HEALTH & CARE

Hemangiosarcoma in Dogs: Is There Any Hope?

Checking for hemangiosarcoma
Wyatt Robinson
Written by Wyatt Robinson

Hemangiosarcoma in dogs is a prevalent type of cancer, which affects them more than any other species. The dog breeds which are more prone to develop tumors from this category are: Boxers, English Setters, German Shepherds, Golden Retrievers, Great Danes, and Pointers.

The risks are also higher for male dogs which have an age between 6 to 10 years. However, some cases also appear in the female population as well as in younger dogs. In this article we’ll tell you everything you need to know about hemangiosarcoma, from causes and symptoms to diagnosis and possible treatments.

What is hemangiosarcoma?

The cells that line your dog’s blood vessels are called vascular endothelial cells. The tumor which affects at first the endothelium or in other words, the lining of the blood vessels, and then spreads throughout the blood vessels themselves is called hemangiosarcoma.

It’s important to note that these tumors are malignant. There is also the benign type of tumors which affect the vascular endothelial cells. These tumors are called hemangiomas, they are caused by direct and prolonged exposure to sunlight, and they don’t present a direct peril to your dog’s life. In fact, many people get hemangiomas as well.

Hemangiosarcoma facts

On the other hand, when it comes to hemangiosarcoma, this is an almost dog-specific type of tumor, which people don’t get. The equivalent that could be attributed to human beings is called angiosarcoma, but less than 1% of the people with cancer develop this particular tumor. The ones who do mainly get infected with dangerous chemical substances from their workplace, or receive some type of radiation treatment for other forms of cancer.

Although it’s assumed that this disease affects almost 2 million dogs in the US annually, doctors don’t know all that much about it and they consider it a pretty challenging illness to deal with. The experiments that have been done to lab rats show that they develop hemangiosarcoma if they present a certain chromosomal mutation, but it’s not yet established if that’s also the case for dogs.

What causes it?

There is no simple answer to this question because basically the causes are unknown. There are however, some scientific assumptions on what could determine these type of tumors to appear in dogs. We’ll analyze them below.

Genetic factors

One of the reasons why it’s believed that hemangiosarcoma can be caused by heredity is that it’s a tumor that occurs almost exclusively in dogs. As such, breeding or genetics are important risk factors. However, it’s how they are modeled by the environment that counts the most in developing these mutations.

Genetic factors

As a matter a fact, the interactions between genetics and environment can be best described like this: the cells mutate because of heredity, and these mutations affect your dog’s cells in two ways: they mess with their growth process and they also cause lesions to those cells.

But why do these tumors occur? Well, the cells in your dog’s body divide at a constant pace to replace older or damaged cells, and they’re controlled by enzymes. Since these enzymes are not infallible, that means that as a mutated cell continues to divide, it will introduce new mutations into your dog’s body, and that’s how a tumor appears.

However, it’s important to notice that mutation does not equal cancer. In reality, your dog may have a certain mutation in his body without actually being diagnosed with cancer. As such, the mutation is just a risk factor to be taken into consideration.

Stem cells

Stem cells got a lot of media attention as of late, because they’re deemed a panacea. However, recent research suggests that they may be the only cells in our bodies – or in your dog’s body for that matter – which cause cancer. The mutation through division theory we’ve discussed above is now challenged by a new hypothesis, which entertains the assumption that this division of mutated cells isn’t without an end.

Stem cells

Actually, it aims to prove that the mutation-inducing cells’ population is limited just to the cancer stem cells. These cells are able both to renew themselves and to produce new cells of different types and functions.

As such, a few stem cells in a tumor that can renew themselves and make other types of cells as well, are the ones which generate the big mass of a tumor. If secondary mutations develop with a lot of different type of cells in them, then they’ll become aggressive tumors. Otherwise, they’ll be low-grade and called indolent tumors.

If we’re to accept this theory on cancer, it may very well be that we get a more complete explanation as to why the dogs develop hemangiosarcoma later in their lives and not much earlier: it’s because just a few stem cells have the capacity to give rise to a tumor. On the other hand, the probability for any given dog to develop cancer is still staggeringly high.

Another good thing that could come out of this scientific model, if it turns out to be true, is that the actual therapies can be better targeted to the stem cells, to treat the hemangiosarcoma with more success and even with less toxic therapies.

What are the most common types?

