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InFocus

A case of neoplasia in Suricata suricatta

A male meerkat presenting with a sudden onset oral mass underwent surgery to remove the tumour and provide a palliative effect for the patient

Suricata suricatta, better known as the meerkat, is a member of the mongoose family endemic to Southern Africa, primarily within arid regions. They are a commonly kept zoological species of animal within both large and small institutions as well as the private keeper sector. Small in stature, they are a highly social species and live within complex hierarchal “mobs” which is highly important for their captive needs to be met. Therefore, when providing veterinary treatments, it is important to consider any potential impacts in order to maintain social stability within the group.

Case report

A male meerkat, which belonged to a collection, was presented to the author’s clinic with a sudden onset mass upon its mandible. The mass was reported to have suddenly appeared and then steadily grown over a short period of time, and was beginning to impact the patient’s ability to undertake normal behaviours, including grooming and consumption of certain food items. The individual was young and of unknown ranking within the mob.

Clinical examination and diagnosis

FIGURE (1) This male meerkat was presented with an oral mass on the buccal aspect of the right-hand side of the mandible

On examination, it was clear that a significant mass was present on the buccal aspect of the right-hand side of the mandible (Figure 1). It had an ulcerative surface and was proliferative in nature, leading to a suspected diagnosis of neoplasia. It was evident that either surgical debulking or euthanasia were the only suitable options in this patient’s case, and the outcome of success was not guaranteed as, in order to obtain clean margins, a mandibulectomy would likely be required.

The meerkat presented with a body condition score of 3/5 and so, after consideration, the collection elected for surgical intervention. The meerkat was placed onto a course of oral meloxicam pending surgery. Monitoring of the individual while awaiting surgery was conducted by the keepers, in order to ensure anorexia did not occur and the patient didn’t require additional nutritional support.

Surgical intervention

The patient was presented for surgery a week later and the keepers reported that since meloxicam had been started, the patient’s ability to eat had improved.

On examination, the mass had almost doubled in size. Due to this, the likelihood of recurrence following removal was deemed to be high and the prognosis was guarded. The collection opted to proceed with surgery in order to provide a minimum of a palliative effect for the patient.

Anaesthesia

FIGURE (2) The meerkat was intubated using a laryngoscope, using a similar technique to that required in ferrets. Note the iodine used for preparing the surgical site

The patient was premedicated with a combination of midazolam and buprenorphine via intramuscular injection. Once the patient was suitably under sedative effect, he was removed from the carrier and placed into an induction chamber. He was induced with sevoflurane gas before being removed and intubated using a laryngoscope, using a similar technique to that required in ferrets (Figure 2). Once intubated, the patient was moved onto isoflurane gas and maintained on it throughout the surgery until recovery. The ability to shave the surgical site was highly limited due to the location of the mass, and iodine was used as a surgical preparation cleaning agent.

The patient was transferred to the operating theatre and monitoring of the anaesthetic was achieved through use of temperature, pulse oximeter, capnography and auscultation (Figure 3). Oesophageal auscultation was not suitable in this case due to the location of the mass for surgical removal.

FIGURE (3) Anaesthesia was monitored through use of temperature, pulse oximeter, capnography and auscultation

The patient’s body condition had deteriorated very little, likely due to the patient’s ability to continue maintaining his body condition following introduction of analgesia. The patient’s anaesthesia was stable throughout the surgery with no concerns noted by the author.

Surgery

The surgeon performing the surgery removed the mass primarily by sharp dissection and diathermy was utilised to cauterise blood vessels around the area of removal (Figure 4). The mass had a narrow base on dissection, and the surgeon elected to not perform a partial mandibulectomy and instead debulk as much as possible from the gum location of the mass (Figure 5). Minimal bleeding occurred and the site was closed with fast-dissolving sutures.

Recovery

The patient recovered in the induction chamber solely on oxygen before being transferred into his carrier. Post-operative monitoring was conducted from a distance and within an hour of recovery the patient was consuming insects well and was deemed suitable to be returned to the collection.

Post-operative monitoring

The collection kept the patient separate from the main mob during a post-operative course of meloxicam with the addition of co-amoxiclav; however, separation was only via wire so the individual and the group could see each other and smells could still be transferred between them. The patient was successfully reintroduced to the mob following completion of the course of medication and sign-off by the veterinary surgeon.

Pathology

The excised mass was sent for histology and was diagnosed as a squamous cell carcinoma. It was found to contain a high portion of fibrous stroma induced by the neoplasia. On some of the mass edges, the laboratory reported that there was no evidence of any obvious neoplastic cells suggesting that some suitable margins had been achieved, though on others, the tumour stroma had extended to the edges.

Occurring due to mutations within the DNA of the thin squamous cells, squamous cell carcinomas grow beyond control as seen in this patient’s case and close monitoring will be required by the collection going forward. Metastasis could possibly have occurred and evaluation of regional lymph nodes was recommended.

Conclusion

At time of writing this article (four months post-surgery), the patient has recovered well and no recurrence has been observed. The meerkat has successfully reintegrated into the mob and is displaying fully normal behaviours, with no noted negative side effects from the surgery.

While the surgery was ultimately performed to prevent euthanasia and to provide palliative qualities, it has had an undoubted positive impact upon the patient’s well-being alongside maintaining its position in, and overall group stability of, its family mob.

Adam Gregory

Head Nurse at Great Western Exotics

Adam Gregory, Bsc (Hons), CertHE, DMZAA, RVN, DipVNZS, APVN (Zoo, Wildlife, Small Mammal, Avian, Reptile and Amphibian), has attained experience globally as both a zoo keeper and a veterinary nurse, leading to combine the two areas into his current role. He has developed a particular interest in anaesthesia of non-domestic species and is pursuing this within a certificate of anaesthesia in the near future.


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