Case of the Month: uterine cancer in Pet Pigs

Case of the Month: uterine cancer in Pet Pigs

This past Monday, CVC got to work in a 130 pounds 10 years old female pot-bellied pig named Piglet.  Her abdomen was really distended and her caretaker knew from the first time that this was probably due to an uterine neoplasia. The mass was growing fast but Piglet was just doing great and her caretaker was worried about the risks from surgery. 

The distended belly is due to the presence of two large masses weighing 34 lbs.

Piglet was finally seen at CVC and she underwent surgery. During surgery, she was spayed and we removed two large uterine tumors attached to  her uterine horns. Both masses and the uterus weighed 34 lb. This was about 25% of the total body weight of Piglet. These masses were likely to be leiomyomas.

Largest of the masses, it needed to people to support the weight of the mass

Smaller mass, it was about to baseball balls together

After a week post surgery, Piglet is now doing well. In the last two days, she has regained a lot of strength back and will be joining her other pig friends soon. 

Unlike commercial pigs, pot-bellied pigs tend to live very long with a life span estimated to be as long as 20-25 years with the majority of them (average) living of 10-15 years. Cystic endometrial hyperplasia (CHE) has been found to be the most common finding in older pigs with reproductive disease. This is a disease characterized by excessive proliferation of the inner lining cells of the uterus (endometrium). About 44% of those, CHE can be present in conjunction with a smooth muscle tumor. 

One study found that uterine tumors are very common (70%) in the 5 year old or older female pig. From those, 65% were leiomyomas+.  Leiomyomas are a benign smooth muscle neoplasm that very rarely becomes cancer (0.1%). They can occur in any organ, but the most common forms occur in the uterus, small bowel, and the esophagus. 

Uterine leiomyomas, commonly termed fibroids, clinically affect approximately 25% of women of reproductive age in the United States (over 30 years of age), with a subclinical (no obvious for the person to realize about the growth) incidence as high as 77%. Interestingly, the pig has become a medical model for this disease in woman as it has some similarities+. 

In pigs, clinical signs include abdominal distension or vaginal bleeding. Like in human, in many cases they are just identified during spay. Tumors can range from microscopic to 99 lb, are often multiple, and primarily involved the uterine horns.

To sump up, spaying really helps with this as females will jump on you, whine for hours, and forget their potty training during heat  (which will occur every 21 days for about 5-7 days). The health benefits of spaying or castrating your pet pig also include the prevention of reproductive related diseases such as cancer and infection. In one study done on pet pigs ranging from 4 months to 19 years of age, 75% had cystic endometrial hyperplasia (CEH) and 62.5% of those had cancer. Aging is a risk factor and cancer was found in pet pigs of 5 years old or older*.



+ Mozzachio K, Linder K, and Dixon D. Uterine smooth muscle tumors in potbellied pigs (Sus scrofa) resemble human fibroids: a potential animal model. Toxicologic Pathology 2004: 32, 402-407.
*Ilha MRS, Newman SJ, van Amstel S, Fecteau KA, and Rohrbach BW: Uterine lesions in 32 female miniature pet pigs. Veterinary Pathology 2010: 47(6) 1071-1075. 

A great story with a good ending!

Saphira is a 2 year-old female, and "now", spayed panther chameleon. She was presented to CVC because she was not able to pass her eggs and the fact that she was not eating. Saphira was seen at another veterinary clinic that helped her with some treatments in an attempt to making her lay the eggs. Unfortunately, this was not working and she was declining. At the time of our first visit, she was weighing 62 g.

Saphira's xray showing what may be eggs in her belly.

At that time, surgery was the only option. So Dr. David Martinez proceeded with an exploratory surgery in an attempt to remove the possible eggs and help her recovery. In this case, there were not eggs but rather large ovaries full of pre-ovulatory eggs. This is referred as a pre-ovulatory follicular stasis. The ovaries will create the yolks but they will never make it down to the oviducts for them to develop into the full eggs. In these cases, these pre-ovulatory eggs will not be ovulated or reabsorbed. It is unclear why this occurs, but it may be related to inappropriate environmental cues. Differentiating ovarian follicles from oviductal eggs can be challenging but the follicles tend to be spherical instead of ovoid in shape. 
 
The degree of disease was such, that some of the ovarian tissue was already disease and compromised. To our surprise, two formed eggs were present in the colon. This means that she has formed  at least two eggs and when she went to laid, she could not pass them and went back to intestinal tract. Reptiles have one exit named cloaca, and all systems (urinary, reproductive and digestive system share the same opening) will join there. When she could not pass the eggs, those eggs back track into the wrong system.

