Annie, a one-year old Fox Terrier-Poodle mix, presented with an enlargement of the front portion of her skull. Skull x-rays revealed bony
proliferation and bony necrosis in the area of the skull mass. Annie was scheduled for a bone-core biopsy of her skull. Bone biopsy results were hopeful with an initial diagnosis of
benign fibrous connective tissue and bony necrosis consistent with an old injury. The decision was made to monitor the mass for further development.
Two months later, Annie was presented with visible significant growth of the skull mass. A second bone biopsy was performed. The time test results were disheartening…osteoma with a high potential
for malignant transformation to osteosarcoma (bone cancer).
Annie was scheduled for a CAT scan to evaluate the extent of the mass and plan for surgical excision. Due to the extensiveness of
Annie's tumor, surgery included reconstructive facial surgery after the removal of the front portion of her skull, eye sockets, and one-third of
her nasal bone. A methylmethacrylate skull cap was implanted to replace the removed skull bone.
Post-operatively, Annie seemed to recover well from surgery.
However, within three weeks she developed a serious bacterial (Pseudomonas) infection at the surgery site. The infection failed to respond to antibiotic therapy.
A special dye study called fistulogram showed a fistulous draining tract over the implant with a pus-like discharge. Annie returned to surgery to remove part of the implant and irrigate the surgery site.
Unfortunately, two weeks later, the surgery site was again infected and the suture line was deteriorating. Over the next two months Annie underwent three additional surgeries attempting to treat the chronic
severe bacterial infection around the implant. When those surgeries failed, the decision was made to remove the majority of the implant.
Two-thirds of the plate was removed with the back one-third left in place to protect the brain. Once again the post-operative period was complicated with a recurrent Pseudomonas infection.
After much though and discussion among the Heritage doctors, specialists, and Annie's family it became apparent that the entire methylmethacrylate plate implant would need to be removed to
resolve the chronic bacterial infection. Seven months after the plate had been implanted to cover the bone defect resulting from the excision of her skull tumor, it was removed entirely. Now only soft
tissue would protect Annie's brain from harm. With the implant and therefore the underlying cause for infection gone, Annie's bacterial infection resolved completely.
Amazingly, Annie remained alert, sweet, and loveable throughout the eleven-month ordeal. Annie's treatment was possible largely due to her family's love, commitment, and dedication. With the cooperative
effort among doctors at Heritage, the Fox Valley Animal Referral Center and the University of Wisconsin Veterinary Hospital, Annie was able to receive the most advanced surgery available in treating
her bone tumor.
It has been almost a year since the end of Annie's ordeal, she is an energetic and adorable family member who leads a normal life.
