Popcorn is a 7 year old Shih Tzu who has recently had open chest surgery.
Popcorn first presented to her usual vets as she was becoming increasingly tired and out of breath during her walks, she had also lost some weight. On examination, Popcorn’s heart could not be heard on the left hand side of her chest and any heart sounds that were audible were very muffled and unclear. We should be able to hear lung and heart sounds over both sides of the chest so this was an indication that something was affecting these sounds and further investigations were needed.
Popcorn had chest x-rays which showed a large mass in her chest on the left hand side. In order to decide how to treat Popcorn a sample would need to be taken to determine the type of chest mass; some masses can carry a poor prognosis therefore it is very important to do this. Popcorn had a short general anaesthetic and biopsies of the mass were taken for analysis. Luckily, Popcorn’s mass came back as a Thymoma.
Thymoma’s are relatively benign masses which do not tend to invade local tissues or spread to other areas in the body. As a result surgical removal of the mass should be curative. However surgery in the chest is still very risky and removing a mass here can be difficult due to its close proximity to large bloods vessels, the lungs and the heart. This type of surgery needs to be performed by a very experienced and specialist surgeon. Therefore Popcorn was transferred to Hollybank where a specialist surgeon who we work with was able to perform the operation and we were able to monitor her post-operative care closely.
Popcorn’s surgery was challenging. The mass was very large and adhered to the left lung lobes and surrounding vessels which took lots of careful dissection. The anaesthetic also had to be very carefully monitored as we had to manually inflate Popcorns lungs during surgery to allow her to breathe whilst her chest was open. However, the surgery was successful and the mass was removed! A drain was placed in Popcorns chest at the end of the procedure to allow drainage of any fluids (inflammatory fluids created during tissue handling) or air (the lungs could leak air if removing the mass had disrupted there surface).
Popcorn then began her post-operative care with us at Hollybank. It was very important to monitor Popcorns breathing rate and effort following surgery in case there was any fluid or air accumulation in her chest. For this reason we also drained Popcorns chest every couple of hours via her chest drain; initially we had inflammatory fluid. Over the next few days Popcorn received lots of TLC and was receiving injectable medications such as strong pain relief, anti-inflammatory drugs and antibiotics. We also put local anaesthetic down Popcorns drain to provide extra local pain relief. She was even lucky enough to have lots of fresh chicken due to her insistence that she didn’t like dog food!
Popcorn stayed with us for one week post-operatively and made really great progress. The amount of inflammatory fluid from her chest gradually reduced and we were able to take her chest drain out. Her surgical wounds were healing really well and on listening to her chest we were now able to hear her heart and lung sounds on both sides. Popcorn was considerably brighter and happier by the end of the week and we felt she was well enough to go home. Since then Popcorn has been putting on weight and doing really well at home. It has been great to see her back looking so bright and lively!