Sarcomas in Dogs Karri Miller

SARCOMAS UNDER YOUR DOG'S SKIN

Last month, I discussed how cats can develop sarcomas under their skin that are rarely associated with vaccines.  This month, I will address sarcomas that can occur under the skin in your other furry family member, the dog.  Unlike in the cat, the development of these tumors is not linked to vaccines.  

These tumors may first be noticed as a small lump or swelling under the skin in any location.  The appearance of a soft tissue sarcoma can be very similar to other common tumors under the skin, such as benign fatty tumors (lipoma) and mast cell tumors.  It is important to realize that you cannot diagnose the tumor type by the way it feels.  Some people think that any soft mass under the skin is a lipoma, while any mass that is more firm is a malignant tumor.  This is not always the case, as some soft tumors are diagnosed as mast cell tumors or soft tissue sarcomas.  On the other hand, some lipomas can feel firm if they form under a thin layer of muscle.  The good news is there are easy diagnostics that can be performed to differentiate between these different tumors.  A sample of cells from the mass can be obtained by sticking a small needle into the mass and smearing the cells onto a slide.  The slide can be evaluated by your veterinarian or a clinical pathologist to determine the tissue of origin.  

If your pet has a soft tissue sarcoma under the skin, the best treatment option is surgery.  Prior to surgery, it is recommended that your pet have basic bloodwork performed to make sure they are healthy enough for surgery and chest x-rays to make sure the tumor has not spread to the lungs.  Most of these tumors will have a low rate of metastasis, but it is very important to determine they are metastasis-free before pursuing treatment.  Just as with the cat sarcomas, the first surgery is usually the best attempt to rid your pet of the entire tumor.  Sarcomas have microscopic finger-like projections that extend out from the mass you can feel.  Therefore, surgery will involve taking a few centimeters of normal tissue to ensure the entire tumor has been removed.  If the entire sarcoma is removed with a large margin of normal tissue around it, your pet may be cured.  

In some cases, it is not possible to remove a large amount of normal tissue.  Sarcomas that occur on any of the legs can present this problem.  In those cases, it is still recommended to remove as much of the mass and normal tissue that is possible.  If wide margins were not obtained, radiation therapy may be recommended.  Side effects of radiation therapy are confined to the area that is treated.  If surgery is followed by radiation therapy, there is a 75% control rate of the tumor at 5 years.  When radiation therapy is not possible, metronomic chemotherapy may be a viable option.  This type of chemotherapy involves a low dose chemotherapy pill and a non-steroidal anti-inflammatory that slows tumor blood vessel growth.  This has been shown to delay the time it takes for the tumor to regrow and is associated with minimal side effects.  If your pet’s tumor is not completely removed and no other treatment is pursued, the tumor most likely will regrow in that area.  The time it will take to regrow depends on a number of factors including:  how much of the tumor was removed, tumor location, and tumor grade.

As you can see, treatment options are available for long term tumor control or cure for dogs with soft tissue sarcomas.  Pursuing diagnostics and treatment when the mass is first noticed and small in size, can be very beneficial.  It is important that any new masses on your pet should be evaluated by your veterinarian to determine their origin and a treatment plan.  

Blog by:

Karri Miller DVM, MS, DACVM (Oncology) 

http://www.lapoflove.com/default.aspx?sid=8

www.lapoflove.com

Lap of Love Veterinary Hospice 

Dr. Karri Miller provides Skype and Phone consultations to families across the United States whose pets have been diagnosed with cancer. As a Board Certified Oncologist, she will be able to provide your family with information about cancer, treatment options, and expectations.

Blog originally prepared for the Lakeland Ledger (Florida)

Posted by Vet Mary Gardner

Cat Tumors from Vaccines

RARE CAT TUMORS FROM VACCINES

Many years ago, when I started my career in veterinary medicine as a veterinary technician, I remember being puzzled as to why we vaccinated cats in so many different locations on their bodies.  The rabies vaccine was given in one leg, while the feline leukemia vaccine was given in another leg, and the panleukopenia vaccine was given in yet another leg.  When I was brave enough to ask why we vaccinated cats this way, I was given my first taste of veterinary oncology.  It turns out that in about 1 out of every 10,000 cats, vaccines can cause something called vaccine-associated sarcomas.  

The notion that a vaccine can cause a type of tumor is scary for cat owners.  However, over the past 10-20 years, there has been a lot of effort by the veterinary community to decrease this risk.  Special task forces have been developed in an effort to determine the best location to vaccinate your cat, how often to vaccinate, and the safest vaccine.  You may have noticed that your veterinarian used to vaccinate your cat between the shoulder blades and now they do it on a leg or on the tail.  This practice was developed in order to make it easier to treat a tumor if it occurred.  Some vaccines are administered every year, while others can be administered every three years in an effort to decrease the risk of developing a sarcoma.  Vaccines, such as feline leukemia virus, may only be given to your cat if your veterinarian feels that your pet is at an increased risk of catching this virus.  

