Short-Term Complications following Single-Session versus Staged Bilateral Tibial Plateau Levelling Osteotomies Stabilized with Locking Plates for Treatment of Bilateral Cranial Cruciate Ligament Disease: A Retrospective Study.

OBJECTIVE: The aim of this study was to compare complications between dogs with bilateral cranial cruciate ligament disease treated with single-session bilateral tibial plateau levelling osteotomies (BSSTPLO) versus staged bilateral TPLO (STPLO) procedures stabilized with locking plates. STUDY DESIGN: Medical records of client-owned dogs treated with BSSTPLO or STPLO stabilized with locking plates between March 2017 and July 2018 at two associated institutions were reviewed. Patient data and complications from 37 dogs with BSSTPLO and 18 with STPLO were compared between groups. Major complications were defined as any complication that required further surgical or medical treatment whereas minor complications did not. RESULTS: Incidence for major complications for BSSTPLO and STPLO was 7/37 and 6/18 respectively. Incidence for minor complications for BSSTPLO and STPLO was 3/37 and 2/18 respectively. No significant differences in minor or major complication rates existed between study groups (p = 0.2). Mean body weight was significantly higher in the STPLO group (p = 0.001); however, no correlation between weight or BCS and complication rate existed within either group. Increasing age was the only significant risk factor for major complications (p = 0.01) in either group. CONCLUSION: Our findings support the claim that BSSTPLO and STPLO performed with locking implants have similar complication rates. The decision to perform BSSTPLO or STPLO in dogs with bilateral cranial cruciate ligament disease should be based on other considerations rather than just complication rates.

Outcomes and prognostic variables associated with central division hepatic lobectomies: 61 dogs.

OBJECTIVE: To determine the outcome and prognostic variables associated with long-term survival and complications in dogs undergoing hepatic lobectomy of the central division. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Sixty-one client-owned dogs with central division masses. METHODS: Medical records of dogs undergoing hepatic lobectomy of the central division from January 1, 2000 to January 1, 2015 were reviewed for signalment, clinical signs, preoperative staging, preoperative cytology or biopsy results, date of procedure, location of mass, surgical technique, whether cholecystectomy or cholecystopexy was performed, complications, histopathologic diagnosis and margin evaluation, date of local recurrence or detection of metastatic disease, and survival. RESULTS: Hilar resection was associated with increased intraoperative and postoperative complications. Intraoperative complications occurred in 29 dogs, with 20 dogs experiencing intraoperative hemorrhage. Nineteen dogs required transfusions. Immediate postoperative complications occurred in 20 dogs. Perioperative mortality rate was 11%, and 2-week mortality rate was 14.7%. The median survival time for dogs with hepatocellular carcinoma (HCC) was not reached. The 1- and 3-year censored survival rates for dogs with HCC was 82.1% and 82.1%, respectively. Margin status did not impact survival time. CONCLUSION: Hepatic lobectomy of the central division was associated with hemorrhage in approximately 33% of dogs, but there was a relatively low perioperative mortality rate. Hepatic lobectomy for HCC resulted in long-term survival, regardless of margin status. CLINICAL SIGNIFICANCE: Surgeons should anticipate the requirement for blood products in dogs that may require hepatic lobectomy of the central division. Long-term survival can be expected after surgical treatment of HCC, regardless of margin status.

Sternotomy and ventral slot decompression for treatment of T1-2 intervertebral disk disease in a Dachshund.

CASE DESCRIPTION A 9-year-old 7.5-kg (16.5-lb) castrated male Dachshund was referred for emergency evaluation of pelvic limb paraplegia of < 24 hours' duration. CLINICAL FINDINGS A spinal cord lesion between T3 and L3 was suspected given the dog's history and neurologic examination results. Computed tomography and myelography spanning T3 through L4 identified an extradural compressive lesion at the L3-4 disk space. Hemilaminectomy was performed, and disk material adhered to and compressing the spinal cord was identified. However, because the material appeared to have been present for an extended period, postoperative CT of the cervicothoracic region was performed, which revealed extrusion of disk material from the T1-2 space and marked spinal cord compression. TREATMENT AND OUTCOME A sternotomy of the manubrium and ventral slot decompression of the T1-2 disk space were performed successfully without entering the thoracic cavity. A large amount of disk material was removed from the spinal canal. No loss of intrathoracic negative pressure was appreciated, and intraoperative complications included only mild hemorrhage. The dog maintained pelvic limb pain sensation postoperatively and regained motor function 2 days after surgery. CLINICAL RELEVANCE Intervertebral disk disease is rare at T1-2 in Dachshunds. Typically, a dorsal approach has been used to decompress the spinal cord, but findings for this dog suggested that a ventral approach may also be appropriate. Consideration should be given to include the T1-2 disk space when performing advanced imaging in dogs because of the inconsistent ability to identify lesions at this location by means of neurologic examination.

