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Betty's mammary lumps

LucyP

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Hi all

Finding myself in a difficult situation with our lovely Betty. She is our 3-3.5 year old sow, who came from a hoarding rescue operation in the north west of England in 2019, where I was told dozens of pigs from one home were dispersed to rescue centres across the country for rehoming (some people on here I think may remember that?). We adopted her and her best friend Winnie in Oct 2019. They arrived ragged (bite marks in their ears etc) and nervous. Despite that they settled well and they now popcorn, squeak and chut chut chut their way around all day, and seem to be very happy piggies.

In her first 12-18 months with us Betty had numerous issues: fungal infections, URI and UTIs but thankfully all were eventually resolved with good vet care. The fungal issues were more stubborn in Betty than in Winnie. Betty can be a bit grunty/honky after she's eaten (she inhales her food at lightening pace) but that clears up once she's cleared her throat. She has a very healthy appetite and is just under 1.3kg.

After a rocky start, in the last year she's only needed the vets for haypoke and her routine check ups, and all has been good. However, we recently noticed she has two lumps, one under her left nipple, enough to make the nipple protrude, and the a smaller one near but not under her right nipple. They do not appear to be growing, I think they are smooth edged, there are no signs of infection, but when the vet squeezed her left nipple, there was a small amount of blood/fluid. She doesn't appear to be in pain but I know they can hide that well. Her mobility and alertness is good and her general check up went really well apart from that. But we know that kind of exam only shows you so much.

Our vet's inclination in these situations would be to remove the lumps, however, we are all aware that Betty had a difficult start to life and may have some underlying vulnerabilities. The last time she had a general anaesthetic (for scans and blood tests to do with her bladder), it took her days to recover, she barely moved, was totally spaced out ('the lights were on but no-one was home') and I was really worried she wouldn't make it. And that wasn't even following an operation, just some tests. She did bounce back from that after several days and we managed to keep her food intake going, so it was ok. but I am very aware of the risks of GA and quite nervous about that. So jumping into an operation decision feels risky in this case.

Another option is a fine needle aspiration but in the vet's experience, these are often inconclusive. She would be willing to try in case we got lucky and found out something helpful from that, and it would be done consciously. I am not sure I want to put Betty through that if it's not likely to tell us much, and it sounds like an uncomfortable procedure.

Another option would be for Betty to have a CT scan, which might give a clue to whether she would be a good candidate for surgery (for example it could detect if there are underlying lung or major organ issues). And in the worst case scenario (god forbid), if this is a malignancy we are dealing with, if the CT scan shows that it has spread to other parts of her body, the vet would not want to put Betty through surgery. The CT scan would be done under deep but not full anaesthetic so might feel slightly safer as a first step.

If the CT scan does not reveal a spread of anything nasty or suggest she has underlying issues, then the next step would be surgery to remove the lumps.

Having read up on many mammary cases on here and on the American GP site, I can see that more often than not, surgery IS successful, provided the vets are experienced, the surgery happens before the lumps have become problematic, the pig's general health is ok and the after care is good etc.

We have vet funds and time and we are happy to do any or several of those things but I am wondering about the most sensible approach/order of actions which gives Betty the best chance. If she wasn't felt to be vulnerable then we'd probably go straight for the operation, but her previous issues make us wonder about her immunity and general strength. Saying that, in herself she seems fine. She is an amazing pig who tells us what she's thinking at all times, loves her food and loves to explore and interact. Maybe we are over thinking the issue of her being a good candidate for surgery? I know age is on her side but I also get the feeling that a pig's general health/underlying strength is probably more important than their specific age?

I should add that our vets are recommended and experienced exotics and they have helped us brilliantly with various illnesses to date, so I am happy about that side of things and I do trust them. I also appreciate them thinking through the options with us rather than pushing one option or another on us as the only way.

I don't expect people to know exactly what to do, but would really appreciate if anyone has been through similar and may have words of wisdom. These are our first pigs and this would be the first operation situation we have found ourselves in. Betty is such a lovely pig and we just want her to be as healthy and safe as possible.

Many thanks and sorry for the long post!
Lucy
 
Hi

HUGS

It is always difficult with piggies needing an operation that have other underlying issues/previous bad history with GA.
The problem with mammary tumors (whether benign or malign) is that they don't go away on their own and that they simply never stop growing, however huge they can get when left untreated - to the degree that a piggy is no longer able to put all four feet on the ground at once, as I have seen from pictures of one or two rescue surrenders. It's pretty horrendous - thankfully they finally did get their life-saving op at the rescue. :(

The operation itself has - like most lumpectomies - a good survival rate,as mammary tumors are not deep inside the body or near any sensitive organ under normal conditions, which generally makes for a pretty quick procedure. The longer a piggy is under, the greater generally the risk of complications/a bad recovery. Would your vet consider using another GA drug, even if it is more expensive?

I know that it is a horrible decision for you to make but this is a factor that you and your vet will need to take into consideration as well. I am ever so sorry that poor Betty has really pulled a short straw in terms of health issues.

