Baffy: Oral Squamous Cell Carcinoma

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Baffy on Friday morning, the day of his surgery. “We wish to thank each & everyone of you who have come forward to help Baffy during his difficult time. Despite a horrible past, we hope he can feel all the love now.” (Photo: Gwen)

“We adopted Baffy from Causes for Animals. No one knew his history. He was found in a forested area with a string around his neck. He must have been tied to a tree and while struggling to get free, hurt his neck badly. Although he was skin and bones, this boy has never shown any aggression to human being or dog. All he does is love unconditionally.

We are sharing Baffy’s story to highlight the plight of pets being abandoned. There is no good reason to give up a pet. You can fail in all the progress of technology and comfort of living, but you cannot fail in being a good human. One with compassion and loyalty. Pets are part of family and they deserve love, respect and most importantly health care from their care giver. The abandoned dogs often suffer in silence and most of them cannot survive in the wild. 

Not all dogs are lucky like Baffy to  get a second chance at life. Baffy now has a family who loves him and his future couldn’t be brighter with so many people rooting for his recovery. If there is anything our dogs teach us, it is to Leave No Man Behind. Whatever life throws at you.” ~ Gwen


Squamous cell carcinomas are malignant cancers originating from the lining cells of the mouth

They are locally invasive and occur mostly in the gums or tonsils. In Baffy’s case, a tumour located in the rostral oral cavity (towards the oral or nasal region) has a lower metastatic rate (lower chance of spreading to other parts of the body).

"About 6 weeks ago, we noticed a lump in Baffy's mouth. It was small and we thought it was an ulcer. When it did not subside, we took him  to the vet for a biopsy. He still seemed healthy but was losing weight." 

“About 6 weeks ago, we noticed a lump in Baffy’s mouth. It was small & we thought it was an ulcer. When it did not subside, we took him to the vet for a biopsy. He still seemed healthy but was steadily losing weight.”

Clinical signs include
  • difficulty eating (especially with tumours in the back of the throat)
  • drooling
  • bleeding from mouth
  • weight loss despite normal appetite
  • displacement or loss of teeth
  • facial swelling
  • swelling under the jaw

A thorough physical examination, complete blood count and biochemical profile were done and chest X-rays taken to determine if the oral tumour has spread. These tumours may provoke an inflammatory reaction that causes pain, and while controlling inflammation may help reduce superficial swelling and pain, it does not cure the cancer. Surgical removal of the tumour is the treatment of choice. 

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Computed tomography (CT) is helpful to define the extent of the tumour before surgery.

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If the tumour has not spread to other locations, surgery is the treatment of choice. Dr Dennis Choi, Mount Pleasant Vet Centre (Gelenggang) prepares to perform rostral mandibulectomy to surgically remove the tumour, including the extensions into underlying tissue & part of the jawbone, together with the incisors & canines.

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Surgery is considered successful if the tumour is completely removed. If the tumour has not spread, surgery is curative & can extend the animal’s life.

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Dogs adapt quite well to partial jaws. They may need to be hand-fed for a period of time before they learn to eat on their own again. Most importantly, they are no longer in pain or discomfort.

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Day after surgery. “Visited our Big Baby Baffy. The nurses said that he has good appetite, vitals are all good but not ready to come home yet. He is happy to see us & made a whole lot of noise when we left. We are very glad he is still his usual naughty self.” (Photo: Gwen)

“With Dr Dennis’ clear explanation of Baffy’s condition, we understand that surgery will save his life, even if it means removing part of his jaw. Otherwise we might have been more paranoid and perhaps too late to help Baffy. It is Dr Dennis’ confidence that helped us make the right decision for Baffy.

Baffy is now back home enjoying meat balls and soft foods, knocking everything down with his cone! Almost back to his usual self. We cannot be more thankful. Never give up on your pets, especially when they are ill. They need us even more then.” ~ Gwen

4 july 2016
You know what they say when you have been so near death that when u have been given a chance to live again, you just keep counting your blessings and live day by day to the fullest? It's all true. Baffy is as of today 45 days cancer free, and he is living his every moment to the fullest by being the naughtiest he could be. But we will take all the naughtiness at any moment. We want to Thank you for loving him!

“You know what they say about being so near death that when you are given a chance to live again, you just keep counting your blessings & live day by day to the fullest? It’s all true.
Baffy is 45 days cancer free & he is living every moment to the fullest by being the naughtiest he can be.”

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“But we will take all the naughtiness at any moment. We want to thank you for loving him!”

4 NOVEMBER 2016 

Like time and tide, cancers wait for no man. In May, Baffy went through rostral mandibulectomy to remove an oral tumour. He lost part of his lower jaw but is no longer in pain, and happier and more energetic than ever. His family’s prompt decision has added many good days to this big baby’s life!

