Oscar is an 11 year-old Border Collie owned by our own Dr Kate. Planning to do a dental clean procedure and remove some fatty cysts, we performed a routine pre-anaesthetic blood screen on Oscar and found some very mild abnormalities. Despite Oscar ‘appearing’ healthy and well, Dr Kate asked Dr Lara to perform an abdominal ultrasound on Oscar to check that there was nothing else going on with him prior to the planned anaesthetic.
What we found shocked everyone – Oscar had a 5cm tumour near his left adrenal gland and kidney, and invading the caudal vena cava which is the major vein that takes blood back to the heart. The anaesthetic procedure was cancelled, and on further testing, this tumour was found to be ‘active’ meaning it is secreting large amounts of adrenaline hormones which can cause surges in blood pressure. The presence of this type of tumour can make anaesthesia very risky.
We work closely with the specialist veterinarians at Advanced Vet Care, and Oscar was taken up to Kensington for a repeat ultrasound and CT scan, in the hope that the tumour could be surgically removed. Unfortunately, the tumour was considered inoperable, due to the involvement of blood vessels to both kidneys and the extent of invasion into the caudal vena cava. The specialist described the tumour as ‘the strangest lesion he has seen in 20 years’.
Happily though, Oscar has continued to remain well and relatively asymptomatic of his problem for the last 6 months – he has blood pressure monitoring regularly, but it is hard to believe that something so invasive and potentially life-threatening can exist in this way. He has not had his dental procedure and instead Dr Kate is taking some of her own well-versed advice and is brushing his teeth at home to keep the periodontal disease at bay.
This case shows the value of pre-anaesthetic blood testing in our older pets, and the role that both in-house diagnostic imaging and specialist referral can play in the management of our day to day cases.