11 / 12
Harvey
is a 9 years old Labrador, with a mass on his lower jaw. A biopsy confirmed
this to be a cancerous tumour known as squamous cell carcinoma.
The tumour made it difficult
for him to eat, causing a lot
of drooling, bleeding when
rubbed, and developed a
bad smell due to secondary
infection. Almost certainly
it was also a source of
discomfort, which none
of us want for our pets
or patients.
Blood tests, ultrasonography
and radiographic imaging did
not find any evidence of the
tumour having spread to
other sites.
When dealing with cancers
surgically, we try to remove
a margin of cancer-free tissue
in all directions. This can
sometimes mean removal of
quite large areas of tissue.
Harvey underwent a
mandibulectomy procedure to
remove the front half of his
lower jaw. As well as opioid
and anti-inflammatory pain
relief we give these patients
nerve blocks, which last for
6 - 8 hours keeping them as
comfortable as possible in
recovery. Within 12 hours of
his operation, Harvey was
drinking water on his own, and
starting to eat 3 cm meat
balls, offered by hand. As
much as he enjoyed being
hand fed, he was able to eat
soft food, on his own, within
3 days.
Lower jaw prepared for surgery
Side profile after mandibulectomy
Reconstructed lower jaw after
tumour removal
Dogs tend to cope
incredibly well with
a mandibulectomy,
and unlike cats, rarely
require a feeding tube
in the recovery period.
Studies suggest that
91% of dogs with this
type of tumour should
survive more than 12
months with a range
of between 6 months
to 7 years.
Surgical removal of oral
tumours is usually the
treatment of choice and can
often be curative. Surgery is
sometimes, but not always,
used together with anti-cancer
medicines (chemotherapy).
Radiotherapy can also
sometimes be an option, but
availability can be difficult.
The owners wanted Harvey to
have surgery and naltrexone
medication, which is an
unproven drug, albeit seemingly
with minimal side effects,
suspected of slowing the
progression of cancers in man.