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Things are not always as they seem
Leah is a 12year old female black Labrador who has been a patient with us for 10 years. Initially trained as a guide dog, she was rejected from the program because of fainting attacks. Even the Veterinary Specialist Group (VSG) in Auckland could not find an answer.
She retained her good health and immaculate good manners; we only saw her for the usual Labrador indiscretions of eating things she shouldn’t, like packaging and diabetes medication, a urinary tract infection, skin spots and a neck swelling that was diagnosed as a cyst (fluid filled swelling). Then a lumbar disc problem occurred. This caused lots of wobbliness and stiff hind legs which brings us to the incident of sudden collapse one evening.
During her usual walk around the local park, Leah’s hind legs became tangled, and she fell and was unable to get up. Unlike her fainting in her younger days, Leah did not recover. Her owner noticed something stuck in her throat which appeared swollen Her breath was harsh sounding labored and noisy.
Rushed into the clinic as an emergency, the considerable swelling under her tongue and throat looked like a hematoma (blood blister), or that she had swallowed a snake! We thought Leah had a blood clotting problem but there was no history of “rat bait” being eaten (the commonest clotting disorder we see). Blood coagulation tests where normal, chest x-rays showed an enlargement in the front of her chest. Suspecting a growth was present we asked Angela Hartman, a specialist radiograph for her opinion on the films and she diagnosed the presence of fluid. We didn’t know what kind of fluid and it wasn’t in an easily accessible area to sample. Despite four days of anti-inflammatories for the swelling Leah only showed minor improvement, her appetite was poor too – most unusual for a Labrador.
After some discussion, Leah was referred to the Animal Referral Centre (ARC) in Auckland for further assessment. A computed Tomography (CT) scan was carried out. This helps visualize a three-dimensional structure like the complicated area of the head and neck and distinguishes fluid from soft tissue much clearer than X-rays can. An infected cyst was found! It reached from the front part of the chest right up through the neck and finished under the tongue. Yes, it was connected to the earlier neck cyst. A surgeon carefully dissected this out which is tricky in the chest area as ventilation during anesthesia is necessary. Biopsies were taken and swabs for culture and sensitivities.
Leah recovered very well and had a drain in her chest for a week, she enjoyed her time in Auckland (and I know they loved Leah too). A couple of antibiotic courses cleared up the infection and her neck swelling completely disappeared. Unfortunately, her biopsy revealed a thyroid carcinoma, this is a slowly spreading cancer and lifespan averages 18months without treatment, with chemotherapy it could be longer. Leah saw the oncologist, but her owner decided that as she was older and made such a good recovery, he wanted to let things take natural course.
We keep an eye on Leah, it has been three months since the surgery and so far, so good. It’s certainly the first infected cystic thyroid carcinoma I have seen but Leah doesn’t seem to mind and still enjoys a roll on her back!
You may bump into her in town, she wears a retired Guide Dog coat and helps with collections on Daffodil Day, and you are welcome to give her a pat if you see her.
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