Ex vivo evaluation of a novel cell salvage device to recover canine erythrocytes.

OBJECTIVE: To determine the ability of a cell salvage device to recover canine erythrocytes by direct aspiration of diluted packed red blood cells (pRBC) and saline rinse from blood-soaked surgical swabs. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Twelve recently expired units of canine pRBC. METHODS: pRBC units donated from a pet blood bank (after quality analysis) were diluted with anticoagulant, divided into two equal aliquots, and subsequently harvested by direct suction (Su), or soaked into swabs, saline-rinsed and suctioned (Sw). The volume of product, manual packed cell volume (PCV), and red blood cell mass (rbcM) were measured and compared before and after salvaging. The rbcM recovery was recorded as percentage ([rbcM post salvage]/[rbcM presalvage]x100). Statistical analysis of all measured values was performed (significance p < .05). RESULTS: No difference was detected between pre- and post-salvage PCV or mean rise of PCV for either group. The volume of salvaged blood was 143 ml (SD ± 2.89 ml; Su) and 139.83 ml (SD ± 3.30 ml; Sw), p < .001. The average rbcM recovered was 88.43% (Su) and 84.74%. (Sw) averaged 84.74% (p = .015). Blood type and order of processing did not influence recovery. CONCLUSION: The tested cell saver device reliably salvages canine blood in this ex vivo setting. Cell salvage via direct suction produces higher volumes of salvaged blood than rinsing blood-soaked swabs and salvaging the flush. CLINICAL SIGNIFICANCE: Washing blood-saturated surgical swabs results in a high harvest of red blood cells. The authors recommend it as an adjunct to direct suction to maximize erythrocyte recovery.

Outcomes of eight cats with oral neoplasia treated with radical mandibulectomy.

OBJECTIVE: To report outcomes after radical mandibulectomy in cats. STUDY DESIGN: Multi-institutional retrospective study. ANIMALS: Eight cats were included. METHODS: Medical records were searched for cats with confirmed oral neoplasia treated with radical mandibulectomy. Data collected included demographics, surgical procedure, histopathological diagnosis, postoperative management, and outcomes. RESULTS: Ages ranged from 8 to 17 years. All cats had 75% to 90% of the mandible removed and feeding tubes placed. Seven cats had squamous cell carcinoma, and one cat had a giant cell tumor. Six cats ate on their own postoperatively. Three cats had local recurrence and tumor-related died at 136 and 291 days. Six cats had no recurrence, with survival times of 156, 465, 608, and 1023 days, and two cats were still alive at 316 and 461 days after surgery. The three long-term survivors died of causes unrelated to oral neoplasia. One cat died at 156 days due to aspiration of food material. The overall estimated mean survival time was 712 days. CONCLUSION: After radical mandibulectomy, independent food intake was achieved in 6 of eight cats, and four cats lived longer than one year. CLINICAL SIGNIFICANCE: Radical mandibulectomy should be considered for the treatment of extensive oral neoplasia in cats. Successful long-term outcomes are possible with aggressive supportive care perioperatively.

Primary appendicular hemangiosarcoma and telangiectatic osteosarcoma in 70 dogs: A Veterinary Society of Surgical Oncology retrospective study.

