Dog Breed Info Center(R) DBIC

Bruno's Mast Cell Tumor Ordeal Continues

Mast (Mastocytoma) cell tumor in dogs

Bruno the Boxer sitting in front of a dog bowl with his paw in the air waving for a sweet potato chip

I have pretty much accepted the fact that Bruno is not going to be one of those dogs where you remove a tumor and that’s it, they never come back. It is apparent that he will continue to get the tumors in various places on his body. As of right now, if we remove them in a timely manner he continues to live a normal, happy life. Should we not remove them, the cancer will spread throughout his body and he will eventually get very sick and die. One look at his happy, wiggle-butt mannerism and there is no doubt he wants to live.

Tumor on Left Back End (ischium)

The back end of Bruno the Boxer with an arrow pointing to a tumor on Bruno's backside

I noticed a lump on the left side of his back end. I took him to see his oncologist and they aspirated the area. Sure enough, it was a small spot of cancer. Here we go again. Because this area is so close to his anal gland the doctor prescribed the steroid Prednisolone, which is not as harsh as Prednisone, but will shrink the tumor so they can properly remove what is left. Prednisolone is not hard on the liver the way Prednisone is. When Bruno was on Prednisone he had started having liver issues. I am hoping he will not have these issues from the Prednisolone. The medicine will make him feel hungry and thirsty. Bruno is super food motivated so this should be an interesting week as he waves for a treat with even more enthusiasm.

Bruno the Boxer backside is shaved, with a black circle around the area

The vet shaved and circled the area with a marker on his left ischium. In a week Bruno will have what is left of the tumor removed.

Bruno the Boxer and Spencer the Pit Bull Terrier with Luna the Beabull standing on a blacktop

In the meantime we have road trips, hikes and playdates to attend, as life goes on for him. This is Bruno and Spencer the Pit Bull helping to teach their new friend Luna the Beabull puppy how to walk on a leash.

Tumor on Left Back End (ischium) Removed

Bruno the Boxer looking at the emergency room swinging doors

This is Bruno the day of his surgery to get the tumor on his left ischium removed. He is staring at the door where he knows a vet tech will eventually show up, at which time he will wiggle his entire back end, giving her a couple of play bows before she reaches him. At that point he will continue wiggling as he walks to the back with her. Anyone who has owned a Boxer before knows exactly what I am describing.

Bruno the Boxer shaved backside with stitches on his back end

I was able to pick Bruno up the same day. This picture shows his incision area. The care instructions are the same as all of his other mast cell removal procedures.

He had a shot of steroids while at the vet before the surgery was performed to help keep any other tumors from popping up.

He is on the following medications:

Famotidine 20mg - 2 pills once a day (generic form of Pepcid)

Cefpodoxime 200mg - 1 1/2 pills once a day (antibiotic)

Tramadol 50mg - 3 pills every 8-12 hours (pain reliever)

Close Up - Bruno the Boxer standing in a kitchen looking up at the camera

The vet stated that Bruno may not feel like eating the first day or so, which is common in dogs that have had surgery. At dinnertime we laughed as he gobbled all his food down. This boy always wants food. This is him looking at me after he ate his dinner the night he came home from surgery and I am sure he is thinking, "Food... you got any more food?!"

Results

I had a bad feeling about this particular mast cell because it seemed to have started deeper in the body rather than on the surface of the skin. When we first spotted the bump, it felt like all bone, as if something inside was pushing it out. The vet went ahead and attempted to remove the tumor.

Other Tumors showing up near the stitched area

Two days later, I noticed a small mast cell appear on the skin next to his stitches with several smaller tumors surrounding it. Oh no, this was not good, not good at all. Bruno was also passing a lot of gas which is a side effect of high histamine levels in his body. I finally got the phone call I was waiting for: the results were in. I was saddened but not surprised to hear that the biopsy came back with dirty margins, which means they did not get all of the cancer. Bruno has an appointment in a few days for suture removal and at that point we will get more information about the severity of his condition and what to do next.

