Wednesday, June 26, 2013

1480. Update on 14-year-old Maltese X dog with ear tumours

tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS

Date:   27 June, 2013  
Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits
Ear tumours spreading to the face   
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   27 June, 2013 
Be Kind To Pets
Veterinary Education
Project 2010-0129

1480. Update on 14-year-old Maltese X dog with ear tumours

Jun 26, 2013  7.11 pm, I  phoned young lady owner to follow up on post-op care of her beloved dog. She took much trouble checking out the health care for the dog's right ear tumours which had become smelly. 

1. Ear very "smelly". Has lots of pus and bleeding. She used cotton balls and antiseptic to wipe this large wound. I advised: "Use warm water & antiseptic and put into a scoop or syringe and irrigate area. Too large a wound to be cleaned by cotton balls.

2. Left eye can't close when the dog sleeps. "Most likely the tumour had involved the facial nerve which was damaged during the two massive ear tumour surgery," I said. "Use eye drops 3X/day and keep eye wet."

3. "Is the dog eating?" I asked on this 3rd day after surgery
   "Yes, she eats by herself today."  

4. "Is the dog in pain?"
  "No," she said. "Only shakes her head."

5. History
A year ago, large "stomach lump" with nipple cut off was located near the "uterus". I told her this would be the mammary tumour. The petite fair lady vet whom I know to be a recent graduate at that time did advise histopathology of the lump but was rejected.

She had advised excision of the ear tumour which was small then, just like an extra piece of meat.  Then 2-3 months ago, this ear tumour in the vertical ear canal grew fast and large. It became smelly. So, the dog needed a 3rd operation done by me to remove the ear tumours. The first op was spaying and the second one was the mammary tumour which does occur even in spayed dogs, but very rarely as compared to a female dog not spayed. 

6. The pre-op blood test was requested by the lady on Jun 20, 2013.

LIVER. SGPT/ALT 94  (<59>
KIDNEY  Urea 13.9 (4.2-6.3), creatinine 144 (89-177)
HAEMATOLOGY- normal but the lady had asked Dr Daniel for antibiotics. In conclusion, this dog was fit for anaesthesia. But she had heart murmurs and no ECG was done to lower medical costs. 

7. Surgery done by me on Jun 23, 2013. My first consultation for the rotten ear was on May 30, 2013 and I had said the only option was surgery as medication would not last long to stop the ear scratching and bad smell. However, the dog was too old to take the anaesthesia and so the lady had to decide on the risks.

The right ear oozed out pus over many months and ulcerated due to continuous scratching. It was hardened rock-hard as it evolved into ear canal tumours. Hence a bony hard vertical canal and a large subcutaneous tumour outside the vertical canal were palpated. This means there were actually two ear tumours and this could be malignant cancers as they grow rapidly and increase in size over 2-3 months.

This was a messy surgery taking 51 minutes of isoflurane + gas and involvement of the facial nerves which if cut off, would affect the eyelid closing. Surprisingly, the old dog survived such a long surgery.

Not every aged dog survive such long anaesthesias and so it is best to get tumours excised when they are small and that includes breast tumours.
Small tumours in old dogs are best removed when they are small.
In 10 days' time, I will take out the stitches. This dog was a puppy when the lady was in Sec 2, she told me. So, 14 years had passed by so fast but the dog looked so young owing to excellent care.

This case shows that the many of the younger Singaporeans in their late 20s are much more educated and sophisticated and will care sufficiently to ensure that their beloved companion get back to good health. This is unlike the older baby-boomer generation who would think that it is cheaper to buy a new puppy and let the sick old dog die. 

I don't know how the above-mentioned dog develops ear tumours as I had not seen this dog in the past years.

Ear inflammation in your dog, if left untreated for many years, may evolve into hard bony ear canal tumours in old age. There is the lateral ear resection surgery to resolve chronic ear infections in floppy-eared dogs, preventing later medical problems. Many dog owners are unaware of this surgery and many vets don't offer this surgery as many owners seldom want it, owing to the expenses involved. So, the chronic infection persists till the ear canal hardens and the tumours form and become ulcerated and infected. 
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