
For Oliver, our seven year-old Weimaraner, lumps and bumps were far from unusual. Fatty tumors are common in this breed (and many others) and are very easily observed since the Weimaraner coat is extremely short.

We regularly pointed out his lumps to his veterinarian during annual physicals. Our local veterinarian (we’ll call her Dr. G) has always carefully monitored these areas and performed needle aspirations when one appears suspicious. Thankfully, all had been simple lipomas (benign fatty tumors) and were no cause for alarm. However, the new lump on Oliver’s right flank near his hip seemed to arise more quickly than others. Just to be safe, we made an appointment to have it checked. Dr. G. did a series of needle aspirations on five lumps and only the “new” lump produced a bloody mixture rather than the fatty material that usually comes from lipomas. So, we made an appointment for two days later to have the lump removed and sent to a pathologist.

Two days later, Dr. G. called and said “I’ve been putting off calling you because I don’t know how to tell you this, except to tell you directly. Oliver has a Malignant Peripheral Nerve Sheath Tumor” (MPNST). I nearly collapsed with shock, this dog is only seven and I’m not prepared to lose him. Dr. G said that she would call the local veterinary referral service surgeon the next day and get back to us. She explained that surgical removal of the tumor plus “clean margins” (an area of healthy tissue surrounding the malignancy and assuring that the cancer has not spread into the surrounding tissue) is the best chance for a “cure”.

I decided that I needed to learn as much as I could about MPNST for two reasons. The first was to be the best possible advocate for my beloved dog, but selfishly, the second was so that I could prepare myself for what might happen. I started with the internet, and became quickly aware that very little information is available on MPNST; there were a few cases documented about human occurrences and a couple scholarly studies in advanced canine occurrences. None of this seemed to apply directly to Oliver’s case. He was an otherwise healthy dog with no symptoms.

One of the most valuable things I did next was to Google “pets with cancer” which linked me to the Pets With Cancer Lifeline (PWCL) website and provided me with an email address so that I could reach out. I was trying to find other people with pets diagnosed with MPNST. As it turned out, I received several supportive emails; however none were from people with MPNST experience. BUT, those supportive emails made a huge difference. Suddenly, I wasn’t alone. There were other people out there who were feeling, or have felt, all the same emotions. I even received a phone call from one person, just offering support and understanding. I can’t overstate the value of a supportive network when one is waging an unexpected battle. The kindness and goodness of utter strangers became the “wind beneath my wings” as I now had a “team”. I was researching and fighting for my Oliver, but also for other people who might receive the MPNST diagnosis.

I began compiling recommendations from people in the “dog world” including my aunt who prevailed upon her friends in the Newfoundland community, and from PWCL about treatment centers in driving distance from our home. It came down to three locations: the University of Pennsylvania in Philadelphia (about 2 hours from home), the office of Dr. Anne Jeglum in West Chester, PA (about 1.5 hours, although their radiation therapy office is in Chalfont, PA about 3 hours away) and Dr. Boshoven’s practice in Gaithersburg. I called and requested appointments at Dr. Jeglum’s and at Penn. The first appointment available was at Dr. Jeglum’s in a few days. Since Dr. Jeglum was on vacation, we saw another doctor in her practice.

By the way, going to a veterinary oncologist’s office is a tough experience; there are lots of sick animals and sad people. This was tough to get through. The doctor who examined Oliver explained that he would need to undergo radiation therapy to treat his tumor. Here is a description of what that entails:
Radiation therapy for MPNST is a 19 treatment protocol with treatments being administered daily (Monday through Friday) for 4 weeks. Each treatment must be administered under anesthesia and with intubation. The dog will develop burn-like sores after about the first week and may need steroids and pain medications. Bone tumors in irradiated areas sometimes occur later.
While I was preparing myself for the likelihood that radiation would be required, I decided to research whether there are other protocols that involve fewer or less frequent treatments. I called Penn, but found that the radiation oncologist will not speak with non-clients (I learned that this is the standard response from specialists). Since it was not yet our appointment date, I couldn’t determine what the regiment would be at Penn. Finally, I spoke with Dr. Craig Clifford at Red Bank Veterinary in New Jersey



The incision was twelve inches long, and they removed two inches of tissue in width, so there were multiple layers of stitches internally and staples externally. We left with codeine for pain and Deracoxib for inflammation. The ride home was horrific. Oliver cried, panted, lost control of his bowels, and yelped in pain. His tongue was so dry and numb that it wouldn't retract into his mouth. Once we were home, he continued panting and crying, wouldn't lie down, and only wanted to stagger around. We made a bed on the floor and tried to hold him there. I thought my heart would actually break; it was so bad that I trembled. Finally, at 6 pm, I called back to the vet. He said that Oliver's personality makes him very stressed under sedation; he just doesn't like to feel that something is off. As for the pain, he said that we could increase the codeine to four tablets every four hours, but that the risk was that the analgesia would stress Oliver in the same way the sedation did. It was a long, difficult night for all of us.
Then the wait began. While Oliver was suffering that first night, we said that this was the last thing we would put him through. It was enough. I was so afraid that if radiation was required, he wouldn’t be able to tolerate the daily anesthesia.
Six long days later, we were awakened by a call from Dr. Saylor’s assisting surgeon. It was the good news for which we had prayed. The wide excision and aggressive removal of tissue seemed to contain all the "bad stuff" plus a clean one centimeter margin. In fact, the pathology report said that they detected no malignant nerve sheath tumor cells in the sample; however, since there was a fairly large area of inflammation, the tumor cells could have been hidden by the huge number of cells present. Regardless, the clean margin was enough that the doctor recommended forgoing radiation treatments, especially given Oliver’s reaction to the surgery and anesthesia. It will be important for Oliver to be examined for recurrences every three months for two years. The final report said that if recurrences were not present over the two years, the cancer could be considered cured.
As I write this, it has been a little more than four weeks since Oliver’s diagnosis, and nearly three weeks since his last surgery. The recovery from surgery has been a bit more difficult than I originally anticipated. The staples closing the incision are under constant stress and pull on the skin remaining on either side. This is due to the large size of the incision and “gap” that needed to be closed after removing enough tissue to achieve clean margins”. As do most dogs, Oliver really wants to lick his wound.
Having a pet with cancer is a big challenge. It takes a great deal of dedication and stamina. Consideration of the pet’s best interest is obviously paramount, and this requires a robust combination of research, networking and persistence - all tempered with the very private understanding of one’s individual pet. I am very thankful that we were so well supported by the members of PWCL and our “family” of friends. I don’t think we could have navigated these turbulent waters otherwise.

Please direct comments and questions to: oliversblog@hotmail.com
Update - I just checked this page after so many years, and am so sorry for the missed messages. I wrongly assumed I would get emails when new posts were posted. I feel for each and every person who posted and am sorry to have not been more supportive.
Oliver passed away on April 14, 2013, at the age of nearly 13 and 6 years after his MPNST surgery. We had to say good-bye to him after he awoke with profound paralysis. This was a Sunday morning after he had climbed the stairs the previous night and slept soundly on my pillow. I don't think the nerve sheath tumor caused the paralysis, especially after so many years. He had a good relatively long life (for a large Weimaraner) and I consider my time with him to have been a divine gift. He will live inside my heart as long as it beats.