Bruno the Boxer sitting on a dog bed in a van

Another thing I noticed is Bruno seems to be losing weight even though he is eagerly eating all of his food and has been getting lots of treats on the side. While I did see him throw up twice before his surgery, I have not seen him do it at all since. His collar is looser and his overall build seems to be going down.

Close Up - Bruno the Boxer with tumors near the stitched backside

A few days later the new mast cell has turned from a pink color to brown and I am not positive, but I think there still are one or more smaller mast cells next to the larger one. Now that they have turned colors it is harder to see them. Mast cells can appear very quickly and they can also shrink just as quickly.

Behavior Changes

As soon as I heard the news that this time we didn't get all of the cancer removed I had a sinking feeling inside. We still had to see the oncologist for a plan of action, however, in reality I knew we were not winning the battle. I started noticing behavioral changes in Bruno. On walks he started pulling off to the side to sniff and pee where he wanted, which would catch me off guard, making me stumble and sometimes drop what I was holding. This was not like him. He started leaning on me and standing close, wagging his nub. He was following me around the house more and he was getting a little on the pushy side, squeezing himself between me and whatever I was standing close to. It crossed my mind over the next several days that Bruno sensed how I was feeling, but I had not thought too much of it. Then I saw him steal Spencer's bone, leaning over him in a dominating manner. One wrong move from Spencer and Bruno was going to start a brawl. That is when I realized it really did matter that Bruno was reacting to my emotions about his health. On the outside I was acting like a pack leader in motion only, but inside I was sad and he knew it. Bruno was not changing because he was sick, he was changing because he sensed that deep down I was not as mentally strong and he was taking a shot at moving up a notch to help me while I was feeling down. Oh, Bruno, I am going to have to pull it together for your sake. Now get away from Spencer, you’re not getting that bone tonight, big buddy.

I watched both dogs that night and saw Spencer not want to lie on the dog bed next to Bruno. Spencer was feeling it too as Bruno attempted to claim the dog bed as he had done once before in the past. Spencer walked over to me and sat down. Then he walked back over in front of the bed and stood there, not looking at Bruno or the bed, but standing in front of it in the middle of the room. He wanted to lie down, but he didn't want to challenge Bruno. OK, that was it. I got up and sat down on the dog bed very close to Bruno. It was my bed, not his. I leaned into Bruno and just sat there, taking deep breaths to pull out of feeling bad for Bruno. Spencer started to wag his tail and he licked my face. Then he lay down on the bed. Bruno yawned. I looked at him and he averted his gaze. Spencer curled up surprisingly close to Bruno, who had obviously given up. I waited a few minutes and got up.

Bruno the Boxer and Spencer the Pit Bull Terrier laying together in a dog bed

It's been a couple of days since and things are back to normal. They are not back to normal because I claimed the bed, but because I was able to mentally pull it together. The best thing I can do for Bruno is to help him continue to be balanced, secure and happy. I know a dog’s temperament can change if the humans change, but it was still eye opening to me for Bruno to change his actions so quickly to match my feelings. Alright Bruno, you win. I will work very hard to live in the moment just like you do, and instead of grieving that we will lose you someday I will be happy you are still here right now. Time to take more deep breaths.

Good News

I was pretty bummed out to hear over the phone that the margins were not totally clean and I jumped to thinking the worst. However, at today’s appointment we learned additional good news. While Bruno's biopsy did come back with traces of cancer in the margins, apparently the grade of cancer was so low that it appears to have disappeared, which is what mast cells can do, come quickly and disappear quickly.

An Arrow pointing to another lump on Bruno the Boxers Backside

The area where I thought the little mast cell had appeared is still there but it shrunk, hardened and flattened out. The oncologist didn't think much of it. I will have to keep an eye on it. The oncologist said that the surgery could have triggered healthy mast cells to attack the bad ones. Bruno is still not on any ongoing medications besides the joint supplement, fish oil and Benadryl, which he has been on during this whole ordeal. The plan is to continue watching for any new signs. The doctors all say Bruno is the type of dog that will continue to get mast cells throughout his life and we will continue to fight them off as best we can. Bruno weighed in at 84 pounds. While he is eating well, the doses of past steroids have knocked some pounds off of him and the bright side of that is less stress on his knees.

