Mast Cell Tumors Beware! Our Oncologist has a mark on you!

Mast Cell Tumors Beware! Our Oncologist has a mark on you!   

When looking for advanced veterinary care, we are here for you with cutting edge treatment options. Dr. Irene Vazquez, our board certified oncologist is your neighborhood pet cancer specialist.

STELFONTA is a prescription medicine used in dogs to treat mast cell tumors on the skin or in the tissues just under the skin. Given as an injection directly into your dog’s tumor, it destroys the tumor by breaking down cancer cells and starving their blood supply. A “pocket” or wound is left at the injection site where the tumor was. This is generally a healthy wound ready for skin and hair to grow back in a few weeks.
Pretreatment involves oral medications, including corticosteroids and antihistamines, prior to the injection of STELFONTA. These medications are very important to reduce the risks associated with inflammatory substances that can be released from the tumor as the mast cells are destroyed. Premedication is given 2 days pretreatment and continues until 7 days post treatment. It is essential that you give all medications as prescribed.

Most dogs do not need sedation or anesthesia during the procedure although occasionally, dogs may be sedated.

Side effects reported in dogs treated with STELFONTA were generally mild and short lasting, but they can be severe, especially if not treated in a timely manner.

The most common adverse reactions included wound formation, injection-site pain, lameness in the treated limb, vomiting, diarrhea and hypoalbuminemia (low levels in the blood of the protein albumin). Although most side effects/adverse reactions seen in clinical studies were mild, the most serious side effects occurred in the first 4 days. Excessive pain, lameness, tiredness, refusal to eat for more than one day, repeated vomiting or diarrhea, trouble breathing, changes to the treated tumor site (including increased or excessive swelling and bruising, extensive wound formation, increased irritation) or any other symptoms should be examined immediately and treated accordingly.

When looking for advanced veterinary care, we are here for you with cutting edge treatment options. Dr. Irene Vazquez, our board certified oncologist is your neighborhood pet cancer specialist.

Irene Vazquez, DVM, MS, DACVIM (Oncology)

We Can-cer-vive Cancer! Meet Charlie!!!

Meet cancer survivor Charlie and learn how a team approach to health care is so important when it comes to your pet's health. 

Charlie is a very adorable 14 year old cat that was diagnosed with an ear canal cancer known as ceruminous gland adenocarcinoma. This type of cancer is one of the most common ear canal cancers seen in both cats and dogs. Clinical signs associated with this disease include excessive cerumen accumulation, discharge, swelling, itchiness, and recurrent infections. In order to obtain a diagnosis, advanced imaging such as a CT scan is usually required. 

Most commonly, ear carcinomas are locally invasive and have a low chance of spreading to other locations. The treatment of choice for this type of cancer is surgical resection, which involves completely removing the ear canal (TECA- total ear canal ablation). 


A TECA or in Charlie's case a TECABO is a Total Ear Canal Ablation or Total Ear Canal Ablation Bulla Osteotomy. This procedure involves the complete removal of the ear canal middle ear, leaving only the ear flap remaining. 


Although this type of surgery may sound like a lot for your pet to go through, they tend to feel so much better once it is performed and it gives them the best chance at achieving a long survival time. With successful surgery and no identified negative prognostic indicators, patients can live a long time after removal of their cancer. 

Charlie was initially evaluated by Dr. Irene Vazquez at our the Oncology Service and had a CT scan performed, which showed he had a mass within his ear canal. The mass was sampled and the results were consistent with carcinoma. Charlie was then evaluated by Dr. Andrea Clark at our Surgery Service and had surgery performed to remove his tumor. 

Charlie on his 5 month anniversary cancer free!

Since his surgery, Charlie has been doing great at home and is currently cancer free. He continues to come in for routine evaluations to make sure his cancer is not spreading and so far, he's been doing amazing! He is the sweetest boy and our hearts melt every time he comes in. 

We wish Charlie the best of luck and the longest survival time! Our VCA Hollywood family is SO proud of him 💙.


Contributors: Irene Vazquez, DVM and Andrea Clark, DVM

Charlie after surgery. 

Ear Canal Tumors

What are tumors of the ear canal?
Tumors of the ear canal are abnormal growths that can develop from any part of the ear canal (the skin, the glands of the skin that produce earwax and oil, and the underlying connective tissues, muscles, and bones). Ear canal tumors can be benign or malignant. Benign tumors do not spread, while malignant or cancerous tumors can spread to the surrounding tissues or even other areas of the body (metastasis). Tumors of the external ear canal are more common than tumors of the middle or inner ear.

