Help with managing a difficult case...

Re: Help with managing a difficult case...

Emma Purnell — Tue, 31 Jan 2012 15:41:16 GMT

[quote user="Cheryl RVN"]

Aw poor thing. Have you done a FNA on his lymph nodes or xr-ayed his chest to make sure it's not spread? If not them some vets might amputate the limb which might sound excessive to the client and also depends on money. Like other ppl have said bandaging and padding are probably the best management.

[/quote]

The owners, unfortunately, don't want to do too much more.

I have JUST had an update as they haven't been in since I last updated and the steroid injection we gave into the mass shrunk it right down and it has been no problem since!

Thank you for all your help - I really have appreciated it

Re: Help with managing a difficult case...

F1chick — Tue, 13 Dec 2011 20:44:03 GMT

How's he getting on?

Re: Help with managing a difficult case...

Cheryl RVN — Sat, 10 Dec 2011 11:52:25 GMT

Re: Help with managing a difficult case...

Nick Shackleton — Sat, 10 Dec 2011 11:41:39 GMT

Am sure the soft tissue surgeon that I used to work with would be happy to offer some advice! Have seen some amazing reconstruction surgery she has done.

http://nwsurgeons.co.uk/

her name is Catherine Sturgeon

Re: Help with managing a difficult case...

A Little TLC — Sat, 10 Dec 2011 09:50:56 GMT

Davies are amazing, we have referred a few animals over there, they are incredible.

Re: Help with managing a difficult case...

Emma Purnell — Fri, 09 Dec 2011 10:39:22 GMT

The Davies referral idea is one I had discussed with this vet for a different case a few weeks ago but we hadn't discussed for Bruno - I will mention it as soon as I get to work in case!

The drip bag didn't work unfortunately, he is very tolerant but was really annoyed by it.

Masivet/Mastinib only works against certain types of MCT and is very expensive, the test to check if the tumour will actually react to it will be potentially hundreds of pounds as well as needs to go to America.

I like the sock and foam insert ideas, I might work on a combination of both! The velco may be a problem though - he just pulls velco off!

Re: Help with managing a difficult case...

Nicola Smith — Fri, 09 Dec 2011 09:34:16 GMT

Would a chils slipper sock be any good, obviously not when outside as would get wet but my friend is using them on her poodle with micropore round the top and the grippers mean not as slippery as normal socks?

Re: Help with managing a difficult case...

Sal the 1st — Fri, 09 Dec 2011 00:45:52 GMT

as I understand it masivet/ mastinib has greatly reduced in price since its introduction, but only your vet would know if this was a suitable case? but as you mention that cost is an issue maybe this isnt for this dog unless there can be a way found to fund it. re a padded dressing would you be able to make a dressing to cover it in the same way you make the foam inserts for ie camera cases where you use a number of layers and have a cut out in various layers to accomodate in this case the mass. allevyn would probably do this quite well for you in more than one layer and then if you used something like a velcro strip just to secure it (not too tight)

Re: Help with managing a difficult case...

Phrin Vernon RVN — Fri, 09 Dec 2011 00:23:02 GMT

Going down the mikki boot line of thought... and I'm sure you've tried it, but would a 1L fluid bag cover it?

Obviously the owners would need to change regularly, and give pooch plenty of time with it off (perhaps overnight?)

Just a thought.

I really like Sal's idea above though - gotta be worth a try no?

Re: Help with managing a difficult case...

Sal the 1st — Fri, 09 Dec 2011 00:09:21 GMT

http://www.vetnurse.co.uk/blogs/veterinary_news/archive/2011/11/07/122508.aspx

just a thought?

Re: Help with managing a difficult case...

Emma Purnell — Thu, 08 Dec 2011 20:20:13 GMT

[quote user="Fuzzyduck"]

Given that he has a mast cell tumour, he is going to have a short life anyway.

Obviously its not ideal and i dont know the age or body condition of the dog ie if hes grossly overweight.

