# Gracie's cancer



## sweetstrwbrry (May 26, 2014)

It has been awhile since I've posted but I thought I would update everyone on Gracie and hope posting will help others someday if this was to happen to their dog. It really is a rare thing to happen in a maltese, especially one Gracie's age at 7 years. We got lucky the vet found it, as it could have gone undiagnosed and we would have been back at the vet at some point when she crashed again.

Gracie is indeed diagnosed with insulinoma, a tumor of the pancreas which was found by a blood test as nothing showed on an ultrasound. The blood test must be done when the dog is in a hypoglycemic state (Gracie's blood was taken for this test when it was 28, normal is 70-110ish) as it is comparing a glucose-insulin ratio. The tumor can be a nodule or microscopic but eventually always metastasizes. The tumor produces large amounts of insulin which causes these dogs to have hypoglycemic episodes including seizures. Luckily we have not had that happen to us. Gracie's been home from the hospital for 3 weeks now! 

She is on prednisone (a steroid) and diazoxide (an insulin inhibiting drug). This is the best combo of drugs for this disease. She was originally on 10 mg of pred a day which caused her muscle wasting, ataxia, weakness, and made her lethargic. Since my last post, her platelets went back to normal so we now have the option of doing the surgery. We have opted to do it which is essentially exploratory for us b/c they didn't see anything on the ultrasound. We have been weaning her down off the prednisone for 3 weeks now. She cannot be on it during the surgery b/c it will delay healing and high risk of complications. She is now on 2mg a day and we are going to be scheduling the surgery Wednesday for soon. Her energy level and strength have returned with each decreasing dose of pred. She is back to normal right now and it is absolutely amazing.

I am nervous about the surgery. The biggest risk is pancreatitis as they need to palpate the pancreas. She may have to be in the hospital for a few days to be monitored. It is very major surgery. It will not cure this disease as it is not possible to remove all microscopic evidence of cancer but removing the bulk of the tumor will stave off hypoglycemia for quite some time. We do not know if it has already spread but it sounds unlikely b/c she is not experiencing symptoms currently. They also did not see anything definitive on the ultrasound. It is going to be hard b/c she will need to be in a crate for 2 weeks post-op. She literally cannot move, stand, or do anything for 2 weeks. 

Gracie is fed 4-5 small frequent meals a day. It is necessary to do this to keep her blood sugar in check. I had to change her diet completely. Dogs with this need a high protein, high fat, and low complex carb diet as it will not feed the tumor. She also is on her meds which we may or may not be able to stop after the surgery. It really depends on how her sugar is after the surgery. Dogs that have surgery can live an average of 18 months but it can be medically managed then and they can live up to 3.5 years or more! We are praying for this to happen to us, but with this disease everything varies. Some can only live 2 months.

Right now she is thriving... you wouldn't even think she is sick by looking at her. We are happy to have our tail wagging, hyper pup back. We are just thrilled because we almost lost her a few weeks ago. She was so close to leaving us so we are ever so grateful she is still here. Our challenge right now is keeping her calm, as dogs with insulinomas can only have short periods of exercise. Too much exercise can cause their sugar to drop too rapidly and with the insulin from the tumor it will drop even more. Her meds do a good job of keeping that from happening. We still are able to take her on short walks, and she is just elated to do that. We do have good days and bad days. Lots of side effects from the pred included constant urination (peeing in the house), increased hunger yet only being allowed small meals (chewed up carpets and getting into paper trash cans has been a problem), constant thirst, being restless (wide awake at 3am), etc. It has been an absolute nightmare of a ride but here we are. It has affected us mentally, physically, emotionally, and financially in the worst way.

I do think of how unfair it is... why did this happen to my pup? It is very hard to think of that and it is on my mind often. But we are at the point of accepting that this has happened. We are making the best of it and trying to keep her going for a long as we can. Research is our best friend as even the vets aren't all familiar with it. All is not lost... the disease can be very manageable and it is amazing what medical care can do for dogs today. We are holding onto the hope that we will be one of the lucky ones. I hope this post brings knowledge to those who don't have any about this disease and that it will help someone someday!


