Page 9 - Summer 14

Homeopathic treatment of a canine thyroid carcinoma by Mark Carpenter, UK
Bob, a 10 year 11 month old Border collie dog was presented in March 2010 for homeopathic treatment of a recently diagnosed thyroid car- cinoma. On examination a 45mm diameter soft swelling was noted in the proximal right jugular groove. Local submandibular glands were not notable enlarged, and the swelling was painless. Surgical excision had been attempted by the first opinion practice, but this was not pos- sible due to the involvement of the jugular vein. Surgical biopsy was carried out, and histopathology revealed a thyroid carcinoma with likely vascular permeation amongst part of the fibrous capsule. Chemotherapy and radiotherapy was suggested by the local oncology centre, but the owner opted for referral for homeopathy. Treatment with Spongia tosta and Carcinosin on Ramakrishnan principles, along with other immune supports and dietary adjustment, resulted in the disappearance of the mass within 4 months. There was no recurrence before he was euthanased due to mobility problems in November 2013.
Introduction
Thyroid carcinoma represents between 1
and 4% of canine tumours. Most commonly they arise from the cells lining the follicles (responsible for thyroid hormone synthesis) and are known as follicular carcinomas. Those arising from parafollicular cells (which secrete the hormone calcitonin) are called medullary thyroid carcinomas or C-cell carcinomas: these are less common. Immuno- histochemical analysis is available to distinguish between tumour types where necessary.
The majority of thyroid carcinomas are non-functional, and presenta- tion is made because the swelling has been noticed by the owner rather than the dog showing any clinical signs. 85-90% of palpable thyroid swellings in the dog ( 85-90%) are malignant neoplasms.
Clinical history
Bob had been rescued in 1999. Detailed earlier history was unavailable. His medical clinical history was unremarkable, consisting of the occasional gastro-intestinal tract upset; one episode of back pain; a grade 3/6 systolic ejec- tion murmur of no evident clinical significance; and regular vaccinations. Mrs White first noticed the mass in November 2009 on the right side of Bob’s neck.
He attended his primary care vet in January 2010, and surgery was arranged. The mass was found to be involving the jugular vein and inoperable. A surgical excision biopsy was taken, which resulted in considerable haemorrhage. Support care (involving IVFT and analgesia)
was given and he recovered uneventfully. Histopathology was carried out by Idexx Laboratories.
Histopathology report
“One section of the submitted biopsy is exam- ined. This contains portions of a cellular mass composed of closely packed and coalescing nests and islands of cells amongst fibrovascu- lar stroma with occasional formation of acini. They have oval nuclei with fine chromatin and one or two small nucleoli. Their cytoplasm is eosinophilic and moderate in amount. Mitotic rate is low. Areas of haemorrhage are seen amongst the stromal tissue. Small amounts of fibrous capsular noted in one area and tumour cells appear to occupy a distended vessel within the capsule
Comment
This is a thyroid carcinoma. These tumours are often locally invasive and in this case there appears to be vascular permeation amongst part of the fibrous capsule. Metastasis, particu- larly to the lungs, is common as well as involve- ment to regional lymph nodes and sometimes other sites. Given the close association with the jugular, adequate excision would seem difficult
or impossible to achieve. The prognosis is very guarded to poor.”
I saw Bob on March 25th 2010.
Homeopathic history
Behaviour in consulting room
Quiet; gently panting; looks somewhat worried but calm; slowly wandering around.
Mentals
Very gentle /Very quiet /Very friendly
Traumatic start
Used to be chained in an oil drum, just his head could stick out, He was petrified of everything. Took 2 years to get him to go out when 1st owned as was so scared. He can now be taken out with- out a lead but goes home if he hears a bang.
Friendly when out. Doesn’t panic, will come back. Took him a long time to interact with the other dogs – not obviously fearful but like a “lit- tle loner”. Face and eyes were “just nothing”, “almost autistic”.
Used to be “rigid” when owner came to him to give attention, just didn’t respond.
Currently undemanding but quietly comes to seek attention.
Fears: Open spaces; bangs. “Petrified” by thun- der/fireworks – hides and shakes (no other physical symptoms consequential to the fear). Owner feels was hit before she took him on, as he used to “hit the ground” if something thrown and was scared if an arm was raised.
Greets visitors to the house, wags tail but never jumps up; makes “funny noises” when happy.
Anger: Never (occasionally can bark/snap when running up the garden with the other dogs if he wants to be first)
Generally not a hierarchical dog – not worried. One of seven dogs, all are equal except one, who is the boss (will stare the others out)
If another dog went for him, he would “probably
try and get away” but might stand up for him- self a bit (“not a lot”).
If other dogs in the group have a squabble, he doesn’t get involved.
Sympathy: No reaction to other dogs. If his owner is unwell, he will come and quietly sit with her, “just to be there”
He used to be quite a hunter, run off with others and hunt for rabbits. Otherwise does not run off.
Behaviour: Easy to train but was always so worried about everything, may do wrong because he was so scared. Unworried if told off, may put tail down and ears back “if shouted at”.
Diet
Been on Eukenuba. Changed since diagnosis to organic home prepared food (raw beef/lamb/ chicken/salmon/mackerel); broccoli; yoghurt; evening primrose oil plus omega-3. No great thirst but prefers outside water.
Clinical examination
R thyroid goitre, soft, plum-sized. Suspect has the start of identical swelling on left side. Bilateral epiphora, watery discharge only, no evident ocular inflammation. Some wearing down of canine tips and cranial edge of UPM4, no notable gingival reaction.
Rest of clinical exam unremarkable, general condition good
Generals
Quite likes the fire. Likes his comforts - “never had any”. No great temperature/ time/ weather modalities of note. “Always asleep but ready to go out at any time”
Repertorisation
Repertorisation was carried out with Radar 10.5.003, rubrics being taken from Synthesis Treasure (veterinary edition) (Schroyens).
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