mast cell tumors

glassslippers-and-tinywhiskers  asked:

Could you discuss delayed desexing and the alternatives like an ovary sparing procedure? It seems clear that in breeds like the GSD it benefits their health, but do we know much in regard to smaller breeds? (I know this topic can be controversial so if you'd prefer not to delve into it, or already have I understand) Also I've been loving the breed posts, thank you for taking the time to write them up!

I don’t at all mind discussing the topic when everyone remains civil about it. It’s very interesting and an aspect of veterinary medicine that’s bound to change as we gather more information. I’m happy to discuss it as long as all participants refrain from making personal insults.

It’s a long discussion folks. I’d grab a cuppa tea if that’s your thing. Also, unfortunately I can’t hide it under a ‘read more’ because it’s an answer to an ask, and Tumblr will eat the hidden part if I do. I will try to make it look pretty if you’re not interested.

Traditionally in dogs we have performed desexing (spey) by performing an ovariohysterrectomy, removing both ovaries and the uterus. Some alternatives have been suggested including tubal ligation, hysterectomy (removing only the uterus), ovariectomy (removing only the ovaries) or doing nothing. This is good. Science as a process should periodically review data, question the knowledge base and make recommendations based on new research. Otherwise it’s just dogma.

I don’t think you can claim that it is ‘clear’ that leaving the ovaries benefits the health of breeds like the GSD. The practice is still controversial at best, with some veterinarians outright labeling it at malpractice. There is some breed variability in terms of what relative benefits and risks might be expected, but I really wouldn’t call it ‘clear’.

Originally posted by wolfyoubemyvalentine

Before I talk about various cancer risks, let’s talk about relative risks of non-cancerous conditions.

With an ovariohysterectomy (traditional spey)that is properly performed, there is zero risk of pyometra. Stump pyo can occur if remnants of the uterus or ovaries are left behind. Cruciate tears are affected by multiple factors, but desexed dogs seem more prone to them than entire dogs. Weight gain and obesity is more common in desexed dogs.

The relative risk of pyometra in non-desexed dogs is about 25%. Risks typically increase with age.

With an ovary sparing spey (hysterectomy), only the uterus is removed. Pregnancy is prevented. Pyometra can still occur if any uterine or cervix tissue remains (a stump pyo). With the apparent influence of oestrogen, these dogs may be less at risk of cruciate disease and are less at risk of obesity.

With an ovariectomy, only the ovaries are removed. This renders the dog infertile and removes the influence of oestrogen. The uterus will atrophy and shrink down without stimulation from female hormones, rendering the risk of pyometra basically zero. It may still increase the risk of obesity and cruciate disease like the traditional spey.

Considering that pyometra is often lethal, while cruciate disease is painful but treatable, personally I would err on the side of preventing pyometra. Also keep in mind that obesity in dogs can be moderated with owner control of the diet, and obesity will predispose to cruciate injury. I would recommend removing at least the ovaries.

Male dogs have less surgical options. Vasectomy can be considered, but these dogs are basically entire but infertile.

An entire male dog is more at risk of perineal hernia, benign prostatic hyperplasia, perianal adenoma and inter-male aggression. A castrated male dog is relatively more at risk of, again, obesity, cruciate ligament disease, and possibly diabetes.

With the information above, and I haven’t brought cancers into the equation yet, you might wonder of preventing obesity in desexed dogs might reduce the incidence of cruciate disease and subsequently other conditions that we know are more common in obese dogs, namely cruciate ligament disease and diabetes. You might conclude that there is little benefit to leaving a dog entire if you’re able to control its weight.

I think that’s a reasonable assumption so far, though it’s clear to me that the benefits of traditional desexing are more pronounced in females.

Originally posted by heartsnmagic

Now lets talk about cancers.

There are multiple types of cancer. Some are more devastating than others. Some are more common than others. In terms of highly malignant cancers that show up relatively commonly in dogs, the ones we talk most about, and of most interest in this topic, are mammary cancer, haemangiosarcoma (HSARC), Mast Cell Tumor (MCT) and osteosarcoma (OSC).

  • Mammary cancer is extremely common in entire female dogs. In European countries where prophylactic desexing is not routinely performed mammary tumours make up 50-70% of all cancers seen. They are relatively rare in countries with a high desexing rate but extremely predictable in dogs desexed late in life or not at all. Speying earlier appears more protective compared to being left entire: speying before the first heat reduces risk to 0.05%, before second heat to 8%, and before 3rd heat to 26%. after the third heat there is negligible reduction in risk of mammary cancer compared to intact dogs.
  • Osteosarcoma may be three times (3x) more common in desexed large breed dogs.
  • Mast Cell Tumors maybe up to three times (3x) more common in desexed dogs of certain breeds. Lymphoma may be up to 10% more common in desexed dogs of certain breeds.
  • Haemangiosarcoma may be more common in neutered dogs of some breeds, but less common in neutered dogs of other breeds.