OBJECTIVE: To define and compare clinical characteristics of canine primary appendicular hemangiosarcoma (HSA) and telangiectatic osteosarcoma (tOSA), including signalment, presentation, response to treatment, and prognosis. STUDY DESIGN: Multi-institutional retrospective study. ANIMALS: Seventy dogs with primary appendicular HSA or tOSA. METHODS: Patient data were obtained from institutions' medical records. Immunohistochemistry was applied to archived tissues to establish tumor type. Patient characteristics, treatment responses, and outcomes were described and compared by tumor type. RESULTS: Forty-one HSA and 29 tOSA were identified. Dogs with HSA were more likely than dogs with tOSA to be male and have hind limb tumors; 78% of HSA occurred in hind limbs, particularly the tibia. Dogs with tOSA weighed a median of 9.9 kg (95% CI 4.6-15.3) more than dogs with HSA. Most dogs received antineoplastic treatment, predominantly amputation with or without adjuvant chemotherapy. Overall survival with local treatment and chemotherapy was 299 days (95% CI 123-750) for HSA and 213 days (95% CI 77-310) for tOSA. Younger age and more aggressive treatment were associated with longer survival in dogs with HSA but not tOSA. One-year survival rates did not differ between dogs with HSA (28%) and those with tOSA (7%). CONCLUSION: Distinct clinical features were identified between HSA and tOSA in this population. Both tumors were aggressive, with a high incidence of pulmonary metastases. However, local treatment combined with chemotherapy led to an average survival 7 months for tOSA and 10 months for HSA. CLINICAL SIGNIFICANCE: HSA should be considered as a differential in dogs with aggressive lytic bone lesions, particularly medium-sized dogs with tibial lesions. HSA has a unique clinical presentation but similar therapeutic response and outcome to OSA. Amputation and chemotherapy appear to prolong survival in some dogs with HSA and tOSA.

Outcome and complications in dogs with appendicular primary bone tumors treated with stereotactic radiotherapy and concurrent surgical stabilization.

OBJECTIVE: To document the outcome of dogs with appendicular primary bone tumors treated with stereotactic radiotherapy (SRT) and concurrent stabilization. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Eighteen dogs with presumptive or definitive diagnosis of appendicular osteosarcoma. METHODS: Medical records of dogs with appendicular primary bone tumors treated with SRT and stabilization were reviewed for signalment, preoperative staging and diagnostics, radiation dose, stabilization method, and outcome. RESULTS: The distal radius was affected in 13/18 cases. Osteosarcoma or sarcoma was confirmed cytologically or histologically in 15/18 cases. Seven dogs were diagnosed with a pathological fracture at the time of treatment, and 11 were considered at high risk for pathological fracture. Dogs received a single dose (n = 5) or 3 doses (n = 13) of SRT. Surgical stabilization was performed under the same anesthetic event as the final dose of SRT in 10 dogs. Stabilization was achieved with a bone plate (n = 15) or interlocking nail (n = 3). Seventeen dogs received adjuvant chemotherapy. Complications occurred in 16/17 dogs, 15/17 of those being considered major complications. Four dogs experienced more than one complication. Infection was the most common complication, diagnosed in 15/17 cases, and considered as a major complication in 13/15 cases. Postoperative fracture was recorded as a major complication in 3 cases. Nine dogs were amputated at a median of 152 days. The median survival time was 344 days. CONCLUSION: Treatment of bone tumors with SRT and concurrent stabilization was associated with a prohibitively high complication rate in dogs. Alternative methods for limb salvage should be considered for dogs at risk for pathologic fracture.

Retrospective Evaluation of Whole Body Computed Tomography for Tumor Staging in Dogs with Primary Appendicular Osteosarcoma.

OBJECTIVE: To evaluate whole body computed tomography (CT) for staging canine appendicular osteosarcoma. STUDY DESIGN: Retrospective case series. ANIMALS: Client-owned dogs diagnosed with appendicular osteosarcoma (n=39). METHODS: Medical records for client-owned dogs diagnosed with appendicular osteosarcoma from August 2008 to July 2014 were reviewed. Dogs were included if they had a confirmed diagnosis of appendicular osteosarcoma and were staged using whole body CT. Data collected included signalment, body weight, primary tumor location, serum alkaline phosphatase (ALP) activity, findings on 3-view thoracic radiographs, cytologic or histologic results, and findings on CT. RESULTS: Thirty-nine dogs (median age 8.5 years; median body weight 37 kg) had osteosarcoma of the distal radius (n=17), proximal humerus (11) and other sites. Serum ALP activity was elevated in 14 dogs. Bone metastasis was not detected in any dog on whole body CT. Pulmonary metastasis was considered definitive on CT based on board certified radiologist assessment in 2/39 dogs (5%). Two additional dogs (2/39, 5%) had soft tissue masses diagnosed on CT, consistent with concurrent, non-metastatic malignancies. CONCLUSION: Bone metastases were not identified in any dog with whole body CT. Thoracic and abdominal CT detected lung lesions and concurrent neoplasia in dogs with primary appendicular osteosarcoma. Whole body CT may be a useful adjunct to other screening tests for disseminated malignancy.

