Jammer is a 4 year old, intact male Entlebucher Mountain Dog that was presented to our hospital after having various non-specific symptoms ranging from nausea and gagging, to coughing, sneezing, trouble breathing, decreased appetite and weight loss. Jammer had been sick for about 2-3 months. He was seen by several different veterinarians and recently had an extensive evaluation at the local specialty/referral hospital that included blood tests, radiographs and an abdominal ultrasound to help diagnose the cause of his symptoms. He had been treated with various antibiotics, dewormers and anti vomiting medications. None of these treatments resolved any of Jammer's symptoms, and he continued to decline. His owner had told each veterinarian who saw Jammer that she was sure she was feeling a lump on the outside of his neck, but no abnormalities were found in this area on previous examinations.
When I examined Jammer at our hospital I found that he was very thin, had lost a significant amount of muscle mass, was salivating and had a very dull hair coat. His owner was concerned she may have to euthanize him because he was not getting any better. We decided to repeat radiographs of Jammer's chest, this time including his neck and base of the skull. These x-rays showed a mass in Jammer's pharynx just past his epiglottis. An oro-pharyngeal exam was performed (Jammer is a very good dog!), and a mass was palpated at the very deep base of the patient's tongue, just past his epiglottis. Although it could be felt by placing a hand into the back of Jammer's throat, the mass could not be visualized just by looking in the mouth.
Jammer was placed under anesthesia for a more thorough exam of his throat and oral cavity. He had a pedulculated mass (hanging by a thin stalk of tissue) on the right side of his pharynx near his tonsil. The mass was surgically excised using the surgical CO2 laser to decrease bleeding after surgery. The mass was submitted to our lab for biopsy and was found to be a pharyngeal papillary adenocarcinoma, a type of cancerous tumor derived from glandular tissue.
Jammer recovered well from his surgery and began eating soft foods later that night. Within 2 days, all of his previous symptoms had resolved. He was more active, breathing normally, eating, drinking and gaining weight. He did not experience any more nausea, drooling, gagging or coughing.
In general, oral tumors tend to be aggressive and it is usually difficult to surgically remove all of the affected tissue associated with the tumor. Because of this, Jammer was referred to another local specialty hospital for consultation with an oncologist and CT scan to further assess the extent of his cancer. He had a full course of radiation therapy to help reduce the chance of recurrence and spread of the cancer.
It has been about 10 months since Jammer was diagnosed and treated. He is in remission and continues to do well. We are closely monitoring him for recurrence of his tumor and long term side effects of his radiation therapy. We are very happy that we were able to determine the cause of his illness and get him back to the sweet, strong, tennis ball loving dog that he was before he became sick. This case shows the importance of listening to what owners tell us about their pets, and also the value of performing a thorough examination on all of our patients.