Neuropathic pain in cats: Mechanisms and multimodal management.

PRACTICAL RELEVANCE: Chronic pain is a significant welfare concern in cats, and neuropathic pain, which arises from aberrant processing of sensory signals within the nervous system, is a subcategory of this type of pain. To comprehend this condition and how multimodal pharmacotherapy plays a central role in alleviating discomfort, it is crucial to delve into the anatomy of nociception and pain perception. In addition, there is an intricate interplay between emotional health and chronic pain in cats, and understanding and addressing the emotional factors that contribute to pain perception, and vice versa, is essential for comprehensive care.Clinical approach:Neuropathic pain is suspected if there is abnormal sensation in the area of the distribution of pain, together with a positive response to trial treatment with drugs effective for neuropathic pain. Ideally, this clinical suspicion would be supported by confirmation of a lesion at this neurolocalisation using diagnostic modalities such as MRI and neuroelectrophysiology. Alternatively, there may be a history of known trauma at that site. A variety of therapies, including analgesic, anti-inflammatory and adjuvant drugs, and neuromodulation (eg, TENS or acupuncture), can be employed to address different facets of pain pathways.Aim:This review article, aimed at primary care/ general practitioners, focuses on the identification and management of neuropathic pain in cats. Three case vignettes are included and a structured treatment algorithm is presented to guide veterinarians in tailoring interventions.Evidence base:The review draws on current literature, where available, along with the author's extensive experience and research.

Gallbladder carcinoid in a cat.

Carcinoids are rare tumors that originate from neuroendocrine system cells. There has apparently only been 1 report in the veterinary medical literature of a cat with a gallbladder carcinoid, with no long-term follow-up information available from that case. Furthermore, apparently only 9 dogs with gallbladder carcinoids have been reported, again with no long-term follow-up. This case report describes the clinical presentation, surgical appearance, histopathologic and immunohistochemical findings, postoperative adjuvant chemotherapy treatment, and long-term outcome of a domestic longhair cat with a gallbladder carcinoid. The diagnosis of a gallbladder carcinoid in the present case was based on histologic and immunohistochemical findings. Clinical signs of a gallbladder carcinoid are nonspecific and ultrasonographic findings may not be definitive; however, it should be considered as a potential differential diagnosis in cats with lesions of the gallbladder or in the region of the gallbladder. The prognosis is poor, with a potentially high metastatic rate. In the present case, metastasis occurred 7 mo postoperatively despite adjuvant therapy, and the survival time was only 10 mo from the time of diagnosis. Key clinical message: This case report describes the clinical presentation, surgical appearance, histopathologic and immunohistochemical findings, postoperative adjuvant treatment, and long-term outcome of a cat with a gallbladder carcinoid, which should be considered as a potential differential diagnosis in cats with lesions of the gallbladder or in the region of the gallbladder.

Carcinoïde de la vésicule biliaire chez un chat. Les carcinoïdes sont des tumeurs rares qui prennent leur origine des cellules du système neuroendocrinien. Dans la littérature médicale vétérinaire il n'y aurait qu'un seul cas rapporté d'un chat avec un carcinoïde de la vésicule biliaire, sans aucune information de suivi à long terme disponible pour ce chat. Également, il y aurait 9 cas rapportés de chiens avec des carcinoïdes de la vésicule biliaire, mais encore là aucun suivi à long terme. Le cas présenté ici décrit la présentation clinique, l'apparence chirurgicale, les trouvailles histopathologiques et immunohistochimiques, le traitement post-opératoire par chimiothérapie adjuvante, et le devenir à long terme d'un chat domestique à poil court avec un carcinoïde de la vésicule biliaire. Dans le cas présent, le diagnostic de carcinoïde de la vésicule biliaire était basé sur les trouvailles histologiques et immunohistochimiques. Les signes cliniques d'un carcinoïde de la vésicule biliaire sont non-spécifiques et les trouvailles échographiques pourraient ne pas être concluantes; toutefois, il devrait être considéré comme un diagnostic différentiel possible chez des chats avec des lésions à la vésicule biliaire ou dans la région de la vésicule biliaire. Le pronostic est mauvais, avec un risque élevé de métastases. Dans le cas présent, des métastases sont apparues 7 mo post-chirurgie malgré une chimiothérapie adjuvante, et le temps de survie a été de 10 mo à compter du moment du diagnostic.Message clinique clé:Ce rapport de cas décrit la présentation clinique, l'apparence chirurgicale, les trouvaille histologiques et immunohistochimiques, la thérapie adjuvante postopératoire, et le résultat à long-terme pour un chat avec un carcinoïde de la vésicule biliaire, qui devrait être considéré comme un diagnostic différentiel potentiel chez les chats avec des lésions à la vésicule biliaire ou dans la région de la vésicule biliaire.(Traduit par Dr Serge Messier).

