Sunday, September 25, 2011

634. Circum-anal tumours in a 14-year-old Shih Tzu

A young couple who came on Sunday Sep 25, 2011 as their vet (Vet 1) had at first said that their dog was too old for surgery to remove growths around the anus. When the growths spilled discharge, Vet 1 decided that surgery was necessary. A flip flop decision can cause a loss of confidence in a dog owner.

"Your dog has circum-anal tumours," I said while Dr Vanessa examined the dog with a stethoscope. "It usually occurs in a old dog, not neutered, old age. In some cases, on a busy day, I do get into the consultation room to do joint consultations with Dr Vanessa.

The young lady smiled. I was right on 3 counts. "Do you know what is the meaning of circumference?"

The couple nodded as they would have studied this during secondary school in Singapore. "Vet 1 is correct in saying that your dog is 'too old' for surgery - meaning that it is highly risky to operate on your dog as he may die from general anaesthesia. He is already 14 years old and is very old." I told the couple of a 16-year-old Fox Terrier whose circum-anal tumours grew to large sizes such that they cause a lot of bleeding and infection set in. This would be what happen if the dog lives up to a very ripe old age.

A blood test had been taken. This is a very high risk anaesthesia. I spoke to the couple and Dr Vanessa. If the anaesthesia is less than 15 minutes, the old dog seldom dies from anaesthesia. "That means doing the operation in 3 or 4 stages," I said to the couple. "Neuter first to remove the male hormones stimulating the growth of the circum-anal tumours. After 3 weeks, remove the larger tumours within 15 minutes and repeat with the remainder some 4 weeks later."

The tumours had spread under the anal skin from 9-3 o'clock in the upper side. Then at 5 o'clock a large tumour protruded with another small one. I did not take a picture. But this would be a protracted surgery and highly risky. If neutering and Tardak injection shrinks the tumours, then there may be less operating time. But owners and vets need to be patient in the treatment of circum-anal tumours in a very old dog.

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