With Dr. Patricia Kupanoff
Duncan is one of our Scottish Terrier rescues. He was found in early 2007 on a social networking web site listed simply as “Scottish Terrier – come get him.” That is exactly what Stacey Brainard of From the Heart Rescue of Austin, Texas did.
Stacy picked up nine month old Duncan from an individual who clearly had little interest in this tiny Scottie. Duncan was emaciated, did not appear to have ever been groomed and certainly had little or no medical care.
Stacey put out the word she had a special Scottie rescue needing immediate attention. On March 16, 2007, within two days from Stacy’s call we had Duncan in our hands. Stacey was headed to California with other rescues. We met just outside Chandler AZ where I met Duncan.
It was obvious Duncan needed immediate medical attention. Without delay I took Duncan to First Regional Animal Hospital in Chandler. Duncan weighed only twelve pounds. From the sparse records obtained by Stacey we determined that Duncan was about nine months old.
Tests showed Duncan had an upper respiratory infection, had been neutered and seriously underweight. He was started on Clavamox® and taken home.
Duncan was so sick I had to isolate him from our other Scotties. I was not sure if he would make it through the first few days. I was wrong.
Within a week Duncan was running all over the house, tearing up anything not bolted down and generally acting like a Scottie puppy should - capable of uncontrolled mayhem.
In less than four weeks Duncan went from one sick fellow to a happy and healthy Scottish Terrier.
Our other Scotties grudgingly accepted Duncan into the pack. Duncan quickly became the true Scottie we all expected him to be.
Interestingly enough, Duncan exhibited at least one non-Scottie behavior. He wasn’t snotty. Duncan liked everyone. When I take him places he is the first one to greet people with copious tail wagging and generous doses of hugs and kisses.
In May of 2009 I noticed a lump on his upper right arm. It was a very small mass. I felt it when I was bathing him. I waited a couple of weeks to see if the mass would go away – maybe it was an insect sting.
The mass not only did not go away but I could tell it was slowly growing in size. The lump felt soft – similar to fatty tumors called a Lipoma I have seen before our Scotties. A Lipoma is almost always benign.
A few weeks passed. The lump was continuing to grow in size so it was off to First Regional Animal Hospital to see Dr. Keith Joyner. Dr. Joyner has been seeing and caring for our Scotties in 1995.
Dr. Joyner suggested that we open the lump surgically to determine the nature of the mass and obtain tissue samples for biopsy. Later that day Duncan was anesthetized and a small incision made in his upper right arm. Samples were removed for testing.
What Dr. Joyner told me after the surgery came as a surprise to both of us. The lump was an invasive tumor! Dr. Joyner said that in his forty years of veterinary practice he had never seen this type of tumor.
Dr. Joyner referred me to Dr. Patricia Kupanoff, a surgical specialist with First Regional.
Dr. Kupanoff explained that based on the previous biopsy, the mass was an infiltrative lipoma.
Infiltrative lipomas do not typically spread to other sites, but have a tendency to recur at the same site due to the difficultly in completely excising the tumor. Many times, treatment includes surgical debulking followed by radiation therapy to treat the residue tumor cells.
Because Dr. Kupanoff thought the mass would continue to grow, I decided to wait a few more weeks to monitor the mass prior to proceeding with surgery.
Finally, I decided that Duncan’s invasive tumor had become large enough it was time for action.
Duncan and I visited with Dr. Kupanoff. We decided together that surgery was a necessary option.
On the day of surgery Duncan first met with Veterinary Technicians Dori Lamb and Jayne Gusse.
By this time the invasive tumor was about two inches inch across.
Duncan was prepared for surgery. He was anesthetized and placed on his back with his legs stretched forward. The right was shaved and aseptically prepped for surgery.
Dr. Kupanoff described the surgery in her notes as follows:
“A 5cm elliptical incision was made around the previous incision on the medial aspect of the right elbow. The tumor was dissected.”
“The subcutaneous dissection was continued approximately 2cm proximal and 1cm distal from the skin incision.”
“The tumor extended (deep) to the medial aspect of the proximal ulna and extended along the cranial aspect of the radial heal. Distally, the deep margin of the tumor was along the cranial aspect of the radius.”
“Proximally, a separate section of fat was dissected from the distal humerus. This involved 2cm of subcutaneous dissection proximal to the incision. This fat was submitted for histopathology and labeled distal humerus.”
“Distally, the deep fascia was sutured with 3-0 pds, interrupted. The subcutaneous tissue was apposed with 3-0 PDS, interrupted. The skin was apposed with 4-0 nylon, simple continuous.”
“Duncan recovered from anesthesia uneventfully.”
So, what about this invasive tumor? Here is what the histological report said:
“The mass removed from the humerus is a Lipoma and benign. That is great news. The mass removed from the right elbow is an Infiltrating Lipoma.” This is the diagnosis and finding I am most concerned about as are Duncan’s doctors.
An infiltrating lipoma may have a high tendency to reoccur unless widely excised. Time will tell if the entire infiltrating tumor was removed. If not, the next step will be radiation treatment. If that happens, there will be a sequel to this story.
The decision to have the surgery performed was necessary for the continued health of Duncan. Our Scottish Terrier population are cursed with breeding histories which leave a legacy of cancer and other serious diseases.
Responsible changes to breeding may hopefully reduce the need for surgeries of the type Duncan endured.
Today Duncan is a healthy Scottie – back to his usual pursuits and behaviors. He is a joy to have as a member of our pack.
I recognize our Scotties are healthy today because of the talents, dedication and training of Duncan’s entire medical team.
Author Ken McLeod lives in Chandler AZ with his wife of 40 years, Carol and their Scotties: Duncan, Sean, Mr. MacBean, Matie Mae and Ginger. Ken’s articles about Scottish Terriers have been published in Great Scots magazine. His first book “The McLeod Scotties – Living With Thirteen Rescued or Adopted Scottish Terriers” has received positive reviews and is available on Amazon.com.
Dr. Patricia Kupanoff is a surgical specialist at First Regional Animal Hospital in Chandler, AZ
Dr. Kupanoff graduated from Oregon State University as a Doctor of Veterinary Medicine. She is a Diplomate of the American College of Veterinary Surgeons.
Dr. Kupanoff is a butcher!
ReplyDelete