Update on Cedar's Elbow Hygroma

Got a call from Cedar's summer home in Jackson WYO the other day. As some of you will recall, Cedar's elbow hygroma has gotten worse over the summer despite all of Ellie and Mike's nursing care. The mass had grown to the size of an orange and was ulcerated and infected and required daily and sometimes twice daily bandage changes.

Cedar's local Jackson veterinarian had recommended surgery and referred Mike and Ellie to a surgeon in a nearby town who has had success removing persistent Hygroma's with laser surgery. Unfortunately, when he examined Cedar and saw the size of the mass, laser surgery was out of he question.

 

Instead he removed it conventionally and as of now everything is still together and healing. As we mentioned before surgery to remove these masses is very difficult because the constant trauma that initiated the original injury impedes the healing process. In many cases they will come back over time.

 

Something had to be done, however, as the mass was continuing to grow. The consensus was "let's remove it and hope for the best and if it comes back we'll deal with that down the road."

 

Ellie is changing the bandage over the suture line daily and applying a topical antibiotic to go with the oral antibiotics. The last thing we need is a local infection at the site of the surgery. The Dogg Legg bandage is serving a useful purpose in padding the site, minimizing the trauma to the surgery site. We'll keep our fingers crossed.

 

There is another complication, however. The surgeon took biopsies of the mass during surgery and they came back positive for squamous cell carcinoma. Squamous cell carcinoma is one of the most common types of cancer in dogs. These tumors arise from the epidermis or mucosal surfaces in various places in the body. The skin and the oral cavity are common sites for this tumor.

 

Squamous cell does metastasize but more commonly they are locally invasive and can spread to deeper tissue like the bone of the jaw or even the bony tissue of the elbow, in Cedar's case.

 

Mike sent me the biopsy report and the pathologist indicated that the margins of the biopsies were clean of cancerous tissue. That's good and may indicate that the surgeon removed the entire carcinoma. It does not mean that Cedar is our of the woods. It could have spread to other areas.

 

I would suggest that they biopsy local lymph nodes, too. Ellie is worried that recently developed hacking noises coming from Cedar may be the result of oral squamous cell carcinoma near the epiglottis. That would not be good.

 

As you can imagine Ellie and Mike are in quite a state. All this has brought Cedar's mortality into focus. He is an elder statesman for a giant breed and it is starting to dawn on Mike and Ellie that Cedar won't be around forever. I'm going to get in touch with a colleague working at Jornada Veterinary Clinic over in Las Cruces to handle follow up care. 

 

I'll be sure to keep everyone updated on Cedar's recovery. I'm quite hopeful that Cedar will recover in the short term if Ellie and Mike have any say in it. They provide excellent care for Cedar. I'm thinking we'll be writing about Cedar for some time to come.