In January 2000 Roxy Shepard, a 7 year old spayed Boxer, was presented because she had a reddened area near her rectal area. She was moderately overweight at 80
lbs. and had continued to gain weight even after switching to a Light Diet.A small rectal polyp was noted near the right anal gland orifice. The gland was normal size, but somewhat painful and
contained a blood tinged discharge. Her lymph nodes internally and externally were normal.
Differential diagnosis at the time was anal gland infection +/- a rectal polyp or
Neoplasia. She was also considered to be a likely hypothyroid dog. After discussion with Roxy's owners, we decided to see if a course of antibiotics would improve her condition.
Within 10 days the lesion had grown to thumb size and was very necrotic appearing. It also extended internally 2 inches and involved the rectal wall.
Referral to a surgical specialist was declined. Roxy's owners requested that we attempt resection even with a very guarded prognosis. Preanesthetic bloodwork was normal and a difficult surgery proceeded.
The mass along with the right anal gland and a portion of the rectal muscle and surrounding tissue was resected. The right side of the rectum required some reconstruction during surgery as well.
Following recovery from anesthesia our veterinary technician noticed a slight nose bleed from the left nostril which quickly resolved. It was assumed that she had
bumped her nose during recovery. However, three days post-op she also started to weep blood from her incision. Upon exam small areas of bruising on other
parts of her body was noticed. These problems indicated a clotting defect. Her packed cell volume was still normal, therefore she was not in need of a
transfusion yet, but her platelet count was only 2000 (normal is 100,000 - 300,000). She was diagnosed with Idiopathic Thrombocytopenia, an autoimmune disease which causes the bodies own destruction of blood clotting
cells.
She was started on immunosuppressive drugs and maintained on long-term antibiotics because of the delayed healing and potential for infection caused by
these agents. The pathology report on the mass found was found to be non cancerous, but with an inflammatory eosinophilic component. This indicated also
a possible reaction to her bodies own anal gland components. In addition, her thyroid function test results indicated self destruction of 3 different thyroid
proteins. Roxy was in serious trouble with various body systems being destroyed by her own immune system. Fortunately for Roxy, she responded well to nursing
care, a dedicated owner, thyroid supplementation and immunosuppression.
Eight monts later she is only on thyroid medication and is a happy energetic svelte 66 lb. lady.
