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Mast Cell Tumor In A Dog

by doctorlaura50 - December 11, 2017 View Case Report

Jezebelle is an 8 year old Pitbull with a high grade mast cell tumor. She has a history of yeast dermatitis (feet, muzzle, ventral abdomen, ears) which has responded very well to a change in diet to raw and intermittent treatment with Si Miao San. She has also had a history of eating inappropriate items (one surgery required) and annual hospitalizations in late summer or fall for nausea/vomiting that required fluid therapy. I began treating her in June 2016 for these problems when she was started on a raw diet and Si Miao San intermittently (no more hospitalizations for gut related issues).

Feb 2017: low grade mast cell tumor removed on the right front paw (digits 1 &2 amputated) with clean margins and a clean cervical lymph node.

July 5, 2017: cutaneous mass removed from left caudal thigh dorsal to BL 40. High grade mast cell tumor with clean margins. Owner wanted oncology consult prior to starting herbs and decided not to do chemotherapy. Started on modified Xue Fu Zhu Yu Tang in August in addition to the Si Miao San for her skin & intermittent gastritis.

12/6/17: Seen by RDVM for large mass in left inguinal region. Aspirate showed poorly differentiated mast cells with likely infiltration of the inguinal lymph node. A small ulcerated cutaneous mass at the surgical site on the thigh was also discovered & the aspirate was consistent with an inflamed mast cell tumor.

12/11/17: I saw Jezebelle today & the inguinal tumor is 4 inches long, 2 inches wide, and 2 inches high. It is warmer than the surrounding tissue but not hot & there is no ulceration. The cutaneous mass at the surgical site has a small scab. Pulse was only done on the right side and was deep with some finger lift, didn't compress easily but didn't feel wiry (not taut). The tongue was pink and dry and darker underneath. The head was warmer than the rest of the body, paws & ear tips slightly cool. Her body was warm but not hot. She had erythema of the ventral abdomen which I have never been able to eliminate but which has improved since I first saw her.

I don't think there is a TBO-ALP and cholesterol low normal and needling GB points didn't seem to change the pulse (although I find pulses challenging).

Questions: Should I discontinue the modified XFZYT and try Hoxey-like formula. She doesn't have excessive heat signs and with her intermittent nausea, I wasn't sure if this was the best approach, but the tumor appears to be aggressive now. I was also considering Xian Fang Huo Ming Yin orally but the tongue did not match. I also considered Chai Hu Jia Long Gu Mu Li Tang but she lacks pronounced heat signs.

She is currently taking Benadryl. Can quercitin and Benadryl be taken together? She is on Milk Thistle and we will be adding high dose vitamin A/D (owner was reluctant at first), curcuma, L-glutamine and quercitin if it can be given with Benadryl.

I really appreciate your help and any other suggestions you might have.

Laura

by naturevet

December 14, 2017

Hi Laura,

I would definitely make a start with Hoxsey. It is as much a moving formula as anything else, and the pulse and timing of this latest tumor development suggests Blood stasis. It pairs well with SMS, and I've used it for other highly malignant mast cells to induce remission. Note that in those cases, though, the main tumor was surgically debulked.

Another option, to use in addition perhaps, is topical use of Xian Fang Huo Ming Yin. Mix about 10g of granules into a basic salve (e.g. Calendula), and apply a couple of times a day. I've seen it shrink tumors this way, and heal ulcerated ones.

Maybe if you can shrink the lesion small enough, surgery may be contemplated.

We also use vitamin A and D orally in high doses, probably a couple of times a week for this dog. We take the injectable large animal prep, and dose for vitamin A at 5,000 IU per lb. If you start getting somewhere, you can back off to weekly

Hope this helps you out. As you can tell, I like your thinking and feel like you're on target here. Stop the XFZYT, as this dog does not seem deficient given its Damp Heat history. I suspect this lesion is Blood stasis due to Phlegm obstruction, which the two formulas are suited to.

Steve

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