{"id":1379,"date":"2019-08-13T11:55:23","date_gmt":"2019-08-13T15:55:23","guid":{"rendered":"https:\/\/www.drphilzeltzman.com\/blog\/?p=1379"},"modified":"2022-07-11T10:02:45","modified_gmt":"2022-07-11T14:02:45","slug":"harper-the-greyhound-needs-reconstructive-surgery-of-the-lip","status":"publish","type":"post","link":"https:\/\/www.drphilzeltzman.com\/blog\/harper-the-greyhound-needs-reconstructive-surgery-of-the-lip\/","title":{"rendered":"Harper the Greyhound needs reconstructive surgery of&#8230; the lip"},"content":{"rendered":"<p><span style=\"color: #000000;\">Harper, a 7 year old greyhound, had a fleshy mass the size of a silver dollar inside her right upper lip.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-1419 size-large\" src=\"https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/08\/Harper-2000x1500.jpg\" alt=\"Harper, a 7 year old Greyhound\" width=\"2000\" height=\"1500\" srcset=\"https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/08\/Harper-2000x1500.jpg 2000w, https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/08\/Harper-1100x825.jpg 1100w, https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/08\/Harper-768x576.jpg 768w, https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/08\/Harper.jpg 2016w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" \/><\/p>\n<p><span style=\"color: #000000;\">Her family vet did a \u201cdebulking\u201d surgery to try and remove as much of the mass as possible without removing the lip itself. The tissue removed from Harper&#8217;s mouth was sent to the lab for biopsy. The biopsy revealed a mast cell tumor, which is unusual in the mouth.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-1383 size-large\" src=\"https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/07\/2.-Harper-mass-2000x1494.jpg\" alt=\"A tumor on the jaw\" width=\"2000\" height=\"1494\" srcset=\"https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/07\/2.-Harper-mass-2000x1494.jpg 2000w, https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/07\/2.-Harper-mass-1100x822.jpg 1100w, https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/07\/2.-Harper-mass-768x574.jpg 768w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" \/><\/p>\n<p><span style=\"color: #000000;\">Mast cells are normal white blood cells we all have. They play a role in the body&#8217;s response to allergies and inflammation. Sometimes, they become cancerous, most commonly in the skin. <\/span><\/p>\n<p><span style=\"color: #000000;\">Occasionally, they can affect other body parts, such as the spleen, the liver or the intestine\u2026 or the mouth as in Harper\u2019s case.<\/span><\/p>\n<p><span style=\"color: #000000;\">Complete removal of the mass is the ideal treatment. When we try to get \u201cclean edges\u201d in surgery, we call it getting \u201cclean margins\u201d.<\/span><\/p>\n<p><span style=\"color: #000000;\">More aggressive tumors or \u201cdirty margins\u201d (i.e. when the tumor was not completely removed) sometimes require additional treatment such as radiation or chemotherapy.<\/span><\/p>\n<p><span style=\"color: #000000;\">Unfortunately for Harper, due to the size and location of her mass, clear margins were not obtained with her first surgery. That&#8217;s when I was called in to perform a more invasive surgery, which would require reconstructive surgery.<\/span><\/p>\n<p><span style=\"color: #000000;\">To ensure clean margins were achieved this time around, I needed to remove a big chunk of Harper&#8217;s lip.<\/span><\/p>\n<p><span style=\"color: #000000;\">This left us with a hole I had to get creative to close.<\/span><\/p>\n<p><span style=\"color: #000000;\">I used what is called a skin flap. Using skin from the cheek, and by pulling it into the surgical area, I was able to reconstruct Harper&#8217;s upper lip (the pictures are a bit too graphic for this humble blog). There was some considerable pressure along the incision postop, which was a concern for healing. There was a chance the stitches would not hold up\u2026<\/span><\/p>\n<p><span style=\"color: #000000;\">Harper recovered smoothly from anesthesia. She went home with instructions to keep her quiet and to prevent her from chewing on anything, including toys. The incision had to be protected at all time with a plastic cone (E collar).<\/span><\/p>\n<p><span style=\"color: #000000;\">About a week later, the biopsy was read as a mast cell tumor \u2013 no surprise there. The great news was that we were able to \u201cget it all\u201d, i.e. we had clean margins.<\/span><\/p>\n<p><span style=\"color: #000000;\">Three weeks later, Harper showed good healing, but I was concerned that the incision looked so crusty. Rather than aggravating the incision by removing the stitches and the scabs, we decided to leave the sutures in for an additional week.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-1381 size-full\" src=\"https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/07\/3.