Tuesday, May 14, 2013

1415. Updated: The old dog's tongue hangs out

tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS

Date:   15 May, 2013  
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
The old dog's tongue hangs out  
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   15 May, 2013 
Be Kind To Pets
Veterinary Education
Project 2010-0129

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, that is, to cut off the jaw and the dog would adjust to this loss. He prescribed clinadmycin and meloxicam as well as codeine recently.

The oral tumour now was 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 right 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. The other sibling had no oral tumours. He showed me his smartphone images of his two slim and fit female dogs and we had a good chat on their behaviours.

In retrospect, would early excision of the lump at the back of the tongue prevent spread two years later? Though unlikely as the histological report said it was locally invasive and likely to recur, this might slow the increase in size. However, this is very difficult to predict. Removal of the jaw bone is not acceptable by all dog owners, in my opinion as they could not imagine how the dog would eat her food. Personally, I would have got the small oral tumour excised but warn the owner of the recurrence.
Updates will be at this webpage:  http://www.sinpets.com/F5/20130516old_dog_oral_tumour_toapayohvets.htm
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e-mail judy@toapayohvets.com
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All rights reserved. Revised: May 15, 2013

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