Treatment of retroperitoneal sarcoma results in improved outcomes.

OBJECTIVE: To report the clinical characteristics, treatments, and outcomes in a cohort of dogs with histologically confirmed retroperitoneal sarcoma (RPS) and to identify potential variables of prognostic significance. ANIMALS: 46 client-owned dogs from 10 clinics with histopathologic diagnosis of a sarcoma originating from the retroperitoneal space. METHODS: Medical records were retrospectively reviewed to obtain information regarding clinical characteristics, treatments, and outcomes. Recorded variables were analyzed to report descriptive data for all cases and overall survival time. Multivariate analysis was utilized to evaluate prognostic factors for overall survival. RESULTS: Hemangiosarcoma was the most common histologic subtype diagnosed (76.1%). Cytoreductive and curative intent surgical excision of the RPS was attempted in 12 and 22 dogs, respectively; 12 dogs underwent no surgery or had an exploratory laparotomy with incisional biopsy only. Nineteen dogs received adjuvant chemotherapy, either injectable or metronomic, and 1 dog received adjuvant radiation therapy. Fourteen of the 34 (41.2%) surgically treated dogs developed evidence of local recurrence, but there was no difference in local recurrence when comparing dogs categorized as curative intent versus cytoreductive surgery. The median overall survival time was 238 days. On multivariable analysis, treatment approach was associated with survival with surgical excision (vs palliative treatment) and adjuvant chemotherapy following surgery being protective against death. A diagnosis of hemangiosarcoma was associated with a greater hazard of death. CLINICAL RELEVANCE: This study demonstrates a substantially greater survival time than previously published and suggests a survival benefit from surgical excision and adjuvant chemotherapy.

Risk factors influencing death prior to discharge in 302 dogs undergoing unilateral adrenalectomy for treatment of primary adrenal gland tumours.

Adrenalectomies for canine adrenal tumours are associated with peri-operative morbidity and mortality. Objectives of this study included assessing the prognostic value of tumour- or surgery-related variables in predicting peri-operative mortality and overall survival in dogs undergoing adrenalectomies for primary adrenal tumours as well as pre-treatment with phenoxybenzamine on survival to discharge with pheochromocytomas specifically. A multi-institutional retrospective cohort study was performed across nine institutions. Electronic medical record searches identified 302 dogs which met the inclusion criteria. Data collected included dog-related, tumour-related, treatment-related, surgery-related, and outcome variables. Univariate and multivariable logistic regression and cox proportional hazards models were used to identify variables associated with death prior to discharge and tumour-related survival. Overall, 87% of dogs survived to discharge with a tumour-related survival time of 3.96 years. Post-operative complications were reported in 25%. Increased surgical time (p = 0.002) and pre-surgical medical treatment other than phenoxybenzamine (p = 0.024) were significantly associated with increased peri-operative mortality while ureteronephrectomy (p = 0.021), post-operative pancreatitis (p = 0.025), and post-operative aspiration pneumonia (p < 0.001) were significantly associated with decreased overall survival. Phenoxybenzamine pretreatment had no effect on peri-operative mortality. Thirty-seven of 45 (82%) dogs with pheochromocytomas not pretreated survived to discharge, and 50 of 59 (85%) dogs with pheochromocytomas pretreated with phenoxybenzamine survived to discharge (p = 0.730). This study provides information on risk factors for death prior to discharge and tumour-related survival that may help guide clinical management and owner expectations. In addition, the study findings challenge the previously reported benefit of phenoxybenzamine for pretreatment of dogs undergoing adrenalectomies for pheochromocytomas.

Retrospective study of 20 cats surgically treated for insulinoma.

