RESUMO
The objectives of the study were to describe clinicopathologic findings in dogs that underwent surgical treatment of liver tumors and to define outcome-associated variables in this canine population. Medical records of 118 dogs that underwent liver lobectomy were reviewed. Variables were assessed via univariate and multivariate Cox regression analyses. Hazard ratios, median survival times (MSTs), and Kaplan-Meier Survival curves (KMSCs) were created for significant variables. Of the dogs with surgically addressed hepatic tumors, 93% survived to discharge. The MST was not reached. Lethargic dogs had a mortality risk 10.2 times that of non-lethargic dogs. Non-tachypneic dogs had a mortality risk 4.3 times that of tachypneic dogs. Dogs that experienced anesthetic complications had a mortality risk 100 times that of dogs that did not. We conclude that the prognosis associated with liver tumors is good. Lethargy, respiratory rate, and anesthetic complications were associated with outcome.
Facteurs associés à la survie à long terme chez les chiens subissant une lobectomie du foie pour traiter les tumeurs hépatiques. Les objectifs de l'étude étaient de décrire les résultats clinicopathologiques chez les chiens qui avaient subi le traitement chirurgical de tumeurs hépatiques et de définir les résultats associés aux variables dans cette population canine. Les dossiers médicaux de 118 chiens qui avaient subi une lobectomie du foie ont été examinés. Les variables ont été évaluées par des analyses de régression de Cox à une et à plusieurs variables. Des ratios des risques, de la durée de survie médiane (DMS) et des courbes de survie de Kaplan-Meier ont été créés pour les variables importantes. Parmi les chiens avec des tumeurs hépatiques corrigées par chirurgie, 93 % ont survécu jusqu'au congé. La DMS n'a pas été atteinte. Les chiens léthargiques avaient un risque de mortalité 10,2 fois supérieur à celui des chiens non léthargiques. Les chiens non tachypnéiques présentaient un risque de mortalité 4,3 fois supérieur à celui des chiens tachypnéiques. Les chiens qui avaient connu des complications lors de l'anesthésie présentaient un risque de mortalité 100 fois supérieur à celui des chiens qui n'avaient pas eu de complications. Nous concluons que le pronostic associé aux tumeurs hépatiques est bon. La léthargie, le taux respiratoire et les complications à l'anesthésie étaient associés aux résultats.(Traduit par Isabelle Vallières).
Assuntos
Doenças do Cão/cirurgia , Complicações Intraoperatórias/veterinária , Neoplasias Hepáticas/veterinária , Animais , Cães , Feminino , Fígado/patologia , Fígado/cirurgia , Neoplasias Hepáticas/cirurgia , Masculino , Fatores de Risco , Resultado do TratamentoRESUMO
OBJECTIVE: To determine response rate and reduction in tumor burden and effect of dose on tumor response in dogs treated with neoadjuvant prednisone for cutaneous mast cell tumors (MCTs). DESIGN: Combined prospective clinical study and retrospective case series. ANIMALS: 49 dogs with MCT. PROCEDURES: Medical records were retrospectively reviewed for dogs with primary untreated cutaneous MCT managed with neoadjuvant prednisone administration and surgery. Tumor characteristics and response to treatment were recorded. A subset of dogs assigned to low-dose (LD) treatment with neoadjuvant prednisone (1.0 mg/kg [0.45 mg/lb], PO, q 24 h) or high-dose (HD) treatment (2.2 mg/kg [1.0 mg/lb], PO, q 24 h) was used to determine the effects of dose. RESULTS: The overall objective response rate was 70% for dogs treated with neoadjuvant prednisone; prednisone dose was not significantly associated with response. Prospectively, the median sum maximal diameter (MaxD) reduction was 45.2%, and reduction in tumor volume was 80.6%. In both treatment groups, the mean percentage MaxD reduction and tumor volume reduction were significant. The difference in response between the LD and HD groups was not significant. The LD group had mean MaxD and tumor volume reductions of 35.4% and 52.5%, respectively, compared with mean reductions of 48.8% in MaxD and 78% in tumor volume in the HD group. CONCLUSIONS AND CLINICAL RELEVANCE: Treatment with neoadjuvant prednisone appears to be useful for inducing reduction of MCTs and may facilitate resection when adequate surgical margins cannot be confidently attained because of mass location or size or both.