The oncologist said, "Bruno appears to have healed well from his surgery. The mast cell tumor removed was one under the skin. These tumors tend to behave in a benign fashion when excised. The biopsy report likewise indicated this was a slow-growing tumor. At this time I do not recommend any additional therapy for this mass. As we have discussed, Bruno is a Boxer and has shown he is prone to mast cell tumors, all of which so far have been independent events and benign in their behaviors, meaning they are not the type that quickly and aggressively spread. We will need to monitor him for additional tumors throughout his life and address any which may arise."

At the appointment Bruno's butt wiggles the entire time he is there. Anyone that gets close gets a lick in the face. If they don't get close enough for his tongue to actually make contact he dry licks the air as if they are close enough, all the while wiggling with happiness.

It's Back

Close Up - Finger pointing to a mast cell tumor on Bruno the Boxer

Remember the spot that decided to appear and then disappear? Well it reappeared once again. No big surprise. There is a reason they call mast cell tumors "the great pretenders." They can come and go very quickly appearing, disappearing and morphing into many different forms. Bruno is scheduled to have it removed before it spreads and stirs up some real trouble inside his body.

Bruno the Boxer sitting in front of a door

This is Bruno listening to the voices on the other side of the door. He cocks his head and his nub of a tail begins to wag. They are coming to see ME! I know they are. Got to get my licks in!

Close Up - Bruno the Boxer licking beef stew from a spoon

Bruno's weight is holding steady at 84.7 pounds. He is still eating well. The day Bruno decides he does not want to eat I will be worried. He seems to eat whatever is put in front of him without even taking the time to smell it. Tonight he got some grass-fed beef chunks mixed into his regular food along with some licks of homemade beef stew on a spoon. Are you thinking what I think you're thinking? "Goodness...the tongue!" That tongue is what gets all the vets and vet techs in the face at every appointment. :) Just when you think you are out of reach of the tongue, you're not!

The Removal

Spencer the Pit Bull Terrier laying on a dog bed with his head resting on a frog plush toy

Spencer seemed pretty lonely the day Bruno was gone getting the tumor removed. He's a smart dog, yet his reasoning / logic is not like a human’s. Spencer rode along when we drove Bruno to the vet. He saw me walk Bruno into the building and come back out without him. Yet, when we arrived back home he ran around the house looking for Bruno.

Sutures on the backside of Bruno the Boxer

Bruno was able to come home the same day. We picked him up that evening. Spencer was happy to see him, yet respectful. He did not jump all over him, but the tail was going a mile a minute and he was full of happy, submissive body gestures.

Bruno the Boxer and Spencer the Pit Bull Terrier snuggled together on a dog bed. Brunos paw is on Spencer's nose

As always, Spencer snuggled right in.

Bruno the Boxer and Spencer the Pit Bull Terrier snuggled together on a dog bed with Bruno's paws all over Spencer

We often notice that Spencer copies Bruno in odd ways. He takes note of the direction Bruno is sleeping and lies down the same way. At first we thought it was a coincidence, but it happens too often to be just by chance. The two dogs will often be on separate dog beds yet sleeping the same way. If Bruno is upside down, Spencer is often upside down. If Bruno is facing left with his head to one side, Spencer is sleeping left with his head to the same side. If Bruno's body his hanging halfway off the bed, Spencer's body is hanging halfway off the bed, too. When Bruno shifts directions, Spencer shifts directions. This happens inside the home and also when driving in the car. We joke that when Bruno is gone, Spencer does not know which direction to sleep. It's a good thing Bruno is a good boy because he has a big influence on his kid brother.

Biopsy Results

Bruno's biopsy results came back. The tumor was labeled as a multifocal, low grade two. Cancer was found in both the skin and under the surface. The margins of the biopsy were clean, meaning whatever tumors they removed they did completely get out. Multifocal means that there was not just one area that had cancer cells. There were several little individual clusters. This would make sense as to why after the last tumor was removed another appeared next to the stitches. He does not just have one tumor but a cluster of areas. The fact that the cancer is low grade is good news. The fact that we are dealing with an area that has a cluster of potential tumors that are both surface area and below is not so good news.

