Thyroid Cancer

[iLLt3cK]

Recently had one of my dogs (10yr old American bulldog mix) diagnosed with thyroid cancer and wanted to get some help on deciding how to move forward based upon everyone's experience.

Unfortunately, the cancer has already metastasized to the lymph nodes and lungs so it will be terminal but I've been presented with a couple of options after working in depth with Texas A&M Small Animal Vet Hospital.

Initially I noticed some atrophy on the right side of her head and her third eyelid exposing itself more than normal. Despite how it looks she doesn't know anything is wrong with her as her exercise, mood, and appetite remain unchanged.

Option 1:  Radiation therapy over two weeks

Context: This would require her to live @ the hospital for a week at a time (two weeks total) and be put under for the radiation six times over that time span. During the initial triage we also found she had a 2/6 heart murmur which would require a cardiology work up before proceeding.

Option 2: Chemotherapy indefinitely (Palladia) 

Context: The oncologist doesn't have many specific examples of Palladia efficacy with thyroid cancer although they claim an 80% success rate (palliative) for three to four months. It would require frequent blood work to ensure no harm is being done to her liver / kidneys.

Option 3: Do nothing

I've already asked if there are any alternatives to Palladia but have had very bad experience with doxorubicin with my first Border Collie, Tate. What approach have others taken when presented with similar options? The hospital is 2hrs away and the radiation approach seems extreme when considering quality of life over the rest of her time here. I'm accepted our fate, just trying to find a good balance as we move forward together in this phase of our time together.

[EvoPA]

I'm very sorry to hear about your dog. We lost our 6 year old Boxer a few months ago to hemangiosarcoma so how you're feeling is fresh in my mind. It was about 101 days from diagnosis to when he passed. He had his spleen removed and was on chemo for most of that time (doxorubicin) with no real bad side effects. He did (allegedly) get doxorubicin induced cardiomyopathy so we had to stop but I think he may have just gotten woozy and was losing some blood from a tumor bleed on his liver.  

You mentioned that it would be around 3-4 months on the Palladia, what would the prognosis with Radiation be?

We were going to switch to Palladia. For reference, his dose was 30 days 90 mg (he was about 75lbs) every other day and the dose cost us about $700 (compounded at the pharmacy) and that would be every month (I actually still have it, it says it's expired on 4/7 otherwise I would send it to you if you wanted) but unfortunately the day we received it from FedEx, another growth on his liver hemorrhaged and he passed away.

If I'm being honest, I'm not sure what I would do if I was you. We spent close to $15,000 over those 101 days. His surgery was about 6k, the rest was the chemo, the staging every 6 weeks, and for the treatment when he started having seizures (probably due to the cancer going to his brain). I don't think that the chemo helped him much in his case but it's also a very aggressive cancer. He was staged and they said no spread they could see two days before he passed away (although they said his deep chest made it hard to visualize all the liver).

I enjoyed every day we had with him and until about 2 weeks before he passed, he was doing great and had a great quality of life. The end is going to be tough no matter what you do, it always is. Unless radiation has a chance of 'curing' him, I would shy away from that and enjoy your time with him at home, mine spent a night at the vet for monitoring when he had his seizure and I wish I would have just taken him home after he got his medicine. 

As far as the chemo, I don't think it could hurt and if he doesn't respond to it well you can stop. I'm not 100% for all natural cures but I know a lot of people are seeming to have luck giving their dogs Turkey Tail Mushrooms especially this brand (https://www.buyimyunity.com). My only regret is I wish I bought this and gave it to him too.

Sorry to hear and good luck with whatever you choose. 

[urge to herd]

My Buzz had bone cancer and we went the chemo therapy route with him. I won't do that again unless I see lots of evidence that there's a really good chance for recovery. Each therapy appointment took a lot out of him, several days to recover. He was never himself again after the initial one. 

I know that chemo is different for different cancers. The treatment protocol you describe seems to be asking a lot of her and a lot of you, with not much 'good' time left over. I grew up in Houston and know that TX A&M vet hospital and school is a very good one, and if you decide to go the treatment route, she'll get as good a chance as possible with what has already happened.

