Hi Kimberly,
Acanthomatous epulis (now usually called acanthomatous ameloblastoma) is a benign tumor. They are locally destructive and can get very large but to not metastasize. These can be cured with complete excision, which does require rostral mandibulectomy. But most patients do very well, particularly in rostral locations like this one. I know the idea is scary to many owners though. I'm a little confused about the terminology they gave you here so if this is some other variant, then maybe behavior is different?
I've treated a few acanthomatous ameloblastomas (acanthomatous epulis) with herbs after excisional biopsy (which removed gross disease but not underlying bone) and have had some good success, although the patients I have treated had pretty small tumors to begin with (smaller than this one). I haven't done too many though because I usually have a long discussion about high cure rate with surgery, which is ultimately less expensive, especially for a 5 year old dog that will likely need to stay on herbs for life to prevent recurrence if there is success. So most of my clients have gone to surgery.
Having said that, the two patients I treated after excisional biopsy did experience good long term control (a few years before I lost track of them). There was no gross tumor when we started so I can't tell you how long until regression. But I'd say if the owner is committed to going that route, as long as the mass isn't growing I'd continue with therapy. I usually tell people 3-6 weeks before a response is seen, but the tumor should not continue to grow at the same rate it was before starting herbs. I'd just be careful and monitor very closely so they don't wait too long that surgery will have to be more aggressive in order to remove all the disease if they are open to doing surgery if the herbs don't work.
I used Modified Xue Fu Zhu Yu tang in both of these patients. And with the tongue and pulse you are describing here, suggesting blood deficiency and blood stasis, that should be a good fit. One of the patients had some early regrowth about 6 months later (as best I can recall) and was showing signs of blood deficiency, so I just added Si Wu Tang to the protocol and we achieved disease control again. I find that many of my patients on long term blood movers like XFZYT do eventually need more blood tonification once the stasis is resolved. So, that's my n=2. FWIW.
Let us know how this guy does. I'd be interested to know.
Erin