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1.
Vet Comp Oncol ; 21(4): 739-747, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37727977

RESUMO

Malignant peripheral nerve sheath tumours (MPNST) of a plexus nerve or nerve root cause significant morbidity and present a treatment challenge. The surgical approach can be complex and information is lacking on outcomes. The objective of this study was to describe surgical complication rates and oncologic outcomes for canine MPNST of the brachial or lumbosacral plexus. Dogs treated for a naïve MPNST with amputation/hemipelvectomy with or without a laminectomy were retrospectively analysed. Oncologic outcomes were disease free interval (DFI), overall survival (OS), and 1- and 2-year survival rates. Thirty dogs were included. The surgery performed was amputation alone in 17 cases (57%), and amputation/hemipelvectomy with laminectomy in 13 cases (43%). Four dogs (13%) had an intraoperative complication, while 11 dogs (37%) had postoperative complications. Histologic margins were reported as R0 in 12 dogs (40%), R1 in 12 dogs (40%), and R2 in five dogs (17%). No association was found between histologic grade and margin nor extent of surgical approach and margin. Thirteen dogs (46%) had recurrence. The median DFI was 511 days (95% CI: 140-882 days). The median disease specific OST was 570 days (95% CI: 467-673 days) with 1- and 2-year survival rates of 82% and 22% respectively. No variables were significantly associated with recurrence, DFI, or disease specific OST. These data show surgical treatment of plexus MPNST was associated with a high intra- and postoperative complication rate but relatively good disease outcomes. This information can guide clinicians in surgical risk management and owner communication regarding realistic outcomes and complications.


Assuntos
Doenças do Cão , Neoplasias de Bainha Neural , Neurofibrossarcoma , Cães , Animais , Neurofibrossarcoma/veterinária , Neoplasias de Bainha Neural/cirurgia , Neoplasias de Bainha Neural/veterinária , Neoplasias de Bainha Neural/patologia , Estudos Retrospectivos , Doenças do Cão/cirurgia , Complicações Pós-Operatórias/veterinária , Plexo Lombossacral/cirurgia , Plexo Lombossacral/patologia
2.
Vet Comp Oncol ; 21(4): 673-684, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37652746

RESUMO

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.


Assuntos
Neoplasias das Glândulas Suprarrenais , Doenças do Cão , Feocromocitoma , Animais , Cães , Neoplasias das Glândulas Suprarrenais/cirurgia , Neoplasias das Glândulas Suprarrenais/veterinária , Adrenalectomia/veterinária , Doenças do Cão/tratamento farmacológico , Alta do Paciente , Fenoxibenzamina/uso terapêutico , Feocromocitoma/cirurgia , Feocromocitoma/veterinária , Feocromocitoma/patologia , Estudos Retrospectivos , Fatores de Risco
3.
Vet Comp Oncol ; 21(4): 587-594, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37464904

RESUMO

Renal carcinomas (RC) are uncommonly encountered in feline medicine. Limited information regarding clinical presentation and postoperative outcomes is available. The purpose of this multi-institutional, retrospective study was to describe the presenting features and clinical outcomes of cats with RC undergoing nephrectomy. Thirty-six client-owned cats were included. Medical records from participating institutions were searched to identify cats that had a histopathologic diagnosis of RC and underwent nephrectomy from January 2001 to October 2021. The most common presenting complaints were weight loss (36.1%) and hyporexia (30.6%). Based on preoperative imaging and intraoperative findings, eight cats had suspected metastasis at the time of surgery (22.2%). Twenty-eight cats survived to discharge (77.8%). Median progression free interval (PFI) could not be determined, as only six cats developed suspected recurrence (16.7%) and seven cats developed suspected metastasis (19.4%). The all-cause median survival time (MST) was 203 days (95% confidence interval [CI]: 84, 1379 days). When cases that died prior to discharge were excluded, MST increased to 1217 days (95% CI: 127, 1641 days). One-year, two-year, and three-year survival rates were all 40.4%. Neither renal tumour histologic subtype nor the presence of preoperative azotemia, anaemia, erythrocytosis, haematuria, or suspected metastasis at diagnosis were found to influence survival. For cats surviving to discharge, prolonged survival times were possible. Further studies are necessary to elucidate other potential prognostic factors, the utility of postoperative adjuvant treatment, and to identify cats at-risk of mortality in the perioperative period.


