Jack ended up having three surgeries.....the first one was to clean up the nail and get it to biopsy. The second my vet decided to "take what was needed but keep what he could". I think the main reason they went with this was because the toe was a weight bearing toe and they wanted to save as much as possible. The biopsy came back with clean margins but only 2-3 mm...they usually like more than that. The oncologist that we were referred to suggested that the whole toe be removed. We had the choice to have the board certified surgeon do the surgery (because it was weight bearing) or our vet if they felt comfortable. My vet stated that he did feel comfortable doing it and it was quite a bit less expensive. In some ways he was reluctant to do the third surgery because he felt he got all the cancer in the prior surgery and was worried that taking the whole toe would affect his ability to walk. Thankfully Jack walked out of the vet office after the surgery! My vet was amazed!! He is now not only walking but running and jumping!! Its a good thing that we did the final surgery as they found a small amount of cancer. His margins are now clean for 2.2 cm...much better. If I had to do it again I would have just had them take the whole toe, its the only way to get better margins.
Jack continues to do great. We will take him in on Thursday for a CBC. His next treatment will be a week after that. That treatment will be with a different chemotherapy drug so I hope he does as well on that one as he has on this one! This picture shows him minus his toe. Still a great looking dog :-)
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