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## Furbabies mom (Jul 25, 2011)

I'm terribly sorry that your little one is so sick. Praying that the surgery goes well, and you have Gracie for a long time.


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## Maidto2Maltese (Oct 19, 2004)

Sorry your little Gracie ( and you!) are going thru this... but good to see she seems to be feeling pretty well with the decrease in meds for the moment.
My missy had diabetes which is much more manageble but I can understand how exercise and whatever eaten can so affect those blood sugar levels.

My Missy also had developed bladder cancer ... I believe I had mentioned that in earlier post.
As to the potty issues ... I used baby diapers on her when needed...just cut an "X" at the tail area. They worked well and saved a lot of work. I was available to change often so not an issue for us but know others who did use a little A&D ointment on skin to prevent any urine burns if it was awhile between diaper changes.

Will be praying things go well for you all!


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## sherry (Jan 4, 2013)

I'm so sad for you and your husband and Gracie. Such hard decisions to make. Being at peace with your decisions is so important and it sounds like you and your husband are. Hugs and prayers for all of you!


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## maggieh (Dec 16, 2007)

I'm so sorry you are going through this. Praying she does well through the surgery and that it can be managed for a very long time!


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## lydiatug (Feb 21, 2012)

Sounds like a rough ride, but you still have hope. Praying all goes well with Gracie's surgery & meds.


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## maggie's mommy (Mar 12, 2006)

Sending prayers and positive thoughts for a successful surgery. Gracie is so lucky to have such caring parents who are so willing to give her every chance to get better.


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## 4furkidsmom (Nov 29, 2009)

I am so sorry for both you and Gracie having to go through this health crisis. Yes, it is unfair that at such a young age of 7 she has cancer, and that she will have to go through so much pain and discomfort to fight it. I had a similar situation in 2008 with my beautiful 8 year old Ernie. He was on death's door with autoimmune hemolytic anemia. He was within hours of dying. Also, had to take prednisone the 10mg. I spend hours on the internet researching his symptoms and the autoimmune hemolytic anemia came up, which I had never heard of. Do you know when I gave all these symptoms to the vet, I had two pages of notes, he did not mention it. Just took his blood to send to the lab. I called several times throughout the next day for the results, no call back. Finally, at the end of the day, the vet called with the diagnosis and I had to drive 23 miles asap to an animal hospital. I lost my trust in vets after that as his not diagnosing during the office visit, what I found on the web, caused Ernie's red cells to further deteriorate and put him on death's door. Ernie was in the hospital one night, I then took him home, and did the home care as I figured the stress of being in the hospital would hinder his recovery. Ernie is now 13 and in remarkably good health. If I were you I would double check up on everything the doctors and hospital do and tell you, and every perscription they give you . Again, so sorry for what you are facing. Praying for you and Gracie.


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## michellerobison (Dec 17, 2009)

I hope Gracie will be helped with surgery and can have her pancreas managed through meds... It's so scary when our little ones go through so much!


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## wkomorow (Aug 26, 2011)

She is lucky to have you. I am so sorry you teo are going through this.


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## Piccolina (Dec 25, 2009)

4furkidsmom said:


> . Ernie is now 13 and in remarkably good health.




How wonderful and encouraging:aktion033:






G.............God will give Gracie the power to heal:amen:

R..............Remember that there is always hope for a miracle:hump:

A..............And I hope that Gracie will receive the miracle:clap:

C..............'Cause we are all prayingrayer: for a successful surgery and a fast recovery

I...............In few weeks you will look back and ask: "How did I do it?":smpullhair:

E...............Everybody here sends good vibes to you and Gracie:dothewave:





*


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## Brick's Mom (Apr 19, 2014)

Sending positive energy to you and Gracie.


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## sweetstrwbrry (May 26, 2014)

Thank you everyone! We love our pup so much and want to keep her with us as long as we can. Luckily I am in nursing school and know a lot about hypoglycemia and the pathophysiology of diseases. I've done a lot of research and have a good idea of what would be best for her. I hope that we can be one of the lucky ones and that she does get 3.5 years or more. Only time will tell, cancer is a horrible thing! You never expect it to happen to your precious pup and when you get those results from the vet, I don't even think I can describe it. It is just the worst feeling in the world. Our next hurdle is getting through the surgery which will probably be next week sometime. I feel bad because she's been feeling so good lately and that the surgery is definitely going to take her down a bit. But I think in the long run it will be be most beneficial for her. She is very resilient so I have hope that she will bounce back pretty quickly.


