The vet just called. He said that he removed a mass from Meg's bladder during the surgery and sent it out to the lab. They say that it is a "low-grade malignant sarcoma." The vet feels that it is possible that this is a side effect of the chronic cystitis, but it is also possible that she has bladder cancer.
She is still doing fine. Becky, I'm giving 20 ml of LRS every day.
I think bladder stones are a symptom of bigger problems rather than the cause of other problems. This is why I think this. The many pigs I've read about here and on the stones list seem to have various other medical situations. There doesn't seem to be any commonality, particularly with the multiple-stoner pigs.
In some of the reading I've been doing, calcium absorbtion seems to be affected by various other conditions/diseases/illnesses. I think something gets out of whack and this awful cycle of stones, irritation, sludge, more stones, begins.
I also think there's a difference between the pig that has one, isolated stone and those that go on to produce multiple stones.
Again, this is pure conjecture on my part, but I think it's important and interesting to discuss these things. I'd love to hear what some of the vet techs, nutritionists, chemists, scienctists, etc., have to say about this.
From what I understand, Satins can have a Ca deficiency. Usually we supplement with calcium lactate for that.
I don't know why, but this is bothering me a lot. She's on her third stone surgery, has one failing kidney and a damaged liver, and somehow the fact that she might have bladder cancer is really upsetting.
She's getting good care, seems to be comfortable and is doing really well for three surgeries. Sometimes there are factors beyond our control. If it's cancer, you'll deal. That's what you do.
In the meantime, enjoy all those headbutts.
- Little Jo Wheek
There are options. I would certainly continue supportive care and ask your vet for prognosis on the type of tumor she has.
Josephine, would you start her on prednisone right away? Her meds now are Torb, Bactrim, and Polycitra. I do think she needs pain meds at least until those stitches come out.
One good thing is that her bladder was not infected the way it was last time (it was bad). The vet said it healed up really well.
I know that other people may feel differently, but I do not think I would have chemo done. She is a lovely girl and I don't know how I am going to part with her, but her entire life since I have had her has been full of surgery and recovery, then more surgery, and it seems like she is starting to show her years in many areas. She may be older than 5, a ripe old age for a Monterey sow.
- Little Jo Wheek
Personally, if the vet thinks it was complete excision I would not use pred unless there was node involvement. I only use pred for severe trauma, neurologic problems, and terminal or dying pigs. The side effects aren't great and pred shouldn't be used long term unless there is significant health risk without it.
I totally understand about the chemo. It also has side effects and usually (depending on the cancer) doesn't buy more than a few months. Sometimes the side effects don't make it worth it in my opinion. In other cancers, especially with a bit younger animals, it can buy years. It may not even be indicated in her case with the type of tumor she has. I really don't know enough about oncology to recommend the exact course of treatment. In dogs, they often get highly malignant bladder cancers which have much poorer prognoses.
If it was a malignant tumor, I think you got the best news that you could. I would just continue her supportive care and current meds unless the DVM thinks otherwise.
The specimen consists of urinary bladder. There is an exophytic, polypoid mass of the urinary bladder wall which is discontinuously lined by mildly to moderately hyperplastic transitional epithelium. Focal areas of erosion and ulceration of the epithelium are present. The submucosa is markedly expanded by stromal spindle shaped cells with scan to moderate pale basophilic cytoplasm, indefinite to definied borders and generally uniform oval nuclei with condensed chromatin. Mitotic figures are common (0-2 per 400x field). These cells form loose sheets and elongate streams within a loose, edematous and occasionally slightly myxomatous stroma. There are scattered small caliber submucosal blood vessels within the mass and in the adjacent submucosa, and foci of mild acute hemorrhage. Moderate multifocal mixed inflammation is peresent deeper in the submucosa and consists predominantly of scattered heterophils and lesser lymphocytes and occasional plasma cells. Focal Lymphoid aggregates are present in the deeper portions of the submucosa. Significant infectious organisms are not detected in the submitted specimen.
Urinary bladder; mesenchymal neoplasm, low-grade malignant (possible low-grade sarcoma).
Although polypoid changes and stromal fibroblastic proliferation have been described in chronic cystitis in the cavy, the uniform cell population, significant mitotic index, discrete polypod mass formation and paucity of signifcant inflammation directly associated with this lesion support a diagnosis of a mural mesenchymal tumor.
And that is clear as mud to me. Anyone?
The mitotic figures are how "active" the cancer is. 0-2/field seems like a low number to me.
She's probably going to have issues with her bladder the rest of her life.
I guess I could flush, leave it alone until tomorrow, or take her to an emergency vet considering that it is Sunday.
Any other options or opinions?
Another thing I have noticed is a hard, 'pokey' thing underneath the skin on her belly. Pigglies felt it and thought it could be a growth, but to me it feels like a foreign body, like a staple maybe?
I will take her to Dr. R and ask about the little pokey thing, but as far as the hairloss goes I am guessing that I will find better answers here.
To refresh, Meg is a senior Monterey sow who has had 3 bladder stone surgeries -- Ca Oxalate and Ca Carbonate both. She was spayed recently and then re-spayed to remove a fragment of ovary left in. During the re-spay the vet removed a malignant growth from her bladder and 3 stones. U/S showed one kidney not functioning properly and liver damage from hyperestrogenism (sp).
Meds are Polycitra and Meloxicam. She maintains her weight, but once a day she gets Critical Care mixed with Echinacea, E, C, (vegetarian) Missing Link, B-complex, and a little Naked Juice for flavoring. She is on a special veggie diet aimed at decreasing oxalates and keeping a low Ca:Ph ratio. Otherwise she eats orchard grass, oat hay, and Cavy Cuisine.
I am not giving her SQs anymore because they frightened and hurt her and I decided that was not how I wanted to spend what little time we had left together. She is not dehydrated.
I would just like to know if the hairloss/coat quality could be do to a vitamin deficiency or something else that I can take care of to make her more comfortable. I'm aware that it could be a side effect of kidney failure, bladder cancer, Cushing's or Addisons. Those things I can't do anything about. But does coarse hair come with these things too?