Browsing tag: operation

Skitzo under anaesthetic, showing the tumor on the edge of his bottom eyelid

Vets are very used to dogs, cats and small furries developing growths on various parts of their anatomy. We very often take a small sample of the growth by means of a needle (known as a fine needle aspirate or FNA) before deciding what action to take. In most cases the growth is removed surgically.

Skitzo was a 9 year old cat with something of an attitude to being handled by vets (and sometimes his owner). A fast growing lump had come up beneath his right eye and was very close to the edge of the eyelid. A fine needle aspirate was impossible in this case without him being anaesthetised so we decided to remove the lump and send it off to the lab for the pathologists to tell us what tissue type we were dealing with.

The most important thing they can tell us is whether the tumour is benign or malignant. Sometimes growths can seem to be benign but still cause problems by recurring in the same place they were removed. The worst type of tumour is one which is malignant and which has the potential to spread (metastasise) to the lungs or other organs via the blood stream.

Skitzo’s tumour was a surgical challenge because it was so near to the margin of the eyelid. If too much tissue is removed, the lower lid will turn outwards (called ectropian) leaving a gaping pocket and encouraging infection, inflammation and an overspilling of tears. On the other hand, cutting too close to the growth risks tumour cells being left behind and the growth returning very quickly.

Skitzo after the operation, still under anaesthetic

 
Dissolving stitches were used because Skitzo was never going to let us take them out when he was awake. We fitted him up with an Elizabethan collar so that he could not scratch or rub the stitches out. The plastic collars look unwieldy and owners are often tempted to take them off as soon as they get home but most animals adapt to them very well and it’s only a relatively short time before the stitches are removed and life returns to normal. Nylon stitches are usually removed in 8 to 10 days after the operation but this can be extended if the skin is especially thick, under tension or if the animal is receiving steroid treatment.

Skitzo’s tissue sample came back as a benign growth and there is every prospect that the surgery has been a complete success. Fortunately Skitzo’s pet insurance company paid the bill for the surgery and the laboratory tests which were needed.

If you are concerned about lumps or any other problems with your cat, please contact your vet or use our interactive Cat Symptom Guide to help you decide what to do next.

Gizmo and his vet, Reg.

Gizmo was a lovable cat who had been known to the practice for many years. He was one of those vocal Orientals who sounded like a baby crying. In fact he had reached the tremendous age of 21 years with no major health problems until his teeth started to loosen and he had difficulty eating.

We are always extremely cautious with giving anaesthetics to aged cats so we took some blood tests for organ function which came back completely normal. He came through his dental with flying colours.

A couple of months later he came back with a very painful leg, swollen around the left knee (stifle). When we X-rayed the leg our worst fears were confirmed: Gizmo had bone cancer. We took further X-rays and there was no sign of spread to any other part of his body.

Bone cancer in dogs is highly malignant and has often already spread by the time the diagnosis is made. Although chemotherapy and amputation are options, survival time can be very poor.

Cats are a slightly different proposition and their form of bone cancer (osteosarcoma) tends to stay more confined and is slower to spread.

My instinct with Gizmo being 21 was to recommend him being put to sleep but his owner was determined that we should do everything possible for him providing that he did not suffer. Prior to the surgery we were having great trouble keeping Gizmo free of pain and at home he was on strong oral pain relief every couple of hours. I agonised over the decision to operate but was eventually persuaded to go ahead by his owner’s dedication to him and the fact that Gizmo behaved like a cat half his age.

Gizmo after amputation of a hind leg.

The surgery went well and Gizmo recovered very quickly and was much more comfortable with the leg removed and surprisingly mobile. He lived on for another seven months when unfortunately the cancer returned in his pelvis and reluctantly at this point we had to admit defeat.

Looking back, my colleagues thought I had lost my reason undertaking this surgery on such an old cat but I think the extra quality of life which Gizmo went on to have justified going ahead. Anaesthetics and pain relief are so much better these days than they were twenty years ago. He was certainly one of those cats who seemed to inspire the old folklore about a cat having nine lives and he will never be forgotten by all of us who knew him.

If you are concerned about pain, swelling, lumps or any other problems in your cat, please contact your vet or use our interactive Cat Symptom Guide to help you decide what to do next. For more information about insurance which could ensure the cost of operations like this one are covered, please see our pet insurance pages.

Rusty with his Vet

Young Rusty the Cavalier King Charles Spaniel had an embarrassing problem. Everything was going well until he started to cock his leg at about five months of age. Instead of watering the local lampposts, Rusty had a problem which meant he urinated on the underside of his body and under his armpits. He was now over a year old with no sign of things getting better.

His owners were becoming very distraught about the problem. It meant Rusty had to be bathed at least once a day and his skin was starting to get sore where it was constantly wet. Something drastic had to be done. We all scratched our heads in the practice. Rusty had no illness problems and all his nerve reflexes were fine but he just seemed to slightly arch his back when he had a pee and everything went skywards.