Importance of early diagnosis, multimodal treatment, and a multidisciplinary approach for oral eosinophilic lesions in cats: a retrospective study of 38 cases (1997-2022).

OBJECTIVE: This study aimed to characterize the clinical and histopathologic features of oral eosinophilic lesions in cats. Animals: 38 client-owned cats. METHODS: The medical records database was searched for cats diagnosed with histologically confirmed eosinophilic oral lesions from 1997 to 2022. Information such as medical history, lifestyle factors, clinical presentation, and radiographic and histopathologic features was included for 38 client-owned cats. Response to treatment and long-term follow-up was also recorded. RESULTS: The most affected site was the tongue, with approximately half of the affected cats showing signs of oral discomfort and difficulty eating or breathing. Ulcerative lesions were common, with two-thirds of patients showing more than 1 site affected. Histological samples had a classic appearance, whereas some had an atypical appearance characterized by degenerate collagen clusters associated with multinucleated giant cells. A significant association between lesion location, clinical signs, and prognosis was also found, with patients with palatal lesions being more likely to show respiratory signs and less likely to respond to treatment. Finally, treatment response was observed in most cases within 2 months of commencing therapy combining antimicrobial, and immunosuppressive treatment. CLINICAL RELEVANCE: The results of this study demonstrate the importance of early diagnosis and treatment of cases of oral eosinophilic lesions in cats. Additionally, it emphasizes the need for a multimodal approach to treatment which should include antibacterial therapy. Of no less importance is that other systems may be affected in these patients, warranting a multidisciplinary approach to their management.

Pro-stride and extracorporeal shockwave therapy as treatment of lateral collateral desmopathy of the proximal interphalangeal joint in a Dutch Warmblood gelding.

A 6-year-old chestnut Dutch Warmblood gelding was presented for right front lameness 1 mo after being cast in a stall at a 1.20-meter jumping event. Lameness work-up revealed mild lameness on the right and left front legs, with diffuse swelling over the right front pastern. Ultrasonic evaluation yielded suspicion of collateral desmopathy of the proximal interphalangeal joint that was subsequently confirmed via MRI. Two weeks after initial evaluation, the proximal and distal interphalangeal joints were injected with Pro-Stride Autologous Protein Solution, immediately followed by Extracorporeal Shockwave Therapy of the lateral and medial collateral ligaments. Follow-up at 2 and 3 mo after treatment revealed reduced joint effusion of the proximal and distal interphalangeal joints, as well as improved fiber organization of the associated collateral ligaments. This should inform practitioners that multimodal therapeutic treatments including biologics and stimulation of healing through sound waves can aid in ligamentous injuries in sport horses.

