Canine Hemangiosarcoma: Summer’s Story

Most stories about dogs with the deadly cancer hemangiosarcoma end sadly and this one does too. Just so you know. But I want to tell the story because canine hemangiosarcoma is so sneaky and can be hard to diagnose. For Summer, it all started with a backache, though it turned out not to be the main problem.

Hemangiosarcoma is a type of cancer that originates in the blood vessels and their linings. It is also called angiosarcoma and hemangioendothelioma. In dogs, visceral hemangiosarcomas are usually in the spleen, liver, or heart, and are almost always fatal. They grow fast and they bleed, episodically or explosively.

brown mixed breed dog lying on a mat, looking tired, soon to be diagnosed with hemangiosarcoma

Summer, not feeling well after a trip outside

Summer’s History

Summer had a couple of flare-ups of intervertebral disc disease in her last years. The first one was from an obvious cause: we were playing with the garden hose. She loved to jump and bite the water. She jumped one time too many and landed wrong and very soon after was experiencing back pain. I was familiar with how dogs’ posture can change with that particular problem because I had had two previous dogs with back issues and I took her straight to the vet.

Summer got a course of steroids and muscle relaxants and soon seemed as good as new. I didn’t let her jump anymore when we played with the hose and was more careful with her activities in general.

She had another bout of back pain a few months later, and this time the cause was not obvious. But I saw that posture again, took her to the vet, and again she responded well to the medication.

In June 2017, when she was 11 1/2, she had a physical with a full blood workup. Everything looked great.

On July 21st, we were playing some very active training games. Too active for a senior doggie, and she slid and fell. She was in that “backache” posture again a few hours later. She was panting and in a lot of pain this time. It was after hours and I took her to the emergency vet clinic. I didn’t crate her in the car because she was so weak that I was afraid I wouldn’t be able to get her out. She threw up on the way to the vet.

Summer after hurting her back

Vet Visit 1: ER Vet 7/21/17

After ascertaining that she probably wouldn’t bite him, a tech carried Summer into the clinic. The ER vet was thorough. He reported to me that he tested reflexes and the back issue was affecting all four of her legs. He showed me which part of the back was likely affected. He mentioned that the nerves that came from that part of the back also went to the heart and lungs so impairment could become serious. He said we were “not nearly at that point” but he wanted me to know. I had brought the meds that my regular vet had prescribed the last time, but he said he preferred a different approach. He prescribed gabapentin and meloxicam. Summer didn’t perk right up, but over the next two days got a lot better.

I needed to accommodate her infirmity. I have 12 steps down into my back yard and we worked out a system of walking around the side of the house—day and night—to avoid the steps. She was a little too big for me to carry safely down the steps. It would have been great if she would eliminate in the front yard, but she refused to go that way. I have no idea why. That refusal was a completely new behavior for her.

Summer on a good day

The pain started to dwindle, but her behavior got a bit strange. She would avoid certain areas of the yard, peering around, seemingly afraid of part of her regular areas. She started acting a little like my dog who had dementia, standing in the bathroom, staring off into space, seemingly unable to turn around to come out.

Vet Visit 2: Our Regular Vet 8/1/2017

On August 1st, I took Summer to my regular vet. She had taken the course of the RX prescribed by the ER et, but she was still showing pain and discomfort intermittently. She panted a lot. It may have been pain, but she was also clearly hot—I started setting up a floor fan for her and she would lie in front of it day and night.

My vet checked her out. She showed me some sluggish responses in her feet that indicated neurological problems related to disc disease. She palpated Summer’s back and identified the same area the previous vet had said was probably the location of the problem. She suggested steroids and muscle relaxants, and I was glad to switch. We both believed that the gabapentin was causing her strange behavior. But Summer didn’t bounce back as she had previously. I texted with the vet the next day because Summer was still very uncomfortable, and she said Summer could also have tramadol to help control the pain. I filled the prescription and ended up giving her the high end of the dosage the vet suggested.

