This dog presented to me yesterday after being rescued by Saving Grace Animal Society because she had a large lump on the bottom (ventral) aspect of her jaw. The mass was firm to the touch, mildly painful, warm, and covered with normal appearing skin/hair (integument). She was otherwise normal in appearance except her right hind leg had an abnormal lateral rotation that made her ‘toe out’ on that leg. We planned on doing X-rays under sedation.
We started by aspirating the lump. I was able to pull several ml of mildly thick (viscous), brown, clouded material from the lump (see image). I suspected this was an abscess but to be sure we looked at the cells under the microscope. The material was composed of mostly cocci bacteria and neutrophils. This is consistent with an abscess.
We sedated the dog to drain the abscess (see video). The area was clipped and cleaned. A scalpel was used to cut a small incision in the abscess to allow drainage. The abscess was explored (to make sure there was no foreign material) and flushed with stanhexidine and water. A Penrose drain was sutured into the incision to keep it open so the pus can continue to drain out. It will be removed in 3-5 days. She was given an injectable anti-inflammatory for the pain and started on antibiotics.
When she was sedated, we noticed something sticking out of her right hind hip. It was quite hard and covered with normal skin/hair. It felt like a bone (see video). GUESS WHAT… WE WERE RIGHT! It was bone and this is why her right hind was externally rotated. You can see on X-ray that she has an old fracture of her femoral neck of her femur. The hip is still kinda in the socket (acetabulum) but the femur is no longer attached to it. The socket has quite a bit of damage and boney proliferation too. She is still able to walk on the leg because it is being stabilized by the surrounding muscles.
NOW WHAT??
We need to figure out what to do with her leg. We have two options that we can do at our clinic.
Option 1: a femoral head ostectomy (FHO) can be done to remove the broken femoral head but leave the rest of the leg. The muscles around the leg will stabilize it similar to what they are doing now.
Option 2: a leg amputation can be done to remove the entire leg including the femoral head and she will live with 3 legs.
Surgery should be scheduled for this week and I will keep you updated on what we end up doing with this sweet girl!
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