From the Miami Herald
By JEFF KAHLER, D.V.M.
McClatchy Newspapers
Danny has a lump under his neck that Allison describes as almost tennis ball-sized and firm to the touch. She is positive it was not there the night before. The lump apparently does not bother the 6-year-old golden retriever, but it does bother Allison and her family.
Anytime a mass develops, it should be addressed. Most of these masses are not problems, but that is not always the case. Danny needs to see his veterinarian for diagnostics to determine the origin of the mass and its treatment.
A fine needle aspirate, in which cells from the mass are removed, would be my first recommendation. The aspirated material is placed on a slide and sent to a laboratory for microscopic examination by a cytologist. This test often will reveal what type of mass we are dealing with.
Without the benefit of diagnostic test results, I am guessing as to the origin of the mass. One possibility is lymphoma, a cancer of the lymph system that involves the lymph nodes. There are lymph nodes in the neck area close to the angle of the lower jaw on each side. When cancer is involved, these nodes, one or both, can become extremely enlarged. I do not think Danny has lymphoma, primarily because Allison has convinced me that there was no mass one night and then a big mass the next morning. Though lymphoma can come on as enlarged lymph nodes quickly, it is usually not that quick. The fine needle aspirate I mentioned will give the answer.
Focusing on the rapid appearance of the mass, my strongest suspicion is that Danny has a salivary mucocele, or the accumulation of saliva under the skin. It most commonly occurs as the result of the tearing of a salivary duct. The gland connected to the torn duct keeps producing saliva, but rather than ending up in the mouth cavity it dumps under the skin in the area of the rupture. These mucoceles can feel very firm, as if they were solid. Aspiration will reveal a thick, clear fluid, sometimes with some blood.
I think Danny has a mucocele because of the sudden onset and because Allison mentioned in her letter that Danny likes to play tug of war with his rope toy. I suspect Danny was playing tug of war and ruptured a salivary duct. The saliva built up under the skin in the ventral neck area and by the next morning Danny had a mucocele. Tug of war is a common cause of salivary mucoceles.
Treatment for salivary mucoceles can be a bit frustrating. I begin with draining the mucocele as flat as possible. I then will introduce anti-inflammatory medication into the lesion and send the patient home. This procedure can be repeated several times with the hope of scarring of the duct and cessation of the mucocele. If this does not work, surgery becomes the next option.
Surgery is performed with the hope of finding the ruptured salivary duct and closing it off, but the ruptured duct can be difficult to locate. We sometimes introduce radio-opaque dye from the salivary duct opening in the mouth into the duct. This is followed by radiographs of the head, which highlight the dye and the origin of the leak.
In Danny’s case, the answer lies in performing a fine needle aspirate. I hope Danny will have a mucocele instead of lymphoma. Of course, there are other possibilities.
Jeff Kahler is a veterinarian in Modesto, Calif. Questions can be submitted to Your Pet in care of LifeStyles, The Modesto Bee, P.O. Box 5256, Modesto CA 95352.
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