Surgery or no surgery...that is the question.

Re: Surgery or no surgery...that is the question.

Kate Richardson — Tue, 31 Jul 2012 13:36:57 GMT

[quote user="Tracy Arend"]

Thanks I will do.

Having read a few articles from In Practice, if the owner wished to go to surgery, it may be quicker, and less traumatic to just castrate without debulking the anal adeonma (at the moment it is not causing any obstruction) with the view that castration alone should shrink the size. Would you agree? Is there much benefit in debulking (if the mass is currently not causing a problem)?

[/quote]

I would still test treat w ypozane first because if it doesn't shrink, castrating to remove testosterone source will be a waste of time and money. If the owners don't want to use ypozane then I would remove the anal mass and given likelihood of ademoa, I would probably castrate after discussing it fully with the owner and makng them aware of the albeit small possibiity it is something else. If Ypozane does shrink the mass, I would consider excising it under the same ga for confirmation of diagnosis, but obviously you have to give the owners the choice

Re: Surgery or no surgery...that is the question.

Andrew Mellor — Tue, 31 Jul 2012 10:05:23 GMT

I do a large number of anal adenomas in old and often otherwise knackered dogs under local, they seem increadibly insensitive to the sting in that part of the world and never had an issue, bleed well but close them and they heal increadibly well. These are usually the large split open bleeding everywhere type adenomas that have not been noticed by the owner until they explode everywhere. I know that castration is the answer really but I have had some on castrated dogs and a really large one on a spayed bitch too.

Re: Surgery or no surgery...that is the question.

Tracy Arend — Tue, 31 Jul 2012 09:54:55 GMT

Thanks I will do.

Re: Surgery or no surgery...that is the question.

Kate Richardson — Fri, 27 Jul 2012 13:36:16 GMT

I had a similar case recently (FNAs consistent with perianal gland adenoma) in that the owners don't want to go to surgery unless absolutely necessary for different reasons so I discussed w Virbac- they advise test treating with Ypozane first and if testosterone responsive they should reduce in size and possibly resolve completely within 2-3 weeks; if so then follow up with either surgical castration or chemical ie Suprelorin, but need to use Ypozane first. Speak to Virbac, they are very helpful

Re: Surgery or no surgery...that is the question.

Rob Davis — Fri, 27 Jul 2012 08:48:08 GMT

[quote user="Mark Holmes"]

I have never come across a case when liver parameters have made a snippet of difference wrt GA. If worried do BAST first and check function rather than basic parameters which increase rapidly even with minor insult and/or steroids. Use fluids and castrate. That said.... I don't think suprelorin is a bad solution at all. The daily steroid and wound healing implications are probably a greater concern than liver parameters.

My initial feeling is I would probably operate but this would depend on seeing the dog, the size of the lump, discussion with the owners and previous history. If I felt there was a good chance of the dog not seeing a further 12 months I might suggest superlorin 9.4mg and see how that went.

[/quote]

I agree, BAST would give you more information about hepatic function. Raised ALT/ALP on their own would not greatly concern me if BAST is normal.

Re: Surgery or no surgery...that is the question.

Anthony Todd — Thu, 26 Jul 2012 18:12:45 GMT

[quote user="Mark Holmes"]basic parameters which increase rapidly even with minor insult and/or steroids[/quote]

Yes, many is the time way back when where dogs with some sort of dermatitis and on steroids were diagnosed with liver disease and that was the cause of the skin....much to the disgust of the client and my inadequate rebuttal.

I wonder why the rule with pred is to use a continuous low, or adequate dose, when I usually found that a higher dose, only when necessary for relief of symptoms worked quickly and very effectively, 'cos a lot of the time [flea bites etc] the allergen was only intermittent.

I understood that intermittent steroids didn't cause as many side effects as a continuous, even low, dose?

As the GA is given to effect Idoubt if it would affect the GA at all, and steroids, in practice, don't affect healing that much, if at all, and certainly cut down wound irritation which is probably more relevant in wound healing.

Re: Surgery or no surgery...that is the question.

Mark Holmes — Thu, 26 Jul 2012 17:56:48 GMT