Please let us know how your girl gets on, and know we are here for you.

Ruth & Gibbs

[GentleLake]

I'm so very sorry you're finding yourself in this position, @iLLt3cK

The part I don't see in your options above is the prognosis with each of the treatment plans. I think you need to have a frank discussion with the vets asking what, if any, real quality of life your dog will have during the treatment period and, again if any, what extension of life it may (or may not) afford.

Many years ago one of my dogs had a rare and unidentified bone marrow cancer. The oncology vets at U Penn vet hospital wanted to do more tests that would have been painful and invasive and then move on to a course of treatment. But they said the most I could expect from it would be another 2 or possibly 3 months of life and even that wasn't guaranteed. There was no way I was going to make his final days any less peaceful and pain free than they could possibly be. We (the dog and I) had a sit down and I asked him to let me know when it was time. He did, and we made one last trip to a vet who was also our friend when he was still in good spirits and not in a lot of pain. I've never regretted that decision and wouldn't hesitate to make exactly that same choice again.

My father was presented with a similar choice only a week ago, only in his case the doctors told him he'd be completely miserable during treatment and it would only extend his life by perhaps a week or 2. He also opted to go the no treatment route and died on Tuesday, spending his last days made as comfortable as hospice could possibly make him.

To my mind, quality of remaining life far outweighs being able to spend a few more days alive. Everyone must make their own choices though, for themselves and the people (and in that I include dogs) involved.

Wishing you and your dog well. I hope you're able to appreciate the time he has remaining to the fullest.

[Journey]

GentleLake, my condolences to you and your family..

[Lawgirl]

GentleLake, I am very sorry to hear about your father.  My dad passed from complications of biliary duct cancer over ten years ago, and it still hurts, although it is slowly getting less.

My deepest condolences.

[iLLt3cK]

16 hours ago, GentleLake said:

I'm so very sorry you're finding yourself in this position, @iLLt3cK

The part I don't see in your options above is the prognosis with each of the treatment plans. I think you need to have a frank discussion with the vets asking what, if any, real quality of life your dog will have during the treatment period and, again if any, what extension of life it may (or may not) afford.

Many years ago one of my dogs had a rare and unidentified bone marrow cancer. The oncology vets at U Penn vet hospital wanted to do more tests that would have been painful and invasive and then move on to a course of treatment. But they said the most I could expect from it would be another 2 or possibly 3 months of life and even that wasn't guaranteed. There was no way I was going to make his final days any less peaceful and pain free than they could possibly be. We (the dog and I) had a sit down and I asked him to let me know when it was time. He did, and we made one last trip to a vet who was also our friend when he was still in good spirits and not in a lot of pain. I've never regretted that decision and wouldn't hesitate to make exactly that same choice again.

My father was presented with a similar choice only a week ago, only in his case the doctors told him he'd be completely miserable during treatment and it would only extend his life by perhaps a week or 2. He also opted to go the no treatment route and died on Tuesday, spending his last days made as comfortable as hospice could possibly make him.

To my mind, quality of remaining life far outweighs being able to spend a few more days alive. Everyone must make their own choices though, for themselves and the people (and in that I include dogs) involved.

Wishing you and your dog well. I hope you're able to appreciate the time he has remaining to the fullest.

Thanks to everyone that has replied so far. You've offered me invaluable insight that is helping me immensely.

@GentleLake Thanks for the reply and my condolences go out to you during what I can only imagine is a tough time. The following link helped me during some dark times in my life and I hope it helps you as well.

To answer your question, their prognosis is 3-6 months if we do nothing but the frustrating part is they haven't provided a prognosis with either of the first two paths and only speak in general terms. To your point, I plan to have a more direct conversation looking for answers soon.

[GentleLake]

Thanks for the condolences, folks (and thanks for the link). I didn't mean to hijack the thread but to use it as an example.

2 hours ago, iLLt3cK said:

...but the frustrating part is they haven't provided a prognosis with either of the first two paths and only speak in general terms...

Yes, to me that would be critically essential information to have when considering the options. It's inconceivable to me that they wouldn't have offered that information without having to be asked.

Wishing you and your dog the best.