Perioperative Management and Outcome of Bilateral Adrenalectomy in 9 Dogs.

OBJECTIVE: To report perioperative care, postoperative management, and long-term outcomes in dogs undergoing bilateral adrenalectomy. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs undergoing bilateral adrenalectomy from 2008 to 2013 (n=9). METHODS: Data retrieved from the record, when available, included signalment, preoperative clinical signs, laboratory data, diagnostic imaging, blood pressure measurement, preoperative treatment for adrenal gland disease, intraoperative procedures, treatments and complications, postoperative treatment and diagnostics during hospitalization, diagnostics and management following discharge, histopathologic diagnosis, and survival. RESULTS: Seven dogs underwent concurrent bilateral adrenalectomy and 2 dogs had staged adrenalectomy. Surgery was uncomplicated in most cases. All dogs received IV dexamethasone SP intraoperatively. Eight dogs received intramuscular desoxycorticosterone pivalate intraoperatively. Histopathology revealed adrenocortical adenoma (7 dogs), adrenocortical carcinoma (4), pheochromocytoma (6), and adrenocortical atrophy (1). One dog died perioperatively and the remainder died due to unrelated causes. Postoperative management of hypoadrenocorticism included oral prednisone and intramuscular desoxycorticosterone pivalate (6 dogs), oral prednisone and fludrocortisone (1), and oral fludrocortisone alone (1). The median survival time in dogs surviving to hospital discharge was 525 days (range 67-966 days). No dogs developed metastatic disease or died due to signs of hypoadrenocorticism. CONCLUSION: Based on the cases reported here, the perioperative mortality in dogs undergoing bilateral adrenalectomy may be lower than previously reported. Management of postoperative hypoadrenocorticism is both achievable and straightforward.

ASSOCIATION BETWEEN COMPUTED TOMOGRAPHIC CHARACTERISTICS AND FRACTURES FOLLOWING STEREOTACTIC RADIOSURGERY IN DOGS WITH APPENDICULAR OSTEOSARCOMA.

The objective of this observational, descriptive, retrospective study was to report CT characteristics associated with fractures following stereotactic radiosurgery in canine patients with appendicular osteosarcoma. Medical records (1999 and 2012) of dogs that had a diagnosis of appendicular osteosarcoma and undergone stereotactic radiosurgery were reviewed. Dogs were included in the study if they had undergone stereotactic radiosurgery for an aggressive bone lesion with follow-up information regarding fracture status, toxicity, and date and cause of death. Computed tomography details, staging, chemotherapy, toxicity, fracture status and survival data were recorded. Overall median survival time (MST) and fracture rates of treated dogs were calculated. CT characteristics were evaluated for association with time to fracture. Forty-six dogs met inclusion criteria. The median overall survival time was 9.7 months (95% CI: 6.9-14.3 months). The fracture-free rates at 3, 6, and 9 months were 73%, 44%, and 38% (95% CI: 60-86%, 29-60%, and 22-54%), respectively. The region of bone affected was significantly associated with time to fracture. The median time to fracture was 4.2 months in dogs with subchondral bone involvement and 16.3 months in dogs without subchondral bone involvement (P-value = 0.027, log-rank test). Acute and late skin effects were present in 58% and 16% of patients, respectively. Findings demonstrated a need for improved patient selection for this procedure, which can be aided by CT-based prognostic factors to predict the likelihood of fracture.

Stereotactic radiosurgery and fracture fixation in 6 dogs with appendicular osteosarcoma.

