Prospective assessment of canine thyroid cancer-part I: nodal metastatic rate and impact of nodal immunohistochemistry in 70 dogs.

OBJECTIVE: To determine the rate of nodal metastasis in dogs with thyroid cancer and evaluate whether immunohistochemistry (IHC) identifies additional metastases beyond evaluation with H&E. ANIMALS: 70 prospectively enrolled client-owned dogs with thyroid cancer managed with thyroidectomy. METHODS: Dogs underwent thyroidectomy with concurrent elective bilateral medial retropharyngeal (MRP) ± deep cervical lymphadenectomy. Thyroid tumors and associated lymph nodes were reviewed by a single board-certified pathologist. Immunohistochemistry was used for all primary tumors (thyroid transcription factor-1 and calcitonin) to support a diagnosis of follicular or medullary carcinoma. Lymph nodes without evidence of metastasis after H&E review were labeled with the antibody associated with the wider uptake in the primary tumor. RESULTS: 77 thyroid cancers were resected from the 70 dogs enrolled, including 61 (79.2%) follicular, 8 (10.7%) medullary, and 7 (9.3%) mixed follicular/medullary carcinomas, with 1 (1.3%) carcinosarcoma. Twelve dogs had evidence of nodal metastasis following H&E review. Occult micrometastasis was identified in 1 dog following nodal IHC, resulting in documented metastasis in 13 of 70 (18.6%) dogs. Metastasis was more common with medullary (5/8) and follicular/medullary carcinoma (3/7) than follicular carcinoma (5/61). All MRP metastases were ipsilateral (7/77 [9.1%]), without contralateral MRP metastases (0/62). Fourteen of 41 (34.1%) deep cervical lymph nodes were metastatic. CLINICAL RELEVANCE: Nodal metastasis was uncommon for follicular carcinoma but was seen in > 50% of dogs with thyroid cancer involving a medullary component. Routine nodal IHC appears to be low yield for thyroid carcinoma. Extirpation of ipsilateral MRP and identifiable deep cervical lymph nodes is recommended with thyroidectomy until detailed preoperative risk stratification becomes available.

Surgical approach and presence of preoperative pleural effusion impact thoracostomy tube usage in dogs and cats following thoracic surgery for suspected neoplasia.

OBJECTIVE: To assess factors associated with increased pleural fluid and air evacuation, longer duration of thoracostomy tube usage, and longer hospitalization in dogs and cats following surgery for thoracic neoplasms. ANIMALS: 62 dogs and 10 cats. METHODS: Medical records were reviewed for dogs and cats undergoing thoracic surgeries between August 1, 2019, and June 30, 2023, for resection of suspected neoplasia in which a thoracostomy tube was placed. Data collected included patient signalment, type of procedure performed, histologic diagnosis of the primary mass removed, volume of fluid and air evacuated from the thoracostomy tube, and time in hospital. RESULTS: Median sternotomy was associated with increased total fluid evacuation (median, 12.1 mL/kg; IQR, 15.4 mL/kg; P = .012), whereas rib resection was associated with increased total air evacuation (median, 2.1 mL/kg; IQR, 13.6 mL/kg; P = .06). The presence of preoperative pleural effusion was associated with higher total fluid evacuation (20.6 mL/kg; IQR, 32.1 mL/kg; P = .009), longer duration with a thoracostomy tube in place (42.5 hours; IQR, 41.9 hours; P = .027), and longer hospitalization period (61 hours; IQR, 52.8 hours; P = .025). Cats had a thoracostomy tube in place for a longer time compared to dogs (median, 42.6 hours; IQR, 23.5 hours; P = .043). CLINICAL RELEVANCE: Animals undergoing median sternotomy and rib resection may be expected to have higher fluid and air volumes, respectively, evacuated postoperatively. This often leads to an increased duration of thoracostomy tube usage and a longer period of hospitalization.

Unilateral nephrectomy in dogs is associated with a high rate of intraoperative and postoperative complications.

OBJECTIVE: To determine the incidence of complications in the intraoperative and postoperative period for dogs undergoing nephrectomy for renal disease. ANIMALS: 69 dogs. METHODS: Medical records of dogs undergoing nephrectomies for renal disease were reviewed for signalment, date of surgery, results of blood analyses, and intra- and postoperative complications. Long-term follow-up was obtained via client telephone interview or referring veterinarian medical records. A Fisher exact test was used to assess the relationship between postoperative acute kidney injury and NSAID administration with long-term development of chronic kidney disease. RESULTS: Complications occurred in 44.9% and 42.6% of dogs in the intraoperative and postoperative periods, respectively. Most of these were lower-grade complications, though a total of 7 dogs died during the postoperative period. An acute kidney injury was diagnosed in 12 dogs postoperatively, with 2 dogs euthanized due to the severity of the injury. Long-term follow-up was available for 53 dogs, with 24 (45.3%) dogs developing chronic kidney disease. Postoperative acute kidney injury (P = .385) and NSAID administration (P = .519) were not statistically associated with the development of chronic kidney disease in this population. CLINICAL RELEVANCE: Unilateral nephrectomy is associated with high intraoperative and postoperative complication rates in dogs. Chronic kidney disease was diagnosed in almost 50% of the population with available long-term follow-up.

A Review of Beneficial Low-Intensity Exercises in Diabetic Peripheral Neuropathy Patients.

The American Diabetic Association standards of medical care for diabetic patients recommends moderate intensity exercise to help manage diabetes; however, this recommendation may be unmanageable for patients who have become inactive or unable to reach this intensity. The purpose of this review is to determine if low-intensity exercises demonstrate improvement in diabetic peripheral neuropathy symptoms in order to utilize these exercises as a starting point for inactive patients. Studies in low-intensity exercises from 2013 to May 2018 were systematically searched in PubMed, SCOPUS, and Cochrane Library databases. The studies in this research have shown that low-intensity resistance exercises have promising outcomes such as improvements in pain interference with daily activities, pain thresholds, and reductions in neuropathy symptoms. Low-intensity aerobic therapy adds to the quality of life of the patient, and increases in strength of the lower limbs show an improvement in foot sensation and a reduction in pain and tingling symptoms.