Not Expecting The Unexpected

Today I neutered a three year-old boxer.  He had recently been seen at my practice for testicular pain, with the suspicion of an inflammation or infection in or around the testicles.  He responded well to antibiotics and pain medication, but on the recheck exam I noticed that the firm swelling had not resolved.  Suspecting other problems, including cancer, I convinced the owner to have him neutered with the possibility of a biopsy of any suspected tissue.

Normally a routine neuter takes me around 10 minutes to do.  Since I was expecting some masses attached to the testicles I thought it might add an additional 10 or so minutes to the surgery time.  After having been in practice for almost 13 years, I should know better than to expect things to go smoothly in cases like this.  The more I was involved in the surgery, the more I realized that the abnormal tissue extended much farther than I had initially thought.  I could feel irregular, firm tissue extend along the length of the epididymis (just off the testicles) down to where the tissue attached to the scrotum.  I found myself in a surgery unlike any I've done before, and ended up doing the procedure for just over an hour.

One of the things you learn as a vet is that the unexpected can happen at any time.  The bad part is when this happens during a surgery, because suddenly it becomes difficult to do it part-way and stop the procedure.  You have to trust in your abilities and experience, knowledge of surgery and anatomy, and hope for a little good luck.  In this case I knew that I had started to remove the affected tissue and couldn't very well close up the pet with the job only partly done.  So in the end I ended up removing his scrotum to make sure I removed all of the abnormal tissue (this is sometimes done for cosmetic reasons in large, adult dogs who are neutered, as the empty scrotum tends to hang down and is unattractive).

The dog recovered normally, and we sent some of the tissue to the diagnostic lab or a pathology review.  If we're lucky we'll end up with merely a severe inflammation or a benign cancer.  Unfortunately boxers are prone to cancer, so the report may give news of a malignancy.  We'll know by next week.

Now the final lesson came when the owner picked him up.  I was explaining the surgery and findings as well as the possible outcomes.  She asked me if this could have been prevented by having him neutered when he was a puppy.  I don't like to brow-beat clients, especially ones who are trying to do the right thing.  But I had to be honest with her and tell her that if he had already been neutered this would never have happened.  Testicular disorders aren't common, but they do happen.

So make sure to have your dogs spayed and neutered.  I will help to prevent many types of health disorders later in life.