Predictive ability of fine-needle aspirate cytology for incompletely resected mast cell tumor surgical sites.

The goal of this study was to evaluate whether fine-needle aspirate cytology of a previous surgical site was predictive of recurrence for incompletely excised mast cell tumors (MCTs). Electronic medical records were searched for dogs diagnosed with MCTs; those with histologically confirmed, incompletely resected MCTs evaluated by scar aspiration cytology within 60 days after surgery were included for analysis. Variables were compared between groups using Fisher's exact test and logistic regression. Twenty-nine cutaneous and 7 subcutaneous tumors were evaluated. Local recurrence, confirmed by either histopathology or cytology, occurred in 13.8% of cases. No significant differences were identified for any variables other than surgical site cytology status. The negative predictive value of surgical site aspirate cytology without residual mast cell tumor was 93.5%, with an overall predictive accuracy of 88.9%. For the dogs evaluated in this report, surgical site aspiration cytology was predictive of local disease control for incompletely resected MCTs.

Capacité prédictive de la cytologie d'aspiration à l'aiguille fine de sites de chirurgie de résection incomplète de mastocytomes. L'objectif de la présente étude était d'évaluer si la cytologie d'aspiration à l'aiguille fine d'un site chirurgical antérieur permettait de prédire une récurrence lors de l'excision incomplète d'un mastocytome (MCT). Les dossiers médicaux électroniques furent examinés pour trouver des chiens avec un diagnostic de MCT; ceux avec confirmation histologique d'un MCT avec résection incomplète évaluée par cytologie d'une aspiration de la cicatrice en dedans de 60 jours après la chirurgie furent inclus pour analyse. Les variables furent comparées entre les groupes en utilisant le test exact de Fisher et une régression logistique. Vingt-neuf tumeurs cutanées et sept tumeurs sous-cutanées furent évaluées. Une récurrence locale, confirmée par histopathologie ou cytologie, est survenue dans 13,8 % des cas. Aucune différence significative ne fut détectée pour les différentes variables autres que le statut de la cytologie du site chirurgical. La valeur prédictive négative de la cytologie d'une aspiration du site chirurgical sans cellule résiduelle du mastocytome était de 93,5 % avec une précision prédictive globale de 88,9 %. Pour les chiens examinés dans cette étude, la cytologie d'une aspiration du site chirurgical était prédictive d'une maîtrise locale de la maladie lors de résection incomplète d'un MCT.(Traduit par Dr Serge Messier).

Total laryngectomy and permanent tracheostomy in six dogs.

The objective of this report is to describe the surgical technique for total laryngectomy and outcome in six dogs. Laryngeal cancer is an uncommon and challenging clinical problem. Total laryngectomy can provide local disease control but is uncommonly performed. Detailed procedural descriptions are limited and similarly limited information is available regarding patient outcome. Institutional medical records were searched for dogs treated with total laryngectomy. Six dogs were identified. The procedure resulted in postoperative quality of life similar to permanent tracheostomy alone. Surgical margin status was evaluated in five of six cases and was complete in those five. All dogs survived to discharge from the hospital. Complications were mostly related to tracheostomy occlusion or collapse which is recognized as a complication associated with permanent tracheostomy. Patient quality of life was acceptable. Local recurrence was suspected in one dog. Recurrence was not observed in the case with unknown margin status.

Evolution of the monitoring and evaluation strategies to support the World Health Organization's Global Programme to Eliminate Lymphatic Filariasis.

The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was established with the ambitious goal of eliminating LF as a public health problem. The remarkable success of the GPELF over the past 2 decades in carrying out its principal strategy of scaling up and scaling down mass drug administration has relied first on the development of a rigorous monitoring and evaluation (M&E) framework and then the willingness of the World Health Organization and its community of partners to modify this framework in response to the practical experiences of national programmes. This flexibility was facilitated by the strong partnership that developed among researchers, LF programme managers and donors willing to support the necessary research agenda. This brief review summarizes the historical evolution of the GPELF M&E strategies and highlights current research needed to achieve the elimination goal.

Total prostatectomy as a treatment for prostatic carcinoma in 25 dogs.