Fingers firmly crossed for her!
 
Thanks both, appreciate this.

I didn't realise that all lumps will definitely keep growing but it makes sense that it's not a good idea to leave them. I can talk to the vets about different GAs. It does seem that leaving the lumps is not an option so I think I just need to decide whether it could be helpful to try the CT scan and/or needle biopsy first before jumping into the surgery. She seems so happy I feel like I want to understand as much as possible about her health/what's going in internally before putting her under.

Reassuringly, of the 60+ mammary lump removal cases I read up on online, losing a pig DURING surgery seems quite rare, but I did read of a few cases where complications set in afterwards which for some pigs were fatal (wound issues, failure to eat etc). I guess that's where the post-op care comes into play.
 
Thanks both, appreciate this.

I didn't realise that all lumps will definitely keep growing but it makes sense that it's not a good idea to leave them. I can talk to the vets about different GAs. It does seem that leaving the lumps is not an option so I think I just need to decide whether it could be helpful to try the CT scan and/or needle biopsy first before jumping into the surgery. She seems so happy I feel like I want to understand as much as possible about her health/what's going in internally before putting her under.

Reassuringly, of the 60+ mammary lump removal cases I read up on online, losing a pig DURING surgery seems quite rare, but I did read of a few cases where complications set in afterwards which for some pigs were fatal (wound issues, failure to eat etc). I guess that's where the post-op care comes into play.

Loss of appetite in the wake of an operation is generally caused by the GA and recovery care at the vet clinic.

Personally, I would very much consider whether it is in Betty's interest (seeing that she as an issue with GA recovery) to put her under for further investigation before any op since the lumps will unfortunately need to come out anyway. She would need sedation for a scan.
Anyway, the biopsy can be done much more comfortably and safely as soon as the tumors are out of the body for you to know what sort she has got without any extra stress or discomfort for Betty.
The smaller the lumps, the easier they are to operate out. As long as they can be got out whole, it doesn't actually matter all that much whether they are benign or malign because there is no risk of anything spreading further through the body. Mammary tumors don't usually reoccur. ;)

Personally, I would not so much focus on pre-op exploration but on everything that can minimise the risk of another bad reaction to a GA for Betty and on keeping operating time as short as possible for an easier recovery. However, I would recommend to discuss with your vet before making any decisions.
 
Thank you, that's a very helpful perspective.
 
Loss of appetite in the wake of an operation is generally caused by the GA and recovery care at the vet clinic.

Personally, I would very much consider whether it is in Betty's interest (seeing that she as an issue with GA recovery) to put her under for further investigation before any op since the lumps will unfortunately need to come out anyway. She would need sedation for a scan.
Anyway, the biopsy can be done much more comfortably and safely as soon as the tumors are out of the body for you to know what sort she has got without any extra stress or discomfort for Betty.
The smaller the lumps, the easier they are to operate out. As long as they can be got out whole, it doesn't actually matter all that much whether they are benign or malign because there is no risk of anything spreading further through the body. Mammary tumors don't usually reoccur. ;)

Personally, I would not so much focus on pre-op exploration but on everything that can minimise the risk of another bad reaction to a GA for Betty and on keeping operating time as short as possible for an easier recovery. However, I would recommend to discuss with your vet before making any decisions.
Sorry - I realise I made a typo error in my post above. The vet's not suggesting a biopsy (her view is if you're going to do that you may as well just remove the lumps anyway). She mentioned a fine needle aspiration, which she said some people go for, but in her view they are often inconclusive anyway. She would only do that if we really wanted it.

Anyway I will discuss with her the pros and cons of going straight for an op versus any pre-op scan/work up first. I had hoped they might be able to do a CT scan with just a whiff of gas but it sounds more than that ('deep but not full').

I will also ask about the different anaesthetics they use, that's a good point.

Thanks again.

PS - If shouting at the top of your voice for veggies is a sign of good lungs, then Betty is top of the class - she's louder than a car alarm!
 
Sorry - I realise I made a typo error in my post above. The vet's not suggesting a biopsy (her view is if you're going to do that you may as well just remove the lumps anyway). She mentioned a fine needle aspiration, which she said some people go for, but in her view they are often inconclusive anyway. She would only do that if we really wanted it.

Anyway I will discuss with her the pros and cons of going straight for an op versus any pre-op scan/work up first. I had hoped they might be able to do a CT scan with just a whiff of gas but it sounds more than that ('deep but not full').

I will also ask about the different anaesthetics they use, that's a good point.

Thanks again.

PS - If shouting at the top of your voice for veggies is a sign of good lungs, then Betty is top of the class - she's louder than a car alarm!

I agree with your vet - a biopsy is more usually done on any removed tissue and a needle aspiration can cause more trouble than it is worth.

Think it through. It is not yet at the stage of an emergency op but I would also recommend not to wait for too long, either as none of us has an idea of the lumps' growth rate. Right now, they are not a real bother for Betty.
 