Another Test

Since Bruno's biopsy came back as multifocal the specialists decided to do an immunohistochemistry (IHC) test. They take the last tumor that was removed and test to see if Bruno's cancer is solely the mast cell type or if it has turned into a general cancer that could be attacking his body. In about 2 weeks we should know the results of the test.

Throw up

Bruno the Boxer's bile from throwing up on the hardwood floor

The vet had asked of Bruno ever throws up. I have seen him throw up yellow bile about three times, but I often see him swallowing something that was trying to come up back down. I guess Bruno likes his food and he does not want to let it come out.

Close Up - Bruno the Boxer's bile from throwing up on the hardwood floor

About a week later more throw up from Bruno. It's bile again. This was right before he was fed his breakfast. He still ate his food like he normally does and kept it down. We are still waiting for the test results.

Bruno the Boxer standing over Mia the American Bully Puppy

Oh boy, this same day as the throw up above Bruno was playing with is new 7-week-old kid sister Mia, the Bully Pit puppy when he suddenly and without warning threw up a second time.

Bruno the Boxer's throw up on a dog bed

I let him outside. He went to the bathroom and I cleaned up the mess.

Bruno the Boxer in the face of Mia the American Bully Puppy

I let him back inside and he started another play session with Mia, dropping a squeaky toy into the bed where she had finally settled down to take a nap, and squeaking it right next to her then pawing gently to try and get her back playing. Bruno I am glad you are still in good spirits, but if you let Mia sleep maybe I can get some other things done buddy.

Test Results

Bruno's immunohistochemistry (IHC) test results came back with relatively good news. It shows that his cancer in general is slow growing and that it has not spread throughout his body. When a tumor is removed there is only a 20% chance that that individual tumor will grow back. Knowing Bruno's history he will most likely keep getting tumors, however they are all individual and separate from one another. They are not something that has spread from one area to another. Bruno views going to the vet as party time, loving everyone he sees. He has no problems walking off with a stranger. He will lick up their face as he curls into a U wagging his back end. Removing the tumors does not cause him anxiety and/or stress. Both the test results and his attitude confirms that in his case removing them without any ongoing cancer medication is our best route to take.

Check-Up

An Arrow pointing to a fatty pocket on Bruno the Boxer's hip

I saw a spot on Bruno I was not so sure about. It looked like another tumor. The cancer specialist asperated the area and I am happy to report that it was just a fat pocket and not a mast cell. Bruno weighed in at 85.3 pounds.

Check-Up—3 Months Later

Close Up - Hand and Arrow pointing to a lump on Bruno the Boxer

Three months after the lump on the hip tested to be just a fat pocket and not cancer, I spotted another lump on Bruno under this lower teet on this belly. I took him into the oncologist and they aspirated the area, which means they sucked some of the tissue out with a needle. They tested it right in the office but were not able to tell if it were cancer. This means it is either non-cancerous or its too small and cannot be detected with just an inhouse visit under the microscope. The sample was sent out to the lab to be more extensively tested. The results should come back in a few days.

Check-Up—3 Months Later—Update

The sample that was sent to the lab was too small to get an accurate diagnosis, therefor Bruno is having a biopsy done on the lump to see if it is cancer.

While we were checking in at the vet's front desk another Boxer walked in. Bruno looked at the dog and instantly the two of them growled. "Hey! No! Bruno leave it!" Bruno quieted down, wiggled a little at me and went back to staring at the dog as if he was on guard. I tapped him on the head. "Don't even think about it, dude. What's wrong with you?" Immediately after the other Boxer passed a Jack Russell walked in. Bruno wiggled at it, wiggled at me and didn't mind that dog one bit. He seemed to rather like it. "That's more like it, Bruno." The vet tech took Bruno into the back for his procedure and I headed out the door to leave. As I passed the other Boxer I admired how nice looking it was. As I was thinking good thoughts about the dog, it looked right into my eyes and growled. Oh, wow. I didn't have Bruno with me, so the dog was growling at me, not my dog. Now I get why Bruno reacted like he did. Even if I had known I would have told Bruno to "Leave it" however. I do not want him reacting like that, things could get out of hand. But he is proving more and more that he only does it when the other dog is either not balanced or untrustworthy in some way.

