Case Details
Bob by minimo
Nasal Adenocarcinoma
   

Signalment

  • Age: 9 years
  • Breed: Elkhound Mix
  • Species: dog

Disease Notes

  • Certainty: confirmed
  • Final Status: resolved as of day 1047 of treatment

Treatment and Outcome


Problem Notes
  • Elevated ALT: ALT=164
  • Lung Mets: Metastasis secondary to anal gland tumor
    One large met (8 mm), possibly few other smaller ones.

Treatments
Day 0

Notes:  This initial visit was 3 weeks after the patient had "cyber knife" radiation therapies at specialist referral center.
He has also been started on a homemade diet with the direction of a board certified nutritionist, however the owner is adamant that she will adapt the diet as she sees fit based on readings regarding cancer nutrition.
Tongue: Light pink
Pulse: superficial, toned

Acupuncture points were stimulated


Day 25

Notes:  Brief visit. Dog is better overall and stable.
Owner reports dog seems polyuric / polydipsic.


Day 36

Notes:  Urinalysis recheck.
Progress report from owner is overall favorable.


Day 54

Notes:  Dog is stable, without epistaxis for over a month now. No congestion, breathing is clear without stridor.
Tongue: pink, with only thin redness at tongue margins at tip.
Pulse: Moderate, normal.
Brief flare-up of soft stool.
Appetite is excellent.
Proteinuria is 1+, Microalbinuria=3.7, still abnormal, but slightly better than last visit.
Start Yunnan Baiyao, not for hemostasis, but for purported anti-neoplastic effects.


Day 76

Notes:  Bloodwork (CBC, Chem, T4) is all normal.
UA shows unchanged proteinuria, still slightly elevated.
The dog is having a mild recurrence of sneezing, clear nasal discharge and mild epiphora (mucoid).


Day 174

Notes:  Mild liver enzyme elevation (ALT), started on Denamarin.
Dog continues to do well with a minimum of symptoms.
Proteinuria continues. Monitoring for progression, but no clinical impact at this time.
*Hoxsey is continued, but not able to select in Prescriptions(?)


Day 392

Notes:  Dog had elevated Calcium at last bloodwork.
At referral, ultrasound of liver is normal, but they did detect an anal gland tumor.
Surgery performed at referral practice.


Day 430

Notes:  Started Piroxicam 7 mg PO SID


Day 487

Notes:  First occurrence of epistaxis since original diagnosis of nasal tumor


Day 489

Notes:  CT scan performed at referral, no evidence of nasal tumor


Day 522

Notes:  Several skin masses surgically excised, all are benign


Day 525

Notes:  Completed chemotherapy (carboplatin) for anal gland tumor at referral


Day 581

Notes:  Start Si Miao San to add additional COX-2 anti-inflammatory effect


Day 614

Notes:  Bloodwork performed.
Improvement in ALT and AST, just marginally elevated.


Day 642

Notes:  Recheck at referral hospital reveals new mass in ventral rectal floor, suspected to be recurrence of anal gland tumor in new location. Also subiliac lymph node enlargement.
Started Palladia.


Day 668

Notes:  Urine sample: UPC=0.5


Day 747

Notes:  Owner has briefly discontinued all supplements with food, since he was becoming more picky with eating. Has been re-introducing each one at a time to identify specific issues with each one.
Celebrating 2 years since was diagnosed with nasal carcinoma!


Day 1047

Notes:  Intermittent liming LF - osteoarthritis
Chest radiographs reveal metastasis, likely from persistent and recurrent anal gland tumor