Laser treatments for canine eyelid tumors

Joshua Broadwater, DVM, DACVO, discusses treating eyelid tumors in aging dogs. He explains the benefits of using laser technology to remove these masses, offering an alternative to traditional surgical methods that require general anesthesia.

Transcript:

Joshua Broadwater, DVM, DACVO: My name is Joshua Broadwater. I'm a veterinary ophthalmologist at a clinic in Charlotte, which is Charlotte Animal Referral and Emergency. I’ve been there for about 8 years now. I'm from Maryland originally, a little small town in western Maryland up in the mountains. I had to leave there as soon as I could, so I ended up in undergrad in Chapel Hill, North Carolina. Then I went to vet school at Virginia Tech. I did my general medicine and surgery rotating internship at the time, which was Florida Veterinary Specialists in Tampa, Florida, and then I did my residency at a private ophthalmology practice on the other coast, on the east coast of Florida. Then I got tired of the heat, and I came back up here to North Carolina about 8 years ago, and have been here ever since.

In our field, we see so many dogs with eyelid tumors that are very invasive to the eye. They're very irritating to the eye. And of course, it always happens in our patients that are 14, 15, 16 years old with a lot of other health issues—heart issues or other issues that prevent them from undergoing general anesthesia. And so we still want to address these masses. So how can we remove these tumors from the eyelid without putting these guys under the risk of general anesthesia?

So my first talk is focused on that: how do we remove these masses without the risk of general anesthesia? This talk mainly focuses on the ways that we can do the procedure while these animals are awake, under very minimal sedation—sometimes no sedation at all—and how the procedure can be done with a laser to remove the masses permanently with a very low chance of regrowth. That way, we get them comfortable, prevent future irritation, but minimize any risk of anesthesia.

Whenever we are talking about the benefits and the risks of this procedure, the biggest benefit of doing the laser removal is by far the anesthetic risk, which is very, very minimal with this procedure. The aftercare is much less involved as well because we're usually not having to place any sutures in the eyelid. Without any sutures, they're able to go home with maybe an E-collar on for a day or 2. Because when I tell an owner they have to have a cone on for 2 weeks, you would think the world is ending. So if I can get away with telling them, 'Give me 48 hours and we can take that cone off your little puppy’s head,' then they’re going to be much better with that.

As far as risks, when we remove these with the laser, there's about a 90% success rate that this mass is done and gone forever. But there is about a 10% risk it could regrow because I'm not taking big, wide margins like I would do with a surgical resection. So that's probably the one risk that I do discuss with people if we go the laser route versus the surgical route.

With the surgical route, the advantage is a very low risk of recurrence because we're taking very wide margins on these masses. But we are also having to place several stitches, we are also putting them under general anesthesia, and they're going to have to have this E-collar on their head for about 2 weeks. So it is a much more involved, much more invasive procedure. Most owners, if I give them the option of A or B, are going to choose the laser removal almost every single time. And especially as their animal gets older, with more risks with anesthesia, they almost always choose the laser removal of these masses. That’s why it has become very popular. I would say it's actually the most common procedure I do in my practice eye wise.