Photodynamic Surgery for Feline Injection-Site Sarcoma.

Musculoskeletal sarcomas are rare and aggressive human malignancies affecting bones and soft tissues with severe consequences, in terms of both morbidity and mortality. An innovative technique that combines photodynamic surgery (PDS) and therapy (PDT) with acridine orange has been recently suggested, showing promising results. However, due to the low incidence of sarcoma in humans, this procedure has been attempted only in pilot studies and stronger evidence is needed. Naturally occurring tumors in cats are well-established and advantageous models for human cancers. Feline injection-site sarcoma (FISS) shares with human musculoskeletal sarcomas a mesenchymal origin and an aggressive behavior with a high relapse rate. Furthermore, wide surgical excision is not always possible due to the size and site of development. We assessed the feasibility and the effectiveness of PDS and PDT with acridine orange to prevent FISS recurrence by treating a short case series of cats. For PDS, the surgical field was irrigated with an acridine orange solution and exposed to UV light to enlighten the residual tumor tissue, and the resultant fluorescent areas were trimmed. For PDT, before wound closure, the field was again irrigated with acridine orange solution and exposed to visible light to get the antitumoral cytocidal effect. The procedure was easy to perform and well tolerated, we did not observe any major complications, and all the surgical resection margins were free of disease. Finally, at follow-up, all treated patients did not show evidence of tumor recurrence and had a significantly higher event-free survival rate in respect to a control group treated only by surgery. In conclusion, by this study we demonstrated that, in FISS, PDS and PDT with acridine orange may improve local tumor control, granting a better outcome, and we laid the foundation to validate its effectiveness for the treatment of human musculoskeletal sarcomas.

Identification of CSPG4 as a promising target for translational combinatorial approaches in osteosarcoma.

BACKGROUND: Osteosarcoma (OSA) is a highly metastatic pediatric bone tumor. Adjuvant chemotherapy and surgical resection represent standard treatments; however, the prognosis is still poor. Effective strategies are urgently needed. Chondroitin sulfate proteoglycan (CSPG)4 is a transmembrane proteoglycan with a low expression in normal tissues but high expression in several solid tumors, where it plays a central tumorigenic role. Therefore, it represents a promising therapeutic target. The high homology between human and canine CSPG4 and the recognized translational power of canine tumors as preclinical models for human malignancies prompted us to evaluate CSPG4 expression and the consequences of its immune-targeting for both human and canine OSA treatment. METHODS: We analyzed CSPG4 overexpression in human and canine OSA samples and its significance for the survival of OSA patients. We exploited functional in vitro experiments to assess the antitumor potential of CSPG4 immune-targeting. RESULTS: CSPG4 is overexpressed in OSA and has possible clinical implications as suggested by an evident correlation between CSPG4 overexpression and a shorter survival for both OSA-affected humans and dogs. The potential of CSPG4 immune-targeting for OSA treatment came from the ability of anti-CSPG4 monoclonal antibodies and sera, derived from human-CSPG4-DNA vaccinated canine patients, to significantly inhibit human and canine CSPG4-positive OSA cell proliferation, migration, and osteospheres generation. Moreover, CSPG4 immune-targeting has been shown to potentiate the effect of doxorubicin. CONCLUSIONS: Overall, these results provide the rationale to investigate the CSPG4 immune-targeting as a promising weapon for the treatment of CSPG4-positive OSA canine patients, to be successfully translated to a human setting.

Imaging and genetic investigations of neural tube defect in a calf: case report and review of the literature.

A 15-d-old female crossbreed calf was referred because of paraplegia since birth. Clinical examination revealed a skin defect covered by hair on the dorsal midline in the thoracic area of the spine. Thoracolumbar spinal cord neuroanatomic localization was determined based on neurologic examination. Computed tomography of the thoracolumbar spine revealed incomplete fusion of the vertebral arches from T6 to T10 and duplication of the vertebral arch of T7. At the level of T6-T7, duplication of the spinal cord with 2 segments completely separated by a septum of hyperattenuating, probably cartilaginous, tissue was noted. Histologically, the spinal segments had different degrees of duplication. Three central canals were detected in one region. Genetic investigation for the presence of methylenetetrahydrofolate reductase (MTHFR) polymorphism, which has been investigated in both human and veterinary medicine as a possible cause of neural tube defects and abortion, was carried out and was negative in both the calf and her dam.