There are four more common types of hemangiosarcoma:

  • Dermal – located on the skin.
  • Hypodermal – located under the skin.
  • Visceral – located on the spleen, liver, pericardium, and heart.
  • Mesenchymal – located on the lymphatic and circulatory systems, as well as on the connective tissues throughout the dog’s body, such as bone and cartilage

There are also other sites where this tumor can develop: the right atrium, lungs, kidneys, mouth, muscles, bones, urinary bladder, left ventricle, uterus and retroperitoneum. When it comes to the incidence of each of the above types, the dermal and hypodermal hemangiosarcomas are responsible for only about 3% of the total cases, the liver tumors occur in 5% of the cases, while the spleen’s hemangiosarcomas are noticed in 50% of the cases. Mesenchymal tumors occur in 12% to 21% of all the cases.

Types of hemangiosarcoma in dogs

Apart from being the most frequently seen, they’re also the most dangerous, because they go undetected for very long and then they prove deadly. Hemangiosarcoma gets filled with blood fast until they rupture and produce massive hemorrhage, fainting and death. Unfortunately, most dog owners don’t realize their dogs are sick until this last point in the tumor’s evolution.

What are the symptoms?

The problem with hemangiosarcoma is that it’s rarely detected in time. In fact, most cases show a time period of about two months from the discovery of some worrying symptoms to the actual death of the dog exhibiting them after surgery.

As such, it’s wiser to take your dog to the vet for regular consults and blood tests, because early detection is how you can increase his chances of survival.

Dog at vet check up

Apart from this, there are some signs which may put you on the guard that something’s up. If you notice a red or black growth on hairless portions of your dog’s body, like his belly, that may be a type of hemangiosarcoma found on the skin.

Otherwise, further symptoms include:

  • Weight loss
  • Weakness
  • Lameness
  • Intermittent collapse
  • Rapid heartbeat (tachycardia)
  • Muscle incoordination (ataxia)
  • Seizures
  • Palpable abdominal mass
  • Dementia
  • Pale mucous membranes
  • Abdominal (peritoneal) fluid
  • Partial loss of movement (paresis)
  • Acute blood loss (often fatal)

These symptoms are generally related to visceral hemangiosarcoma, which affects the internal organs. Since it can spread anywhere from your dog’s spleen to his other internal organs, the symptoms can be more easily grasped.

Consequently, when a dog or a human is battling with any type of cancer, their body will try to starve the “enemy”, and that’s why you’ll notice a lack of appetite in your dog as well as a potential weight loss.

An incipient tumor can also lead to weakness as a sign that something’s wrong, but if that tumor is more developed it can even lead to collapses. In fact, that’s even more likely if the hemangiosarcoma has reached your dog’s lungs or brain. If he can’t breathe properly because his lungs are affected, then he can’t be on his feet for long.

If the tumor has reached his brain, you may notice a partial paralysis called paresis, or even ataxia (inability to coordinate muscles), as well as a few seizures. Your dog can also show signs of confusion and even dementia. Because he’s losing brain cells rapidly, he’ll forget stuff, be constantly anxious and nervous, maybe even become incontinent.

Symptoms in dogs

You’ll notice lameness as well if your dog’s brain is affected, but you can also see him limping because his bones are damaged. If he’s in huge pain, he may also not be able to move properly.

If your dog is losing blood because of the cancer, and if his organs aren’t functioning as they should, you may also notice that his heart will start beating faster in an effort to pump blood more efficiently. That is called tachycardia. Moreover, anemia caused by acute blood loss can be noticed from his pale mucous membranes. If the lining of his nostrils, lips and ears are whiter than usual, that’s a sure sign of anemia in your dog.

More to the point, if you touch his belly and feel it very full, that may be a sign of abdominal fluid gathering there, or even an abdominal mass, which may indicate cancer.

There are other types of symptoms as well, like an impaired spleen function if the tumor is located in the spleen, or an impaired liver function if it’s positioned in the liver. In the first case scenario, your dog’s immune system will be affected more, you’ll see your dog getting sick more easily, maybe even being more prone to intestinal parasites, but a rise in his red blood cells can also be observed in his blood tests.

As for the second case, the liver’s job is to aid the digestion process, eliminating the toxic substances from your dog’s body. As such, if you notice that your dog is feeling apathetic and has problems digesting the food, being bloated, constipated or diarrheic you can conclude there might be something wrong with his liver.