OBJECTIVE: To report the clinical signs, histopathology results, and prognostic factors for outcomes following excision for feline insulinoma (INS). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Twenty client-owned cats. METHODS: Medical records from 2006 to 2020 were reviewed by Veterinary Society of Surgical Oncology members for cats with hypoglycemia resulting from INS, with surgical excision and follow up. Clinical signs and histopathology results were summarized. Factors potentially related to disease-free interval (DFI), disease-related death (DRD), and overall survival time (OST) were analyzed with a Cox proportional hazards regression analysis. RESULTS: All cats were hypoglycemic on presentation with neurologic signs in 18 out of 20 and inappropriate insulin levels in 12/13. Excision of insulinomas resulted in immediate euglycemia or hyperglycemia in 18 cats. Eighteen cats survived to hospital discharge. The median time to death or last postoperative follow up was 664 days (range: 2-1205 days). Prognostic factors included age at presentation (for DFI); time to postoperative euglycemia (for DRD); preoperative and postoperative serum blood glucose concentrations; metastasis at the time of surgery (DFI and DRD), and histopathologic tumor invasion (for OST). The median OST for all cats was 863 days. The 1-, 2- and 3-year survival rates were 75%, 51%, and 10%, respectively. CONCLUSION: Excision of insulinoma resulted in euglycemia or hyperglycemia in most cats. Negative prognostic factors included young age, low serum glucose concentrations, metastasis at time of surgery, tumor invasion, and shorter time to euglycemia. CLINICAL SIGNIFICANCE: Surgical excision resulted in survival times comparable to those of canine INS.

Comparison between propofol and alfaxalone anesthesia for the evaluation of laryngeal function in healthy dogs utilizing computerized software.

Laryngeal paralysis is a well-documented cause of upper respiratory tract obstruction in canines. Diagnosis of laryngeal paralysis is usually made by visual evaluation of laryngeal motion whilst patients are under a light-plane of anesthesia. However, in human studies of laryngeal function evaluation, it has been shown that subjective scoring can lead to significant interobserver variance, which may cause false diagnosis. In this study, we propose to introduce a more objective method of assessing laryngeal function using GlotAnTools and Tracker software to directly measure laryngeal motion in anaesthetized patients. Additionally, two anesthetic agents, alfaxalone and propofol, were compared in this study to assess their relative effect on laryngeal motion and thus their suitability for use in this diagnostic process. This study was a two-stage, cross-over, 1:1 randomization, with two active treatment arms. Ten beagles (10-18 months, five males and five females) were exposed to both anesthetic agents and laryngeal motion was recorded using videoendoscopy. GlotAnTools and Tracker software were applied to the recorded images to measure glottal gap area (A) and length (L). A normalized measure of laryngeal function-computed as A/L-was created, representing the "elongatedness" of the rima glottidis. The glottal gap area was significantly reduced in dogs receiving alfaxalone. This study objectively establishes that alfaxalone impacted laryngeal motion significantly more than propofol and confirms the capability of these computational methods to detect differences in laryngeal motion.

Outcome with surgical treatment of canine soft tissue sarcoma in the region of the ischiatic tuberosity: A veterinary society of surgical oncology retrospective study.

The aim of this study was to determine the outcome of dogs with soft tissue sarcoma (STS) within the region of the ischiatic tuberosity (ITSTS) treated surgically. This was a multi-institutional retrospective study. Fifty-two dogs met the inclusion criteria, which were: histologically confirmed STS in the region of the IT treated with surgical resection between March 1st, 2009 and March 1st, 2021 with a minimum follow-up time of 6 months. Data collected included patient signalment, preoperative diagnostics, surgical intent/method, surgical complications, histopathology, margins, outcome and cause of death. Statistical analyses were performed to determine significant factors in the treatment and prognosis of ITSTS. Overall survival time (OST) and disease progression were negatively associated with tumour grade, while recurrence was positively associated with grade and incomplete margins. Of the 52 included dogs, there were 24 grade I, 20 grade II and 7 grade III tumours. Forty dogs had reported histopathologic margins of which 26 were reported to be complete and 14 were incomplete. OST and progression-free survival was not reached for tumours graded as I or II and was 255 and 268 days respectively, for grade III. Median time to recurrence was not reached for tumours excised with complete margins and was 398 days for those with incomplete margins. The surgical complication rate was 25%. ITSTS was not found to be a unique clinical entity in dogs as tumour behavior, treatment recommendations, and prognosis were similar to STS in other locations, with overall outcome and prognosis influenced by histologic grade and margins. While surgical complications were common, none resulted in significant morbidity or mortality.

Diagnostic accuracy of optical coherence tomography for surgical margin assessment of feline injection-site sarcoma.