Saphira during her surgery. An endotracheal tube allows lung ventilation

Those are the ovaries laying beside a scalpel blade handle. The scalpel blade handle is actually the same size of Saphira

After three weeks of treatment and supportive care, Saphira has made full recovery. She came the other day for her suture removal and she is 100% back to herself. The broken skin is due to normal reptile shedding. Skin shedding increased during time of skin healing which is what she was doing due to the presence of the sutures and surgery site.

    The End!!! ... at least for now, more stories to come soon. Stay tune in.

Amelia, the owner, and her sweet Saphira

Hoof care of the pet pig

HOOF CARE:

Overgrown, elongated hooves are a cause of lameness in the pet pig. Once overgrown, they can develop serious leg problems as long hooves shift the weight back and break down the hoof and ankle structure. Overgrown hooves will cause the hooves to crack leading to infection and they will promote serious joint disease (osteoarthritis). This is even worse when they get overweight, so watching out for their calorie intake is very important.

Regular hooves trimming may be needed. The best thing is to have this done under sedation as this would be a stressful procedure for both you and your piggy. This can be done regularly, like once a year, or as needed depending on your pig's lifestyle.

Naturally, they are meant to eat for long periods by foraging for food. This is the best practice to help them keep their hooves in optimal condition. They should have access to a yard or paddock so that they can spend time walking while searching for food.

Another option is regular exercise on abrasive surface (e.g. concrete). This will help your pig wear down his hooves. Now, it is important to remember that their feet are not meant to walk over hard surfaces and that too much walking over these type of surfaces can be too abrasive and promote cracking of the hooves. If your pig is only used to soft surfaces, this may even be uncomfortable on the pig. If you would like to use this technique, you should introduce this process slowly.

Pigs are very smart and can be trained. Therefore, a third option may be to slowly train your pig to let you trim his/her hooves when he/she is laying down to get belly rubs or when he/she is eating. Just a little at a time and do not force it.

Things about puppies we should all know!!; vaccines and normal puppy behavior/learning stages

Things about puppies we should all know!!

Vaccines:

We all know that all puppies should start getting their core vaccines about 6 weeks of age. But why? Maternal antibodies, the protection that mom gives them at birth, will decrease at 6-8 weeks of age. Therefore, vaccines should be started at 6 weeks, and then they are given every 3 to 4 weeks till about 16 weeks of age to minimize interference with those potential maternal antibodies. If maternal antibodies are present, vaccine protective effect diminishes. If maternal antibodies are not present, vaccine induced protection begins. This vaccine series will then ensure immunity (protection) for dogs that may not have adequately responded to the first puppy vaccines. 

Core vaccines are those that are required by every dog in order to protect them from life-threatening infectious diseases that remain present throughout the world. These vaccines are given until 16 weeks of age. There are non-core vaccines that are administered based on geographical location and risks associated to the area where your dog live. Some examples are leptospirosis, kennel cough, canine influenza and lyme vaccine.

Normal behavioral things you should know:

Chloe first time visit, a 7 weeks old Shih Tzu female puppy

Did you know that from birth until about 2 weeks of age, factory and tactile sensory are developing.

By 2-3 weeks, the puppies' eyes should open and their social behaviors begin. This is when mild human interactions should begin like weighing them daily. It is around days 12-20^th, when this becomes more clear. Puppies will startle to sound and become more coordinated.

By about 3 to 8 weeks of age, puppies learn how to interact with each other. Puppies should also be introduced to novel things and situations, and this should continue as they grow. This will help making your puppy more tolerant to noises, strangers other dogs and pets in the household, etc. Puppies will learn how to interact with people around 5-12 weeks of age. Therefore, around five weeks of age, interactions with people should slowly increase. This could involve walking them on leashes, massaging ears and paws, training them to sit and come, etc. Halters and leashes should be introduced at around 5-9 weeks of age. This is the time period when they are more responsive to halters and leashes. If during this time of interaction, aggression toward toys and food is noticed, you should inform your veterinarian. This can be used as an early indicator for future aggression and behavior should be work on to help decreasing unwanted behaviors in the future.

Do you know that early separation from the mom does not make the human-dog bond stronger? When dogs are separated and avoided of normal puppy-mom interactions, abnormal behaviors may be more common. At 6-7 weeks of age it is the most upsetting and destabilizing time if puppies are separated from home and companions. To relieve this effect, puppies of this age should be exposed to other places in the house as a group. Also, separation from litter mates at six weeks of age have nevative effects on physical condition and weight. Therefore, the best time to place a puppy in an new home is between 7 and 1/2 and 8 and 1/2 weeks of age. This will help with house training for two reasons: too much stress will impede learning and at 8 and 1/2 weeks of age is when puppies develop a preference to where they will urinate and defecate. 