Assuntos
Antineoplásicos Hormonais/uso terapêutico , Doenças do Cão/tratamento farmacológico , Sarcoma de Mastócitos/veterinária , Prednisona/uso terapêutico , Neoplasias Cutâneas/veterinária , Animais , Terapia Combinada/veterinária , Intervalo Livre de Doença , Doenças do Cão/patologia , Doenças do Cão/cirurgia , Cães , Relação Dose-Resposta a Droga , Feminino , Masculino , Sarcoma de Mastócitos/tratamento farmacológico , Sarcoma de Mastócitos/patologia , Sarcoma de Mastócitos/cirurgia , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Estudos Prospectivos , Distribuição Aleatória , Estudos Retrospectivos , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVE: To determine the history, clinicopathologic findings, and results of surgery for effusive-constrictive pericarditis associated with Coccidioides immitis infection in dogs. DESIGN: Retrospective study. ANIMALS: 17 client-owned dogs that underwent a subtotal pericardectomy and epicardial excision. PROCEDURE: Hospital records from May 1999 to June 2003 were reviewed. Data collected included history, clinicopathologic findings, treatments, and outcome. Follow-up information was obtained via recheck examination and by use of standardized telephone interviews with referring veterinarians and owners. RESULTS: All dogs were of large breeds, and most were male (mean age, 4.66 years). Ten dogs had no prior history of C. immitis infection, and 7 dogs had chronic infection with C. immitis. Having a chronic C. immitis infection reduced the odds of survival, compared with no previous infection. All dogs had clinical signs of right-sided heart failure. All dogs had serum titers (range, 1:8 to 1:256) for antibodies against C. immitis prior to surgery, and titers were not significantly associated with outcome. Predominant echocardiographic findings were thickened pericardium, reduced right ventricular filling, and pleural or pericardial effusion. All dogs underwent a subtotal pericardectomy and epicardial excision and had fibrosing pyogranulomatous pericarditis in biopsy specimens obtained during surgery. The perioperative mortality rate was 23.5%, and the 2-year postdischarge survival rate was 82%. CONCLUSIONS AND CLINICAL RELEVANCE: Surgical treatment via subtotal pericardectomy and epicardial excision is successful at relieving right-sided heart failure in dogs with effusive-constrictive pericarditis secondary to C. immitis infection, but long-term treatment with antifungal agents may still be required.
Assuntos
Coccidioidomicose/veterinária , Doenças do Cão/cirurgia , Pericardiectomia/veterinária , Pericardite/veterinária , Animais , Cruzamento , Coccidioides , Coccidioidomicose/complicações , Doenças do Cão/etiologia , Doenças do Cão/mortalidade , Cães , Feminino , Masculino , Pericardiectomia/métodos , Pericardite/etiologia , Pericardite/mortalidade , Pericardite/cirurgia , Pericárdio/cirurgia , Derrame Pleural/etiologia , Derrame Pleural/veterinária , Estudos Retrospectivos , Fatores Sexuais , Análise de SobrevidaRESUMO
Three dogs with advanced-stage adenocarcinoma of the gastrointestinal tract were treated by use of resection, adjuvant chemotherapy with cisplatin and 5-fluorouracil, and second-look laparotomy (SLL). In combination with histologic examination of biopsy specimens obtained during the procedure, SLL is the most accurate diagnostic procedure for identification of residual or recurrent microscopic or macroscopic abdominal neoplasia; however, to the authors' knowledge, there are no reports of its clinical use in the field of veterinary oncology. This lack of clinical use in animals is likely because of factors such as cost, procedure-associated risks perceived by the owners and veterinarians, lack of data to define proper clinical application, and, perhaps to some degree, an entrenched belief that treatment of advanced stage cancer in animals is inappropriate. Nevertheless, the use of SLL should be considered for evaluation of abdominal tumors or intra-abdominal metastases in dogs that appear to be in complete clinical remission near or at the anticipated completion of chemotherapy (especially if effective second-line chemotherapy protocols are available) or when secondary cytoreduction might be beneficial.