131 treatment in dogs with hyperthyroidism caused by a non-resectable ectopic thyroid tumour: 5 cases (2008-2019).

OBJECTIVES: This study aimed to describe the clinical and diagnostic characteristics, as well as outcomes of radioiodine treatment in dogs with hyperthyroidism caused by a non-resectable ectopic thyroid tumour. MATERIALS AND METHODS: This retrospective study reviewed the medical records between 2008 and 2018 of dogs diagnosed with hyperthyroidism secondary to a non-resectable ectopic thyroid tumour and treated with radioiodine. RESULTS: Five dogs were included in the study. Three dogs had sublingual ectopic tumours, of which one also had a unilateral cervical thyroid tumour. The remaining two dogs were diagnosed with an ectopic thyroid tumour at the level of the caudal pharynx and the heart base, respectively. All cases were treated with radioiodine. The size of the ectopic masses decreased after radioiodine treatment. Total thyroxine concentrations returned to reference ranges in all dogs. Further, clinical signs of hyperthyroidism disappeared after treatment in all patients. One dog developed myelosuppression secondary to radioiodine treatment. The dog with metastasis had a very short survival compared to the four dogs without metastasis (3 months compared to 7, 36, 50 and 24 months, respectively) and succumbed most likely to thyroid-related problems. In the remaining four dogs, their quality of life improved. They died due to diseases unrelated to the ectopic thyroid tumour. CLINICAL SIGNIFICANCE: Radioiodine therapy should be considered as a treatment option in dogs diagnosed with hyperthyroidism due to a non-resectable ectopic thyroid tumour.

Radiological protection of the patient in veterinary medicine and the role of ICRP.

At the request of the Main Commission of the International Commission on Radiological Protection (ICRP), Task Group 107 (TG107) was set up to consider the issue of radiological protection of the patient in veterinary medicine. TG107, who authored this article, brought together information relating to the use of diagnostic imaging and radiation oncology in veterinary medicine. A number of specific areas were identified that appeared to be appropriate for attention by ICRP. These included the use of dose quantities and units, the need for re-evaluation of stochastic and deterministic risks from ionising radiation in animals, and the growing use of imaging and therapeutic equipment for animals that is little different from that available to humans. TG107 unanimously recommended that it was both appropriate and timely for ICRP to consider and advise on these issues, and the Main Commission agreed. This paper summarises the findings of TG107.

Cortical motor threshold determination in dogs.

In humans, determining the cortical motor threshold (CMT) is a critical step in successfully applying a transcranial magnetic stimulation (TMS) treatment. Stimulus intensity, safety and efficacy of a TMS treatment are dependent of the correct assessment of the CMT. Given that TMS in dogs could serve as a natural animal model, an accurate and reliable technique for the measurement of the CMT should be available for dogs. Using a visual descending staircase paradigm (Rossini paradigm), the CMT repeatability was assessed and compared to the electromyographic (EMG) variant. The influence of a HF-rTMS treatment on the CMT was examined. Subsequently, the CMT was measured under sedation and general anaesthesia. Finally, the coil-cortex distance was associated with the CMT, weight, age and gender. During one year the CMT was measured three times, during which it remained constant, although a higher CMT was measured (40% higher machine output) when using EMG (P-value < .001) and under general anaesthesia (P-value = .005). On average, a 40% and 12% higher machine output were registered. An aHF-rTMS protocol does not influence the CMT. Males have on average a 5.2 mm larger coil cortex distance and an 11.81% higher CMT. The CMT was positively linearly associated (P-value < .05) with the weight and age of the animals. Only within female subjects, a positive linear association was found between the CMT and the coil-cortex distance (P-value = .02). Using the visual Rossini paradigm, the CMT can be reliably used over time and during a TMS treatment. It has to be kept in mind that when using EMG or assessing the CMT under general anaesthesia, a higher CMT is to be expected. As in humans, every parameter that influences the coil-cortex distance may also influence the CMT.

