TOA
PAYOH VETS
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.
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.
