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.

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.

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.

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.

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.

Hemipelvectomy to treat sarcoma of the proximal portion of the femur in a rabbit.

CASE DESCRIPTION: A 7-year-old sexually intact female rabbit was admitted to the hospital because of a 6-month history of chronic right pelvic limb lameness. CLINICAL FINDINGS: Clinical examination revealed a prominent right pelvic limb lameness and signs of pain on manipulation of the right hip joint, with a focal, well-defined soft tissue mass palpable in the right pelvic area. Pelvic radiography revealed a lytic hip joint lesion and CT detailed an expansile lesion within the proximal portion of the femur with an appearance consistent with a soft tissue mass. Histologic evaluation of incisional biopsy samples of the soft tissue mass revealed a poorly differentiated sarcoma. TREATMENT AND OUTCOME: A hemipelvectomy was performed, and histologic evaluation of the soft tissue mass confirmed the diagnosis, with tumor-free margins achieved. The patient recovered well from surgery and had good mobility. The patient survived 21 months after surgery and died of a non-cancer-related disease. Anatomic dissection was described in a cadaver rabbit to aid future surgeries. CLINICAL RELEVANCE: To the authors' knowledge, this was the first report of a hemipelvectomy performed in a rabbit. Hemipelvectomy is more routinely performed in canine and feline patients, but with the right candidate and owner commitment to aftercare, it may be safely and successfully performed in rabbits.

Prevalence of pulmonary nodules suggestive of metastasis at presentation in dogs with cutaneous or subcutaneous soft tissue sarcoma.

OBJECTIVE: To investigate the prevalence of pulmonary nodules suggestive of metastasis at the time of initial presentation in dogs with cutaneous or subcutaneous soft tissue sarcomas (STSs) and no previous related thoracic diagnostic imaging. ANIMALS: 146 client-owned dogs with a cutaneous or subcutaneous STS. PROCEDURES: Medical records were retrospectively searched to identify dogs with STSs that underwent initial thoracic diagnostic imaging when presented for referral examination between September 2014 and March 2018. Data collected included patient and tumor characteristics. Results were evaluated for dogs grouped on the basis of variables of interest (eg, STS grade, duration, or history). RESULTS: Initial thoracic imaging was performed with CT (131/146 [89.7%]) or radiography (15 [10.3%]). Although the presence or absence of pulmonary nodules suggestive of metastasis on thoracic imaging was uncertain in 9 dogs, it was certain in the remaining 137 dogs, with nodules present in 16 (11.7%) dogs (5/77 [6%] with grade 1 STSs, 2/36 [6%] with grade 2 STSs, and 9/24 [38%] with grade 3 STSs). The odds of such pulmonary nodules being present on initial examination were higher (OR, 10.8 and 3.14, respectively) for dogs with grade 3 STSs (vs grade 1 or 2 STSs) and for dogs with an STS duration > 3 months (versus ≤ 3 months). CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that pulmonary staging was a low-yield diagnostic procedure for dogs with grade 1 or 2 cutaneous or subcutaneous STSs, especially when tumors had been present for ≤ 3 months.

Gene Expression Profiling of B Cell Lymphoma in Dogs Reveals Dichotomous Metabolic Signatures Distinguished by Oxidative Phosphorylation.

Gene expression profiling has revealed molecular heterogeneity of diffuse large B cell lymphoma (DLBCL) in both humans and dogs. Two DLBCL subtypes based on cell of origin are generally recognized, germinal center B (GCB)-like and activated B cell (ABC)-like. A pilot study to characterize the transcriptomic phenotype of 11 dogs with multicentric BCL yielded two molecular subtypes distinguished on the basis of genes important in oxidative phosphorylation. We propose a metabolic classification of canine BCL that transcends cell of origin and shows parallels to a similar molecular phenotype in human DLBCL. We thus confirm the validity of this classification scheme across widely divergent mammalian taxa and add to the growing body of literature suggesting cellular and molecular similarities between human and canine non-Hodgkin lymphoma. Our data support a One Health approach to the study of DLBCL, including the advancement of novel therapies of relevance to both canine and human health.

