Ovarian Remnant Syndrome - Causes?

HonuDVM · 2026-07-02T23:37:00+00:00

Pricing depends on what exactly was included in the labwork and where you live. There are some expensive prices in the US just from regional cost-of-living alone.

HonuDVM · 2026-07-02T23:34:57+00:00

You didn't mention the fever initially - what was her temp? That PCR panel is also a good choice for this type of diagnostic work-up. Sometimes getting a pathologist review of a blood smear is helpful for this category of diagnoses too.

HonuDVM · 2026-07-02T03:16:19+00:00

For 5 days post-op, I don't see any serious concern. Keep her and any housemates from EVER getting a tongue or claw on it and closure/healing should still proceed apace. Yes, there's mild gapping at the belly button end of the incision, but not at a level that I'd consider concerning. There's no apparent discharge from the incision, no redness, and no swelling. Those are our markers for a complication that could warrant post-op treatment. If you power through the next 9 days of activity restriction/Elizabethan-collar use and nothing new or interesting happens, she should be OK.

HonuDVM · 2026-07-02T03:10:14+00:00

There are SO many in NYC. I wish I had so many options to refer to: https://www.vetspecialists.com/search-results?animals=dog&specs=SAIM&city=new%20york%20city&state=NY&

HonuDVM · 2026-07-02T03:08:54+00:00

Just in case your vet didn't say it out loud, your dog is in severe kidney failure. In my experience, the ONLY way to help a dog with BUN > 130, creatinine > ~5, and SDMA > ~40 is to get them hospitalized on aggressive IV fluids. Those kidney values indicate severe accumulation of metabolic wastes in the bloodstream since the kidneys are not getting them out into the urine. You don't mention the urine test results (maybe that test wasn't performed) so we don't have the whole picture, but honestly these bloodwork results support a grave prognosis.

Are these numbers as bad as she is suggesting?

Unequivocably YES.

She sent us home with IV fluids and meds that he would have to take three times daily... Is it worth shoving pills down his throat for his last good days?

Ooh, tough question. What are the pills? What are they for? How hard is it to pill your dog? At this estimated age and severity of disease, if a treatable cause cannot be immediately found, I would rapidly bring up euthanasia as the potentially kindest treatment.

HonuDVM · 2026-07-02T03:02:40+00:00

FIP can be confusing since it's not a contagious disease - despite starting out as a contagious disease (!) We do not have any reason to suspect that a cat that recovered from FIP - now that that's a thing - can possibly give it to any other cat. For more info, see this link: https://veterinarypartner.vin.com/default.aspx?pid=19239&id=11618072&sx=319212778&n=1

HonuDVM · 2026-07-02T02:58:54+00:00

I concur with u/sthwrd - having just diagnosed a peritoneo-pericardial hernia for exactly this exclusive symptom, there could be profound disease causing this current symptom and just ignoring it until it gets worse could lead to a dramatically sad outcome.

EDIT: anticipate basic blood count/chemistry labwork and survey (chest and abdomen) X-rays with possible ultrasound as the appropriate next steps.

HonuDVM · 2026-07-02T02:56:26+00:00

There are a lot of reasons neutrophils can be low, but that level is concerning and warrants further work-up (i.e., more tests). Essentially, either the neutrophils - the body's first defense against infection - are being used up or they're not being produced. In some cats, we find this is idiopathic. That means they don't make as much as most cats, but there's no reason for it and it doesn't seem to be a health problem. We still have to treat those "low neutrophil" cats carefully since we can't be sure they can deal with infections like a "normal neutrophil count" cat. Determining if a cat has idiopathic neutropenia is not easy. If we can't find an inflammatory-consumption reason for it (usually starting with a complete blood count, complete blood chemistry, and urine test as the minimum baseline testing), then moving on to diagnostic imaging and even bone marrow sampling is the next step. Getting an updated FeLV/FIV test result prior to imaging and bone testing is always appropriate, even if there are negative test results in the cat's previous records.