OBJECTIVE: To describe the complications and outcome after total prostatectomy in dogs with histologically confirmed prostatic carcinoma. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: 25 client-owned dogs. METHODS: Medical records of dogs undergoing total prostatectomy were reviewed from 2004 to 2016. Data retrieved included signalment, presenting signs, preoperative clinical findings, laboratory data, diagnostic imaging, surgical technique, histologic diagnosis, postoperative complications, occurrence of postoperative metastasis, and survival. RESULTS: Twenty-five dogs underwent total prostatectomy for prostatic carcinoma. Urinary anastomotic techniques included urethrourethral anastomosis in 14 dogs, cystourethral anastomosis in 9 dogs, ureterocolonic anastomosis in 1 dog, and anastomosis between the bladder neck and penile urethra in 1 dog. All dogs survived to discharge. Fifteen dogs were diagnosed with transitional cell carcinoma, 8 dogs with prostatic adenocarcinoma, 1 with prostatic cystadenocarcinoma, and 1 with an undifferentiated carcinoma. Permanent postoperative urinary incontinence was present in 8 of 23 dogs. The median survival time was shorter in dogs with extracapsular tumor extension compared with those with intracapsular tumors. The overall median survival time was 231 days (range, 24-1255), with 1- and 2-year survival rates equal to 32% and 12%, respectively. CONCLUSION AND CLINICAL SIGNIFICANCE: Total prostatectomy, combined with adjunct therapies, prolongs survival and lowers complication rates compared to previous reports of dogs with prostatic carcinoma. It should be noted, however, that case selection likely played a significant role in postoperative outcome.

Application of a household-based molecular xenomonitoring strategy to evaluate the lymphatic filariasis elimination program in Tamil Nadu, India.

BACKGROUND: The monitoring and evaluation of lymphatic filariasis (LF) has largely relied on the detection of antigenemia and antibodies in human populations. Molecular xenomonitoring (MX), the detection of parasite DNA/RNA in mosquitoes, may be an effective complementary method, particularly for detecting signals in low-level prevalence areas where Culex is the primary mosquito vector. This paper investigated the application of a household-based sampling method for MX in Tamil Nadu, India. METHODS: MX surveys were conducted in 2010 in two evaluation units (EUs): 1) a hotspot area, defined as sites with community microfilaria prevalence ≥1%, and 2) a larger area that also encompassed the hotspots. Households were systematically selected using a sampling interval proportional to the number of households in the EU. Mosquito pools were collected and analyzed by real-time polymerase chain reaction (qPCR). Two independent samples were taken in each EU to assess reproducibility of results. Follow-up surveys were conducted in 2012. RESULTS: In 2010, the proportion of positive pools in the hotspot EU was 49.3% compared to 23.4% in the overall EU. In 2012, pool positivity was significantly reduced to 24.3% and 6.5%, respectively (p<0.0001). Pool positivity based on independent samples taken from each EU in 2010 and 2012 were not significantly different except for the hotspot EU in 2012 (p = 0.009). The estimated prevalence of infection in mosquitoes, measured by PoolScreen, declined from 2.2-2.7% in 2010 to 0.6-1.2% in 2012 in the hotspot area and from 0.9-1.1% to 0.2-0.3% in the larger area. CONCLUSIONS: The household-based sampling strategy for MX led to mostly reproducible results and supported the observed LF infection trends found in humans. MX has the potential to be a cost-effective, non-invasive monitoring and evaluation tool with sensitive detection of infection signals in low prevalence settings. Further investigation and application of this sampling strategy for MX are recommended to support its adoption as a standardized method for global LF elimination programs.

Biomechanical comparison of two ostectomy configurations for partial mandibulectomy.

OBJECTIVE: To determine the stiffness and load to failure of two different ostectomy configurations using canine mandibles. STUDY DESIGN: Cadaveric biomechanical assessment. ANIMALS: Paired mandibles (n = 30). METHODS: Standardized partial ostectomies were created on the alveolar surface of 30 mandibles. Samples were randomly assigned to right-angled (n = 15) or crescentic ostectomy (n = 15). Excision spanned the mesial aspect of the fourth premolar tooth to the distal aspect of first molar tooth. Mandibles were loaded to failure in three-point bending. The stiffness, displacement at maximum load, and load to failure were measured. RESULTS: There was no significant difference in stiffness (p = 0.59), displacement at maximum load (p = 0.16) and load to failure (p = 0.76) between right-angled or crescentic ostectomy. Right-angled and crescentic ostectomy failed mostly by fracture through an empty alveolus (11/15 and 13/15, respectively). CLINICAL RELEVANCE: No significant differences in load to failure or stiffness between ostectomy techniques were observed. Crescentic ostectomy did not improve the acute load to failure for partial mandibulectomy. The empty alveolus served as a focal stress concentration point eliminating the potential mechanical advantage of a crescentic ostectomy.