Changes in canine cerebral perfusion after accelerated high frequency repetitive transcranial magnetic stimulation (HF-rTMS): A proof of concept study.

Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a treatment for several neuropsychiatric disorders in human beings, but the neurobiological effects of rTMS in dogs have not been investigated to date. A proof of concept study was designed to evaluate the effect of rTMS on cerebral perfusion, measured with single photon emission computed tomography (SPECT), in dogs. An accelerated high frequency (aHF)-rTMS (20Hz) protocol was applied to the canine left frontal cortex. To accurately target this area, eight dogs underwent a 3 Tesla magnetic resonance imaging (MRI) scan before stimulation. The left frontal cortex was subjected to five consecutive aHF-rTMS sessions with a figure-of-eight coil designed for human beings at an intensity of 110% of the motor threshold. The dogs underwent 99mTc-d,1 hexamethylpropylene amine oxime (HMPAO) SPECT scans 1 week prior to and 1day after the stimulations. Perfusion indices (PIs) were determined semi-quantitatively; aHF-rTMS resulted in significantly increased PIs in the left frontal cortex and the subcortical region, whereas no significant differences were noted for the other regions. Behaviour was not influenced by the stimulation sessions. As has been observed in human beings, aHF-rTMS applied to the left frontal cortex alters regional cerebral perfusion in dogs.

Biodistribution and tolerance of intravenous iodine-131-labelled hypericin in healthy dogs.

Hypericin (Hyp) is a necrosis-avid compound that can be efficiently labelled with radioiodine for both diagnostic and therapeutic purposes. Before 131 I-Hyp can be considered as a clinically useful drug in a combination therapy for canine cancer patients, evaluation of its toxicity is necessary. The aim of this study was to investigate the biodistribution and tolerance of a single dose administration of 131 I-Hyp. Three healthy dogs were included. 131 I-Hyp at a dose of 0.2 mg/kg and an activity of 185 MBq was intravenously injected. The effects on physical, haematological and biochemical parameters were characterized and the biodistribution and elimination pattern, the effective half-life and dose rate were assessed. Drug-related adverse events were limited to mild gastrointestinal signs, resolving within 48 hours. No significant differences were found in blood haematology and serum biochemistry before and after treatment. Following administration, highest percentage of injected dose (%ID ± SD) was found in the liver (5.5 ± 0.33), the lungs (4.17 ± 0.14) and the heart (3.11 ± 0.78). After 24 hours, highest %ID was found in colon (4.25 ± 1.45) and liver (3.45 ± 0.60). Clearance from all organs was effective within 7 days. Effective half-life was established at 80 hours, and the dose rate fell below <20 µSv/h at 1 m within 1 day. The current study reveals that single dose treatment with 131 I-Hyp at the described dose is well tolerated by healthy dogs and supports the use of radioiodinated hypericin in a combination therapy for canine cancer patients.

Clinical, pathologic, and immunohistochemical prognostic factors in dogs with thyroid carcinoma.

