Case Report: Removal of Gastrointestinal Mass
Otis, a nine-year nine-month old Labrador Retriever, is finally back to normal after undergoing surgery to remove a gastrointestinal mass.
Otis went to his regular veterinarian in May for chronic vomiting. A plan was formulated and Otis did well until July. On July 4th, Otis’ parents brought him to the Emergency Division of the Veterinary Referral Center of Northern Virginia because he had started vomiting overnight. They noticed that some of the vomit contained blood. Otis was hospitalized for dehydration due to the vomiting and was placed on IV fluids. He was also given injectable medications to stop the vomiting and help decrease acid production in his GI tract.
Otis felt better and was sent home later that day on a bland diet of chicken and rice and medications to fight the nausea and GI acid production. An ultrasound and consultation with the Internal Medicine Division was recommended to try and determine the cause of Otis’ GI issues. The following day Otis was brought to the Internal Medicine Division for an ultrasound and consultation with a specialist. The ultrasound was relatively normal except for an area of the stomach wall that appeared to be thickened.
Otis continued on the bland diet and anti-nausea medications and did very well until mid-September when he began to vomit again. Otis returned to the Internal Medicine Division on September 27th for another ultrasound. Yet another area of the stomach wall appeared thickened, so biopsies were taken via endoscopy. These biopsies were submitted to a laboratory to determine what kind of tumor was present.
The biopsy results showed that a plasma cell tumor was present. This is a cancerous tumor that needed to be removed to give Otis a fighting chance. Otis was then referred to the Surgical Division for removal of the tumor. On October 5th Dr. Bradley removed the pyloric antral gastric tumor by performing a gastroduodenostomy, a surgery known as Billroth I. This procedure connects the stomach directly to the duodenum allowing the removal of the pylorus along with the tumor. The mass was submitted to a laboratory to look for clean margins which means no cancerous cells on the outer most layer of the mass. It had already been determined that the mass was a malignant plasma cell tumor. The good news is that the margins were clean and there is a very minimal chance of recurrence. More good news—these types of tumors have less than 1% chance of metastasis which means spreading to other parts of the body.
Otis seemed to be recovering fine at first, but 48 hours later his abdomen became distended and he became very nauseous. Otis was taken back into surgery where Dr. Bradley discovered a silent perforation and leakage with secondary pancreatitis. The defects were repaired, IV fluids were continued, and injectable medications were given to allow Otis’ GI system to heal. Otis spent several more days in the hospital recovering before returning home. It was quite a battle for Otis to fight, but his Mom reports that he is feeling like his old self. His activity level is back to normal, he is putting on weight, eating well, and not vomiting. It was a long uphill battle, but we are very happy that this sweet boy prevailed!