Agreement Between Cytology and Histopathology for Regional Lymph Node Metastasis in Dogs With Melanocytic Neoplasms.

Melanocytic neoplasms are common in dogs and frequently occur within the oral cavity or in haired skin. The behavior of melanocytic neoplasms is variable and depends on tumor location, size, and histopathologic features. This study compared cytopathology and histopathology of 32 lymph nodes from 27 dogs diagnosed with melanocytic neoplasms. Agreement between the original cytology report, cytology slide review, original histopathology report, and histopathology slide review was determined for each lymph node. A subset of lymph nodes was subjected to immunohistochemistry (Melan-A) and additional histochemical stains/techniques (Prussian blue, bleach) to assist in differentiation of melanocytes and melanophages. Agreement ranged from slight to fair for each of the variables evaluated with weighted kappa (κw) or kappa (κ) analysis (original cytology vs cytology review κw = 0.24; original cytology vs original histopathology κw = 0.007; original cytology vs histopathology review κw = 0.23; cytology review vs original histopathology κw = 0.008; cytology review vs histopathology review κw = 0.006; and original histopathology vs histopathology review κ = 0.18). The diagnoses (metastatic, equivocal, or negative for metastasis) of the original report and slide review for both cytology and histopathology were not significantly correlated with survival in this population of patients. Overall, agreement between cytology and histopathology was poor even with a single clinical or anatomic pathologist performing slide review. Consensus between routine cytology and histopathology for staging of lymph nodes in patients with melanocytic neoplasms is poor and does not correlate with survival.

'Hygienic' lymphocytes convey increased cancer risk.

Risk of developing inflammation-associated cancers has increased in industrialized countries during the past 30 years. One possible explanation is societal hygiene practices with use of antibiotics and Caesarian births that provide too few early life exposures of beneficial microbes. Building upon a 'hygiene hypothesis' model whereby prior microbial exposures lead to beneficial changes in CD4+ lymphocytes, here we use an adoptive cell transfer model and find that too few prior microbe exposures alternatively result in increased inflammation-associated cancer growth in susceptible recipient mice. Specifically, purified CD4+ lymphocytes collected from 'restricted flora' donors increases multiplicity and features of malignancy in intestinal polyps of recipient ApcMin/+ mice, coincident with increased inflammatory cell infiltrates and instability of the intestinal microbiota. We conclude that while a competent immune system serves to maintain intestinal homeostasis and good health, under hygienic rearing conditions CD4+ lymphocytes instead exacerbate inflammation-associated tumorigenesis, subsequently contributing to more frequent cancers in industrialized societies.

Pathogenic intestinal bacteria enhance prostate cancer development via systemic activation of immune cells in mice.

A role for microbes has been suspected in prostate cancer but difficult to confirm in human patients. We show here that a gastrointestinal (GI) tract bacterial infection is sufficient to enhance prostate intraepithelial neoplasia (PIN) and microinvasive carcinoma in a mouse model. We found that animals with a genetic predilection for dysregulation of wnt signaling, Apc (Min/+) mutant mice, were significantly susceptible to prostate cancer in an inflammation-dependent manner following infection with Helicobacter hepaticus. Further, early neoplasia observed in infected Apc (Min/+) mice was transmissible to uninfected mice by intraperitoneal injection of mesenteric lymph node (MLN) cells alone from H. hepaticus-infected mutant mice. Transmissibility of neoplasia was preventable by prior neutralization of inflammation using anti-TNF-α antibody in infected MLN donor mice. Taken together, these data confirm that systemic inflammation triggered by GI tract bacteria plays a pivotal role in tumorigenesis of the prostate gland.