A comparison of microRNA expression profiles from splenic hemangiosarcoma, splenic nodular hyperplasia, and normal spleens of dogs.

BACKGROUND: Splenic masses are common in older dogs; yet diagnosis preceding splenectomy and histopathology remains elusive. MicroRNAs (miRNAs) are short, non-coding RNAs that play a role in post-transcriptional regulation, and differential expression of miRNAs between normal and tumor tissue has been used to diagnose neoplastic diseases. The objective of this study was to determine differential expression of miRNAs by use of RNA-sequencing in canine spleens that were histologically confirmed as hemangiosarcoma, nodular hyperplasia, or normal. RESULTS: Twenty-two miRNAs were found to be differentially expressed in hemangiosarcoma samples (4 between hemangiosarcoma and both nodular hyperplasia and normal spleen and 18 between hemangiosarcoma and normal spleen only). In particular, mir-26a, mir-126, mir-139, mir-140, mir-150, mir-203, mir-424, mir-503, mir-505, mir-542, mir-30e, mir-33b, mir-365, mir-758, mir-22, and mir-452 are of interest in the pathogenesis of hemangiosarcoma. CONCLUSIONS: Findings of this study confirm the hypothesis that miRNA expression profiles are different between canine splenic hemangiosarcoma, nodular hyperplasia, and normal spleens. A large portion of the differentially expressed miRNAs have roles in angiogenesis, with an additional group of miRNAs being dysregulated in vascular disease processes. Two other miRNAs have been implicated in cancer pathways such as PTEN and cell cycle checkpoints. The finding of multiple miRNAs with roles in angiogenesis and vascular disease is important, as hemangiosarcoma is a tumor of endothelial cells, which are driven by angiogenic stimuli. This study shows that miRNA dysregulation is a potential player in the pathogenesis of canine splenic hemangiosarcoma.

Programmatic Use of Molecular Xenomonitoring at the Level of Evaluation Units to Assess Persistence of Lymphatic Filariasis in Sri Lanka.

BACKGROUND: Sri Lanka's Anti Filariasis Campaign distributed 5 rounds of mass drug administration (MDA with DEC plus albendazole) to all endemic regions in the country from 2002-2006. Post-MDA surveillance results have generally been encouraging. However, recent studies have documented low level persistence of Wuchereria bancrofti in Galle district based on comprehensive surveys that include molecular xenomonitoring (MX, detection of filarial DNA in mosquitoes) results. The purposes of this study were to demonstrate the use of MX in large evaluation units (EUs) and to field test different mosquito sampling schemes. METHODOLOGY/PRINCIPAL FINDINGS: Galle district (population 1.1 million) was divided into two EUs. These included a coastal EU with known persistent LF and an inland EU with little persistent LF. Mosquitoes were systematically sampled from ~300 trap locations in 30 randomly selected clusters (health administrative units) per EU. Approximately 28,000 Culex quinquefasciatus were collected with gravid traps and tested for filarial DNA by qPCR. 92/625 pools (14.7%) from the coastal EU and 8/583 pools (1.4%) from the inland EU were positive for filarial DNA. Maximum likelihood estimates (MLE) for filarial DNA rates were essentially the same when the same number of mosquito pools were collected and tested from 75, 150, or 300 trap sites (range 0.61-0.78% for the coastal EU and 0.04-0.07% for the inland EU). The ability to use a smaller number of trap sites reduces the cost and time required for mosquito sampling. CONCLUSIONS/SIGNIFICANCE: These results suggest there is widespread persistence of W. bancrofti infection in the coastal Galle EU 8 years after the last round of MDA in 2006, and this is consistent with other data from the district. This study has shown that MX can be used by national programs to assess and map the persistence of W. bancrofti at the level of large EUs in areas with Culex transmission.

Effect of histologic processing on dimensions of skin samples obtained from cat cadavers.