Assuntos
Carcinoma de Células Renais , Doenças do Gato , Neoplasias Renais , Gatos , Animais , Carcinoma de Células Renais/cirurgia , Carcinoma de Células Renais/veterinária , Estudos Retrospectivos , Resultado do Tratamento , Nefrectomia/veterinária , Neoplasias Renais/cirurgia , Neoplasias Renais/veterinária , Doenças do Gato/cirurgia
4.
Artigo em Inglês | MEDLINE | ID: mdl-37436906

RESUMO

OBJECTIVE: To describe the appearance of lesions noted on abdominal computed tomography (CT) in dogs with spontaneous hemoperitoneum and determine the utility in using CT to differentiate benign from malignant lesions. DESIGN: Retrospective case series. SETTING: Single-center, university veterinary teaching emergency service. ANIMALS: Twenty-six dogs presented between 2015 and 2020 with spontaneous hemoperitoneum confirmed via abdominocentesis with pre- and postcontrast abdominal CT performed prior to surgery or euthanasia. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: On histopathological diagnosis, 20 of 26 lesions were found to be malignant, and 6 of 26 were benign. Two radiologists reviewed the CTs. Radiologist 1 correctly identified 5 of 6 (83.3%) benign cases and 18 of 20 (90%) malignant cases. Radiologist 2 correctly identified 2 of 6 (33.3%) benign lesions and 18 of 20 (90%) malignant cases. Of the 10 imaging descriptors evaluated, none were significantly associated with the histological diagnosis. CONCLUSIONS: Results from the current study suggest that abdominal CT imaging of spontaneous hemoperitoneum cases is not a reliable indicator of malignancy versus benignancy. As such, prognosis should not be defined using this modality alone prior to emergency surgery and instead should be concluded based on the clinical course of the patient and histopathological findings of the resected tissues after surgery.


Assuntos
Doenças do Cão , Hemoperitônio , Cães , Animais , Hemoperitônio/diagnóstico por imagem , Hemoperitônio/veterinária , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/veterinária , Doenças do Cão/diagnóstico por imagem
5.
J Am Vet Med Assoc ; 261(10): 1-5, 2023 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-37290758

RESUMO

OBJECTIVE: To report to what degree narrative operative reports for soft tissue sarcoma (STS) and mast cell tumor (MCT) resections met a predetermined template made up of essential elements. ANIMALS: 197 consecutive client-owned animals between May 1, 2017, and August 1, 2022. PROCEDURES: A consensus list of 9 elements made up the final synoptic operative report (SR) template. Consecutive narrative surgery reports (NRs) of dogs that underwent MCT or STS resection were then reviewed to determine how many of the SR elements were present in each NR. A score was then determined for each NR out of a maximum total of 9. RESULTS: Overall, 197 reports (99 MCT and 98 STS) were included. The median score was 5 (56% of elements reported). No report had all 9 elements, and 1 report had none of the elements reported. When MCT and STS were analyzed independently, the median score was 6 (67% of elements reported) for MCT and 5 (56% of elements reported) for STS. There was a trend of more cases with MCT that had a preoperative diagnosis, intraoperative measurements of the tumor, and surgeon margins marked compared to dogs with STS. More dogs with STS had an estimated Enneking dose compared to dogs with MCT. CLINICAL RELEVANCE: Our data show that essential elements of STS and MCT resection in dogs were inconsistently recorded and no case had all elements present. This mirrors data in people and presses the need for more standardization in reporting of cancer operations in veterinary medicine.