Training:

Training starts as soon as possible at around 5 weeks of age. This should be done in short time intervals (1-5 min) throughout the day.

• If chewing on things beside toys, simply take the item away and give it the proper toy.
• If he is biting you, you should react and stop playing.
• You should never yell or punish your puppy. Punishing your puppy can result in him/her associating the punishment with you and not with the action.
• Pay attention to your puppy. It is more important to avoid bad behavior than pushing for it.
• Begin massaging the feet and ears and looking in his/her mouth on a regular daily basis. You should also hold him/her by the collar and encourage him/her to stay still. This should be practiced daily. This is just a game as well as trying to teach some manners.You should never punish your puppy for not remaining still.
• Crate training will take several weeks to achieve. It is important to remain patient during this time. Never force your puppy into a crate. The crate should always be associated with something pleasant. Place the crate in an area where the family spends a lot of time. At first, you should ensure that the door stays open so that it does not close and scares your puppy during this first learning exercises. You should encourage him/her to go into the crate by tossing treats into the crate. Continue this daily until your puppy enters the crate calmly. Always let the puppy come right back out at this state if he/she desires it. When the puppy is relaxed going in and out of the crate, you can start feeding the puppy in the crate. When the puppy can stand comfortably while eating meals in the crate, then you can close the door. At first, open the door as soon as he/she is done eating. With each successive meal, leave the door closed longer. If whining starts, wait tell it stops an then open the door. At the next feeding, shorten the time period.Then slowly practice calling the dog into the crate during other random times. At first it should be very short periods of time and rewards should be given. Over time, decrease the amount of treats and increase the time interval. If the dog begins whining, shorten the time period. Leaving random treats in the crate and giving enrichment toys while in the crate helps the dog to associate the crate with a pleasurable experience.
• House training. Remember 8 and 1/2 weeks is when puppies learn a preference for urinating and defecting. It is helpful to have a flexible schedule, however, house training is still possible for working owners. Leave a small area for the puppy to make sure there is enough room for the puppy to move around and use the bathroom. Puppies will not defecate/urinate where they sleep or eat/drink. Set up a toilet area for the puppy to use with some potty pads, if needed. Don't punish him/her if accidents happen. It is the accident happens near the pad, you can smear some of the urine in the pad to encourage him/her to go back to the same spot. Try to come as soon as possible for lunch or dinner, so that he/she can be reminded where we will want him/her to eventually go and to clean pats appropriately. As  he/she gets older, it will become easier. Once the puppy becomes reliably house trained, the you can increase the confined area.
• Attention walking should begin as a puppy. This will help him/her learn to focus on you later in adulthood. Once your puppy is comfortable to the leash, halter or harness, you can start walking around the house at first with encouraging treats throughout the process reinforcing when he/she walks close to you and pays attention to your commands.  
• Adding treats randomly to a food bowl is a great way to prevent food aggression. If the bowl is taken away, make sure you give the puppy something extra yummy.
• Periodically approach and reward a puppy for playing with its toys., Also it is a great idea to smear yummy treats on toys such as cheese and peanut butter. This will help prevent toy aggression.
• Reward calmness and pay attention to them when they are also calm and laying down comfortably. We do not need to only pay attention when they are barking or jumping at us. 
• Socialization begin as soon as possible. Interact with as many proper people, dog and children. You should also bring your puppy to new places as often as possible. After vaccines are finished, he/she should not be in dogs parks or areas where there may be dogs of unknown medical history. If your puppy's weight allows it, you can try taking him/her in your arms or in a carrier bag to places. You can have friends bring your friend's fully vaccinated low risk dogs to your house for play date. Puppy kidnergarten is a prefect option. 
• Puppy classes and kindergarten. Things you should watch for are: how many puppyes are in the claass, age group, vaccination status and requirements and trainer knowledge. Ideally you want the class of puppies to be around the same age 9-16 weeks, all must have at least two rounds of vaccines given, fully dewormed and someone present to help with the training. Human interaction interaction is also very important.
• As soon as an aggressive or fearful behavior occur, you should notify a veterinarian. There are not perfect dogs, but you should make sure the things you see in your pet are acceptable or not.

Spaying a pet pig at CVC

SPAYING A PET PIG AT CUMMING VETERINARY CLINIC

Did you know that pet pigs need to be spayed or castrated? There are many reasons why we should have pet pigs spayed or neutered. First of all, there are already so many unwanted pigs. Piglets are very cute and small during the first year but can grow to be very large. Many pet pigs are given up because of behaviors resulting from not being spayed or castrated. Unwanted behaviors can make keeping a pig even harder, thus many pigs end up in rescue groups and pig sanctuaries. 