Vet Visit 3: ER Vet 8/13/17

We were in the weaning down phase of the steroid treatment and Summer was having one pill every other day. She was still taking tramadol, and still a high dose. She had never felt great on the steroids and now she was feeling worse again. Sometimes she would just suddenly lie down in the yard while walking. We ended up at the ER vet again on a Sunday afternoon. I felt I had to try again. It was the same practice, different vet this time. They were very busy and we were there for four hours.

This vet couldn’t detect any pain in Summer’s back. She wrote down her symptoms as seizures, “risk of ” back pain, and “risk of” dementia. She was seeing the zoning out behavior that had started when Summer was on the gabapentin. I realized she could only advise on the symptoms she could identify but this was frustrating. She said we could do X-rays but she didn’t think they would show anything. Since we had already been there all that time, and it seemed to me that we were eventually going to have to do X-rays, I asked them to do a set.

The vet showed them to me. Summer’s back looked pretty good to her—no gnarly arthritis or anything obvious. She showed me a couple of places where the discs looked a bit too close together, which could indicate a problem. She didn’t notice the big round blob visible in Summer’s abdomen that was visible on at least two of the slides. I did, but I didn’t know what her abdomen was supposed to look like so didn’t mention it.

I asked the vet what I should do since my dog really was still in pain. She said to keep giving her the tramadol if that was helping. (I guessed it was.) She said I could talk to my regular vet about putting Summer on an NSAID, but that there was supposed to be a two-week washout period between the steroids and the NSAIDs. So I took Summer home and didn’t schedule another appointment right away. Two vets had suggested joint supplements so I bought some.

Summer lying in front of the fan

Summer got more restless at night. She started lying on her side almost all the time when she lay down, preferably next to an air vent or the fan I kept running for her. She started licking the bed covers sometimes, which I knew could be a sign of nausea.

August 20, 2017, was the last day she had a steroid pill, and the last day she ate normally. The next day she wouldn’t eat some of her usual favorites foods. I scheduled an appointment with the vet for August 25th. I was still trying to give some time for the steroids to wash out. But I felt like she was starting to fail physically.

On Thursday, August 24th, Summer was running a fever and also still not eating.  I wondered suddenly about tick-borne diseases. I had already had a rough experience with one dog with that. Many of Summer’s symptoms matched. I called the vet practice to see if I could change Summer’s appointment to that day. I prepared materials for the vet: some videos I had taken of Summer practically collapsing, and the X-rays.

Vet Visit 4: Our Regular Vet

I brought my vet up to date and showed her a video, then the X-rays. She pointed to the blob on the X-ray and said, “I don’t like the looks of that.” She immediately started telling me about tumors on the spleen. I was familiar with hemangiosarcoma but was stunned at this development. The owner of the veterinary practice, an internal medicine specialist, was there and did an ultrasound of Summer’s abdomen.

My vet came back looking grim but said there was some hope. It did look like a hemangiosarcoma, but because it was already so very big and they didn’t see any metastases, there was a possibility it was a very rare, benign type. She said that she normally didn’t recommend surgery because with the malignant tumors the life expectancy was very short even after removal. But if it were her dog, she would get the surgery because of how the tumor looked. And get it ASAP. I looked at that big blob and thought about what could happen, what would happen if this was a hemangiosarcoma.

We scheduled the surgery for the next morning. She told me to be ready for a phone call during the surgery. If the tumor were metastatic, I would need to decide whether to remove everything they could and wake Summer up again or have them euthanize her.

I thought I had gone to the vet with a dog with a bad back. And now I was facing possible euthanization in less than 24 hours. But even in my stunned state, I knew that if the tumor were metastatic, that’s what I would opt for. Summer had had a month of discomfort, the last 5 days of which had been pretty miserable for her. If I had them perform surgery on the metastatic tumor and wake her up again, she would have to recover from major surgery with no future except more tumors coming very soon. It wouldn’t be fair.

