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Date:   28 June, 2011  
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
 
Gum Tumours In Old Dogs
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case done: May 25, 2009
Date:  28 June, 2011  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129
In 2011, I usually consult from 9.30 am to 11 am except on Saturdays while Dr Vanessa Lin practises from 11 am to 7 pm. The caseload is sufficient for one vet without giving undue stress and causing long waiting times of more than 15 minutes in the majority of cases.

From Sunday to Thursday, starting from Sunday, June 27, 2011, I was on full-day duty as Dr Vanessa Lin had taken leave.  Sunday had two interesting cases, the most memorable was the Fibrosarcomas in a young cat  brought in for a second opinion by a young couple in their early 30s.

The second memorable case of the 12-year-old Fox Terrier which had "skin disease" every 6 months for the past 10 years. The owner was living in Toa Payoh and did not know that Toa Payoh Vets existed till he searched the internet yesterday. He had been to another practice for the past 10 years till recently when the vet in that practice gave him another type of antibiotics which did not cure his dog from having dandruff and itchiness.

I looked at his veterinary report and said: "The vet recommends total canal ablation with bulla ostectomy. Why don't you accept his advice?"

"The cost of the surgery is $3,000!" the man in his 50s said. "After 10 years consulting the vets there, I am told that my dog needs an ear surgery! Every time I go there, I see a different vet!"

I said: "The surgery recommended takes a longer time to perform and therefore costs more than a simple lateral canal resection which costs around $500 per ear in Toa Payoh Vets".

"You go to a very busy brand-name practice. More pet owners go there for the name too and don't mind waiting for over an hour. Therefore it must employ many vets to cope with the large numbers of cases. Therefore, you don't get to see the same vet every time you go there for your antibiotics."

It is not a good practice to just prescribe antibiotics when the owner asks for it as the dog needs to be examined. But I note that some owners in my practice request the same medication for their skin problems too. Usually, I will not give them repeat medication after two times as skin problems need to be reviewed as you can see in this Fox Terrier case where antibiotics every half yearly for the past 10 years has not resolved the problem. The dog had large circular patches characteristic of ringworm in his trunk and legs! Antibiotics do NOT cure ringworm!

I am still handling the Fox Terrier which was a generalised ringworm infection including infestation of the two dog ears which are black pigmented due to the last 10 years of scratching.  If the ringworm and yeast infections in the ears can be cured, there is no need for the $3,000 ear surgery or any ear surgery in this old dog. It is 12 years old and is a very high anaesthetic risk case. I don't want to do this ear surgery as no dog owner appreciates a dead dog on the operating table even if the veterinary cost is only $5.00.                        

Back from my digression, on Monday, June 27, 2011, a young man in his late 20s wanted me to examine an 8-year-old toy poodle he had adopted. The dog was well groomed but his internal health was rotten.  

"This dog has a large gum tumour on the left upper gum and bad breath," I showed him the reddish purple tumour of 8 cm x 5 cm by everting the left upper lip of the dog.

"Are you sure you want to adopt this dog? Why not adopt a younger one as you will need to spend money to cure this old dog," I advised.

"The dog is thin and dehydrated due to his difficulty in eating and drinking," I said. "His gum tumour needs to be removed. There is a high chance that he may die on the operating table as he is a very high anaesthetic risk. I have to be upfront with you about the financial costs to prevent misunderstanding. Removal of the gum tumour does not mean that the tumour will not recur again if it is cancerous. I have a young lady client who had her dog with a similar problem operated 3 or 4 times by me as the gum tumour was malignant."    

The young man was OK with the money matters.  A blood test was taken. The dog was given antibiotics for the next 7 days. Whatever the results of the blood test, there was no option but surgical excision of the gum tumour as the dog had great pain and difficulty in eating and drinking. The teeth and gum were infected too.

I searched my past case histories and below is a similar case of a gum tumour in an old dog. Most likely I will use electro-surgery to excise the gum tumour of the toy poodle. Gum and mouth tumours occur in dogs whose dental health is poor. So, a good tip for dog owners to prevent such tumours will be to get their dog's teeth and gums in good health and to get a dental scaling done at least once in two years and to brush the teeth!
 

A May 2009 case. Intern Daphne seen here had completed her A levels. Now, she is a 2nd year veterinary undergraduate and  enjoying every second of her studies in Australia. I remember Daphne well as she has a happy disposition
 and a keen interest in veterinary medicine and surgery

Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets Isoflurane Gas Anaesthesia. Electro-cutting removed gum tumour first. Note hard palate tumour. Toa Payoh Vets
Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets Large cancerous gum and hard palate tumour. Jack Russell, 10 years. Toa Payoh Vets
Electrosurgery stops profuse bleeding during gum & hard palate tumour removal. Toa Payoh Vets Gum and hard palate tumours in old dogs can be prevented with good dental hygiene and health. Toa Payoh Vets.
Large cancerous gum and hard palate tumou excised. Jack Russell, 10 years. Toa Payoh Vets Jack Russell, Gum & Hard Palate Tumour excised. Vet Intern. Toa Payoh Vets.
tpvets_logo.jpg (2726 bytes)2349 - 2356. Ensure that the dog is stable. Had antibiotics >7days. Plan ahead for your surgery. Shorten isoflurane gas anaesthesia and surgery time to minimum to ensure survival of old dogs. Don't do dental scaling and extraction. What the owner wants is a live dog at the end of surgery. Therefore decrease surgery time by using a bigger team to assist during electro-surgery.     

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