Vet Lessons 106-107

OK, so here are the other two cases that I ran out of time to show you yesterday.

Case #1 - yet another tumor

This case was a 13 yr old lab. The referring vet found a mass inside his cheek on his yearly physical exam. Upon further exam she discovered that his lymph node under his jaw on the same side as the mass was enlarged and hard. She asked me to remove the mass in the mouth, which really did not appear to be that bad (I thought it was probably benign) and biopsy the lymph node. I was very worried about the size and hardness of the lymph node so I removed the entire thing. When I was dissecting it out, I saw what looked like a deflated white balloon (like clowns use to make balloon animals) lying right over the lymph node. The lymph node in this area is right by the jugular vein and the carotid artery. I used careful blunt dissection (no sharp instruments)and removed the lymph node and when I looked in the hole left, the jugular vein was lying there huge, purple and inflated. That was what the balloon looking thing was it was just flattened out by the pressure of the enlarged lymph node. It was really cool and thank goodness I didn't cut it! Sorry I don't have a picture of it, but here is the lymph node after removal and sliced open.



Doesn't it look kind of like a brain? Anyway, it should be about 1/3 that size. We sent off the mass in the mouth and also the lymph node for histopath and it came back malignant amelanotic melanoma (bad) and of course, it had already spread to the lymph node as well. Because of the dogs age and other health issues, his owner chose no treatment, but just to keep him comfortable in hospice as long as possible. Clients often wonder if a dog really needs a physical every year, and this is a classic example of why it is a good idea. The vet totally found this tumor, the owner had no idea. You also have to remember that dogs age at a much faster rate than humans, so only having an exam once a year is like having an exam only once every 5-7 years as a human!

Case #2 - cherry eye (prolapse of the 3rd eyelid gland)

This is Roxie, a Boston Terrier. Isn't she the cutest thing? Oh, I just love this breed!


Anyway, notice the large red bulbs in the corners of her eyes? You may have to click on the picture to enlarge it to really appreciate them. These are glands that are located in the 3rd eyelids of dogs and cats. Did you know they had third eyelids? They are the white lids that come up from the bottom of the eye when they are sleeping. These glands can get inflammed and then prolapse (protrude up and out) and thus are called "cherry eyes" for their color and shape. Some breeds (cockers, bulldogs, pugs, bostons) are predisposed to this occurring, though it can happen in any breed. These glands are a contributor to tear production in the dog, so it is important to save them and not cut them out, which is the treatment some vets use. Notice how they are protruding even though Roxie is under anesthesia now.



The treatment I use is to make an incision in the third eyelid above and below the gland and then to pull the tissue over the top of the gland with suture and create a pocket for the gland. Here are Roxie's eyes when she is done with surgery. The glands are still present they are just tucked below in a pocket that will heal over the top of the gland, preventing it from popping back out.



OK class, that is all the pictures I have of the interesting cases I've had lately. I actually had many more cool cases, but I'm not always able to get pictures. But I try, just for you, cause they are just so fascinating...don't you think? Alright, so I am off to watch some American Idol and see who is going home and then I am off to bed.

Peace Out!
Tri-Vet