How is it diagnosed?

The diagnosis process requires your dog’s medical history and a detailed account of all the symptoms you’ve noticed so far.

Diagnosed dog with hemangiosarcoma

That can tell doctors where the tumor is located and which body parts it affects.

Be prepared to answer these questions:

  1. How is your dog’s appetite?
  2. Has your dog recently lost weight?
  3. Has your dog fainted?
  4. Has your dog recently had seizures?
  5. Is your dog more anxious or irritable than usual?
  6. Is your dog less active?
  7. Has your dog been experiencing incontinence?

Additionally, your vet will most likely have to conduct a series of tests, such as:

  • This can show if there are too many red blood cells and if there’s something wrong with the spleen.
  • Serum biochemistry. This test can indicate chronic hemorrhage, and also assess the liver function, by looking and the levels of protein, glucose, electrolytes and enzymes.
  • Coagulation testing. If your dog’s blood isn’t coagulating properly, that can indicate blood vessel abnormalities.
  • To see if your dog has any toxins in his urine or foreign skin fragments which show that his liver and kidneys aren’t working properly.
  • X-rays.These can tell your doctor if your dog has an abdominal mass or abdominal fluid.
  • Thoracic radiography. This will diagnose any presence of the tumor in your dog’s chest.
  • This technique can reveal the presence of tumors in the spleen or in the liver.
  • If your dog has signs of fluid accumulating near his heart, this will reveal a possible tumor in his heart.
  • This is used for a biopsy. The doctor will insert a fine needle in the tumor and extract some tissue to further analyze it, to see what type it is, if it’s malignant or not, and thus get a more reliable diagnosis.

What is the treatment?

If your doctor finds your dog suffers from hemangiosarcoma, depending how far along the cancer is and how much it has spread, the courses of treatment he may indicate to you are:

  • Surgery. This is the most aggressive option, during which your dog’s affected tissues will have to be removed, and in most cases the entire organ will have to be cut out, like in the case of most hemangiosarcomas of the spleen. During the surgery, the doctors will examine the entire abdomen. Afterwards, they’ll send samples of the collected tissue to be examined.
    The basic problem with surgery is that it presents a high risk of irregular heart beats for your dog and he’ll have to be monitored after for up to 2 days. Sadly, a successful splenectomy gives your dog just about 3 more months to live.
  • Chemotherapy. This procedure can be employed alongside surgery, and if the combination between the two is effective, it can give your dog more time to live, almost up to a year. Generally doctors strongly recommend chemotherapy after surgery with some intravenous medicine given for a period of 3 weeks. If the hemangiosarcoma is very advanced and can’t be successfully operated, then chemotherapy can reduce its severity and ameliorate the symptoms.
  • Radiotherapy. This form of treatment isn’t used very much at the moment, because hemangiosarcoma has a high metastatic rate and because it can be spread throughout your dog’s body. However, radiotherapy could be employed as a palliative measure, alongside chemotherapy especially for dermal hemangiosarcoma.

There are also some other forms of treatments associated with inpatient care, such as:

  • Intravenous fluids for dehydration.
  • Blood transfusions for severe anemia.
  • Coagulation management.

All that being said, hemangiosarcoma is a dreadful type of cancer both for you and your dog, and its negative strain on your lives don’t cease even after the surgery. As such, your dog will have to be kept away from strenuous activities. Besides this, he’ll also experience some pain, and you can give him medicine for that, but you’ll also have to be prepared to accommodate him indoors, even if he’s an outdoor dog. It’s also advisable not to take him out very often, not even for urinating or defecating.

Treatment for hemangiosarcoma in dogs- surgery

Moreover, you’ll have to make some appointments for follow-up thoracic and abdominal radiographies, as well as abdominal ultrasounds so that the possibility of recurrence can be monitored and managed.

Following the proper recovery measures and indications given by your vet is very important for preventing the apparition of spontaneous hemorrhaging, as well as for improving your dog’s life expectation.

So is there any hope? The genes that determine hemangiosarcoma in certain breeds could be identified and eliminated. Thus, this terrible cancer could be eradicated, or at least diminished. However, for now the most important thing is for you to be there for your dog. Even if he’s ill, he can still feel your love.

