Cancerous Eye

Good week for reader questions! Here's one from Darlene.

Our cat, Tig, is a 13 year old (indoor only) domestic short haired cat. She has been in very good health until the last month or so. We began to notice the color of her iris began to get darker. In addition, sometimes her pupil began to stay open wider than the other pupil in the other eye. She has not shown any signs of pain. She does not wash that eye anymore and will let you pet her face near that eye. We recently took her to the vet to be examined.
They informed us she likely has an iris melanoma with glaucoma in that eye. They have recommended she have an enucleation procedure performed. They would have the eye sent to UGA to see if the tumors in the eye were Cancerous. We have become more comfortable with the removal of her eye. However, we are very concerned that if it is Cancerous, has it spread to her other eye or any other part of her? This has all happened so fast with the change in eye color just in a month so we are very concerned if it is cancer and if the cancer has spread.
Is there a way to screen her for cancer to find out if it is through out her body? I have attached her photograph. Sadly, if she does have cancer in the rest of her body we would not like to put her through the procedure removing her eye and the cost to us for only extended her life briefly.


All good questions, Darlene. I didn't include the pictures in this post because they weren't as clear as I would like, and it's hard to tell as much as I would like. But I can see some potential issues, including the darkening of the iris.

It wouldn't be possible to tell 100% for certain that this is a melanoma without sending tissue samples off, though this certainly sounds and looks like the main possibility. If a tumor is growing on the iris it can affect the outflow of fluid from the eye, leading to glaucoma. Glaucoma by itself is pretty serious and can lead to permanent blindness as well as being painful. Add a likely tumor to the issue and you have a bad situation. Either one of these problems alone could warrant removing the eye, and when you combine them the best solution is to have the surgery done.

Pets do very well with only one eye. It's a bit harder for cats because of the loss of depth perception, making it harder for them to judge distance when they're climbing and jumping. But they quickly learn how to compensate and live with the difference. I've removed many eyes myself, and certainly think it's a valid procedure and better than the alternative.

So let's talk about the other concern. What about metastasis (spread to other locations)? This is a valid question, and one that should be examined. However, there is no way to be completely certain that a tumor hasn't spread. All you can do is your best due diligence, examine as much as you can, and pray that there isn't anything hidden. Some tumors are small enough that we can't detect them with any means, and there aren't simple blood tests for most forms of cancer. In a situation like this you want to perform a full blood chemistry and blood cell count, looking for signs of organ abnormalities and alterations in the white blood cells. You also want to do chest radiographs as the lungs are a common place for tumors to spread. If these tests are normal, you've done the best you can to screen for cancer outside of going to a specialty clinic and having a CT or MRI performed on the pet.

If there are abnormalities, especially tumors in the chest, I would agree that major surgery like enucleation wouldn't help improve longevity and would be unnecessary. If everything is normal, I would recommend having the surgery done as soon as possible. There will always be the chance that something was missed on the screening and you may have tumors appear later, but that's a risk that everyone takes when dealing with cancer.

I hope this helps with the questions. Good luck!

Painful Swallowing

Here's a case sent in by Kristin...

I have an 8 month old Maltipoo that I rescued 4 months ago. He was late getting his shots because the previous owners did not give him his shots. He has had his 6 in 1 shots but has not received Bordatella because I thought it was included in the 6 in 1.

Recently he has been sick. Slight cough, slight fever so I took him to the vet and he has been on antibiotics for approximately a week.
Nothing too abnormal about this scenario so far right? Well, here is where it gets interesting.
I told the vet the first thing I noticed about him being sick was an unusual behavior. When he would attempt to eat he would extend his front left leg out in front of him and whine in pain. He went off his feed entirely just prior to me taking him to the vet for about 3 days. The vet prescribed him doxycycline twice a day and he seems better in the sense that he is not lethargic, wants to play. However he still does not want to eat and still exhibits discomfort when he does try to eat.

I know you say its unlikely he would have anything stuck in his throat-as did my vet but he is acting normal with exception to this behavior and he refuses to eat. Whenever he does attempt to eat he extends that front leg and it seems painful to him. I've tried force feeding him baby food, canned food and soft table scraps. He wants to eat but then he remembers that its going to hurt and only eats a very little when hes practically starving.

If he did have kennel cough, wouldn't a weeks worth of doxy get him back on track-why is he still experiencing pain? Any thoughts, advise or experience you may have had with these symptoms would be so greatly appreciated. 

This doesn't sound like kennel cough to me, though I can't say for certain without having seen the patient.  Kennel cough normally causes a dry, resonant cough that can be easily stimulated with palpation of the trachea.  Doxycycline is a great antibiotic for this kind of infection, though it can take 10-14 days to fully resolve a case.  The pain and odd behavior that you describe isn't something that we see with kennel cough or other respiratory infections.