"After Baffy's surgery, we were advised to watch out for any strange lumps. On Sunday, we felt a growth on his chest. A large amount of pus was discharged & today the growth is much smaller. It's good to have Baffy checked by Dr Dennis Choi so we have peace of mind. We're thankful he is alright. He's very happy everyday & has put on 3kg!" ~ Gwen

“After Baffy’s surgery, we were advised to watch out for any strange lumps. On Sunday, we felt a growth on his chest. A large amount of pus drained out & today the growth is much smaller. It’s good to have Baffy checked by Dr Dennis Choi so we have peace of mind. So thankful he is alright. He has put on 3kg!” ~ Gwen

Note: An abscess forms when bacteria enters a wound, even a tiny break in the skin. Abscess “pockets” are filled with pus. Depending on the extent of infection, the wound can be properly cleansed, drained and flushed by a vet, and a course of antibiotics prescribed.


Pain is common in pets with cancer, with some tumours causing more pain than others. Our pets may also experience pain associated with cancer treatments such as surgery or chemotherapy. Untreated pain decreases our pet’s quality of life. Read about “Managing Pain In Our Pets”.

Oliver: Little Guy With A Big Story

We met a brave little guy at Mount Pleasant Central Vet Clinic (Whitley). His name is Oliver.

Oliver. Little guy with a big story.

Oliver turns 13 this April. He is a fabulous mix of Beagle x JRT x Dachshund.

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Oliver was adopted as a teeny weeny pup. (He’s still tiny now!) He grew up in the United States with BFF Hannah & humans Rich & Kristen Gridley. 2 years ago, he packed his doggy bags for sunny Singapore.

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Wait. Not leaving his birth place without some glamour shots!

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“Cos I am cool like that.” ~ the one & only Oliver Gridley

24 December 2015, Christmas Eve

“We notice a small bump between his eyes. It was the size of an insect bite. We got him some antibiotics from the clinic.”

February 2016

The little bump did not go away. It grew bigger and Oliver started sneezing more. Oliver’s family decided to run more tests and send some soft tissue samples for biopsy.

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“On our way to get the biopsy done. Oliver looks mad because he didn’t have brekkie or water that morning so he wasn’t happy with me.” (We love this little guy’s attitude!)

When the report came back, Oliver was diagnosed with nasal carcinoma. By the time nasal carcinoma is detected, the disease is already highly infiltrative. CT Scan at Mount Pleasant (Gelenggang) confirmed the nasal mass has extended intracranially. Surgery is not an option.

2 March 2016

Oliver came for his first chemotherapy session with Dr Cheryl Ho. It appears that dogs and cats tolerate chemotherapy better than humans and side effects are minimal. Common side effects of chemotherapy are vomiting, diarrhea, loss of appetite and loss of energy.

Doses of drugs and treatment schedules are calculated to minimise discomfort to Oliver. The goal is to kill and slow the growth of cancer cells, while producing minimal negative effects on normal cells.

“We were of course hesitant about chemotherapy but once the veterinary oncology specialist recommended it, we decided to see how Oliver would respond. We are taking it one treatment at a time. If he starts to decline or if the chemotherapy starts making him feel bad, we will stop. Simple as that. Again, his quality of life is priority.

9 March 2016
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“There are good days and there are a few bad days. On a bad day, Oliver would be tired and did not follow me all around the house. But mostly he is doing fine. His appetite has changed slightly. He wants to eat smaller and more frequent meals instead of two bigger meals. So we adjust. He’s still eating the same amount of calories every day.”

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Dr Cheryl Ho measures the mass. It remains the same size at 5.5cm x 5.5cm; it did not grow bigger.

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Oliver loves people, loves attention & of cos, loves treats!

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Mabel draws some blood for testing. Chemotherapy drugs can affect the bone marrow & reduce the body’s ability to produce new blood cells, including white blood cells that fight infections. If Oliver’s white blood cell count is low, he will be more susceptible to developing an infection. Thankfully, Oliver’s blood test results are normal.

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More treats? What’s not to like about vet visits!

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“Oliver still has the energy, still wants to go for walks, sniff things. But we will never keep him alive just for us. When there are more bad days than good days, we will have to make that tough decision.” ~ Kristen


15 march 2016

All cancer patients need regular blood testing to monitor the effects of chemotherapy. Oliver came back for his blood tests. The mass between his eyes has reduced in size and measured 4.5cm x 3.5cm.

22 march 2016

Oliver’s 2nd session of chemotherapy with Dr Cheryl Ho. The mass is yet again smaller at 3.5cm x 3.5cm.

12 april 2016

Oliver’s 3rd session of chemotherapy with Dr Cheryl Ho. This boy is just so happy to see his vet! When Dr Cheryl stepped away for a few minutes, he stared at the door, waiting for her to come back.