BACKGROUND: Prognostic markers for dogs with thyroid tumors are limited. HYPOTHESIS/OBJECTIVES: To identify clinical, pathologic, and immunohistochemical prognostic factors for dogs with thyroid tumors. ANIMALS: Seventy dogs with thyroid neoplasia. METHODS: Retrospective study. Dogs with thyroid neoplasia were included when follow-up information and formalin-fixed paraffin-embedded tumor samples were available. Immunohistochemistry (IHC) was performed for thyroglobulin, calcitonin, Ki-67, and E-cadherin. Correlation of tumor variables (diameter, volume, localization, scintigraphic uptake, thyroid function, IHC) with local invasiveness and metastatic disease was performed on all tumor samples. Forty-four dogs treated by thyroidectomy were included in a survival analysis. RESULTS: Fifty dogs (71%) had differentiated follicular cell thyroid carcinoma (dFTC) and 20 (29%) had medullary thyroid carcinoma (MTC). At diagnosis, tumor diameter (P = .007; P = .038), tumor volume (P = .020), tumor fixation (P = .002), ectopic location (P = .002), follicular cell origin (P = .044), and Ki-67 (P = .038) were positively associated with local invasiveness; tumor diameter (P = .002), tumor volume (P = .023), and bilateral location (P = .012) were positively associated with presence of distant metastases. Forty-four dogs (28 dFTC, 16 MTC; stage I-III) underwent thyroidectomy. Outcome was comparable between dogs with dFTC and MTC. Macroscopic (P = .007) and histologic (P = .046) vascular invasion were independent negative predictors for disease-free survival. Although time to presentation, histologic vascular invasion and Ki-67 were negatively associated with time to metastases, and time to presentation was negatively associated with time to recurrence, no independent predictors were found. E-cadherin expression was not associated with outcome. CONCLUSIONS AND CLINICAL IMPORTANCE: Prognostic factors have been identified that provide relevant information for owners and clinicians.

Primary and concomitant flexor enthesopathy of the canine elbow.

OBJECTIVES: To report the characteristics of two types of flexor enthesopathy, primary and concomitant, based on different diagnostic techniques. MATERIALS AND METHODS: Over a period of three years a prospective study was performed on dogs admitted for the complaint of elbow lameness. Based on the radiographic findings a selection of dogs underwent a complete series of different imaging modalities. With each technique, pathology of the medial epicondyle and the presence of other elbow disorders were recorded. All joints with signs of flexor pathology apparent with at least three techniques were selected. A distinction was made between primary and concomitant flexor enthesopathy based on the absence or presence of other elbow disorders. RESULTS: Primary flexor enthesopathy was diagnosed in 23 joints and concomitant flexor enthesopathy in 20 joints. In 43% of the joints with primary and in 75% of the joints with concomitant flexor enthesopathy, pathology at the medial epicondyle was demonstrated by all techniques. All joints with concomitant flexor enthesopathy had a diagnosis of medial coronoid disease, osteochondritis dissecans, or both. CLINICAL SIGNIFICANCE: Pathology at the medial epicondyle is a sign of flexor enthesopathy. It may be present as the only sign in a joint with primary flexor enthesopathy or concomitant with other elbow pathology. In both groups flexor lesions can be demonstrated with different imaging techniques. The distinction between the primary and concomitant form is based on the presence or absence of other elbow pathology, mainly medial coronoid disease. Recognizing both types is important for a correct treatment decision.

The use of planar bone scintigraphy and HiSPECT for diagnosis of primary and concomitant flexor enthesopathy in the canine elbow.

OBJECTIVE: To investigate the possibilities and limitations of planar bone scintigraphy and high resolution single photon emission computed tomography (HiSPECT) to diagnose flexor enthesopathy and to distinguish primary flexor enthesopathy from the concomitant form. MATERIALS AND METHODS: A prospective study of 46 dogs with primary flexor enthesopathy, concomitant flexor enthesopathy, medial coronoid disease, and normal elbows was performed. All dogs underwent planar bone scintigraphy and HiSPECT imaging. The obtained images were visually scored for increased radiopharmaceutical uptake in the medial humeral epicondylar and medial coronoid process region using a score from 1-3. RESULTS: Planar bone scintigraphy demonstrated increased radiopharmaceutical uptake in all diseased elbow joints, except for one. HiSPECT demonstrated increased radiopharmaceutical uptake of the medial humeral epicondyle in nearly all clinically affected joints with primary and concomitant flexor enthesopathy. Additional uptake of the medial coronoid process was recorded in all clinically affected joints with concomitant flexor enthesopathy and in six out of 18 with primary flexor enthesopathy. No difference in intensity of the uptake was noticed. CLINICAL SIGNIFICANCE: Planar bone scintigraphy allows the attribution of lameness to the elbow joint in cases of primary flexor enthesopathy with minimal or even absent radiographic changes. The more detailed HiSPECT enables the localization of pathology within the elbow joint and is a sensitive technique to detect flexor enthesopathy. However HiSPECT is insufficient to distinguish primary from concomitant flexor enthesopathy.