OBJECTIVE: To evaluate clinical outcome of dogs with appendicular osteosarcoma (OSA) treated with stereotactic radiosurgery (SRS) and subsequent internal fixation of a pathologic fracture. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs with spontaneous-occurring appendicular OSA (n = 6). METHODS: Medical records (May 2002-January 2008) of dogs that had SRS for appendicular OSA were reviewed. Dogs were included if they had a pathologic fracture either before or after SRS and were treated with internal fixation. Signalment, history, physical examination findings, clinicopathologic data, diagnostic imaging findings, biopsy results, surgical complications, number of surgeries, adjuvant therapy, development of metastatic disease and cause of death were recorded. RESULTS: Six dogs met the inclusion criteria. Two dogs had a pathologic fracture at admission and 4 dogs developed a fracture after SRS with a mean ± SD time to fracture development of 6.25 ± 1.65 months. The first 3 fractures were repaired using an open approach and the latter three using minimally invasive percutaneous osteosynthesis (MIPO). Infection occurred in 5 dogs and implant failure in 3. Limb function was subjectively assessed as good in all dogs when the implants were stable and infections were subclinical. Survival times ranged from 364-897 days; 1 dog was lost to follow-up. CONCLUSIONS: Fracture repair using internal fixation should be considered a viable limb-sparing alternative for pathologic fractures that have been treated with SRS.

Hemipelvectomy: outcome in 84 dogs and 16 cats. A veterinary society of surgical oncology retrospective study.

OBJECTIVE: To report clinical findings, perioperative complications and long-term outcome in dogs and cats that had hemipelvectomy surgery for treatment of neoplasia. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Dogs (n = 84) and cats (16). METHODS: Medical records (January 2000 to December 2009) of dogs and cats that had hemipelvectomy at participating institutions were reviewed. Postoperative progress and current status of the patient at the time of the study was determined by either medical record review, or via telephone contact with the referring veterinarian or owner. RESULTS: Complications were infrequent and usually minor. Hemorrhage was the main intraoperative complication; 2 dogs required blood transfusion. One dog developed an incisional hernia. In dogs, hemangiosarcoma had the worst prognosis with a median survival time (MST) of 179 days. MST for chondrosarcoma (1232 days), osteosarcoma (533 days), and soft tissue sarcoma (373 days) were not statistically different. Median disease-free interval (DFI) for local recurrence of all tumor types was 257 days. Cats had 75% survival at 1 year, which was significantly longer than dogs. CONCLUSIONS: Survival times for most tumor types can be good, but surgical margins should be carefully evaluated to ensure complete tumor removal. Adjuvant therapies may be advisable particularly for dogs to reduce rates of local recurrence or distant metastasis.

Functional metastatic parathyroid adenocarcinoma in a dog.

A 12-year-old dachshund dog was presented for persistent hypercalcemia and hyperparathyroidism despite bilateral parathyroidectomy. Magnetic resonance imaging of the head, neck, and cranial mediastinum identified an increased number of cranial mediastinal lymph nodes with heterogeneous signal intensity. Hypercalcemia and hyperparathyroidism resolved after surgery to remove multiple cranial mediastinal lymph nodes, one of which contained presumed metastatic parathyroid tissue.

Adénocarcinome parathyroïdien métastatique fonctionnel chez un chien. Un chien Dachsund âgé de 12 ans a été présenté pour de l'hypercalcémie et de l'hyperparathyroïdie persistantes malgré une parathyroïdectomie bilatérale. Une imagerie par résonance magnétique de la tête, du cou et du médiastin crânien a identifié un nombre accru de ganglions lymphatiques médiastinaux avec une intensité hétérogène du signal. L'hypercalcémie et l'hyperparathyroïdie se sont résorbées après la chirurgie pour enlever les nombreux ganglions lymphatiques médiastinaux crâniens, dont l'un contenait du tissu parathyroïdien métastatique présumé.(Traduit par Isabelle Vallières).

Apoptotic effects of the tyrosine kinase inhibitor, masitinib mesylate, on canine osteosarcoma cells.

