Cardiac Hemangiosarcoma - Advice - German Shepherd Dog Forums
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post #1 of 27 (permalink) Old 10-23-2014, 01:19 AM Thread Starter
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Cardiac Hemangiosarcoma - Advice

Hercules has taught me how to love unconditionally. I have had many animals in my life, but 7 years ago when I got my GSD puppy I formed a bond that I didn't know existed. He is my best friend, has been through so much with me. He is a sweet, affectionate, talkative, loving German Shepherd. He has had a wonderful life, from playing on the ranch with the horses, to his obsession with my cat - chases her everywhere and she swats at him from behind furniture and then curls up with him at night. He goes to work with me on a daily basis, does long distance runs, patiently waits in line with me in the morning at starbucks, and always makes sure to check everyones desk ever 30 minutes to make sure no one has forgotten he is there. A dog with quite a personality is an understatement! I never have to guess how he is feeling, he will always let me know.

Three weeks ago I took him out to go to the bathroom at work and then he just stood there staring off into space. I had to practically drag him back inside (which is abnormal as it gets for a dog that loses his mind if he doesn't know where I am.) I called the vet immediately, walked him home (he had to stop every few minutes, it was a struggle just to get him to the car.) 8 hours later, lots of tests, it was found that his pericardial sack around his heart was filled with fluid and there was a large mass on the base of the heart. They removed the fluid and told me they believed it was hemangiosarcoma and the outlook was grim - without treatment days to weeks. I went and saw the oncologist the next day and both him and the cardiologist were looking at the case and believed that it actually may just be a tumor due to the location and density of the mass. This was definitely more positive news. Unfortunately due to the location of the mass they thought it would be too risky to do a biopsy and suggested we wait 3 weeks, come back and do another ultrasound to see if the mass has grown and how quickly the fluid was building back up within the sack.
Almost two weeks later Herc woke me up at 4 am showing the same lethargic symptoms, I rushed him back to the ER and the sack had filled back up already. Additionally at this point he developed an arrhythmia. Based on how quickly the bleed started again and apparently they couldn't see the mass on the ultrasound anymore because they looked at it after the fluid was removed they were back to the original prognosis of Hemangiosarcoma.

At this point I could wait for him to have another bleed and bring him in to do another tap (which he could die really at any point), chose to remove the pericardium sack or consider chemo. The oncologist didn't recommend starting with chemo because they still weren't 100% sure what it was and did not want to treat him incorrectly.

Hercules just had his 7th birthday a month ago today. I decided to do the Surgery because it also allowed us to get a biopsy. The surgery went extremely well, he is 6 days out and practically dragging me around, chasing the cat (as much as I will let him) and acting like his old self. The biopsy revealed a confirmed diagnosis of Hemangiosarcoma.

Hercules has never been sick a day in his life. He has been a healthy happy dog, and I know many others have shared this same experience. I am always sad at his birthday's because I don't want him to get older, but never did I expect a few weeks later with no warning that he was going to die.

I have read up on quite a few forums but I haven't been able to find many situations quite like this in which people have taken the same route. The mass on his heart is inoperable. The only option now is to do nothing or to do a mild or more aggressive chemo treatment. With there being a mass I'm not sure chemo is really worth it. According to the oncologist, with his prognosis after surgery he says he has about 2-3 months. With chemo possibly 4-5. I know there are a lot of people with dogs that experience this on the spleen and they are able to remove the mass but I don't know how quickly the masses grow again and if it presents even more danger if it is on the heart and can't be removed.

I am leaning towards not doing the Chemo simply because it doesn't seem worth putting him through another treatment every 3 weeks for the possibility of a month or two more. But if there are any stories of people in a similar situation that had good results I'm definitely interested in hearing. And I'm asking specifically for those who's pup had a inoperable cardiac mass.

I am so sorry for anyone else who has had to deal with such a terrible disease. It is unfair that such amazing companions in our life can leave us so quickly but I would not give up these 7 years for anything, even knowing the outcome.

Thank you all for any advice that you give and for reading my story
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post #2 of 27 (permalink) Old 10-23-2014, 01:44 AM
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So hemangiosarcoma WILL cause a tumor. I dont understand why they said a tumor meant it wasnt hemangio? We see goldens and shepherds all the time with heart base masses that are likely hemabgio. If there WASNT a tumor I would suspect something else. That's eventually what bleeds. Dogs usually develop masses on their spleens, liver, or heart. Spreads fast and really not much you can do.

