Sunday, May 12, 2013

1414. Saturday May 11, 2013's interesting case. A 3rd opinion - inoperable oral tumour

The 13-year-old brown cross-bred was slim and trim. "Her tongue slips out from the left side of the mouth when she is panting," the owner told me. "She is not eating much now." He was seeking a 3rd opinion from me after surfing the internet.

Two years ago, there was a pea-sized growth in the inner cheek. His vet had sent a biopsy to a  histopathologist and the diagnosis was adenoma of the salivary gland. The report stated that it had few numbers of mitotic cells and would recur since this tumour was locally invasive. His vet advised "debaulking" and cutting off the right jaw.

The owner would not agree. So his vet referred him to the competitor who said that he did not think the histopathological results were correct. "He recommended CT scan and chemotherapy. He also said a sample should be sent to the U.S," the owner told me. However nothing was done as his advice was similar to the first vet. He prescribed clinadmycin and meloxicam as well as codeine. The oral tumour now is more than 5 cm x 3 cm x 3 cm and two more swellings of 1 cm x 1 cm and 1.5 cm x 2 cm below the left lower jaw on the underside of the neck had developed.

"Was an X-ray done by the 2 vets to see if the jaw bone was involved?" I asked.
"No," he said.
"As the growth of the tumours is fast recently, it is likely to be cancerous."
"Due to the massive size and spread, there are inoperable tumours. With surgery, there will be recurrence within weeks."
The owner agreed not to have surgery.


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