CHRONIC OTITIS EXTERNA IN AN OLD MALTESE x.
May 30, 2013. Consult and 3 weeks of medication and ear cleaning.
June 23, 2013. Surgery.
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VETERINARY STORIES by Dr Sing Kong Yuen, BVMS (Glasgow)
Smelly painful and hardened right ear in a 14-year-old Maltese X.
2013 Case.
CASE
This 14-year-old Maltese X dog scratches his bleeding right ear area day and night. This ear leaked blood and pus. The smelly ulcerated wounds do not heal despite cleaning and repeated antibiotics by vets. Why?
"This is not the usual ear infection of the right ear," I explained to the lady owner. "When you feel her right ear, you will feel bony lumps. She suffers from chronic ear infections when the infection has been occurring for more than 3 months.
"Pus and blood are formed inside the vertical ear canal. The pus and blood amount increased due to infections and long periods of scratching."
BLOOD WORK.
The total white cell count shows an abnormally high number of total white cell count and the number of neutrophils. This blood test show that the dog has a blood-borne bacterial infection. Antibiotics and painkillers were given for 3 weeks. Surgery would follow.
X-RAYS.
NOT DONE. To reduce vet costs.
GENERAL ANAESTHESIA.
Many owners are worried about their old dogs dying during anaesthesia when the dog has ear surgery. This dog has heart disease, increasing the anaesthetic risks. The least amount of anaesthetic drugs is used
UPDATE ON AUGUST 2013. The vertical ear canal was taken out. The dog has recovered fully.
TIPS AND ADVICES
Removal of the vertical canal is the most effective and least expensive treatment as compared to frequent ear cleaning and medication. root canal treatment in the dog.
Pre-op 3 weeks of antibiotics and painkillers orally and ear cleaning solutions. "My dog has recovered," the lady owner said. "No need to operate."
"The itch and smell will return a few days after the end of drug treatment," I said. "It is best to get the tumours with the vertical ear canal excised."
No X-rays and histology of the ear tumours was done to lower veterinary cost.
See video and images.
FOR MORE INFORMATION (Image):
TOA PAYOH VETS PTE LTD
Block 1002, Toa Payoh Lor 8, 01-1477, Singapore 319074
+65 6254-3326, 9668-6468, 9664-0404
judy@toapayohvets.com
99pups@gmail.com
www.toapayohvets.com
CREDITS
Be Kind To Pets Veterinary Educational Video
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Signs of ear canal
tumors include ear discharge (waxy, pus-filled, or bloody) in one ear, a
foul odour, head shaking, ear scratching and swelling or draining
abscesses near the ear.
Ear cancer in dogs can often be treated with surgery, radiation and/or
chemotherapy. In some cases, it can be cured. It’s worth noting that an
ear canal tumor in a dog can be benign (non-cancerous) too.
Diagnosing Ceruminous Gland Ear Cancer in Dogs
Regardless of the symptoms being displayed, a veterinarian will run a
series of tests in order to confirm or dispel a suspected diagnosis of
ceruminous gland adenocarcinoma in a dog. These may include:
- Bloodwork: A complete blood count (CBC) and a blood
chemistry profile help a veterinarian assess the dog’s overall health,
which factors into which treatment course is best.
- Three-view X-rays: Imaging of the chest cavity is
recommended to assess whether or not there is any metastatic disease
(spread of cancer) to the lungs.
- Otoscopy: This procedure entails a veterinarian
using a tool called an otoscope to examine structures within the inner
ear. At times, a dog will be anesthetized for deep and more thorough
evaluation.
- Biopsy: If the presence of a mass is confirmed, a
veterinarian may try to extract at least a portion of the tumor so that
it can be analyzed by a pathologist. A pathologist looks at tumor
characteristics such as the mitotic rate — how fast cells are dividing
— to determine how aggressive the cancer is.
- Fine needle aspiration: If a regional lymph node is
of concern for spread of disease, a fine needle aspiration can be used
to collect a sample. These cells would be provided to a pathologist for
further examination.
- CT Scan: In some cases, a CT scan might be
recommended prior to treatment to assess the extent of the disease in
the ear canal, the surgical feasibility and in preparation for radiation
therapy.
TREATMENT AND PROGNOSIS
Surgery
Since a diagnosis of ceruminous gland adenocarcinoma in a dog means
the tumor is malignant, surgical removal is often the treatment of
choice. In such cases, a CT scan might be ordered to determine how
infiltrative the tumor is and to help the surgeon better map out the
procedure. Depending on the case specifics, the surgery can be complex: A
total ear canal ablation (TECA) may be indicated, which entails
removing the entire ear canal and along with some bone tissue. The goal
with removal is to get wide, clean margins, which means a specified
depth of the edges of the removed portion are cancer-free. This would
indicate that the entire malignancy has been removed. Dogs typically
don’t seem to have issues from undergoing a TECA, and they can still
hear with the other ear.
If a dog ear tumor is benign, removal with clean margins can be curative.
Radiation Therapy
If the entire cancerous mass cannot be removed during surgery,
post-operative radiation therapy is an option. That also holds true if
the dog’s family declines the TECA procedure for any reason. Radiation
is also an option if the disease is locally extensive, for example if
the skull or the brain is involved as a result of local progression of
the mass. Dogs tend to do well with radiation treatment.
There are two primary types of radiation: conventionally fractionated radiation therapy (CFRT) and Stereotactic Radiation
(SRS). The objective is to destroy or at least slow down cancer cells
by directing high-energy rays at them. SRS is the more advanced option,
using higher dosages and precision targeting. SRS also typically
requires just one to three treatments, whereas CFRT requires 15 to 21.
Since anesthesia is required for radiation, this is another benefit of
SRS. The significantly reduced number of anesthetic events can be an
important consideration, especially for older dogs or those with
additional health issues.
Chemotherapy
Chemotherapy may be recommended for aggressive and/or systemic
cancers (those that have spread). This might be the case if the
pathology report shows a very aggressive ceruminous gland adenocarcinoma
in a dog — for example, if the cancer has a high mitotic rate (fraction
of cells dividing), has invaded into the blood vessels or has spread to
the lymph nodes.
Forgoing Treatment
If ceruminous gland adenocarcinoma is left untreated, the tumor will
continue to grow. Eventually, it will become troublesome for the dog.
His or her ears could begin to smell bad. Discomfort might lead to a
loss of appetite and lethargy, at which point the pet parent(s) may face
a decision about euthanasia based on quality of life. In the event of
pain or discomfort, pain medications are recommended.
Reference
to:
https://petcureoncology.com/ear-cancer-in-dogs/
