Abscess or Cancer?

Dr. Marie replied:

Oh, this is a difficult situation. The biggest problem with veterinary medicine is that we often have to make really hard decisions based on tests that are not always completely accurate.

I think the most important thing for us to know in this situation is how certain the pathologist is on the diagnosis of cancer. It's not always black and white. So, if the histology report is very certain that this is an anal sac cancer, then this really pushes me towards the decision to euthanize. A tumor certainly can rupture and become infected.

I have seen a lot of anal sac infections and I can't say that I have ever seen one make a dog sick enough to need stabilization or else he is in danger of dying. This really does sound like there is something very serious going on.

The coffee colored vomit and black tar are very suspicious for internal bleeding, but we can't say 100% if this is the case. If it is though, this is a bad sign.

When you say his bladder has failed, I'm wondering if you mean perhaps his kidneys? Kidney failure would be another sign that this is likely to be a fatal condition. We don't really see bladder failure...but we could see that the bladder is blocked by a tumor perhaps. This would be bad as well.

Most cancers are not detectable on blood work. If this is a cancer then there likely was no test that could have been done to pick it up prior to it causing obvious problems.

The decisions you have to make here are really hard though. Everything really looks like this is cancer. And if this is the case, then in my opinion, euthanasia is the best option. While many cancers are treatable, it sounds like this would be extremely hard and maybe not possible to cure.

But, there still is a small possibility that this is not cancer. Again, I would be wanting to know from the vet how certain the pathologist is on the diagnosis of cancer.

So, let's say that the diagnosis is uncertain and you want to go ahead with treatment. The risk here is that you could end up spending a large amount of money just to end up making a decision for euthanasia. And, if this happens, in hindsight, you would probably be sad that your dog had to suffer through extra days of pain and discomfort for naught. Still, I do think that there is a small chance that this could be all related to an anal sac infection. A very small chance.

The other factor that could help in your decision making is how he is responding to treatment. If things are not improving despite being on antibiotics then this is a bad sign as well.

In cases like this the best advice that I can give is to trust your vet's advice. They have your dog's best interest in mind and really should be able to advise you well.

I hope things do work out ok.

Dr. Marie


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