German Shepherds Forum banner

1 - 20 of 22 Posts

·
Registered
Joined
·
5,605 Posts
Discussion Starter #1
Of all the weird cancers...limbal melanoma is tumor on the eye. It manifests as a dark spot, usually on the sclera (white part of the eye), near the junction with the cornea. It's probably genetic, though little is known about cause -- it's not sun though (unlike skin melanoma in humans).

My regular vet noticed what looked like a dark fleck in the eye during a routine visit. It was just a little thing that didn't look particularly concerning. My vet told me to get a vet ophthalmologist to look at it ASAP -- it might be nothing, but it might be cancerous. At the initial consultation, eye specialist was on the fence and thought there a 50/50 chance that it might turn out to be a melanoma. It was...but we caught it early enough to save the eye (hopefully).

The tumor had to be cut out, all the way through the sclera into the eyeball. Then the eye doc reconstructed the eyeball with a graft. My boy's vision should be saved if recovery goes well and we don't have complications. It was major surgery though, with several weeks of healing time (crate rest, harnessed leash walks, no stepping down out of the SUV, and lots and lots of meds).

I suppose the good news is that melanoma of the eye in dogs is slow growing not usually metastatic. The worst case scenario if we were to have complications would be losing the eye --not losing my dog!

I want to put this thread out there so that everyone knows that if you see a dark spot on the white part of your dog's eye, get to a vet ophthalmologist ASAP! (The longer you wait, the greater the risk of losing the eye.)
 

·
Registered
Joined
·
3,849 Posts
Sorry to hear your dog had to go through this, but thank you for sharing this info, I'd have never known!
 

·
Registered
Joined
·
1,810 Posts
Thank you for bringing awareness to this. I had no idea and did some extra research on it. That being said, I'm sorry your guy went through this and that you caught it early.

My thoughts for a really quick, complete and uneventful recovery. Your guy could not be in better hands. And Magwart, thank you for all those who you have helped both on this board and through your work.
 

·
Super Moderator
Joined
·
4,634 Posts
wow, one more thing to be concerned about. I'd not heard about this before so thank you for the heads up. And I am glad it isn't caused by sunlight (going to get some Rex Spex anyhow for when we take our guys on the boat)
 

·
Registered
Joined
·
5,605 Posts
Discussion Starter #5
Thank you all for the good wishes. This one hit me out of the blue -- he's only middle-aged, much too young for me to be thinking about cancer.



I had a good cry after learning it was presenting as classic limbal melanoma requiring aggressive surgery, and then I had to remind myself how very fortunate we are: it's not life-threatening, and we hopefully caught it in time. We were in the care of a good specialty referral hospital to do the graft and reconstruction of the eye, with a very experienced vet ophthalmologist....and we have Healthy Paws pet insurance, so I have no worries about the cost of this. All those things are reasons to be grateful -- he's a a lucky, lucky dog.



When I picked him up, he cried and cried to tell me how unhappy he was at the clinic and how ready he was to get out of there. Finally late yesterday, his ears went up inside the cone, and I got a happy face. (First time in two days!) I can tell when his pain meds are wearing off though. He really needs them.



He's on 8 (!!!) meds, multiple times per day.... I can't sleep for more than 5 hours before he needs to be medicated, but if I've got a happy boy, I know we're going to be okay. Seeing his ears go up and a happy face made it all worth it.
 

·
Registered
Joined
·
2,120 Posts
So sorry you're going through this. I'm glad your boy is doing well after the surgery, and that you caught it early. I've never heard of that kind of a cancer. It sounds like you have a good vet to notice something may not be right. (Seems like it would be an easy thing to miss in a routine appointment). Thank you for sharing your experience, and keep us updated. I'm hoping your boy has a quick and uneventful recovery!
 

·
Registered
Joined
·
5,605 Posts
Discussion Starter #7
What an ordeal. My poor boy is still in a cone, and will be for at least two more weeks. However, we think we've saved the eye.

A week after the first surgery removing the eye tumor, the eye globe graft started leaking -- his eye globe was losing pressure and fluid. He required a second, emergency surgery, this time with donor tissue and a different suturing technique. He was in surgery for 2.5 hours (!!!) the second time. It went very well, and the eye looks good at this point. It's healing exactly as we want it to, finally.

On the advice of both his ophthalmologist and oncologist, we also have started the relatively new melanoma cancer "vaccine" (ONCEPT), an alternative to chemo that is a DNA-based immuno-stimulant that "teaches" the dog's immune system to identify and kill melanoma cells (since "clean" margins aren't ever possible inside an eye). Calling it a "vaccine" is kind of a misnomer since it's not prevention. It's supposed to be curative, and it's only administered after diagnosis. It's intradermal (small needle), extremely safe without major side effects, but it costs about the same as chemo for the loading dose (4 shots, 2 weeks apart).

When I called Healthy Paws to check on whether they'd cover the ONCEPT treatment, they didn't hesitate -- it's covered! I was expecting "weasel language" about it being a "vaccine" (= not usually covered), but they totally understood it's a chemo alternative. The oncologist thinks that it should make it less likely that the melanoma can return after surgery....with virtually no risk of ill effects since the dog's own immune system will do all the work. Interestingly, they appear to have gotten approval for this treatment in dogs as a step toward getting approval for something very similar to treat melanoma in people.

I think we're going to be in the running for "top 10 most expensive dogs" in the annual end-of-year email that Healthy Paws sends out....but thank goodness we're covered.

I'm still shellshocked that the "little spot" turned into all this.
 