OBJECTIVE To determine changes in dimensions of feline skin samples as a result of histologic processing and to identify factors that contributed to changes in dimensions of skin samples after sample collection. SAMPLE Cadavers of 12 clinically normal cats. PROCEDURES Skin samples were obtained bilaterally from 3 locations (neck, thorax, and tibia) of each cadaver; half of the thoracic samples included underlying muscle. Length, width, and depth were measured at 5 time points (before excision, after excision, after application of ink to mark tissue margins, after fixation in neutral-buffered 10% formalin for 36 hours, and after completion of histologic processing and staining with H&E stain). Measurements obtained after sample collection were compared with measurements obtained before excision. RESULTS At the final time point, tissue samples had decreased in length (mean decrease, 32.40%) and width (mean decrease, 34.21%) and increased in depth (mean increase, 54.95%). Tissue from the tibia had the most shrinkage in length and width and that from the neck had the least shrinkage. Inclusion of underlying muscle on thoracic skin samples did not affect the degree of change in dimensions. CONCLUSIONS AND CLINICAL RELEVANCE In this study, each step during processing from excision to formalin fixation and histologic processing induced changes in tissue dimensions, which were manifested principally as shrinkage in length and width and increase in depth. Most of the changes occured during histologic processing. Inclusion of muscle did not affect thoracic skin shrinkage. Shrinkage should be a consideration when interpreting surgical margins in clinical cases. 945).

A multi-institutional prospective trial in the USA confirms that the 4Kscore accurately identifies men with high-grade prostate cancer.

BACKGROUND: The 4Kscore combines measurement of four kallikreins in blood with clinical information as a measure of the probability of significant (Gleason ≥7) prostate cancer (PCa) before prostate biopsy. OBJECTIVE: To perform the first prospective evaluation of the 4Kscore in predicting Gleason ≥7 PCa in the USA. DESIGN, SETTING, AND PARTICIPANTS: Prospective enrollment of 1012 men scheduled for prostate biopsy, regardless of prostate-specific antigen level or clinical findings, was conducted at 26 US urology centers between October 2013 and April 2014. INTERVENTION: The 4Kscore. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome was Gleason ≥7 PCa on prostate biopsy. The area under the receiver operating characteristic curve, risk calibration, and decision curve analysis (DCA) were determined, along with comparisons of probability cutoffs for reducing the number of biopsies and their impact on delaying diagnosis. RESULTS AND LIMITATIONS: Gleason ≥7 PCa was found in 231 (23%) of the 1012 patients. The 4Kscore showed excellent calibration and demonstrated higher discrimination (AUC 0.82) and net benefit compared to a modified Prostate Cancer Prevention Trial Risk Calculator 2.0 model and standard of care (biopsy for all men) according to DCA. A possible reduction of 30-58% in the number biopsies was identified with delayed diagnosis in only 1.3-4.7% of Gleason ≥7 PCa cases, depending on the threshold used for biopsy. Pathological assessment was performed according to the standard of care at each site without centralized review. CONCLUSION: The 4Kscore showed excellent diagnostic performance in detecting significant PCa. It is a useful tool in selecting men who have significant disease and are most likely to benefit from a prostate biopsy from men with no cancer or indolent cancer. PATIENT SUMMARY: The 4Kscore provides each patient with an accurate and personalized measure of the risk of Gleason ≥7 cancer to aid in decision-making regarding the need for prostate biopsy.

Role of surgery in multimodal cancer therapy for small animals.

Surgery is a critical component in the treatment of most solid tumors in small animals. Surgery is increasingly combined with adjuvant therapies such as chemotherapy and radiation so surgeons who are treating cancer must have a good understanding of surgical oncology principles, cancer biology, and the roles and potential interactions of surgery, radiation, and chemotherapy. The sequencing plan for these modalities should be determined before treatment is initiated. The surgical oncologist must have a working knowledge of chemotherapy agents and radiation and the effect of these treatments on the ability of tissues to heal and the outcome for the patient.

Hemipelvectomy: outcome in 84 dogs and 16 cats. A veterinary society of surgical oncology retrospective study.

OBJECTIVE: To report clinical findings, perioperative complications and long-term outcome in dogs and cats that had hemipelvectomy surgery for treatment of neoplasia. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Dogs (n = 84) and cats (16). METHODS: Medical records (January 2000 to December 2009) of dogs and cats that had hemipelvectomy at participating institutions were reviewed. Postoperative progress and current status of the patient at the time of the study was determined by either medical record review, or via telephone contact with the referring veterinarian or owner. RESULTS: Complications were infrequent and usually minor. Hemorrhage was the main intraoperative complication; 2 dogs required blood transfusion. One dog developed an incisional hernia. In dogs, hemangiosarcoma had the worst prognosis with a median survival time (MST) of 179 days. MST for chondrosarcoma (1232 days), osteosarcoma (533 days), and soft tissue sarcoma (373 days) were not statistically different. Median disease-free interval (DFI) for local recurrence of all tumor types was 257 days. Cats had 75% survival at 1 year, which was significantly longer than dogs. CONCLUSIONS: Survival times for most tumor types can be good, but surgical margins should be carefully evaluated to ensure complete tumor removal. Adjuvant therapies may be advisable particularly for dogs to reduce rates of local recurrence or distant metastasis.

