Nemo's Latest Lump
4/30/09
Nemo had a large lipoma in and around his left shoulder joint. We had it diagnosed as a lipoma by ultrasound-guided needle aspirate about 18 months ago. At that time it was small and not bothering him at all, so his surgeon said "Leave it, he's been through enough." We agreed. Unfortunately it grew so large that in the past month or so it was causing him significant pain. He started to toe in on the left side and his shoulder blade was forced out. He also started trying to carry all of his weight on the right side. He was getting muscle spasms in both shoulders in the evening, on the left from the joint disruption and the right from holding all his weight all day. He would be laying on the couch, in air conditioning, and just start panting from the pain.
We had the mobile vet out to check him, she did full bloodwork a UA and 8 views of radiographs. His bloodwork, including thyroid was perfect, pretty good for a dog who will be 14 in 4 months. His radiographs showed no osseous invovlement and a normal thorax (we were concerned about mets from previous tumors and his heart because of his age) and the radiologist gave us a thumbs up for anesthesia from his point of view. He also said the joint looked significantly affected by the placement of the mass. You could see the scapula was not only pushed out an extra 1.5" from his ribcage, it was twisted out of place.
Here are his radiographs:
http://petget.com/images/dogs/Nemo/nemorad1.jpg
http://petget.com/images/dogs/Nemo/nemorad2.jpg
http://petget.com/images/dogs/Nemo/nemorad3.jpg
Here's the lump, it was hard to get pictures of because it was socked in behind the shoulder, so I waited until he was bent in a way so you could see it:
The doctor called around 10am to say that he was done and that he's almost positive is was a straight up lipoma, not an invasive one like we feared. It weighed almost a pound, and was 10"x7"x5", which is gigantic. He said it had nowhere left to go and was squeezed in incredibly tight between the scapula, chest wall muscle and shoulder muscle (the report says deep to left scapula, latissimus dorsi and serratus ventralis). It was putting constant pressure on the joint, muscles and brachial plexus - no wonder the Deramaxx and Tramadol weren't helping. He's going to have a drain for 7-10 days because it left a giant space.
Friday May 1 - 1 day post-op
Sunday May 3 - 3 days post-op
3 days post-op
Monday May 4 - 4 days post-op
4 days post-op