Tuesday, March 21, 2006

Cancer in Dogs

Cancer is the #1 cause of death in dogs. In people, it is heart disease, then cancer. In cats, its kidney disease, followed by cancer. My household is a statistic: I lost my cat to kidney failure, and both dogs to cancer.

Not all canine cancer is hopeless. I am currently treating 2 dogs with chemotherapy for lymphosarcoma, a cancer of the lymph nodes that has a relatively good prognosis with treatment. I also recently had a successful case of Mast Cell Tumor:


Happy Post Operative Patient

This cute little pug had a tumor on her right front foreleg. Dogs often get mast cell tumors - tumors of the cells that contain granules full of histamine and other mediators of inflammation. Most mast cell tumors can be cured with wide excisional biopsy - meaning you cut out a lot of surrounding tissue, so that you get clean borders, and its gone. Occasionally we see dogs with mast cell tumors that are of a higher grade - much more aggressive. Those come back with a vengeance. Fortunately, most are grade 1 or 2.

This cutie-pie came in with a large, diffuse tumor over her forelimb. Consider your forelimb, with a tumor on it the size of a cookie. Now imagine to get rid of it, I have to cut the tumor out as well large amounts of skin and tissue around that tumor. You can imagine the difficulties closing the skin on this wound.

When I approached this girl's tumor, I mentally told myself not to think about closing the tumor when I cut it out. I just focused on removing it all. After it was gone, I thought, Oh man, now what am I gonna do? There was a huge gap that exposed muscle and tendon. Closing it simply would put the skin edges under too much tension. Tension causes pressure on the capillaries; without blood supply, the skin edges die -- and definitely do not heal.

When I approached the wound as a puzzle, it seemed a little more possible. I made a few tension releasing incisions, and closed the wound in a zig-zag pattern. I pulled the skin together with tension-relieving suture patterns. I used all the tricks I knew, and I still thought the skin at the center corners may not survive.


Immediately after surgery

Fortunately, this girlie did well. The biopsy came back low grade with clean borders. Her skin actually healed well! I rechecked a small swelling last week, to make sure there was no return of tumor. We all breathed a sigh of relief when there were no mast cells seen.

Close up 1 month after the initial surgery.

I don't know who was more pleased with the outcome, the owner or me!

10 comments:

Dad said...

Smashing! Last week I saw the same strategy of zig-zag closure done on a Beverly Hills plastic surgery patient.

The little doggie didn't know how advanced her stitch up was!

Leigh-Ann said...

Looks super -- I bet the owners are relieved, too! My Anatolian has had two lumps that we thought *might* be mast cell tumors (because of his age), but they were both benign histiocytomas. We were pretty aggressive with the first one and had it removed surgically, but then we just treated the second with Prednisone and Atarax and it shrunk quite quickly. Any growth is scary, though -- I'd be quite happy to not have to see any more of them.

Emily said...

So cool, Jenn! I really love watching you in action. The couple of times I've had the opportunity to see you perform surgery, I'm amazed at the closings. I was just thinking of you the other day when I was sewing up some pillow cases and trying to remember how you hid all the stiches inside...?

Aunty Norma said...

...!!! you done well,Girlie..:o)(as they say)..the stitching up looks good..7 years out of your life to learn all there is to know about being a Vet. and boy,you sure do know your business ..hahaa I sound quite 'with it' don't I? seriously,Jenn. we are all proud of you.xxx

paula said...

Amazing work Jenn, you should be extremely proud of yourself XXXX

sciencefreakimeangeek said...

THAT'S BECAUSE YOU ARE THE BOMB DIGGITY!!!

Anonymous said...

And brilliant Dr. Jenn strikes again!

Congrats on the successful surgery! Those stiches look really neato! I'm so happy the doggie is doing much better and the tumor appears to be GONE!. =)

Lucky to be related to this awesome vet,

-Bevie-

EdamameMommy said...

I used to not like pugs, but now they are growing on me. That one is pretty adorable. Especially with a Dr Jenn war wound. Very cool. Start your professional blog already!

gretel's mom said...

Dr. Martin...
I think it's her mommy that is the most pleased (: Paige (from BAH) emailed me the link to your blog so I can see my girl, and again admire your work...I am so pleased, blessed and grateful for your talent!

fllady said...

I currently have a male APBT who just had a Mast Cell tumor removed. Low Grade 2, luckily. His post op course has been very very rocky. 7 days later he is much better but we now have this open wound that is not closing, the MST was on his left flank. I am wondering if this Z pattern would help? His story is here
http://www.dogster.com/dogs/516687
with pictures of his wound.
Suggestions are greatly appreciate.