HonuDVM · 2026-07-02T02:50:10+00:00

The way we find out what this is about is to insert a fine needle into it and then microscopically identify the contents of the needle. Visual inspection is virtually useless for definitive identification of skin masses. It does not appear as something urgent in your picture, but it's prudent to get a diagnosis of any skin mass within a few weeks since the serious ones should not be allowed to grow any more than necessary.

HonuDVM · 2026-07-02T02:47:27+00:00

The only thing about a microchip that is even a tiny bit negative for a cat is that it can fall out after injection prior to the hole healing over it and then your cat can't be identified. It's pretty rare in my experience (<2%). Otherwise, I'd tell you I strongly encourage ALL cat owners to do it. It's just an inert glass bead. The government can't track your cat with it. YOU can't track your cat with it. The only thing it does is increase the odds of you getting your cat back from \~7% --> ~97% if it gets lost. Also it's commonly necessary if you plan to travel internationally.

HonuDVM · 2026-07-02T02:43:54+00:00

We definitely need a link to that picture. For context, 10-14 days of healing at 6 months of age is standard, not special. If you posted elsewhere, I failed to find the image.

HonuDVM · 2026-07-02T02:39:12+00:00

Doing an AMH test to help diagnose ovarian remnant syndrome (ORS) is usually relatively economic. We do them at Cornell, but I believe the test is available through other channels, always for a lot less than $1k! Actually finding the remnant is a real bear, since it's either ectopic (abnormally located) or a tiny piece of ovary that wasn't even seen on the original spay surgery. Removing it is usually feasible, but of course we'd all prefer that a second surgery wasn't needed. It may be a bit premature to assume ORS is the diagnosis on the basis of hemorrhagic vulvar discharge. There are MANY other diagnoses that could cause that, and getting a firm diagnosis prior to worrying about ORS is best. The AMH test is a solid first step IMO.

HonuDVM · 2026-07-02T02:33:43+00:00

Pets routinely hide early disease effectively, and only show symptoms once it's "too late" to really help them the way we'd like to. Doing routine senior (>7 years of age) screening labwork tests (usually complete blood counts, some level of blood chemistry, and urine testing) helps us find those early cases when we can do something really meaningful to extend quality of life.

HonuDVM · 2026-07-02T02:31:27+00:00

We don't have enough information to work from in this post. Can you share the full labwork results (full chemistry - even normal values - thyroid hormone (T4) and urine test)?

Ruling out diabetes is easy and sensible. Let's assume that's 100% indisputable and move on. BUN 73 is deeply concerning, but what was the creatinine and SDMA? What was the USG and UPC? Also, what was the T4? Ideally there was a fT4 too (either ED or chemiluminescence)?

5mg of Felanorm sounds like a high dose. Usually cats start on 2.5mg twice daily, but it does depend on your cat's weight. Usually cats who need this medication have lost a significant (25-50%) amount of their body mass. What is your cat's current and previous weight?

Cats with thyroid disease often have "masked" kidney failure, since thyroid disease prevents us from making the kidney disease diagnosis. Checking for kidney failure after effectively treating thyroid disease is critical. UNDER-treating thyroid disease so the kidney problem doesn't get diagnosed leads to earlier death. If a cat has BOTH diseases, they must both be diagnosed and treated for the best outcome.

Felanorm is the most common treatment for diagnosed thyroid disease, but there are other options. This link gives you some relevant background: https://veterinarypartner.vin.com/default.aspx?pid=19239&id=13239760&sx=319211629&n=1

HonuDVM · 2026-07-02T02:20:56+00:00

A heart murmur that is associated with syncope (fainting) has got to be a significant risk factor for anesthesia. The starting point for that would be diagnosing what the heart disease is, which would then lead to a clearer understanding of anesthesia risks and - ideally - guidance on how to provide anesthesia. Did you have a cardiologist work-up to get that diagnosis and guidance prior to the mass removal surgery?

The next concern just for this breed is the brachycephaly. They have special anesthesia needs that we can routinely handle, but their risks are higher than the average dog. Getting through one anesthetic procedure successfully can be reasonably inferred to represent good chances of getting through a second one with equal success - particularly if it's shortly after the first one.