There isn’t much consensus across ALL dog breeds in ALL situations. There are numerous retrospective studies, and more coming out all the time (Science!) but more data needs to be analysed.

What is fairly clear is that there is a dramatic reduction in otherwise common mammary cancers by early desexing of females. There is probably some benefit in reducing other cancer risks to later desexng, or not desexing, dogs also.

So do you? Or don’t you?

There’s certainly more incentive to desex female dogs, as even pyometra on its own is a sneaky, life threatening condition. I recommend desexing most female dogs in their senior years if they haven’t already been done for this reason alone.

Assuming you do chose to desex, and I’m talking about procedures that involve at least removal of the gonads, it becomes a matter of when. If you don’t remove the ovaries then you have no benefits from desexing other than infertility. There’s no significant benefit in leaving the ovaries compared to leaving the dog entire.

For a small dog, OSC is incredibly rare. HSARC is rare. MCT can happen to anything. We weight up those relatively low risks compared to the very high risk of mammary cancer and pyometra, and I would advise speying before the first heat. With males timing is not as critical unless behavioural factors are involved.

For a larger dog, I personally think it’s worth delaying desexing to between the first and second heat. I would get too nervous about mammary cancers to wait beyond the second heat but there may be some benefit in preventing osteosarcoma by delaying surgery until more skeletal maturity, and same for cruciate injuries.

(I have a theory that osteosarcoma occurs in its predilection sites due to increased bio-mechanical forces in these areas, so waiting for skeletal maturity before removing the gonads might be helpful.)

On the other hand, screening for hip dysplasia and desexing if the dog definitely has it so you can perform a JPS also has benefits, because you’re addressing pathology the dog definitely has right now.

There are so many unknowns in these hypothetical scenarios. This makes it a challenge to make recommendations when clients just want the ‘right’ answer.

The best plan for the individual dog may depend on breed or breed mix (genetic testing would be ideal, but an added cost) or any known predispositions within the family or bloodlines.

So, this explanation is getting rather long, but there’s so much interesting information on this topic and it’s growing all the time.

Originally posted by mensweardog

TL:DR there is probably a benefit to delayed desexing in dogs prone to OSC, cruciate injury and HSARC. Some of the other risks may be mitigated by weight control. There is minimal if any benefit, and definitely some risk, in delaying desexing for small breeds.

But this field may change as more information is gathered. It will be worth watching over the next decade.

NB: shelters and rescues will always desex as young as possible, because their primary aim is population control. They are justified in doing this and their cases shouldn’t be considered in these scenarios.

(Majority of these statistics come from ‘The spay/neuter controversy’ presented at the OVMA by John Berg, DVM, DACVS and ‘ Long-term health effects of neutering dogs: comparison of Labrador Retrievers with Golden Retrievers‘ by Hart, Hart, et al)

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Goya was my dog.

She was a 10 year old corgi/golden retriever mix that I brought with me from Spain. I know a lot of people have their special pets and their “heart animals”; and she was mine. Truly, she was my heart, and my life. We were inseparable. To this day I can’t talk about her without getting emotional, and miss her with every bit of my still broken heart.

Goya rapidly developed a cancerous growth (mast cell tumor) on her right side that we had scheduled surgery to remove. She had gone through a previous surgical procedure to remove two burst cysts and came from that healthy and fine - she was eating and playing that very night! So I figured that even at her age she was strong enough to go through one last surgery.

I began to take pictures of her to make a chronicle of her weeks before surgery, in order to keep spirits up and invite people to meet her a little better. She has a tag all of her own that is still difficult for me to visit.

Goya went into shock after surgery. The mast cells had begun to degranulate. We took her to the ER, but she didn’t make it. I lost a very big piece of my heart that night.

Seeing Goya in-game is a way for me to have a bit of her around that I can visit and interact with, and can’t thank the people that made it happen enough because it may have been such a small thing but for me it means what Goya was to me - the world.

3

Three skin masses present on a 15 year-old, female-spayed, Domestic Short Hair.  The kitty cat’s owner recently felt 3 small, firm masses on the patient’s left forelimb.  The masses were about 1cm apart and non-painful on manipulation.  Aspirates from all three lesions showed…

*

Copious amounts of these round cells!  Most of these bad boys contain discrete, purple (or metachromatic!) granules.  Any idea what these cells are…..?  These are mast cells!  Making this a mast cell tumor, sometimes called a mastocytoma.  These cells will often ‘pop’ when cytology slides are made, releasing the granules into the background (see all the free granules in the bottom picture?)

