Veterinary Medical and Surgical Care Case Report “Tessa” Thoracic Wall Resection Veterinary Specialist Group Monday 13th September 2010 – Friday 17th September 2010

Abstract

Tessa was referred from her clinic and presented at the Veterinary Specialist Group Hospital on Monday 13^th September 2010. A thoracic wall resection was performed on her left thoracic wall and there were no significant complications during the surgery or recovery and the patient was allowed to return home on Friday 17^th September 2010.

Patient Details

Patient Name: Tessa

Species: Canine

Breed: Fox Terrier

Colour: Black and White

Gender: Female (spayed)

Age: 10 years, 10 months (estimated)

Weight: 8.3kg

History

On Wednesday 21^st April 2010, Tessa was seen by The Strand Veterinarian clinic. It was recorded that she had a small mass on the left hand side of her thoracic wall. It was noted that the mass had been present for a long period of time, possibly since she was a puppy. However, it had grown rapidly over the past 18 months. In November, 2009, radiographs and a fine needle aspirate were taken at the clinic that Tessa attended (Animalz in Mount Eden, Auckland) before moving to The Strand Veterinary Clinic. It was suggested that chondrosarcoma was the cause of the mass. 

However, since this diagnosis, Tessa has maintained her body condition and seemed to have shown no exercise intolerance.

In April, 2008, Tessa had a recorded episode of intermittent coughing. She was referred to the Veterinary Specialist Group for a definitive diagnosis. After performing various tests, no diagnosis was found. This coughing does not seem to cause problems for Tessa anymore.

On Saturday 5^th June, 2010, Tessa was seen for a re-check and the original diagnosis of chondrosarcoma was doubted but not ruled out. It was reported that the growth was spreading locally rather than systemically. A 10mL Oral Carprofen[1] was dispensed with the instructions stating, please give once daily over food to the 7.5kg mark. The client was going on holiday and taking Tessa along with her and she was told to only use this medication for pain relief if she believed that it was necessary.

On Monday 30^th August 2010, Tessa re-visited The Strand Veterinarian Clinic and it was recorded that the mass seemed unchanged and a resection would be considered if advisable. A referral was made to Dr. Alex Walker BVSc (Dist) MACVSc at the Veterinary Specialist Group. At this time, Tessa was showing no signs of pain or distress associated with the mass or any possible metastasise (Walker, 2010).

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[1] Metacam – Boehringer Ingeheim Ltd, New Zealand

Clinical Examination

	Temperature (°C)	Heart rate (bpm)	Respiration rate (brpm)	Mouth (MM colour, capillary refill time)	Demeanour
Monday 13th	36.4 (post op)	104	20	Pink, ≤ 2	BAR
Tuesday 14th	37	100	28	Pink, ≤ 2	BAR
Wednesday 15th	38.2	108	Panting	Pink, ≤ 2	BAR

Physical Exam

On Tuesday 7^th September 2010, a physical exam was performed on Tessa and a large hard mass located on the caudal thoracic wall which involved most of the left lateral abdominal wall. Tessa seemed healthy otherwise and her heart rate and pulse quality was normal. All her thoracic cavity sounds were clear (Walker, 2010).

Diagnosis

In November 2009, the mass on the left thoracic wall was diagnosed as chondrosarcoma after taking radiographs and a fine needle aspirate. However, on Saturday 5^th June 2010, the original diagnosis of chondrosarcoma was doubted as the mass seemed to spread locally rather than systemically. It was noted that a biopsy would be required to confirm this rather than the fine needle aspirate which was performed previously (Alderson, 2010). After the thoracic mass was resected on Monday 13^th September 2010, it was sent to the Gribbles Laboratory to have the histopathology tested. The morphologic diagnosis came back as a chondrosarcoma with necrosis and haemorrhage (Gribbles Laboratories, 2010). The diagnostic imaging report also mentioned chondrosarcoma as one of the possibilities among other things such as ossifying fibrosarcoma, ossifying fibroma, ossifying neurofibroma or osteosarcoma (Warman, 2010).