Patient of the Week candidates for March 22 through March 26:

Last week was a close one for awhile, but Belle ended up POTW with 48 votes, Congratulations!  The week of the 22nd through the 26th was a short week, but the babies in question are below. 

Vote to the right, to the right ~~~>>

CASE STUDY:

Lola is an English Bulldog.  She weighs 10# and is 2mo old.  Dr. Bob Mills with North Arkansas Veterinary Clinic referred her to us for Upper Airway issues.  Dr. Mills identified stenotic nares and elongated soft palate.  Lola had previously responded well to steroid and antibiotic therapy.   Upon Dr. Dew's examination, she exhibited moderate stridor at rest, and her nares collapsed. Radiographs demonstrate mildly hypoplastic trachea.  Dr. Dew discussed hypoplastic trachea, stenotic nares and elongated soft palate with her owner.  He decided to proceed with nares revision and soft palate reduction.

TREATMENT:
Dr. Dew used an oral approach for Lola's surgery.  Her soft palate was reduced to the level of tonsilar crypts, and on her nares he performed wedge reduction naroplasty.  Lola's prognosis is good for recovery from the procedure, uncomplicated healing and improved respiratory function.  Exercise restriction will help facilitate an uncomplicated recovery.

CASE STUDY:
Duncan is a 42# 7yr old West Highland White Terrier.  Dr. Scott Hollensworth of Springhill Animal Clinic sent him to us for a hemi maxillectomy.  Radiographs taken previously did not demonstrate any evidence of pulmonary metastasis.  Osteolysis/osteoproductive changes were noted on maxilla and rostral zygomatic arch.  Duncan's owners wished proceed with partial hemi maxillectomy.
TREATMENT:
Dr. Dew used an intra-oral approach for this surgery.  The tumor tissue extended full thickness through hard palate and lateral maxilla, and there were periosteal changes on the zygomatic arch.  Tumor tissue also extends to medial canthus.  The tumor was excised en block with 1mm margins obtained at ventral border of eye and medial canthus; otherwise 3-10mm margins soft tissue and bone.  The maxillectomy was from the canine root to the rostral border of the zygomatic arch.  All tissue was submitted for histologic assessment to the Arkansas State lab.  Duncan's prognosis is good for soft tissue healing from the sugery.  Due to the aggressive nature of the tumor, size, and location there is little doubt that recurrence will be seen.  However Duncan should be much more comfortable during this time.

CASE STUDY:
Ginger is an 11# 3yr old Dachschund.  Dr. Susan Belt at Benton Veterinary Hospital is her referring veterinarian.  Six weeks previous, Ginger had an acute onset of left rear paresis, and responded well to prednisone and rest.  3-4 days previous to referral to Dr. Dew, she exhibited bilateral rear limb weakness.  Prednisone was re-instituted with no response, and her ambulatory function continued to decline.  Upon examination by Dr. Dew, she was unable to move her back limbs at all.  She is at Grade V rear limb paresis, panniculus localizes lesion to T9.  Dr. Dew discussed the severity of Ginger's clinical presentation.  Surgery would be of benefit to decompress the cord, prognosis for improvement 30-65%.  Her owner decided to proceed with myelogram and hemilaminectomy.
TREATMENT:
Myelogram:  Dr. Dew administered 2 lumber injections, each of 2.5ml iohexol, and loss of columns at T11-12 and T8-9 were observed.  He then called and discussed these findings with Ginger's owner.  It was advised that surgery would be beneficial, but due to multiple lesions and clinical signs, prognosis is poor to guarded for return of ambulation until improvement is noted, she wishes to proceed with hemilaminectomy.
Hemilaminectomy:  Dr. Dew used a Left dorsolateral approach.  He observed cord swelling and chronic disc protrusions at each site.  There was also a loss of epidural fat in the affected areas.  Disc material was removed, the canals explored.  Ginger's prognosis is good for healing and improved neurologic function. A transient worsening of neurologic function can be noted after a myelogram and surgery.  This condition will usually resolve to the pre-operative state in 3-10 days.  The nervous system is very slow to heal. Improvement can be expected for up to 5 months.  Nursing care, physical therapy and exercise restriction all play critical roles in avoiding complications and aiding recovery.

CASE STUDY:
Cosmo is a Brussells Griffon.  He is 4yrs and 3mo old and weighs 24#.  Dr. Allison Patchell of Patchell Veterinary Clinic referred him to us with a history of recurrent urethral calculi, and at the time of his exam was only able to dribble urine.  Dr. Dew discussed a scrotal urethrostomy, cystotomy and stone analysis, recovery and prognosis.  Cosmo's owners wished to proceed with surgery.
TREATMENT:
Dr. Dew used a ventral celiotomy approach for Cosmo's surgery.  He observed that the stones were spiculated, urethra adequate lumen at level of urethrostomy.  The urethrostomy was at 1.5cm in length, Dr. Dew lavaged the bladder and urethra, and submitted the stones for analysis to the Arkansas State Lab.  Cosmo's prognosis is good for healing and recovery from the surgical procedure.  Cosmo should have a significantly easier time urinating as a result of the surgery.  Uncomplicated healing will be facilitated with exercise restriction and the use of the e-collar.

 

CASE STUDY:
Chugalug is a 137# 1yr old St. Bernard.  Dr. Claire Kelly at Edwards Veterinary Clinic referred him to us for a hygroma on right elbow.  It had been drained repeatedly but still recurs.  Upon examination, it is a fluid filled mass over the right calcaneous,a nd is 6cm in diameter.  Dr. Dew explained the nature of hygromas in young dogs, suggested surgical excision and closure of joint capsule.  His owner decieded to proceed with removal.
TREATMENT:
Dr. Dew used a lateral approach for Chugalug's surgery.  Also identified a defect in his joint capsule.  The hygroma capsule was excised and the joint capsule defect was closed.  The prognosis for Chug is good for normal soft tissue healing.  Exercise restrictions must be followed to maximize the prognosis for uncomplicated healing.