*

Cytologic diagnosis:  Mast cell tumor.  Feline mast cell tumors are typically low-grade in behavior - meaning they grow locally but rarely spread to other parts of the body.  In this case, the patient could be facing a more high grade tumor as she has multiple skin tumors simultaneously.  The presence of multiple cutaneous mast cell tumors in a cat is no bueno - many of these cats actually have disseminated disease.  In cats, disseminated mast cell disease will often shore up in the spleen.  No word yet on this patient’s next move, although I suspect these masses will be removed and a hunt will begin for internal tumors.  

lillieisabllagrace  asked:

If boxers aren't in line to get evaluated, I'd like to put them there... No hurry. :)

Ah, Boxers. Clowning cancer factories. They’re such an interesting breed and frequent visitors to the vet clinic. They’re also one of the addictive breeds, meaning that despite their flaws there are a lot of people that once they own one, are never without one ever again. You might want to sit down and have a cup of tea.

Disclaimer: These posts are about the breed from a veterinary viewpoint as seen in clinical practice, i.e. the problems we are faced with. It’s not the be-all and end-all of the breed and is not to make a judgement about whether the breed is right for you. If you are asking for an opinion about these animals in a veterinary setting, that is what you will get. It’s not going to be all sunshine and cupcakes, and is not intended as a personal insult against your favorite breed. This is general advice for what is common, often with a scientific consensus but sometimes based on personal experiences, and is not a guarantee of what your dog is going to encounter in their life.

Originally posted by orbo-gifs

So, the number one thing that Boxers as a breed are known for in veterinary medicine, if there one one solitary defining feature that was the reason most veterinary professionals decide against owning a boxer, a breed they would otherwise like, then at the risk of being insensitive, (since you like sparkly gifs) its…

Boxers are prone to cancer like no other breed I know, closely followed by Golden Retrievers. They develop all sorts with great ease, at unfortunately young ages with great regularity.

Mast Cell Tumors are the bane of the boxer breed. These tumors can develop anywhere on the body, including in organs like the spleen, and in any layer of the skin. These tumors are sometimes called the Great Pretenders because they can look like lots of different things. They’re easily mistaken for benign lipomas by feel, and can be misdiagnosed if they’re growing under a lipoma by FNA as it’s easy to miss a small lump with a small needle.

While a low grade MCT has a chance to be cured with surgery of detected early, a high grade one is all kinds of trouble even with modern chemotherapy options. It’s fear of these tumors that cause many vets, including myself, to be highly suspicious of every single lump on a boxer or boxer cross.

Boxers also seem highly prone to other cancers too, lymphoma being high on the list. Individuals with a white belly also get squamous cell carcinomas and cutaneous haemangiomas.

They are one of the very few breeds known to develop malignant histiocytomas, which is especially unfortunate considering that in most dogs a histiocytoma goes away all on its own in a few months, but in Boxers it will potentially kill them.

So while any lump on any dog can be a malignant cancer, Boxer’s have the added ‘fun’ of developing lumps that probably would have been fine on an other dog and look benign but sometimes actually aren’t. Can you understand my paranoia?

Boxers are a brachycephalic breed, meaning they have shortened muzzles and flattened faces. There is significant individual variation within this breed, but more extreme individuals do suffer from Brachycephalic Airway Syndrome (BAS)

Their facial conformation leaves their eyes prone to numerous Eye Conditions, including but not limited to cherry eye, entropion, exposure keratopathy and corneal ulcers. They also get a particularly difficult to treat eye ulcer called ‘indolent ulcers’ which are sometimes just called ‘Boxer dog ulcers’. They also get progressive retinal atrophy which is probably more genetic than anything else.

Speaking of diseases that are names after the breed (rarely a good sign), this breed also gets an unusual gastrointestinal disease called Histiocytic Ulcerative Collitis, which is also called Boxer Dog Collitis. For brevity’s sake, think of it a bit like a type of IBD of Chron’s disease.

And while we’re still on the topic of diseases named after this breed, Boxer Cardiomyopathy, which is really a arrhythmogenic right ventricular cardiomyopathy that’s primarily identified in boxers, also afflicts this breed. It’s not their only heart condition though, Dilated cardiomyopathy, atrial-septal defect, subaortic stenosis and sick sinus syndrome also occur.

This is turning into a long post, isn’t it. Do you want a break? How about another gif?