Thérapie avec Pro-Stride et ondes de choc extracorporelles comme traitement de la desmopathie collatérale latérale de l'articulation interphalangienne proximale chez un hongre Warmblood hollandais. Un hongre Warmblood hollandais alezan de 6 ans a été présenté pour boiterie avant droite 1 mois après s'être blessé lors d'une compétition de sauts à 1,20 mètre. Le bilan de boiterie a révélé une légère boiterie sur les pattes avant droite et gauche, avec une enflure diffuse sur le paturon avant droit. L'examen échographique a révélé une suspicion de desmopathie collatérale de l'articulation interphalangienne proximale qui a ensuite été confirmée par imagerie par résonnance magnétique. Deux semaines après l'évaluation initiale, les articulations interphalangiennes proximales et distales ont reçu une injection de solution de protéines autologues Pro-Stride, immédiatement suivie d'une thérapie par ondes de choc extracorporelles des ligaments collatéraux latéral et médial. Le suivi à 2 et 3 mois après le traitement a révélé un épanchement articulaire réduit des articulations interphalangiennes proximales et distales, ainsi qu'une meilleure organisation des fibres des ligaments collatéraux associés.Ceci devrait informer les praticiens que les traitements thérapeutiques multimodaux, y compris les produits biologiques et la stimulation de la guérison par des ondes sonores, peuvent aider dans les blessures ligamentaires chez les chevaux de sport.(Traduit par Dr Serge Messier).

Successful multimodal treatment of extreme hypertriglyceridemia in a juvenile diabetic dog.

OBJECTIVE: To describe the therapeutic protocol used to normalize severe hypertriglyceridemia in a dog. CASE SUMMARY: A 7-month-old, 1.2-kg female Pomeranian presented with acute polyuria, polydipsia, and ocular discoloration. Diagnoses included diabetic ketosis, severe hypertriglyceridemia (>225 mmol/L [>20,000 mg/dl]), lipemia retinalis, and bilateral uveitis. The triglyceride concentration was near normal within 2 days of initiating treatment with fenofibrate, regular insulin constant rate infusion (CRI), manual therapeutic plasma exchange (TPE), and a low-fat diet. All clinical signs resolved. The dog has had no relapse of hypertriglyceridemia at the time of writing the manuscript, 6 months later, with continued treatment of diabetes mellitus. NEW OR UNIQUE INFORMATION PROVIDED: This is the first case report documenting the combination of fenofibrate, insulin CRI, and manual TPE for treatment of severe hyperlipidemia in a dog. Detailed protocols for manual TPE and a novel insulin CRI are provided. A discussion of multiple spurious biochemical and hematologic errors associated with the severe hypertriglyceridemia is also provided.

Local tumour nanoparticle thermal therapy: A promising immunomodulatory treatment for canine cancer.

Distinct thermal therapies have been used for cancer therapy. For hyperthermia (HT) treatment the tumour tissue is heated to temperatures between 39 and 45°C, while during ablation (AB) temperatures above 50°C are achieved. HT is commonly used in combination with different treatment modalities, such as radiotherapy and chemotherapy, for better clinical outcomes. In contrast, AB is usually used as a single modality for direct tumour cell killing. Both thermal therapies have been shown to result in cytotoxicity as well as immune response stimulation. Immunogenic responses encompass the innate and adaptive immune systems and involve the activation of macrophages, dendritic cells, natural killer cells and T cells. Several heat technologies are used, but great interest arises from nanotechnology-based thermal therapies. Spontaneous tumours in dogs can be a model for cancer immunotherapies with several advantages. In addition, veterinary oncology represents a growing market with an important demand for new therapies. In this review, we will focus on nanoparticle-mediated thermal-induced immunogenic effects, the beneficial potential of integrating thermal nanomedicine with immunotherapies and the results of published works with thermotherapies for cancer using dogs with spontaneous tumours, highlighting the works that evaluated the effect on the immune system in order to show dogs with spontaneous cancer as a good model for evaluated the immunomodulatory effect of nanoparticle-mediated thermal therapies.

Strontium 90 plesiotherapy for the treatment of eyelid squamous cell carcinoma in eight cats.