Osteosarcoma (OSA) is the most common primary bone tumor in dogs and the guarded prognosis highlights the necessity to find new treatments. Masitinib mesylate is a highly selective tyrosine kinase inhibitor that predominantly targets c-Kit and PDGFR-α/ß. This study evaluated the in-vitro activity of masitinib against three canine OSA cell lines after treatment with increasing concentrations of masitinib (0.1-50 µmol/l) at 24, 48, and 72 h. The IC50 values at 72 h for the three OSA cell lines (POS, HMPOS, and COS31) were determined to be 11.04, 7.09, and 9.74 µmol/l, respectively. In addition, increases in caspase-3/7 activity and transferase dUTP nick end labeling-positive cells indicated apoptotic cell death. Because increased levels of vascular endothelial growth factor are found in dogs with OSA, vascular endothelial growth factor in the supernatant was quantified. Overall, the study found that masitinib causes dose-time dependent OSA cell death in vitro through initiation of caspase-mediated apoptosis, which supports future OSA clinical trials.

Comparison of computed tomographic angiography and ultrasonography for the detection and characterization of portosystemic shunts in dogs.

The purpose of this retrospective study was to compare the accuracy of computed tomographic angiography (CTA) and abdominal ultrasonography in detecting and characterizing portosystemic shunts (PSS) in dogs. Medical records of 76 dogs that underwent CTA and/or abdominal ultrasonography suspected to have PSS were reviewed. Presence or absence, and characterization of PSS (when present) on CTA were reviewed by a board-certified veterinary radiologist that was blinded to the clinical findings. The abdominal ultrasonography findings were reviewed from the medical records. Visualization and description of the origin and insertion of PSS on CTA and abdominal ultrasonography were related with laboratory, surgical, or mesenteric portographic confirmation of the presence or absence of PSS. The sensitivity for detection of PSS with CTA (96%) was significantly higher than abdominal ultrasonography (68%; P < 0.001). The specificities for CTA and abdominal ultrasonography were 89% and 84%, respectively (P = 0.727). Computed tomographic angiography detected the correct origin in 15 of 16 dogs and correct insertion in 15 of 16 dogs with congenital PSS. Abdominal ultrasonography detected the correct origin in 24 of 30 dogs and correct insertion in 20 of 33 dogs with congenital PSS. Multiple acquired PSS were seen in four of five dogs and in one of six dogs on CTA and abdominal ultrasonography, respectively. Computed tomographic angiography was 5.5 times more likely to correctly ascertain the presence or absence of PSS when compared to abdominal ultrasonography (P = 0.02). Findings indicated that CTA is a noninvasive diagnostic modality that is superior to abdominal ultrasonography for the detection and characterization of PSS in dogs.

Detection of Necrosis in Digitised Whole-Slide Images for Better Grading of Canine Soft-Tissue Sarcomas Using Machine-Learning.

The definitive diagnosis of canine soft-tissue sarcomas (STSs) is based on histological assessment of formalin-fixed tissues. Assessment of parameters, such as degree of differentiation, necrosis score and mitotic score, give rise to a final tumour grade, which is important in determining prognosis and subsequent treatment modalities. However, grading discrepancies are reported to occur in human and canine STSs, which can result in complications regarding treatment plans. The introduction of digital pathology has the potential to help improve STS grading via automated determination of the presence and extent of necrosis. The detected necrotic regions can be factored in the grading scheme or excluded before analysing the remaining tissue. Here we describe a method to detect tumour necrosis in histopathological whole-slide images (WSIs) of STSs using machine learning. Annotated areas of necrosis were extracted from WSIs and the patches containing necrotic tissue fed into a pre-trained DenseNet161 convolutional neural network (CNN) for training, testing and validation. The proposed CNN architecture reported favourable results, with an overall validation accuracy of 92.7% for necrosis detection which represents the number of correctly classified data instances over the total number of data instances. The proposed method, when vigorously validated represents a promising tool to assist pathologists in evaluating necrosis in canine STS tumours, by increasing efficiency, accuracy and reducing inter-rater variation.

Relationship between magnetic resonance imaging findings and histological grade in spinal peripheral nerve sheath tumors in dogs.

