Personal adventures in brain tumor diagnosis, treatment, and death
This is perhaps one of the scariest cancers we vets see in pets. Both dogs and cats suffer it. And unless it’s one of the microscopic variety (and these do exist rather commonly, mind you), they’re almost invariably untreatable—that is, by conventional means most owners can afford.
Believe it or not, most brain tumors are not the malignant monsters we’d expect after witnessing the severity of their effects. Many of them are quite benign when it comes down to the nuts and bolts of pathological classification. Try to tell that to owners of a seizuring cat with evidence of a brain lesion, though, and they’d likely disagree with this fine point.
However, it’s true that we see under the microscope is often hard to correlate with what we see in our afflicted pets. That’s because the tumors do most of their damage not by invading brain cells directly, but by growing large enough to press on these delicate cells which border the mass.
My own Boxer dog, Bruno, had one of these tumors. He was already one of those Boxer disasters we vets are all too familiar with: orthopedic issues, skin allergies and heart problems. The coup de grace, though, was his apparent brain tumor…at the untimely age of seven.
At the time, brain tumor treatment wasn’t routinely considered (it was thought more experimental than therapeutic). So why bother with the CT or MRI?, I reasoned. All his symptoms match the description of an “intra-cranial neoplasm.” In his case, this included seizures of increasing frequency and severity over the course of a week—with no other obvious neurologic signs, normal labwork on every major test, and no response to any of a wide range of drugs (steroids, a slew of antibiotics and lots of anti-seizure medications).
Other signs of brain tumors include muscle loss with bizarre patterns, motor difficulties, blindness, and a bunch of other weird changes in attitude and alertness that sometimes appear very subtle, even to a neurologist.
But in Bruno’s situation, the neurologist felt strongly that, “If it walks like a duck…” (you know the rest) Sure, he wanted to do more tests, but he wasn’t crazy about spending all my money on a hopeless chase (even with my professional discount the sums were astronomical for this then-recent grad).
Eight years later, my tack would be significantly different: I would certainly have opted for a CT and spinal tap—at least. After all, a seven year-old dog (even a Boxer with Bruno’s issues) has at least three to five comfy years to go. And this dog was sooooo worth it.
Today, brain tumor treatment is uncommon, if not downright rare—but it’s doable. More patients every day are going under the knife or getting chemo for what we once thought an unnecessarily cruel foray into last-ditch survival efforts, given the poor prognosis for significant recovery. But how much worse is brain surgery or chemo to a brain tumor patient than chest or abdominal treatments? Arguably, it’s much less stressful, especially when you consider the pain involved in large-cavity surgery.
The hard part is that too many of these tumors are of the “unoperable” variety. Still, I feel [now] that knowing for sure what Bruno’s skull contained would have given me more peace, at relatively little cost to his comfort. And it might have meant treatment…and a cure, if not remission of his seizures for a time.
It’s easier to say all that in 2007, now that intra-cranial masses are more frequently addressed either surgically or chemotherapeutically (with exciting new interventional radiological techniques). It’s impressive, even to me, how much we can do in today’s vet medicine—and we don’t even necessarily have to travel to a fancy teaching hospital to have it done.
So do I feel guilty about Bruno’s seemingly lackadaisical care way back in 1999?
Sure, a mother always feels the guilt…even when she knows she did everything reasonable…even when she understands that eight years is a long time when it comes to our rapidly evolving standard of care in veterinary medicine…even when she knows she couldn’t afford it at the time…even when she knows that putting him to rest in her arms late one night was undeniably the best thing for him.