The invasive, locally aggressive nature of feline injection-site sarcomas (FISSs) poses a unique challenge for surgeons to obtain complete margins with surgical excision. Optical coherence tomography (OCT), an imaging technology that uses light waves to generate real-time views of tissue architecture, provides an emerging solution to this dilemma by allowing fast, high-resolution scanning of surgical margins. The purpose of this study was to use OCT to assess surgical margins of FISS and to evaluate the diagnostic accuracy of OCT for detecting residual cancer using six evaluators of varying experience. Five FISSs were imaged with OCT to create a training set of OCT images that were compared with histopathology. Next, 25 FISSs were imaged with OCT prior to histopathology. Six evaluators of varying experience participated in a training session on OCT imaging after which each of the evaluators was given a dataset that included OCT images and videos to score on a scale from cancerous to non-cancerous. Diagnostic accuracy statistics were calculated. The overall sensitivity and specificity for classification of OCT images by evaluators were 78.9% and 77.6%, respectively. Correct classification rate of OCT images was associated with experience, while individual sensitivities and specificities had more variation between experience groups. This study demonstrates the ability of evaluators to correctly classify OCT images with overall low levels of experience and training and also illustrates areas where increased training can improve accuracy of evaluators in interpretation of OCT surgical margin images.

Ventilatory failure in a cat following radical chest wall resection for feline injection site sarcoma.

CASE SUMMARY: A 12-year-old spayed female domestic shorthair cat presented for chest wall resection and radiation therapy following incomplete surgical excision of a feline injection site sarcoma. A CT scan for surgical planning was performed under general anesthesia and showed extensive tumor infiltration of the soft tissues of the right thorax. The cat recovered uneventfully from this anesthetic event. Nineteen days later, the patient was reanesthetized for forequarter amputation plus radical chest wall resection, including ribs 3-8 and all associated soft tissues plus adjacent spinous processes. Postoperatively, the patient developed acute respiratory failure secondary to hypoventilation. The cat was mechanically ventilated for 12 h prior to being successfully weaned from the ventilator. However, the improvement was transient and mechanical ventilation was reinitiated 6 h later owing to respiratory fatigue. On the second day, the cat developed unexplained central nervous system signs and was euthanized. RELEVANCE AND NOVEL INFORMATION: To our knowledge, this is the first case report to describe ventilatory failure secondary to radical chest wall resection in a cat. Hypoventilation with subsequent need for mechanical ventilation is a potential complication that should be considered during preoperative planning in patients requiring extensive chest wall resections.

Zürich cementless total hip arthroplasty as a treatment option for capital physeal fractures in dogs: Outcome in 53 cases.

OBJECTIVE: To review the outcome of dogs that underwent Zürich cementless total hip arthroplasty (Z-THA) for the repair of acute and chronic capital physeal fractures (CPF) and document the CPF-related hip remodeling. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Fifty-three Z-THA in 53 dogs. METHODS: Medical records of dogs (2006-2019) that underwent Z-THA for CPF management were reviewed. Dogs were divided into two groups on the basis of the days elapsed between CPF diagnosis and Z-THA, acute (≤30 days) and chronic (>30 days). Hip remodeling variables were determined from preoperative radiographs or intraoperatively. Descriptive statistics were performed, and the complication rates, outcome, and coxofemoral remodeling were recorded. Comparisons of remodeling variables and rates between groups were performed by using Fisher's exact test. RESULTS: In total, 23 of 53 (43.4%) cases were acute, and 30 of 53 (56.6%) cases were chronic. There was no difference in the femoral remodeling rates between the acute and chronic groups (P = .184), whereas acetabular remodeling was more prevalent in the chronic group (P < .001). Intraoperative complications occurred in four of 53 (7.5% [1/23 acute, 3/30 chronic]) cases, and postoperative complications occurred in six of 53 (11.3% [2/23 acute, 4/30 chronic]) cases. Good clinical outcomes were achieved in 51 of 53 (96.2% [21 acute, 30 chronic]) cases. CONCLUSION: Complication rates of Z-THA for CPF repair were similar to the complication rates reported for Z-THA of dysplastic hips. Hip remodeling was common regardless of CPF chronicity. CLINICAL SIGNIFICANCE: Zürich cementless total hip arthroplasty is viable for surgical management of CPF. There is a high likelihood that hip remodeling will be encountered, even in fractures treated within 30 days of presenting for hind limb lameness.

Effects of stylet-in versus stylet-out collection of cerebrospinal fluid from the cisterna magna on contamination of samples, sample quality, and collection time.