Thanks everyone.

We did a CT scan in the end to check her over following discussion with the vets, they did it as lightly as possible and monitored her closely throughout and after, they also gave her a syringe feed and kept her there for a few hours after. She was dopey and not herself at first when we got her home so we were worried that night, but she bounced back fine within 24 hours and was munching away, bossing us around.

We just got the CT results back and there are two mammary masses which are mildly pressing on her abdominal wall but they’re not infiltrating, and so should hopefully be a fairly simple op to remove.

The CT suggests her lungs and liver and overall body looked generally good. However, she has slightly enlarged lymph nodes on both sides, and also in her chest cavity, which is a worry. But the overall state of her lungs looks good (we had worried she had potential lung issues).

Incidental findings included a narrower than normal nostril (may explain why she sometimes honks after eating) and slight signs of mild arthritis in some of her joints, which I wasn’t expecting as she’s not shown signs of that and is only 3.5. But I know they hide things. I will look into the arthritis issue more once we’ve got these lumps dealt with.

We have booked in surgery for may 24th and they will keep her overnight to monitor and feed her and all being well we collect the next day.

We will send the lumps off for examination to hopefully see what we’re dealing with. I know the lymph issues may be a bad sign but that vet also suggests to not assume at this stage as there can be various reasons for that.

We’re not sure what the future holds for the lovely Betty, but having had a good chat with the vets (who has done these kind of surgeries many times and is able to complete the ops quickly), going ahead with surgery seems to be the best option for Betty.

I will ask if her companion Winnie can go with her as they never spend time apart and rely on each other when one’s below par.

Thanks for all your support and we’ll keep you posted on how things go.

Feeling obviously worried but also glad to have a plan of action to hopefully give her the best chance.
 
Good luck with Betty’s operation. My Bill developed two mammary tumours around one of his nipples. Simon Maddock removed them and Bill sailed through the op with absolutely no problems at all. I think you have made the right decision. When Simon squeezed the nipple it bled too (it’s was actually dripping blood) and he said that often points to a malignancy. He also said that these lumps can grow very rapidly quite suddenly and become much harder and invasive to remove

Good luck x
 
Thanks so much- I hope things are as smooth for Betty too. I’m glad to be hopefully getting them before they become attached to anything.

Here’s Betty blissfully unaware (I think) enjoying her carrot cottage/boat - looking hyper alert because she heard a rustle of a food bag!2BA3DE9A-3747-4B01-AB10-E39BCD75A8ED.webp
 

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Hi all, a little update on Betty:

She had her op yesterday afternoon and two mammary lumps were removed. The operation went well from the vets point of view. She stayed in overnight for monitoring, pain relief, antibiotics and feeds, which was as planned, (accompanied by her cagemate Winnie).

The vets are happy with how the wound is holding up so far (we’ve been warned it is quite a large wound site).

We’ve been busy deep cleaning and washing all the fleece pads and vet bed so we can keep her nice and clean and dry.

She was due back home today but this morning she was still groggy and not eating on her own, and has a slightly raised temperature, so they’re keeping her in another night to keep a close eye on her and do the feeds etc.

Really hope she’ll be bouncing back a bit more tomorrow. She’s with a great team with lots of surgery experience which makes us feel better but it’s always nerve wracking and I hate to think of her feeling unwell and disorientated.

Will keep you posted.
 
Hi all, a little update on Betty:

She had her op yesterday afternoon and two mammary lumps were removed. The operation went well from the vets point of view. She stayed in overnight for monitoring, pain relief, antibiotics and feeds, which was as planned, (accompanied by her cagemate Winnie).

The vets are happy with how the wound is holding up so far (we’ve been warned it is quite a large wound site).

We’ve been busy deep cleaning and washing all the fleece pads and vet bed so we can keep her nice and clean and dry.

She was due back home today but this morning she was still groggy and not eating on her own, and has a slightly raised temperature, so they’re keeping her in another night to keep a close eye on her and do the feeds etc.

Really hope she’ll be bouncing back a bit more tomorrow. She’s with a great team with lots of surgery experience which makes us feel better but it’s always nerve wracking and I hate to think of her feeling unwell and disorientated.

Will keep you posted.

Fingers very firmly crossed for her!
 
Thank you. We’ve got the post op guide you wrote bookmarked too and that’s been helpful.

The lumps are being sent off for analysis also.
 
Thank you. We’ve got the post op guide you wrote bookmarked too and that’s been helpful.

The lumps are being sent off for analysis also.

I am keeping my fingers firmly crossed!
 
Thanks! Just waiting on this morning’s update and hoping she’s had a better night. It’s very quiet without them here bossing us around!
Really hope she’s had a good night bless her, glad her op went so well too ❤️ Crossing everything for you the lumps were nothing to worry about when biopsies are done, at least they’ve gone now!
It is so strange when you’re used to these pigwigs giving you your morning alarms, sending hugs! Hopefully she’s back home where she belongs soon! :) x
 
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