In dogs, the most common external ear canal tumors are ceruminous gland adenomas (benign) and adenocarcinomas (malignant). Other tumors include inflammatory polyps, papillomas, sebaceous gland adenomas, and more.

In cats, the most common external ear canal tumors are nasopharyngeal polyps, squamous cell carcinomas, and ceruminous gland adenocarcinomas.

Lymphoma, fibrosarcoma, and squamous cell carninomas are occasionally seen in the middle or inner ear of dogs and cats.

What causes these kinds of tumors?
The reason why a particular pet may develop this, or any other tumor or cancer, is not straightforward. Very few tumors and cancers have a single known cause. Most seem to be caused by a complex mix of risk factors, some environmental and some genetic or hereditary. Although there does not appear to be a genetic or hereditary cause for ear canal tumors, chronic inflammation is believed to play a role. German Shepherds and Cocker Spaniels, for example, are at increased risk of developing these tumors. This may be related to the tendency of both breeds to have recurrent and severe ear infections.

What are the clinical signs of ear canal tumors?
horners_syndrome_dog_arrow_2018Initially, these types of tumors may appear as one or more pink, white, or purple nodular masses in the ear canal. If benign, they may grow to a certain size and may or may not be problematic. If malignant, they may grow, ulcerate (break open) and bleed, and nearly invariably become infected, causing recurrent or chronic ear infections. As they grow, they can narrow and even fill (and obstruct) the ear canal.

The most common clinical signs of pets with ear canal tumors include an inflamed, itchy and painful ear, persistent odorous discharge (that can be waxy, pus-filled, or bloody), head shaking, and ear scratching. Sometimes pets will shake or scratch hard enough to cause an ear hematoma (a blood blister). Occasionally draining abscesses may form just below the ear. If the middle or inner ear is involved, pets may experience head tilt, circling, loss of balance and coordination, nystagmus (darting of the eyes back-and-forth), Horner’s syndrome (see photo), facial paralysis (with facial drooping, salivation, and difficulty eating), loss of hearing, and other neurologic signs.
(Image via Wikimedia Commons / Joel Mills (CC BY-SA 3.0.)

How are these kinds of tumor diagnosed?
If deep in the ear canal, these tumors may be difficult to see and therefore diagnose. If the ear canal is severely inflamed, the inflammation may need to be alleviated first to more clearly see the mass. Once the mass is identified, it may (or may not) be possible to take a sample of the tissue, depending on the location. If the mass can be accessed, fine needle aspiration (FNA) or biopsy will be performed. FNA involves taking a small needle with a syringe and suctioning a sample of cells directly from the tumor and placing them on a microscope slide. A veterinary pathologist then examines the slide under a microscope. A biopsy is surgical removal of a piece of the tumor. The tumor tissue is then examined under the microscope. This is called histopathology.

If a diagnosis of malignancy is made from the FNA or biopsy, a CT scan of the head and neck region may be performed to determine how invasive the tumor is and plan a surgical approach. Staging (searching for potential spread to other locations in the body) is highly recommended for malignant tumors, as they tend to spread. This may include bloodwork, urinalysis, X-rays of the lungs, and possibly an abdominal ultrasound. If any lymph nodes appear to be enlarged or firmer than normal, samples may be taken to look for spread.

How do these types of tumor typically progress?
Benign tumors, such as inflammatory polyps, typically only grow to a certain size, but are often irritating and interfere with the ear’s normal function, resulting in waxy buildup and chronic infections. The biggest concern with malignant tumors (other than the possibility of metastasis) is local spread. If the tumor is not treated, it may continue to grow and invade the surrounding tissues, causing pain and increasing the risk of the more serious clinical signs and complications listed above.

What are the treatments for these types of tumor?
The treatment of choice for ear canal tumors is surgical excision. This is curative for benign tumors that are completely removed. Laser surgery may be an option. More extensive surgery is required for malignant ear canal tumors. One procedure, called total ear canal ablation and bulla osteotomy (TECA-BO), involves removing the outer and inner ear canal, as well as the tympanic bulla (the middle ear), leaving only the ear flap remaining.

If complete removal of the tumor is not possible, radiation therapy may be recommended to treat the remaining tumor cells. Radiation therapy may also be recommended for large tumors that cannot be surgically removed, to slow tumor growth or relieve pain. Chemotherapy may be an option if the tumor is highly malignant or if there is evidence of metastasis.

Is there anything else I should know?
It is important to recognize that tumors of the ear canal may grow without much outward evidence, only causing subtle signs in your pet. If your pet suffers from recurrent or chronic ear infections, or shows signs of pain or discomfort, rechecking with your veterinarian at frequent intervals may assist with early detection.