OBJECTIVE: To evaluate safety of stylet-in and stylet-out techniques for collection of CSF from the cisterna magna and to assess whether there were differences between techniques with regard to contamination of samples, sample quality, and efficiency of collection. ANIMALS: 10 adult purpose-bred research Beagles. PROCEDURES: A prospective crossover study was conducted. Preanesthetic physical and neurologic examinations and hematologic analyses were performed. Dogs were anesthetized, and collection of CSF samples from the cisterna magna by use of a stylet-in or stylet-out technique was performed. Two weeks later, samples were collected with the other sample collection technique. Samples of CSF were processed within 1 hour after collection. RESULTS: Cellular debris was detected in higher numbers in stylet-in samples, although this did not affect sample quality. The stylet-out technique was performed more rapidly. No adverse effects were detected for either technique. CONCLUSIONS AND CLINICAL RELEVANCE: Both techniques could be safely performed in healthy anesthetized dogs. The stylet-out technique was performed more rapidly and yielded a sample with less cellular debris. Both techniques can be used in clinical practice to yield CSF samples with good diagnostic quality.

Fine-needle aspiration of cutaneous, subcutaneous, and intracavitary masses in dogs and cats using 22- vs 25-gauge needles.

BACKGROUND: Fine-needle aspiration (FNA) is a common procedure as a diagnostic tool in veterinary medicine. However, it is unclear whether the gauge of the needle affects the quality of cytology. OBJECTIVE: This study compared the quality of cytologic samples obtained via FNA using 22- or 25-gauge needles. METHODS: Fine-needle aspiration was performed on 50 masses (cutaneous, subcutaneous, or intracavitary) obtained from client-owned animals. The size of the needle was randomly assigned using either of the following two sequences: 22-25-22 gauge or 25-22-25 gauge. Samples were evaluated by two board-certified clinical pathologists to assess cellularity, blood contamination, amount of cellular debris, degree of cellular trauma, and the overall ability to make a diagnosis for each sample. RESULTS: No significant difference was detected between the 22- and 25-gauge needle samples for cellularity, whereas a significant difference was present for blood contamination, amount of cellular debris, and degree of cellular trauma. The overall ability to make a diagnosis was not significantly affected by the needle gauge. The degree of cellular trauma was significantly increased in intracavitary samples. CONCLUSIONS AND CLINICAL RELEVANCE: Needle gauge is a contributing factor to FNA sample quality. However, it did not affect the overall ability to make a diagnosis. Samples obtained using 25-gauge needles resulted in less blood contamination yet increased cellular trauma compared to 22-gauge needle samples.

Histologic evaluation of mandibular and medial retropharyngeal lymph nodes during staging of oral malignant melanoma and squamous cell carcinoma in dogs.

OBJECTIVE: To assess histologic evaluation of mandibular lymph nodes (MLNs) and medial retropharyngeal lymph nodes (MRLNs) for metastatic disease during tumor staging for dogs with oral malignant melanoma (OMM) and oral squamous cell carcinoma (OSCC). DESIGN: Retrospective multi-institutional study. ANIMALS: 27 dogs with OMM and 21 dogs with OSCC. PROCEDURES: Medical record databases of 8 institutions were searched to identify dogs with OMM or OSCC that underwent unilateral or bilateral extirpation of the MLNs and MRLNs during the same procedure between January 2004 and April 2016. Information extracted from the records included signalment, primary mass location and size, diagnostic imaging results, histologic results for the primary tumor and all lymph nodes evaluated, and whether distant metastasis developed. RESULTS: Prevalence of lymph node metastasis did not differ significantly between dogs with OMM (10/27 [37%]) and dogs with OSCC (6/21 [29%]). Distant metastasis was identified in 11 (41%) dogs with OMM and was suspected in 1 dog with OSCC. The MRLN was affected in 13 of 16 dogs with lymph node metastasis, and 3 of those dogs had metastasis to the MRLN without concurrent metastasis to an MLN. Metastasis was identified in lymph nodes contralateral to the primary tumor in 4 of 17 dogs that underwent contralateral lymph node removal. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated histologic evaluation of only 1 MLN was insufficient to definitively rule out lymph node metastasis in dogs with OMM or OSCC; therefore, bilateral lymphadenectomy of the MLN and MRLN lymphocentra is recommended for such dogs.

Apocrine gland anal sac adenocarcinoma in cats: 30 cases (1994-2015).