I'm a bit puzzled as to what could be causing the behavior based only on the description.  It sounds like there is pain in swallowing, which may be related to a problem in the esophagus. I would want to rule out some kind of stricture or narrowing of the esophagus, which can be very difficult to determine in a general practice.  The two best ways are with an endoscope or fluoroscopy.  Fluoroscopy involves a moving x-ray taken while a pet is in the act of swallowing, and requires special radiology equipment that you won't find in a private general practice.  Some veterinarians do have endoscopes, so this might be another option.

However, a simpler option could be pain from an inflamed throat or esophagus, similar to what happens to us when we have a sore throat.  This should improve with antibiotics, though it may take longer than a week.  Analgesics or steroids prescribed by your vet could also help.  I would recommending talking to your vet about this option first, and if you don't start seeing results within a few days look into further diagnostics.  Keep in mind that such diagnostics may involve being referred to a specialist and will not be cheap, but at the same time he can't go for long without eating easily.

Make sure to do follow-ups with your vet.  Good luck!

Chupacabra Revealed

Here's a story that's perfect for Halloween.

For those who aren't into cryptozoology, the chupacabra is a creature seen in parts of the Americas that has a legendary status similar to Bigfoot and the Loch Ness Monster. The name literally means "goat sucker" based on its behavior of drinking the blood of goats and other farm animals. The Wikipedia entry on chupacabras lists the following description:  
The most common description of chupacabras is a reptile-like being, appearing to have leathery or scaly greenish-gray skin and sharp spines or quills running down its back.This form stands approximately 3 to 4 feet (1 to 1.2 m) high, and stands and hops in a similar fashion to a kangaroo. In at least one sighting, the creature was reported to hop 20 feet (6 m). This variety is said to have a dog or panther-like nose and face, a forked tongue, and large fangs. It is said to hiss and screech when alarmed, as well as leave behind a sulfuric stench. When it screeches, some reports assert that the chupacabras' eyes glow an unusual red which gives the witnesses nausea.

Here are some images of what the chupacabra is supposed to look like...

There is no scientific proof for this creature, though biologists and other scientists have tried to prove or disprove its existence.  As shown in a recent Discovery News article, most mainstream scientists believe that sightings of a chupacabra are actually a case of mistaken identity with the actual creature being an extremely mange-ridden coyote or wild dog.  Compare the images above to the pictures and video capture below.

I've always had a passing interest in cryptids, having learned a lot about the Yeti and Sasquatch as a child and having been to Inverness and Loch Ness as a teenager.  Besides my interest in the fantastic and mythological, I also find these creatures intriguing because of my background as a biologist and veterinarian.  In the case of the chupacabra, the thing that fascinates me the most is that the type of mange scientists believe are affecting these canids is scabies (Sarcoptes scabiei).  I've treated many cases of these mites!

This is actually a not-uncommon external parasite of dogs and can affect pet dogs.  In the huge majority of cases the pets see us vets long before they get to the point of complete baldness, as the mite causes intense itching.  It's also a mite that is relatively easy to treat through several methods and is not considered a major health concern. Yet in wild animals the mite can lead to severe skin disorders and even death due to weakness and secondary infection.

Does the chupacabra actually exist?  My instincts say no, though I'm sure there are cryptozoology aficionados who can argue otherwise.  Other cryptids?  I think the jury is still out on some of them.  And frankly, I like the idea of there still being some mysteries left in the world.  It keeps things from being too boring.

Happy Halloween!

A Little Stardust

A new adventure has begun in the life of the Bern family.  Today we brought home our new puppy.

After losing our dog, Guinevere, to lymphoma in the brain back in August, my wife had been wanting to get a new puppy that she could bond with and have as a snuggle-buddy.  Last month we found a Labrador retriever breeder that had a litter of puppies born September 15th.  My wife picked one out, we waited until she was old enough, and today we brought her home.

Little Yvaine (pronounced "ee-vane"; "Evie" for short) is named for the female lead in the movie Stardust.  Played by Claire Danes, Yvaine is a living star that falls from the sky and is discovered by a young man named Tristan who has left his home to recover the fallen star for the woman he thinks he loves.  Yvaine and Tristan go on an adventure as he brings her back, and the two end up falling in love.  It's a great fantasy and romantic comedy, one which I would recommend to anyone who likes happy endings.  And Robert De Niro has a very memorable role as a tough skyship captain who has a secret affinity for frilly dresses.

Our Yvaine slept the whole way home and has had the typical puppy pattern of moments of playfulness interspersed with deep sleep.  She is a really sweet girl but with a bit of a rotten streak.  She is pretty courageous, already having dared going up and down the stairs at our house, something other dogs have taken months to master.  Right now we're trying to get her to calm down enough to go to sleep, and it's a bit of a challenge.