Spaying or castration really helps with this as females will jump on you, whine for hours, and forget their potty training during heat  (which will occur every 21 days for about 5-7 days); and males will have an unpleasant odor and will try to ride your leg or furniture all the time. The health benefits of spaying or castrating your pet pig also include the prevention of reproductive related diseases such as cancer and infection. In one study done on pet pigs ranging from 4 months to 19 years of age, 75% had cystic endometrial hyperplasia (CEH) and 62.5% of those had cancer. Aging is a risk factor and cancer was found in pet pigs of 5 years old or older.*

At CVC, we spayed yesterday Mimosa. As you can see in the images, we carry out all surgeries with proper monitoring equipment. Mimosa was intubated so that oxygen and the gas anesthetic can be properly delivered. She had an intravenous catheter for fluid administration during surgery and she was connected to a cardiac monitor so that we can monitor her heart rate, blood pressure, electrical heart activity (ECG), oxygen blood saturation at all times. Her rectal temperature was also monitored throughout the surgery to prevent hypothermia (low body temperature). Hypothermia is common during deep sedation or general anesthesia and it is associated with patient discomfort and shivering as well as it can have detrimental effects. To alleviate this, Mimosa was connected to a thermal blanket.  After surgery was performed, Mimosa received oxygen for about 10 minutes until she was ready to have her endotracheal tube removed. Her hoofs were trimmed and she was ready to go home in no time. 

Mimosa has her IV catheter in her right ear and she has been just intubated with an endotracheal tube for proper ventilation

She is now connected to a blood pressure monitor and her surgery site is being prepped for surgery

During surgery, she is connected to a cardiac monitor and fluids are delivered intravenously to help with blood pressure and blood supply to all body organs

She has a heating blanket device to help her maintained good temperature throughout the surgery

During recovery, she gets a pedicure!

Our lovely Mimosa is now fully awake and ready to go home!

* Ilha MRS, Newman SJ, van Amstel S, Fecteau KA, and Rohrbach BW: Uterine lesions in 32 female miniature pet pigs. Veterinary Pathology 2010: 47(6) 1071-1075. 

Zeuterin is a novel and all natural injectable way to neuter your male dog without the need for anesthesia and anesthesia. The important health benefits of this more novel technique of castration is that your dog retains 40-50% of testosterone instead of none as with surgical castration. This important hormone has been demonstrated to play critical role in the health of your male dog affecting metabolism, muscle tone and physiological processes. This procedure is done in less than 10 minutes and without the need for anesthesia or surgery. Please call us today for more information about Zeuterin or watch the promotional video below.


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The entire procedure, including recovery, takes about an hour. A sedative is given to facilitate the procedure. It is performed by an experienced and licensed veterinarian. There is minimal pain or discomfort throughout the entire procedure. All dogs will be screened to ensure Zeuterin is appropriate for them. To learn more, go to https://www.youtube.com/watch?v=oLktosN7n6A

For additional information and to schedule an appointment, please call Dr. David Martinez, DVM at
Cumming Veterinary Clinic.

To learn more about Zeuterin™, go to www.zeuterin.com.


Important Safety Information: Zeuterin™ is an FDA approved prescription drug available only to licensed veterinarians. The safety and effectiveness of Zeuterin™ has been established in dogs 3 months of age to 10 months of age. In a field study with 270 dogs, 6.3% of dogs had adverse reactions at the injections site and systematic reactions. In only 2.6% of treated dogs the Zeuterin™ injection was observed to be painful. The most commonly reported systemic reactions to the Zeuterin™ injection were neutrophilia, vomiting, anorexia and lethargy. The most severe reactions occurred when dogs bit or licked the scrotum following injection. These were observed in fewer than 1% of dogs. For complete product disclaimer and information please visit http://www.arksciences.com/images/pdf/ZeuterinCMCPackageInsertFinal.pdf

 

Stories: Turtle spay (oophorectomy)

Dr David spayed last week a red eared slider. "Steve", as she is name, has been having a lot of reproductive problems. Finally, after two months of retained eggs, the owner elected to have her fixed. In mature females, this can be done through the femoral fossa, which allows a successful surgery without having to break through the plastron (shell).

"Steve" was first sedated and then prepared for surgery. An endotracheal tube was placed to assist with ventilation and the delivery of anesthetic gas.

The surgery was performed with the use of an endoscope. An endoscope allows direct access to the coelomic cavity (abdomen) and permit easy visualization of the different organs. With the use of a non traumatic forceps, the ovaries were then exteriorized and removed.

The two ovaries were successfully removed.

"Steve" is now recovering and enjoying again the sunshine and the great days ahead.