OBJECTIVE To describe the signalment, clinical signs, biological behavior, and outcome for cats with apocrine gland anal sac adenocarcinoma (AGASACA) that underwent surgical excision. DESIGN Retrospective case series. ANIMALS 30 client-owned cats. PROCEDURES Databases of 13 Veterinary Society of Surgical Oncology member-affiliated institutions were searched for records of cats with a histologic diagnosis of AGASACA that underwent tumor excision. For each cat, information regarding signalment, clinical signs, diagnostic test results, treatment, and outcome was extracted from the medical record. The Kaplan-Meier method was used to determine median time to local recurrence (TLR), disease-free interval (DFI), and survival time. Cox regression was used to identify factors associated with TLR, DFI, and survival time. RESULTS Perineal ulceration or discharge was the most common clinical sign in affected cats. Eleven cats developed local recurrence at a median of 96 days after AGASACA excision. Incomplete tumor margins and a high nuclear pleomorphic score were risk factors for local recurrence. Nuclear pleomorphic score was negatively associated with DFI. Local recurrence and a high nuclear pleomorphic score were risk factors for death. Median DFI and survival time were 234 and 260 days, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that, in cats, perineal ulceration or discharge should raise suspicion of AGASACA and prompt rectal and anal sac examinations. Local recurrence was the most common life-limiting event in cats that underwent surgery for treatment of AGASACA, suggesting that wide margins should be obtained whenever possible during AGASACA excision. Efficacy of chemotherapy and radiation therapy for treatment of cats with AGASACA requires further investigation. (J Am Vet Med Assoc 2019;254:716-722).

Influence of fixation systems on complications after tibial plateau leveling osteotomy in dogs greater than 45.4 kilograms (100 lb).

OBJECTIVE: To determine the influence of 3 fixation systems on complications rate after tibial plateau leveling osteotomy (TPLO) in dogs >45.4 kg. STUDY DESIGN: Retrospective case series. SAMPLE POPULATION: Dogs (N = 287, 342 stifles) >45.4 kg with cranial cruciate ligament tear treated with TPLO. METHODS: The medical records of dogs treated with TPLO were reviewed for fixation and postoperative complications, with a follow-up of at least 6 weeks. A random effects logistic regression model was used to evaluate the association between the type of TPLO fixation system and complications. RESULTS: The fixation systems included a 3.5-mm broad TPLO plate alone (8P; 78.4%), a 3.5-mm broad TPLO plate with SOP (String of Pearls) plate (8AP; 14.9%), and a 3.5-mm standard TPLO plate (6P; 6.7%). Among the included stifles, 214 (62.6%) fixation systems were classified as locking, and 128 (37.4%) were classified as nonlocking. The fixation system was predictive of complications. The 8P had the lowest odds ratio for complication among the 3 fixation systems. Odds of developing complications were higher with the 8AP fixation system than with the 8P fixation system. Locking fixation eliminated the association between weight and complication rate. CONCLUSION: Fixation of a TPLO with the 8AP increased the risk of complications compared with the 8P in this population of large dogs. CLINICAL SIGNIFICANCE: Locking fixation of TPLO with a 3.5-mm broad TPLO plate alone should be considered in large dogs because it may reduce complications.

Ulnar ostectomy decreases the stability of canine cadaver carpi as assessed with stress radiography.

Distal ulnar ostectomy may be performed palliatively in patients with distal ulnar osteosarcoma. Concurrent arthrodesis of the carpus has been proposed to counteract joint instability following transection of carpal ligaments associated with removal of the distal ulna. The objective of this prospective one group pretest, posttest study was to assess stability of the carpus following distal ulnar ostectomy using pre- and postoperative stress radiographic views in a group of canine cadaver limbs. Seven thoracic limbs from six canine cadavers weighing more than 20 kg were obtained. Lateral and dorsopalmar, extended lateral, medial stress, and lateral stress radiographs were made before and after distal ulnar ostectomy. Presurgical canine cadaver carpal angle measurements were as follows (mean ± standard deviation): extension 205.9° ± 5.4; medial stress 25.1° ± 5.7; and lateral stress 13.3° ± 5.2°. Cadaver limb joint angles exceeded those previously reported in live dogs. A significant increase in carpal angle was noted following ulnar ostectomy. The mean increases in carpal angle were as follows: (mean ± standard deviation (95% confidence interval)): extension 6.2° ± 4.9 (2.6-9.8) (P = 0.007); medial stress 3.2° ± 3.0 (1.0-5.5) (P = 0.015); lateral stress 6.2° ± 5.2 (2.4-10.1) (P = 0.010). Findings from this cadaver study support the use of supplementary stabilization for clinical patients undergoing distal ulnar ostectomy. Future studies are needed in clinical patients to evaluate changes in limb positioning and gait associated with distal ulnar ostectomy.

