So Katy’s been a tripawd for a month now, hard to believe. She’s off all pain meds and is back to her spoiled babydog self, even playing with her sisters in the backyard. She has yelped a couple times when Annie, our yellow Lab, has wrestled her down and kinda rolled her the wrong way, but it hasn’t had any lasting effect. She’s doing just fantastic. It may sound stupid, but this dog is my hero. *sillygrin*
Ah yes, the results. I believe I mentioned that when Katy’s leg was amputated, my vet disarticulated it at the elbow (he removed the entire leg, scapula and all) and sent the lower part off for histopathology. Well it only took 3 BLASTED WEEKS, but the results finally came back. You better believe I was an absolute nag about it too. Evidently they would have been back sooner, but the pathologist wasn’t satisfied with the first set of samples that the lab techs prepared for him so he had them go back to the leg and chop off some more 😛 Guess I should be glad he was happy with the second set, otherwise I’d still be waiting most likely. At any rate, I have myself a copy of the report, let me quote a couple chunks of it for you:
“Sections of tissue from an amputated thoracic limb are examined. There is a subcuticular mass which is composed of cells arranged in sheets subdivided by a few thin fibrous trabeculae. These cells are round with highly vacuolated cytoplasm and flat nuclei with condensed chromatin and a low (<1 mitotic figures per 10 hpf) mitotic index. There is an encapsulated are of necrosis.
MICROSCOPIC FINDINGS: Suspicious of infiltrating lipoma
COMMENT: Numerous sections of bone were examined. No periosteal reactive changes were seen but there is an area suspicious of infiltration of periosteal collagen by neoplastic cells. This finding is suggestive of an infiltrating lipoma. Infiltrating lipomas are characterized by slow invasion of muscle and other connective tissue. These neoplasms do not metastasize.”
Mmkay, so in English? In the research, admittedly limited, that I’ve done on the subject, infiltrating lipomas are basically a few very weird cells shy of liposarcoma. So Katy did not have cancer, per se. What she had was a very aggressive growth of fatty cells that was invading her muscle and even bone to some extent. Infiltrating lipomas do not normally “turn into” liposarcoma, but in and of themselves they’re a pain in the butt and can cause a multitude of problems, and surgery is the only treatment for them, either excision with VERY clean margins (because the damn things will grow back with a vengeance) or full-on amputation, depending on the location. I have to admit, looking at pictures, that histopath sections of infiltrating lipomas and liposarcomas look very similar to me on gross examination (with the naked eye). I suppose that’s the reason they can only be differentiated microscopically; they’re both made of fat cells but the cells have distinct characteristics that set them apart.
I was rather surprised to read this report and not see the word “sarcoma” anywhere. My immediate thought was, Oh great, I took my dog’s leg off and she didn’t even have cancer. And my vet knew I would feel that way, he was very quick to confirm that I made the right decision to amputate Katy’s leg. He said that normally if you told people you had your dog’s leg removed because of a lipoma they’d look at you sideways, BUT this was not your ordinary innocent little fatty growth lipoma. This bugger was mean and there was just nothing else to do, Katy was lame with it and in considerable pain, amputation was the absolute best option we had. I am convinced I did the right thing by her.
The question becomes, what do I tell other people? Like I’ve said before, I like taking Katy out with me as my lil tripawd ambassador, and of course people ask what happened. Up til now I’ve been saying “cancer” because that’s pretty much what we thought it was, and it’s an easy answer that doesn’t require a whole lot of complicated medical explanation. But what now? I suppose I can say it was a tumor, that’s pretty straightforward, just a big nasty tumor that couldn’t be removed by itself, they had to take the leg. I just don’t want to say it was cancer anymore because it wasn’t, and because I don’t want to jinx anything 🙂 But most people understand what a benign tumor is, right? I have just way too much medical knowledge, too much terminology, and I’m with people all the time who speak the same language; I take it for granted that people know what I’m talking about and forget to “dial it back” when I’m not among vet tech folk. So I figure I can tell people Katy had a benign tumor that grew out of control and could not be removed without taking the leg. Easy enough? Anybody else got a tripawd in the same boat?