About the author
Wyatt Robinson
Wyatt Robinson

Wyatt Robinson had a great 25-years career as a veterinarian in United Kingdom. He used to be a member of British Veterinary Association and worked in 3 pet hospitals in London and Manchester. He is shining when he sees his pets healthy and full of energy and it is his duty to help other dog owners to keep their best friends full of life.

  • Aaron Musk

    My old dog died of hemangiosarcoma, and it really is a cruel illness. We’ve tried everything for him, including surgery, but if I’d get a do over, I would consider euthanasia from the start. It seems to me that he suffered more than he had to.

    • Thank you for sharing your experience with us Aaron! I know it wasn’t easy.

    • Theresa Semona

      Thank you Aaron for your response. Trying to make a decision now. My German Shepherd is 9 yo with a splenic tumor. I opted for no surgery because lungs and heart look unusual, not obvious cancer but definitely not normal. His abdomen is swollen, he drinks eats and urinates, but I have not seen him defecate in days. Brought in home to keep him as comfortable as possible to keep him near me. But I worry it is the wrong thing to do, should I put him to sleep, don’t know really how much pain he is in, sometimes he seems happy and wags his tail. But he can’t jump into the car, he can no longer run, his abdomen is swollen, he pants. Is awful awful to watch, but somehow he knows how much he is cared for. But really, is it for me, or for him, if his quality of life is so changed.

      • Wyatt Robinson

        This is a very heartbreaking situation you are in, Theresa. It is a very tough call to act upon. Should you consider making the important decision, don’t let the emotions take over. Decide with a sound mind and a faithful heart because this decision is a one-way street.

        • Theresa Semona

          Thank you Wyatt. Tough decision, certainly a painful one, but would rather Rex pass without so much suffering, as am sure he will not survive this condition. If only these tumors could shrink, ugghh.

          • Wyatt Robinson

            I am really hoping one day that all illnesses will finally get its corresponding cure or vaccine because it is not just painful for the dog, but also heart shattering for the devoted pet parent.

  • Hilary Reddy

    My son’s dog died of this dreadful disease and it’s really heartbreaking. It’s even sad to think that there’s no way of preventing it. There’s no early detection either. I understand that cancer takes priority in studies and researches. But is there an ongoing research for a cure?

  • Ellen Finch

    Too, too many dogs I’ve had or known have died from hemangiosarcoma. I talk about some of them in various posts on my dog-agility blog. http://dogblog.finchester.org/search/label/hemangiosarcoma

  • Thank you for sharing your story and opinions, Ellen. Losing a dog from hemangiosarcoma is such a painful experience, and all we can hope for is that our fur baby is now pain-free as it crossed the rainbow bridge.

  • Misty Groves

    My dog passed from hemangiosarcoma. She will never be forgotten.
    Looking at the list above, I could have answered a definite “no” to all those points mentioned. She was almost 15 but behaved like a much younger dog….just as she always had behaved. She loved her food and exercise.
    She never lost her appetite. Never showed any symptoms. But a couple of months before her diagnosis, went in for an unrelated surgery, and shockingly, her clotting time post-surgery was extended. She bled so much. No-one knew why. Even the vet (he didn’t have any reason to suspect hemangiosarcoma)
    She recovered very quickly and well however.
    The next thing was she developed a sudden slight limp. (She had no arthritis, remarkably) I thought she’d sprained from running for that frisbee! After all -I thought -she IS getting on in years…. The limp went away.
    Sometimes she’d stare at me in a strange way when on walks. I didn’t know what this meant. I’d ask her “do you want to go back to the car?” then crouch down in the grass to slow down our walk. But she would come bounding up to me, all happy then, and wanting a game! So, I figured, there can’t be much wrong with her!
    She showed no symptoms but those.
    Until her first internal bleed. Out of the blue. She almost died that night but pulled through for 6 more days of a happy life. But hemangiosarcoma was diagnosed then. I put her on ‘home hospice care’, and she went gently but happily through those last days, never losing her appetite. (She ate in the last few hours of her life.)
    The second bleed was massive. Too massive. I think she had a ruptured spleen. I had her put to sleep.

    Run free in your beautiful Spirit, my dear friend and companion….Misty. Bless you.

    • I sincerely appreciate your story, Misty. Thank you very much for sharing.