OBJECTIVES: Squamous cell carcinoma (SCC) is the most common eyelid tumour in cats. The main treatment is extensive surgery and the cosmetic outcome can be worrisome for some owners. Strontium 90 (ST-90) plesiotherapy is a therapeutic modality used for superficial tumours, including SCC. The aim of this study was to describe the use and response of feline eyelid SCC to ST-90 plesiotherapy either as single treatment or as adjuvant therapy following surgery. METHODS: A referral centre clinical database was searched for all cats diagnosed with SCC located on an eyelid. Cats treated with ST-90 plesiotherapy were included. The response to treatment was evaluated visually every 4-6 weeks until complete healing and based on response evaluation criteria in solid tumours (RECIST). Descriptive statistics of the survival were applied to the data collected. RESULTS: Eight cats treated between 2014 and 2017 met the inclusion criteria. The median age was 10.8 years. In six cases, ST-90 was used as the only treatment modality, while in two cats it was used as an adjuvant to surgery. Four cats received a single protocol and four a hypofractionated protocol. In the six cats in which ST-90 was used as the primary treatment, the response was 100%. Four cats died at a median time of 9 months (3-17 months) after ST-90 due to causes unrelated to SCC. Of the remaining four cats, three had no signs of recurrence at a median time of 34 months and one was lost to follow-up at 17 months with no signs of recurrence. CONCLUSIONS AND RELEVANCE: This small study showed that ST-90 can be used for treatment of eyelid SCC with good therapeutic and cosmetic outcomes.

[Long-term follow-up of a multimodally managed pulmonary mucoepidermoid carcinoma in a cat]. / Langzeitstudie einer multimodalen Behandlung eines mukoepidermoiden Lungenkarzinoms bei einer Katze.

INTRODUCTION: The present case describes the treatment of a mucoepidermoid carcinoma in a 13-year-old female sterilized European domestic cat, using lung lobectomy and -accompanying mitoxantrone chemotherapy. Six, 14, 19 and 27 months after the initial treatment tomodensitometric and radiographic examinations showed no abnormalities. However, the cat had to be euthanized 27 months after the lung lobectomy due to a soft tissue sarcoma in the interscapular area.

INTRODUCTION: Ce cas décrit un carcinome mucoépidermoïde chez un chat européen femelle stérilisée de 13 ans, entité non rapportée jusqu'alors chez cette espèce, pris en charge par lobectomie pulmonaire et chimiothérapie adjuvante avec de la mitoxantrone. L'examen tomodensitométrique et les clichés radiographiques, réalisés respectivement 6 mois, 14, 19 mois, et 27 mois après la chirurgie, ne mettaient en évidence aucune anomalie. Cependant, vingt-sept mois après l'intervention chirurgicale, une euthanasie est réalisée suite à l'aggravation en quelques mois d'un sarcome des tissus mous en région inter-scapulaire.

Adjuvant Sirolimus Does Not Improve Outcome in Pet Dogs Receiving Standard-of-Care Therapy for Appendicular Osteosarcoma: A Prospective, Randomized Trial of 324 Dogs.

PURPOSE: The mTOR pathway has been identified as a key nutrient signaling hub that participates in metastatic progression of high-grade osteosarcoma. Inhibition of mTOR signaling is biologically achievable with sirolimus, and might slow the outgrowth of distant metastases. In this study, pet dogs with appendicular osteosarcoma were leveraged as high-value biologic models for pediatric osteosarcoma, to assess mTOR inhibition as a therapeutic strategy for attenuating metastatic disease progression. PATIENTS AND METHODS: A total of 324 pet dogs diagnosed with treatment-naïve appendicular osteosarcoma were randomized into a two-arm, multicenter, parallel superiority trial whereby dogs received amputation of the affected limb, followed by adjuvant carboplatin chemotherapy ± oral sirolimus therapy. The primary outcome measure was disease-free interval (DFI), as assessed by serial physical and radiologic detection of emergent macroscopic metastases; secondary outcomes included overall 1- and 2-year survival rates, and sirolimus pharmacokinetic variables and their correlative relationship to adverse events and clinical outcomes. RESULTS: There was no significant difference in the median DFI or overall survival between the two arms of this trial; the median DFI and survival for standard-of-care (SOC; defined as amputation and carboplatin therapy) dogs was 180 days [95% confidence interval (CI), 144-237] and 282 days (95% CI, 224-383) and for SOC + sirolimus dogs, it was 204 days (95% CI, 157-217) and 280 days (95% CI, 252-332), respectively. CONCLUSIONS: In a population of pet dogs nongenomically segmented for predicted mTOR inhibition response, sequentially administered adjuvant sirolimus, although well tolerated when added to a backbone of therapy, did not extend DFI or survival in dogs with appendicular osteosarcoma.

