Sunday, January 22, 2012

832. Tonsillitis in an old dog


Dear Dr. Sing,

Patient Ref. No. ... (... (Silkie, 8.5 yrs old))

We were at your clinic last Sunday (15 Jan).

I'd like to have a better understanding regarding B's lump at his throat:

On 11 Dec 2011 after his dental scaling (during which you checked on his throat), we were told that the tip of his epiglottis was red. Antibiotics prescribed, to be reviewed.
15 Jan 2012 review: we were told there is a lump at his left tonsil (right tonsil could not be seen as Bowie was struggling too much). I forgot to ask, what about the redness at tip of epiglottis?

Your advice was to put him on antibiotics first and to review again in 1-2 months' time. As B is such a nervous dog, he'll be sedated for a proper diagnosis for his next review. You said that if it is indeed a lump, the tonsil/s will be removed. Is tonsil/s removal the only treatment option, even though the lump may be benign? Without tonsil/s, wouldn't he be more susceptible to virus infection in the future? What if the lump is a cyst or an abscess?

Your reply via e-mail will be greatly appreciated, Dr. Sing. Thank you!

It is best to speak by phone as email replies can be misinterpreted. Questions can be answered immediately and clarification can be made immediately too.

In this case, tonsil removal is advised in case the tonsil is a growing malignant tonsillar carcinoma as the dog is old. The red lump of the is around 0.5 cm x 0.5 cm and visible. An aspiration biopsy can also be done in this case to check whether the tonsil is an abscess, cyst or cancerous. Sedation will be needed and anaesthetic risks are always there.

It is worrisome for the owner. The vet's duty is to inform the owner of the presence of the tonsillar growth. Excision or biopsy depends on the economics and malignancy or otherwise of the growth.

I have an image of an 8-year-old Chihuahua with tonsillitis and will post it later. 13 teeth were extracted.

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