Rick park 2011-07-14 03:03:38
My 15 yo Bichon b**** recently and rapidly developed a very large pocket of
fluid under the loose skin covering the scruff of her neck and shoulders.
To put in perspective, she is a large (24 lb) dog for her breed; the volume
of the fluid looks to be somewhere between a cup and a pint and will freely
shift from one shoulder to the other over her neck. It looks grotesque, but
does not seem to have caused any ill-effects to her health and her vital
signs and functions are all normal.
I have had her to the vet twice – once for the initial check and a
follow-up. The vet suspects some kind of internal trauma involving a cyst
or tumor; when we first noticed a swelling on her shoulder, it was palpably
firm and tender. Now there is no swelling or tenderness and I suspect that
his diagnosis of a burst cyst accompanied by the body’s reaction to mobilize
immune system products and plasma account for the rapid buildup (about 3
days to gain the current volume of fluid).
The fluid seems to have stabilized. The vet sent out a sample for analysis
and it was consistent with the type of fluid build-up from an internal
wound, but no cancer cells were noted.
She is on Baytril antibiotic in case there was some external cause like a
tick bite but we have noticed no marks or contusions (the site is shaved).
Just wondering if anyone has experience with this kind of condition.
The vet doesn’t think it needs imminent treatment but says if surgery is
required, it will involve a foot-long incision with scraping of fat and
examination for ulcers/cysts. We agreed to wait and watch for another week,
then decide what to do and at the least get another pathology test on the
He had initially considered a ruptured salivary gland duct backing up into
the space, but when he took another sample, felt that it was not likely this
was the cause.
Any thoughts welcome.
Tallgrassprair 2011-07-14 03:04:48
A foot long incision, huh?? Not.
Couple ways this could be managed….if it is blood, it is a
hematoma….one this size probably should be drained every day or two,
or when it has re-accumulated.
If it is serous….clear to slightly pink….it probably should be
drained as above. In both these cases, a needle and syringe will
suffice. I would use a 16gauge needle and a large syringe.
If this is pus, the wound needs to be opened and allowed to drain;
your description does not suggest this.
so….your dog probably has a serous cycst, cause unknown. As long as
it is not infected, you can just keep an eye on it, and it will
probably go away over time, maybe leaving a small knot in the space
If you and the vet decide to open this cyst, I would suggest two
small, linear incisions, one perpendicular to the other…+…then
take each point of skin, fold it over and suture that point of skin to
skin further out from the incision. This process is called
marsupialization. Then, take a foley catheter…a bladder catheter,
insert into the cyst space, inflate the bulb of the catheter, and let
the lesion drain around the catheter. The catheter can be sutured to
adjacent skin to help keep in in place. The wound would need to be
kept clean, and would eventually heal from the inside outward.
Unless the vet is trying to remove this cyst entirely, draining the
cyst should be adequate.
More information than you wanted, eh?
Linda H., M.D., not a vet
Buglady 2011-07-16 00:13:33
……..Yeah, that’s what I was thinking. Can’t imagine why the vet wouldn’t
try to drain a bit of this off instead of waiting for the body to reabsorb
and deal with it all.
take out the dog before replying
Rick park 2011-07-16 00:14:31
Thanks to buglady and Tallgrass for the info.
The fluid was not pus but more of a plasma/serum color. An earlier lab exam
of the fluid showed some infection and blood but she has been on antibiotics
for a week.
Had another discussion with the vet and although his preference is to open
the area and do some examination, we decided that an ultrasound diagnostic
for tissue abnormality, followed by draining to be the next step.
We agreed that the draining would be a one time event and if it resumed
filling with fluid, that surgery would be the next step.
One other thing I didn’t mention is that the initial set of events resulting
in this balloon of fluid followed cessation of prednisone (in a controlled
weaning) which was given for severe allergy symptoms. I surmise that her
immune system may have overshot its response to whatever caused the initial
swelling. The vet is suggesting that she resume prednisone for a period of
time to control inflammation and possible resumption of the swelling.
Tallgrassprair 2011-07-16 00:14:36
Cutting and anesthetics mean more $$$ for vets. Some of them lose
sight of what might be the better approach to a problem and get stuck
in the rut of telling patients/clients that they need a larg incision,
instead of this being the last resort.