# Bladder Cancer - when to say good bye?



## happyd11 (Apr 14, 2009)

A dear friend recently learned that her dog has bladder cancer and is distressed bc her dog is lethargic and had some bowel issues in the house last night. She threw up this morning but then ate well. Her husband thinks they should deal with things this week and not wait for the weekend.

It was just 8 days ago that they got the diagnosis after taking to the vet a time or two earlier for bladder problems. This is what she said then:

The tumor is taking up 80% of her bladder. She is not in pain which is the silver lining. Chemotherapy is not an option because it wouldn't cure, only (maybe) extend her life a few months. She will be on some medicine to help with inflammation. She is having no other issues yet, so we may have a few more months with her. Perhaps less.

Any suggestions? I suggested that she might want to call her vet to see what they say. Though thought that some of you might have some good thoughts and or experience regarding a dog in such circumstances, or similar.

TIA[/SIZE]


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## dogsule (Nov 6, 2013)

We were in a sort of similar situation in May. We found a small lump on our 10yr old girl in April and it was tested and was found to be mast cell cancer. The lump was removed and the pathology came back as a grade 2. Our girl had dropped weight before we found the lump which the vet thought was due to a bad tooth and that she just wasn't eating as much. She was fine for a month when one morning she threw up, pretty forcibly and then proceeded to go outside and almost collapse on the lawn. She was shaking and in incredible pain. We rushed her to the vet and they did xrays (everything looked good) and they thought it was due to an antibiotic she was on killing the good bacteria in her gut. They gave her some meds and she actually bounced back the same day. We thought all was good. A week later the same thing happened. They did blood work and xrays, the blood work was all bad, things high, things low, xrays showed the mast cell cancer had invaded her spleen. There was nothing they could do at this point. As far as how long she had, the vet couldn't say. She had stopped eating and even with 5 meds and anti nausea meds it took approx 3 days to get her to eat again. Then she would only eat hot dogs and pizza crust, her two absolute favorite treats. She did get back to feeling better once she started eating something but we had no clue how long it would last before it would strike again, could be a week, could be a month. We took a weekend and took her to her favorite spots and treated her like a queen and then took her in and let her go peacefully and without pain. It was sooo hard to do and I am just bawling typing this but we did not want to see her in such great pain again. 

Our situation is a little different as our dog had been in pain and that would make a big difference to me in when to say goodbye. We did however have a lot of people tell us that they waited too long with their dog and they were in pain in the end. I think if it were me in your friends shoes right now I would talk to their vet and see what the vets says can and will happen, I know the timetables can vary but they will know what to watch for maybe. I know they won't know how long but we did that with our vet and it pretty much confirmed what we were doing was right. If my dog wasn't in pain and hadn't been in pain I would probably wait but probably not too long cause you don't want them to suffer.

Positive thoughts to your friend....It is not an easy decision to make.


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## [email protected] (Nov 18, 2013)

Most cases of bladder cancer are transitional cell carcinoma (TCC), which is usually very slow to grow and even slower to metastasize. When it does spread, it usually goes to the pelvic lymph nodes, but most dogs are euthanized before the enlarged lymph nodes become a problem. It would be unusual for the other symptoms that you are describing (lethargy, bowel problems) to be related to the bladder cancer, unless the medication is causing side effects. More likely your friend is seeing two unrelated sets of symptoms, and if she is patient the lethargy and bowel issues will resolve and she can determine if the bladder problem is interfering with the pet's quality of life.
In most cases because the tumor is so slow growing, most of my patients with TCC go months (sometimes well over a year) before being euthanized. It would be very, very unusual to go from a diagnosis to a euthanasia in a few weeks.
The preferred medication for TCC is Feldene (Piroxicam), which is both a pain-reliever and anti-inflammatory. Several studies have shown that it has some actual efficacy against the tumor (slows growth), so I usually use this specific medication instead of any other (theoretically similar) medicines.
Most patients with TCC are euthanized because they are having problems urinating. Interestingly there is a surgical procedure to place a stent that goes from the bladder to the outside, with a cap that the owner can remove when they want to empty the bladder. I am not a fan of this procedure (it seems a little "heroic" for me), but I have sent a number of patients to see the specialty surgeons to have a stent placed. These patients will often live quite happily for another 6-12 months. They are prone to urinary tract infections, but these are easily managed when they occur.


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## happyd11 (Apr 14, 2009)

Thanks so much for your responses.

Dogsule, so sorry for your loss. What a sweet thing to have done for her last weekend.

Vet, that's really interesting. Now I don't know what to share with her. Apparently her husband is really shook up and they've called the vet to come to their house to put the dog down!


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## [email protected] (Nov 18, 2013)

That may not be the worst thing in the world. It seems that many owners, once they know that their pet has cancer, start looking for a reason to say goodbye. My guess is that they are using the (likely insignificant) current symptoms to justify making a decision that they know they will have to make eventually. If they are ready, then I wouldn't present them with a lot of information to suggest that they should wait.


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## happyd11 (Apr 14, 2009)

Thank you, I just talked it over with a mutual friend and she basically said what you did.

This seems to be one of the very few down sides of having a dog, having to say good-bye and worse yet, needing to make the decision. The 80% blockage does sound very significant... Daisy's relatively young, maybe 5 or 6 years old.


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