Teaching Tip: Virtual Oncology Clinic.

Due to limitations in traditional approaches to didactic and clinical learning, professional veterinary medical students face challenges in developing skills and competencies related to clinical practice. The Veterinary Information Network's (VIN) Virtual Clinic (VVC) aims to support learning by using gaming techniques to simulate clinical case management in a low-risk setting. The VVC lets students explore medical scenarios inside a virtual hospital. The purpose of this article is to describe the development and implementation of a learning approach that blends classroom instructor-directed learning with online simulation-based learning, using the VVC. We share challenges and successes of this approach. The case vignettes in the specific example described herein are for canine multicentric lymphoma. However, the lessons learned through the implementation of this oncology clinic module are expected to apply to a wide range of clinical disciplines.

Biologic behavior and clinical outcome of 25 dogs with canine appendicular chondrosarcoma treated by amputation: a Veterinary Society of Surgical Oncology retrospective study.

OBJECTIVE: To characterize biologic behavior, clinical outcome, and effect of histologic grade on prognosis for dogs with appendicular chondrosarcoma treated by amputation alone. STUDY DESIGN: Case series. ANIMALS: Dogs (n=25) with appendicular chondrosarcoma. METHODS: Medical records were searched to identify dogs with appendicular chondrosarcoma treated by limb amputation alone. Information recorded included signalment, anatomic location, radiographic appearance, and development of metastasis. Histopathologic diagnosis was confirmed and graded (1, 2, or 3). Survival curves were generated by the Kaplan-Meier method and the association between covariates (gender, age, weight, and tumor grade) and survival were evaluated using the univariate proportional hazards model. RESULTS: Histopathology slides were available for 25 dogs. Rates of pulmonary metastasis were as follows: grade 1-0%, grade 2-31%, and grade 3-50%. Overall median survival time (MST) was 979 days. Age, weight, and sex were not significantly associated with survival (P=.16; .33; and .31, respectively). Survival was significantly associated with tumor grade (P=.008), with dogs with tumor grade of 1, 2, and 3 having MSTs of 6, 2.7, and 0.9 years, respectively. CONCLUSION: Canine appendicular chondrosarcoma can be treated effectively with amputation alone. Low to intermediate grade chondrosarcoma has a good prognosis, whereas high-grade tumors appear to behave aggressively. CLINICAL RELEVANCE: The overall prognosis for appendicular chondrosarcoma is better than that of appendicular osteosarcoma treated by amputation alone or in combination with chemotherapy.

Clinical outcome of nonnasal chondrosarcoma in dogs: thirty-one cases (1986-2003).

OBJECTIVE: To evaluate metastatic rate and survival times of dogs with chondrosarcoma of nonnasal bony sites treated by wide surgical excision. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=31) with chondrosarcoma. METHODS: Medical records were retrospectively reviewed to identify dogs with chondrosarcoma of bone in potentially surgically accessible sites. When complete information was not available in the medical record, owners and referring veterinarians were contacted by telephone to evaluate the course of disease and survival times. When possible, histopathologic diagnosis was confirmed by a single board certified pathologist and tumors were histologically graded. RESULTS: Dogs treated by wide surgical excision (n=18) had a mean survival time of 3097 days and did not reach median survival time. Dogs untreated except for diagnostic biopsy (n =13) had a median survival time of 523 days and a mean survival time of 495 days. Method of treatment and tumor grade predicted survival time (P=.016 and P=.007, respectively). Metastatic rate was 28% for treated dogs and 15% for untreated dogs, with no significant difference between the 2 groups (P=.39). CONCLUSIONS: Wide surgical excision significantly improves survival time for dogs with chondrosarcoma of nonnasal bony sites, but does not affect the likelihood of metastasis. Grade may be prognostic for survival. CLINICAL RELEVANCE: Surgical excision benefits dogs with chondrosarcoma and can result in prolonged survival times. Metastasis still occurs in approximately 1 of 4 dogs even after surgical resection.