Assuntos
Doenças do Cão , Sarcoma , Neoplasias de Tecidos Moles , Cães , Animais , Mastócitos/patologia , Doenças do Cão/cirurgia , Doenças do Cão/patologia , Sarcoma/cirurgia , Sarcoma/veterinária , Neoplasias de Tecidos Moles/cirurgia , Neoplasias de Tecidos Moles/veterinária , Estudos Retrospectivos
6.
Vet Comp Oncol ; 21(2): 327-331, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36861227

RESUMO

Apocrine gland anal sac adenocarcinoma (AGASACA) is a highly relevant disease in dogs, with a high rate of lymph node (LN) metastasis during the course of disease. A recent study showed that risk for death and disease progression was significantly associated with primary tumour size less than 2 and 1.3 cm, respectively. The objective of this study was to report the proportion of dogs that have primary tumours less than 2 cm in diameter, that are diagnosed with LN metastasis at presentation. This was a single site retrospective study of dogs that underwent treatment for AGASACA. Dogs were included if physical examination primary tumour measurements were available, abdominal staging was performed, and confirmation of abnormal lymph nodes by cytology or histology was done. Over a 5-year period, 116 dogs were included for review with 53 (46%) having metastatic LN at presentation. The metastatic rate for dogs with primary tumours <2 cm was 20% (9 of 46 dogs) compared to 63% (44 of 70 dogs) in dogs with primary tumours ≥2 cm. The association between tumour size group (<2 vs. ≥2 cm) and the presence of metastasis at presentation was significant (P < .0001) with an OR of 7.0 (95% CI: 2.9-15.7). Primary tumour size was significantly associated with LN metastasis at presentation but the proportion of dogs that presented with LN metastasis in the <2 cm group was relatively high. This data suggests that dogs with small tumours may still have aggressive tumour biology.


Assuntos
Adenocarcinoma , Neoplasias das Glândulas Anais , Sacos Anais , Doenças do Cão , Cães , Animais , Metástase Linfática/patologia , Glândulas Apócrinas/patologia , Sacos Anais/patologia , Adenocarcinoma/veterinária , Adenocarcinoma/patologia , Estudos Retrospectivos , Neoplasias das Glândulas Anais/patologia , Doenças do Cão/patologia , Linfonodos/patologia
7.
Vet Comp Oncol ; 21(1): 82-90, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36271481

RESUMO

Surgical resection of solid tumours, especially in early stages of disease, remains a cornerstone of cancer treatment in dogs and cats. There are numerous publications that show a strong association between local tumour control and outcome. To achieve local control in some cases radiation therapy and surgery are combined, with radiation therapy being delivered in the neoadjuvant or adjuvant setting. The objective of the study was to report acute toxicity and surgical site complication data in dogs that received a short-course pre-operative (SCPO) radiation therapy protocol, followed by surgical excision for various solid tumours. Medical records were reviewed, and data was analysed retrospectively. Dogs were included if a dermal or subcutaneous solid tumour was treated with SCPO radiation therapy and then was resected on the last day of radiation or 2-3 weeks later. A total of 34 dogs with 35 primary tumours were included. Acute radiation toxicity was diagnosed in 14 sites (40%). VRTOG scores were grade 1 in 50%, grade 2 in 43%, and grade 3 in 7%. Surgical site complications were identified in 17% of dogs with an overall surgical site infection rate of 11%. According to the Clavien-Dindo classification, two dogs required medical intervention (grade 2), 1 dog required surgical intervention under general anaesthesia (grade 3b), and 1 dog died as a result of complications (grade 5). Logistic regression analysis found that anatomic site was significantly associated with complications, where tumours located on the extremity was protective (P = .02; OR 0.06).


Assuntos
Doenças do Cão , Neoplasias , Animais , Cães , Doenças do Cão/radioterapia , Doenças do Cão/cirurgia , Estudos de Viabilidade , Terapia Neoadjuvante/veterinária , Neoplasias/radioterapia , Neoplasias/cirurgia , Neoplasias/veterinária , Estudos Retrospectivos
8.
Animals (Basel) ; 12(15)2022 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-35892519