Originally posted by skullvis

Okay, let’s talk some more about Boxers from a veterinary standpoint.

Boxers are prone to a couple of neurological disorders, Wobbler Syndrome is more common in larger males but degenerative myelopathy can occur in any boxer, is they live long enough to get it.

Younger boxers may develop demodex, if they’re juvenile when they do so it’s likely due to a funky immune system, which might explain a lot about this breed. Boxers that are predominantly white may also be deaf in one of both ears. It’s claimed that white boxers are more prone to cancer too, and for skin cancers this is true, but all boxers are prone to cancer. Hence the sparkly gif.

Possibly related to an interesting immune system, the breed is prone to allergies and atopy. This is a day to day annoyance on top of he life threatening/shortening conditions this breed is likely to develop.

Speaking of life threatening, the boxer dog is certainly deep chested enough to develop Gastric Dilatation Volvulus and need a trip to the emergency clinic.

And possibly the least interesting thing on this list the breed is seen relatively frequently for in the veterinary clinic is hip dysplasia.

Gosh, a long list never looks good, especially when three conditions are named after the breed.

Boxer’s also have a reputation for anaesthetic sensitivity. This is often exaggerated in breed circles, assuming the boxer in question doesn’t have one of the aforementioned heart conditions, but because they are brachephalic they have a higher vagal tone and are more sensitive to the common sedative acepromazine.

This doesn’t mean you can’t use acepromazine in boxers, only that you have to be careful with it. I will often use it at a tenth to a quarter the dose in young, nutty individuals before surgery, but some vets wont use it at all.

Can you see how living with one of these dogs would drive me nuts from a medical paranoia standpoint?

Lucy, Boxer (6 y/o), 79th & Amsterdam Ave., New York, NY • “She lost her ear because of a mast cell tumor. She’s a bossy clown – she’ll talk at the dinner table and if I’m sitting at the keyboard, she’ll push my hand away with her head.”

PLEASE READ THIS!!!!!!
Hi This is my dog Atlas! He is a rescue dog i got Two years ago! He is four years old and He has A LARGE CANCEROUS MAST CELL TUMOR GROWING RAPIDLY ON HIS SIDE. Unfortunately my vet refused to advise surgery soon enough for the tumor to be removed in its earlier stages and When he finally recommended surgery the tumor had already grown substantially in size.
It quickly reformed after A PAINFUL SURGERY AND HAS BECOME LARGER THAN THE INITIAL TUMOR. My mother REFUSES TO HELP PAY FOR TREATMENT and me and my father cannot afford to make serious lifestyle changes such as a raw food diet and holistic medicine. I REALLY DONT KNWO WHAT ELSE TO DO!!! PLEASE ANYTHING WOULD HELP US !!
PLEASE DONATE TO MY PAYPAL AT Cherubgrin@gmail.com

IF YOU NEED MORE IMFORMATION/ PROOF/ OR AN UPDATE FEEL FREE TO SEND ME A MESSAGE !!!

I WILL SEND BONUS PICS AND VIDEOS TO ANYONE WHO DONATES!!!!!!!!

Mast cell tumor. In a cat! I so rarely see cats with external masses. Surgical removal was offered to the owner, they may proceed with surgery at a later date. The purple granules throughout the photo contain substances like histamine, which cause swelling, itching, and nausea in large amounts; they can be released simply by squeezing or handling the mass and in large masses could potentially cause anaphylaxis.

anonymous asked:

You recently did a post about the breed of bull terriers, would you have the same stance of Staffordshire bull terriers ? Also I have heard a few times over the years that mixed breed dogs like mongrals tend to be healthier than pure breeds. Would you agree with this? Thanks

Staffordshire Bull Terriers (SBTs for short) are one of the most popular dog breeds locally. They are quite different to Bull Terriers, but talking about them is confused because I see three different types of dog called SBTs.

The first type is the classic English SBT. This breed is actually kind of small, but has lots of muscle packed on.

(Photo By Sannse on en.wikipedia)

The second type is the American Staffordshire Bull Terrier, sometimes called the AmStaff.

(Photo via pintrest, but watermark states ‘art of staff’)

The AmStaff is a bigger breed, distinctly taller and locally they are the breed most likely to be called a ‘pit bull’.

The third type of dog presented to me called a SBT is either a mix of the two, or a similar looking dog with brindle or black-brindle coat that looks close enough to be a SBT mix, but doesn’t actually have any SBT DNA when tested.

If I keep the focus of this post on actual SBTs and their mixes, then these are the the points I always bring up with perspective owners.

