Cytotoxic drug use in treatment of dogs and cats with cancer by UK veterinary practices (2003 to 2004).

OBJECTIVES: To describe the range and frequency of cytotoxic drugs prescribed within UK veterinary practices to treat dogs and cats with cancer, determine the effect of practice demographic variables on this practice and determine the frequency with which intravenous catheters were used during administration of parenteral cytotoxic drugs. METHODS: A postal survey of 1838 veterinary practices providing care for dogs and cats within the UK. RESULTS: Prescription of cytotoxic drugs to treat dogs and cats with cancer during the preceding 12 months was reported by 70.8 per cent practices. The most widely prescribed agents were cyclophosphamide (65.4 per cent) and vincristine (63.5 per cent). Twenty-three per cent of responding practices had prescribed an antitumour antibiotic and 8.3 per cent had prescribed a platinum agent. The median frequency of prescription was between once a month and once every three months. Increasing frequency and range of cytotoxic drug prescription were associated with practice employment of higher numbers of veterinary surgeons and increased levels of pet insurance among practice clients. Almost a quarter of practices administering vesicant parenteral cytotoxic drugs failed to always use intravenous catheters to do so. CLINICAL SIGNIFICANCE: Prescription of cytotoxic drugs, and therefore the potential for occupational exposure of staff, was widespread among UK veterinary practices providing care for dogs and cats.

Metabolic epidermal necrosis in a dog associated with pancreatic adenocarcinoma, hyperglucagonaemia, hyperinsulinaemia and hypoaminoacidaemia.

A case of metabolic epidermal necrosis associated with a pancreatic carcinoma is described. Normoglycaemia, reduced serum fructosamine, and hypoaminoacidaemia were identified. Hyperinsulinaemia and hyperglucagonaemia were documented. Immunohistochemistry documented strong tumour expression of both insulin and glucagon supporting combined paraneoplastic production of both hormones by the tumour. Enteral protein and fatty acid supplementation and parenteral amino acid supplementation proved ineffective. Metastasis to regional lymph nodes was identified and the patient was euthanased.

Association between Key-Gaskell syndrome and infection by Clostridium botulinum type C/D.

There is growing evidence that equine dysautonomia is a toxicoinfection with Clostridium botulinum type C. The possibility that feline dysautonomia has the same aetiology was investigated by attempting to detect botulinum type C neurotoxin in the food, faeces and the contents of the ileum of affected cats, and by serology. The toxin was detected directly in four of eight affected cats and after enrichment in seven of them, and in their dried food. No toxin was detected in healthy control cats or in their tinned food. Recent exposure to the organism was assessed by the detection of immunoglobulin A (IgA) in the faeces of healthy control cats and affected cats. The levels of IgA antibodies to the toxin and to surface antigens of C. botulinum type C in the faeces of the affected cats 14 weeks after the outbreak were significantly higher than in the faeces of the control cats.

Treatment of a well differentiated pulmonary adenocarcinoma in a cat by pneumonectomy and adjuvant mitoxantrone chemotherapy.

Primary lung neoplasia is a rare condition of older cats. This report describes a case of left-sided pulmonary collapse, secondary to pulmonary adenocarcinoma in an 11-year-old cat. Left sided pneumonectomy was performed, and adjuvant chemotherapy with mitoxantrone (Novantrone; Lederle) was administered every 3 to 5 weeks, for 10 doses after surgery. Thirty-four months after surgery, the cat remains well and has no radiographic evidence of pulmonary metastasis.

Thoracic high-resolution computed tomography in the diagnosis of metastatic carcinoma.

Three dogs were presented for investigation of recurrent pyrexia of unknown origin, chronic vomiting and respiratory distress, respectively. One dog was markedly underweight and the other two were cachexic. Physical examination and initial diagnostic tests failed to establish the underlying cause of the presenting signs. Thoracic radiographs were within normal limits for the age of the dog. In each case there was a high index of suspicion for an occult neoplastic process in view of the profound unexplained weight loss present. High-resolution computed tomography (HRCT) of the thorax was performed. The lung fields were divided into three zones for analysis and a novel classification scheme was used to describe the HRCT findings in each zone. Postmortem examination and histopathology confirmed the presence of an infiltrating metastatic carcinoma in all three cases. The HRCT changes correlated closely with the pathological findings. The authors conclude that HRCT of the lung should be considered for pulmonary metastatic screening in the dog and introduce a classification system for HRCT findings, based on terminology used in human medicine.

Treatment of canine and feline diaphyseal radial and tibial fractures with low-stiffness external skeletal fixation.

The healing of 62 cases of radial and tibial fractures treated with low-stiffness Kirschner-Ehmer external skeletal fixation frames (frame types 1a, 1a plus intramedullary pin [1aIMP], 1b and 2b) was evaluated. The mean time to clinical union was 65 days. All cases treated with 1b, 2b or 1aIMP frames healed. Four of 25 cases treated with 1a frames failed to heal due to premature pin loosening; these failures were in heavier patients than 1a cases which healed (P=0.041). Complications occurred in 40 of 62 cases, and were more common in cases treated with type 2b frames. Pin loosening was the most frequent complication (35 cases) and most commonly involved the most proximal pin (P<0.001). In type 2b frames, full pins loosened more frequently than half pins (P<0.001). This study indicates that canine and feline fractures can heal readily when treated with these frames, suggesting that more rigid type 2a or type 3 frames are unnecessary in the majority of cases. Increased morbidity compared with the use of more rigid frames need not be expected, but 1a frames should be avoided in heavier patients.

