July 30th - My decision on Erde's situation

I spent a few hours yesterday researching what might be going on with Erde's gingival mass, especially since her regular vet either missed seeing this during Erde's May physical, dismissed it as nothing serious, or it was not there then and is growing fast.  Here is what I learned (courtesy of DentistVet.com and others).

Oral growths (tumors) in dogs are either benign or malignant.

Benign tumors do not usually metastasize or spread to distant organs but some can invade into the surrounding local tissues and contribute to secondary problems like swelling, pain, adjacent tooth

death, extension into the nose or eye, or even jaw fractures.

Epulis refers to any tumor or growth of the gingiva (i.e. gum tissue). An epulis can be a non-cancerous growth that occurs as a result of

chronic irritation. There are three main types in dogs: fibromatous, ossifying, and acanthomatous.

Odontogenic tumors and cysts are oral growths that develop from dental

tissues. They are not malignant and they do not usually

metastasize or spread to distant organs lung or brain. Some of the

tumors can be very aggressive locally, and some like to invade into bone and

surrounding teeth.

Cheek chewers granuloma is non-cancerous tissue swelling caused by

self-inflicted trauma when chewing.  Tissue should be biopsied to rule out other tumors including eosinophilic granuloma, a great mimicker of cheek chewers lesions.

Malignant tumors have the potential to metastasize or spread to distant

organs. Some can also invade into the surrounding local tissues and contribute to secondary problems like swelling, pain, adjacent tooth death, extension into the nose or eye, or pathologic jaw fractures.

Malignant melanoma(MM) is the most common malignant oral tumor seen in the

dog and often metastasizes to other parts of the body. Aggressive surgery is indicated in addition to radiation therapy and chemotherapy and perhaps a melanoma vaccine.

Squamous cell carcinoma(SCC) is the second most common malignant oral tumor and can metastasize to other parts of the body. The prognosis is

more favorable for tumors located toward the front of the mouth. Metastasis

is more common when tumors are located toward the back of the tongue or

tonsils. Early aggressive surgical excision and radiation therapy are needed.

Fibrosarcoma(FSA) is the third most common malignant oral tumor in the dog and can metastasize to other parts of the body. FSA can grow large and

invade into the nasal cavity. Surgical removal of the

tumor is needed, but FSA is poorly responsive to radiation therapy and chemotherapy.

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So, here are the nine possibilities of what it could be:

1- nothing to worry or do anything about

2- benign fibromatous epulis (EF).

3- benign ossifying epulis (EO).

4- benign acanthomatous epulis (EA).

5- benign odontogenic tumor/cyst (OT).

6- benign cheek chewers granuloma (CCG).

7- malignant melanoma(MM) tumor.

8- malignant squamous cell carcinoma(SCC) tumor.

9- malignant fibrosarcoma(FSA) tumor

This morning it occurred to me that I have been misled in the past by the residents at the animal hospital where I take my dogs, causing me to suffer undue stress and added expense, and in one case, days of great misery for Leben in the past. I think they are all very good, but they have no experience to make sound judgment calls of the type needed by me now; they are going on classroom knowledge alone. I am sure they will all make fine vets someday, but I need that someday to be now. Unfortunately, the vet in Erde's case could not offer any experience to help me judge what the prospects are for her and what I should do now. (To her credit, she had the good sense to check Erde's mouth when that had nothing to do with the reason I went to the vets, and I am very thankful for that.) So, on the basis of what I read, there is a 66% chance that what Erde has is either nothing or a benign tumor that can be left alone or wait 60 days before removing, and a 33% chance that it is a malignant tumor. On the basis of this, I will go ahead Erde's biopsy on Thursday, and go ahead with the trip as planned on Sunday or as soon  thereafter, now that I have lost two  whole  days over Erde's situation. Then, if on the road  I find out that the growth is a malignant tumor requiring immediate treatment, I will schedule the surgery and turn around and head home. If I continue the trip and the benign growth grows or interferes with Erde's health, I will also return home (or go to a nearby vet) to have it treated.  I may, of course, change my mind about this after I speak with the vet on Thursday after Erde's biopsy.