It’s not that often that we see a primary kidney cancer in a young pet. This page will show you how we diagnosed and treated it on a one year old Basenji. This story emphasizes how fast things change, and a pet that is perfectly healthy on a physical exam and blood panel, can change for the worse in a short period of time.
If this owner had not brought this dog in for an exam this dog would have died. This is why Wellness Exams are recommended every year, and more often on senior pets.
It also shows the teamwork and expertise needed between veterinary clinician (us), radiologist, pathologist, and oncologist for a successful outcome. Luckily, that is available in Southern California.
Not only that, but a drug called L-asparaginase was used to successfully treat this dog. L-asparaginase is an enzyme from the bacteria E. coli. This enzyme breaks down an amino acid called asparagine that cancer cells need to make protein. Who are the genius scientists that figure this stuff out?
Graphic photos of a kidney with cancer on this page.
A healthy dog was brought to us at 6 months of age to be spayed. All of our surgeries undergo exams within 24 hours of surgery. This dog passed with flying colors.
We routinely have student externs at our hospital training as part of their senior year clinical experience. This is a good opportunity to teach them how to do a thorough exam on a pet that is about to undergo anesthesia.
Note the circle over BUN and Creatinine. They are tests of the kidneys, and they are normal.
Surgery and healing progressed as expected for a young dog, and within a few days it was back to normal. Over the next several months there was no indication of any problem. Three months later the owner noticed something was just not right for a few days and brought this dog in for an exam.
Decreased appetite and lethargy over several days. There were no other problems like vomiting or diarrhea that would cause lack of appetite and lethargy
Body Temp- 101.6 degrees F
Mucous membranes- pink
Respiratory rate- 40 breaths per minute
Heart rate- 150 beats per minute
Musculoskeletal system (bones and muscles)- normal
Peripheral Lymph nodes- normal
Weight- 22#- no change from 3 months prior. This is a flashing red light on a pup that is growing and should be putting on normal weight.
Interpretation- Even though this exam is essentially normal, a lack of appetite in a young dog is of concern. Also, no weight gain over the last 3 months is cause for concern in a young animal that is still growing, and confirms the owners observation of lack of appetite.
Based on breed, age, and frequency of disease, this is our differential (sometimes called tentative) diagnosis at this point in time:
Internal Parasites (worms). This is common in puppies and can easily explain the symptoms
Hormone Disease- Addison’s might be one example.
Internal Organ Disease- Two of the more important organs in the body are the liver and the kidney
Cardiac Disease- A congenital cardiac problem is a possibility
Systemic Disease- In infection or inflammatory disease
Toxin- almost any toxin can cause these symptoms.
There are many other potential causes to this pups lack of appetite and low body weight.
Diagnostic tests are now needed to rule in our rule out these diseases. We start with what we call a minimum database. This consists of:
Urinalysis- came back normal
Fecal for parasites- Came back normal
Thyroid panel- Came back normal
Heartworm test- Came back normal
Full blood panel- Came back abnormal, see below
It is obvious there is a serious problem with the kidney tests compared to 3 months prior. The BUN is now 95 (3x normal) and the creatinine is 4.8 (3x normal). In addition, other tests are elevated, all leaning towards a serious kidney problem.
These are very high values for a young animal, and warrant additional testing. Because we have a radiologist that is an expert at ultrasound available to us an ultrasound was scheduled as soon as we received this blood report.
This is the abdominal ultrasound report. Read it carefully to see how detailed it is and note the abnormalities. The abnormalities are marked in the pictures to follow.
This dog has kidney cancer, and possibly liver cancer, that requires the expertise of a veterinary oncologist
The cancerous right kidney
The cancerous left kidney
One of the liver nodules
To help you visualize what we are seeing in the ultrasound this is the necropsy photo of an elderly cat with kidney cancer. The kidney is split down the middle and opened up to see the inside. This is how lymphoma looks in a cat, not the dog above.
The cancer is at the arrow, from the 8 PM to 2 AM position on the left
One of the advantages to having an experienced radiologist perform the ultrasound is this person’s ability to do what is called a Fine Needle Aspirate. In this test they are able to guide a special needle into the kidney to get a sample. The cells from this sample are put on a microscope slide and a pathologist performs a cytology on it.
There is no guarantee this will give us a diagnosis, but at this point in time it is much better than an invasive exploratory surgery (called a laparotomy or celiotomy) to get a kidney biopsy.
The sample is sent to a pathologist for microscopic analysis. This is a veterinarian that does not do any clinical work. He spent an additional 4-6 years in school and residency after veterinary school to learn the skills needed for the microscopic world he practices in. His work is invaluable to us.
It came back a malignant cancer called lymphosarcoma (LSA), also known as malignant lymphoma
This dog has a serious problem that needs to be treated by a veterinary oncologist. We send our cancer cases to the Veterinary Cancer Group- they are the best!
They have many doctors and several offices throughout Southern California
This is the chemotherapy treatment protocol they instituted. They also do many other types of therapy including radiation therapy. This is the protocol they used for treatment.
Notice the L-asparaginase treatment dose?
After several courses of chemotherapy our patient is back to normal, which is confirmed by the now normal kidney values on the blood panel.