Recurrent corneal hemangiosarcoma in a cat with subsequent extension into the orbit.

A 7-year-old neutered female Domestic Short-haired cat was presented for evaluation of ulceration and severe vascularization of the left cornea. Ophthalmic examination revealed a large red irregular mass over the whole cornea in the left eye. A lamellar keratectomy was performed. Histopathology revealed a chronic lymphoplasmacytic, histocytic, neutrophilic ulcerative keratitis with fibrosis and vascularization. The tumor recurred within 3 months, and another lamellar keratectomy and sclerotomy were performed. The lesion was diagnosed histopathologically as a hemangiosarcoma with incomplete margins. The mass recurred locally 6 weeks later, and an enucleation was performed. Histopathology revealed infiltration of the limbus and connective tissue beyond the sclera. Seven weeks later, a fluctuant swelling was found in the left orbit. Computed tomography confirmed a soft tissue attenuating mass measuring 33 x 24 mm diameter in the orbit. There was no sign of metastasis. Clinical remission was achieved with combined chemotherapy with doxorubicin and radiation therapy. The patient remained in clinical remission 20 months post-chemotherapy.

Neoadjuvant chemotherapy and radiation therapy in veterinary cancer treatment: a review.

Multi-modality treatment strategies are more becoming commonplace in veterinary oncology practice yet the evidence base is far inferior to what has been generated in people. Surgery is unquestionably the cornerstone of most solid tumour treatment plans but certain scenarios dictate combining surgery with systemic chemotherapy and radiation therapy as an adjunct. By using these in the neoadjuvant setting, one can leverage certain effects of the treatment to improve local disease control, improve overall survival, gain insight into drug efficacy, reduce surgical morbidity and reduce long-term complications. An unintended consequence of combining therapies is an increased flow of information between members of the care team upfront that in almost all cases leads to improved patient outcomes albeit a difficult metric to quantify. This review sets out to explore some of the principles of neoadjuvant therapies and discuss potential opportunities to expand the evidence base in veterinary medicine.

Efficacy of BCG vaccine and Mitomycin C for the treatment of ocular squamous cell carcinoma in bovines.

Bovine ocular squamous cell carcinoma (BOSCC) also called cancer eye, represents the most economically important neoplasm in large animals. Hereditary factors, environmental factors, lack of eyelid pigmentation, age and dietary habits have all been reported to play a role in the etiopathogenesis of bovine ocular squamous cell carcinoma. In group I, six animals with small, localized eye cancer where vision was not affected were included and subjected to intralesional injection of Bacillus Calmette- Guerin (BCG) vaccine at 0, 14, 35, and 56 days interval. In group II (six animals), surgical excision and Mitomycin C 0.04% topically on alternate weeks for two months as adjunctive therapy. All the animals recovered completely with no recurrence for a follow up period of one year.

Response and outcome following radiation therapy of macroscopic canine plasma cell tumours.

