Monday night we took Milo to the Emergency vet. He hadn’t eaten in 5 days, his belly was filled with fluid, he was lethargic, his breathing was becoming labored, he would barely walk… he could barely even stand. We had made an appointment to see the Cardiologist for today (Wednesday), but we weren’t sure he’d make it.
They admitted him in and did an ultrasound. They found that his abdomen and chest cavity were filled with fluid, so they recommended draining it, in the hopes it would help his appetite and make him feel better so he would make it to the Wednesday appointment. We agreed, so they took him to the back and basically tapped him like a keg.
They removed 1.5L of fluid from his abdomen, but when they got to his chest, they realized the fluid was around his heart, a pericardial effusion. They removed the fluid, 750mL, but in the fluid they noticed blood. Also, during the ultrasound, they spotted what they believed was a mass, but they weren’t sure. We took home a very high dog, but one that began to show signs of improvement, and even began eating.
Today the cardiologist took a look and noticed there was an accumulation of fluid around his heart again, so she recommended tapping him (they removed 200mL) with the caveat that we shouldn’t look too deeply into the fluid removal, and then she gave us her opinion of what she saw on the echocardiogram:
There was a mass. Typically they can tell what it is by its location, but this one wasn’t in the usual spots. Still, her initial guess, with 60-65% certainty is hemangiosarcoma, an aggressive form of vascular cancer. Treatment is typically surgery with chemotherapy, but the overall prognosis isn’t very good: 0-3 months untreated, maybe 6 months with treatment. Her other thought was a “heart-based mass”, probably chemodectoma, which doesn’t grow very quickly and can be mitigated with a pericardectomy to remove the lining around the heart. The pericardectomy could add a year to two years to his life.
The next steps are observation. He was taken off his meds, aside from an herbal coagulant to slow the bleeding from the mass, and we were told to make an appointment for 2 weeks out. If it’s a hemangiosarcoma, the tumor will have shown significant growth, if it’s roughly the same size, it’s likely a heart-based mass. Of course, if anything suddenly changes, we’ll bring him back into the ER.
If the tumor is confirmed as a hemangiosarcoma, we’re not opting for treatment. Our priority will shift to keeping him happy and comfortable until he is no longer, and then we will let him rest. If it’s a heart-based mass, we will explore whatever options are financially feasible.
But… the Milo we know and love is back. The fluid removals have made him feel much, much better, and as I type this, he and Tam are in the other room playing. He’s eating, he’s alert, he energetic, he’s farting… oh man is he farting… but he’s better, and he’s happy again.