-Harper-scabby.jpg\" alt=\"A crusty incision\" width=\"480\" height=\"640\" \/><\/p>\n<p><span style=\"color: #000000;\">Harper was able to open and close her mouth without any issues, which was a huge relief. Her family vet was able to take a picture while she was yawning at the clinic!<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-1382 size-full\" src=\"https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/07\/4.-Harper-yawning.jpg\" alt=\"Yawning\" width=\"480\" height=\"640\" \/><\/p>\n<p><span style=\"color: #000000;\">That showed us that Harper could fully open her mouth. It turn, it meant that she could play with chew toys and balls in the future.<\/span><\/p>\n<p><span style=\"color: #000000;\">One week later (1 month after surgery), the incision looked immensely better. The stitches were removed. And Harper could resume her normal activity.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-1380 size-large\" src=\"https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/07\/5.-Harper-pretty-2000x1500.jpg\" alt=\"Stitches removed, and the incision looks better\" width=\"2000\" height=\"1500\" srcset=\"https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/07\/5.-Harper-pretty-2000x1500.jpg 2000w, https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/07\/5.-Harper-pretty-1100x825.jpg 1100w, https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/07\/5.-Harper-pretty-768x576.jpg 768w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" \/><\/p>\n<p><span style=\"color: #000000;\">Harper&#8217;s mouth will be checked by her family vet during regular check-ups. She is still doing great 6 months after surgery.<\/span><\/p>\n<div dir=\"auto\">\n<p>Her owner GK wrote:<\/p>\n<p>&#8220;Hello Dr. Zeltzman,<\/p>\n<p>We wanted to share with you how happy we are with the outcome from Harper\u2019s surgery.<\/p>\n<p>She looks absolutely fantastic, with her scar only being approximately 1\/2 inch long.<\/p>\n<p>The healing process was a little rough in the beginning but with all the excellent instructions we were given we knew what to expect.<\/p>\n<p>But overall it seemed to be a quick process and Harper is as good as new and back to her silly greyhound antics.<\/p>\n<p>Thank you for taking such excellent care of our girl.&#8221;<\/p>\n<\/div>\n<p><em>Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Harper, a 7 year old greyhound, had a fleshy mass the size of a silver dollar inside her right upper lip. Her family vet did a \u201cdebulking\u201d surgery to try and remove as much of the mass as possible without removing the lip itself. The tissue removed from Harper&#8217;s mouth was sent to the lab [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[171,157,218,156,10],"class_list":["post-1379","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-mast-cell-tumor","tag-phil-zeltzman","tag-reconstructive-surgery","tag-veterinary-surgeon","tag-veterinary-surgery"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Harper the Greyhound needs reconstructive surgery of... the lip | Dr Phil Zeltzman\u2019s Blog<\/title>\n<meta name=\"description\" content=\"Harper, a 7 year old greyhound, had a fleshy mass the size of a silver dollar inside her right upper lip.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.drphilzeltzman.com\/blog\/harper-the-greyhound-needs-reconstructive-surgery-of-the-lip\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Harper the Greyhound needs reconstructive surgery of... the lip | Dr Phil Zeltzman\u2019s Blog\" \/>\n<meta property=\"og:description\" content=\"Harper, a 7 year old greyhound, had a fleshy mass the size of a silver dollar inside her right upper lip.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.drphilzeltzman.com\/blog\/harper-the-greyhound-needs-reconstructive-surgery-of-the-lip\/\" \/>\n<meta property=\"og:site_name\" content=\"Dr Phil Zeltzman\u2019s Blog\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/DrZeltzman\/\" \/>\n<meta property=\"article:author\" content=\"PhilZeltzman\" \/>\n<meta property=\"article:published_time\" content=\"2019-08-13T15:55:23+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-07-11T14:02:45+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2019\/08\/Harper-2000x1500.jpg\" \/>\n<meta name=\"author\" content=\"Dr. Phil Zeltzman\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Dr. Phil Zeltzman\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.drphilzeltzman.com\/blog\/harper-the-greyhound-needs-reconstructive-surgery-of-the-lip\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.drphilzeltzman.com\/blog\/harper-the-greyhound-needs-reconstructive-surgery-of-the-lip\/\"},\"author\":{\"name\":\"Dr. Phil Zeltzman\",\"@id\":\"https:\/\/www.drphilzeltzman.com\/blog\/#\/schema\/person\/f7a1e1d287769c21b7f44ad05ffdeabe\"},\"headline\":\"Harper the Greyhound needs reconstructive surgery of&#8230; 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