BACKGROUND: Peripheral nerve sheath tumors (PNSTs) are a group of neoplasms originating from Schwann cells or pluripotent cell of the neural crest. Therapeutic options and prognosis are influenced by their degree of malignancy and location. HYPOTHESIS/OBJECTIVES: Identify magnetic resonance imaging (MRI) features predictive of PNST histologic grade. ANIMALS: Forty-four dogs with histopathological diagnosis of spinal PNSTs and previous MRI investigation. METHODS: A multicenter retrospective study including cases with (a) histopathologic diagnosis of PNST and (b) MRI studies available for review. Histologic slides were reviewed and graded by a board-certified pathologist according to a modified French system (FNCLCC) for grading soft tissue sarcomas. The MRI studies were reviewed by 2 board-certified radiologists blinded to the grade of the tumor and the final decision on the imaging characteristics was reached by consensus. Relationships between tumor grade and histological and MRI findings were assessed using statistical analysis. RESULTS: Forty-four cases met inclusion criteria; 16 patients were PNSTs Grade 1 (low-grade), 19 were PNSTs Grade 2 (medium-grade), and 9 were PNSTs Grade 3 (high-grade). Large volume (P = .03) and severe peripheral contrast enhancement (P = .04) were significantly associated with high tumor grade. Degree of muscle atrophy, heterogeneous signal and tumor growth into the vertebral canal were not associated with grade. CONCLUSIONS AND CLINICAL IMPORTANCE: Grade of malignancy was difficult to identify based on diagnostic imaging alone. However, some MRI features were predictive of high-grade PNSTs including tumor size and peripheral contrast enhancement.

Surgical management of a subepiglottic thyroglossal duct cyst in a dog.

A 2 yr old dog presented for dysphagia and coughing secondary to a 4 cm × 4 cm turgid subepiglottic mass. Cervical radiographs, an esophagram, and computed tomography confirmed the presence of a cystic mass that was not intimately associated with any surrounding structures. An incisional biopsy confirmed the cystic nature of the mass and helped to rule out a malignancy. A marginal surgical excision was performed via a ventral approach. Histopathology of the mass was consistent with a thyroglossal duct cyst. This is the first report of a thyroglossal duct cyst in this location in a dog. There was no recurrence of clinical signs 14 mo after surgery.

Toxicity of zoledronic acid after intravenous administration: A retrospective study of 95 dogs.

BACKGROUND: There is a paucity of veterinary literature on the safety or outcome of zoledronic acid (ZA) use in dogs for either bone pain or hypercalcemia. HYPOTHESIS/OBJECTIVES: The primary aim was to report the adverse events in dogs receiving intravenous administration of ZA. ANIMALS: Ninety-five dogs with ZA use. METHODS: A retrospective cohort study was performed; all dogs that received at least 1 dose of ZA and had a serum biochemistry profile performed before and after treatment were reviewed. Diagnosis, indication for treatment, adverse events and survival times were recorded. RESULTS: Ninety-five dogs met the inclusion criteria. Thirty-one (33%) received multiple intravenous infusions of ZA (range, 2-7), making a total of 166 administrations in all dogs. The dose range was 0.13 to 0.32 mg/kg, given at intervals of 4 to 6 weeks. Thirteen adverse events were recorded in 10 dogs: azotemia (n = 8), vomiting (n = 2), pancreatitis (n = 1), cutaneous ulceration (n = 1), and diarrhea (n = 1). Zoledronic acid could not be confirmed as the cause of azotemia in any case. The change in serum creatinine concentration from dose to dose was not related to the total dose received (P = .46). Five dogs (5%) changed Veterinary Comparative Oncology Group Common Terminology Criteria (VCOG-CTAE) renal/genitourinary grade after administration of ZA; their total dose 0.4 mg/kg (range, 0.26-0.66) was not significantly different to the group which did not change VCOG-CTAE renal/genitourinary grade 0.35 mg/kg (range, 0.2-1.50; P = .93). CONCLUSIONS AND CLINICAL IMPORTANCE: Multiple doses of ZA were well tolerated in dogs within this study. A small number of dogs developed progressive azotemia which was not associated with cumulative dose.

Intraoperative cell salvaging: ex vivo evaluation of two swab-washing methods.