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## sweetstrwbrry (May 26, 2014)

We have a date! Gracie's surgery to find and remove her pancreatic tumor is set for next Tuesday, July 8th. I would be lying if I didn't say that I am terrified. Very major surgery here... I hope she will not suffer any complications. They are keeping her overnight so that does give me some comfort. I know my pup is strong and that she will be okay but it still scares me a lot. Hoping that this gives her the best possible chance with this disease!!


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## MalteseJane (Nov 21, 2004)

We will all worry with you. Keep us updated. :grouphug::grouphug:


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## wkomorow (Aug 26, 2011)

Hoping for the best.


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## maggie's mommy (Mar 12, 2006)

Praying for a good outcome and a speedy recovery for Gracie.


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## Chardy (Oct 30, 2008)

Alison, you have my prayers and strength to get through this.


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## Furbabies mom (Jul 25, 2011)

Praying all goes well with the surgery, and a speedy recovery.


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## Snuggle's Mom (Jan 3, 2008)

Thinking positive thoughts that Gracie will get through this and have an uneventful recovery from her surgery next week.


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## Matilda's mommy (Jun 1, 2005)

Allison, I will keep little Gracie and you on my prayers, it just doesn't seem fair, I hate the word cancer. Stay strong, we are here for you, with all I have been through with my little grandson, if I didn't have SM and all the prayers and support I am sure I would not be able to feel so positive. God is a God of miracles, I'm praying for one for Gracie and my precious 2 year old grandson


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## maggie's mommy (Mar 12, 2006)

Alison, thinking of you and Gracie today and praying for a successful procedure. Please let us know when she is out of surgery.


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## sherry (Jan 4, 2013)

Allison, I'll be thinking of you and Gracie today. Please keep us updated.


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## mdbflorida (Feb 28, 2013)

I am so sorry you are going through this and best of luck today!


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## Kathleen (Aug 4, 2011)

Sending love to Gracie today. :wub:


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## wkomorow (Aug 26, 2011)

Good luck today


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## Snowball Pie's Mommi (Oct 16, 2008)

Alison, my thoughts and prayers are with you and your husband and precious Gracie. My heart goes out to all of you. I am so sorry you are all going through this.

Gracie is blessed to have such wonderful and devoted parents. You are doing everything possible to help her feel better. 

I will be thinking about you tomorrow and will be checking in for updates. Thank you for sharing your story so that it might help those of us who might one day encounter the same kind of medical issues with our fluff babies.

Sending you love and hugs. Please give darling Gracie gentle hugs and kisses from her Auntie Marie.:heart:


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## CorkieYorkie (Apr 10, 2012)

Will be keeping sweet Gracie in my thoughts and praying for a successful surgery and speedy recovery!


Sent from Petguide.com Free App


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## S&LP'S Mommy (Feb 20, 2011)

Hoping and praying everything goes as smoothly as possible.


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## zooeysmom (Aug 1, 2011)

More love and prayers for precious Gracie today!


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## sweetstrwbrry (May 26, 2014)

Thank you everyone SO MUCH! We have had a CRAZY turn of events! The surgeon on Gracie's case does NOT think she has the cancer! Our vet and the specialist have been debating all morning, our vet think she has it and the surgeon does not! They have been going over lab work all morning. Gracie had low platelet and blood counts during her episode a month ago, and these do NOT present with insulinoma! Also she has stabilized her sugar on her own without the prednisone! She is not a textbook insulinoma case to the surgeon so she is very suspicious! The insulin glucose ratio test came back positive a month ago which is the diagnostic test. But she think it may have been a false-positive!! They drew blood from her again and it all came back good and her glucose was perfect even after fasting for 18 hours! With this cancer low sugar is the hallmark of this disease as they have to be fed every 4-5 hours to keep the sugar from dropping! We have been going back and forth on the phone all morning. 

