Honey the thirteen year old Shih Tzu

At thirteen years of age, Honey is now an elderly dog, even though she’s still as fit and healthy as ever. As a small breed of dog, she may live on to be fifteen, sixteen, seventeen or even eighteen years old. However, being objective,  she’s no longer a “young thing”. 
For this reason, when she developed a minor problem which might need surgery, Mari wasn’t keen to rush into it. There’s an inevitable small risk of complications with any general anaesthetic, just as there is with humans. And as animals grow older, this risk increases slightly, so it makes sense to avoid unnecessary anaesthetics.

honey developed a few lumps on her skin

Honey started to develop a few lumps on her skin around eighteen months ago. They were tiny at first but they gradually grew bigger.  They were small, pink-coloured growths sprouting out of her skin. Most people would probably call them “warts”, but skin growths in animals are different to those in humans.
Warts in humans are skin growths caused by the human papillomavirus (HPV). In dogs, it’s rare for a virus to cause skin growths. This means that human home treatments for warts, based on anti-virus medication, are unlikely to have any effect on skin lumps in dogs.
Most wart-like lumps in dogs are actually benign skin tumours; the most common type is known technically as a “sebaceous adenoma”. For ease, many vets still call them “warts”, because they look so similar to human warts, but it’s more accurate to call them “wart-like growths”.
These growths are common in older dogs: I remember one terrier who had around thirty of them, all over his body. They didn’t bother him at all, and he lived with them until the end of his life at the age of sixteen.
Once wart-like growths have been checked by the vet, it’s generally safe to leave these alone, as long as they are not annoying the dog at all. They are often only a cosmetic problem: they look unsightly, but they don’t cause any harm.

three of the wart-like growths started to get bigger

After having Honey’s growths checked,  Mari had been monitoring them. They had remained unchanged and they weren’t irritating Honey, so there was no need to do anything. Then this summer, three of the wart-like growths started to get bigger, and their colour changed from pale pink to red. They began to look sore, and they began to bother Honey.
She started to scratch at them, and the fur around them became matted, because they had started to ooze with a sticky discharge.
Mari brought her to see me, and it was clear that the three growths had progressed, and it was now time to have them surgically removed.
Vets commonly operate on elderly dogs, and it’s often not anything to be afraid of when it needs to be done. There are three extra steps that are typically taken to keep any anaesthetic risk to a minimum. 
First, after the usual thorough physical examination has been carried out to ensure that the dog is in good health (including listening to the heart and lungs with a stethoscope), a blood test is taken to check that the internal metabolism is functioning normally.
Second, an intravenous drip is set up before, and during, the entire procedure. This ensures that the dog’s blood pressure is maintained at the optimal level, lessening the chance of placing vital organs under stress during the anaesthetic.
Third, specific precautions are taken to optimise anaesthetic safety: special short-acting drugs are used, effective pain relief is given, and anaesthetic monitoring is carried out with particular care, including electronic monitors and a qualified veterinary nurse staying with the patient until they have made a full recovery, so that they are sitting up and looking around.
Careful attention to these three areas minimises any anaesthetic risk for older patients.

honey had an operation

So when Honey arrived for her operation last week, the first stage was to set up an intravenous drip, and to process her blood sample. As it happened, the blood test showed that she had elevated liver enzmyes. Low-grade liver disease is common in elderly  dogs; sometimes this is just due to the wear and tear of advancing age, and as long as there are no signs of illness, it’s doesn’t necessarily mean that extensive investigations and treatments are needed. The result meant that we needed to choose Honey’s pain relief carefully: the standard drug is metabolised by the liver. Instead, we used a “liver friendly” type of pain control, which was safer for her. 
We went ahead with the surgery despite the signs of mild liver disease: the skin growths were troubling Honey, so it had to be done.
We kept the anaesthetic as brief as possible while we rapidly excised six small lumps. As well as removing the three that were troubling her, we removed three others, because it seemed likely that they would start to trouble her in the coming months. It was better to have just one anaesthetic, and to get everything done at the one time.
Honey recovered rapidly from the anaesthesia, going home that same evening. She has been in good spirits, and her stitches will come out later this week. She’s now lump-free and much happier with life. Hopefully a long and healthy old age now awaits her.

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