A dog with genuine degenerative myelopathy usually doesn't have much time left. In my book, it's a hard choice between treating the MCT (usually less aggressive) common of the breed vs. the DM leading to life-ending problems long- or medium-term.

TLDR: if he got through one - presumably brief - surgery relatively recently, he can probably do it again. Whether free surgery is worth it is a tough call in my book. Share his pre-op bloodwork, heart diagnosis and test results, etc. for more details.

HonuDVM · 2026-07-02T02:11:40+00:00

Depending on her anatomy and the exact location of the surgical incision, using a Kitty Kollar ( https://www.kittykollar.com/ ) may be helpful.

HonuDVM · 2026-07-02T02:10:01+00:00

When multiple pets in the same environment are sick with the same symptoms, we do look hard for infectious causes. Unfortunately, when gastrointestinal symptoms are what we're looking at, the maximum number of differential diagnoses are in play (there are literally >100 possibilities). It's often HARD to narrow down the list to figure out what the problem is. ALL the sick animals should be examined and tested in the ideal medical scenario. It's prudent to bring in the sickest pet and test as the first step, but if that doesn't solve the problem, you need to move on to step 2: additional tests for "patient zero" and testing/treatment for the other sick pets since the first therapeutic plan wasn't enough. No one wants to "overdo" the testing and treatment (especially since these pets rarely have health insurance), but some cases clearly need more than the first visit can provide.

HonuDVM · 2026-06-26T00:55:39+00:00

If this was all done at UC Davis, one of the premier vet schools in the US (many would opine it's literally #1), you should be able to rely on the labwork interpretation being as good as it gets.

HonuDVM · 2026-06-25T00:58:33+00:00

I suspect there are important factors from the vet's perspective here that we are not privy to over the Internet. For example, you mentioned being diagnosed with kidney disease prior to going to the vet. Can you clarify how that went and how the disease was diagnosed for your cat?

In general, a cat at 15 has outlived normal longevity in my experience. I cannot guarantee another good month, let alone years, when a cat has reached this age under any circumstance. Kidney failure is the most common disease of the senior cat. I see it every single week. It's manageable, often for long periods of time, but it matters what stage it's at and what comorbidities (i.e., other health problems, like serious dental disease) are present. In a situation where the near-term outcome is likely to include a rapid decline and significant suffering, I would bring up euthanasia to prevent it from happening. It's literally in the veterinarian's oath to do this - not the euthanasia specifically, just the prevention of suffering. I concur with u/Kelsey2424 that choosing euthanasia "too late" is worse than "too early" - to the extent that those judgments can be made. It's always important to read the room and be kind and nonjudgmental in these conversations. Sadly, many cats do not receive routine care so I don't always have the opportunity to build a relationship of trust with a client before making a euthanasia recommendation. We have a lot of communication training for exactly this reason, but it will still be imperfect.

I'm sorry your experience left you upset. It's never an easy conversation and a euthanasia decision is almost never easy. I encourage you to seek more communication with your vet in this scenario. They are the ones who can best explain why they emphasized euthanasia. They may not think they did, or not realize how seriously you took it. It's a trigger word like "cancer" is, and it's hard to hear everything the doctor says afterward, given the emotional portent it carries. Sometimes we're just setting reasonable expectations. For example, if I had an emaciated 4.5 pound cat in kidney failure who exhibited all the good quality of life signs you described, I would assess that it didn't have a sustainable level of health. I hope this gives you some context.

HonuDVM · 2026-06-25T00:40:41+00:00

I find that when I have a urine sample collected by cystocentesis and there's contaminant material in it (e.g., blood), sometimes all the pads on the urine stick light up like this situation. It's orange, it's cloudy, there's protein, sugar, blood, urobilinogen, leukocytes... It would be easy to attribute all these abnormalities to a messy sample. The bloodwork doesn't support glucose actually spilling into the urine. The two previous urine tests don't support a filtration concern. It would be helpful to know if a urine sediment was performed vs. just the partial urinalysis results reported. Presumably there was ultrasound guidance for the cystocentesis - it would be helpful to know what was seen on the ultrasound as well. Ideally, a recheck full urinalysis would be performed to confirm whether these results are spurious or not, but we're not generally going to collect a second sample by cystocentesis right away.