    • chrisculotta

      Thanks for your story i just put my11 yr old german shepherd to sleep for the same thing she had an emergency vet appt last saturday and they told me she had a mass on her spleen and in her lymph nodes. He said they couldnt do surgery i had a couple months. I came home sat night and she was breathing crazy and couldnt get up watching her like that killed me. Called the vet and had her put to sleep was the hardest thing i have ever ever done in my life. Im not handling this well at all im angry im dying. Your story helped me with the quilt tho. This is just to much .

      • Wyatt Robinson

        I’m sorry for your loss, Chris. Your fur baby is now free from pain and disease. Let us know if you need help and we’ll be here for you.

      • F’in Kiddin’ Me?

        This was me last night watching my 9 YO GSD breathe last night, my heart breaks watching this happen. The vet has removed over 1000 ml of blood from his pericardium in the past two days. All the online reading as to what his future brings is depressing, I am sorry you had to go through this.

        • Wyatt Robinson

          Let us know how we can help you with this ordeal. Hemangiosarcoma in dogs is really something beyond painful for pet parents.

  • Michael Boom Tucker

    Reading this article has brought tears to my eyes over the loss of my boy Phoenix. On the 3/1/2017 i had to put him to sleep he was 9/10 years old. Woke up on the 3/1/2017 to find my boy at the back door unable to stand up. I tried to encourage him up but he yelped. I waved his leader in front of him and that didnt work. So i knew something as very wrong. I rushed him to the vets. He was so weak managed to jump in me van to get to the vets. Two hours later vets rang me to say they had carried blood tests out and a ultra sound. He had low white blood cell count and masses on spleen and liver which were bleeding in the abdomon. I had very little choice to and let him go taking his pain away. He showed signs but i had put that down to age and breed. He was a siberian husky and was prone to go periods of not eating. He was very picky at times. He panted at times when relaxed but i put that down to his coat and uk climate and i had my heating on. In all honesty i thought he had been piosoned or picked something up on a walk. I am destroyed but this article has helped me come to terms with it. He was never diagnosed with this illness as i didnt want a autopsy. Just wanted to get him cremated and brought home with me.

    • Wyatt Robinson

      Thank you for sharing your story, Michael. This is, in my opinion, one of the hardest topics to write because of the poor prognosis and the amount of emotional burden and trauma it can give to both the pet parent and the dog itself. What we can think about now is that your dog is now pain-free and is happily watching you from a distance.

  • Amy Oskin Reiche

    My sweet 6 year Old sheltie Libby was diagnosed with this terrible cancer on December 13, 2016. She was diagnosed after her spleen had to be removed during emergency surgery. They also determined that the cancer has metastasize and there were several nodules throughout. They did the best they could to remove what they found but said there were hundreds of little pin needle to marble size nodules. She has had a really good past six weeks and is still playing and eating well. I have just noticed over the past couple days she seems to be getting more tired and her gums are very pale. I fear we may be headed towards the end. This is devastating. I’ve read many different situations on the blog and how everyone experience something different towards the end. Emotionally the past six weeks has been very difficult. My hearts breaking. She has the sweetest soul. I’m very blessed for the time we have had since her diagnosis but It is also very difficult knowing what’s ahead. I have been giving her the Chinese herb that decreases bleeding. Not sure if that has helped her get through this past six weeks or not. There is a little red pill that comes with the pack that you use in an emergency situation. Her gums are slightly blue today and I’m not sure if I should give that to her or not. Does anyone have experience with this? It’s yunnan Baiyo jiaonang. Any words of encouragement or ideas on what to expect would be greatly appreciated. It was mentioned we could do a transfusion but I know that would only prolong the end possibly a few days or weeks. I’m not sure that’s fair to do to her. Thank you so much.

    • Wyatt Robinson

      This is one of the most emotional articles I have ever written to be honest, Amy. Hemangiosarcoma is curable on some cases, but more cases are less lucky. If the veterinarian gave a green light on the traditional/alternative management, there is nothing to lose at this point. The only advice that I can provide at this point is to stay strong and expect less because it will hurt less.

