Computed tomography angiography aids in predicting resectability of isolated liver tumors in dogs.

OBJECTIVE: To assess the accuracy of CT angiography (CTA) in predicting resectability, degree of surgical difficulty, and individual factors that may impact resectability of isolated hepatic masses in dogs. ANIMALS: Prospective study of 20 dogs with 21 isolated hepatic masses. PROCEDURES: All CTAs and surgeries were performed between June 16, 2013, and November 30, 2016, at The Animal Medical Center in New York. Preoperative CTA images were evaluated by a board-certified surgeon (n = 2). A preoperative assessment was completed, documenting several predetermined factors aimed at predicting resectability of each mass and the degree of surgical difficulty. Resectability was divided into gross resectability and complete histologic excision. Following surgery, the surgeon completed a postoperative assessment documenting the intraoperative findings. Independently, a blinded board-certified radiologist analyzed the images and completed an identical preoperative assessment. RESULTS: The radiologist was more accurate in lesion localization compared to the surgeon (P = .023). Seventeen (17/21) masses were grossly resectable in surgery. Two additional (2/21) masses that were deemed grossly resectable were incompletely excised on histopathologic analysis. Both the surgeon and radiologist were accurate in their prediction of gross resectability and complete excision. Major vascular involvement, multilobar involvement, and right-sided laterality negatively affected resectability. The surgeon was significantly more accurate in predicting the degree of surgical difficulty (κ = 0.50) when compared to the radiologist (κ = 0.38). CLINICAL RELEVANCE: Preoperative CTA of isolated hepatic masses is useful in prediction of surgical difficulty and resectability, as well as identifying several factors that impact resectability.

Bladder wall adhesion causing a vesicular septum in a dog following surgical cystotomy.

CASE DESCRIPTION: An 8-year-old spayed female Yorkshire Terrier-Poodle dog was evaluated for persistent pollakiuria and stranguria following routine cystotomy for calcium oxalate cystoliths. CLINICAL FINDINGS: The dog presented for a cystotomy with intermittent hematuria. Postoperative radiographs revealed no remaining cystoliths. Urine, cystolith, and bladder mucosal aerobic cultures were negative. Pollakiuria, stranguria, and hematuria developed immediately after surgery and persisted despite antibiotics. Ultrasound revealed suspected fibrous adhesions within the urinary bladder lumen connecting the dorsal and ventral bladder wall creating a septum. This was confirmed cystoscopically 4 weeks after surgery. TREATMENT AND OUTCOME: Cystoscopic-guided laser ablation was performed to incise abnormal tissue connecting the ventral and dorsal bladder wall using a holmium:yttrium-aluminum-garnet laser. Three weeks later, ultrasound revealed adhesion resolution though mild pollakiuria and stranguria persisted. Oxybutynin was prescribed and clinical signs resolved. At 27 months after ablation, hematuria occurred with recurrent cystoliths. These cystoliths were removed by percutaneous cystolithotomy, documenting a cystoscopically normal bladder wall. The patient had normal urination for 55.5 months after ablation, with normal bladder wall thickness on ultrasound repeated at 27 and 36 months after ablation. CLINICAL RELEVANCE: To the authors' knowledge, an adhesion creating a septum between the dorsal and ventral bladder wall has not been previously reported as a complication after cystotomy in any species and should be considered as a cause of persistent lower urinary signs after surgery. Ultrasound identified the lesion in this dog. Because bladder abnormalities can develop quickly after surgery, ultrasound might be considered if urine testing is not supportive of infection. Cystoscopic-guided laser ablation was a successful minimally invasive treatment in this case.

Chronic splenic torsion in a dog with an accessory spleen.