Thirty dogs with macroscopic plasma cell tumours (PCTs) were treated with radiation therapy (RT). Twelve patients were treated with palliative-intent prescriptions (range, 4-10 Gy/fraction (median, 7 Gy/fraction) for a total dose of 20 to 35 Gy (median total dose 30 Gy). Eighteen patients received definitive-intent prescriptions (range, 3.0-4.2 Gy/fraction (median, 3 Gy/fraction) for a total dose of 42 to 54 Gy (median total dose 48 Gy). Involved sites included the oral cavity, skin, multiple myeloma (MM)-associated lytic bone lesions, bone (solitary osseous plasmacytoma; SOP), nasal cavity, larynx, retrobulbar space, lymph node and rectum. Ninety-five percent of evaluable dogs had a complete (CR; 16/22) or partial response (PR; 5/22). Patients with MM experienced significant analgesia. The median progression-free survival (PFS) was 611 days (range: 36-2001 days). Events in the non-MM cases included in-field progression (5/26, 19%) and disseminated disease (5/26, 19%). The median survival time (MST) for all dogs was 697 days (range: 71-2075 days), and when only non-MM cases were considered, MST was 771 days (range: 71-2075 days). Fourteen patients were alive without disease progression or had died of unrelated causes. Achievement of a PR was associated with an inferior PFS and MST as compared with CR. Palliative-intent RT was associated with inferior MST as compared with definitive-intent RT. RT is a useful therapeutic modality for PCTs and tumour responses are often complete and durable, with protracted survivals. The optimal radiation dose and schedule are yet to be defined.

Multimodality treatment including ONCEPT for canine oral melanoma: A retrospective analysis of 131 dogs.

Canine oral melanoma (OM) is an aggressive cancer with a high rate of metastasis. Surgery and/or radiotherapy (RT) are effective local treatments, yet many dogs succumb to distant metastasis. Immunotherapy represents an attractive strategy for this potentially immunogenic tumor. The objective of this multi-institutional retrospective study was to examine the clinical outcome of dogs with OM treated with ONCEPT melanoma vaccine. Most dogs also underwent surgery and/or RT (8 Gy × four weekly fractions). Dogs with distant metastasis at diagnosis and those receiving concurrent chemotherapy were excluded. One hundred thirty-one dogs treated with ONCEPT were included: 62 had adequate local tumor control defined as complete tumor excision or irradiation of residual microscopic disease; 15 were treated in the microscopic disease setting following an incomplete excision without adjuvant RT; and 54 had gross disease. Median time to progression, median progression-free survival, and median tumor-specific overall survival were 304, 260, and 510 days, respectively. In multivariable analysis, presence of gross disease correlated negatively with all measures of clinical outcome. Other negative prognostic indicators were primary tumor ≥2 cm, higher clinical stage (stages 2 and 3), presence of lymph node metastasis at diagnosis, and caudal location in the oral cavity. Radiotherapy had a protective effect against tumor progression. To date, this is the largest reported series of dogs with OM treated with ONCEPT. Several previously reported prognostic indicators were confirmed.

Combined Surgical, Radiation, and Medical Therapies for Osteochondrodysplasia in a Scottish Fold Cat.

Osteochondrodysplasia affects both homozygous and heterozygous Scottish Fold cats, and various treatments have been attempted to control chronic pain and improve mobility in these animals. However, to date, there is no single effective treatment that can be used to treat all cats with Scottish Fold osteochondrodysplasia (SFOCD). A 4 yr old castrated Scottish Fold cat presented with plantar exostoses in the right hindlimb, the largest of which was caudal to the tarsometatarsal joint and had stretched the overlying skin, causing ulceration and bleeding. There was right hindlimb lameness. The cat was diagnosed with SFOCD, and the skin lesions were treated by excision of the exostoses, removal of the damaged skin, and wound closure. All extremities were treated with radiotherapy and subcutaneous pentosan polysulfate for chronic pain. The cat's gait improved after surgery, and increased activity was noted after radiotherapy. There were no signs of excessive bone proliferation or adverse effects at 80 wk postoperatively. In conclusion, a combination of surgical, radiation, and medical therapies could be an effective treatment strategy for SFOCD with skin ulceration.

