Genome-wide analysis of canine oral malignant melanoma metastasis-associated gene expression.

Oral malignant melanoma (OMM) is the most common canine melanocytic neoplasm. Overlap between the somatic mutation profiles of canine OMM and human mucosal melanomas suggest a shared UV-independent molecular aetiology. In common with human mucosal melanomas, most canine OMM metastasise. There is no reliable means of predicting canine OMM metastasis, and systemic therapies for metastatic disease are largely palliative. Herein, we employed exon microarrays for comparative expression profiling of FFPE biopsies of 18 primary canine OMM that metastasised and 10 primary OMM that did not metastasise. Genes displaying metastasis-associated expression may be targets for anti-metastasis treatments, and biomarkers of OMM metastasis. Reduced expression of CXCL12 in the metastasising OMMs implies that the CXCR4/CXCL12 axis may be involved in OMM metastasis. Increased expression of APOBEC3A in the metastasising OMMs may indicate APOBEC3A-induced double-strand DNA breaks and pro-metastatic hypermutation. DNA double strand breakage triggers the DNA damage response network and two Fanconi anaemia DNA repair pathway members showed elevated expression in the metastasising OMMs. Cross-validation was employed to test a Linear Discriminant Analysis classifier based upon the RT-qPCR-measured expression levels of CXCL12, APOBEC3A and RPL29. Classification accuracies of 94% (metastasising OMMs) and 86% (non-metastasising OMMs) were estimated.

The effect of functional-task training on activities of daily living for people with Parkinson`s disease, a systematic review with meta-analysis.

OBJECTIVE: To evaluate the effect of functional-task training on activities of daily living (ADL) in people with Parkinson`s Disease. METHODS: We searched five databases (Cinahl, Embase, Medline, Pedro and CENTRAL). The included studies were assessed on therapeutic validity and risk of bias. We classified the quality of evidence according to the principles of the GRADE approach. All assessments were executed independently by two researchers. The results of included studies were pooled in a meta-analyses and heterogeneity was explored by meta-regression analysis. RESULTS: Out of 2546 identified studies, 69 full texts articles were checked for eligibility, of which ten were included in the systematic review. Moderate quality of evidence indicated that exercise interventions containing functional-task training had a positive effect on ADL performance scores on the Unified Parkinson's Disease Rating Scale (UPDRS) in people with Parkinson (pwp) directly after intervention (UPDRS=-2.62(-5.34;0.10)). This effect improved, in favor of functional-task interventions, at the first follow-up (UPDRS=-4.0(-7.56;-0.4)). A post-hoc meta-regression analysis yielded a significant relationship between intensity rate (minutes/week) and the size of the (average) effect on ADL score. CONCLUSION: Exercise interventions containing functional-task training have a clinically important positive effect on ADL performance in pwp directly after intervention and at first follow-up, compared to no intervention or placebo. The intensity rate of the functional-task training should be as intense as possible, within the capabilities of the person with PD. Future research is necessary to determine the exact amount of effect that can be contributed to functional-task training.

Is the caudal auricular axial pattern flap robust? A multi-centre cohort study of 16 dogs and 12 cats (2005 to 2016).

OBJECTIVE: To determine the frequency and type of healing complications arising after the use of the caudal auricular axial pattern flap to close defects on the head in dogs and cats. MATERIAL AND METHODS: Multi-centre retrospective cohort study. Centres were recruited by the Association for Veterinary Soft Tissue Surgery Research Cooperative. Medical records of 11 centres were reviewed, and data from all dogs and cats treated with a caudal auricular axial pattern flap were retrieved. The following data were recorded: signalment, reason for reconstruction, flap dimensions, anatomic landmarks used, histological diagnosis, flap healing and whether revision surgery was required. RESULTS: Twenty-eight cases were included: 16 dogs and 12 cats. Flap length: width ratio was approximately 3:1 and flap length extended to the scapular spine in most cases. Optimal wound healing occurred in five of 16 (31%) dogs and six of 12 (50%) cats. Wound dehiscence without flap necrosis occurred in one of 16 (6%) dogs and one of 12 (8%) cats. Wound dehiscence with flap necrosis occurred in 10 of 16 (63%) dogs and five of 12 (42%) cats. Revision surgery was performed in eight of 16 (50%) dogs and three of 12 (25%) cats. CLINICAL SIGNIFICANCE: The caudal auricular axial pattern flap can provide full thickness skin coverage for large defects on the head in dogs and cats. Partial flap necrosis is a common complication, and revision surgery may be required in order to achieve final wound closure.