A 4-year-old, neutered male, mixed breed Old English sheepdog was presented for evaluation and treatment of anorexia, vomiting, and diarrhea. Presumptive severe pancreatitis was diagnosed based on the referral bloodwork. Abdominal ultrasonography identified a suspected liver lobe torsion based on the presence of a normal spleen. However, an exploratory laparotomy identified a splenic torsion in addition to a grossly normal spleen. Key clinical message: This case demonstrates that a second, potentially large area of splenic tissue (ectopic or accessory) can be present in the dog; therefore, the presence of a normal appearing spleen on abdominal ultrasonography does not rule out splenic torsion.

Torsion splénique chronique chez un chien avec une rate accessoire. Un chien berger anglais de race mixte âgé de 4 ans, mâle castré, a été présenté pour évaluation et traitement d'anorexie, de vomissements et de diarrhée. Une pancréatite sévère présumée a été diagnostiquée sur la base des analyses sanguines. L'échographie abdominale a identifié une torsion suspectée du lobe hépatique basée sur la présence d'une rate normale. Cependant, une laparotomie exploratrice a identifié une torsion splénique en plus d'une rate grossièrement normale.Message clinique clé :Ce cas démontre qu'une deuxième zone potentiellement large de tissu splénique (ectopique ou accessoire) peut être présente chez le chien; par conséquent, la présence d'une rate d'apparence normale à l'échographie abdominale n'exclut pas une torsion de la rate.(Traduit par Dr Serge Messier).

Pilot study comparing serum chemotherapy levels after intra-arterial and intravenous administration in dogs with naturally occurring urinary tract tumors.

The proposed advantages of intra-arterial chemotherapy (IAC) are based on the premises of local dose escalation to the tumor and reduced availability of systemic drugs. There is a lack of objective pharmacokinetic data to confirm the advantage of IAC in dogs with naturally occurring urogenital tumors. The objective of this study was to determine if IAC administration in urogenital tumors would result in decreased systemic drug exposure when compared to intravenous routes. Twenty-two dogs with naturally occurring urogenital tumors were enrolled in this prospective case-controlled study. Mitoxantrone, doxorubicin, or carboplatin were administered by IAC and intravenous routes [intravenous awake (intravenous chemotherapy - IVC) and under general anesthesia (IVGAC)] 3 weeks apart. Serum assays were used to determine the extent of systemic drug exposure. Dose-normalized peak systemic serum concentration (Cmax) and area under the serum drug concentration-time curve (AUC) were used to quantify systemic exposure. A total of 26 mitoxantrone treatments were administered to 10 dogs. While there was no significant difference in Cmax, the AUC was significantly lower after IAC compared with IVGAC. Ten doxorubicin treatments were administered to 5 dogs. There were no significant differences in Cmax or AUC. A total of 14 carboplatin treatments were administered to 7 dogs. The Cmax was significantly lower for IAC compared to IVC, while the AUC values were equivocal. This study demonstrates certain lower serum values may be achieved after IAC delivery of carboplatin and mitoxantrone. These chemotherapy agents may have a preferred pharmacological profile for regional chemotherapy delivery in dogs with urogenital tumors.