Check-Up—3 Months Later—Update—Heart Arrhythmia

During his check-up at his biopsy appointment the doctors discovered Bruno had a heart arrhythmia. Luckily it is not the type that leads to congestive heart failure. He was put on Sotalol to keep it under control. We are to keep track of his rest time breathing to make sure it stays under 30 breaths per minute. His report reads,

Diagnosis: Arrhythmogenic Right Ventricular Cardiomyopathy has developed. ARVC is a common hereditary condition in Boxers with variable age expression and due to fatty cell iniiltration in the right ventricular wall which causes the positive morphology ventricular premature complexes. There is no evidence of dilated cardiomyopathy (DCM), congestive heart failure or pulmonary arterial hypertension at this time.

Check-Up—3 Months Later—Update—Biopsy Results

Good news, Bruno's biopsy came back that the lump was not cancer. We will continue to check him for new tumors.

3 Months Later—Lump on Snout

Arrow pointing to a possible mast cell on Bruno's face

Bruno is now 7 years old. Last night I noticed a lump on Bruno's snout that looks like a mast cell. Bruno has an appointment scheduled to get it tested. For two days in a row Bruno did not finish all of his breakfast, which is very much out of character for him, although he did finish his dinners. My guess is he has a lot of histamine in his body from the tumor even though he is still on the antihistamine allergy medicine.

Close Up - Lump on Brunos face

Lump on Bruno's snout

Close Up - Another lump on Bruno's face. This time under his eye

Another lump on Bruno's face

3 Months Later—Lump on Snout—Update:
Great news, Bruno's oncologist believes the lumps are warts rather than mast cells. We are to keep an eye on the areas for any changes, but as of right now they will not be treating them. The last three times Bruno went in to get checked the lumps turned out to be negative, but that is what one must do with a dog who gets mast cell tumors, check every single lump that appears just in case.

Cardiology Check-up

Bruno had an electrocardiogram with the cardiologist for his heart and received good news. His report reads "Bruno, a 7 year old male neutered Boxer diagnosed with arrhythmogenic right ventricular cardiomyopathy (ARVC) is doing well on Sotalol 80 mg tab in the A.M. and 1/2 in the P.M.. Bruno's cardiac status is very stable, compensated and improved compared with his initial cardiac workup. There are no further ventricular arrhythmias and no evidence of dilated cardiomyopathy, congestive heart failure or pulmonary arterial hypertension at this time. Current therapy with Sotalol as prescribed with no additional cardiac drugs required at this time."

11 Months Later—Lump on Tail:

Close Up - Lump at the base of Bruno's tail

I noticed a lump at the base of Bruno's tail. His tail was docked at birth by the breeder. I didn't know if it was just from having a docked tail, the hot weather or another tumor. We were off to the oncologist to get it checked just in case. The hardest part of the whole visit was getting Bruno to stop wagging his nub long enough for the vet to get a good look at it. The attempts to lick the vet in the face didn't help either. When I remembered the command Sara taught Bruno when getting her "Things on Bruno" pictures... I said in a serious voice, "Bruno Wait" and he froze long enough to allow the vet to take a look.

The oncologist thought it felt more like a fatty deposit than a tumor. He didn't see any signs on the skin either. To get a needle in to aspirated the area would require sedating Bruno since he has a hard time keeping his tail still. His feeling was that it was not a tumor. In order to check the area he had to massage and feel around the tail base. If it were a mast cell tumor it would swell up three times the size from almost immediately after to the next day and if that happened, I was to bring him back for surgery. The area did not swell up at all. It remained the same, which is a good sign that it is just a fatty area as the oncologist suspected. If the area grows at all we will be heading back to the vet. For now however, it looks like Bruno simply has a fat pocket at the base of his nub. If you suspect your dog has a mast cell tumor it is not wise to massage or irritate the area in any way. When the tumor grows the cancer can spread. Mast cell tumors can swell quickly, right before your eyes.

Raising a Puppy: Bruno the Boxer