Allergies are the most common problem I encounter with either types of SBT. Ths can range from a seasonal plant allergy to full blown atopy. Food allergies aren’t as common but can still occur. The allergies can then predispose to pyoderma, and require maintenance to keep the dogs comfortable

Demodex mange is also reasonably common, though less so with over the counter parasite products available that just happen to treat it.

They are prone to anxiety. This varies in how severe it is, and more of them are barkers than destroyers, though they have a decent set of jaws and can chew through an awful lot of stuff if given the opportunity. These dogs, especially the English, really need a human. They’re very people focused and many of them just can’t handle the world without ‘their’ people.

They’re often hyperactive and hyperexcitable, but that’s personality. The difficulty with that comes when they are poorly behaved in public, especially with the AmStaff, and members of the public call them ‘pit bulls’ which can get them investigated by the council.

Some of them will chew rocks and wood, wearing down and damaging their teeth. This isn’t a genetic weakness, but it is something that benefits from careful management.

Skeletally they’re not too bad. They’re a common breed to present for cruciate ligament rupture, but to be fair this usually happens after the dog has jumped off something particularly silly.

They are one of the breeds unreasonably prone to Mast Cell Tumors. They get lipomas more often, but you can’t tell without testing whether one lump on a dog is a fairly benign lipoma, or a dangerous Mast Cell Tumor. While some Mast Cell Tumors are highly treatable with surgery, early detection increases your chance of a cure.

English SBTs are, technically, brachycephalic. However their anatomy is nowhere near as extreme as the breeds notorious for brachycephalic airway syndrome. These dogs generally breathe well, but you will often come across individuals with a mild symptoms, such as a subtly elongated soft palate or a moderate collapsing trachea in their old age.

Epilepsy seems to crop up in these dogs a bit more than average, but it’s generally manageable. It means lifelong medication, but often it’s initially more stressful for the owners than for the dogs.

The AmStaff version still has a hip dysplasia problem and I would recommend pennhip screening from 16 weeks of age, especially from ‘breeders’ who are breeding primarily for ‘rare colors’.

Originally posted by introxlifetrap

These dogs are extremely popular, and consequently also the most popular breed to end up in the local shelter. There are a large number of people who keep wanting to breed their ‘rare, blue’ SBT of either type, that wont let me talk them out of it. 

I think the shelter problem is compounded by how common they are alongside their neediness. The vocal range of this breed is huge, the sounds they can make include ‘screaming child’ and ‘strangled goat’. People get the cute puppy, but decide they can’t meet the needs of the adult dog.

The AmStaff version as a whole social issue of its own to contend with, because a certain segment of the population is in love with the idea of the aggressive Pit Bull, and they want one, but can’t get a ‘real’ one, so get themselves an AmStaff since it’s not a restricted breed. Pit Bulls are here, but the situation is a bit sticky because you don’t ave to prove the dog is a pit bull, you have to prove that it’s not. The enforcers of these laws have a checklist of physical attributes, and if the dog meets enough of them it can be labeled a ‘pit bull’, no matter what it is.

I’m very loathe to ever label a dog as a Pit Bull, because there are some breed restrictions around me, and I don’t wish to accidentally get a dog into serious trouble. The dog breed DNA test we use also won’t publish anything with the words ‘Pit Bull Terrier’ on it, lest the dog gets euthanized for that reason either.

But for these people what actually want the tough looking pit bull, not a pibble couch buddy, the dogs are often not well socialized and unfortunately problematic in the clinic.

SBTs are one of the breeds I would label as ‘addictive’. Once somebody has owned one, more often than not they end up with multiple dogs, or find themselves unable to enjoy life without owning a dog of this breed. They are kind of like kids to their special people.

As for mixed breed dogs, their issues are less predictable, and their anatomy generally less extreme, but they are no guarantee of health. If you cross two breeds with the same health concerns,you are equally likely to see that concern in the resulting cross. I would not guarantee a mixed breed dog would be healthy, but there is very little in general that I would guarantee.

Traps for new vets

There are certain pearls of wisdom that you really want to hear before you have a chance to make these mistakes yourself. Note: This list is by no means exhaustive.

