Rio’s problem began with vague signs. One day, he seemed dull, and he refused his dinner. He was holding his head lower than normal, as if something was troubling him. He was just “not himself”, and so Cliona brought him down to see me. When I examined him, he seemed like a fit, healthy dog, apart from one problem: there was a golf-ball sized swelling on the underside of his jaw in the midline, above and in front of his voice box. Rio’s body temperature was a little higher than normal, so it seemed likely that this swelling related to infection of some kind. I treated him with antibiotics and anti-inflammatory drugs, and arranged to see him again on the following morning.
When he came back after the weekend, Rio was back to his usual self, eating and playing, but the swelling was still present. We decided that it would be safer to investigate this in more detail. Under general anaesthesia, I took x-ray pictures of his skull and neck, but everything was normal. I opened his jaws wide, and visually inspected the back of his throat. This is when I found the first significant clue to the cause of his problem. The area around the base of his tongue and his tonsils was bright red, and I found small sharp pieces of grass and grass seeds impaled into the area around his right tonsil. I carefully picked them all out with tweezers. Could they have caused his body to react with a large swelling as part of his body defences? Rio came around from his anaesthetic and went home that evening, on continuing antibiotics and anti-inflammatory medication. Blood samples were sent off to the laboratory to look for other clues about his mystery problem, but they all came back as normal.
When I questioned Cliona, she told me that she had never seen him eating grass, like some dogs. But he did love running through long grass. He had done this throughout his whole life, and it had never caused a problem before.
During the following couple of weeks, Rio went on to make a full recovery. The swelling disappeared completely, and it seemed that his illness had been a minor one-off problem.
Six weeks later, the swelling recurred, but it was different now. This time, one of the lymph nodes under his jaw was the focus. Lymph nodes are bean-shaped nodules that are located throughout the body. They contain millions of white blood cells, and they are designed to filter out microscopic particles from the blood stream, protecting the body. Lymph nodes become enlarged when they are “in action”, due to the accumulation of extra cells in the body’s effort to deal with a problem. They most commonly become enlarged because of infection, but more sinister causes, such as strange immune diseases or even cancer can also cause them to get bigger. In Rio’s case, the lymph node was over two inches in diameter, which was around five times its normal size.
I collected a small biopsy sample from the lymph node by pushing a fine needle into it, and the sample was sent off to the laboratory. The result showed that the reaction was caused by infection, and a resistant bacteria was cultured from the sample. Rio was put onto a potent modern antibiotic, and again, the swelling went down in size.
At this stage, I knew there were two possibilities. Either Rio had been unlucky enough to pick up a particularly nasty bacterial infection when he had the initial problem, and it had not been cleared by the original course of antibiotics. It this was the case, the problem should now resolve, since I had put him on an antibiotic that I knew from the laboratory tests to be highly effective.
The second possibility was more complicated. If some of the sharp grass seeds had penetrated the back of his throat, they could travel inside his body, like tiny needles moving underneath the surface. If this was the case, they would continue to bother him, causing repeated infections until they were physically removed. It is very difficult to find these grass seeds, since they do not show up on x-rays. Ultrasound examination or MRI scans are needed to pinpoint their location, and even then, it is not always easy.
Rio’s problem fluctuated over the following two weeks, getting better then worse, then better and worse again. In the end, we decided to refer him to the surgery department in the Veterinary Teaching Hospital at UCD. An ultrasound scan of his throat was carried out, and as we suspected, several small sharp grass seeds were found. These were removed with delicate surgery. At last, the cause of Rio’s problem had been identified and removed. He went on to make a full and permanent recovery.
Rio still runs through long grass from time to time, but Cliona prefers him to exercise in other areas where possible. Rio has been through enough trauma, and she doesn’t want a simple grass seed to get the better of him again.
- It is common for dogs to graze on grass and this does not usually cause any harm
- Occasionally, grass seeds can puncture the back of the throat, causing problems
- Grass seeds that have penetrated the body surface are very difficult to find