18 Hours

Brown mixed breed dog lying on a bed, with a woman's hand reaching out to her and holding her shoulder

My last photo of Summer. Calm but clearly not feeling well.

I took her home and proceeded as if these were our last hours together. Her appetite was poor, but she would eat chicken baby food and beef jerky, so I gave her tidbits through the evening. We sat on the bed together with the other dogs locked out. I wished I had spent more time with her by herself. She loved just being with me. The other dogs didn’t like her and she didn’t like them. We made those 18 hours count.

In the morning we sat on the bed just a little bit more before our dear friend came to pick us up. I gently petted her head and she would put her paw on my hand to ask for more when I stopped. I told her she would feel better by afternoon. That was the only true thing I knew to say about the future.

The Surgery

Leaving her at the vet’s was horrible. I had dreaded it. I could barely think about the fact that possibly her last couple of hours on earth were going to be in a cage, scared, waiting for surgery. But I had no choice. And she had been through procedures before and I had always come back for her. I hoped against hope that she wouldn’t be petrified; that it would just be another episode at the vet for her. One she would survive.

This is one of the many reasons that it’s a really good idea to condition vet visits to be a positive as possible for our dogs.

A technician called at 10:45 AM to tell me they were starting the surgery. At 10:55 AM they called again. This time it was one of the veterinarians and I knew the news when I heard her sympathetic voice.  They had found tiny cancer metastases all over Summer’s abdomen in addition to the giant tumor. And the tumor was bleeding. There had not been blood in her abdomen per the ultrasound the day before but there was no. Weeping, I told them to let her go.

Afterwards

In a later conversation, my vet said that the tumor had probably been bleeding episodically. That’s why she would feel really bad for a period, then recover and clearly feel better.

I’m not upset at the ER vet for not noticing the tumor. At that point, the outcome was predetermined. All that would have happened is that I would have had 10 fewer days with her. I’m sorry that for 5 of those 10 days she was feeling badly, but I’m selfishly glad we had them. From most of the stories I have read, this is actually one of the less awful hemangiosarcoma experiences. Summer was spared the acute pain and trauma of a bleed-out, and I have read stories where it took much longer to diagnose the problem. By all appearances, she was feeling quite good at the beginning of July. She had episodes of pain and discomfort through late August, but things didn’t turn really bad until four or five days before she died. Her last night was a good one and she seemed comfortable and was calm on the morning of her last day.

I do believe she had an episode of disc disease. Both vets did neurological tests and had the same diagnosis. But it’s possible that our rowdy training that day caused the tumor to bleed, rather than causing a back problem. But I don’t think so. Her abdomen was never tender and her back was. It just made things really complicated when trying to track down the serious problem.

I debated making this video, but it seemed important to document the episodic nature of her pain. That’s part of what made it difficult to diagnose.

Link to the video for email subscribers.

Note about the video: while perhaps not a really smart thing to ask an 11-year-old dog to do, the jumping in and out of the bathtub training at the beginning of the movie is not how Summer hurt her back.

If your dog exhibits symptoms of apparent pain, weakness, or intermittent fatigue, see your vet. It could be so many different things, but you and your vet need to know.

Summer how I will remember her–this is from a May 2017 video of her first experience with a Snuffle Mat.

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Copyright 2017 Eileen Anderson

 

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44 Responses to Canine Hemangiosarcoma: Summer’s Story

  1. lesleybowen says:

    Eileen, my heart breaks for you. My first dog Christine died of hemangiosarcoma in August 2001. Like you, I had no clue. The sad part is Christine had bleed outs when the tumor would burst and reseal itself…and she’d be good for another six weeks. Back then, not every vet clinic had an ultrasound machine. But I knew Christine’s gums were pale which the vet attributed to her thyroid problems instead. She too had to leave me on the operating table as the tumor (attached to her bladder) had seeded additional tumors on her abdominal wall.