I consulted a soft tissue specialist in Bristol and he said that he had only seen one other case which took two operations to correct. He talked me through the procedure and said that he thought it was something we could do without the need for referral to a specialist centre.

The result of Rusty's operation.

The plan was to close up the hole where Rusty normally peed and make a new hole a little further back but pointing downwards. Technically it’s known as a prepucial urinary diversion operation.

It’s always a little daunting to be doing an unfamiliar operation but the surgery went very well. Rusty seemed very comfortable at his three day post op check and had started to use the new hole almost immediately after going home. His owner was delighted. He even got used to wearing his Elizabethan collar whilst his stitches healed.

On the first trip up the road, Rusty cocked his leg against a car wheel which made a metallic ping when he hit the hub cap. He was so surprised, it made him jump! Now Rusty is marking his territory just like nature intended and we are all delighted.

Joe Inglis BVSc MRCVS is the vet for the One Show, This Morning and BBC Breakfast. He runs his own line of natural pet food called Pet’s Kitchen

I often find myself sympathising with my patients, and feeling for their distress and pain when they are suffering from illnesses or injuries – and never more so than when their problem involves their eyes. There’s something about injuries and diseases of eyes that really affects me more than almost any other type of problem and I can really empathise with how my patient must be feeling. Having an ulcer or other injury to an eye must be horribly painful, not to mention the psychological impact of dealing with the loss of some or all of your sense of sight.

When Sylvester the cat came into the consulting room last week and clambered miserably out of his wicker basket, my heart sank and I felt an immediate sense of shock and distress when I saw his problem. His left eye was barely recognisable, with a large grey ulcer dominating the cornea and angry red blood vessels invading the usually clear surface of the eye from the sides. This was not Sylvester’s first visit to the surgery for this problem, but it was the first time that I’d seen him, and I immediately knew that we needed to do something drastic if we were going to save his eye – and bring his obvious suffering to an end. Looking at his records it was clear that this ulcer had been grumbling on for a couple of weeks by this stage, and despite ongoing treatment with medicated drops it was getting worse rather than better.

At this stage we had a couple of options to consider. One was to refer Sylvester to an eye specialist, but this was quickly ruled out by his owner on the ground of cost and lack of pet insurance cover. The second option would be to continue with medical therapy, taking a swab to find out exactly which bacteria were causing the ongoing damage and preventing the ulcer from healing and potentially changing the eye drops once these results were known. The downside of this course of action was that it would do little to alleviate Sylvester’s discomfort in the short term, but after talking to his owner and explaining that the only other option would be surgery to remove the eye, we agreed that we would try this first.

So I took a swab from Sylvester’s eye and sent it away to the laboratory to see what they could tell us about the infection. While we waited for the results we did what we could to manage Sylvester’s discomfort with painkillers and anti-inflammatories, and then as soon as the results were in we started him on an aggressive course of antibiotics that were targeted specifically at the bacteria the swab had isolated. At this stage I was still optimistic that we could save Sylvester’s eye, but unfortunately things didn’t work out as planned and despite our new treatment regime, the ulcer stubbornly refused to respond and after a week of treatment it became clear to me that we were left with only one option – to remove Sylvester’s eye.

Breaking this news to his owner was not easy, but she did appreciate that it wasn’t fair to let him continue to suffer as he was doing given the now very slim chance that we would be able to save his eye. After a couple of long – and emotional – consultations, we agreed to go ahead and last Friday Sylvester came into the surgery for his operation.

Sylvester the cat under anaesthetic after the operation to remove his eye

Removing an eye is an operation I really don’t enjoy, as I can’t help but really feel for the poor animal that is losing such a crucial part of their anatomy, and the operation itself is also technically tricky and pretty gruesome. Sylvester’s operation went as well as I could expect, but it was not one that I finished with a sense of satisfaction – I felt good that we had brought Sylvester’s suffering to an end, but I also felt as though we’d failed him by having to resort to such a procedure.

If you have any concerns about your cat’s eye please contact your vet or use the interactive cat symptom guide to help you decide what to do next.

One of the most common problems small animal vets see in dogs, almost daily, is anal gland trouble. Although cats have anal glands too, they rarely cause trouble.

All dogs have two anal glands (or anal sacs) situated just inside the rectum, one on each side. The cells which line the glands produce a foul-smelling substance which dogs use as a territory- marking device. When the dog passes faeces, the anal glands get squeezed and the scent is deposited as well. The normal anal gland is about the size of a pea in a small dog or a grape in a larger dog, depending how full it is. The anal gland secretion travels down a short tube or duct to enter the rectum. It can be liquid or more like a paste in texture.