The cats are avoiding her so far, and don't seem too eager.  Our oldest cat, Pooka, isn't as upset as we thought he would be, as this is the third dog that has been brought into his house during his lifetime. Maybe he's getting used to it.  Our other dog, Inara, was eager but unsure at first.  She is still very curious and is starting to play, though Yvaine startles her a bit at times.  Once Inara gets used to the newcomer, I can see them terrorizing the house with their play.

The kids are pretty obsessed with her, which is understandable right now.  As is typical for children their age, they're arguing over who gets to pet her or feed her.  But they are responsible kids, and it's always been important to me that they learn how to properly handle and care for pets, so I know they'll settle down into a normal pattern within a week or so.  By then my son will be back to his video games and my daughter will be tired of cleaning up puppy poop.

My wife is thrilled.  After all, this is her baby, and something she really wanted.  Yvaine is already bonding with her and I came home from shopping this afternoon to find the two of them curled up next to each other on the bed taking a nap.  She's going to spoil this little girl, but I must say that I love seeing the glow in her face when she kisses the little puppy's nose.

And the adventure begins again.  Housebreaking, obedience training, dealing with a whining puppy, handling her chewing on things she shouldn't, cleaning up messes....all of that over again.  But it's worth it to have the little bundle of fur cuddle next to you and see those deep brown eyes.

Yodeling Veterinarian?

For those who aren't familiar with VeggieTales, let me give you a little peek.  Created as a children Christian video series, the appeal of the CGI cartoons has reached the mainstream.  Besides the Biblical lessons and values they are also just fun and entertaining.  One of the key features in all of the videos is "Silly Songs With Larry", one of the main characters, who happens to be a cucumber.  These silly songs are just for fun and can make even adults laugh.

A few years ago they produced one Silly Songs entry about a veterinarian.  Of course this caught my attention, and since then it has become one of my favorites.  Enjoy!

Questionable Anal Mass

Gayle sent this in...

Bandit has always been a healthy Dog!!

but recently he has developed a problem there is a round marble size blood red thing that keeps coming out of his anas he 's not able to have a bowel movement my husband keeps pushing it back in and Bandit seems very happy for the help lol but I'm worried and normally would have him at the vet but we have been out of work for 6 months we have to wait for some money to come in please tell me what this could be and where i can do some research on it thank you so much 

 

Gayle, I know these are financial hard times for many people, but this is something you really need to see a vet about as soon as possible.  If he is having problems defecating it can be a very serious problem. Several things could be the cause, including a hernia, rectal polapse, polyp, or tumor.   If it's a tumor it or hernia, it would need to be corrected as soon as possible, and would require surgery.  Without actually seeing the pet I couldn't be more specific than this.

Earlier this year I had a similar problem in a patient.  There was some bleeding from his anus and we thought it was colitis or a similar problem that would cause blood in the stool.  The owner thought they had seen a small mass, but I had done rectal exams and not found anything.  One one follow-up visit they brought some pictures of the strange mass, taken on their cell phone camera.  It was definitely a polyp of some sort, so I did another rectal exam.  This time since I had an idea of what to look for I was able to feel a very small mass on the "roof" of the rectum that could be easily pulled outwards with my finger.  It was a soft mass and almost blended with the rectal wall, which is why I had missed it before.  We scheduled surgery and I was able to remove the polyp without complications.  It was a benign growth and healed normally.

I know this is a difficult financial time, Gayle, but not being able to have a bowel movement is a serious problem and you need to see a vet this week.  Good luck.

Yes, Males Have Them

One of my favorite humorous web sites is Not Always Right. Today I came across this post under the title "Nip-Picking".  Though I've not dealt specifically with this situation, the idea of males having nipples seems to be a strange concept for many people to understand and I've certainly had to try to convince clients of this biological fact..  Enjoy this real-life encounter.

Nip-Picking

Vet | Ontario, Canada

(A customer brings her dog to the front desk in a panic.)
Customer: “My dog has fleas, so I need you to help me. I have been using the flea medication you gave me, but I can still see flea eggs.”
Me: “Ma’am, you can see flea eggs?”
Customer: “I have been trying to pick them off, but they seem to be stuck.”
Me: “Ok, can you show me the eggs you have been trying to pick off?”
(Customer lifts up the dog to show me it’s belly.)
Customer: “See! These!”
Me: “Ma’am, those are not flea eggs, they are his nipples.”
Customer: “Nipples? But he’s a male, how does he have nipples? They have to be flea eggs.”
Me: “I assure you, he has no fleas, and the ‘eggs’ you have been trying to pick off are in fact his nipples.”
Customer: “Get the vet, you don’t know what you’re talking about, he’s a male! He can’t have nipples.”
Me: “Ma’am, do human males have nipples?”
Customer: *stares blankly for a moment* “Well s***!” *walks out*