    Did you know that there now is a test for hemangiosarcoma? http://healthypets.mercola.com/sites/healthypets/archive/2011/04/19/splenic-hemangiosarcoma-in-pet-dog.aspx I saw it listed on a chart of cancers one can test for at my vet clinic. There was so very little information about hemangiosarcoma when Christine died, but now there’s quite a bit online.

    I am so sorry about Summer.

  2. Leslie Kupkowski says:

    Ahhhh….sweet Summer….I am so sorry for your loss.

    Leslie

  3. Laura says:

    Dear Eileen, I’m am so very sorry for the loss of your girl. I don’t know if it’s easier to lose them quickly or from a prolonged illness. I lost three in 7 weeks, two suddenly and unexpectedly and one whom had been battling leukemia for many months. None were easy. Such a heart ache losing them. You are in my thoughts.

    • Eileen Anderson says:

      Oh my goodness, Laura, that’s too much. It’s hard to compare, isn’t it? But this was harder than losing my little Cricket–with whom I stood ready for two whole years…. Thanks for your kind words.

  4. Renelle Leblanc-Scott says:

    I’m so sorry for your loss Eileen. They never seem to be with us long enough, even though we know that going in… Thank you for sharing Summer’s story and for educating us on this type of cancer. It was wonderful to see the video even if we knew the outcome. RIP sweet girl xx ❤️❤️

    • Eileen Anderson says:

      They never are. I’m glad the video was good to watch. It actually was…satisfying?–is that the word?–to make. I don’t want to forget anything…. Thanks for the lovely comment.

  5. Carolle Bergeron says:

    I am really sorry for your loss.

    Carolle

  6. Skye Anderson says:

    Thank you for sharing. It must have been bittersweet to write.

  7. Chris from Boise says:

    Eileen, thank you for sharing these details and the video. It is so hard when you know in your gut that something is wrong, and the vets can’t pinpoint it. I’m sorry that you couldn’t be there with Summer at the last, but you did the very best you could for her. The visible bond between you two, and the sparkle in Summer’s eyes when she looks at you in the videos, warms the cockles of my heart. You two were meant for each other.

  8. Lisa says:

    so sorry for your loss, Eileen
    Thank you for sharing Summer’s story.
    I love her sweet face /Lisa K

  9. Sheila says:

    I lost a dog to this disease, too. He was a 9 yr old golden retriever who refused dinner one day. The next day I brought him in (I’m a vet) and did bloodwork. Everything was normal and he was back to his normal self. One month later he didn’t eat again and was pale this time. I knew. I did blood tests again and an ultrasound. It was on his spleen and in his liver. That was a Saturday. On Sunday he was feeling good and we did all of his favorite things. On Tuesday I had to put him to sleep. I think if I’d had taken X-rays the first time he didn’t eat, I’d have known then. Like you, I’m glad I didn’t know sooner. We had a great month together, neither of us knowing. And I didn’t have to wrestle with the decision of surgery. That’s such a tough spot to be in. I’m sorry for your loss. A good dog, like Summer, can really break your heart. Like I told you before, you were lucky to have had each other.

    • Eileen Anderson says:

      Oh my goodness. I am also glad that I didn’t have to wrestle with any hard decisions there at the end. That’s partly selfish, but partly not. What a thing it is to have these trusting creatures’ lives in our hands. The decision was a foregone conclusion in our situation as well and for that I am grateful. Thanks for sharing about your golden.

  10. Carin says:

    Eileen, thank you for sharing the details. In addition to being awful in its own right, hemangiosarcoma is so tricky because it often strikes older dogs who already have other issues, and it comes on so quickly. And it can be *so* hard to distinguish back pain from abdominal distress. My Cocker was diagnosed with hemangiosarcoma on his 16th birthday. A week earlier, he had had a completely normal regular checkup – normal for an elderly dog with three or four chronic diseases, that is. In the week that followed, his stools became abnormal – the only sign that something was wrong – and I went back to the vet. I was lucky to have a few more weeks with him after surgery, but still, it was the sneaky disease that got him when he had given in to nothing else for years and years. My condolences on the loss of beautiful Summer.

