Dealing with a sebaceous adenoma on the paw of an obese, aggressive 94kg Komondor dog without sharp excision

RE: Dealing with a sebaceous adenoma on the paw of an obese, aggressive 94kg Komondor dog without sharp excision

Jill Butterworth — Mon, 13 Dec 2021 15:38:26 GMT

If you are worried about worsening fear induced aggression if the dog has a bad experience, some behaviourists use Zanax after a consultation so the dog will hopefully forget what happened and not be worried at the next check up. Don't use it in the sedation tho' because of disinhibition. Ideally do a trial to see how the dog responds.

Keeping it clean is the real challenge, however you manage it. I saw a dog with an infected toe get tetanus once because the owner didn't keep dressings on.

I was always under the impression that cryotherapy went out of favour because it didn't work very well.

From that histology report, I would be trying to cut the lesion out (after pre op antibiotics) and loads of hibiscrub soaks or even neat hibiscrub if you can and really hope you can get the wound back together without too much trauma. If there's still infection present I worry about digit amputation getting infected. Maybe swab for C & S first?

RE: Dealing with a sebaceous adenoma on the paw of an obese, aggressive 94kg Komondor dog without sharp excision

Beats — Sun, 12 Dec 2021 21:37:49 GMT

Hi Dermot. I have no expertise and am merely thinking what I would do if this was my consult - that in no way implies I think you should do the same!

I think I would give the dog a week of steroids (eg 25mg pred daily) and see it back and see what the lesion looked like then with less inflammation. If it was more defined at that point, then I would be much more inclined to cut it out (eg with biopsy punch - through skin only, not tendons below, and expecting bleeding) and suture the skin with eg absorbable 2metric monocryl plus either intradermally or interrupted (or both) with either a (careful) bandage or loose sock taped over foot to be kept dry and changed twice daily by owner. How I chemically restrained the dog would depend on seeing it, but if it was to be a simple biopsy punch job, I would most likely jab with decent dose of medetomidine/butorphanol, sufficient to get iv access and then propofol and tube - I tend to regret doing something like that under sedation and local due to eg bleeding or not spending long enough surgically preppping the foot (I like clipped, cleaned and then hibiscrub filled glove attaached over foot and massaged for 10 minutes); if it was very aggressive, then I would forget the iv access and get ketamine/midazolam IM also; if I had all day, then the owner would squirt a couple of tubes of sileo around gums (assuming safe to do so) first and sit in a consult room with the dog for 40 minutes, then I'd jag it IM with a long enough needle with eg more medetomidine and butorphanol, come back 15 mins later and poke it and give eg some ketamine or midazolam - poke again in 10 minutes until was unconscious enough to muzzle and either get iv access or poke with more IM, or use some local then. Informed consent of GA risks obviously. I would operate on the floor.

I would personally most certainly NOT rush into a digit amputation in this size of dog at this age.

RE: Dealing with a sebaceous adenoma on the paw of an obese, aggressive 94kg Komondor dog without sharp excision

Dermot Doherty — Sun, 12 Dec 2021 17:12:00 GMT

Many thanks for you feedback Neil. Apologies that I didn't include its age...it's 4.5 years.

RE: Dealing with a sebaceous adenoma on the paw of an obese, aggressive 94kg Komondor dog without sharp excision

Neil Wheadon — Sun, 12 Dec 2021 11:18:11 GMT

If this is a 'one shot job' then take the toe off.

If a 2 shot job, surgically excise the lesin and see if you can get the wound edges together. If you can't take the toe off

The concern in this case is ongoing management, cryotherapy or debriding will require attention to that foot by yourself and your staff. I wouldn't want to do this in a nasty 94kg dog. In short it's the owners responsibility that they have a dog of this type not yours to manage that issue

How old is the dog?

Neil