Retrobulbar cellulitis and abscessation: focus on short- and long-term concurrent ophthalmic diseases in 41 dogs.

OBJECTIVE: To describe concurrent ophthalmic diseases in dogs with retrobulbar cellulitis and abscessation. MATERIALS AND METHODS: Retrospective analysis of clinical records of dogs with retrobulbar inflammation. RESULTS: Forty-one dogs were diagnosed with retrobulbar inflammation; of these, 23 presented with abscessation and two with zygomatic sialoadenitis. Diagnosis was based on orbital ultrasound, MRI, CT and cytological and microbiological examination of fluid or tissue samples. Management involved evacuation of fluid contents using ultrasound-guided fine-needle aspiration via the pterygopalatine fossa or orbitotomy. Patients received systemic antibiotics (except for one with sialoadenitis), glucocorticoids, non-steroidal anti-inflammatory drugs, opioids and fluid therapy. At initial presentation one or more ophthalmic complications were reported in 19 dogs (46%) including internal ophthalmoplegia (n=5), blindness due to optic nerve damage (n=5), facial nerve paralysis (n=3), prolapse of the third eyelid gland (n=3), corneal ulceration (n=8), anterior uveitis (n=4), chorioretinitis (n=3), retinal detachment (n=2) and increased intraocular pressure (n=7). Information on ophthalmic complications after cessation of active inflammation was available for 33 patients. One or more concurrent disease was found in 10 cases (30%): in addition to persistent neurological deficits and third eyelid gland prolapse reported at initial presentation, visual deficits after retinal re-attachment (n=2), loss of corneal sensation (n=1), corneal oedema (n=1), corneal fibrosis (n=4), corneal lipidosis (n=1) and strabismus after suspected fibrosis (n=2) were diagnosed. CLINICAL SIGNIFICANCE: Ophthalmic complications are common in patients with retrobulbar inflammation indicating that these patients should undergo ophthalmic assessment and follow-up.

Surgical management of impalement injuries to the trunk of dogs: a multicentre retrospective study.

OBJECTIVES: To review a large series of dogs referred for treatment of traumatic impalement injuries to the thorax and/or abdomen and to report aetiologies, injury characteristics, management and long-term outcomes. MATERIALS AND METHODS: Previously collected data on dogs that were surgically treated for impalement injuries to the trunk at six veterinary specialist referral institutions in the UK over an 11-year period were reviewed. Data included patient signalment, physiological variables, injury-specific variables, diagnostic imaging reports, surgical procedures undertaken, duration of hospitalisation, antibiotic use, complications and outcomes. Data were reported with summary statistics. RESULTS: Fifty-four dogs were included. Impalement occurred most frequently on wooden objects (n=34), and the thoracic cavity was most commonly penetrated (n=37). Computed tomography was sensitive and specific to identifying wooden material in 64% and 88% of cases (n=11), respectively. Thoracotomy was performed in 56%, coeliotomy in 20% and a foreign body or its fragments were retrieved during surgery in 37% of the cases. Complications occurred in 19 dogs (35%), and of these, 68% were minor and 32% major. The survival rate for thoracotomy cases was 93% (n=30). Overall long-term survival was 90%. CLINICAL SIGNIFICANCE: Despite the often dramatic presentation of impalement injuries, the majority of patients treated in the specialist referral setting can achieve excellent outcomes. These injuries require thorough diagnostic imaging and interpretation before adequate surgical exploration and management, augmented by anaesthesia and critical care during the peri- and postoperative periods; therefore stable patients should be referred to centres able to provide this type of care.

Modified tube gastropexy using a mushroom-tipped silicone catheter for management of gastric dilatation-volvulus in dogs.

