Reoccuring Growths - misdiagnosis?
 

Hello! I'm a newbie in serious need of help. My 20 month old Great Dane Schultzy had paw surgery about 9 months ago. They were diagnosed as papilloma virus. The growths never spread to his mouth and they weren't "warts", they were large, bumpy and discolored. They're back. He has one large one on his front paw. I want to be better educated before I return to my vet. Can anyone help me identify this? Thank you so much!

Hester :)

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I never saw these before ..... and I'm curious to know what your vet will tell you.

This paw looks huge , any other picture where we could see the entire dog ? I love great danes. :o

It looks a little like the histiocytomas that our dogs have had in the past--but I've never seen one that 'blossomed' like that. It looks sore. Does he chew at it?

Histiocytomas do bleed easily, and if they're in a bad place, they're usually removed. Otherwise, they tend to resolve by themselves with time. I don't know how similar they are in appearance to papilloma warts. :shrug:

Oh, and I second Frenchy's request for pics of the entire megaSchultzy! :D

I think the growth has been flattened because of the location (next to the pinky toe on the ring finger toe on the front left paw). I'd be flat as a pancake if I was between his toes! The base where it is attached is the size of a dime, the face of the growth is close to the size of a nickel. The texture is bumpy and the surface of each small bump moves independently almost like a cluster of enlarged tastebuds. The mass is fleshy but a bit firm. I'm at a loss. :confused: Thanks for the suggestions so far! Keep 'em coming!

As requested... :D

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ahhhhhh what a beautiful boy you have !! :lovestruck: love the picture where he splashes in the water :cloud9:

Your dane is gorgeous! Not sure what it could be. You may want to find a veterinary dermatologist, who may be better informed about it and why it is reocurring? Don't forget to bring the dog's file with you. This may also be a "breed predisposition" condition. I presume you got your dog from a breeder? You can also call them and ask. Another idea is that you may have veterinary books at your local library. They cannot be taken out but you may want to make copies of some pages. Good luck.

Schultzy is one very handsome boy. :lovestruck: And, I also love the pic of him running out of the water. :cloud9:

I'm sorry that I don't know what the growths are either but I would perhaps get your vet to refer you to a specialist. :)

He [I]is[/I] gorgeous! :flirt: My modem can't handle the water pic, but the others downloaded just fine...and Schultzy is one handsome Dude! :cloud9:

[QUOTE=hazelrunpack;611805]He [I]is[/I] gorgeous! :flirt: My modem can't handle the water pic, but the others downloaded just fine...and Schultzy is one handsome Dude! :cloud9:[/QUOTE]


I resized the water pic for you! Sorry that was so huge.

He looks like he's walking on top of the water! Beautiful [I]and[/I] talented! :thumbs up :D

So when do you go back to the vet to have his growths checked again?

I went in yesterday. The vet thinks it's a papilloma of some sort and recommended crushing it with my fingers. I asked if it would hurt him and she said probably; I opted for the 15 minute laser surgery. His surgery is scheduled for Friday. She wants him completely knocked out which will cost a pretty penny! :frustrated:

Good luck with the surgery !! :goodvibes: I hope those things won't come back :fingerscr

Oh and Nelly says good luck too , I showed her pictures of your boy and she said : rrrreeeerrrrr :flirt:

[QUOTE=hesterific;611201]Hello! I'm a newbie in serious need of help. My 20 month old Great Dane Schultzy had paw surgery about 9 months ago. They were diagnosed as papilloma virus. The growths never spread to his mouth and they weren't "warts", they were large, bumpy and discolored. They're back. He has one large one on his front paw. I want to be better educated before I return to my vet. Can anyone help me identify this? Thank you so much![/QUOTE]

From your excellent pictures, the mass does have a papilloma wart appearance, however, histopath is the only way to be sure! It sounds 9 months ago, you had the masses tested. It is a bit unusual for them to just recur 9 months later. Most often the warts occur and persist until the immune system can fight them off. However there are some that are persistent or recurrent. In my experience, the papilloma warts outside the mouth are bit more difficult.

A few things to consider. First, if it is a papilloma wart recurrence, I would want to make sure that there are no underlying problems which may have led to the recurrence. Also you might want to ask your veterinarian about the topical use of Aldara (Imiquimod) 5% which helps stimulate the immune system against the virus. I recently had a boxer patient who had a recurrent and persistent papilloma wart (biopsied it twice) and this medication worked well for it.


Here is a Client Education handout excerpt which was written by Dr. Wendy Brooks....

"[I][B]Viral Papillomas of Dogs[/B]

[B]Does my Dog Have Warts?[/B]
Certain viruses are able to cause the growth of small round skin tumors commonly referred to as warts. Everyone who has ever seen a drawing of a fairy tale witch knows what warts look like, so when the family dog develops small round skin growths, many people assume that these too are harmless warts. It is important to realize that viral warts are a specific condition and that a growth on the dog’s skin may or may not be a viral wart.

Human warts are round, somewhat flat, and relatively smooth. Viral warts in dogs tend to possess frond-like structures that create a sea anemone or cauliflower-like appearance, although they can be smooth as well. The classical canine viral wart patient is a young dog with warts in or around the mouth or eyes. In such cases where warts have a classic appearance in a classic patient, diagnosis may be obvious, but in older patients with warts in locations other than the face, other types of growths become more likely. Because growths can appear harmless but behave malignantly, removal and biopsy are often recommended.