RESUMO

The aim was to prospectively measure the shrinkage of primary apocrine gland anal sac adenocarcinoma (AGASACA) tumors after 24 and 48 h of formalin fixation. Dogs that were diagnosed with AGASACA pre-operatively by aspiration cytology were prospectively enrolled in the study. Tumor extirpation was performed in a closed technique. The tumor and associated tissues were examined on the back table away from the patient and the widest dimension of the tumor was measured using a sterile ruler (Medline®; Northfield, IL, USA). This measurement was recorded in mm (t0). The tissue was placed in 10% buffered formalin and stored at room temperature. Two further measurements were taken after 24 (t24) and 48 (t48) hours of formalin fixation. Once the 48 h measurement was taken, the tissue was submitted for histopathology. The percentage of shrinkage between time points was calculated by using the following equation: (1 - [time b/time a]) × 100. Overall, 23 dogs with 23 tumors were enrolled. The mean percentage of shrinkage after 24 and 48 h of formalin fixation was 4.8% and 7.2%, respectively. The median diameter of the tumors reduced by 1 mm over 48 h and was not significantly different at any time point. These data will aid clinicians in interpreting measurements of AGASACA tumors following formalin fixation and shows that minimal change in tumor size is expected following 48 h.

9.
Vet Comp Oncol ; 20(1): 82-90, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34033204

RESUMO

While the majority of canine osteosarcomas (OSA) arise from the medullary cavity, a subset arises from the surface of bone. In humans, surface OSA often has a more indolent disease course with better outcomes than medullary OSA. The aim of this retrospective case series was to evaluate the clinical outcome and potential prognostic factors of dogs with surface OSA. Medical records from 11 dogs previously diagnosed with surface OSA were included. Histopathology of cases was evaluated during case review by two veterinary anatomic pathologists. Median progression free interval (PFI) and overall median survival time (OST) were estimated using Kaplan-Meier methods. Intergroup comparisons were performed using log-rank tests. Six dogs were diagnosed with periosteal OSA, 4 dogs with parosteal OSA, and one dog with an unclassified surface OSA. Two dogs were found to have metastatic disease at the time of diagnosis and four developed metastatic lesions after treatment. The median PFI and median OST for all dogs with surface OSA was 425 and 555 days, respectively. The 6 dogs diagnosed with periosteal OSA had a median PFI of 461 days and median OST of 555 days, while the 4 dogs with parosteal OSA had a PFI of 350 days and the OST could not be calculated. Multiple prognostic factors (surgery, systemic adjunctive therapy, elevated alkaline phosphatase at diagnosis, appendicular vs axial location, mitotic count, and tumour grade) were evaluated and none were prognostic for PFI or OST. Dogs with surface OSA appear to have prolonged PFI and OST, consistent with humans with surface OSA.


Assuntos
Neoplasias Ósseas , Doenças do Cão , Osteossarcoma , Animais , Cães , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/veterinária , Doenças do Cão/patologia , Osteossarcoma/diagnóstico , Osteossarcoma/tratamento farmacológico , Osteossarcoma/veterinária , Estudos Retrospectivos
11.
Vet Comp Oncol ; 19(4): 685-696, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33993605

RESUMO

Excellent outcomes have been reported following thyroidectomy for thyroid carcinoma in dogs, but outcomes for thyroid carcinomas with gross vascular invasion are poorly described. This study describes the clinical outcomes and complications in dogs with thyroid carcinomas with gross vascular invasion undergoing thyroidectomy. Medical records of dogs that underwent thyroidectomy between January 1st 2010 and December 31st 2019 were reviewed at 10 hospitals. Signalment, diagnostic data, primary and adjuvant treatments performed, and outcome were abstracted. Survival was calculated using Kaplan-Meier analysis. Multiple logistic regression was used to identify variables associated with disease-specific survival. Seventy-three dogs were included, of which 58 underwent unilateral thyroidectomy and 15 underwent bilateral thyroidectomy. Complications were reported in five dogs (three major, two minor; 6.8%) intraoperatively and 12 dogs (two major leading to death, 10 minor; 16.4%) postoperatively. Seven (9.6%) dogs developed locoregional recurrence at a median of 238 days postoperatively (range: 15-730 days). Distant metastasis was suspected or confirmed in nine dogs (12.3%) at a median of 375 days postoperatively (range: 50-890 days). Twenty-seven dogs (37%) received adjuvant therapy (chemotherapy: n = 21; radiotherapy: n = 6). Thirty-nine dogs were euthanized or died, with 20 deaths related to disease (n = 10) or of unknown cause (n = 10), 19 due to unrelated causes, and nine lost to follow-up. Median overall and disease-specific survival were 621 days and not reached respectively. One-year disease-specific survival rate was 82.5%. No variables were associated with disease-specific survival in our dataset. Surgery may be considered for loco-regional therapy in dogs with thyroid carcinoma with gross vascular invasion.