The effects of local irradiation on circulating lymphocytes in dogs receiving fractionated radiotherapy.

Localized radiation therapy can be an effective treatment for cancer but is associated with localized and systemic side effects. Several studies have noted changes in complete blood count (CBC) parameters including decreases in the absolute lymphocyte count (ALC) and increases in the neutrophil:lymphocyte ratio (NLR). These changes could reflect immunosuppression and may contribute to decreased efficacy of immunotherapies used to treat cancer. We hypothesized that dogs would demonstrate decreased ALCs during a course of radiotherapy. A retrospective study was conducted on 203 dogs receiving definitive-intent radiotherapy. Demographic information, CBC values and details of the radiotherapy protocol were collected. The mean lymphocyte count pre-treatment was 1630.68 cells/µL (SD ± 667.56) with a mean NLR of 3.66 (SD ± 4.53). The mean lymphocyte count mid-treatment was 1251.07 cells/µL (SD ± 585.96) and the mean NLR was 6.23 (SD ± 4.99). There was a significant decrease in the mean lymphocyte count by 351.41 lymphocytes/µL (SD ± 592.32) between pre-treatment and mid-treatment (P < .0001), and a corresponding significant increase in the mean NLR of 0.93 (P = .02). Lymphopenia grade increased in 33.5% of dogs and was significant (P = .03). The ALC decrease was not correlated with the volume irradiated (P = .27), but correlated with the irradiated volume:body weight ratio (P = .03). A subset of patients (n = 35) with additional CBCs available beyond the mid-treatment time point demonstrated significant and sustained downward trends in the ALC compared with baseline. Although severe lymphopenia was rare, these decreases, especially if sustained, could impact adjuvant therapy for their cancer.

Combined control evaluation for Neospora caninum infection in dairy: Economic point of view coupled with population dynamics.

Neospora caninum infection is regarded as one of the most important infectious causes of abortion in dairy cattle. To intervene in its spread, four potential controls including test-and-cull, medication, vaccination, and selective breeding are considered and assessed in this study. The cost of each control, together with the inevitable annual loss due to population dynamics, is adopted as an assessment criterion from an economic point of view. By performing simulation and sensitivity analysis, our results demonstrate that compared with each single control, combined controls are worthwhile with better financial outcomes. For farm affected with significant prevalence (equal to or greater than 30%), vaccine treatment is the most effective and economical option among all control strategies. On the other hand, for farm where prevalence is relatively low (around 10%), combined control, by applying vaccination followed with test-and-cull, medication or selective breeding, could be alternative treatment to provide better financial outcome against single control in an observed period.

CT angiography and MRI imaging features do not predict the tumor type and grade of feline injection site sarcoma.

Computed tomographic angiography (CTA) and magnetic resonance imaging (MRI) have been described as methods for preoperative surgical planning in cats with feline injection site sarcomas (FISS), however, few published studies have compared these modalities. The objective of this retrospective, secondary analysis study was to determine if imaging features of FISS on CTA and MRI are predictive of neoplastic peritumoral projections. Archived data from a previous prospective study were retrieved for 10 cats with FISS. All cats had been evaluated in a single anesthetic episode with MRI and dual phase CT (CTA) imaging followed by surgical removal. Histopathological grading and targeted histopathology of imaging-identified peritumoral projections were performed. Two observers evaluated the CTA and MRI studies for FISS shape, margination, size, enhancement pattern, postcontrast uniformity, pre- and postcontrast margination, the number of muscles involved, mass mineralization, and bone lysis. Metal was present in the imaging field of three of 10 cats, resulting in one nondiagnostic MRI. Peritumoral projections were detected in all cats with both imaging modalities, and most were benign. At least one neoplastic peritumoral projection was detected in six cats using MRI, five cats using CTA, and three cats with both modalities. Higher grade FISS were larger than low grade using MRI, and FISS were larger using MRI. Other FISS imaging features using MRI and CTA were similar. Findings supported use of either MRI or CTA for detecting neoplastic peritumoral projections in cats with FISS. Authors recommend CTA for cats with known metallic objects in the scan field.