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.

Apocrine gland anal sac adenocarcinoma in cats: 30 cases (1994-2015).

OBJECTIVE To describe the signalment, clinical signs, biological behavior, and outcome for cats with apocrine gland anal sac adenocarcinoma (AGASACA) that underwent surgical excision. DESIGN Retrospective case series. ANIMALS 30 client-owned cats. PROCEDURES Databases of 13 Veterinary Society of Surgical Oncology member-affiliated institutions were searched for records of cats with a histologic diagnosis of AGASACA that underwent tumor excision. For each cat, information regarding signalment, clinical signs, diagnostic test results, treatment, and outcome was extracted from the medical record. The Kaplan-Meier method was used to determine median time to local recurrence (TLR), disease-free interval (DFI), and survival time. Cox regression was used to identify factors associated with TLR, DFI, and survival time. RESULTS Perineal ulceration or discharge was the most common clinical sign in affected cats. Eleven cats developed local recurrence at a median of 96 days after AGASACA excision. Incomplete tumor margins and a high nuclear pleomorphic score were risk factors for local recurrence. Nuclear pleomorphic score was negatively associated with DFI. Local recurrence and a high nuclear pleomorphic score were risk factors for death. Median DFI and survival time were 234 and 260 days, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that, in cats, perineal ulceration or discharge should raise suspicion of AGASACA and prompt rectal and anal sac examinations. Local recurrence was the most common life-limiting event in cats that underwent surgery for treatment of AGASACA, suggesting that wide margins should be obtained whenever possible during AGASACA excision. Efficacy of chemotherapy and radiation therapy for treatment of cats with AGASACA requires further investigation. (J Am Vet Med Assoc 2019;254:716-722).

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.

Neuromuscular blockade and inspiratory breath hold during stereotactic body radiation therapy for treatment of heart base tumors in four dogs.

CASE DESCRIPTION 4 dogs were examined because of pleural effusion and ventricular tachycardia, coughing and supraventricular tachycardia, appendicular osteosarcoma, and syncopal episodes. CLINICAL FINDINGS In all 4 dogs, a heart base tumor was identified by means of thoracic CT. TREATMENT AND OUTCOME In all 4 dogs, the heart base tumors were treated by means of stereotactic body radiation therapy. Dogs were anesthetized, and neuromuscular blockade was achieved with atracurium or vecuronium. A circle rebreathing system with 15 m (50 feet) of anesthetic tubing coursing through the vault wall was used to connect the patient to the anesthesia machine, which was located in the control room. After a brief period of hyperventilation, an inspiratory breath was held at 20 cm H2O for the duration of beam delivery. Each beam delivery lasted between 30 and 100 seconds. Immediately following the breath hold, assisted ventilation was resumed. Mean treatment delivery time for each patient was 26 minutes; mean total anesthesia time was 89 minutes. All patients recovered without complications. There was no evidence of hemoglobin desaturation or hypercapnia during the anesthetic procedure. CLINICAL RELEVANCE The technique allowed for control of the respiration cycle from outside the radiation vault and a short overall treatment time. No adverse effects were encountered. This procedure should be considered when delivering radiation to structures within the thoracic cavity.

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.

Surgical placement and management of jugular vascular access ports in dogs and cats: description of technique / Implantación quirúrgica y gestión de catéter venoso central en la vena yugular de perros y gatos: descripción de la técnica / Implante cirúrgico e manejo de cateter venoso central na veia jugular de cães e gatos: descrição da técnica

Background: vascular access ports (VAPs) are designed to allow repeated access to the vascular system with minimum patient distress. Objective: to describe the surgical technique, care and complications of jugular VAPs currently used at the Veterinary Oncology Service of the University of Florida Small Animal Hospital. Conclusion: the VAPs can remain in site for long terms (months) with minimum complications, and its placement is a reliable technique that should be considered by veterinarians, particularly for a longterm treatment.

