Elvis The Maltese: Thoracotomy (Open-Chest Surgery)

Note: The following images may be unpleasant for some viewers.

16-year-old Elvis the Maltese had been losing weight despite a normal appetite. He was also generally quiet and showing signs of respiratory distress with a grating cough throughout the day. 

Echocardiogram (ultrasound of the heart) and CT scan revealed a large mass in the right caudodorsal chest.

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A thoracotomy (open-chest surgery) was performed by Dr Patrick Maguire, Veterinary Specialist (Small Animal Surgery) & Dr Dennis Choi, Mount Pleasant Veterinary Centre (Gelenggang), to excise the mass which was compressing the right main bronchus & oesophagus. Following anaesthetic induction, a ventral midline approach was made to the thoracic cavity.

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A saggital saw was utilised to perform a caudal sternotomy – making an incision in the centre of the chest to separate the sternum (chest bone) & gain access to the heart & nearby organs.

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Upon entering the thoracic cavity, a large, slightly irregular but seemingly well-encapsulated mass was identified, associated with the right caudal lung lobe. [The colour in this photo has been toned down]

Elvis

The mass was removed from the thoracic cavity & sent to the laboratory for histological examination. A chest tube was placed to drain air or fluid from the thoracic cavity before the surgical site is closed.

“Histopathological findings are consistent with a pulmonary carcinoma in the lung lobe, and based on morphology of the neoplastic cells is most consistent with papillary variant of pulmonary adenocarcinoma. Pulmonary adenocarcinoma is associated with mucus production by neoplastic cells. Clinical signs include cough, pneumonia, dyspnea, cachexia.”  ~ Excerpt from lab report by Dr Ong Chee Bing

* Dyspnea: difficult or laboured breathing
* Cachexia: weight loss in patients with cancer or other chronic diseases

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Elvis may have been diagnosed with cancer but this little trooper is making every day count. Few hours after his major surgery, Elvis was eager to have a good dinner.

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Elvis during one of his reviews with Dr Sebastien Monier, 6 weeks post surgery.

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Elvis continues to be on medication for his existing bilateral uveitis (inflammation in the eye) & heart condition.

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“I was very apprehensive about putting Elvis through surgery until I spoke with Dr Sebastien to understand how he’d be carefully monitored under general anaesthesia. Elvis is happier & more active after surgery. He coughs much lesser & it’s not the grating painful cough he had before. His coat is also healthier & he has a good appetite. We celebrated his birthday on 10 November. He is 16 now.” ~ Justine Duerden

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