Peg writes from Pennsylvania: Dr. Randolph, my puppy recently had a Cuterebra larva removed. I was wondering, would it have been safer for the fly to develop and self-extract itself for a 9 week old pup vs. surgery. Also, what would the surgical procedure typically cost? Any comments would be helpful. As a new pet owner I just want to do the correct thing by my pup in the future.
Peg, you have posed an interesting question. There are SO many variables:
- location of Cuterebra larva (also called “wolf worm”) infestations,
- size of the Cuterebra larva,
- size of the “breathing pore” the Cuterebra larva is using,
- temperament of the patient, and,
- pain tolerance of the patient.
In 32 years of practice I have performed Cuterebra extractions under all conditions, from no anesthesia and minimal restraint to local anesthesia and sedation to general anesthesia to obtain total immobility of the pet.
On one extreme, if an animal is calm, doesn’t mind being restrained, has a larva in an easily accessible location and can stand the breathing pore to be stretched, those are easy, fast, inexpensive extractions.
The other extreme is a pet who doesn’t want to cooperate (such as an aggressive cat or dog), has a low pain tolerance, a larval penetration location in a difficult spot (such as the ventral chest), that pet may require light-to-heavy sedation or even general anesthesia.
Puppies like to squirm. Few have learned tolerance of restraint by nine weeks of age. They typically have low tolerance for pain, too, and will scream at the top of their lungs for discomfort that is minimal in duration and intensity. Combine that with difficult-to-reach Cuterebra location and he becomes a good candidate for short-acting anesthesia.
With that many variables it is impossible to estimate cost.
Allowing the larva to just “develop and self-extract” is not an option. The longer the foreign material stays in the body, the more discomfort occurs and the greater the risk for rupture and anaphylactic reaction.
See you tomorrow, Dr. Randolph.