The use of the HiSPECT bone scan in canine flexor enthesopathy and coronoid pathology.

In this study the use of the high resolution Micro-Single Photon Emission Tomography (HiSPECT) system with a radioactive bonemarker, (99m)Tc-oxidronate, was evaluated in dogs with coronoid pathology and/or flexor enthesopathy. Sixty-five elbows of 34 dogs were included. CT and HiSPECT were performed on all elbows, arthroscopy on 59. Tracer uptake in 8 anatomical regions was graded according to two models. Increased activity in the medial epicondylar region was associated with flexor pathology on CT (P=0.0002) and arthroscopy (P<0.0001) and increased uptake in the medial coronoid (P<0.0001) and the medial condylar area (P<0.013) with coronoid pathology. Uptake in the remaining areas was not associated with both pathologies. In conclusion, the improved resolution of the HiSPECT system allows identification of increased tracer uptake in the anatomical regions involved in coronoid pathology and flexor enthesopathy. This modality may improve the diagnostic potential of the bone scan in canine elbow disease.

Evaluation of semi-quantitative bone scintigraphy in canine elbows.

Scintigraphy is an extremely sensitive tool for the detection of early changes in bone metabolism. Sixty-eight lame dogs underwent a scintigraphic examination. For each elbow lateromedial (LM), caudomedial (CdM) flexed and caudomedial (CdM) extended scintigraphic views were obtained. Semi-quantitative analysis was performed to determine radiopharmaceutical uptake at the medial coronoid process (MCP) and at the attachment of the flexor muscles at the medial humeral epicondyle, normalised to activity registered in either the total elbow joint or the radius/ulna. MCP pathology/flexor enthesopathies were divided into simple (containing one abnormality) or complex (containing more than one abnormality) lesions. The influence of different views or normalisation procedures on sensitivity and specificity was evaluated. MCP lesions were detected on radiography, ultrasound, computed tomography, magnetic resonance imaging and/or arthroscopy in 49 elbows, with 13 simple and 36 complex lesions. Flexor enthesopathy was diagnosed in 54 elbows, with 14 simple and 40 complex lesions. In seven elbows only degenerative changes were present, whereas in 50 elbows no abnormalities could be detected. MCP lesions were best detected with the CdM extended view, whereas for flexor enthesopathy the CdM flexed view offered the best result. To detect simple lesions, the normalisation procedure to the elbow gave the best result, whereas normalisation to the radius/ulna was the best choice for complex lesions. This study suggests that semi-quantification is a valuable method in case of simple pathology, especially when MCP lesions are considered. For elbows with complex lesions, the quantification procedure is less reliable.

High-resolution micro-SPECT to evaluate the regional brain perfusion in the adult Beagle dog.

Conventional Single Photon Emission Computed Tomography (SPECT) precludes a detailed evaluation of the subcortical region. Micro-SPECT (µ-SPECT) has a higher resolution, but has not been used to evaluate the dog's brain until now. In this study, µ-SPECT of the brain was evaluated in 10 Beagle dogs. Magnetic Resonance Imaging (MRI) of the brain was used to draw a new region map containing 19 volumes of interest (VOIs). Semi-quantitative analysis of the µ-SPECT data was performed and the regional cerebral perfusion was represented by the perfusion indices (PIs). The highest perfusion was found in the parietal cortex and the lowest in the piriform cortex. An asymmetry toward the left hemisphere in general and a regional asymmetry in the frontal, temporal and parietal cortex were found. This study shows that functional imaging of the canine brain is possible using µ-SPECT and it describes the normal regional brain perfusion in the adult Beagle dog.