We have just decided that we are going to go through with exploratory surgery. If we don't do this now and leave it and it really is an insulinoma, she will get sick again. We will spend $4000 to get her stabilized again when that happens and then another $3000 for the surgery. We are so invested in this now that we are just going to do it. If they find it, they remove it and it gives her a good amount of time. If they don't find anything, they are going to take tissue samples and see if they can find out what happened. It may very well have been a septic event or an immune-mediated event! 

I am floored at the possibility of this not being cancer. We will know this afternoon! She is going into surgery right as I type this. Thank you everyone for your support and I will keep updating as I find out more information!!!!


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## Snuggle's Mom (Jan 3, 2008)

I will be keeping my fingers crossed for your little one and you too. Sure hope for a positive outcome and that Gracie will continue to do well.


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## MalteseJane (Nov 21, 2004)

I am wondering if the prednisone had anything to do with her sugar level. The prednisone was to get the platelets back up. But it could have messed up something else. I had a dog who was on prednisone for a long time because of allergies, he ended up diabetic and for me it's because of the prednisone. Gracie was not long enough on prednisone to get to that point, but maybe it just messed up the lab tests. When Alex was on prednisone for 6 months because of the low platelets we only checked the platelets nothing else, so I don't know how is sugar level was.


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## wkomorow (Aug 26, 2011)

Wow. It is so difficult when diagnoses are all over the place. Hoping the best for Gracie.


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## Chardy (Oct 30, 2008)

Allson! This is exciting to read! I bet the surgeon is right and will pray for that! Our small maltese dogs just cannot handle all standard vaccines and everything else that we are told to do. Eventually, the immune system just gets weak... and havoc ... one way or another. I wish there was such a thing as a maltese vet only... one who can study genes and what possibly happen after we overload them. I am grateful that my vet is on board with most of this... prayers sent to you sweetie...


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## sweetstrwbrry (May 26, 2014)

What a day!! Gracie ended up going through the exploratory surgery this afternoon. She is doing well now and recovering overnight at the hospital. We are just floored at the results! Earlier today the surgery was delayed b/c our vet and surgeon were butting heads. Surgeon said that her symptoms last month do not manifest a typical insulinoma. As the blood test came back positive a month ago the vet kept saying it has to be an insulinoma. Finally my boyfriend and I agreed to just do the exploratory surgery. If she has cancer, they can get most of it. If not, then we will test her tissue to see what happened or if there is anything else going on. We have invested a lot of money and time into this so its too late to stop now.

They opened her up and they said everything looks great, completely normal! They found one tiny brown spot on her pancreas but they are not concerned about it. They have seen plenty of insulinoma and it does not look like that. They took it off anyway and are testing it to be safe. They also biopsied tissue on her liver just because, not that they saw anything. If both these tests are negative, than she is IN THE CLEAR! She will never have had insulinoma! For whatever reason she would be a false positive as far as the cancer blood test goes from a month ago! 

The surgeon thinks it could have been an immune-mediated or sepsis event that happened a month ago! We are just so elated at the possibility of her not having cancer!!! We have to wait 5-7 days for the biopsy results but then we will know!! From what it sounds, it is very likely not! I cannot believe this is a possibility after being devastated for so long about this! I also cannot believe that everything could possibly go back to normal! We have changed our lives around her feedings, bathroom times, medications, etc. Please keep praying for us and that she does not have this cancer! This is the best news we've heard in 2 months!!


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## MalteseJane (Nov 21, 2004)

:chili::chili::chili:


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## Chardy (Oct 30, 2008)

sweetstrwbrry said:


> What a day!! Gracie ended up going through the exploratory surgery this afternoon. She is doing well now and recovering overnight at the hospital. We are just floored at the results! Earlier today the surgery was delayed b/c our vet and surgeon were butting heads. Surgeon said that her symptoms last month do not manifest a typical insulinoma. As the blood test came back positive a month ago the vet kept saying it has to be an insulinoma. Finally my boyfriend and I agreed to just do the exploratory surgery. If she has cancer, they can get most of it. If not, then we will test her tissue to see what happened or if there is anything else going on. We have invested a lot of money and time into this so its too late to stop now.
> 
> They opened her up and they said everything looks great, completely normal! They found one tiny brown spot on her pancreas but they are not concerned about it. They have seen plenty of insulinoma and it does not look like that. They took it off anyway and are testing it to be safe. They also biopsied tissue on her liver just because, not that they saw anything. If both these tests are negative, than she is IN THE CLEAR! She will never have had insulinoma! For whatever reason she would be a false positive as far as the cancer blood test goes from a month ago!
> 
> The surgeon thinks it could have been an immune-mediated or sepsis event that happened a month ago! We are just so elated at the possibility of her not having cancer!!! We have to wait 5-7 days for the biopsy results but then we will know!! From what it sounds, it is very likely not! I cannot believe this is a possibility after being devastated for so long about this! I also cannot believe that everything could possibly go back to normal! We have changed our lives around her feedings, bathroom times, medications, etc. Please keep praying for us and that she does not have this cancer! This is the best news we've heard in 2 months!!



OMG!! OMG!! :chili::chili::chili::aktion033::aktion033::aktion033: This is just the greatest news ever!! Thank the lord! So happy for you!! Bless you all!!


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## maggie's mommy (Mar 12, 2006)

Wonderful news! So happy for you.


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## Kathleen (Aug 4, 2011)

Checking in on Gracie this morning.
I hope that she is doing well and home with you! :wub:


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## Snuggle's Mom (Jan 3, 2008)

Just seeing this now and thrilled that Gracie is doing so well and praying for positive results. Sounds very encouraging and hope it continues.


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## wkomorow (Aug 26, 2011)

Wonderful news. Glad she came through it so well and they did not find anything.


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## donnad (Aug 22, 2006)

I am just seeing this...I am so happy for you and your baby! What a relief it must be for you!


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## S&LP'S Mommy (Feb 20, 2011)

Wow that is great news. I'm sure you are anxiously waiting for the biopsy results. Hoping she is in the clear!


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## Furbabies mom (Jul 25, 2011)

Wonderful news!!! I know that you and your husband are ecstatic!!! Praying the biopsies are benign!!!!!


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## Maglily (Feb 3, 2009)

This is wonderful news, praying all goes well and you can soon put this behind you!


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## sweetstrwbrry (May 26, 2014)

Thank you everyone! I just picked her up from the hospital and she is doing well! We had a bit of a setback because on the second day she spiked a fever to 105. It could have been caused by a number of things... an infection, cancer, inflammation from surgery. But she was given antibiotics and it came down really quick so that is good. What is encouraging is that her sugar has been good. It did drop the first day but very possible because she was just not eating. She's so tiny and I know that makes her sugar go down low. She's been eating well for them at the hospital and that seems to be stabilizing it. That's a good sign.

She had biopsies of her stomach, liver, and small intestine to check those tissues just because. They removed 2 lymph nodes which were very mildly enlarged. We are checking them to see if anything comes of it as well. They could very well be normal. The spot they found on her pancreas was 1mm and at the very tip. They chopped it off with a 1cm margin. They said it does not look like a typical insulinoma they would normally find in dogs. So that is hopeful that it could still possibly not be cancer! Regardless, even if it does turn out to be cancer, it was very tiny. And they did not see any evidence of cancer anywhere. That would give us a very good amount of time with her. Praying for the best here... either way we are getting a good outcome. She will either be cancer free which in itself would be a miracle, or will have a good amount of time with us because the spot was so tiny. They say with these tumors it is almost always spread when they open them up. Pray for us and thank you so much~!! I will update when we get the biopsy results back!


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## Piccolina (Dec 25, 2009)

G............God has answered your prayersrayer:

R.............Really a miracle:yahoo:

A.............And I can say I knew she was gonna be ok:yes:

C.............'Cause all you had to do was believe in prayers:amen:

I..............It is a happy day for all of usarty:

E.............Everyone is so relieved with the outcome:smheat:






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## Matilda's mommy (Jun 1, 2005)

:hugging:THANK YOU LORD


Allison, I am thrilled for all of you. I will be praying and watching for a update


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