Elevated serum thymidine kinase activity in canine splenic hemangiosarcoma*.

Thymidine kinase 1 (TK1) is a soluble biomarker associated with DNA synthesis. This prospective study evaluated serum TK1 activity in dogs presenting with hemoabdomen and a splenic mass. An ELISA using azidothymidine as a substrate was used to evaluate TK1 activity. Sixty-two dogs with hemoabdomen and 15 normal controls were studied. Serum TK1 activity was significantly higher in dogs with hemangiosarcoma (HSA) than in normal dogs (mean ± SEM = 17.0 ± 5.0 and 2.01 ± 0.6, respectively), but not dogs with benign disease (mean ± SEM = 10.0 ± 3.3). Using a cut-off of 6.55 U/L, TK activity demonstrated a sensitivity of 0.52, specificity of 0.93, positive predictive value of 0.94 and negative predictive value of 0.48 for distinguishing HSA versus normal. When interval thresholds of <1.55 and >7.95 U/L were used together, diagnostic utility was increased. Serum TK1 evaluation may help to discriminate between benign disease and HSA in dogs with hemoabdomen and a splenic mass.

Somatostatin analog treatment of pancreatic fistulas.

In order to hasten healing of pancreatic fistulas, we have treated 11 men and one woman with octreotide, a long-lasting somatostatin analog. This agent was administered subcutaneously in doses of 0.05-0.20 mg, two to three times per day. Fistulas were secondary to pancreatic biopsy (1), pancreatic abscess drainage (2), operative injury (3), and blunt abdominal trauma (4). The two patients with fistulas secondary to pancreatic biopsy had outputs of 1000 mL/d. The patient with blunt trauma had pancreatic ascites, with outputs of 750 mL/d. The remainder had outputs of 100-250 mL/d for periods ranging from 1 wk to 11 mo. After octreotide administration, fistula output decreased from 360 +/- 347 mL/d to 110 +/- 131 mL/d on the first day of therapy (p < 0.05) and to 44 +/- 72 mL/d on the seventh day (p < 0.05). Seven patients eventually closed their fistulas. Failure to achieve fistula closure with octreotide was secondary to pancreatic duct stenosis (4); pseudocyst (1) or recurrent sepsis (4); and patient noncompliance (4). Somatostatin analogs are useful in the management of pancreatic fistulas. They significantly decrease (p < 0.05) the volume of fistula output, and they seem to aid fistula healing. Somatostatin analogs are safe even for outpatient management of pancreatic fistulas.