Possible Gastric Neuroendocrine Carcinoma -- Need Advice

[jmang]

Hi Everyone

I have a two-year-old female named Paco (I'm so used to using male pronouns with Paco, however, since I didn't find out Paco is female until recently, so I'm just going to stick to that here). Within the past couple weeks, Paco stopped eating. He was brumating for a few months and just came out of it probably only about two/three months ago and his behavior in these last weeks was similar to that during brumation, so I figured I'd just keep an eye on his weight but otherwise wasn't too concerned. This past Sunday, though, I realized he'd definitely (and seemingly suddenly) lost a bit of weight. Then, after a soak in the tub, he threw up, had diarrhea, and his beard/tail went jet black, so I knew something was seriously wrong.

I was able to get him to the vet yesterday morning where he had a full physical exam and blood work done. His blood work showed that he is severely anemic and had a sky high blood glucose level of nearly 950. The vet halted the rest of the plan for the day (x-rays) and suggested Paco have an ultrasound to scan for tumors as soon as their ultrasound vet would be available (sometime next week). She explained her concern about the anemia and high glucose level and how these symptoms are often signs of gastric neuroendocrine carcinomas. She said there could be something else going on, such as issues with his liver or other organs, and that some prognoses were far worse than others, but there's a small chance it could be something we could work with. From what she told me, however, and from what I've been reading, it seems regardless of what an ultrasound shows, it's not looking great for Paco. To make matters worse, they quoted me a high estimate of $400-$500 for the ultrasound, and after already paying $300 yesterday, that left me pretty stunned. I don't really have that kind of money right now, especially to spend on something so uncertain, but if there was a decent chance an ultrasound could actually help Paco, I wouldn't think twice about it. I hate having to even think about putting finances before my pet's health. I love Paco immensely, but I also don't want to end up with no Paco AND no money.

So my reason for posting is to ask for some advice on what to do next, especially from anyone who's dealt with a similar issue. Do you think an ultrasound would be worth the investment considering the likely grim prognosis? Should I just do everything I can to make him as comfortable as possible and decline the ultrasound? From reading about the gastric cancer and considering his symptoms (high glucose, anemia, anorexia, vomiting/diarrhea), it certainly seems likely that this is what we're dealing with. I just don't want to put him through any unnecessary stress while he's in such obvious discomfort. His beard is still black today, he's still lethargic, and he had diarrhea this morning. I'm really not sure how long he's going to be able to hold on at this point or if he'll even make it for an ultrasound next week. I'm currently syringe-feeding him and giving him carafate per my vet's instructions, as well as providing lots of snuggles and daily soaks. I'm at a loss and don't want to let Paco down

 

[CooperDragon]

I'm sorry to hear this =(. Based on the blood test results and the symptoms, it does sound like neuroendocrine carcinoma. My first dragon, Cooper, had this as well and I believe it to be genetic. I don't know that there is much to be done about it so if the additional tests will be a financial strain for you, I would go with the current diagnosis and make her as comfortable as possible. Make the best of the time you have with her. Bring her outside for some sunshine and give her some adventures. Give her some of her favorite treats and make her as comfortable and happy as possible. You may want to speak with your vet about possible treatment but I'm not aware of any at this point. I wish I had better advice for you on this one but it's a tough case.

 

[jmang]

Thanks for your reply and I'm sorry to hear about Cooper! If you don't mind my asking, how much time did you have with Cooper from when symptoms started/he was diagnosed? How was he diagnosed?

My vet did say that if they can confirm cancer, the only realistic treatment would be to just make Paco as comfortable as possible. She told me that once symptoms begin to show, it's often already metastasized throughout the body, so there's not much that can be done, hence my hesitation to go forward with the ultrasound.

 

[CooperDragon]

At the time we didn't really know anything about it. He was quite healthy but when he reached adulthood he started showing some swelling on his fingers that was diagnosed as gout. We kept treating that and he was seemingly happy and healthy but was losing weight after he turned about 2 or so. He was still very alert and active until one day he was lethargic and had a jet black beard. We got him to the vet and she did a blood test. He died the next day a few months short of his 3rd birthday. The results of the blood test showed the elevated glucose levels which told us he probably had gastric neuroendocrine carcinoma. He didn't show any other outward signs of it and we didn't even know about it until after he died. He seemed happy and healthy until the end. I didn't see any indication that he was suffering or unhappy. There isn't anything we could have done aside from making him happy and comfortable which he was.