Recombinant human thyrotropin in veterinary medicine: current use and future perspectives.

Recombinant human thyrotropin (rhTSH) was developed after bovine thyrotropin (bTSH) was no longer commercially available. It was approved by the Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) as an aid to diagnostic follow-up of differentiated thyroid carcinoma in humans and for thyroid remnant ablation with radioiodine. In addition, rhTSH is used in human medicine to evaluate thyroid reserve capacity and to enhance radioiodine uptake in patients with metastatic thyroid cancer and multinodular goiter. Likewise, rhTSH has been used in veterinary medicine over the last decade. The most important veterinary use of rhTSH is thyroidal functional reserve testing for the diagnosis of canine hypothyroidism. Recent pilot studies performed at Ghent University in Belgium have investigated the use of rhTSH to optimize radioiodine treatment of canine thyroid carcinoma and feline hyperthyroidism. Radioiodine treatment optimization may allow a decreased therapeutic dosage of radioiodine and thus may improve radioprotection. This review outlines the current uses of rhTSH in human and veterinary medicine, emphasizing research performed in dogs and cats, as well as potential future applications.

Effects of medetomidine and ketamine on the regional cerebral blood flow in cats: a SPECT study.

Brain perfusion can be investigated using single photon emission computed tomography (SPECT) and the intravenous injection of (99m)technetium ethyl cysteinate dimer ((99m)Tc-ECD). However, sedation using medetomidine, an α(2)-agonist, or anaesthesia using medetomidine and ketamine, an N-methyl-d-aspartate-(NMDA)-antagonist, may be required for SPECT studies in cats but can affect the regional cerebral blood flow (rCBF). The effects of medetomidine, with or without ketamine, on regional brain perfusion were therefore investigated in six cats under three conditions. Injection of tracer occurred before sedation or anaesthesia (condition A), following intramuscular (IM) sedation with medetomidine (condition M) or after IM anaesthesia with medetomidine and ketamine (condition MK). Medetomidine and medetomidine with ketamine caused a significantly higher total tracer uptake in all brain regions. Semi-quantification of brain perfusion gave lower perfusion indices in several sub-cortical regions in conditions M and MK, compared to A. Left-right differences were observed in the temporal cortex (A), the temporal, parietal cortex and the thalamus (M) and the frontal cortex (MK). A significantly higher perfusion index in the sub-cortical regions, compared to the whole cortex, was only present in condition A. This study showed that caution is needed when quantifying brain perfusion indices when using sedative or anaesthetic agents that may affect rCBF.

Metabolic correlates of tumour hypoxia in malignant canine mammary carcinoma.

Given its importance in human and canine tumour biology, a profound understanding of tumour hypoxia is of paramount importance. Therefore, the aim of this work was to investigate the relationship between tumour hypoxia and the expression of a number of hypoxia-induced proteins that play a role in tumour metabolism. The hypoxia marker pimonidazole was administered to dogs affected by spontaneous mammary carcinoma and compared with immunohistochemical staining for GLUT1 and 3, HK 2 and CA IX. A statistically significant correlation was found between pimonidazole staining and GLUT1-expression (R=0.607; p=0.001). These results indicate a strong interaction between tumour hypoxia and tumour metabolism by the induction of proteins essential to maintain a stable tumour microenvironment.

Recognition of anatomical predilection sites in canine elbow pathology on bone scans using micro-single photon emission tomography.

The limited resolution of planar bone scintigraphy precludes exact anatomical localisation within a joint. Micro-single photon emission tomography (µ-SPECT) has a much higher resolution, and in this study the use of µ-SPECT in the evaluation of the canine elbow joint and fusion with structural imaging data were tested. Twelve elbows of seven normal dogs were included. µ-SPECT was performed with a conventional triple head gamma camera adapted with three multi-pinhole collimators (HiSPECT). Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) were performed on all elbows and data from CT and MRI were fused to the HiSPECT data using dedicated software. Different important anatomical regions could be recognised on the HiSPECT images. The improved resolution of the HiSPECT system allowed better differentiation of the anatomical areas in the elbow joint. Two case studies were included to demonstrate the potential of this methodology. Fusion software facilitated the use of combined structural and functional information.