Les avantages proposés de la chimiothérapie intra-artérielle (CIA) sont basés sur les prémisses d'une escalade de la dose locale à la tumeur et d'une disponibilité réduite des drogues systémiques. Il y a un manque de données pharmacocinétiques objectives pour confirmer l'avantage de l'administration de CIA chez les chiens avec des tumeurs urogénitales se produisant naturellement. L'objectif de la présente étude était de déterminer si l'administration de CIA lors de tumeurs urogénitales résulterait en une diminution de l'exposition systémique aux drogues lorsque comparé aux voies intraveineuses. Vingt-deux chiens avec des tumeurs urogénitales d'occurrence naturelle participèrent à cette étude cas-témoin prospective. De la mitoxantrone, de la doxorubicine, ou de la carboplatine furent administrées par CIA et voies intraveineuses [intraveineuse éveillée (chimiothérapie intraveineuse ­ CIV) et sous anesthésie générale (CIVAG)] à 3 sem d'intervalle. Des analyses du sérum furent utilisées afin de déterminer l'étendue de l'exposition systémique aux drogues. Le pic de la concentration sérique systémique normalisé pour la dose (Cmax) et la surface sous la courbe de la concentration sérique de la drogue-temps (SSC) furent utilisés pour quantifier l'exposition systémique. Un total de 26 traitements à la mitoxantrone fut administré à 10 chiens. Bien qu'il n'y ait pas de différence significative dans le Cmax, la SSC était significativement plus basse après la CIA comparativement à la CIVAG. Dix traitements de doxorubicine furent administrés à cinq chiens. Il n'y avait pas de différence significative dans le Cmax ou ls SSC. Un total de 14 traitements de carboplatine fut administré à sept chiens. Le Cmax était significativement plus bas pour la CIA comparativement à la CIV, alors que les valeurs de SSC étaient équivoques. Cette étude démontre que certaines valeurs sériques plus faibles peuvent être obtenues après CIA avec la carboplatine et la mitoxantrone. Ces agents de chimiothérapie pourraient avoir un profil pharmacologique préférentiel pour livraison régionale de chimiothérapie chez les chiens avec des tumeurs urogénitales.(Traduit par Docteur Serge Messier).

Comparison of carbon dioxide laser versus bipolar vessel device for staphylectomy for the treatment of brachycephalic obstructive airway syndrome.

Carbon dioxide (CO2) laser and bipolar vessel sealing device (BSD) are industry standards for soft palate resection. No studies exist to directly compare these 2 techniques in a clinical setting. The purpose of this study was to describe and compare clinical outcomes for dogs that underwent CO2 laser versus BSD staphylectomy. Medical records of brachycephalic dogs that underwent CO2 laser (Group-L) or BSD staphylectomies (Group-B) between September 2013 and September 2017 were reviewed retrospectively. Of 60 dogs that met the inclusion criteria, 26 dogs (43%) were designated Group-L and 34 (57%) Group-B. Techniques did not differ in procedure or anesthetic time (P = 0.52 and P = 0.19, respectively) or major complication rates [intraoperative (P = 1.00), post-operative (P = 0.72), short-term (P = 1.00), and long-term (P = 0.68)]. This study suggests that patient outcomes are similar for dogs undergoing staphylectomy performed by CO2 laser and BSD.

Comparaison du laser au gaz carbonique par rapport au dispositif de coagulation bipolaire lors de la staphylectomie pour le traitement du syndrome de brachycéphalie d'obstruction des voies respiratoires. Le laser au gaz carbonique (CO2) et le dispositif de coagulation bipolaire sont des normes de l'industrie pour la résection du palais mou. Aucune étude n'existe afin de comparer ces deux techniques dans un milieu clinique. Le but de cette étude consistait à décrire et à comparer les résultats cliniques pour les chiens qui ont subi une opération au laser CO2 par rapport à une staphylectomie à l'aide d'un dispositif de coagulation bipolaire. Les dossiers médicaux de chiens brachycéphales qui ont subi des staphylectomies au laser CO2 (Groupe-L) ou à l'aide d'un dispositif de coagulation bipolaire (Groupe-B) entre septembre 2013 et septembre 2017 ont été examinés rétrospectivement. Parmi les 60 chiens qui satisfaisaient aux critères d'inclusion, 26 chiens (43 %) ont été désignés dans le Groupe-L et 34 (57 %) dans le Groupe-B. Les techniques n'ont pas différé pour la durée de l'intervention ou de l'anesthésie (P = 0,52 et P = 0,19, respectivement) ou les taux de complications majeures [intra-opératoires (P = 1,00), postopératoires (P = 0,72), à court terme (P = 1,00) et à long terme (P = 0,68)]. Cette étude suggère que les résultats des patients sont semblables pour les chiens subissant une staphylectomie réalisée par laser au CO2 et à l'aide d'un dispositif de coagulation bipolaire.(Traduit par Isabelle Vallières).