Antecedentes: los catéteres venosos centrales (VAPs) están diseñados para permitir el acceso repetido al sistema vascular con las mínimas molestias para el paciente. Objetivo: describir la técnica quirúrgica, atención de mantenimiento y las complicaciones de los VAPs en vena yugular, que se utiliza actualmente en el Veterinary Oncology Service en la University of Florida Small Animal Hospital. Conclusión: el VAP puede permanecer en el lugar durante períodos largos (meses) con pocas complicaciones, y su implantación quirúrgica debe ser considerada por los veterinarios, en particular para el tratamiento a largo plazo.

Antecedentes: os cateteres venosos centrais (VAPs) permitem acessos repetidos ao sistema vascular com mínimo desconforto ao paciente. Objetivo: descrever a técnica cirúrgica, cuidados de manutenção e complicações dos VAPs de veia jugular utilizados atualmente no Serviço de Oncologia Veterinária do Hospital Veterinário de Pequenos Animais da Universidade da Florida. Conclusão: o VAP pode permanecer no local por longos períodos (meses) com poucas complicações. O implante cirúrgico descrito no presente trabalho deve ser considerado pelos médicos veterinários, particularmente para tratamentos de longa duração.

Adrenocortical tumor in a cat secreting more than one type of corticosteroid.

CASE SUMMARY: A 14-year-old, spayed female domestic shorthair cat was evaluated because of a right adrenal mass. The referring veterinarian had started treatment for hypokalemia and systemic arterial hypertension. During the initial evaluation the cat was alert and responsive, and serum potassium concentration was within the reference range. Serum concentrations of aldosterone and progesterone were increased. Atrophy of the contralateral adrenal and an exaggerated response of cortisol to stimulation with adrenocorticotropic hormone suggested hypersecretion of cortisol. Unilateral adrenalectomy was performed and recovery was uneventful. Histologic examination of the mass revealed an adrenocortical tumor. After surgery, clinical signs of hypercortisolism, hyperaldosteronism and hyperprogesteronism were no longer observed, and neither potassium supplementation nor antihypertensive treatment were needed. RELEVANCE AND NOVEL INFORMATION: In cases with an adrenocortical tumor, clinicians should investigate whether the tumor hypersecretes glucocorticoids, mineralocorticoids, sex steroids or combinations of these. Hypersecretion of more than one adrenal hormone may occur in a cat with an adrenocortical tumor.

Appendicular osteosarcoma in small-breed dogs: 51 cases (1986-2011).

OBJECTIVE: To describe outcomes for small-breed dogs with appendicular osteosarcoma. DESIGN: Multi-institutional retrospective case series. ANIMALS: 51 small-breed dogs. PROCEDURES: Records from participating Veterinary Society of Surgical Oncology members were searched for dogs that weighed ≤ 15 kg (33 lb) with a histologic diagnosis of appendicular osteosarcoma. The Kaplan-Meier method was used to determine median survival times (MSTs), and Cox regression was performed to identify variables associated with survival time. RESULTS: Tumors were most commonly located on the humerus (n = 15) and femur (14). Of the 51 study dogs, 9 were treated nonsurgically, 16 underwent amputation of the affected limb only, and 26 underwent curative-intent treatment, with MSTs of 112, 257, and 415 days, respectively. The MST did not differ significantly between dogs in the amputation-only and curative-intent groups. For dogs in the nonsurgical group, MST decreased significantly as the tumor histologic score increased. For dogs in the amputation-only group, MST decreased as body weight increased. CONCLUSIONS AND CLINICAL RELEVANCE: For the small-breed dogs with appendicular osteosarcoma of the present study, tumor histologic grade and mitotic index were subjectively lower and MST following amputation of the affected limb without adjuvant chemotherapy was longer, compared with those for similarly affected larger dogs. Results indicated no significant advantage in MST for dogs that underwent curative-intent treatment versus dogs that underwent amputation only, and further investigation of the importance of adjuvant chemotherapy is warranted.