OBJECTIVES: To report the short- and long-term complications and clinical outcomes of a cohort of dogs managed for gastric dilatation-volvulus using a modified right-sided tube gastropexy technique. MATERIALS AND METHODS: Retrospective case series. RESULTS: Of 31 dogs treated, 29 (93·5%) had an excellent short-term outcome, and gastric dilatation-volvulus did not recur in any dog. Twenty-six dogs (84%) were initially fed via the gastrostomy tube postoperatively; three (9·7%) suffered a major complication including septic peritonitis (n=1), and premature tube removal (n=2). Fourteen dogs (45·1%) had minor complications including mild, self-limiting discharge from the stoma site in 13. CLINICAL SIGNIFICANCE: Modified tube gastropexy using a mushroom-tipped silicone catheter is an effective and safe surgical method for the management of gastric dilatation-volvulus. The gastrostomy tube allowed early enteral feeding and easy administration of medications, including gastroprotectants.

Parotidectomy for the treatment of parotid sialocoele in 14 dogs.

OBJECTIVES: To describe the presentation, diagnosis, cause, complications and outcome in 14 dogs that presented with a parotid sialocoele and that were treated by complete parotidectomy. MATERIAL AND METHODS: Multi-institutional retrospective study. RESULTS: Each dog presented with a non-painful, fluctuant, soft tissue mass over the lateral aspect of the face in the region of the parotid salivary gland. Diagnosis was made by sialoradiography (3/14), CT (3/14), ultrasound (11/14) and MRI (2/14). The cause of the sialocoele could be determined in 8 of 14 patients and included: foreign body (2/14), sialolithiasis (1/14), neoplasia (3/14), salivary gland lipomatosis (1/14) and trauma (1/14). Treatment incurred one anaesthetic complication (regurgitation) and seven postoperative surgical complications [self-limiting seroma formation (2/14), haemorrhage (1/14), wound dehiscence (1/14), abscessation 7 months postoperatively (1/14) and facial nerve paralysis (2/14)]. Sialocoele did not recur in any dog during a median follow-up time of 14 months. CLINICAL SIGNIFICANCE: Parotidectomy has been considered a technically challenging procedure but can have a good success rate with long-term resolution of the clinical symptoms. Intra- and postoperative complications are reasonably common.

Treatment of canine nasopharyngeal stenosis using balloon-expandable metallic stents: long-term follow-up of four cases.

Four dogs were diagnosed with nasopharyngeal stenosis using endoscopy and magnetic resonance imaging. Treatment using balloon-expandable metallic stent, placed under fluoroscopic and endoscopic guidance, resulted in immediate resolution of clinical signs. All dogs were clinically normal 40 to 62 months following stent placement.

Omentalisation in the treatment of sublumbar abscessation: long-term outcome in 10 dogs.

The objectives of this study were to report the technique of omentalisation for the management of sublumbar abscessation associated with suspected migrating plant material, the intraoperative and postoperative complications that occurred and the long-term outcome of the cases. A retrospective case series of dogs (n=10) with sublumbar abscessation managed by exploration and drainage combined with omentalisation of the abscess cavity is reported in this study. The sublumbar area was approached through a ventral midline coeliotomy, the abscess was explored, drained, debrided and subsequently packed with omentum. One dog sustained an aortic rupture during exploration of the abscess, the aorta was repaired; there were no postoperative complications. There was long-term (>12 months) resolution of clinical signs in all dogs. Drainage and omentalisation of sublumbar abscesses resulted in complete resolution of signs in all dogs and was associated with a low incidence of complications. Omentalisation is an effective treatment for dogs presenting with sublumbar abscesses associated with suspected migrating plant material.

Use of silicone tracheal stoma stents for temporary tracheostomy in dogs with upper airway obstruction.

OBJECTIVES: To report the use of silicone tracheal stoma stents for temporary tracheostomy in dogs with upper airway obstruction. METHODS: Retrospective review of medical records for dogs in which silicone tracheal stoma stents were placed. RESULTS: Eighteen dogs had a silicone tracheal stoma stent placed for maintenance of a tracheostomy stoma for periods ranging from three hours to eight months. No intra-operative or immediate postoperative complications were recorded. In 11 dogs the stent was removed by simple traction after a period ranging from 36 hours to 6 weeks, and the tracheal stoma was left to heal by second intention. Five of the 18 dogs were determined as being tracheostomy dependent and underwent conversion to permanent tracheostomy after a period ranging from five days to eight months following stent placement. One dog was euthanased after three months, with the stent still in place, because of poor respiratory function, and one dog died of unrelated reasons. In 6 of 10 dogs (60%) where the stent was in place for five days or more, granulation tissue formation caused dislodgement of the stent. CLINICAL SIGNIFICANCE: Silicone tracheal stoma stents may be used as an alternative to conventional tracheostomy tubes in selected dogs with upper airway obstruction. Long-term use of the stent beyond five days is not recommended because of granulation tissue formation. The long-term consequences of partial tracheal ring resection are unknown.