 

[jmang]

I'm so sorry, that's heartbreaking . Thanks so much for the info, though. I'm nearly certain my time with Paco is very limited. Dreading the day I have to say goodbye.

 

[CooperDragon]

I understand the feeling. My best advice is just to give Paco some fun adventures and make the most of your time. Learn as much as you can so your experience with her can help benefit other dragons.

 

[Drache613]

Hello,

Oh dear, I am so sorry to hear about your dragon's condition. What a horribly painful situation
to be faced with. I don't know of any treatments other than the traditional chemo/radiation but those are extremely hard on them. How is he doing today?
Try giving some probiotics to help soothe his tummy. I am sure Paco doesn't feel very well but if
you spend extra time with him I know how much he will enjoy that too. Maybe have him sleep near
you at night also, that will bring him more comfort.
Let us know how he is doing.

Tracie

 

[jmang]

Thank you for your kind words, Tracie. Paco is about the same, although no longer regularly displaying a black beard and tail. He hasn't vomited again but did have a little diarrhea yesterday. Still very lethargic and all-around sad. I've been giving carafate to ease his belly, per the vet's instructions, and have been syringe feeding, although it's a lousy experience for both of us.

What probiotics do you recommend? I've also seen suggestions on here to give a Pedialyte bath for dehydrated dragons -- is this something you'd recommend? He was dehydrated when he went to the vet, but seems less so now after several soaks and drinking the tub water.

Thanks again.

 

[kingofnobbys]

WOW ...

tough call that one , and I know how hard it is , similar experience with our beloved Puff , misdiagnosed by the vet as an abscess but was a large aneurism on his jugular , $800 for surgery under an general , he never survived recovery , had a heart attack due to excess blood loss in surgery , had I known for sure it was an aneurism I would never had agreed to have him operated on.

The ultra sound might show your beardie is clear ATM .... that would be relief , may also be a misdiagnosis so a second opinion before the big spend might be helpful , vets do get it wrong ( frequently ) .... either way , spoil him rotten and enrich his life and let him know he's loved ...

 

[CooperDragon]

Tracie has a good probiotic on her site. I've used it several times http://www.bug-de-lite.com/store/index.php?app=ecom&ns=prodshow&ref=Acidophiliz

I advise against using Bene-Bac as that contains a strain of bacteria which can be harmful to humans if ingested or comes in contact with a wound etc.

 

[Drache613]

Hello,

How is Paco doing today?
That's good news he hasn't vomited any recently, poor guy. I am sure that he knows that he is
loved. It's never easy to see them go through such an illness.
They are pretty sure of their diagnosis though, even without an ultrasound?
We are all thinking about you both.

Tracie

 

[jmang]

Thanks for the kind words and advice everyone.

Paco is more or less the same. He seems a little more perked up, especially earlier on in the day, but not a whole lot. He has more energy when he's out of his tank, so at least he's getting a little exercise.

I spoke to the vet's office and declined the ultrasound. I feel pretty guilty about it and keep wondering if it was the right choice. I suppose I could always call them back if I change my mind. The vet wasn't 100% certain it's cancer but she did say his symptoms, especially the blood test results, are pretty indicative of it. She wasn't too reassuring with any other possible diagnoses either.

 

[CooperDragon]

I wouldn't feel guilty about the ultrasound. The blood test gives a pretty clear indication of what is likely going on. The ultrasound would be another tool to help confirm the diagnosis, but it wouldn't help to resolve the issue. Since it wouldn't help make things better it's not worth financial strain.

 

[jmang]

Thank you for the reassurance, CooperDragon. Now if only I could figure out a way to syringe feed Paco without ending up looking like I got into a fight with a feral cat!

 

[CooperDragon]

Patience. It sometimes took me an hour or two to feed my first rescue, Dundee. Just chase and drip some on the nose, chase again, etc. There is a way to use your thumb to slide their beard down and force their mouth open but I try to keep that as a last resort because it can be (temporarily) stressful. You may want to try attaching some catheter tubing to the syringe end to provide a smaller/softer interface which may help. I've read about some folks offering food that way with success. I haven't tried it myself though.