Testicular Cancer- warning graphic photos.

I had a fun (for me) surgery today involving a ten year old, mixed breed dog named Prince. His owner noticed that his testicles had grown suddenly. It turns out that only his right testicle had grown and it was about 10x the size of the left one.  He had also developed gynecomastia, or enlarged mammary tissue.  This makes the mass most likely to be a seminoma or a sertoli cell tumor.  Testicular cancer is very common in intact male dogs.  One study showed 27% of intact male dogs will develop testicular cancer.  Dogs that are cryptorchid (have a testicle that did not descend from the abdomen into the

There are 3 common types of testicular cancer in dogs.  Seminomas, sertoli cell tumors, and Interstitial (Leydig) cell tumors.

• Seminomas arise from the cells in the testicle that produce sperm.  They can cause feminization (such as gynecomastia) from the production of estrogens.  They are very slow to metastasize.
• Interstitial cell tumors arise from the cells in the testicle responsible for the production of testosterone.  They are often small and an incidental finding.  They rarely spread or cause a problem.
• Sertoli cell tumors are the more aggressive tumor and are more likely to metastasize, but even then only about 15-20% do.  They can produce large amounts of estrogen that can cause severe bone marrow suppression leading to anemia (low red blood cells).  The estrogen can also cause the feminization in the male dog.

We removed Prince's mass today and are hoping that it had not spread to other parts of his body.  We could have taken radiographs and done an ultrasound to look for metastasis, but his owners were more interested in keeping him comfortable and getting rid of the mass that was bothering him.  If the mass is malignant then at least he will feel good for a while.

The surgery was performed a little differently than a regular neuter.  In a regular neuter we don't like to go through the scrotum because they tend to be very vascular and can bleed a lot.  In this case we had no choice but to go through the scrotum.  I also removed the scrotum to prevent possible post-op complications.

 The first image is of the normal left testicle (bottom) next to the testicular mass (top).  The testicles are both still within the testiculat tunic.  The second image is of the actual mass once it has been removed from the tunic.  The large white area is the actual testis.  The slightly darker pink area on top is the epididymis.  The large red cord on the right is pampiniform plexus which is a bunch of blood vessels that supply the testicle with blood. 

Prince is recovering well and is hopefully now cured!

 

 

 

Internet Rumors: Fact or fiction

Just the other day as Cheryl and I were driving to an appointment we some how got onto the topic of bon bons.  You know the old saying "Sitting on the couch eating bon bons."  Almost at the exact same time we asked each other so what exactly is a bon bon.  Since I was driving Cheryl got out her iPhone and looked up what a bon bon is (its basically the French word for candy for those that want to know).  I remember the days when I had to go look through my dad's Encyclopedia Britannica or go to the library to find an answer.  Now you can find it in a matter of seconds on your tiny little phone.  The downside to this is the information you look up may or may not be truth.
When looking up information about your pet I recommend going to reputable sites such as universities, government, or well know organizations.  It is so easy to make something sound true and be completely wrong.  Here are some common things circulating on the Internet recently.

1. The cardboard tube in toilet paper rolls contains toxic levels of zinc.  False! Not sure who came up with this one, but it has absolutely no basis or foundation.




2. Febreeze is toxic to pets. False!  When Febreeze was first marketed in the United States for a very short period of time (less than 6 months) it contained zinc chloride as a stabilizer.  Zinc chloride is a known lung irritant. The chemical was in such small concentrations in the Febreeze that even before they removed the zinc chloride from the formula it was safe to use.  The only potential issue with Febreeze is if it is scented and you have pets with allergies.  Any scented product could make allergies worse (for people too!)




3. Swiffer Wet Jet cleaning solution contains a chemical that is one molecule away from antifreeze and causes liver failure. False and False! First of all let me point out that Anti-freeze, a known common toxin, causes kidney failure in mammals and not liver failure.  Second of all the definition of a molecule is "a group of like or different atoms held together by chemical forces."  This means the statement, while making it sound plausible actually makes it nonsense. 





4. Sugar free chewing gum can kill your dog.  True! Sugar free gums and candies that contain the ingredient xylitol can cause dogs to become severely hypoglycemic leading to seizures.  It can also cause liver damage in some cases.  Dogs so far appear to be the only species that is sensitive to the xylitol.  The amount present in most products is unknown because they are not required to disclose that information so assume any human product with xylitol in it is to be avoided. (As an aside AquaDent, a drinking water additive for dental care, does contain xylitol but in very low concentrations and is safe to use).



5. Tennis Balls are bad for dogs and can cause cancer. False, but a little true.  There are rumors going about that the tennis balls contain toxic gases or have lead in them and will therefore give dogs cancer.  This is not true.  What is true about tennis balls not being so great for dogs is they are a potential foreign body to a dog that chews one up and swallows a piece.  They are also very abrasive to the dogs teeth if they are prone to chewing the ball.  Just play fetch with the tennis balls and don't let your dog chew on them much and all is good!





6.  Ornamental sago palms are very toxic. TRUE!  Sago palm plants are a very common plant in Florida landscaping.  I myself have one in the front of my yard and it is a pretty plant, but deadly.  I have lost a patient that ate the sago palm nuts despite all of our efforts to treat him.  If you have one of these plants in your yard please make sure your pet (or child) can not chew on any part of it.




7. Heartworm prevention is a poison and it is better to just treat if your dog gets heartworms. False! This rumor assumes that the medication we give as a heartworm preventative and the medication we use to treat heartworms are the same thing.  This is not true.  The common heartworm preventatives we have today are ivermectin or milbemycin and their derivatives.  They are given in very low doses to kill of a certain stage of the heartworm life cycle.  They are almost completely out of the body within 24 hours so there is no lingering effect.  The medication we use to treat heartworms is another matter.  It is much safer than what we had in the past, but is still a harsh and potent drug.  It also is only given once heartworms have been diagnosed, which means the worms have already taken root in the heart and have been causing damage since the last negative heartworm test.  This damage is irreversible.  Giving the preventative is much, much safer than the alternative. 




8. Collies and their cousin breeds should not get heartgard (or several other drugs). False.  The collie breeds can have a gene mutation called the MDR1 gene.  Dogs with this gene are very sensitive to certain medications including ivermectin (the active ingredient in Heartgard), loperamide (Immodium), certain chemotherapy drugs to name a few.  This means that these dogs must be given a much lower dose than a normal dog of their size.  The amount of ivermectin in Heartgard is well below the toxic level even to dogs with this gene so it is safe to give.




9. Pregnant women or immunocompromised individuals should not own a cat. False.  Part of this myth came about because of the fact that cats are known to sometimes carry the organism Toxoplasma gondii which can cause fetal deformities or death.  It is estimated that 22% of people in the United states over the age of 12 years are carriers.  Most people get it by eating raw or undercooked meats or playing in the sand or soil (sandbox, playground, gardening).  Cats do play a significant role in the transmission of the disease, but the toxo oocysts shed in the cat's feces don't become infectious for 1-5 days.  Scoop the litter box on a daily basis and you have no worries.

If you have any "facts" you want clarified or validated let me know.  I'm all for well educated pet owners.  It makes my job keeping the pets healtier easier!

**Thank you to Sharon Gwaltney-Brant, DVM, PhD, DABVT, DABT for her rounds presentation on VIN that gave me the idea and some of the tumors for this blog.