But it may buy a little while longer. I have seen large breed dogs have forelimb amputations and do well for a while, as a last resort due to similar either mast cell tumours or osteosarcomas.

[/quote]

I can't say it isn't something we haven't thought about amputating the leg, but I don't think the owners would want to and it would be a very expensive option for them with him being such a heavy dog. I am not sure how he would cope, he is around 50kg, about 5 years old and it would worry me how he would recover. It may be a choice we have to make though - we did discuss it at length today but ideally wondered if we could manage the tumour in-situ for now.

Re: Help with managing a difficult case...

Fuzzyduck — Thu, 08 Dec 2011 20:06:21 GMT

Given that he has a mast cell tumour, he is going to have a short life anyway.

Obviously its not ideal and i dont know the age or body condition of the dog ie if hes grossly overweight.

But it may buy a little while longer. I have seen large breed dogs have forelimb amputations and do well for a while, as a last resort due to similar either mast cell tumours or osteosarcomas.

Re: Help with managing a difficult case...

SmegSlayer — Thu, 08 Dec 2011 19:54:22 GMT

[quote user="Fuzzyduck"]

Obvious but maybe extreme step of amputation, i dont know how old the dog is, or body condition etc but is always an option if the owner wishes

[/quote]

He's a big dog though and it's a forelimb so I was always told that it was best avoided due to the amount of weight that would go onto the remaining forelimb. He'd probably end up with a shorter life anyway due to crippling arthritis in his other fore leg?

Re: Help with managing a difficult case...

Fuzzyduck — Thu, 08 Dec 2011 19:23:13 GMT

Obvious but maybe extreme step of amputation, i dont know how old the dog is, or body condition etc but is always an option if the owner wishes

Re: Help with managing a difficult case...

Emma Purnell — Thu, 08 Dec 2011 18:36:32 GMT

[quote user="F1chick"]

I know removal is too complicated, but maybe debulking and treatment from there?

[/quote]

I discussed this with the vet today but as it is a mast cell tumour, if we incise and debulk it the risk is we may well cause it to spread and actually make the problem worse. It also may well never heal up and we could shorten the amount of time he has left - not a risk the vet wants to take right now. We may have to at some point, but are trying all we can think of management-wise until we have to make the owner make a decision.

Re: Help with managing a difficult case...

Emma Purnell — Thu, 08 Dec 2011 18:34:26 GMT

It is a struggle to keep in place, we are currently getting the owner to try a padded tubigrip just to see if that works any better. We have injected it with steroids today to see if we can get the swelling down, but we are reaching end of the line and don't want to admit it until we must!

Re: Help with managing a difficult case...

F1chick — Thu, 08 Dec 2011 18:33:48 GMT

I know removal is too complicated, but maybe debulking and treatment from there?

Re: Help with managing a difficult case...

Dippy — Thu, 08 Dec 2011 18:30:15 GMT

Could you make some sort of legwarmer type thing from a boot ie if his toes don't need to be covered, somehow adapt a boot/sock by cutting the foot part off if he needs a bigger size to cover the lump but then the foot's too big? Mind you, looking at the way it sags downwards, I suspect it would be hard to keep in the right place!

Re: Help with managing a difficult case...

Emma Purnell — Thu, 08 Dec 2011 18:23:31 GMT

I know which you mean!

I think from chatting with the owner that it seems to be less him traumatising it and more him catching it now it is so big. It has been there for over 12 months with no trauma from him before, it is only now ulceration is an issue.

Re: Help with managing a difficult case...

Dippy — Thu, 08 Dec 2011 18:19:37 GMT

PS Kind of looks like a tyre if that helps!

Re: Help with managing a difficult case...

Dippy — Thu, 08 Dec 2011 18:19:15 GMT

What about those collars which do the job of an Elizabethan but are thick, leathery padded stuff? They're more comfy for long term use and don't restrict vision as they just sit around the neck but might stop him being able to get at it (possibly). Not sure what they're called or who makes them though!