Effect of distal ulnar ostectomy on carpal joint stability during weight bearing in the dog.

OBJECTIVE: To assess the influence of a 50% distal ulnectomy on mediolateral carpal stability in the dog. STUDY DESIGN: Canine cadaveric study. SAMPLE POPULATION: Seven canine thoracic limbs METHODS: Thoracic limbs were placed in a jig to mimic weight bearing with a load representing 30% of body weight. Carpal extension angle was standardized at 190° ± 5°. Frontal plane carpal angles were measured with the limb loaded on craniocaudal radiographs before and after ulnectomy. Valgus and varus stress radiographs with the limb loaded were acquired before and after ulnectomy. The limbs were palpated and were subjectively graded for valgus or varus instability by 2 investigators before and after ulnectomy. RESULTS: Mean (±SD) valgus angulation increased after ulnectomy (2.1° ± 1.7°; P = .017; CI95 = 0.5°-3.7°) when the limb was loaded without valgus or varus stress applied. Mean valgus angulation increased after ulnectomy (2.7° ± 2.8°; P = .032; CI95 = -0.2°-5.5°) when valgus stress was applied to the loaded limb. Varus angulation was unchanged after ulnectomy (0.6° ± 4.6°; P = .383; CI95 = -4.2°-5.3°) when varus stress was applied to the loaded limb. Palpation detected increased valgus score after ulnectomy. CONCLUSION: Distal ulnectomy with excision of the lateral styloid process induces a slight increase in valgus in canine cadaver carpi. The clinical consequences of that valgus on carpal function and health should be assessed in clinical patients.

Long-Term Outcome and Complications Following Prophylactic Laparoscopic-Assisted Gastropexy in Dogs.

OBJECTIVE: To characterize the short- and long-term outcome (>12 months), complications, and owner satisfaction following prophylactic laparoscopic-assisted gastropexy (LAG) in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n = 49). METHODS: Dogs that underwent prophylactic LAG at 2 veterinary academic hospitals were studied. Surgical time, anesthesia time, concurrent intra- and extra-abdominal procedures, and intraoperative and postoperative complications were recorded following review of medical records. Veterinarian and/or owner follow-up was obtained to determine outcome and satisfaction with LAG. RESULTS: Five of 49 dogs (10%) experienced complications related to abdominal access during LAG. Four percent (2/49) of dogs experienced an intraoperative complication. Follow-up information was available for 89% of dogs (44/49). Four dogs died of causes unrelated to LAG or gastric dilatation volvulus (GDV) in the follow-up period. Two dogs experienced major postoperative complications requiring additional veterinary intervention. Thirty percent (13 dogs) experienced a minor postoperative self-limiting wound-related complication. Median follow-up time was 698 days (range, 411-1825). No dogs experienced GDV. One hundred percent of dog owners were satisfied with LAG, would repeat the procedure in a future pet, and would recommend the procedure to a friend or family member. CONCLUSION: LAG was an effective procedure for prevention of GDV and was associated with high client satisfaction in this cohort of dogs. A moderate rate of postoperative wound complications occurred that were minor and self-limiting in nature.

Primary splenic torsion in dogs: 102 cases (1992-2014).

OBJECTIVE: To determine the percentage of dogs surviving to hospital discharge and identify factors associated with death prior to hospital discharge among dogs undergoing surgery because of primary splenic torsion (PST). DESIGN: Retrospective case series. ANIMALS: 102 client-owned dogs. PROCEDURES: Medical records of dogs with a confirmed diagnosis of PST that underwent surgery between August 1992 and May 2014 were reviewed. History, signalment, results of physical examination and preoperative bloodwork, method of splenectomy, concurrent surgical procedures, perioperative complications, duration of hospital stay, splenic histopathologic findings, and details of follow-up were recorded. Best-fit multivariate logistic regression was performed to identify perioperative factors associated with survival to hospital discharge. RESULTS: 93 of the 102 (91.2%) dogs survived to hospital discharge. German Shepherd Dogs (24/102 [23.5%]), Great Danes (15/102 [14.7%]), and English Bulldogs (12/102 [11.8%]) accounted for 50% of cases. Risk factors significantly associated with death prior to hospital discharge included septic peritonitis at initial examination (OR, 32.4; 95% confidence interval [CI], 2.1 to 502.0), intraoperative hemorrhage (OR, 22.6; 95% CI, 1.8 to 289.8), and postoperative development of respiratory distress (OR, 35.7; 95% CI, 2.7 to 466.0). Histopathologic evidence of splenic neoplasia was not found in any case. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the prognosis for dogs undergoing splenectomy because of PST was favorable. Several risk factors for death prior to discharge were identified, including preexisting septic peritonitis, intraoperative hemorrhage, and postoperative development of respiratory distress.