Realistically I've already decided what to do in this case (because german shepherds are so prone to hemangiosarcoma, any kind of tumor found on the heart, I would bet anything on it being hemangiosarc unfortunately). If my dog had pericardial effusion, I would tap and take home. I would see how long the sack took to fill up. I would likely tap them a few times, as long as there was at least 3-4 weeks in between episodes. Taps themselves are fairly fast and have minimal risk, although there is definitely risk of death. But realistically they live pretty normal lives in between taps. The second they started acting clinical otherwise, just declining in health, or if the sack started to fill rapidly, less then a few weeks between episodes, I personally would euthanize. I've had owners that brought their dogs in every 2 days for a pericardial centesis to drain the fluid, I don't personally feel that's fair to the dog.

You also have to realistically understand, your dog could pass at any moment from a fatal arrhythmia or other related complication. That's another risk of treating and managing. Many people euthanize once it's confirmed, and that's not a wrong choice either.

I don't think I would pursue other treatment for hemangio. Prognosis is short term no matter what you do. I'm so sorry about that

~Emergency Vet Tech

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post #3 of 27 (permalink) Old 10-23-2014, 01:47 AM
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I'm really sorry you have to go through this at all. It's one of the worst things we deal with as shepherd owners, the high risk of such a deadly and incurable diaease.

*hugs* to you both. Spend as much good loving time with him as you can

~Emergency Vet Tech

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post #4 of 27 (permalink) Old 10-23-2014, 01:51 AM
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I have lost two dogs to hemangiosarcoma. I am so glad that the surgery was successful. Obviously you will have to make the best decision you can for your dog but if it were me I would not do chemo and just spend as much time with him as possible and enjoy every moment. Make him a bucket list and check off as many things as you can.

Sending all good thoughts to you and your Hercules!

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post #5 of 27 (permalink) Old 10-23-2014, 02:50 PM Thread Starter
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Hi All,

Thank you so much for the advice and the warm wishes.
Regarding the tumor, they meant that they thought it possibly was a benign and more rare tumor. Although that was confirmed not to be the case.

I agree with you on the taps. Because his happened so quickly (11 days after the 1st one) is why I opted to do the surgery. I wasn't going to bring him back in every week to get taps done and the vet said normally each bleed gets worse and more aggressive. So at that point my decision was to remove the sack or let him go when the next bleed occurred.

I do think at this point I'm not going to do the chemo. I just want him to be happy and I'm grateful that he isn't in much pain
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post #6 of 27 (permalink) Old 10-23-2014, 11:37 PM
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They're specialists so they should hopefully know best. I just wonder what they were seeing to make them think otherwise? German shepherd with bleeding heart mass.... if it looks like a duck and quacks like a duck, it's probably hemangio

~Emergency Vet Tech

Berlin vom Spartanville, BH, OB1 1/13/13
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post #7 of 27 (permalink) Old 10-24-2014, 10:25 AM
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I'm so sorry you are going through this. We went through a hemangio scare a couple months ago. I worried myself sick over it not knowing what the outcome would be. We were lucky and the enlarged spleen the doctor found was caused by a UTI as it shrank back down with doxycyline. We still have to go back in another month for another check just to be sure nothing else is happening but the worry makes you numb. Their quality of life is the most important thing you can think of. I hope things go well for you and your fur baby. My heart to yours.

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post #8 of 27 (permalink) Old 10-29-2014, 12:37 AM Thread Starter
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Herc had is post-op checkup today. It is finally nice to get some good news. The incision is healing incredibly well, I'm more then shocked at the quality of the work done by the surgeon. He used stitching on the inside so it is very clean and is almost unnoticeable as his hair is growing over. He is officially off bed rest and can go back to playing normally. He has already been acting like a goofy spoiled dog lately anyways. I feel like all the good manners I taught him have gone out the window these last few weeks since I pretty much let him do whatever he wants now. He ate a waffle out of my trash at work and then barked at me yesterday when I was eating some chicken because he wanted some. He would have never attempted something like that a month ago!

I'm glad to see him happy. As part of our checkup we also did another EKG and it looks like his heart arrhythmia is completely gone (no trace whatsoever.) Now that there is no fluid constricting his heart those symptoms have also vanished, so I will be weaning him off of that medication over the next few days.

I decided to opt out of the Chemo. The oncologist didn't advocate for any specific treatment, and I know he would have pushed more for chemo if he thought it would have any promising results. They also did a quick re-check of his lungs and there is no fluid accumulation there either. We are 12 days out of surgery now. All in all it was good news for a not-so-good all around situation. At this point we have another vet checkup in 3-4 weeks to do an ultrasound but aside from that I plan on continuing spoiling him and making the rest of our time together as happy as can be.
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post #9 of 27 (permalink) Old 10-29-2014, 12:39 AM Thread Starter
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post #10 of 27 (permalink) Old 10-29-2014, 01:30 AM
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From another member of "the club no one wants to belong to", imho your decisions are wise and sound. Enjoy your time, have some beautiful pictures taken. Every day now is a gift. Take care.

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