Results 1 to 4 of 4
  1. #1
    Join Date
    Dec 2019
    Posts
    2
    Post Thanks / Like
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Default Advice needed -- possible biopsy or fine needle aspiration


    LOG IN TO CLOSE THIS AD   


    Hi all,
    Looking for some advice as I have a leopard gecko -- Z -- who may have either a tumor or a cirrhotic liver. The vet is recommending either a liver biopsy or fine needle aspiration (both of which would require anesthesia) to discover the cause of a mass that's either on or near Z's liver. My question is basically this: is it worth it for Z to put him through the stress and risk of these procedures, to potentially discover the source of this mass and possible treatment options?

    Bit of background -- Z is either 13 or 14 years old. I've been his human for a little over two years now. Previously he lived at my parents' house (he was my brother's pet to start with) and was cared for by my dad. I've been going to the same exotic vet (ARAV registered) since I've been his caregiver. Recently he's been fairly active and eating very well, mostly crickets and roaches. He does have a cataract in one eye which affects his vision a bit so he's tong-fed.

    His weight dropped recently despite eating well, which is why I took him in to the vet. Have done multiple fecal tests for parasites and crypto, but nothing in the poop has explained the mass. He got a blood test done and has high liver/kidney values as well as slightly higher than normal white blood cell count. At the exam the vet felt and saw (using a small flashlight) the mass on or near his liver.

    I've talked with my vet over the years about husbandry and he's not concerned about that, but I'm happy to provide more details if needed.

    Just looking for advice as I want to do what's best for Z and not cause him unnecessary suffering. Has anybody had a similar experience, or had a gecko undergo either a liver biopsy or fine needle aspiration?

    Thank you!

  2. #2
    Join Date
    Nov 2018
    Location
    Virginia - for now.
    Posts
    135
    Post Thanks / Like
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Default

    Ultimately the decision is yours, as to risk vs benefit - but I can at least give you an idea of what each procedure entails from a vet tech point of view (sorry word wall):

    A FNA (fine needle aspirate) will be much less invasive and a little less risky - basically Z will need just enough sedation to not wiggle while the vet pokes the mass with a regular sized needle through the skin - like one you would give an injection with. This allows the vet to pull a small sample of cells off the mass, stain them, and look under the microscope to see if they are infection, cancerous, fatty, or other. The aspirate itself would take 1-5 min at most, so depending on the sedation used, he'd be in recovery much faster. There is little real healing time - the hole left by the needle is small enough that the body can close it easily. Just like you getting a shot. The less time he has the drugs in his system, the less stress he'd have on his organs (liver and kidneys remove toxins - the sedative in this case from the blood).

    A biopsy would most likely require an incision into the body cavity and taking either the whole mass out or a chunk of it. (Unless the mass is outside the body like on a toe or skin then an incision has to be made). This is of course more invasive as the vet would have to have him under complete anesthesia because mild sedation won't block the pain response. He would then need either sutures / staples / skin glue or a combo to close the incision. Recovery time would be longer as will healing time.

    Both come with risks. I don't know what drugs your vet has a preference for - if injectable sedation/anesthesia recovery is a little longer, but additional drugs can often be given to reverse the sedation effect. If gas anesthesia is used he'd need to wake up on his own. Recovery time in Leo's can be slightly longer than say snakes because most of the drugs used for sedation are fat soluble - so the drug absorbs into fat (which leos have plenty in their tails lol) and is slowly released, keeping the lizard drowsy.

    Both have risk of complications, any time you add drugs in -esp if his liver and kidney values are already not happy- and respiration / heart rate can be affected. Also, anytime you poke or cut a mass it will bleed, needle aspirates tend to cause less bleeding, once the mass is biopsied (either removed fully or not) it will likely need sutured or cauterized as well to prevent it from bleeding into the body cavity. The biopsy would also probably need him to have some pain meds for a little while, at least if he were a mammal that is standard procedure for any surgery.

    I would also ask the vet if x-rays or ultrasound are an option (very non-invasive) - before doing either procedure. Unfortunately if it is a cancer sometimes it has already spread to other organs, usually the heart or lungs, by the time a large mass is found. You can see the 'snow globe like effect' in the lungs on xray if it is there. If that were the case I would not put him through anything at all and just keep him comfortable. Hope this helps at all. 14 is a good age for a leo to get to, I know they can live longer but I would still consider him a senior, so deciding to just keep his quality of life up and keep him comfortable isn't the wrong answer either.
    Last edited by SpottedDragon; 12-12-2019 at 06:02 PM.
    Nature is the best teacher, learn by observing
    Thanks Elizabeth Freer, elizilla thanked for this post
    Likes Elizabeth Freer, GeckoLeen, Marillion liked this post

  3. #3
    Join Date
    Dec 2019
    Posts
    2
    Post Thanks / Like
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Default

    Thank you so much for the super thorough response. Z and I went to the doc again last week and he explained the procedures some more too, but having it here in writing was really helpful for me. The mass did in fact look bigger at his last exam, making the doc lean more towards thinking it's cancer.
    I asked about x-rays/ultrasound, but the doctor basically said while that could help us pinpoint the location, it wouldn't give us more info about the cause.
    I thought about this a LOT and ultimately decided to not put him through either procedure, since the answer will likely be cancer.
    Z is actually eating quite well and is active, so his quality of life is still good. Just focusing on keeping him as comfortable as possible.
    Thank you again for your perspective!! This decision was really hard for me and getting as many viewpoints as possible did help.
    Thanks SpottedDragon thanked for this post
    Likes SpottedDragon liked this post

  4. #4
    Join Date
    Nov 2018
    Location
    Virginia - for now.
    Posts
    135
    Post Thanks / Like
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Default


    LOG IN TO CLOSE THIS AD   


    Always glad to help. Sounds like you are doing the right thing
    Nature is the best teacher, learn by observing

User Tag List

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •