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Perianal Adenocarcinoma In A Dog

by veerled - January 8, 2019 View Case Report

Dylan, an 11 y old mn terrier, was seen in September 2018 with a confirmed anal adenocarcinoma three weeks earlier, local lymph node enlargement confirmed. He had initially an anal gland abscess. After antibiotics course, it was clear there was an underlying issue. On presentation Dylan was very down with extremely tight lumbar spine, The owner was quite distressed, and the whole situation had been classed as inoperable/ poor prognosis by general practitioner vet and soft tissue surgeon. The entire area was inflamed and the owner had started some homoeopathic treatment.
The dog felt very flat depressed. There were no abnormalities on blood, so no hypercalcemia. The dog is quite reserved in character and has been very close to the owner. As a pup, he had a very poor gut, but this was resolved with a less processed diet and homoeopathic treatment ( sulfur?). There are a few lumps, one cyst that keeps filling and bursting on the flank. There is some eye discharge right side, and a short burst of otitis externa managed with conventional treatment.
Treatment was started with craniosacral therapy and chiropractic combined with acupuncture
Started on Coriolus, milk thistle high amounts
Initially, because of the amount of inflammation and tenderness, I started on Xiao Chai Hu tang which helped with the lower back
I have now added Bloods palace, but I am not sure where to head now. The lump has not grown in my opinion but rather on the rectal exam it feels there is a kind of wart-like mass appearing on the lump on the inside of the rectum. It does not feel tender on palpation. The pulse was very toned, tongue very moist and dark pink. The owner thinks the cyst on the flank seems to fill up faster than before. All in all the dog is 100 % better on the outside and spinal health than when I met him.
He is on a very low dose of Bloods palace to start with so do I increase the dose or do I use angelica and mastic combo for a while?
Any advice appreciated.
Diet is largely canned or kibble

Acupuncture points were stimulated

by naturevet

January 11, 2019

Hi there,

Both your suggestions are good ideas - upping the XFZYT, and maybe using Xian Fang Huo Ming Yin

You should be using Modified Xue Fu Zhu Yu Tang, so you have the benefits of the Curcuma in it.

For some of these dogs, we've been trying Hoxsey with the XFZYT and XCHT, and have seen benefits, so if you don't try XFHMY, give it a go. Or try both. Whatever you add, just do it one step at a time, so you can interpret the response correctly.

I'd start with either more mXFZYT and Hoxsey, or more mXFZYT and XFHMY, maintaining the XCHT. The XFHMY might really end up helping his back, so maybe go with that first

Steve

by veerled

March 5, 2019

Hi

I have rechecked the patient. We tried initially adding Xian Fang HuoMing Yin and then increased modified XFZYT but the lump has increased and now definitely is palpable outside and obstructing the rectum a bit more
there is no lympnode enlargement palpable but I found the whole back / sacrum different on palpation. Not a spinal type of discomfort . I wonder if we are having also some abdominal distention.

he felt a bit warm to touch, clammy but owner says he is still seeking heat, He is amazingly healthy to the outside and behaves like a much younger dog.
Somehow I feel like I am missing something,
I feel somehow like he needs Si Miao san,.. I guess I could combine that with Shao Fu Zhu Yu tang???

by naturevet

March 11, 2019

Hi there,

I would recommend not stopping the MXFZYT, but adding in Hoxsey instead of the XFHMY

Something else we found: using a low dose of prednisone (0.1 to 0.3 mg/kg up to BID) can shrink the tumor mass as well. I'd suggest those two changes. I've just been reviewing some of our own cases and we saw benefits when we took that route

Hopefully it will help. Please continue to let us know

Steve

Hoxsey

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