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Tag: biopsy

  • Challenging Shar Pei dermatology cases

    Shar Pei
    Shar Pei’s are special – dermatologically speaking. Photo credit: FreeImages.com/Renxx Gmdr

    I recently saw a challenging dermatology case involving a 14-month-old Shar Pei bitch. (more…)

  • Don’t remove a mass without knowing what it is

    I came across a paper that advised we should know exactly what a mass is before surgery. The rationale being as follows (Ettinger, 2015):

    “Do something: aspirate or biopsy, and treat appropriately.

    Needle biopsy
    Vet performing a needle biopsy on a cocker spaniel. Image ©iStock.com/Paolo_Toffanin

    “Why diagnose early? Obtaining a definitive diagnosis with cytology or biopsy early and before excision will lead to improved patient outcomes for superficial masses. Surgery is likely curative for the majority of superficial tumours when detected early, when they are small – especially benign lesions and locally invasive tumours with a low probability of metastasis. If tumours are removed with complete surgical margins, the prognosis is often good with no additional treatments needed.

    “Pet owners need to be aware of the ‘pea’ size requirement to have masses evaluated, and veterinarians must measure and document the size of the mass to compare growth.

    “If more than 1cm (or the size of large pea) and present for a month, the mass should be aspirated or biopsied.

    “Knowing the tumour type prior to the first surgery will increase success of a curative-intent surgery.”

    In all honesty, I rarely do this for masses booked in for surgery and I suspect as lipomatosus, and for masses that visually appear consistent for histiocytoma – but there are tips here I will follow in the future.

    Reference
    Ettinger S (2015). Top Ten Oncology Mistakes and How to Avoid Them, North American Veterinary Conference: Small Animal & Exotics Proceedings, Gainsville, Florida.

  • Ticarcillin as a treatment for Pseudomonas otitis

    Pseudomonas aeruginosa otitis externa
    Greenish purulent discharge accompanied by crusting, erythema and punctuate ulcerations in a crossbreed affected by Pseudomonas aeruginosa otitis externa, secondary to an adverse drug eruption. Image source: Veterinary Times 45.01 (Jan 6, 2014) – “Otitis: a diagnostic approach” by Filippo De Bellis.

    I suspect we have all come across that tricky Pseudomonas otitis case that just seem to refuse to completely respond to antibiotic therapy in spite of extensive investigation for underlying causes.

    I had just one such case recently that, in spite of culture and sensitivity, blood work, skin biopsy, extensive flushing, lack of response to licensed products (and so on), just refused to respond.

    A quick look through one of my trusty text books* suggested Ticarcillin.

    Ticarcillin potentiated with calvulanic acid (Timentin) is an extended spectrum penicillin that often has good activity against Pseudomonas. The 100mg/ml antibiotic solution can be applied directly to the ear canal as a drop.

    The case I’m treating has responded really well.

    * Reference: Hill, P.B. (2002) Small Animal Dermatology: a practical guide to the diagnosis and management of skin diseases in dogs and cats. Butterworth-Heinemann. London.

  • When is a lipoma not a lipoma?

    Fine-needle aspiration (FNA).
    Fine-needle aspiration (FNA) of a mass. Image source: BSAVA ’09 Congress Times.

    We recently had a case where a freely mobile, soft mass on the ventral abdomen, which had been present for a number of years, had started to get larger.

    We carried out a fine-needle aspiration (FNA) biopsy, and I fully expected this to confirm the presence of a lipoma (a benign fatty tumour common in dogs).

    However, I was really surprised when the cytology revealed the presence of a mast cell tumour, with a surgical procedure to follow.

    My tip would be that it is definitely worthwhile checking out those seemingly innocuous “lipomas” with FNAs.