Assuntos
Doenças do Cão , Complicações Pós-Operatórias , Neoplasias da Glândula Tireoide , Animais , Doenças do Cão/tratamento farmacológico , Doenças do Cão/cirurgia , Cães , Recidiva Local de Neoplasia/veterinária , Complicações Pós-Operatórias/veterinária , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/veterinária , Tireoidectomia/efeitos adversos , Tireoidectomia/veterinária , Resultado do Tratamento
12.
Clin Cancer Res ; 27(11): 3005-3016, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33753454

RESUMO

PURPOSE: The mTOR pathway has been identified as a key nutrient signaling hub that participates in metastatic progression of high-grade osteosarcoma. Inhibition of mTOR signaling is biologically achievable with sirolimus, and might slow the outgrowth of distant metastases. In this study, pet dogs with appendicular osteosarcoma were leveraged as high-value biologic models for pediatric osteosarcoma, to assess mTOR inhibition as a therapeutic strategy for attenuating metastatic disease progression. PATIENTS AND METHODS: A total of 324 pet dogs diagnosed with treatment-naïve appendicular osteosarcoma were randomized into a two-arm, multicenter, parallel superiority trial whereby dogs received amputation of the affected limb, followed by adjuvant carboplatin chemotherapy ± oral sirolimus therapy. The primary outcome measure was disease-free interval (DFI), as assessed by serial physical and radiologic detection of emergent macroscopic metastases; secondary outcomes included overall 1- and 2-year survival rates, and sirolimus pharmacokinetic variables and their correlative relationship to adverse events and clinical outcomes. RESULTS: There was no significant difference in the median DFI or overall survival between the two arms of this trial; the median DFI and survival for standard-of-care (SOC; defined as amputation and carboplatin therapy) dogs was 180 days [95% confidence interval (CI), 144-237] and 282 days (95% CI, 224-383) and for SOC + sirolimus dogs, it was 204 days (95% CI, 157-217) and 280 days (95% CI, 252-332), respectively. CONCLUSIONS: In a population of pet dogs nongenomically segmented for predicted mTOR inhibition response, sequentially administered adjuvant sirolimus, although well tolerated when added to a backbone of therapy, did not extend DFI or survival in dogs with appendicular osteosarcoma.


Assuntos
Neoplasias Ósseas/terapia , Neoplasias Ósseas/veterinária , Doenças do Cão/terapia , Osteossarcoma/terapia , Osteossarcoma/veterinária , Animais de Estimação , Sirolimo/administração & dosagem , Amputação Cirúrgica , Animais , Neoplasias Ósseas/genética , Neoplasias Ósseas/mortalidade , Carboplatina/administração & dosagem , Quimioterapia Adjuvante , Terapia Combinada/veterinária , Doenças do Cão/mortalidade , Cães , Osteossarcoma/genética , Osteossarcoma/mortalidade , Estudos Prospectivos , Transdução de Sinais/efeitos dos fármacos , Sirolimo/farmacologia , Taxa de Sobrevida , Serina-Treonina Quinases TOR/metabolismo , Resultado do Tratamento
13.
Vet Comp Oncol ; 18(4): 683-688, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32266757