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“Oliver loves attention. He wants everyone to crowd around him.”

Oliver's blood test is clear

A blood sample is drawn to check the white blood cell, red blood cell & platelet count to make sure it is safe to proceed with his 3rd session of chemotherapy. The mass was smaller until 2 days ago when it started getting bigger. “The tumour getting smaller initially then growing a bit seems to be the norm. It happened before treatment too.” ~ Kristen

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Cancer patients need to eat to stay strong to handle chemotherapy & the effects of cancer. “Oliver’s appetite isn’t good for about 5 days after chemotherapy. But we always manage to get him to eat with some yummy wet food mixed into his regular food. He’s spoilt rotten but the way I see it, cancer gets him lots more free passes!”

“Again, we are focusing on Oliver’s happiness, energy level & quality of life. The rest is out of our hands. So we are just enjoying him while we still have him & spoiling him rotten!” ~ Kristen

Here’s a short clip on our favourite little guy till we see him again in 3 weeks’ time.

… to be continued…

Milo The Maltese: Squamous Cell Carcinoma

Few months ago, 13-year-old Milo the Maltese developed an ulcerated mass on his neck. He was having difficulty eating and started losing weight.

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Complete surgical removal of the neck mass is the treatment of choice. Dr Estella Liew, Mount Pleasant Central Veterinary Clinic (Whitley), performed the surgery. However, due to its location (very adhered to the jugular vein & trachea), incomplete excision was expected.

The mass was sent for histopathological diagnosis and confirmed to be Squamous Cell Carcinoma (SCC). Due to its aggressive nature, the cancer is likely to regrow rapidly or metastasise (spread to other parts of the body).

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SCC is a malignant cancer that originates in the squamous epithelium – the outermost layer of skin that is made up of scale-like cells. Tumours may appear as firm, raised, frequently ulcerated bumps on the skin. They can occur in any parts of the body but usually in areas with a lack of pigmentation or hair.

One factor associated with the development of SCC is prolonged exposure to sunlight (ultraviolet radiation). As with most forms of carcinoma, SCC is more commonly seen in older dogs.

Clinical signs of Squamous cell carcinoma include:
  • drooling 
  • difficulty in eating 
  • weight loss
  • halitosis (bad breath) 
  • facial swelling
oronasal fistula

Milo also had two oronasal fistulas, measuring 2cm x 3cm and 3cm x 0.5cm. Symptoms of oronasal fistulas include chronic nasal discharge (with or without bleeding), sneezing, bad breath. Left untreated, oronasal fistulas would cause irritation of the nose, infection and aspiration pneumonia.

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An oronasal fistula is an abnormal passageway between the mouth & nasal cavity. It needs to be surgically corrected to prevent food & water from passing from the mouth into the nasal cavity. Ref: avds-online.org

Causes of oronasal fistulas include:
  • Trauma
  • Bite wound
  • Oral cancer
  • Periodontal disease
  • Upper jaw overbites (canine teeth in bottom jaw pierce the hard palate/roof of mouth)

The smaller fistula was surgically repaired by creating a flap of gingival tissue on the buccal surface and suturing it over the defect. The other fistula was too large to be repaired at the same time. It was suspected that the fistulas developed due to SCC. If so, the repair will likely  fail. Antibiotics are prescribed to control any possible infection.

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With the presence of the large oronasal fistula, an esophageal feeding tube was surgically placed through the side of Milo’s neck to keep him nourished & prevent aspiration pneumonia.

X-Ray was done to make sure the feeding tube was correctly placed through the esophagus (not the trachea). The tube extends the length of the esophagus & terminates just before the stomach. It allows food to enter the esophagus & flow into the stomach.

X-Ray was done to make sure the feeding tube was correctly placed through the esophagus (not the trachea). The tube extends the length of the esophagus & terminates just before the stomach. It allows food to enter the esophagus & flow into the stomach.

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Feeding tubes should be unwrapped, cleaned & re-wrapped once daily initially. After the insertion site has healed, the tube can be cared for every 48 hours to prevent infection at the insertion site.

Although prognosis for SCC patients is poor, Milo still has that sparkle in his eyes. And cancer can’t wipe that smile off his sweet face.

Towards the end of your pet’s life, I guess the best thing to do is remember the memories you have created (even the frustrating ones!) and cherish the moments you have left (yes there will be times your old friend needs to pee at 3am).

When the day comes to bid farewell, do so with a smile amidst the tears. Because he has been such a good dog.

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“I’ll feed Milo in the morning & come home in the afternoon to feed him again. At night, my mom will help. Milo enjoys sitting by the door. Watching the world go by. He is a good boy. We hope he will live past this year.” ~ Maurice & Yuan