It is usually not possible to identify a growth visually although there are some exceptions.

Don't be surprised if what you are assuming is a wart is really something else.

In dogs, we do not call these growths warts; we use the more formal term viral papilloma. As in people, viral papillomas are caused by a papillomavirus although dogs and people have different papillomaviruses and cannot transmit their viruses across species lines.

[B]What do these Papillomas Look Like?[/B]
Viral papillomas are round but often have a rough, almost jagged surface reminiscent of a sea anemone or a cauliflower.
sea anemone
They occur usually on the lips and muzzle of a young dog (usually less than 2 years of age). Less commonly, papillomas can occur on the eyelids and even the surface of the eye or between the toes. Usually they occur in groups rather than as solitary growths.

[B]How is this Virus Transmitted?[/B]
The infection is transmitted through direct contact with the papillomas on an infected dog or with the virus in the pet’s environment. The incubation period is 1 to 2 months. This virus can only be spread among dogs. It is not contagious to other pets or to humans. To become infected, the dog generally needs an immature immune system, and so this infection is primarily one of young dogs and puppies. Beyond this, transmission details are sketchy. It is not known whether the infected dog must actually show visible lesions to be contagious, nor how long after regression of lesions contagion is still of concern.

The canine papillomavirus has been shown to be able to survive at least 2 months at temperatures of 40ºF but only 6 hours at 98ºF.

[B]Are Viral Papillomas Dangerous?[/B]

Not really. They should go away on their own as the dog’s immune system matures and generates a response against the papillomavirus. There have been two cases published where viral papillomas progressed to malignancy but this is extremely rare and by no means the usual course of the infection. Typically, it takes 1 to 5 months for papillomas to regress with oral growths tending to regress sooner than those around the eyes. Occasionally some papillomas will stay permanently.

Sometimes oral papillomas can become infected with bacteria of the mouth. Antibiotics will be needed in such cases to control the pain, swelling, and bad breath.

[B]Treatment[/B]

In most cases, treatment is unnecessary; one simply allows the papillomas to go away on their own. Occasionally an unfortunate dog will have a huge number of tumors, so many that consuming food becomes a problem. Tumors can be surgically removed or frozen off cryogenically. Sometimes crushing several growths seems to stimulate the host’s immune system to assist in the tumor regression process. In humans, anti-viral doses of interferon have been used to treat severe cases of warts and this treatment is also available for severely infected dogs. Sometimes some of the warts can be removed and made into a vaccine that is believed to stimulate the immune system in removing the tumors, though such vaccines do not seem to be as effective as desired and there is presently no manufacturer making them.

Date Published: 9/10/2001
Date Reviewed/Revised: 2/8/2008


Copyright 2008 - 2008 by the Veterinary Information Network, Inc. All rights reserved."[/I]

[QUOTE=Frenchy;612203]Oh and Nelly says good luck too , I showed her pictures of your boy and she said : rrrreeeerrrrr :flirt:[/QUOTE]

Wowwie wow wow! Good thing Schultzy can't see the monitor, he'd start practicing his moves in hopes of a date with Nelly! She is GORGEOUS! :lovestruck:

[QUOTE=Dr Lee;612213]From your excellent pictures, the mass does have a papilloma wart appearance, however, histopath is the only way to be sure! It sounds 9 months ago, you had the masses tested. It is a bit unusual for them to just recur 9 months later. Most often the warts occur and persist until the immune system can fight them off. However there are some that are persistent or recurrent. In my experience, the papilloma warts outside the mouth are bit more difficult.

A few things to consider. First, if it is a papilloma wart recurrence, I would want to make sure that there are no underlying problems which may have led to the recurrence. Also you might want to ask your veterinarian about the topical use of Aldara (Imiquimod) 5% which helps stimulate the immune system against the virus. I recently had a boxer patient who had a recurrent and persistent papilloma wart (biopsied it twice) and this medication worked well for it. [/QUOTE]

Thank you SO much Dr. Lee! I will ask about the Aldara. Is it for treatment, prevention or both? From what I found, Dane's are predisposed to the Inverted Viral Papilomas which don't go away on their own. :yell: They are so gross. I am paying for the biopsy; I want to know what I'm dealing with especially with the reoccurrence AND the predisposition. As you can see Schultzy is a Merle Piebald so you know he already has health problems (both parents carried the Merle gene). I wish I would have known that day what I was getting into. I learned the hard way that my three solid days of research should have been done BEFORE I picked the puppy. :loser: Thank goodness for pet insurance!

Thank you everyone for your kind words and expertise!

Hester and Schultzy

[QUOTE=hesterific;612308]I will ask about the Aldara. Is it for treatment, prevention or both? From what I found, Dane's are predisposed to the Inverted Viral Papilomas which don't go away on their own. :yell: [/QUOTE]

Aldara is for treatment. It can prevent if you know where the mass is going to recur. So if it is in the same area, then yes it can be used for both treatment and prevention. Good question.

It is true that Danes are predisposed. However, making sure that your veterinarian is not worried about another disease is also important. Last year, a close friend of mine's Dane was 9 years of age and had oral papillomas. 4 months later I diagnosed another disease in him which may have been 'brewing' at the time of the papilloma diagnosis. Just FYI.

Again - beautiful pictures!:)