Mama was the epitome of a sweet pit bull, her slow walk and grey muzzle attesting to her elderly age. Her pendulous mammary glands were evidence of multiple litters, and her short-cropped, cauliflower ears and numerous faded scars were testaments to her days as a bait dog when she could no longer whelp pups. Her large eyes frequently flicked back to her owner’s face for reassurance, who told me about her rescue from a dog fighting ring and her current life as a spoiled couch potato. Mama’s owner was worried about her dog’s lumpy mammary glands, especially since there was some black fluid oozing from the teats. My knowledge about mammary tumors was a little fuzzy, so I finished taking a history and went to find one of the supervising veterinarians to discuss Mama’s case.
I knew that the risk of mammary cancer increases with each heat cycle, and Mama had had over a dozen heats in her life. I also knew that in dogs, there was a 50-50 chance of a mammary tumor being malignant, and Mama had 4 palpable mammary masses. What I learned from the supervising vet was that 50% of those malignant mammary tumors have already metastasized to the lungs by the time of diagnosis. We also discussed prognosis: the average canine lifespan is 1 month with a malignant mammary tumor that has metastasized to the lungs and 3-6 months with a nonmetastatic malignant tumor. Also, additional mammary tumors could develop even after surgical excision of existing masses.
It was an emotionally difficult discussion when I went back to talk with Mama’s owner. Medically the best option would be surgical excision and biopsy, after performing chest X-rays to look for metastatic disease and ensuring she was a good anesthetic candidate by performing basic bloodwork. But financially, that gold-standard plan was a lot to ask of a family living in federally subsidized housing. The owner was understandably shell-shocked, so we decided to send her home with an estimate to think things over. I told her to call if she wanted to go ahead with the surgery, or if she wanted to discuss methods of maintaining quality of life. I emphasized that we supported whatever decision she made and that our aim is to provide Mama with the best quality of life for as long as possible.
Mama is one of those patients that has stuck with me, her sweet face and tragic story lingering in my mind months after seeing her. I hope that wherever she is, she knows she’s loved.