Acromegaly in a non-diabetic cat.

CASE SUMMARY: A 14-year-old, neutered male European shorthair cat was evaluated for a routine health check. The owner did not report any clinical signs except for respiratory stridor. On physical examination the main findings were broad facial features and increased interdental spaces. On haematology, a mild, non-regenerative anaemia was detected, whereas the serum biochemistry profile and urinalysis were unremarkable. The serum glucose concentration was within the reference interval. Serum insulin-like growth factor-1 concentration was markedly elevated (>1600 ng/ml). The basal serum growth hormone concentration was elevated and decreased only mildly after somatostatin administration. Basal serum insulin concentration was high, and the insulin concentration increased considerably after glucose loading, consistent with insulin resistance. CT scanning of the skull showed an enlarged pituitary gland and increased skull bone thickness. The final diagnosis was acromegaly. RELEVANCE AND NOVEL INFORMATION: These findings demonstrate that acromegaly should be pursued and suspected in cats other than those with diabetes mellitus.

In vitro description of a new technique for stapled side-to-side jejunocecal anastomosis in horses and CT scan anatomical comparison with other techniques.

BACKGROUND: Stapled jejunocecal anastomoses are commonly performed in equine abdominal surgery. They carry higher complication rates compared to handsewn techniques. In human surgery various causes likely to lead to failure of stapled techniques have been evaluated, including staple line failure. Recently Freeman proposed a technique to perform a stapled jejunocecal anastomosis in horses while avoiding blind pouch formation. The aim of this study is to describe a method for stapled side-to-side jejunocecal anastomosis in horses and to compare it with other techniques with computed tomography to assess stomal area, shape and blind pouch size. METHODS: Intestinal specimens comprising the cecum, ileum and jejunum from 18 horses were collected and were divided into three groups. In Group S a standard stapled side-to-side jejunocecal anastomosis was performed. In Group F the anastomosis was performed using a modified technique proposed by Freeman. In Group G the anastomosis was performed with a modified technique proposed by the authors. Inflated bowel segments were CT scanned to obtain a MultiPlanar Reconstruction of the stoma and afferent small intestine before calculating the cross-sectional area of each of these regions. The ratio of the measured areas was compared between the three techniques. The volume of the blind-end pouch was measured and its ratio with the intestinal area compared between techniques. The cecum was opened and the length of the stoma measured with a caliper and compared to the intended initial length. RESULTS: The stomal/intestinal area ratio was not significantly different between techniques. CONCLUSIONS: Both the Freeman and the new (G) technique were comparable to the standard technique in terms of stomal area, stomal shape and difference in stomal elongation. They consistently produced a smaller blind pouch and allowed easier placement of the staplers.

Ex Vivo Anatomical Characterization of Handsewn or Stapled Jejunocecal Anastomosis in Horses by Computed Tomography Scan.

The aim of this study is to compare handsewn and stapled jejunocecal anastomosis with different stomal lengths in terms of anatomical differences. Group 1 underwent a two-layer handsewn jejunocecal side-to-side anastomosis (HS); Group 2 received a stapled jejunocecal side-to-side anastomosis (GIA). Each group was divided into two subgroups (HS80 and HS100, GIA80 and GIA100). Specimens were inflated and CT scanned. The stomal/jejunal area ratio and blind end pouch volume/area were measured and compared. Effective length of the stoma was measured and compared with the initial length. Stomal/jejunal area ratio was 1.1 for both 80 techniques, 1.6 for the GIA100, and 1.9 for the HS100 technique. Both HS and GIA techniques produced a blind end pouch and exhibited a mean increase of the final stomal length ranging from 6 to 11% greater than the original stomal length. All techniques will exhibit a length increase of the final stomal length compared to the intended stomal length, with a consequent increase in stomal area. Stapled techniques consistently produced a large distal blind end pouch. Length of a jejunocecal anastomosis should be selected in accordance with the diameter of afferent jejunum, and the 80 mm stomal length could be deemed sufficient in horses.