    • Eileen Anderson says:

      I’m sorry for your loss as well. What a heartbreak. I’ve been bragging on Summer for a year or two now, how she didn’t look or act her age. I really did expect many more years.

  11. Barbara S Briggs says:

    Eileen, thank you so much for sharing such a hard experience. Summer surely had the best Mama, and knew she was loved very much. You were her advocate, and kept pushing for an explanation for those symptoms you were seeing. I know you made the right decision in the end, keeping her welfare first and foremost. K9trainerbarbara@gmail.com

  12. Sally Hines says:

    Please accept my deepest sympathies on Summer’s loss. I can empathize, having lost two Labradors, a dog and a bitch, Wally in 2009 and Ella in 2015, to the malignancy. Both were just shy of their 11th birthdays at the time of death; both came to me as puppies from a very reputable breeder and had related pedigrees. Labs and goldens appear have a higher risk for splenic hemangiosarcoma than other breeds. I have a very astute vet who in each case was able to work through the vague symptoms each dog presented. He put together the likely clinical picture, palpated the spleen, and upon finding it enlarged immediately recommended an ultra sound. Each dog was promptly splenectomized, which may have slowed down disease progress a bit. Though there were no visible metastases on their livers, the specialty surgeon who did the surgery both times shook his head and said these cases never had a happy ending, as micro metastases were always to be assumed.
    There is some promising research at the University of Pennsylvania Veterinary School on immunotherapy for dogs diagnosed with hemangiosarcoma. Here’s the link:
    http://www.vet.upenn.edu/test-page/mason-cancer-immunotherapy/canine-hemangiosarcoma

    • Eileen Anderson says:

      Dear Sally,
      I’m so sorry you, too, were affected by this disease. I’m glad you got some time with your Labs from surgery. Thanks for the link; that looks promising.

  13. Clare says:

    My deepest condolences, Eileen. We have a dachshund with IVDD (just had surgery on Monday) and I will keep this in mind for the future. Feel a big hug.

  14. Brenda says:

    I’m so sorry – heartfelt condolences. Summer looked like a real treasure. So many times it’s such guesswork to figure out what’s wrong with our canine family members. Thanks for posting this.

  15. Dear Eileen, I finally mustered the courage to read about Summer. You already know my experience with hemangiosarcoma. I am so deeply sorry for your lost and the way it happened. Thank you for detailing Summer’s journey.

  16. Gwen Quon says:

    I am so sorry . You were the best thing that happened to Summer. She had a beautiful life and was loved deeply. This is the hard part of being a dog owner. Every day is precious and I know you filled those days with Summer with fun, learning and love. Big Hug to you.

  17. Mel says:

    I sat in my work parking lot reading this yesterday afternoon and cried. I am so sorry she is gone. I am so sorry for your pain and how you lost her. I loved Summer. Through you, she taught us so much. Godspeed sweet Summer.

  18. nickynockynoo says:

    Eileen, I cried when I read your post. I’m so sorry. Summer had the best possible life with you, right up to the end. Saying goodbye when the time is right is the last kindness owners can do. You did all you could. Thanks for posting this and the video. I’m glad it helped.

  19. Sadie Cooper says:

    I am so sad for your loss. Thank you for sharing this and for all you share. All of your readers will miss Summer and her sweet face.

  20. Tammy says:

    Eileen –

    I am so sorry for the loss of sweet little Summer. It must have been very hard to write this down for all of us, and by doing so you may help someone else facing the vague symptoms of this awful disease. Big virtual hug to you.

    I am very interested in several of Summer’s symptoms, which match some of my little Missy’s symptoms — and not symptoms that typically show up on lists related to HSA. It may be pure coincidence, but I’m going to note them because Summer’s symptoms were uncannily like Missy’s.