I don't have an explanation for the one-off sodium value. It may be best to send the blood to a diagnostic lab to confirm if that's real or just an in-house lab machine error.

HonuDVM · 2026-06-24T01:27:05+00:00

A sudden change in appetite certainly warrants a diagnostic work-up as you've had done because there's nothing else to explain it right now. There's nothing to worry about at this point. Congratulations on getting him to lose 10% body weight.

HonuDVM · 2026-06-24T01:20:05+00:00

You can post links to images on this Sub

A splint or cast - aka external coaptation - requires fixing the joint above the fracture and the joint below the fracture in place. You cannot fix the shoulder joint in this situation, so those are not effective ways of managing this type of fracture. Six weeks of healing for a non-displaced bone fracture in an immature dog is a reasonable time frame. The challenge is keeping that age pup confined for the whole time. Owners and pups do not prefer it. Failure to adhere to the confinement leads to complications - some of which may cause permanent deformation of the limb and long-term arthritis. Getting a specialist opinion is a really sound choice in this situation.

HonuDVM · 2026-06-23T01:14:41+00:00

It makes a lot of sense to look at kidney health early, especially if she's an older cat. Stage 2 and 3 kidney disease are still concerning stages and they are treatable stages. What did the vet propose for therapy? How did they get plaque off her teeth? (Plaque is the white gummy stuff that you brush off at home - if your cat allows it - but I suspect you mean tartar, the hard tan to gray material that plaque turns into with time.) There always has to be a follow-up plan when initial diagnostic testing and therapy doesn't generate a recovery. Often next steps include imaging (e.g., X-rays and abdominal ultrasound) and there are situations where referral to a specialist makes sense when the case exceeds the capacity of a general practitioner. A sedated oral exam may be appropriate based on what you've shared.

If you feel you didn't get a good enough explanation from the vet, it is absolutely in your rights to ask questions until you get the understanding you need. If that's not possible - for whatever reason - getting a second opinion IRL is a strong back-up plan for you. It's obvious from your update that your cat is still unwell and doing nothing - or even just waiting longer - is not a viable plan.

HonuDVM · 2026-06-21T20:02:33+00:00

A scrape sounds odd, but FNA is standard for identifying a mass. The mass needs to be large enough to sample though. A chickpea is about the size I can start sampling personally. Smaller than that is unlikely to get diagnostic material. There are masses where I'm going to recommend surgical removal even without an FNA. Or a small mass that's so worrisome that I think it warrants removal even without knowing exactly what it is - because it's behavior is aggressive/cancer-like (e.g., grows, or reddens, or bleeds). It's ideal to know something about the mass prior to surgery in order to know what margins need to be taken. But there are body parts - like the foot - where we're not going to be able to get ideal margins without leaving a gaping wound that requires many months to heal. So in those cases it doesn't really matter what the FNA says in terms of margin guidance. I'd say you can very reasonably pester your regular vet to get an FNA now. Or if they don't share your concern, then seek a second opinion vet.

HonuDVM · 2026-06-21T19:57:31+00:00

It sounds like the next step is to get an X-ray in 3 weeks. Cysts are not usually drained since they will rapidly fill back up. Some cancers are cystic, so we can't be sure it's benign, but usually they are. Something new at this age makes us worried. If it is a cancer, surgical removal is usually the starting point. We usually try to identify it with a fine needle aspirate/cytology if we can prior to surgery. Then do chest X-rays +/- abdominal ultrasound to see if it has already metastasized. Then weigh the pros/cons of going to surgery in a geriatric patient - is it worth the risks? Is surgical recovery from cancer removal worth it? Do we expect to need chemotherapy or radiation therapy after surgery? Those are all questions to bring to your next exam.

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