  • When expressing anal glands, do not stand directly behind the animal and do not talk. Keep your mouth shut, do not talk.
  • Always check the animal’s sex before calling them into the exam room. Some people like to give their male pets strongly feminine names and enjoy getting upset when you assume ‘Susan’ is a girl.
  • Never say “At least he doesn’t have a tumor” until you have finished your physical exam.
  • Goats and valium do mix.
  • Book double consultation times for clients that may not be to comfortable with English. Best case scenario is they bring a friend or relative to translate for them, requiring the whole conversation to happen twice. Worst case scenario is that you end up communicating via charades.
  • Mast Cell Tumors look like everything, and anything. It might not be a lipoma.
  • Cats will heal just about anything if you put their pieces close enough together. (If they don’t, look for FIV or FeLV). To think of it another way: Cat’s are nature’s jigsaw puzzles.
  • All dogs bite. That’s how they eat. The breeds most likely to send veterinary staff to hospital for serious dog bites are actually Labradors and Golden Retrievers, simply because you don’t expect them.
  • Don’t use the smallest possible catheter when trying to hit a vein. They’re flimsy and they suck. You can place a 22g in a kitten. You really can.
  • If you’re not sure, and need time to think in front of a client, either put your stethoscope on, listen to the heart/abdomen and shut your eyes or if dealing with cattle, put on a rectal glove, get in there and look as though you’re concentrating hard. Nobody likes to interrupt.
  • If you think a client is using a euphemism for genitals, ask them to show you what they mean and henceforth use correct anatomical terms.
  • You can always use your first principles
  • Don’t say “I don’t know” unless you follow up with “But I have a plan to figure it out.”

One day, there will be a part 2 to this post.

Part 2: http://drferox.tumblr.com/post/80923186387/traps-for-new-vets-part-2-euthanasia-edition

Part 3: http://drferox.tumblr.com/post/88149056416/traps-for-new-vets-part-3-emergencies

anonymous asked:

Question tax: came for Lucifer the bunny and stayed for everything else. Could you do one of those breed diagnosis for Golden Retrievers? Thanks!!

Sure, since you asked so nicely. But before I say much, please note the disclaimer.

These posts are about the breed from a veterinary viewpoint as seen in clinical practice, i.e. the problems we are faced with. It’s not the be-all and end-all of the breed and is not to make a judgement about whether the breed is right for you. If you are asking for an opinion about these animals in a veterinary setting, that is what you will get. It’s not going to be all sunshine and cupcakes, and is not intended as a personal insult against your favorite breed. This is general advice for what is common, often with a scientific consensus but sometimes based on personal experiences, and is not a guarantee of what your dog is going to encounter in their life.

Originally posted by clowny69

From an orthopedic viewpoint, this breed commonly develops elbow and hip dysplasia to varying extents. All breeding dogs should be screened for these conditions.

Golden Retrievers are notorious for cancer. They’re not quite as bad as Boxers, but they’re pretty damn close. In particular Lymphoma seems common in this breed, and lymphoma can occur at any age, not just necessarily older dogs. Osteosarcoma, Mast Cell Tumor and even Haemangiosarcoma occur fairly reliably. They are the more common cancers in this breed.

The most common reason for me to see Golden Retrievers in clinical practice are skin conditions, and very specifically hot spots (moist dermatitis).

Seriously, these hot spots can get so bad that sometimes I’ve had to shave 30% of the dog. Hot Spots are severely infected skin which are both very painful and itchy. They occur when there is persistent moisture trapped against the skin, and they spread rapidly because the presence of a hot spot causes more fluid exudate, so they spread rapidly if ignored. I had so many Golden Retrievers present to emergency last New Years because of hot spots that their owners thought they could leave until their regular vet opened, only to have them spread from ears to chest and cause a huge amount of discomfort for the dogs.

They develop a couple of eye conditions, of which cataracts  and progressive retinal atrophy (PRA) seem to be the most common. Blindness isn’t the end of the world for a dog, but sometimes this occurs concurrently with cognitive dysfunction (Dog senility) and that can be distressing and disorientating.

The breed is reported to be prone to von willebrands disease, a blood clotting disorder, but honestly I’m yet to encounter this in clinical practice.

Many breeders are now screening their dogs for subaortic stenosis, a congenital heart defect. There are not many congenital heart murmurs I’ve encountered in dogs, but for me, for some reason, Golden Retrievers are over-represented. Many of these dogs exceed their life expectancy (so far), but they are being carefully monitored by a specialist and we’ve not put any of them under anaesthetic.

I also have a few of these patients on the go who have idiopathic epilepsy, which often develops in middle aged dogs. They’ve all been very responsive to standard therapy so far. This condition requires lifelong medication, so owners of these dogs have been very glad they took up health insurance. 

These dogs are also big enough to get bloat (Gastric dilatation volvulus), especially the larger males who gobble their food.

Speaking of food, obesity is a common problem for this breed, and it’s associated impact on joint health. It’s very easy of overfeed and under-exercise these dogs. They’re often very loving and it’s tempting to give them lots of treats, and the weight gain can sneak up on people due to their fur.