OBJECTIVE: To compare erythrocyte recovery by a cell salvage device between swab-washing by manual agitation or filtration. SAMPLE: 12 recently expired units of canine packed RBCs. PROCEDURE: The packed RBC units underwent quality analysis before donation from a pet blood bank. Each unit was volume-expanded with anticoagulant and subsequently divided into 2 equal aliquots used to soak surgical swabs before washing. Two different swab-washing techniques were evaluated-standard swab-washing-manual agitation (SW-MA) and swab-washing-filtration (SW-F)-with a novel prototype device. The resulting bloody fluid was processed using the Cell Saver Elite Autotransfusion System (Haemonetics). The volume, manual PCV, CBC, and RBC mass, calculated as the product of the volume and PCV, were measured before and after salvaging. Last, the RBC mass recovery was recorded as a percentage. RESULTS: The RBC mass recovered from SW-MA and SW-F averaged 85.73% and 83.99%, respectively. There was no significant difference in RBC recovery between the 2 methods (P = .52). CLINICAL RELEVANCE: SW-MA and SW-F recovered a similar quantity of RBCs from blood-soaked swabs in an ex vivo setting.

Deep learning for necrosis detection using canine perivascular wall tumour whole slide images.

Necrosis seen in histopathology Whole Slide Images is a major criterion that contributes towards scoring tumour grade which then determines treatment options. However conventional manual assessment suffers from inter-operator reproducibility impacting grading precision. To address this, automatic necrosis detection using AI may be used to assess necrosis for final scoring that contributes towards the final clinical grade. Using deep learning AI, we describe a novel approach for automating necrosis detection in Whole Slide Images, tested on a canine Soft Tissue Sarcoma (cSTS) data set consisting of canine Perivascular Wall Tumours (cPWTs). A patch-based deep learning approach was developed where different variations of training a DenseNet-161 Convolutional Neural Network architecture were investigated as well as a stacking ensemble. An optimised DenseNet-161 with post-processing produced a hold-out test F1-score of 0.708 demonstrating state-of-the-art performance. This represents a novel first-time automated necrosis detection method in the cSTS domain as well specifically in detecting necrosis in cPWTs demonstrating a significant step forward in reproducible and reliable necrosis assessment for improving the precision of tumour grading.

Outcome after repair of a sarcoma-related pathologic fracture in dogs: a Veterinary Society of Surgical Oncology Retrospective Study.

OBJECTIVE: To report outcome in dogs after internal fixation of a sarcoma-related pathologic fracture of the appendicular skeleton. STUDY DESIGN: Multi-institutional case series. ANIMALS: Dogs (n=16). METHODS: Medical records of participating VSSO members were reviewed for dogs with pathologic fracture associated with a confirmed bone sarcoma of the appendicular skeleton repaired by external or internal fixation. Dogs were included if they had a histological diagnosis of osteosarcoma or sarcoma and excluded if they had radiation before fracture. Data collected were analyzed for signalment, fracture location, staging performed, method of fracture fixation, histopathology, adjunctive treatment and outcome. RESULTS: Signalment and fracture location of 16 dogs that met the inclusion criteria was similar to dogs with appendicular OSA without fracture. One of 14 dogs had pulmonary metastasis and 3 of 5 dogs had bone metastasis. Bone plate or interlocking nail were used for repair in 12 dogs. Limb use immediately after surgery in 13 dogs was good (4), weight-bearing but lame (7) and non-weight bearing (2). Adjunctive therapy was administered in 5 dogs (chemotherapy, 3; radiation, 4; pamidronate, 3). Survival time ranged from 18 to 897 days; median survival was 166 days. CONCLUSIONS: Repair of pathologic fracture can result in palliation and prolonged survival.

Oronasal fistula repair utilizing a temporalis muscle flap in a dog with severe trismus.

A 9 yr old spayed female cocker spaniel presented for evaluation of an invasive maxillary squamous cell carcinoma. Curative intent surgery and radiation therapy allowed for local control of the neoplasm; however, the development of a persistent oronasal fistula prevented a complete recovery. A temporalis myofascial rotation flap allowed for successful resolution of the maxillary defect. Implementation of the flap was relatively simple and was associated with few complications.