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I had posted a while back about my dog Kelly having some odd drooling/foamy saliva/lip-smacking symptoms and elevated lymphocytes (WBC is 22,700 lymphocytes 16,798); x-rays and his abdominal ultrasound came back fine, but repeat cytology and flow cytometry are diagnostic for t-cell lymphoma. I have an appointment with an oncology specialist Tuesday, and already had a virtual appointment last week where he recommended prednisone/chemo, to start after the does an in-person exam.

The past couple of weeks, Kelly also had a couple episodes of bleeding from his mouth--I couldn't find the source, but at his latest vet visit they had enough people to really pry his mouth open and look far back towards the base of his tongue and saw a mass (see below). It actually looks to be around where he had a benign plasmacytoma removed about a year and a half ago, but this is bigger, and certainly seems to explain his drooling and raspy breathing when in certain positions.

My issue is that my primary vet suggested doing a biopsy on Tuesday (and maybe a removal, they just sent the estimate, which was unclear as to whether they would just biopsy it or remove it, and when I called to ask questions, no one was available--will be calling back tomorrow!). Kelly is 10, and has had some issues bouncing back from anesthesia before as a younger and healthier dog, and I am hesitant to put him through a surgical procedure that might be risky, especially given the location of the tumor far back on his tongue (and the resulting breathing difficulties), and that he is not otherwise healthy, but has a lymphoma diagnosis that may or may not be related to this mass.

Since he already had a plasmacytoma removed from that same spot, it makes me think that it could be the same thing--so is a biopsy really necessary,? I was already planning to start him on prednisone and chemo for the lymphoma, so would it make sense to stick with that plan and see if they shrink the mass at all, rendering surgery easier or maybe even unnecessary? Or are there any other diagnostic tools that could be used on a tongue mass that wouldn't require anesthesia? I would just hate to put him through a procedure that could cause more harm than good, when a less invasive approach could work. If you all have any insight/wisdom/recommendations, they would be much appreciated!
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bumping up ^^^^^
 

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Doubt given the location it could be even aspirated without major sedation... and things change. I wouldn't trust that it is still benign, especially since plasmacytomas are so rare in the grand scheme and I dk anything really about them but that they 'are'. I know of a Lab mix who had them all over his body, and he had B cell lymphoma. Interesting coincidence.
 

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Well, Kelly started vomiting blood and pretty large blood clots early this morning, he had pale gums and was breathing raspily; I rushed him to the emergency vet where he is getting tests, fluids, and medicine. They think the bleeding is coming from this mass on his tongue, which the emergency vet said is too far back to remove. They offered to needle aspirate, but I was worried about putting him through that, especially with sedation, and opted to just start prednisone and chlorambucil, which they think will treat the mass and help stop the bleeding. I'm terrified for him--it was a lot of blood and he seemed so lethargic and sick, and he was still bleeding at the vet, although not as much. I just wanted to update this in case anyone in the future comes across this with a similar issue--I just found out about this mass last week, but I wish I had been more diligent in looking in his mouth before, and could have found it and started treating it before now.
 

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I am so sorry, this is really scary I know. If you have only seen your primary vet, I hope you will move to an oncologist. They have more options and treatments in their toolbox. I hope the meds reduce the mass and he is more comfortable.
 

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I'm so sorry. I hope the steroids and other med reduce it and give him some relief. Don't beat yourself up- very few people do more than notice if a dog yawns and there is something weird in the mouth.
 

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Thank you all for your kind words and support! I was able to consult with an oncologist at the emergency vet who put him on prednisone and some chemo drugs that are making him feel better tonight. I am worried though because even though the vet said he is alert this evening and seems to be feeling good, his PCV/Hemocrit has gone lower--28 this morning and 22 now. Since normal range is 35-50, I'm still really on edge about that and why it would go lower while he's getting treatment. They are retesting at midnight, so I'm hoping for better results then.
 

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Thank you all for your kind words and support! I was able to consult with an oncologist at the emergency vet who put him on prednisone and some chemo drugs that are making him feel better tonight. I am worried though because even though the vet said he is alert this evening and seems to be feeling good, his PCV/Hemocrit has gone lower--28 this morning and 22 now. Since normal range is 35-50, I'm still really on edge about that and why it would go lower while he's getting treatment. They are retesting at midnight, so I'm hoping for better results then.
Been thinking about you and Kelly. Please let us know how he and you are doing.
 

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Thank you all for your support and keeping Kelly & me in your thoughts! It's been a stressful couple of days. Kelly's PCV dropped to 12 overnight by early Tuesday morning and his breathing and heart rate were up, so they gave him a blood transfusion early Tuesday morning. By the afternoon, his PCV was back up to 20 and the vet felt he could go home for the night and come back the following morning for a recheck of the PCV to see if the transfusion did its job. Otherwise, he would need another transfusion. They also put him on sucralfate to help coat any ulcerations or lesions that might be causing the bleeding, and metronidazole for his tarry stool, so I'm hoping in addition to the other medications, they'll help him feel better. I was worried when he came home, as his breathing seemed really irregular, even at rest sometimes going up to 60 breaths per minute, then going back down to 25, then up to around 40-45. The vet thought it could be related to the stress of the vet visit and the prednisone, but to keep an eye on it. At the recheck this morning, his PCV was 25--so he is back home, thank goodness, and will recheck next week, or sooner if needed.

I'm so, so glad to have him home, but also still scared and trying to monitor him very closely--his breathing has still been more rapid than usual, even while sleeping--sometimes it's close to normal, around 25-30 breaths per minute, but then it will go up to 40, 50, even 60 and I get worried. For some reason, it seems worse when he lays on his side as opposed to his stomach. Although it's better today than it was yesterday. He's also laying with his elbows splayed out sometimes, which makes me worried that he's in pain. The vet did say that he is still anemic, which the vet said could make him breathe faster and work harder to breathe. He's been through a lot the past few days, being away from home for the first time in years, all the new medications, and I'm hoping once the stress wears off, he will keep getting back towards his normal self. In the meantime, I'm keeping a close eye on him and watching his breathing especially.
 

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Glad to hear he is back. We'll keep sending positive thoughts for you knowing how hard this is for you. I'm sure he is happier now at home.
 
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