 

Vaccine-associated sarcomas can develop over weeks to years after a vaccine is administered.  These tumors are thought to occur from inflammation incited by the vaccine that causes these cells to divide.  The best results for tumor control occur when aggressive surgery and radiation therapy are combined.  Cats that undergo this type of treatment can be tumor free for approximately 2 years.  It is recommended that the tumor be removed by a board certified surgeon since these can be extremely difficult to remove completely.  In fact, advanced imaging, such as a CT scan should be performed prior to any surgery to remove a vaccine-associated sarcoma.  A CT scan can show the extent of the tumors in tissues that you cannot feel on the outside of your cat.  If the tumor was not completely removed or if you cannot pursue surgery and radiation therapy, there are other treatment options.  Injectable chemotherapy may help prevent the tumor from growing back if it was not completely removed.  Palladia, a medication approved for the treatment of mast cell tumors in dogs, is currently being investigated for use against vaccine-associated sarcomas in cats.  Preliminary results show that Palladia may slow the growth of this tumor in cats.  

The risk of developing a tumor from a vaccine may be much less than your cat catching a deadly virus that they could have been prevented with a vaccine.  In fact, the rabies vaccine is required by law for all dogs and cats.  Please discuss your cat’s vaccine needs with your regular veterinarian.  It is also important to alert your veterinarian to any masses you may feel when petting your cat at home, so they can be addressed in a timely manner.

Blog by:

Karri Miller DVM, MS, DACVM (Oncology) 

http://www.lapoflove.com/default.aspx?sid=8

www.lapoflove.com

Lap of Love Veterinary Hospice 

Dr. Karri Miller provides Skype and Phone consultations to families across the United States whose pets have been diagnosed with cancer. As a Board Certified Oncologist, she will be able to provide your family with information about cancer, treatment options, and expectations.

Blog originally prepared for the Lakeland Ledger (Florida)

Posted by Vet Mary Gardner

Veterinary Specialists Karri Miller

WHY DOES MY PET NEED A SPECIALIST?

When I tell someone what I do for a living, their response is usually the same, “You are a veterinary oncologist?  I did not know there was such a thing.  Do people treat their pets for cancer?”  This usually prompts a response about what my job entails and my passion for veterinary oncology.    

It is interesting that in today’s society where most households have at least one pet, so few people realize there is specialty care available for their pet.  Just as in human medicine, many specialties now exist in veterinary medicine.  Some examples of the specialties available for your pet include:  internal medicine, neurology, oncology, cardiology, surgery, ophthalmology, and dermatology.  The family physician is the equivalent of a general veterinarian, who your pet visits for basic wellness and vaccines.  If the family physician were to hear a heart murmur or irregular heartbeat on a patient, they would be sent to a cardiologist for tests and an evaluation.  It is very similar in veterinary medicine where a heart murmur or irregular heartbeat found by the general veterinarian, may be further evaluated by a veterinary cardiologist.  Your family veterinarian may be the first doctor to assess any medical problem that your pet has, but they may recommend your pet visit a specialist for additional help managing your pet’s medical condition.  

     

Another question that I get asked when telling people about my job is, “Did you have to undergo special training to do oncology?”  The answer to that is yes!  Any specialist, whether it is a human physician or a veterinarian, has to pursue special training after medical or veterinary school in order to specialize in one area.  This typically involves an internship and residency performed under faculty and mentors that have been specialists in the field for years.  There are also rigorous exams administered upon completion of a residency, to insure that each doctor is able to practice the specialty with a certain level of knowledge and standard of care.  It is only when all of these criteria are met, that someone can become board-certified in a certain field. 

While the comparisons between human physician specialists and veterinary specialists are numerous, there are some differences in the way people and pets are treated.  Sometimes treatments available for people may not yet be available for pets.  Treatments that are available to both people and pets, may be administered differently in pets.  Reasons for this difference include:  cost, availability of the treatment, and the ability to tolerate the treatment.  Dogs and cats metabolize medications differently than people, and some treatments can be ineffective or toxic in these animals.  Ultimately, the goal of any treatment in pets is to maintain a good quality of life, while extending their life span.  

If your pet has any special medical condition, from itchy skin to a growing mass, a board-certified specialist may be able to help.  Your family veterinarian and veterinary specialist work as a team to provide the best care for your pet’s medical condition.  Should you choose to seek a specialist’s help for your dog or cat, your family veterinarian will be able to help locate the right specialist to meet your family’s needs.

  

Blog By:
Karri Miller DVM, MS, DACVM (Oncology) 

http://www.lapoflove.com/default.aspx?sid=8

www.lapoflove.com

Lap of Love Veterinary Hospice 

Dr. Karri Miller provides Skype and Phone consultations to families across the United States whose pets have been diagnosed with cancer. As a Board Certified Oncologist, she will be able to provide your family with information about cancer, treatment options, and expectations.

Blog originally prepared for the Lakeland Ledger (Florida)

Posted by Vet Mary Gardner

Skin Tumors in Dogs and Cats

DIAGNOSING SKIN TUMORS IN YOUR PET

 

The most common location for a dog to develop a mass is on the skin or underneath the skin surface.  These types of masses may not be as common in the cat, but can still occur.  Most of the time, these masses are found while you are petting or playing with your pet at home.  Sometimes, masses can be found by the family veterinarian at annual wellness visits.  Annual visits to the veterinarian are important for many reasons as your pet ages.  Locating and diagnosing new masses is just one example of the importance for these wellness visits.  