RESUMO

Progressive disease is common following anal sacculectomy for apocrine gland anal sac adenocarcinoma (AGASACA); additional therapy may prolong survival. Adherence to medical recommendations influences therapeutic success in humans. The purpose of this study was to assess the adherence to follow-up recommendations in dogs with AGASACA. Medical records of patients that underwent anal sacculectomy for AGASACA, with or without iliosacral lymphadenectomy, between July 2015 and July 2018, were reviewed at eight referral institutions to assess post-operative recommendations and owner adherence to recommendations. One hundred and seventy-four dogs were included, of which 162 underwent unilateral anal sacculectomy, 12 underwent bilateral anal sacculectomy and 39 underwent concurrent iliosacral lymphadenectomy. Seventy-six owners (44%) received recommendations for staging at the time of discharge, histopathology results or at the first follow-up visit. One hundred and forty owners (80%) received recommendations for treatment following the initial surgery. Fifty of seventy-six (66%) owners pursued at least one staging recommendation and 69 of 140 (49%) owners pursued some kind of adjuvant treatment recommendation. Overall, 16 of 76 (21%) were adherent to staging recommendations with 20 adherent for the first year following surgery (26%). Forty-seven of 140 (34%) were adherent to treatment recommendations with 54 (39%) adherent for the first year. Owners that were adherent to restaging recommendations at 1 year following surgery were significantly more likely to pursue treatment for progressive disease (P = .014). Further work is required to assess owner motivation and evaluate strategies to improve adherence, given the potential impact on patient treatment.


Assuntos
Adenocarcinoma/veterinária , Neoplasias das Glândulas Anais/patologia , Neoplasias das Glândulas Anais/terapia , Sacos Anais , Glândulas Apócrinas/patologia , Doenças do Cão/patologia , Doenças do Cão/terapia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Sacos Anais/patologia , Animais , Antineoplásicos/uso terapêutico , Cães , Estadiamento de Neoplasias , Estudos Retrospectivos , Estados Unidos
14.
Vet Comp Oncol ; 18(1): 84-91, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31177624

RESUMO

Appendicular osteosarcoma (OSA) remains a prevalent musculoskeletal cancer in dogs and definitive local control followed by adjuvant cytotoxic chemotherapy is considered the gold standard approach. Several studies support surgical limb salvage as a means of local control with similar outcomes compared with limb amputation. Complications are well described for limb salvage but little is known of dogs that undergo secondary amputation as a result of complications and outcomes specific to this group. A retrospective analysis of dogs in an institutional primary bone tumour registry was performed to identify dogs diagnosed with histologically confirmed OSA treated with surgical limb salvage with a technique that required an implant to reconstruct the osseous defect. A total of 192 dogs were identified with 31 dogs undergoing secondary amputation representing a limb preservation rate of 84%. A total of 111 dogs were analysed: 31 secondary amputation cases and 80 controls were selected for comparison. The most common reasons for secondary amputation were local recurrence (LR) and surgical site infection (SSI), with odds ratios of 3.6 and 1.7, respectively. Dogs that underwent secondary amputation had a significantly (P = .05) longer median disease specific survival time (ST) (604 days) compared with the control group (385 days). Dogs lived for a median of 205 days beyond secondary amputation and 97% had good functional outcome. Significant independent factors that positively influenced ST were secondary amputation, moderate SSI, severe SSI and age.


Assuntos
Amputação Cirúrgica/veterinária , Neoplasias Ósseas/veterinária , Doenças do Cão/cirurgia , Salvamento de Membro/veterinária , Osteossarcoma/veterinária , Animais , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Estudos de Casos e Controles , Doenças do Cão/patologia , Cães , Feminino , Masculino , Osteossarcoma/patologia , Osteossarcoma/cirurgia , Sistema de Registros , Resultado do Tratamento
15.
Vet Surg ; 48(8): 1490-1499, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31179557

RESUMO

OBJECTIVE: To describe the technique and outcomes for bilateral caudal maxillectomy for resection of large caudal maxillary tumors crossing palatal midline in two dogs. STUDY DESIGN: Clinical case report. ANIMALS: Two client-owned dogs. METHODS: Two client-owned dogs with primary caudal maxillary tumors, a poorly differentiated sarcoma, and a multilobulated osteochondrosarcoma. Bilateral caudal maxillectomies were performed for curative-intent resection of these tumors. The angularis oris axial pattern flap was used for primary closure in one dog and for dehiscence repair in the other. RESULTS: Both tumors were resected with complete histologic margins. The defects were closed with local buccal mucosal flaps, with or without a unilateral angularis oris flap. Esophagostomy tubes were placed at time of surgery to bypass oral feeding. Incisional dehiscence and subsequent oronasal fistula formation occurred as a postoperative complication in both dogs (3 and 10 days, respectively). Both were successfully repaired with a combination of local buccal mucosal flaps and the angularis oris flap. Both dogs had good functional outcome and quality of life after recovery from revision surgery. CONCLUSION: Bilateral caudal maxillectomy allowed resection of caudal maxillary tumors crossing palatal midline, with good function and quality of life after recovery in 2 dogs. CLINICAL SIGNIFICANCE: Good outcomes including complete resections are achievable with bilateral caudal maxillectomy despite complications. Local mucosal and axial pattern flaps can be used for dehiscence repair.


