Sequoia is a 12 year old Bichon Frise that came to our clinic with a recent history of bloody diarrhea. Routine blood and fecal testing failed to reveal a definite cause for her problem. Since Sequoia was otherwise feeling great with an excellent appetite and no weight loss, she was treated symptomatically for inflammatory bowel disease of the colon. Her treatment included a special diet with Probiotics, anti-inflammatory and intestinal antibiotic medications. Unfortunately, these therapies had little beneficial effect and Sequoia's problem progressively worsened. When it became apparent that standard medical therapy was ineffective, we scheduled Sequoia for a comprehensive battery of advanced diagnostic tests on October 19.
Following an overnight fast, an abdominal ultrasound exam was performed. This exam revealed an unusual tissue change localized in Sequoia's descending colon. This type of change was suggestive of a possible tumor. The arrows in the following ultrasound image point to the suspected tumor.
The ultrasound exam was then followed by a colonoscopy under general anesthesia to allow for visualization and biopsy of the diseased tissues. The colonoscopy revealed a mass of severely inflamed hemorrhagic tissue suspicious for colonic cancer.
Following the colonoscopy, Sequoia was taken to radiology for a specialized x-ray series known as a "barium enema". These x-ray images allow us to even better define the degree of disease change affecting the colon. The arrows in the following x-rays point to the mass in the colon that is seen as a "filling defect".
The most likely diagnosis based on these images was cancer of the colon known as "adenocarcinoma". This type of cancer is highly malignant and rapidly spreads throughout the body. Sequoia's owner was informed of the likely diagnosis and agreed to have surgery scheduled as soon as possible to remove the mass, even knowing that it may be too late to save Sequoia.
Our surgical specialist, Dr. Bruce Berger, was immediately scheduled to perform this difficult and delicate complicated surgery. The surgery required removing a 12 cm length of Sequoia's colon and took almost 3 hours to complete (even with a second surgeon's assistance for much of the procedure).
Sequoia recovered from her lengthy anesthesia and surgery without complication. Following 2 days of ICU post-op hospital care she was discharged to her owner's loving care.
The following video shows Sequoia demonstrating her desire to go home less than 48 hours after her surgery.
Sequoia continued to recover beautifully at home and was back to normal with "lovely normal bowel movements" within 10 days of her surgery.
To make Sequoia's story even better, the biopsies returned a diagnosis of polyploid adenomatous colitis, a pre-cancerous disease that is cured by surgical removal.
Here's our girl at the time of her suture removal, 13 days following her surgery.
Sequoia's case is noteworthy for several reasons.
First, her disease would not have been diagnosed without the use of our hospital's advanced diagnostic testing services: ultrasonography, endoscopy and digital radiology.
Second, early diagnosis and aggressive treatment was critical to resolving Sequoia's disease before it progressed to colonic cancer. Sequoia's disease is very similar to the colorectal disease in people that leads to colonic cancer and is the reason for routine human colonoscopic exams.
And perhaps most importantly, her case demonstrates that our older pets are perfectly capable of undergoing lengthy anesthetic and surgical procedures. All too often we see pets that have been forced unnecessarily to live with painful and debilitating medical problems due to the owner's misguided assumption that their pet is "too old for anesthesia". With proper pre-anesthetic screening tests and our more advanced anesthetic delivery and monitoring systems, we are capable of successfully anesthetizing geriatric patients with a variety of disease problems and returning them to better health.
Sequoia is a shining example.