Contributors: Christopher Pinard, DVM
© Copyright 2018 LifeLearn Inc. Used and/or modified with permission under license.
https://vcahospitals.com/know-your-pet/ear-canal-tumors

We Can-cer-vive Cancer! #VCAHollywoodPetCancerCareCenter

Meet Apollo! This adorable 7 year old, Golden Retriever received his last chemotherapy dose last week. In October, Apollo was diagnosed with B-cell lymphoma.  

Lymphoma is one of the most common types of cancer seen in dogs. It is a cancer of the immune system that occurs as a consequence of uncontrolled and abnormal growth of lymphocytes, an important cell of the immune system. 

In general, dogs with lymphoma present with multiple enlarged lymph nodes throughout the body and they tend to feel well at the time of diagnosis.  Even though lymphoma is not considered to be a curable disease (curable in <10% of cases), it is highly treatable with chemotherapy and approximately 95% of treated dogs respond to treatment and enter complete remission. 

The treatment of choice for dogs with B-cell lymphoma is chemotherapy with the CHOP protocol. CHOP is an acronym that stands for 4 drugs: cyclophosphamide, doxorubicin (hydroxydanorubicin), vincristine (Oncovin), and prednisone. The total protocol duration time is 15 weeks. With chemotherapy, the survival time in dogs with B-cell lymphoma is approximately 1 year. 

Apollo did great throughout his chemotherapy protocol and we will miss seeing him and his wagging tail through our VCA Hollywood Oncology Department  but we wish him the best of luck and a very long remission duration time!

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The Five Most Common Questions about Cancer in Dogs

How common is cancer in dogs? Unfortunately, cancer is one of the leading causes of death in older animals. According to the Animal Cancer Foundation (ACF), 1 out of every 4 dogs will develop cancer in their lifetime, and each year, approximately 6 million dogs are diagnosed with cancer.

What are some of the most common cancers in dogs?
Like their human companions, dogs can develop many different types of cancer, such as mammary cancers, lymphoma, leukemia, osteosarcomas, mast cell tumors and skin cancers, to name a few. According to the Veterinary Cancer Society, mammary tumors are the most common cancer seen in dogs.

Are there diagnostic tests or exams that should be done regularly to try to detect cancer in dogs? 
To improve the chances of early cancer detection, you should take your pet to your veterinarian at least once a year. Personally, I recommend animals over 6 years of age be seen twice a year. Your veterinarian will do a complete examination, checking your dog from head to tail to look for:

• Abnormal skin growths (lumps and bumps)
• Enlarged organs or masses in your pet’s abdomen (belly)
• Abnormal heart or lung sounds, and abnormalities in the eyes, ears and mouth

These exams are important because veterinarians can discover things that you may never notice. However, not all cancers can be detected by physical examination, so your veterinarian may also recommend screening tests like blood work, urinalysis and radiographs (x-rays), to uncover underlying diseases like cancer. Depending on the age, sex and breed of your dog, your veterinarian may recommend one or all of these tests to help look for cancer.

Are some types of cancers more treatable than others? 
Yes, all cancers are different and some are more treatable than others. The type of cancer, location, size, stage and response to treatment all affect the ultimate prognosis. With many cancers, the earlier the treatment is started, the better the prognosis, and ultimately, the longer the survival times. That's why it is so important to bring your dog to the veterinarian for examinations at least once a year. 

Do chemotherapy and radiation treatments affect dogs the way they affect human cancer patients? 

While remission is the ultimate goal, quality of life is equally as important. As a result, cancer treatments in dogs are generally less aggressive than regimens used in people. Therefore, pets typically do not suffer from some of the troubling side effects seen in people, such as nausea, vomiting, hair loss and extreme fatigue. If side effects occur, your veterinarian will adjust the treatment to ensure that your pet remains as comfortable as possible.

The goal of cancer therapy in dogs, like with many other diseases, is early diagnosis and treatment. In order to give your dogs the best odds of beating cancer, make sure your dog gets regular check-ups, take advantage of recommended screening tests, and become familiar with the common signs and symptoms of cancer in pets so you can look-out for them at home. If you want to know more about cancer, speak with your veterinarian and visit Veterinary Cancer Society or Animal Cancer Foundation 

If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.

Originally posted by Dr. Ruth MacPete, DVM @http://www.pethealthnetwork.com/dog-health/dog-diseases-conditions-a-z/five-most-common-questions-about-cancer-dogs