The role of sentinel lymph node mapping in small animal veterinary medicine: A comparison with current approaches in human medicine.

The relevance of regional lymph node (LN) assessment to quantify the metastatic spread of cancer is well recognized in veterinary oncology. Evaluation of LNs is critical for tumour staging. However, sampling the correct LN may not be possible without sentinel lymph node (SLN) mapping. Methods for diagnostic imaging and intraoperative detection of SLNs are well established in human medicine, in particular, the combination of lymphoscintigraphy and intraoperative application of blue dyes. Nevertheless, alternative imaging techniques are available and have gained increasing interest. Successful implementation of these techniques in dogs have been reported in both clinical and experimental studies. This review aims to provide an overview of SLN mapping techniques in human and veterinary medicine.

Chronic Achilles tendon rupture augmented by transposition of the fibularis brevis and fibularis longus muscles.

A 1 year and 8 months old castrated male Pyrenean mountain dog was presented with an Achilles tendon rupture at least 5 weeks old. The defect between the two tendon ends was 2 cm in full extension of the tarsal joint. A new technique was successfully applied; a transposition and tenodesis of the fibularis brevis and fibularis longus muscles, combined with a 3 loop pulley suture and a tensor fascia lata graft. A transarticular external fixator was used for the first 3.5 weeks after surgery and a splint for the two following weeks. A 3 years follow-up shows the dog walking without any lameness.

Diagnostic exercise: Submucosal gastric masses in a cat.

A 14-year-old neutered male cat presenting with chronic vomiting had 2 masses within the submucosa of the stomach that were excised. They presented histologically as circumscribed, submucosal masses consisting of diffusely arranged medium-sized round cells with a moderate amount of cytoplasm and interspersed eosinophils, separated by trabecular fibroblastic stroma. The overlying mucosa was diffusely infiltrated by the same round cells, and marked epitheliotropism was present. Neoplastic cells labelled positive for CD3 and negative for CD79a and CD117. Giemsa staining and silver staining (SNOBA) were also negative. A T-cell lymphoma with reactive fibroplasia was diagnosed, and differential diagnoses including mast cell tumor and feline gastrointestinal eosinophilic sclerosing fibroplasia could be excluded.

Endoprosthesis (EN) in frontlimb-sparing surgery for distal radial tumours in the dog: preliminary results.

In veterinary medicine, limb-sparing techniques are most implemented when the uninvolved limbs are affected by other orthopaedic or neurological disorders, in large breeds or when the owner declines amputation. This report describes the surgical technique used for implantation of an endoprosthesis following tumour resection in the distal radius in 3 dogs using both standard and angle-stable plates. Endoprosthesis offers an easy and readily available surgical alternative to cortical allografts. Despite post-operative complications, this technique resulted in a good quality of life in all 3 dogs.

Partial pancreatectomy and splenectomy using a bipolar vessel sealing device in a cat with an anaplastic pancreatic carcinoma.

A 14-year old domestic shorthair cat was presented because of vomiting, anorexia and an abdominal mass. A diagnosis could not be made preoperative and during surgery the mass was assigned to the gastric part of the pancreas. A partial pancreatectomy and splenectomy was performed using a Ligasure® vessel sealing device. No surgery related complications occurred. Histological examination revealed an anaplastic carcinoma of the pancreas. The cat was in a good clinical condition 14 days after surgery. After 2 months the cat was euthanized with the suspicion of a bone tumor. Findings of this case demonstrate that pancreatic carcinoma in cats has a poor prognosis but pancreatectomy can be performed using a bipolar vessel sealing device as a safe and fast alternative to standard surgical techniques.

Loss of implant-bone interface following distal radial locking-plate endoprosthesis limb-sparing surgery in a dog.

An eight-year-old, neutered female Rottweiler was presented with lameness of seven days duration. Radiographs were consistent with a distal radial bone tumour. Limb-sparing surgery was performed using a commercially available endoprosthesis with a locking bone plate. Histopathological examination of the resected bone revealed an intraosseous fibrosarcoma, and postoperative adjuvant chemotherapy was initiated three weeks after surgery. Despite initial satisfactory limb function, lameness worsened four months after surgery. Radiographs revealed large areas of bone lysis around the proximal and distal screws, leading to significant resorption of the radius and radial carpal bone with subsequent construct failure. Further treatment was declined by the owner and the dog was subsequently euthanased. This case illustrates that implant failure is not necessarily averted by the use of locking (compared with non-locking) implants combined with an endoprosthesis to treat distal radial tumours in dogs.

Symptomatic treatment of ascites with a peritoneo-vesical automated fluid shunt system in a dog.

A six-year-old Rottweiler with chronic ascites and moderate panhypoproteinaemia that had been treated with large volume paracentesis over several months duration was diagnosed with a large bi-atrial mass and hepatic fibrosis. For palliative treatment, a peritoneo-vesical automated fluid shunt system with an integrated chargeable battery and an integrated computer to control pump function and to transmit data transcutaneously was implanted by coeliotomy. The pump was left in place for 10 weeks, eliminating the need for further paracentesis during this time. At the end of this period, no ascites was discernible and serum protein concentrations had returned to their respective reference intervals. As a complication, decubitus with skin perforation had developed above the pump. Besides palliative treatment of chronic refractory ascites, this pump may have application in other conditions characterised by chronic cavity effusion or in peritoneal dialysis.

Augmentation of the transverse acetabular ligament in canine caudoventral hip luxation.

Open surgical fixation was performed on four hip joints in three dogs who were suffering from caudoventral hip luxations for which closed reduction had previously failed. Stabilization of the joint was achieved with a ventral coxofemoral approach, which augmented the function of the transverse acetabular ligament using a sling implant through a bone tunnel (n = 1), a sling implant around two pelvic screws (n = 1), or an internal fixator plate (n = 2). Transverse acetabular ligament augmentation resulted in successful joint stabilization in all cases, and should be considered for the surgical reduction of caudoventral hip luxations in dogs. The use of an internal fixator plate, while preserving soft-tissue blood supply and resulting in minimal to no long-term arthritic changes, may provide an optimal outcome.

Extracorporeal shockwave therapy in a dog with chronic bicipital tenosynovitis.

A 15-month-old, spayed female, Bernese mountain dog was presented to the Institute of Small Animal Surgery at the University of Zurich because of chronic left forelimb lameness. The referring veterinarian diagnosed pain in the left shoulder region and had treated the dog with systemic non-steroidal anti-inflammatory drugs and restricted exercise for a two-week period. The follow-up examination revealed only minimal improvement and therefore, the dog was referred for further diagnostic evaluation. Chronic bicipital tenosynovitis and tendinitis of the infraspinatus muscle was diagnosed based on survey radiographs, arthrography, ultrasound, computed tomography (CT), and synovial fluid cytology. The dog underwent three sessions of extracorporeal shockwave therapy and substantial clinical improvement was observed. On follow-up examinations, only mild left forelimb lameness was evident following exercise, and changes in the intertubercular groove and at the supraglenoid tuberosity appeared less active on radiographs and CT. However, six months following treatment, mild degenerative joint disease was apparent.