Assuntos
Neoplasias Ósseas/veterinária , Doenças do Cão/cirurgia , Complicações Pós-Operatórias/veterinária , Sarcoma/veterinária , Retalhos Cirúrgicos/veterinária , Animais , Neoplasias Ósseas/cirurgia , Craniotomia , Cães , Feminino , Masculino , Maxila/cirurgia , Complicações Pós-Operatórias/cirurgia , Reoperação , Sarcoma/cirurgia , Deiscência da Ferida Operatória/veterinária
16.
Vet Surg ; 48(6): 923-932, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31140634

RESUMO

OBJECTIVE: To describe the clinical characteristics, perioperative complications, and outcomes in dogs surgically treated for gastric carcinoma. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Forty client-owned dogs with histologically confirmed gastric carcinoma. METHODS: Medical records were reviewed for preoperative diagnostics, surgery, histopathology, postoperative complications, adjuvant chemotherapy, disease progression, and survival. Variables were assessed for associations with outcome by using Cox proportional hazards regression analysis. RESULTS: Surgical treatment included partial gastrectomy (28 dogs), Billroth I (9 dogs), subtotal gastrectomy (2 dogs), and submucosal resection (1 dog). Major postoperative complications occurred in 8 of 40 dogs, including septic peritonitis secondary to dehiscence in 4 dogs. The median progression free interval was 54 days, and the median survival time (MST) was 178 days (range, 1-1902). According to multivariable analysis results, experiencing an intraoperative complication was associated with an increased risk of death (hazard ratio [HR] 3.5, 95% CI 1.1-9.8, P = .005), and administration of adjuvant chemotherapy correlated with an improved survival (HR 0.4, 95% CI 0.2-0.9, P = .03). CONCLUSION: In this population of dogs, MST exceeded historically reported data, major postoperative complication rates were comparable to established literature, and administration of adjuvant chemotherapy was associated with improved survival. CLINICAL SIGNIFICANCE: Results from this study may be used to counsel owners more accurately regarding prognosis for dogs undergoing surgical excision for gastric carcinoma.


Assuntos
Carcinoma/veterinária , Doenças do Cão/cirurgia , Complicações Intraoperatórias/veterinária , Complicações Pós-Operatórias/veterinária , Sociedades Veterinárias , Neoplasias Gástricas/veterinária , Animais , Carcinoma/cirurgia , Quimioterapia Adjuvante , Cães , Feminino , Masculino , Estudos Retrospectivos , Neoplasias Gástricas/cirurgia , Resultado do Tratamento
17.
Vet Surg ; 47(6): 802-808, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30051470

RESUMO

OBJECTIVE: To report modification of the endoprosthesis surgical limb-salvage technique to treat a locally extensive osteosarcoma in a dog and associated functional outcome. STUDY DESIGN: Clinical case report. ANIMALS: One client-owned dog. METHODS: A 9-year-old dog was presented for treatment of a locally extensive distal radial osteosarcoma. A limb-salvage surgery was performed with a second-generation Veterinary Orthopedic Implants (VOI) endoprosthesis to reconstruct the radial segmental and carpal osseous defect. The endoprosthesis was stabilized with a 16-mm-wide locking VOI limb-salvage plate. The level of the osteotomy of the radius/ulna was 3 cm proximal to the periosteal reaction seen on radiographs, and the distal osteotomy extended through the proximal metacarpal bones (II-V), 3 cm from the distal extent of the soft tissue component of the tumor. A 3.5-mm SOP (String of Pearls) plate was used as adjunct fixation. RESULTS: The postoperative functional outcome was classified as acceptable. Ambulation was normal, with mild subjective lameness on the treated limb at examinations 20, 43, and 63 days after surgery. The dog was euthanized 92 days after surgery because of progressive metastatic disease. CONCLUSION: The modified endoprosthetic technique allowed complete excision of the carpal joint, which resulted in acceptable functional outcomes in the dog described here. CLINICAL SIGNIFICANCE: Distal ostectomies may include part of the manus during limb salvage surgery of locally extensive distal radial osteosarcoma and using an endoprosthesis implant to reconstruct the defect.