The effect of medetomidine on the regional cerebral blood flow in dogs measured using Technetium-99m-Ethyl Cysteinate Dimer SPECT.

Sedatives and anaesthetics are known to cause changes in the regional cerebral blood flow. In dogs intramuscular sedation with medetomidine, a potent sedative frequently used in veterinary medicine, is sometimes indicated prior to intravenous injection of (99m)Technetium-Ethyl Cysteinate Dimer ((99m)Tc-ECD) in brain perfusion studies using Single Photon Emission Computed Tomography (SPECT). Based on the knowledge of the distribution of alpha(2)-receptors in the brain, we hypothesized altered regional brain perfusion in dogs receiving medetomidine prior to (99m)Tc-ECD. Two conditions were compared in 10 dogs; tracer injection before and after intramuscular sedation with medetomidine. In our study, medetomidine caused a significantly higher tracer uptake in all brain regions. Semi-quantification of brain perfusion rendered a lower perfusion index in the subcortical region and an imbalance between left and right cortical perfusion induced by medetomidine. This study shows that caution is needed when quantifying the brain perfusion indices under medetomidine sedation.

Effect of recombinant human TSH on the uptake of radioactive iodine ((123)I) by the thyroid gland in healthy beagles.

In human medicine, recombinant human thyroid-stimulating hormone (rhTSH) increases thyroid radioactive iodine uptake (RAIU), allowing radioiodine-131 ((131)I) dose reduction and greater efficacy in the treatment of differentiated thyroid cancer and multinodular goiter. The goal of this study was to evaluate the effect of rhTSH, administered 24 h and 48 h before radioiodine-123 ((123)I), on the thyroid RAIU in healthy dogs. Seven healthy euthyroid beagles were randomly allocated to 3 groups (2 groups of 2 dogs and 1 group of 3 dogs) in a prospective, blinded, crossover study. At Week 1, 1 group received (123)I for a baseline RAIU; 1 group received 100 µg of rhTSH IV 24 h before (123)I, and 1 group received 100 µg of rhTSH IV 48 h before (123)I. All dogs received 37 MBq of radioactive (123)I IV, and thyroid RAIU was determined 8 h, 24 h, and 48 h thereafter. The study was designed in such a manner that each dog received the 3 treatments and a wash-out period of 3 wk was respected in between. Blood samples were taken for measurement of serum total thyroxine (TT4) and thyrotropin (TSH) concentrations at baseline and 6 h, 12 h, 24 h, and 48 h after rhTSH administration. Recombinant human TSH caused no significant change on thyroid RAIU. The overall mean thyroid RAIU significantly decreased during the study independent of the treatment. Recombinant human TSH significantly increased serum TT4 concentration, which peaked 6 h after rhTSH administration. Compared to baseline, serum TSH concentration remained higher at 6 h, 12 h, 24 h, and 48 h. However, a statistically significant difference was reached only at 6 h and 12 h after rhTSH administration. No adverse effects of rhTSH were observed during the study. Further studies are needed to determine the best timing and dosage of administration of rhTSH in healthy and thyroid carcinoma dogs.

Retinol-binding protein in serum and urine of hyperthyroid cats before and after treatment with radioiodine.

