SCC of the nose in dogs

This is an older oncology case of a 6 y f/s, bichon frise with a previous unresponsive to treatment mass of the left alar wing. After investigations, including FNA, this came back as SCC. This was bad news for all involved, owners, dog and medical team. The good part is that there is a low risk for metastasis. The bad news is that surgery should be aggressive to lower the risks for local invasion and/or recurrence. Key points before surgery are owner consent, proper and fair discussions about the objectives, possible outcome and complications. One of the hardest to deal points are the after surgery appearence for the owner and relatives but not the least the walking area public.Aggressive surgery involved at least 1 cm of normal looking tissue in all directions. We know for sure that we have successfully manage to meet the good surgery criteria because hystologic margines were clean and the disease confirmed.Some other key points this kind of surgery are the complications that one should expect and deal properly. Although we hoped for the best, we prepared for the worst. As expected, some degree of laboured breathing was observed after surgery due to local inflamation and a tendency to stenosis. One of the difficult part of the surgery is the mucosa to mucosa suture, due to the lack of elasticity of the nasal mucosa and the ease of tearing.We have decided for a second surgery so we can place two temporary sylicone stents (one can use metal ones for permanent use) in order to keep the new respiratory inlets as open as they can be and to prevent local stenosis until local healing process is completed.Several weeks after the second surgery stents were removed, breathing was on the good side and the dog on the bright side. Last picture is 1.5 y after surgery, still rolling and enjoying life along side courageous owners.We know it is aggressive surgery and we know about some alternatives. Case selection is essential and some cases may benefit from electrochemotherapy ECT.