The breed also seems to be prone to anxiety, and no matter how nice their reputation I simply can’t trust them in the clinic, especially for drawing blood. They drop into neurosis very easily, and as a surprising fact it’s Labradors and Goldens that are responsible for the most dog bites that send vets to hospital.

anonymous asked:

How often do vets actually remove lipomas? Like, have you done it a lot over your career? to me, a layperson, it looks fun to remove a big hunk of fat, but also, it's usually totally unnecessary to remove, right? I know dogs get them all the time, but do cats ever get them? qt: what's your favorite simple trick a dog can do? I love when they sit pretty :3

For tumors that I assume are lipomas based on a Fine Needle Aspirate (FNA), which is basically a tiny, tiny biopsy for cytology, whether we remove the tumor or not depends on a number of factors.

Lipomas are benign tumors of fat. They don’t spread or invade, but they can get stupidly, ludicrously big. The largest I’ve seen was almost 2kg, and that came off a terrier cross. So even if these tumors aren’t all that nasty, they have the potential to negatively impact the dog’s movement and quality of life.

I am more likely to recommend removing an assumed lipoma if:

  • It’s near a joint
  • It’s growing
  • It’s deep or under a muscle layer
  • If it’s changed in some way
  • if I think the FNA result is wrong
  • If it’s cutaneous or not mobile
  • If I have another reason to be paranoid about it (eg Boxer)

And if the owners elect to not remove the tumor, it’s still important that they continue to monitor it. So many laypeople online say that if a lump is a lipoma then not to worry about it, and they’re quire to answer anyone who has a dog with a lump by saying it’s a lipoma, even though it’s impossible to make that assumption without cells under a microscope. If anything about the lump changes, then cut it out.

One of the reasons this is so, is because Mast Cell Tumors (potentially very nasty, very common cancers) can look and feel all the world like a lipoma, and can begin growing underneath a lipoma years down the track. A lipoma is inconvenient, but a MCT will most likely kill its host without surgery.

When removing a lipoma, we shouldn’t be ‘scooping out’ the tumor, it’s still a tumor and should be removed with margins so that you can be reasonably confident you’ve got it all. One of the difficulties with margins in lipomas is that they’re often visually indistinguishable from normal fat, so you can’t always tell where tumor ends and fat begins. For massive lipomas, especially on small dogs, we often can’t take margins and end up debulking and hoping for the best.

Cats can get them, though they’re not as common. Any animal would be capable of getting them, but they are distinctly more common in dogs.

Traps for New Vets: Part 4, neoplasia

Approximately a third of our senior pets with develop cancer at some point in their life. Facts are, if they live long enough then it will definitely happen. Our job is to identify it, and do something about. For some types of cancer a chance to cut is a chance to cure, but only if identified early enough. 

Sometimes you don’t get a chance to identify neoplasia early enough. If a pet owner decides that their pet is ‘healthy’ and elects not to come to the vet for regular checkups until that lump is the size of a watermelon, or until that mast cell tumor has been sitting there for months, then there’s not much you can do about that. But we all do our best with what we’ve got. Different neoplasias have different biological behaviors, and some are sneakier than others. 

  • Mast Cell Tumors cannot be overestimated. They are always considered bad news until proven otherwise. They can pop up anywhere you have immune surveillance, including the spleen. they can also look like just about anything. Subcutaneous Mast Cell Tumors can look and feel exactly like a benign lipoma. The only way to know is a Fine Needle Aspirate (FNA).
  • Speaking of lipomas, don’t tell a client they are absolutely nothing to worry about. There is a tiny chance that it might be a liposarcoma or infiltrative lipoma. That’s really hard to pick on FNA alone, so monitoring is always advised. 
  • The further away from the trunk of the body, the more likely that lump is going to be a nasty little bugger. A 2mm tumor on the toe concerns me much more than a 5cm tumor on the body. 
  • Again, toe tumors are nasty until proven otherwise, especially so if there is lytic lesions in the bones. 
  • Melanomas are not always dark. You can get amelanotic melanomas with no pigment at all. 
  • Haemangiosarcomas/Hemangiosarcomas are most commonly found in spleen and liver, but they can show up anywhere you find blood vessels (almost everywhere). Watch out for intramuscular haemangiosarcomas. They present a bit like a haematoma or a seroma, but they are not. If you try to ‘drain’ these, they will bleed for weeks. They may not stop. Cut the whole thing out and hope for the best.
  • White cats develop squamous cell carcinomas of the face. They can also appear normal on the outside but have horrific oral tumors inside the mouth. Look, and don’t assume it’s just a flesh wound. 
  • If the tumor is annoying the pet or causing pain, cut it out even if it’s benign. This is especially true for eyelid lumps rubbing on the eyeball.
  • In male entire dogs, remember to check those testicles and the anus. Perianal adenocarcinomas are easy to miss.
  • Lymphoma is the most common cancer across all species and age groups. It breaks the rules. It can show up in any age, even juveniles, and anywhere. If it’s anywhere, assume it’s everywhere.
  • Osteosarcomas can present initially as mild lameness that is easy to confuse for arthritis. You only know with an xray. Also, while we learn that they are more common away from the elbow and towards the knee, this is only true in large dogs. Dogs of any size can get them, and in smaller dogs they are more common in the spine and skull. 
  • Multiple myeloma can also look like arthritis if a lesion is near a joint. 
  • Mammary gland tumors are malignant until proven otherwise. If they are present, spey that thing if she isn’t already. Doing so can potentially triple their life expectancy. 

Always look. More things are missed by not looking than not knowing.

Other traps for few vets:

Second most important thing for a veterinarian to remember about the species they are treating

I’m surprised and thrilled that my previous post, Single most important thing for a veterinarian to remember about the species they are treating, has achieved so many notes. I didn’t expect so many people to find this helpful or amusing, but you did.

But it’s been a while. You all work or study hard, so you must be ready for the next lesson.

Here it comes!

If you can find room in your busy brains to remember two factoids about the species you are treating, make room for these.

Dog: Mast Cell Tumors can look like anything. Do your Fine Needle Aspirates!

Cat: Cats are nature’s jigsaw puzzles. Put the pieces close enough together and they will heal.

Horse: Do not trust a pony to tell you it is in pain. They rarely show pain to the same degree as a horse.

Cattle: You cannot push around 500kg worth of opinionated beef. I don’t care how much you work out at the gym, you will not out muscle a cow. Don’t try, sedatives are wonderful things.

Sheep: One day you may have to euthanise somebody’s pet sheep, and a bullet won’t be appropriate. They have a reasonable cephalic vein where wool changes to fur. Actually, all animals have a cephalic vein.

Goats: Goats can be sensitive to sedatives and anaesthesia, but it’s hard to go wrong with valium.

Deer: Why haven’t you shot it yet? They are wild, you can’t medicate them regularly, can barely handle them and fawns raised as orphans will see you as a rival come mating season…

Birds: There are only minor differences between the beak of a large macaw and a flesh eating eagle. Mind fingers.

Raptors(eg Eagles): They are actually easy to poison, they will eat baited meat and poisoned prey.

Chickens: It is not as difficult as you think to give tablets to a chicken.

Water birds: They get fungal pneumonias very easily. Keep all your expired antifungals, you just might need it for a duck on a budget one day.

Rabbits: Don’t fast them very long before surgery. Half an hour to ensure they haven’t got any food in their mouths is adequate, you need them up and eating again fast.

Guinea Pigs: Don’t assume the owner knows what sex they are. Big honking testicles are not as much of a clue as you might think.

Rats & Mice: Caesarians never (to my knowledge) end well. If you have to, treat it like a spey and forget about the young.

Snakes: Remember how I said above every animal has a cephalic vein? There is one notable exception.

Lizards: Some species have a ventral midline vein. If you enter the body cavity like you would speying a mammal, they will bleed to death. Check your anatomy.

Aussie Mammals: A sick joey is probably coccidia.

Fish: If they need antibiotics, be prepared to use large animal drugs with tiny insulin needles and lots of fractions.

Ferrets: Being on heat endlessly will eventually kill a non-speyed female.

Pigs: They investigate with their mouths and will eat just about anything.

youtube

In videos like this one, “Facts that prove pugs are the best dogs ever”, people should mention all the health problems.  Someone might watch this and go “Oh hey, it’s a low maintenance breed, I should get one”

In reality, Pugs need a lot of medical attention. Their wrinkles need to be cleaned to avoid skin problems, they are prone to eye injuries, entropion is common as well, they might need a surgery because they can hardly walk without suffocating and can’t regulate their temperature because of their breathing problems, they overheat quickly and it can actually cause organ failures, their curled tail can cause spinal problems, they are to many kinds of allergies, they are prone to mast cell tumors, can also be prone to “Pug Dog Encephalitis” and they usually can’t even whelp by themselves. 

And they do need more exercise than people think, and they need a healthy diet. Pretty much all the Pugs I’ve seen have been obese, and that’s not normal. 

It really bothers me when people promote a breed without mentioning all their problems, no matter what breed it is. Pugs have great personalities but their health problems are still the same.