Ottoscope

Mollie’s case study

Mollie is a much loved 10 ½ year old Border Collie Cross. Her owners noticed a lump growing under the skin by her left shoulder over about a year, with the rate of growth getting faster with time. She went into her normal vets for a check-up, where they recommended a fine needle aspirate, which is a type of non-invasive biopsy. When the results came back the lump was suspected to be a spindle cell sarcoma, which is a type of cancer affecting the connective tissue between skin, muscle and bone. Spindle cell sarcomas make up about 15% of skin tumours seen in dogs, and can grow very large. Up to 45% of spindle cell sarcomas can spread throughout the body, so surgery is recommended to remove the lump before it has a chance to do so.

Mollie, a dog with spindle cell sarcomas

Because the lump was so big (about 15cm, or 6 inches in diameter!) she was referred to the Your Vets Surgery Service at our Smethwick hospital to arrange to have it removed.

Removing any large lump creates challenges for the surgeon to close the skin left behind afterwards. Skin is naturally elastic and will stretch a little, but in Mollie’s case, the lump was too big to allow the edges of the skin to meet for them to be stitched up like any normal wound. To get around this problem a H-plasty was performed. This is a type of plastic surgery procedure that allows the surgeon to ‘borrow’ skin from in front and behind the surgical site to facilitate closure.

A diagram of h-plasty skin advancement technique

H-plasty skin advancement technique

On the day of surgery, Mollie’s lump was found to be nearly as deep as it was wide, so she had a large amount of tissue removed. The H-plasty was performed without difficulty, but due to the large size of the incision it was expected Mollie would be uncomfortable after surgery, and an infusion catheter was placed under the skin to allow local anaesthetic to be introduced to numb the wound every few hours. Mollie was hospitalised for around 24 hours before she was comfortable enough for the infusion catheter to be removed.

Mollie's tumour after it has been removed

Mollie’s tumour after removal (surgeon’s hand included for perspective)

Once Mollie was home she found her surgical incision was itchy, and tried to scratch at it. She was fitted with an Elizabethan collar to stop her from chewing her stitches, but succeeded in unpicking some bits with her back feet. Her owners ingeniously managed to prevent any further damage by putting socks onto her to cover her claws! The area where the flap had broken down was managed at home by her owners using regular cleaning followed by a cream to prevent infection and promote healing. She was totally healed and signed off by the Surgery Service just 1 month after her operation. She still has a ‘H’ scar, but as her hair grows back this will be completely covered.

A photo showing Mollie's healed injuries

Mollie’s healed surgical site on her last appointment

Specialist analysis of Mollie’s lump after removal found that it had not spread, and was fully removed. Her surgery was a complete success!