Mediastinectomy for management of chronic pyogranulomatous pleural disease in dogs.

The medical records of 12 dogs with chronic pyogranulomatous pleural disease unresponsive to medical management were reviewed retrospectively. Resection of the mediastinal pleura (mediastinectomy) was performed through a median sternotomy to remove all diseased and surgically accessible mediastinal pleural tissue. Dogs were re-examined two weeks postoperatively, and long-term outcome was evaluated by contacting owners by phone. Twelve dogs underwent mediastinectomy; additional surgeries included subtotal pericardiectomy (8), lung lobectomy (4) and partial diaphragmatic resection (2). Histology of resected tissue consistently revealed neutrophilic, pyogranulomatous cellulitis/serositis. Foreign material was evident in the mediastinal tissue of five dogs and microorganisms were recovered from three dogs. Two dogs developed pneumothorax immediately postoperatively; one dog developed haemothorax one month postoperatively and was euthanased. Median follow-up time was eight months (range: 6-43 months); eleven dogs were alive and considered to be symptom-free by their owners. Mediastinectomy resulted in complete resolution of symptoms in most dogs (92 per cent) and was associated with a low incidence of major complications. The results of this study indicated that mediastinectomy results in favourable outcome for dogs with chronic pleural pyogranulomatous pleural disease unresponsive to medical management.

Accuracy evaluation of a two-wire technique for osteotomy positioning in the tibial plateau levelling procedure.

OBJECTIVE: To evaluate a tibial plateau levelling osteotomy (TPLO) saw blade positioning technique and to retrospectively evaluate the accuracy of the osteotomy position. METHOD: Preoperative and postoperative radiographs of 72 cases that had a TPLO surgery using a two-wire technique were reviewed. Three measurements (A1, B1, C1) were obtained in preoperative planning using a computer template system (Orthoview Vet) which mapped the intended osteotomy position. The postoperative radiographs were analysed to determine the variability of these three measurements (A2, B2, C2) and therefore the accuracy of the osteotomy. RESULTS: On average the least variable measurement was B2 (5%) followed by C2 (7%) and then A2 (13%). The maximum mean difference between the intended position and achieved position was 1.5 mm. CLINICAL SIGNIFICANCE: Despite there being a significant difference between the intended and the actual position of the osteotomy, the variation between the intended and actual tibial tuberosity width was small (5%). None of the cases suffered a tibial tuberosity fracture, which also supports the clinical value of this technique. Care must be taken to avoid inadvertent cutting of the Kirschner guide wires.

Improved ELISA for the detection of HBsAg.

A sandwich ELISA for hepatitis B virus surface antigen (HBsAg) was developed using monoclonal anti-HBs for the solid phase and horse-radish peroxidase labelled sheep anti-HBs. The sensitivity was approx. 0.3 U/ml HBsAg, in the standard test procedure, comprising two incubation steps of 1 h at 37 degrees C, or in a shortened procedure comprising two incubation steps of 30 min at 50 degrees C. A slightly reduced sensitivity (approx. 0.5 U/ml) was obtained when the two incubations were combined in a one-step incubation for 1 h at 37 degrees C. All three procedures were completed by an incubation for 30 min at room temperature with peroxide and tetra-methylbenzidine. The number of false positives obtained when donor sera were screened was below 0.5%. False positive reactions occurred more frequently, but still to a limited extent, when previously selected sera containing rheumatoid factor or other possibly interfering factors were tested with the standard procedure. Most sera containing factors that interfere with a commercial ELISA for HBsAg using sheep anti-HBs coated plates, were negative. Rheumatoid factor positive sera seldom gave false positive results. The lower detection limit became approx. 0.1 U/ml when the cut-off was reduced, while the number of false positives in a donor population only increased to 1.5%. The results obtained with reagents from four different batches indicate a stability of up to 4 wk at 37 degrees C and for at least 26 wk at 4 degrees C.