Financial impact of ultrasound-guided lumbar plexus and sciatic nerve blocks with electrostimulation for tibial plateau leveling osteotomy surgery in dogs.

OBJECTIVE: To determine the anesthesia cost from ultrasound-guided lumbar plexus and sciatic nerve blocks confirmed with electrostimulation for unilateral tibial plateau leveling osteotomy (TPLO) surgery in dogs. STUDY DESIGN: Prospective, randomized, blinded clinical trial. ANIMALS: A group of 20 dogs weighing 33.9 ± 6.0 kg (mean ± standard deviation). METHODS: All dogs were administered hydromorphone and atropine, propofol for induction of anesthesia and isoflurane for maintenance. Hydromorphone and carprofen were administered for recovery. The dogs were randomly assigned to one of two groups, lumbar plexus and sciatic nerve blocks with ropivacaine [regional anesthesia (RA)] or sham blocks with saline [control (CON)]. Fentanyl was administered for rescue analgesia intraoperatively and postoperatively. The cost to manage anesthesia was divided into fixed and variable costs using the micro-costing method. The variable costs were compared using Student's t test or Mann-Whitney U test. RESULTS: The fixed anesthesia costs were equal between groups at US$354.00 per case. The variable anesthesia cost range was US$27.90-100.10 for RA and US$21.00-180.50 for CON. Overall, cost per dog in CON was from -US$6.9 to US$80.4 compared with RA. For 160 TPLO cases per year, hospital cost when RA is performed decreased the cost by $12,864 per year up to increased cost by $1104 per year, depending on the requirements for systemic drugs and incidence/severity of anesthesia complications. The estimated fee charge per case for service necessary to reimburse the cost of a new ultrasound (US$25,000.00) and nerve locator (US$925.00) over their life span of 6 and 10 years, respectively, is US$26.62. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasound-guided lumbar plexus and sciatic nerve blocks with electrostimulation confirmation can increase the anesthesia cost through use of specific equipment. However, in most cases, the anesthesia cost decreased as a result of decreased costs for pain management and treatment of complications.

Adjuvant electrochemotherapy with bleomycin and cisplatin combination for canine soft tissue sarcomas: A study of 30 cases.

Electrochemotherapy (ECT) couples the administration of anticancer drugs with the delivery of electric pulses that increase the drug uptake through the cell membranes, thus resulting in an improved efficacy. This study has evaluated the tolerability and efficacy of the combination of systemic bleomycin and local cisplatin as ECT agents for incompletely excised canine soft tissue sarcoma (STS). Thirty dogs with incompletely excised STSs were enrolled. The dogs received intravenous 20 mg/m2 bleomycin, and the tumor bed and margins were infiltrated with cisplatin at the dose of 0.5 mg/cm2. Then, trains of permeabilizing biphasic electric pulses were applied under sedation. More precisely, 5 min after the injection of the chemotherapy agents, sequences of eight biphasic pulses lasting 50 + 50 µsec each, were delivered in bursts of 1,300 V/cm using caliper electrodes. A second session was performed 2 wk later. The treatment was well tolerated and side effects were minimal. Twenty-six dogs had no evidence of recurrence at the time of manuscript writing; four had recurrence and one of the four recurring dogs died of lung metastases. Median estimated disease free was 857 d. Perivascular wall tumors response was compared to that of the other STSs, but the difference in outcome was not significant. ECT using combination of bleomycin and cisplatin appears to be effective in the treatment of incompletely resected STSs in dogs. This therapeutic approach could be a useful addition to the current options in consideration of its low cost, limited toxicity, and ease of administration.