max’s case there the whole time, and I have had no complaints whatsoever. (Other than their not taking up the slack from the specialist who apparently saw no need to give the Punkin kitty pain relief for use at home after major orthopedic surgery. She only saw them for followup once, though, for the eye and tail they removed before sending her elsewhere for the jaw surgery.) Honestly, I have been a lot more impressed at DVMs in general over the years than MDs, and kind of wish they could legally treat me at that practice. They’ve seen us through more than one veterinary emergency by now. And in spite of the fact that they’ve been keeping a fairly close eye on Max’s health the past year or so, they only noticed a few nonspecific symptoms that didn’t concern them that much. He seemed in good enough health that they didn’t hesitate to do the skin tag removal/surprise neutering under a general a few months ago.
The prognosis for most types of canine liver mass is not that good, partly because it’s usually so advanced before the problem becomes obvious. The standard of care for liver tumors has also apparently not changed much in 20-30 years, because they have yet to find more effective treatments. (My stepdad actually had a successful liver resection in the mid-late ’80s, and at least veterinary treatment now really does sound basically the same as what he got then. Thankfully without the $60,000 in 1986(?) money surgical price tag that Blue Cross preapproved and then refused to cover because “experimental” then. :/ ) But, hopefully he can at least have a few more fairly comfortable months with us. I don’t know yet if what he had is a type of tumor that responds well to chemo in case they couldn’t get it all, but even there the focus is on keeping them feeling better for longer with the expectation that it’s maybe a year or two at most. At 15, that is not as bad as it could be, though.
Anyway, I should be able to find out more this evening. He should be up to visitors this evening, Dr. Arciniega said yesterday. Besides really wanting to see Max and reassure him that we haven’t just abandoned him to medical torture, we should be able to find out more in person. He said they also have some photos of the tumor if we want to see them, which got me more curious than Mr. C—who just looked like he might throw up thinking about it. :-| I think he’s stayed in enough shock over the whole deal that he couldn’t even think of many questions to ask on the phone last night. I should probably put together a list on my phone so I don’t go blank and forget what I wanted to know.
He should apparently be able to come home Thursday at the earliest, probably Friday. Not surprised he needs a few days of more closely monitored recovery time, after the crisis he’s been through. I definitely want him to stay there until he’s ready to leave.