  • Melody Doyle

    Glad to find this article and thread, but I’m heartbroken that I’m needing to learn about this cancer. Two weeks ago our 12-yr-old Aussie started bleeding from the right side if her mouth. Upon closer inspection, I found her upper jaw had a super ball-sized lump visible from the outside. She wouldn’t let me manipulate her mouth enough to be able to see what was causing this, so I knew she was in pain. I took her to the vet, where they showed me a large growth on her upper gum line. I couldn’t believe it was as large as it was, since she is groomed every 8 weeks, with teeth being brushed. There was no visible growth st that visit. The vet removed the tumor but told me the cancer had spread to the jaw bone, so he couldn’t get clean margins. The pathology report came in today showing our sweet girl has a hemangiosarcoma. I had never heard of this type of tumor, and I’ve read today that it’s uncommon to be in the mouth. Anyway, the tumor that was removed less than two weeks ago, is already growing back. She bleeds heavily from the mouth at times, so I’m constantly cleaning up blood from the floors, and now has a large lump beneath her jaw on the same side. Yesterday, she literally vomited all day, but today she hasn’t done that. She has diarrhea now. While she is still eating soft food well, I can tell she is in pain and just generally doesn’t feel well. She’s also been moving around a lot at night, which is very unusual. I’d like to know if others have had experience with this cancer being in the mouth? Is it likely that it has spread or possibly originated elsewhere? Any information you can give me will be appreciated. I don’t want her to suffer, but it seems terrible to have her put to sleep when she’s still eating and going out to use the bathroom. However, our vet says with this particular cancer, it might be better to euthanize sooner than later to prevent a traumatic rupture and death in the near future. I’m so torn about what to do. Thank you in advance for your help.

    • Wyatt Robinson

      As your veterinarian has the full grasp of what the prognosis of your dog is, it is a matter of personal decision whether or not you will proceed with euthanasia or not. However, based on your detailed explanation, I regret to inform you that this might be the better solution. It is going to be painful, but on the positive side of this rather dark milestone of being a pet parent, at least your dog’s suffering will end at that moment. Thank you very much for your message, Melody. Let us know how we can support you further.

  • Melody Doyle

    Our 12-yr-old Australian Shepherd was just diagnosed with this type of cancer, but her tumor is on her upper right gum line. About 2 1/2 weeks ago, I noticed a bit of blood on the floor where Scooter had been laying. I didn’t see anything out of the ordinary when I looked her over, so I thought it was possibly a cut on her paw but nothing serious. In just 4 days her upper jaw had a super ball-sized lump visible, and she was bleeding profusely from her mouth. I assumed it was an abscessed tooth, and made a vet appointment right away. Upon the vet’s examination, he found a 4 cm X 2 cm X 2 cm tumor. It literally seemed to have grown out of the blue. We decided to remove the tumor and send the mass to a pathology lab so we would know what we were dealing with. The vet told me the cancer had already eaten into her jawbone, causing one of her teeth to be loose. However, the vet didn’t pull the tooth, as he was afraid of breaking her jaw in the process, due to the bone’s damage. We knew we didn’t have clean margins but at least Scooter seemed more comfortable without the tumor. I found out yesterday that the tumor is a hemangiosarcoma, and the vet has been honest with me about her prognosis. He feels she has days or weeks to live with quality, and is leaving the decision as to when euthanasia is the obvious choice to me. My question is should I go ahead and have her put down now, even though she is still happily eating soft food, able to go outdoors to urinate and defecate, and still occasionally wags her tail and seems happy. More often though she just lies and sleeps, is very restless at night, and looks up at me with full eyes. It’s heartbreaking. She is obviously in some pain, which I am treating with meds, is bleeding on the floor constantly, and spent the day before yesterday vomiting almost the whole morning. Also, the tumor has already grown back to nearly the size it was when we had it removed a week and a half ago, and now she has a large lump beneath the jaw on the same side as the tumor. She won’t let me touch either the upper or lower mouth area on the affected side, so I know it is quite painful. I am constantly wiping and mopping up blood from the floor, and I fear there may be more tumors in other parts of her body, although we didn’t do an X-ray to know one way or the other. What is your opinion on when we should let her go, and have you had any experience with this type of cancer showing up in the mouth? I appreciate any help you can give me.

    • Wyatt Robinson

      Hemangiosarcoma is one of the most aggressive cancers in dogs. I am very sorry about what happened to your dog. As we have previously discussed below, if the condition is progressively worsening as days go by, it would be a sound decision to euthanize your dog to avoid further expense and emotional trauma to you and to the other family members close to your dog.

      • Melody Doyle

        Thank you for both of your responses, and I apologize for the double entry of my post. It hadn’t appeared to be posted to the site initially, which is why I made my second comments. I will let you know if I need additional support or guidance. I’m just taking things day by day at this point. Thanks again.

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