Assuntos
Neoplasias Ósseas/veterinária , Doenças do Cão/cirurgia , Salvamento de Membro/veterinária , Osteossarcoma/veterinária , Próteses e Implantes/veterinária , Animais , Neoplasias Ósseas/cirurgia , Carpo Animal/patologia , Cães , Feminino , Salvamento de Membro/métodos , Osteossarcoma/cirurgia , Resultado do Tratamento
18.
Vet Surg ; 45(1): 60-5, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26547378

RESUMO

OBJECTIVE: To compare the peak vertical force (PVF) and vertical impulse (VI) in dogs with naturally occurring cranial cruciate ligament (CCL) disease with or without concurrent meniscal injury. STUDY DESIGN: Prospective case series. STUDY POPULATION: Client-owned dogs with naturally occurring CCL disease. METHODS: Dogs with hind limb lameness because of CCL disease that required surgery underwent force plate gait analysis. Force plate analysis was performed at a walking gait (speed 1-1.3 m/s; acceleration ± 0.5 m/s(2)) and data were analyzed using commercial proprietary software. Meniscal injury was diagnosed either by mini-arthrotomy or arthroscopy. The primary outcome was PVF and the secondary outcome was VI. Comparisons were made between dogs with or without meniscal injury, and dogs with partial or complete CCL rupture. RESULTS: Forty dogs were included. Meniscal injury was present in 18/40 dogs (45%). PVF (P = .003) and VI (P = .01) were significantly lower in dogs with meniscal injury than in dogs without meniscal injury. CONCLUSION: Dogs with CCL disease and medial meniscal injury had significantly reduced PVF and VI.


Assuntos
Lesões do Ligamento Cruzado Anterior , Doenças do Cão/cirurgia , Ruptura/veterinária , Lesões do Menisco Tibial , Animais , Ligamento Cruzado Anterior/patologia , Ligamento Cruzado Anterior/cirurgia , Artroscopia/veterinária , Fenômenos Biomecânicos , Cães , Fáscia , Meniscos Tibiais/patologia , Meniscos Tibiais/cirurgia , Estudos Prospectivos
19.
J Feline Med Surg ; 13(12): 984-7, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21885312

RESUMO

A 2-year-old male neutered cat presented for further investigation of biliothorax. The cat was initially treated for pyothorax, including bilateral chest drains for lavage of the pleural space. Five days later, the pleural effusion turned clear-yellow and had a bilirubin concentration of 427 µmol/l compared to the serum bilirubin concentration of 15 µmol/l. Exploratory surgery revealed a 2mm tear in the diaphragm, with a corresponding 2mm defect in the diaphragmatic surface of the gall bladder, creating a fistula between the gall bladder and the pleural cavity. The defects were repaired routinely and the cat made a full recovery. It was suspected that the tears had been created at the time of the thoracostomy tube placement. Biliothorax has not been described before in a cat, and appears to be a rare complication following thoracostomy tube placement.


Assuntos
Bile , Fístula Biliar/veterinária , Doenças do Gato/diagnóstico , Doenças da Vesícula Biliar/veterinária , Doenças Pleurais/veterinária , Animais , Fístula Biliar/diagnóstico , Doenças do Gato/etiologia , Doenças do Gato/terapia , Gatos , Diagnóstico Diferencial , Doenças da Vesícula Biliar/diagnóstico , Masculino , Doenças Pleurais/diagnóstico , Toracostomia/efeitos adversos , Toracostomia/veterinária
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