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My dog has swelling to her right rear ankle,...

Resolved • Response time 14 minutes

9 Jun 2012

My dog has swelling to her right rear ankle, xrays taken shows a dense/cloudy view. My vet recommends a bone biopsy for cancer. Is this advised?
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9 Jun 2012

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Dog Veterinarian's response
9 Jun 2012
Dr. Kara
Dr. Kara
Hello, I am sorry to hear that Beauty has swelling to her right ankle.
Did this seem to come up quickly?
Is she running a fever or has she even run a fever when her ankle was swollen (rectal temperature more than 103.5F)? If so have antibiotics been tried?
Is the change in the radiograph to the bones or the joint space itself? Does it seem to affect more than one bone? Does she or has she ever had more than one joint swollen?
If there is any increase in joint fluid or joint "space" an aspirate and cytology and culture of the joint fluid may be very helpful and is less invasive then a bone biopsy.
Are ticks a problem where you live? If so a tick panel may be helpful as tick borne diseases, like Lyme disease, can cause joint swelling and inflammation.
While bone cancer typically occurs in older dogs it is a cancer that can be seen at any age.
If she has never had a fever, ticks are not a problem where you live and the joint fluid aspirate and cultures (for both bacteria and fungi) come back negative a biopsy is the best way to diagnose her condition. Identifying the particular type of tumor she has, if that's what she has, is very important in prognosis and directing therapy. It is not something we do lightly but sometimes it is the only way to get a diagnosis.
Let me know if you have any further questions.
9 Jun 2012
Customer reply
9 Jun 2012
the swelling came on suddenly, we had blood work done. She is slightly anemic, slight low calcium. Is less active and walks with a pronounced limp. Fecal exam shows no parasites and heart worm test was negative. Her thyroid was also slightly low. No fever, eating well, no nausea, vomiting or diarrhea.
9 Jun 2012
Dog Veterinarian's response
9 Jun 2012
Dr. Kara
Dr. Kara
Thanks for the further information.
I am very glad she is felling well and heartworm and gastrointestinal parasite negative.
Slight anemia and slightly low thyroid levels can simply point to stress of dealing with another health problem. It is very likely that if her joint problem is diagnosed and treated those values will return to normal.
With most malignant bone tumors (like osteosarcoma), as well as invasive infections, the blood levels of calcium rise so a slightly low calcium is actually a good sign. Without knowing how low her calcium is it may be a normal level for her as we are all individuals and slightly low may be perfectly normal in some individuals.
I highly suggest at least an aspirate, cytology and culture of her joint fluid as well as a tick panel if ticks are a problem around you if possible before a biopsy. These tests are much less invasive and may give your veterinarian some answers.
If her joint space isn't enlarged and it is impossible to collect joint fluid and tick borne diseases simply aren't a problem around you then logiaclly the next step is a biopsy. It will be the only way to get a diagnosis and thus a treatment plan.
9 Jun 2012
Customer reply
9 Jun 2012
thank you for your advise. I think the next step is a biopsy of her leg. This should also include aspiration of the joint fluid. There is a lot of soft tissue swelling so an xray may not show everything. No fractures were noted above or below the joint and no rough edging to suggest arthritis.
9 Jun 2012
Dog Veterinarian's response
9 Jun 2012
Dr. Kara
Dr. Kara
I think that is probably the best approach as that will get you results the quickest. And you are correct in that they absolutely can collect joint fluid for analysis and culture at that point as well.
Best of luck with your pup, please let me know what the results are.
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Dr. Kara
Dr. Kara
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Over 20 years of experience as a veterinarian.
9 Jun 2012
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