Appendicular osteosarcoma in small-breed dogs: 51 cases (1986-2011).

OBJECTIVE: To describe outcomes for small-breed dogs with appendicular osteosarcoma. DESIGN: Multi-institutional retrospective case series. ANIMALS: 51 small-breed dogs. PROCEDURES: Records from participating Veterinary Society of Surgical Oncology members were searched for dogs that weighed ≤ 15 kg (33 lb) with a histologic diagnosis of appendicular osteosarcoma. The Kaplan-Meier method was used to determine median survival times (MSTs), and Cox regression was performed to identify variables associated with survival time. RESULTS: Tumors were most commonly located on the humerus (n = 15) and femur (14). Of the 51 study dogs, 9 were treated nonsurgically, 16 underwent amputation of the affected limb only, and 26 underwent curative-intent treatment, with MSTs of 112, 257, and 415 days, respectively. The MST did not differ significantly between dogs in the amputation-only and curative-intent groups. For dogs in the nonsurgical group, MST decreased significantly as the tumor histologic score increased. For dogs in the amputation-only group, MST decreased as body weight increased. CONCLUSIONS AND CLINICAL RELEVANCE: For the small-breed dogs with appendicular osteosarcoma of the present study, tumor histologic grade and mitotic index were subjectively lower and MST following amputation of the affected limb without adjuvant chemotherapy was longer, compared with those for similarly affected larger dogs. Results indicated no significant advantage in MST for dogs that underwent curative-intent treatment versus dogs that underwent amputation only, and further investigation of the importance of adjuvant chemotherapy is warranted.

Stereotactic radiosurgery and fracture fixation in 6 dogs with appendicular osteosarcoma.

OBJECTIVE: To evaluate clinical outcome of dogs with appendicular osteosarcoma (OSA) treated with stereotactic radiosurgery (SRS) and subsequent internal fixation of a pathologic fracture. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs with spontaneous-occurring appendicular OSA (n = 6). METHODS: Medical records (May 2002-January 2008) of dogs that had SRS for appendicular OSA were reviewed. Dogs were included if they had a pathologic fracture either before or after SRS and were treated with internal fixation. Signalment, history, physical examination findings, clinicopathologic data, diagnostic imaging findings, biopsy results, surgical complications, number of surgeries, adjuvant therapy, development of metastatic disease and cause of death were recorded. RESULTS: Six dogs met the inclusion criteria. Two dogs had a pathologic fracture at admission and 4 dogs developed a fracture after SRS with a mean ± SD time to fracture development of 6.25 ± 1.65 months. The first 3 fractures were repaired using an open approach and the latter three using minimally invasive percutaneous osteosynthesis (MIPO). Infection occurred in 5 dogs and implant failure in 3. Limb function was subjectively assessed as good in all dogs when the implants were stable and infections were subclinical. Survival times ranged from 364-897 days; 1 dog was lost to follow-up. CONCLUSIONS: Fracture repair using internal fixation should be considered a viable limb-sparing alternative for pathologic fractures that have been treated with SRS.

Complications of reconstructive surgery in companion animals.

Factors that affect wound healing include the general health of the patient, nutritional status, and wound factors. Treatments such as corticosteroids, chemotherapy, or radiation are also common causes of delayed healing. Multimodal cancer treatment has become more common and the veterinary surgeon may be required to perform reconstructive procedures on an animal that has received or will receive chemotherapy and/or radiation treatments. Complications of reconstructive cutaneous procedures include seroma, hematoma formation, infection, wound dehiscence, distal tip necrosis of skin flaps, paresthesia, and free skin graft failure. Procedures such as maxillectomy or hemipelvectomy also have complications. Knowledge of common complications can facilitate client education and even allow the surgeon to avoid these complications.