PCA3 molecular urine test as a predictor of repeat prostate biopsy outcome in men with previous negative biopsies: a prospective multicenter clinical study.

PURPOSE: We evaluated the clinical usefulness of the PROGENSA® PCA3 Assay for predicting repeat prostate biopsy outcome. MATERIALS AND METHODS: Men with at least 1 prior negative prostate biopsy who were scheduled for repeat prostate biopsy based on best clinical judgment were enrolled at 14 centers. Whole blood and post-digital rectal examination urine samples were collected before extended template transrectal biopsy with 12 or more cores. Urinary PCA3 scores and biopsy outcomes were assessed by logistic regression analysis, which also included age, race, serum prostate specific antigen, clinical stage, family history of prostate cancer and the number of previous negative biopsy sessions. RESULTS: A total of 466 men were included in study and prostate cancer was identified in 21.9%. A PCA3 score cutoff of 25 yielded 77.5% sensitivity, 57.1% specificity, and negative and positive predictive values of 90% and 33.6%, respectively. On multivariable logistic regression men with a PCA3 score of less than 25 were 4.56 times as likely to have a negative repeat biopsy as men with a score of 25 or greater. PCA3 score significantly increased the predictive accuracy of the logistic regression model. At 90% sensitivity adding the PCA3 score to the model increased specificity, and positive and negative predictive values by 22.6%, 6.4% and 7.1%, respectively, relative to the model without the PCA3 score. CONCLUSIONS: The PCA3 score supplements serum prostate specific antigen and other clinical information to provide more accurate prediction of repeat biopsy outcome. Thus, it provides clinicians and patients with independent, clinically useful information to make more informed repeat biopsy decisions.

Ex vivo viability of canine and feline sarcomas: a pilot study.

Assay-based chemotherapeutic protocols are common in human gynecologic oncology, most notably for patients with ovarian or breast cancer. The current study examines ex vivo incubation conditions necessary for the assessment of sarcomatous tumor response to potential chemotherapeutic drugs. Slices of sarcomatous tumors were incubated in one of two culture media. Viability indices were measured and compared across time and between media. Neither medium was sufficient to support the growth of sarcomatous tumor tissue slices based on the indices studied. It is likely that sarcomatous tumors require a different approach for ex vivo assessment than their epithelial counterparts. Our long-term goal is to incubate tumor slices with chemotherapeutic agents to predict the in vivo tumor response based on the maintenance or loss of slice viability within this system.

Determinants of success in national programs to eliminate lymphatic filariasis: a perspective identifying essential elements and research needs.

The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000. To understand why some national programs have been more successful than others, a panel of individuals with expertise in LF elimination efforts met to assess available data from programs in 8 countries. The goal was to identify: 1) the factors determining success for national LF elimination programs (defined as the rapid, sustained reduction in microfilaremia/antigenemia after repeated mass drug administration [MDA]); 2) the priorities for operational research to enhance LF elimination efforts. Of more than 40 factors identified, the most prominent were 1) initial level of LF endemicity; 2) effectiveness of vector mosquitoes; 3) MDA drug regimen; 4) population compliance. Research important for facilitating program success was identified as either biologic (i.e., [1] quantifying differences in vectorial capacity; [2] identifying seasonal variations affecting LF transmission) or programmatic (i.e., [1] identifying quantitative thresholds, especially the population compliance levels necessary for success, and the antigenemia or microfilaremia prevalence at which MDA programs can stop with minimal risk of resumption of transmission; [2] defining optimal drug distribution strategies and timing; [3] identifying those individuals who are "persistently non-compliant" during MDAs, the reasons for this non-compliance and approaches to overcoming it). While addressing these challenges is important, many key determinants of program success are already clearly understood; operationalizing these as soon as possible will greatly increase the potential for national program success.

Differences in cutaneous wound healing between dogs and cats.