Peripheral neuropathy in a cat with renal lymphoma.

A 12-year-old male cat was referred for progressive limb weakness lasting 2 weeks. Physical examination detected muscle atrophy and bilateral renomegaly with distortion of the renal contours. The cat was ambulatory but tetraparetic. It showed a peculiar posture on forelimbs with bilateral flexion of the carpi and extrarotation of forearms. The cat was unable to go upstairs or jump. Neurological examination showed findings compatible with peripheral nervous system involvement. Histopathological findings revealed a high grade non-B, non-T cell renal lymphoma and peripheral neuropathy characterised by demyelination, axonal degeneration and muscle denervation. In the absence of congenital, metabolic and infectious diseases or exposure to toxins, a paraneoplastic peripheral neuropathy was hypothesised. In humans and dogs, paraneoplastic peripheral neuropathies have been documented with different neoplastic processes including lymphoproliferative disorders. To the authors' knowledge, this is the first report of suspected paraneoplastic polyneuropathy in a cat with malignant tumour.

Visual and quantitative electroencephalographic analysis of healthy young and adult cats under medetomidine sedation.

A study was designed to investigate the effect of medetomidine sedation on quantitative electroencephalography (q-EEG) in healthy young and adult cats to determine objective guidelines for diagnostic EEG recordings and interpretation. Preliminary visual examination of EEG recordings revealed high-voltage low-frequency background activity. Spindles, k-complexes and vertex sharp transients characteristic of sleep or sedation were superimposed on a low background activity. Neither paroxysmal activity nor EEG burst-suppression were observed. The spectral analysis of q-EEG included four parameters, namely, relative power (%), and mean, median and peak frequency (Hz) of all four frequency bands (delta, theta, alpha and beta). The findings showed a prevalence of slow delta and theta rhythms as opposed to fast alpha and beta rhythms in both young (group A) and adult (group B) cats. A posterior gradient was reported for the theta band and an anterior gradient for the alpha and beta bands in both groups, respectively. The relative power value in group B compared to group A was significantly higher for theta, alpha and beta bands, and lower for the delta band. The mean and median frequency values in group B was significantly higher for delta, theta and beta bands and lower for the alpha band. The study has shown that a medetomidine sedation protocol for feline EEG may offer a method for investigating bio-electrical cortical activity. The use of q-EEG analysis showed a decrease in high frequency bands and increased activity of the low frequency band in healthy cats under medetomidine sedation.

Transanal pull-through rectal amputation for treatment of colorectal carcinoma in 11 dogs.

OBJECTIVE: To evaluate outcome after transanal rectal pull-through amputation of single colorectal adenocarcinoma and in situ carcinoma (Tis) in dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n=11) with colorectal cancer. METHODS: Full-thickness colorectal amputation by either simple transanal (7 dogs) or combined abdominal-transanal (4) pull-through technique. RESULTS: Adenocarcinoma (8) and Tis (2) were removed with 3-6 cm of grossly normal tissue, cranial and caudal to the tumor, or in 1 Tis with 2 cm grossly normal tissue, cranial and caudal. Two dogs that had a combined abdominal-transanal approach died within 4 days. In the other dogs, postoperative complications included short-term tenesmus (6 dogs), rectal bleeding (11), rectal stricture (3), and long-term fecal incontinence (1). Postoperative recurrence and metastatic rates for adenocarcinoma were 18.2% and 0%, respectively. Median disease-free interval and survival time were not reached. Mean disease-free and overall survival times were 44.3 and 44.6 months (range, 0-75 months), respectively. CONCLUSION: En bloc excision of colorectal Tis and adenocarcinoma may be followed by a long survival. Complications of the transanal approach are usually moderate and self-limiting, but complications are more common and severe when more extensive resections are performed through a combined abdominal-transanal approach. CLINICAL RELEVANCE: Transanal rectal pull-through amputation is suitable for en bloc resection of colorectal neoplasia. A combined abdominal-transanal approach should be reserved for tumors extending from the mid-cranial region of the rectum to the descending colon.