    Missy competes in agility with me and had a series of spinal symptoms and diagnoses similar to Summer’s, along with some occasional vomiting. We, too, became very familiar with gabapentin and meloxidyl. Missy also became unusually uncomfortable in the heat; she never loved the heat, but she seemed easily overheated and began panting a lot (some of that was no doubt discomfort or pain). Like you, I brought her in for x-rays because her back problem seemed really to be nagging her and she just was so disinterested in the agility obstacles and, unusually for her, food. So many coincidences, aren’t there? Some are typical of hemangio, but the back and heat symptoms shared by Summer and Missy aren’t. Again — could be coincidence but worth noting.

    We have one of the rare “good” hemangiosarcoma stories because when our vet looked at the xrays, he did notice the grapefruit-sized spleen and took it out the next morning (no metastases). The pathology report came back positive for HSA and we’ve been counting every day since as a blessing. If you’re interested, I’ve been writing about our hemangio journey here: missyhemangiosarcoma.wordpress.com.

    • Eileen Anderson says:

      First, I’m so happy to read about little Missy’s surviving and thriving. Nice blog! Yes, those are some very interesting coincidences. Also, Summer was my agility partner. Summer stayed hot for about the last three weeks of her life. I asked my vet about it and she really didn’t know the answer to that. On her last morning, I counted her respiration rate. 30 breaths per minute at rest. That’s about 3x what it should have been.

      So happy for you that your vet caught it and that Missy’s treatment has been so successful. And thanks for spreading the word about the research in your blog.

      • Tammy says:

        What a great agility partner you had in Summer, Eileen. I started agility after adopting Missy and trying to find a way to help her feel more confident and successful in the world. Now I also work my new agility dog, Chica. It’s a wonderful partnership to have with a dog, isn’t it?

  21. catherine comden says:

    So sorry for your loss. She’s lucky to have had you as mom. Nearly two decades ago, I lost my sweet golden girl to hemangiosarcoma – a sudden bleed out on a typical day where she had been joyfully stalking squirrels and wroo-wrooing her joy for life. I never saw it coming. Just found her gone after leaving her alone for an hour. Looking back – I can see the signs of discomfort – all of which I attributed to other causes – and the guilt took many seasons to pass. You did well by your girl. Thanks for being transparent and for always teaching. You are a huge blessing.

    • Eileen Anderson says:

      I’m so sorry, Catherine, That would be so very tough. Thank you for your kind words and back atcha–I’m sure your golden had the best life ever with you .

  22. Shona Reiter says:

    Dear Eileen,
    I’m so sorry to hear the news about Summer and I wish there was some small way that I could help your sadness. I know only too well what it feels like and that there’s nothing anyone can do to help this pain.

    Thank you so much for sharing that wonderful video of Summer and her last few weeks and days. She was a beauty! Such eyes! Like CCD, sometimes symptoms are masked, and I appreciated your explanations of what to look for.

    You’re a wonderful person and I have appreciated your dedication and help when my little boy, Clyde (Tibetan Terrier) was sick with CCD. Like you and little Cricket, I stayed by his side for 2 years at which time I finally put him to sleep in our home and sitting on my lap. Damn that was heart wrenching. By the way, it’s almost a year since then and I just adopted a new forever friend named Dodie, who is a little Havanese. She certainly brings out a smile in me!

    I’m sure that Summer found her true purpose on Earth through you and the love you showed her. Blessings to you Eileen and I hope you soon have many smiles on your face as you continue to love your other dogs and possibly any new arrivals that come your way.

    Shona

    • Eileen Anderson says:

      Shona, thank you so much for taking the time to write such kind words. I have been having a hard time, and just to know that Summer and I have helped others really helps. Congratulations on getting little Dodie! I have a feeling she just won the doggie lottery in getting to come home with you. Thanks again.

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