 

There are a variety of tumor types that occur on the skin or underneath the skin.  Your veterinarian may be able to narrow down the possible tumor types based on appearance, however, the best way to definitively figure out the origin of a mass is to perform a fine needle aspirate or a biopsy.  There are exceptions to this recommendation in cases where pets have small warts or skin tags.  Those may appear like small masses on the skin and they may not be able to be aspirated or biopsied due to their small size.
  

A fine needle aspirate is a non-invasive test to determine the origin of a mass.  A small needle (about the same size that would be used to draw blood) is inserted into the mass.  Some cells from the mass will enter the needle when it is inserted into the mass.  These cells are then spread onto a glass slide for evaluation.  Sometimes your veterinarian may be able to evaluate the cells under the microscope, but there are times when the slides are sent to a pathologist for review.  

On some occasions, your veterinarian and a pathologist may be unable to determine the origin of a mass based on fine needle aspirate alone.  Some tumor types, both benign and malignant, will not release their cells very easily and can be difficult to diagnose with a fine needle aspirate.  At this point, a biopsy may be necessary.  For a biopsy, your pet may need to be sedated or placed under general anesthesia in order for a small piece of tissue to be obtained.  Alternatively, a biopsy may be able to be performed with just a local anesthetic.  Once the tissue sample is obtained, it is placed in formaldehyde and sent to a pathologist for review.  A biopsy may provide more useful information to your veterinarian or veterinary oncologist than a fine needle aspirate.  Since more tissue is available for review, different parameters such as tumor subtype, grade, and how fast it is growing can be determined from the biopsy.  These are important parameters to determine how aggressive the tumor is behaving and what your pet’s prognosis is with or without treatment.

If you are concerned about a mass present on your pet, please contact your veterinarian for evaluation.  A veterinary oncologist may be contacted to discuss treatment options if your pet is diagnosed with a malignant tumor. 

Blog by:

Karri Miller DVM, MS, DACVM (Oncology) 

http://www.lapoflove.com/default.aspx?sid=8

www.lapoflove.com

Lap of Love Veterinary Hospice 

Dr. Karri Miller provides Skype and Phone consultations to families across the United States whose pets have been diagnosed with cancer. As a Board Certified Oncologist, she will be able to provide your family with information about cancer, treatment options, and expectations.

Blog originally prepared for the Lakeland Ledger (Florida)

Posted by Vet Mary Gardner

Veterinary Oncology Consulations - Lap of Love

Dr. Miller and Annie

Lap of Love announces its new offering of Skype/Phone Consultations with Board Certified Veterinary Oncologist - Dr. Karri Miller 

Most people are surprised to learn that dogs and cats are susceptible to the same types of cancer as humans are. Cancer is the number one reason for death in our companion animals. Some common types of cancer in dogs and cats are lymphoma, osteosarcoma, melanoma, mast cell cancer, prostate cancer and mammary cancer. 

Emily getting chemotherapy

If you have a pet that has been diagnosed with a type of cancer - you will probably feel a multitude of emotions ranging from anger, helplessness, confusion, and sadness.  One of the best things you can do is get properly educated on your pet's disease - so that you know what options you have and what to expect. Many families are nervous about oncology because they relate it directly to human cancer and chemotherapy.  Luckily, therapies for our pets are extremely well tolerated and pets have great quality of lives during treatment. 

Bringing your pet to an Oncologist (a doctor that specialized in cancer) is always the best thing you can do to understand and get fully informed about the disease your pet has.   However, you may not have an oncologist in your immediate area or you simply would like some more information before proceeding to that step. 

Dr. Karri Miller has teamed with Lap of Love to provide Skype and Phone consultations to families across the United States whose pets have been diagnosed with cancer. As a Board Certified Oncologist, she will be able to provide your family with information about cancer, treatment options, and expectations.

Bessie with Dr. Miller after treatment

Dr. Miller received a Bachelor’s degree in Animal Science in 2000 and her Doctor of Veterinary Medicine in 2003.  While in veterinary school at UF, Dr. Miller found that her true passion in veterinary medicine was medical oncology.  She loved that you could extend a pet’s lifespan, while maintaining a very good quality of life.

Lily & Duchess with their favorite Oncologist

 After completing veterinary school, Dr. Miller went on to complete a medical and surgical internship at Texas A&M University and an oncology internship at Regional Veterinary Referral Center outside of Washington DC.   

Dr. Miller then returned to the University of Florida in 2005 to pursue a Masters in Veterinary Science with a focus on veterinary oncology. She received her Masters degree while starting her medical oncology residency at UF’s College of Veterinary Medicine.  Dr. Miller completed her residency in July 2009 and became a board certified member of the American College of Veterinary Internal Medicine at that time.   

To learn more about Dr. Miller and to schedule a consultation - please click here!