Feline epitheliotrophic T-cell lymphoma with paraneoplastic eosinophilia - immunochemotherapy with vinblastine and human recombinant interferon alpha(2b).

A cat with epitheliotrophic T-cell lymphoma with paraneoplastic eosinophilia is described. Initial attempts to control the disease with conventional therapies failed. The addition of recombinant human interferon alpha(2b) (rhINFalpha(2b)) resulted in a clinical, haematogenous and sonographic improvement for 49 days. The overall survival time from initial diagnosis was 100 days. Relapse was correlated with the development of serum antibodies directed against rhINFalpha(2b). To our knowledge, this is the first report describing the clinical use of IFNalpha in the treatment of neoplasia in the cat.

Outbreak of dysautonomia (Key-Gaskell syndrome) in a closed colony of pet cats.

Six of eight pet cats in a closed colony developed overt signs of dysautonomia over a period of seven days; two of them died and one was euthanased. Dysautonomia was confirmed histopathologically in two of these cats, and in the others the diagnosis was based on the characteristic clinical and radiographic findings. In the two apparently unaffected cats abnormal oesophageal motility was demonstrated by fluoroscopy, suggesting that there may be a subclinical form of the disease. The surviving cats had higher and more variable heart rates (mean 165 bpm) than the non-survivors (mean 121 bpm).

Treatment of unresectable hepatocellular adenoma in dogs with transarterial iodized oil and chemotherapy with and without an embolic agent: a report of two cases.

Transarterial iodized oil with chemotherapy was evaluated in two dogs with large, surgically unresectable hepatocellular adenoma. A single cycle of therapy was used in each dog. Chemoembolic mixtures varied: doxorubicin emulsified with iodized oil radiographic contrast (case 1), doxorubicin and mitomycin C emulsified with iodized oil radiographic contrast (case 2). In addition, dog 2 underwent arterial embolization with polyvinyl alcohol granules. Response was assessed by computed tomography at 1 and 3 months after treatment. Superselective catheterization of the hepatic arterial branch supplying the tumour was not achieved in either case. In the immediate post-operative period, both dogs developed mild clinical signs that may have been consistent with post-embolization syndrome, but neutropenia and reduced liver function were not observed. Tumour response was minimal: stable disease at 1 month and progressive disease at 3 months was observed in both cases.

Kitten mortality in the United Kingdom: a retrospective analysis of 274 histopathological examinations (1986 to 2000).

The postmortem findings in 274 kittens were reviewed. The kittens were grouped by age at death: perinatal (< one day), neonatal (one to 14 days), preweaning (15 to 34 days) and postweaning (35 to 112 days); 203 (74 per cent) of the kittens were postweaning and 38 (14 per cent) were preweaning. Infectious disease was identified in 55 per cent of the kittens, and 71 per cent of the infectious disease was viral and detected significantly more frequently in rescue shelter kittens than in kittens from private homes. Twenty-five per cent of all kitten mortality was due to feline parvovirus (FPV). During the neonatal and preweaning periods, the main viral infections were feline herpesvirus and calicivirus. Feline infectious peritonitis caused the death of 17 kittens in the postweaning period. The rescue shelter kittens were significantly younger than the kittens from private homes (median survival 49 and 56 days) and were more likely to have FPV. The non-pedigree kittens were significantly younger than the pedigree kittens (42 v 56 days), and the pedigree kittens were significantly less likely to originate from rescue shelters. There was no significant difference between the age distribution of the male and female kittens. No diagnosis could be found in 33 per cent of the kittens, and this failure was correlated significantly with the submission of tissue samples as opposed to the whole carcase.

Idiopathic hepatic veno-occlusive disease causing Budd-Chiari-like syndrome in a cat.

Budd-Chiari-like syndrome (BCLS) is a rare clinical entity characterised by portal hypertension and ascites. This report describes a case of BCLS in a cat due to obstruction at the level of the hepatic veins. The diagnosis was based on the clinical findings and a histopathological assessment of the liver demonstrating perivenular fibrosis around the central and sublobular veins. Although these lesions are similar to those observed in man with BCLS, the aetiology in this case remains unknown.

Uterine carcinoma in a 10-month-old golden retriever.

A 10-month-old golden retriever was presented for investigation of reduced appetite, occasional vomiting and general dullness. Abdominal radiography demonstrated a large mid-abdominal soft tissue mass. Exploratory laparotomy identified a uterine mass, which was removed surgically. Histopathology confirmed uterine adenocarcinoma. Adjunctive chemotherapy with epirubicin was performed. The dog remained clinically normal without evidence of metastatic disease 24 months after surgery. Canine uterine adenocarcinoma is an extremely rare tumour and, as far as the authors are aware, this is the youngest reported case to date.