Monday, March 24, 2014

Patient of the Week: Nellie

Nellie is a beautiful 13 year old Bishon Frise who doesn’t look a day over five. Her clinical signs were subtle during the summer of 2012 when she began clearing her throat.  The throat clearing progressed to upper airway noise (loud breathing) and a change in her bark by January of 2013.

Nellie presented to Dr. Eileen Snakard at VCA Veterinary Referral Associates for evaluation. Her physical examination revealed a large neck mass displacing her trachea to the left. No other abnormalities were identified.  A laryngeal examination (looking down her throat) revealed the mass extended above her left dorsal nasopharynx (top of her throat).  A small biopsy was attempted, but the vascularity of the mass would not allow. A CT scan of the neck was recommended to identify the parameters of the mass and its association with the trachea, larynx, esophagus and spinal cord. Essentially, the CT scan would determine if surgical resection was feasible.

Nellie returned for the scan with Dr. Katherine Skelly and Willie Laney, our imaging team. Sadly, the results painted a poor prognosis for her. The CT clarified surgical removal was not possible. Although definitive therapy was not an option, palliative radiation therapy was offered with the hope of either reducing the size of the mass or slowing its growth.  Nellie’s family and I were optimistic.   

Nellie received four palliative radiation treatments at VCA Veterinary Referral Associates. The final treatments brought with them the spectrum of radiation therapy side effects, but her large neck mass was no longer palpable!  Nellie handled the side effects with grace and a tail wag.  The only semi-long standing side effect was the rectangle of hair loss at her radiation site which she wore like a badge of honor.  She is now nine months beyond her last radiation treatment, her badge of honor is covered with fur and we still cannot locate her tumor on palpation. Thank goodness no one shared the poor prognosis with Nellie J.


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