·
Registered
Joined
·
2,236 Posts
Yikes! I've never had health insurance on my dogs, but what happened to your boy makes a good a case for it as any I've ever heard of!

Something like this is every dog owner's worst nightmare, especially if you DON'T have insurance!
 

·
Registered
Joined
·
5,605 Posts
Discussion Starter #10
I want to update this thread for anyone who ever searches for limbal melanoma: we are now one year out from the diagnosis, and starting the melanoma immunotherapy (a/k/a "cancer vaccine"). My dog is doing great!



We visited the vet oncologist for a recheck and staging last week. He has no signs of any cancer, anywhere. They sent images to a radiologist to see if they could spot anything the oncologist missed, and even the radiologist said everything looks healthy. If any melanoma cells escaped the surgery, his immune system mopped them up, with the help of the targeted immunotherapy.



The vet oncologists don't like to use the word "remission" for cancer in dogs, but when I asked if when we could use the that word, she smiled and said that she thinks we're there. YAY!!!!!!
 

·
Registered
Joined
·
1,810 Posts
This is such good news! Will you dog's case be written up and added to the research results that are included for consideration for humans? Sorry if I'm not wording it right and are they testing/doing the same for other cancers? It just seems such a huge step as a better alternative to chemo.

Such good news!!!
 

·
Registered
Joined
·
7,365 Posts
This wonderful news:happyboogie::angel: The story remind me of my friends mom who many years ago diagnosed with cancer of the eye. The eye was not red but protruding from a tumor behind it. It took her along time to even go to the doctor. Chemo did not work and she did a trial and she was in remission for many many years. She had passed away in her 80’s due to other causes. So there are always new things out there and hope. I know they use immunotherapy they has been approved for lung cancer. Everything has side effects as it is strong and needs to be. I understand they just approved immunotherapy for triple negative breast cancer - they use it in some cases in conjunction with chemotherapy in treatment in cases that spread. Oncologist will treat cancer with what has the most success but sometimes that does not work for everyone so very happy their is another chance for people.
https://www.bcrf.org/blog/triple-negative-breast-cancer-new-study-highlights-promise-and-challenges-immunotherapy
 

·
Registered
Joined
·
5,605 Posts
Discussion Starter #16
Will you dog's case be written up and added to the research results that are included for consideration for humans? Sorry if I'm not wording it right and are they testing/doing the same for other cancers? It just seems such a huge step as a better alternative to chemo.

It wouldn't surprise me at all if his case gets written up, though they haven't mentioned it. He's one of the first limbal melanoma cases in which this new immunotherapy has been used in (it's a very rare cancer, but predominantly affects GSDs...so AFAIC, this is an important data point). Oncept was actually developed for oral melanoma, but the "signature" of the cancer cell is identical as far as the immune system is concerned, so they were very sure it would work. It's been completely free of side-effects for us.



I have a hunch that dogs are just a step in a process toward human approval -- I've joked with the vet oncologist that if my own derm finds a melanoma on me, I want veterinary treatment instead of human medical treatment. I'm sure the price will sky rocket once it crosses to humans (instead of $700 per dose it will probably be $17,000 per dose, or something like that).
 

·
Registered
Joined
·
1,810 Posts
Magwart, I've got it tucked in my brain that if ever.... for me, him or loved one has to have a biopsy to make them save it.
 

·
Registered
Joined
·
7 Posts
Magwart thank you for this post, I just returned from the veterinary ophthalmologist and apparently my 5 month old black GSD likely has an iris melanoma. We go back in 1 month to reassess for changes and the possible head to laser treatment to reduce the mass. Sounds like there could be a genetic component here and I am wondering about what to tell my breeder as far as that goes...this was the first breeding from both dam and sire. Worst case scenario we remove the eye and the vet said that will be curative, but I was hoping to be able to do IPO with him so I'd rather do anything I can to save his eye. It sounds like your vet did some major surgery, do you mind me asking where you went?
 

·
Registered
Joined
·
5,605 Posts
Discussion Starter #20
Oh wow! That's SO young for melanoma. I'm so very sorry you are going through this.

Your vet ophthalmologist should be able to handle any eye surgery. If you have a state university vet school near you, that's probably a really good place to get the surgery done.

I had the bad luck of getting the diagnosis while we were away for the summer....but good luck to find a wonderful practice to take care of us. The vet ophtho who saved the eye was Dr. Nancy Johnstone McLean with the VCA Referral Center in Albuquerque. She was absolutely outstanding -- it was actually two surgeries due to a complication with the first one, with a graft of donor tissue to save the eye. She had to cut into the eye ball and reconstruct it after removing the tumor. They were long, tedious surgeries, but their eye surgery suite is state-of-the-art, and the clinic has a vet on site 24/7, so after the surgery, there's always a vet there to check on the dog while it's recovering (not just a vet tech). They also had a terrific vet oncologist in the same practice to work with me on thinking through the option of immunotherapy (since clean margins are basically impossible inside an eyeball). I can't say enough good things about this practice in Albuquerque -- compassionate, top-notch care.

The thing to consider about major eye surgery (where they cut in and remove masses) is the dog is on absolute lock-down afterward -- no jumping (even out of the car or off the bed), with gentle movements. My guy had to wear a harness for weeks so that I could keep him slow and calm. I would physically hold the harness handle going up and down stairs so that he couldn't experience impact. The suture thread is thinner than a human hair, so it's delicate until it heals.
 
1 - 20 of 22 Posts
Top