Rare surgical procedures give man and dog a new lease on life

From a distance, no one would think that 11-year-old Labrador retriever Beau looks different from any other dog. Yet earlier this year, the dog underwent a nasal planectomy, a rare type of facial reconstruction surgery, to remove a squamous cell carcinoma (SCC) from inside his nose, significantly altering his appearance.

Nasal planectomy is performed to remove neoplasia within the nasal planum. During surgery to remove the cancer, the fleshy, non-haired tip of the nose is removed and the patient’s lips are used to create a new covering. This procedure is often necessary for survival because this type of cancer typically does not respond to any other treatment. Yet many veterinarians and pet owners are reluctant to choose this option due to fears about potential complications or the animal's post surgical appearance.

While Beau’s owner, Air Force Master Sergeant Charlie Morse, was stationed in California, he was alerted by his dog sitter in Wasilla, Alaska, that Beau was bleeding from his nose. When Morse returned home to Wasilla, the bleeding appeared to be getting worse. Morse took Beau to Tier 1 Veterinary Medical Center in Palmer, Alaska, where the dog was diagnosed with a SCC and given just months to live.

The team at Tier 1 decided the best course of action was to perform a nasal planectomy. “Nasal planectomy is used primarily to remove SCC, which is locally invasive but rarely spreads and is generally not responsive to any type of treatment other than surgery,” says Bradley Schmidt, DVM, DACVIM, the only board-certified oncologist in Alaska, and one of Beau’s caregivers. “It is a technique to help remove the tumor it the entirety.” Schmidt has only referred 3 of these surgeries in over 20 years, but he knew it was Beau’s best hope. Without surgery, the dog was likely to live just a few months.

For Morse, the decision to move forward with the procedure was an easy one. “From 1 to 2 months realistically for him to be with me to hopefully years left. [Beau has] been there for me through thick and thin and has been that constant in my life, and I owed it to him.”

The surgery was a resounding success. The cancer was removed fully, and Beau can still breathe and smell without difficulty. “He works his new nose the same way he did with his nostrils,” Morse says. “He uses the muscles on the side of his face and kind of flares open what I call the ‘mega-nostril’ now.”

In a multi-institutional, retrospective case study published last year, 25 client-owned dogs, most with SCC, underwent radical nasal planectomy and 1 underwent resection of the nasal planum. Complications, including dehiscence, occurred in 19 dogs, 9 required revision surgery, and 1 did not survive to discharge. Median survival was 1542 days (range, 3-2010 days). Among 11 owners interviewed, 10 were satisfied with their dog's appearance, and 8 said they would consent to the surgery again.¹

Given the poor prognosis with other treatment options and the minimal associated long-term complications, the study authors concluded that nasal planectomy is a viable option for dogs with neoplasia of the nasal planum. They noted, however, that preoperative client education is crucial to ensure that the owner understands how different the pet will look after surgery.¹

To learn more about Beau’s surgery, click here.

Reference

1. Dickerson VM, Grimes JA, Vetter CA, et al. Outcome following cosmetic rostral nasal reconstruction after planectomy in 26 dogs. Vet Surg. 2019;48(1):64-69. doi:10.1111/vsu.13120