The arrows show the position of the anal glands

When everything is working properly, the anal glands empty naturally and cause no trouble. Unfortunately it is quite common for the glands to become over-full or for the duct to become blocked, and then they cause discomfort. When they do not empty naturally, they are described as impacted and the condition is called anal gland saculitis. The dog will then try to lick at the area or will “scoot” their bottom along the ground in an attempt to relieve the irritation. This may well make things worse and allow infection to enter, leading to an abscess. If things get this bad, the main sign will be pain, or a blood-stained discharge if it bursts.

Dogs who suffer from this problem regularly will tend to show similar symptoms each time. As well as scooting or licking under their tail, dogs which cannot easily reach the area may chew themselves on their back or their feet instead. Sometimes the first sign of trouble is a distinctive and very unpleasant fishy smell. Owners will usually recognise the signs in their own dog and have the glands emptied promptly by their groomer or vet.

Luckily the anal glands can be emptied fairly easily once the knack has been acquired, and as long as there is no infection present, this will be all that’s necessary. If an owner feels confident to do this job themselves, they could ask the vet to show them how to do it. It is not the nicest job in the world, because of the smell and because of the uncanny ability of the contents to squirt in unexpected directions! On the other hand, it is quite rewarding to bring almost instant relief to the dog in most cases.

If an abscess forms, it may have to be lanced and flushed out, and antibiotics will be needed. Pain-killers may also be advised as an abscess is very painful.

When anal glands cause repeated problems it is sometimes advisable to have them surgically removed under anaesthetic by your vet. Like any other operation, the advantages of this type of surgery need to be weighed up against the possible risks. It would not be recommended in cases where symptoms are mild and easily sorted out by manual emptying.

Prevention may be possible by changing the diet or increasing the amount of fibre to make the dog’s stool firmer, for example by adding bran to the diet. Anything which causes a soft or runny stool can cause anal gland problems.

Further advice can be obtained from your own veterinary surgery.

Jenny Sheriff BVM&S MRCVS

Joe the TV vet performs difficult pelvis surgery on a cat.

Cats lead dangerous lives, dodging traffic, fighting over territory and being chased by dogs, so it is not surprising that we vets spend a reasonable proportion of our working lives patching up the results of their adventures. Whether it’s repairing serious damage caused by road traffic accidents, or patching up less severe injuries from bite wounds, cats that have been in the wars certainly keep us vets busy everyday of the week.

Most of the time these injuries are not too severe – cat bites, and bruises and strains from over-energetic leaping and climbing usually heal well and require nothing much more than antibiotics and painkillers to help the cat recover. Sometimes, however, cats are less fortunate and that is when things get much more serious and the outcomes can be less positive. Road traffic accidents are by far and away the main cause of these more serious injuries, and repairing the damage that a tonne of car can do to 5 kilos of fragile cat can be a very involved and difficult process.

Thankfully there are now many highly specialised vets who can offer amazingly hi-tech operations and treatments that can quite literally put broken cats back together. A friend of mine from university, Toby Gemmill, is now an eminent orthopaedic surgeon in Birmingham and I truly believe that provided the pet’s head and chest are in one piece, there’s not much he couldn’t put back together successfully. Using all manner of techniques, including external fixators (metal frames that hold shattered legs back together from the outside rather than the inside), bone grafts and much more, vets like Toby can work wonders on even the most severely injured animals.

There is a problem though, and that’s the age-old issue of money. The state-of-the-art treatments that Toby and other orthopaedic vets carry out are understandably expensive with costs often reaching many thousands of pounds. This puts them out of the reach of many pet owners, unless of course they have pet insurance, leaving them faced with some very difficult decisions – should they try to beg, borrow or steal the money required for a potentially life-saving operation? Or should they simply call it a day and opt to have their pet put to sleep? These are terrible decisions to have to make, and it is one of the reasons why vets like myself, who are general practitioners rather than specialists, end up tackling complex operations that are well outside our comfort zone.

Take Portia the cat underneath the drapes in this picture for example. She was hit by a car and suffered severe injuries to her pelvis and back legs, and required a major orthopaedic operation if she was going to have any chance of surviving. However, her owner had no pet insurance and could not afford to consider visiting a specialist – but she was desperate to try and save her beloved cat, so I offered to try my best and have a go myself.

The operation Portia required was something I have attempted before, but it really is not something I’m that comfortable with, so it was a very long and stressful operation. The end result was pretty good – definitely not as good as if Toby had done the procedure, but a whole lot better than nothing and I think there’s every chance that she will pull through as a result. In fact it’s me that I’m more worried about – I need a stiff drink and a lie down to recover from the stress!

Joe Inglis BVSc MRCVS is the vet for the One Show, This Morning and BBC Breakfast. He runs his own line of natural pet food called Pet’s Kitchen