BACKGROUND: Retinol-binding protein (RBP) is suggested as a clinically useful marker of renal function in cats. HYPOTHESIS: Serum and urinary RBP concentrations in hyperthyroid (HT) cats differ from those in healthy (H) cats; radioiodine ((131)I) treatment influences serum and urinary RBP concentrations in HT cats. ANIMALS: Ten HT and 8 H cats. METHODS: RBP concentration was evaluated in feline serum and urine samples from a prospective study. RESULTS: There was a significant (P= .003) difference in the urinary RBP/creatinine (uRBP/c) ratios of H (-) and untreated HT (1.4 + or - 1.5 x 10(-2) microg/mg) cats. Serum total thyroxine concentration (1.8 + or - 1.9 microg/dL, 24 weeks) and uRBP/c (0.6 + or - 1.0 x 10(-2) microg/mg, 24 weeks) decreased significantly (P < .001) in HT cats at all time points after treatment with (131)I, and these variables were significantly correlated with one another (r= 0.42, P= .007). Serum RBP concentrations from HT cats (199 + or - 86 microg/L) did not differ significantly (P= .98) from those of H cats (174 + or - 60) and did not change after treatment with (131)I (182 + or - 124 microg/L, P= .80). CONCLUSION AND CLINICAL IMPORTANCE: The presence of urinary RBP in HT cats is a potential marker of tubular dysfunction that is correlated to thyroid status, although it is independent of circulating RBP concentrations. The decreased uRBP/c combined with the absence of changes in serum RBP after treatment suggests that the suspected tubular dysfunction was partly reversible with treatment of (131)I.

Short- and long-term follow-up of glomerular and tubular renal markers of kidney function in hyperthyroid cats after treatment with radioiodine.

Hyperthyroidism can mask co-existing chronic kidney disease (CKD). Previous studies showed that post-treatment renal azotemia can be predicted by pre-treatment assessment of glomerular filtration rate (GFR). We hypothesized that treatment of hyperthyroidism may have different effects on glomerular and tubular function and these changes might be predicted by additional pre-treatment variables than GFR. Serum total T4 (TT4), creatinine and blood urea nitrogen (BUN), blood pressure (BP), body weight (BW), GFR, urine specific gravity (USG), urinary protein/creatinine ratio (UPC) and retinol binding protein/creatinine ratio (uRBP/c) were evaluated before and 1, 4, 12 and 24 weeks post-treatment with radioiodine ((131)I) in 21 non-azotemic hyperthyroid cats. Cats were divided 24 weeks post-treatment into group A (normal kidney function, n=16) and group B (impaired kidney function, n=5). Serum TT4, GFR, UPC and uRBP/c decreased significantly after treatment for the complete group and group A (P<0.05), although GFR and uRBP/c did not change in group B. Serum creatinine and BW increased significantly from 1 week after treatment (P<0.05). There was no change in BUN, USG or BP. Pre-treatment serum TT4, GFR and USG differed significantly between group A and B (P<0.05). GFR at 4 weeks after treatment and maximum decrease in GFR could be partially predicted by a formula using pre-treatment GFR, serum TT4, serum creatinine, BUN and/or USG. Significant changes in kidney function occur within 4 weeks post-treatment and none thereafter. Pre-treatment measurement of GFR, USG and serum TT4 can have possible predictive value regarding the development of post-treatment renal azotemia.

67Gallium citrate scintigraphy to assess metastatic spread in a dog with an oral melanoma.

Gallium scintigraphy was used to evaluate therapeutic response in a 10-year-old, male, Dutch sheepdog, suffering from an oral melanoma. Treatment was performed with a combination of carboplatin and hypofractionated radiation. Nineteen weeks after radiation therapy, the left submandibular lymph node was surgically removed because of metastatic disease. Thirty weeks after radiation therapy, 67Gallium scintigraphy was performed to assess for residual disease and metastasis. Increased uptake in the right submandibular lymph node area was noted and identified as a melanoma metastasis on cytology. Surgical excision was performed. Twenty-one weeks later, the dog was euthanased because of advanced pulmonary metastases. This report of a case of oral melanoma illustrates the advantages of 67Gallium scintigraphy in monitoring for the presence of metastatic disease and effectiveness of therapy.