Regardless of the species involved, wound healing follows a predictable course of overlapping phases. In spite of these commonalities, significant species differences in cutaneous wound healing have been uncovered in the Equidae and, more recently, between the dog and cat. It has also recently been shown that the subcutaneous tissues play an important supporting role in cutaneous wound healing, which may help to ex-plain healing differences between cats and dogs. These discoveries may improve veterinarians' understanding of problem wound healing in the cat and, hopefully, lead to better strategies for wound management in this sometimes troublesome species.

Comparison of the role of the subcutaneous tissues in cutaneous wound healing in the dog and cat.

OBJECTIVE: To describe and compare the contribution of the subcutaneous tissues to 1st and 2nd intention cutaneous wound healing in the dog and cat. STUDY DESIGN: Experimental study. ANIMALS: Domestic shorthaired cats (n=6) and 6 beagle dogs. METHODS: Paired wounds were created on either side of the dorsal midline; the subcutaneous tissue was removed on 1 side and left intact on the other. Square, open wounds of the dorsal aspect of the thorax were observed for 21 days to monitor granulation tissue formation, wound contraction, epithelialization, and total healing (contraction+epithelialization). Breaking strength of sutured linear wounds was measured 7 days after wounding. Laser-Doppler perfusion imaging (LDPI) was used to measure cutaneous perfusion. RESULTS: First intention healing: subcutaneous tissue removal had no consistent effect on sutured wound strength at 7 days in dogs or cats. Second intention healing: removal of subcutaneous tissue reduced wound perfusion, granulation, contraction, epithelialization, and total healing. Granulation tissue formation and wound contraction were delayed to a significantly greater degree in cats than in dogs (P<.05). Two dogs (33%) had minor wound infections. CONCLUSIONS: The subcutaneous tissues make an important contribution to 2nd intention cutaneous healing. Dog and cat wounds had delayed 2nd intention healing when subcutaneous tissues were removed; wounds in dogs, but not cats, had largely recovered from this delay by 21 days. CLINICAL RELEVANCE: Extensive debridement of subcutaneous tissue may delay wound healing particularly in feline patients. A higher risk for wound infections may accompany extensive removal of subcutaneous tissues in dogs.

Buried tension sutures: force-tension comparisons of pulley, double butterfly, mattress, and simple interrupted suture patterns.

OBJECTIVES: To compare suture patterns (simple interrupted, modified pulley, horizontal mattress, double butterfly) by use of a novel in vitro model that quantifies force required for closure against tension. STUDY DESIGN: In vitro study. SAMPLE POPULATION: Suture constructs. METHODS: An in vitro suturing frame was constructed with extension springs to provide a standard resistance against movement of 2 panels of loops toward each other. Four different suture patterns were applied to the frame in randomized trials. The frame was affixed to a tensiometer that measured the force required for each suture pattern to close a fixed distance (3.81 cm) at a constant rate (5.08 cm/min) against the tension (0.6 kg/cm) of the extension springs. The closure distance and tension were selected subjectively to mimic tension encountered clinically during wound reconstruction oncologic surgical procedures. RESULTS: The modified pulley suture required the least force to close, followed by the double butterfly, simple interrupted, and horizontal mattress patterns. CONCLUSIONS: The modified pulley suture and double butterfly suture patterns require less force to close a given distance under tension than either simple interrupted or horizontal mattress suture patterns. CLINICAL RELEVANCE: Application of tension relieving suture techniques for fascia, subcutaneous, and buried-knot subdermal suturing should be considered to facilitate direct closure of wounds under tension. Modified pulley and double butterfly suture patterns offer some mechanical advantage by requiring less force to achieve closure compared with other suture patterns that might be used in reconstructive surgery.

Bilateral rostral maxillectomy and nasal planectomy for large rostral maxillofacial neoplasms in six dogs and one cat.

This paper describes in detail an aggressive rostral maxillectomy procedure in one cat and six dogs, and the postoperative complications and outcomes are reported. The surgeries were performed to attempt complete excision of large and extensive rostral maxillary fibrosarcomas (n=4), squamous cell carcinomas (n=2), or poorly differentiated mesenchymal neoplasia (n=1). The surgeries involved transection of the maxilla at the level of premolar (PM)1 and PM2 in a cat and two dogs, and between PM2 and PM3 in four dogs. There were no intraoperative complications. Complete margins of resection were obtained in all cases. The postoperative appearance was acceptable to owners. Local recurrence was only observed in one dog (10 months after surgery) during a follow-up period of 11 to 66 months (median, 21.5 months).