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Abstract

OBJECTIVE

To assess factors associated with increased pleural fluid and air evacuation, longer duration of thoracostomy tube usage, and longer hospitalization in dogs and cats following surgery for thoracic neoplasms.

ANIMALS

62 dogs and 10 cats.

METHODS

Medical records were reviewed for dogs and cats undergoing thoracic surgeries between August 1, 2019, and June 30, 2023, for resection of suspected neoplasia in which a thoracostomy tube was placed. Data collected included patient signalment, type of procedure performed, histologic diagnosis of the primary mass removed, volume of fluid and air evacuated from the thoracostomy tube, and time in hospital.

RESULTS

Median sternotomy was associated with increased total fluid evacuation (median, 12.1 mL/kg; IQR, 15.4 mL/kg; P = .012), whereas rib resection was associated with increased total air evacuation (median, 2.1 mL/kg; IQR, 13.6 mL/kg; P = .06). The presence of preoperative pleural effusion was associated with higher total fluid evacuation (20.6 mL/kg; IQR, 32.1 mL/kg; P = .009), longer duration with a thoracostomy tube in place (42.5 hours; IQR, 41.9 hours; P = .027), and longer hospitalization period (61 hours; IQR, 52.8 hours; P = .025). Cats had a thoracostomy tube in place for a longer time compared to dogs (median, 42.6 hours; IQR, 23.5 hours; P = .043).

CLINICAL RELEVANCE

Animals undergoing median sternotomy and rib resection may be expected to have higher fluid and air volumes, respectively, evacuated postoperatively. This often leads to an increased duration of thoracostomy tube usage and a longer period of hospitalization.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To describe a modified approach to closed anal sacculectomy and report the short-term outcomes of dogs that underwent the procedure for treatment of neoplasia.

ANIMALS

16 client-owned dogs.

PROCEDURES

Medical records of 1 referral hospital were reviewed to identify dogs that underwent modified closed anal sacculectomy for treatment of anal sac neoplasia between January 2018 and September 2020. Data collected included signalment, examination and diagnostic imaging findings, surgical details, intraoperative and postoperative complications, cytologic and histologic findings, adjuvant treatments, duration of follow-up, and short-term outcome.

RESULTS

15 dogs had apocrine gland anal sac adenocarcinoma, and 1 had a collision tumor. No dogs had intraoperative complications; 1 dog had a minor postoperative complication (paraparesis) that resolved. The median duration of postoperative follow-up was 286 days (range, 67 to 777 days). One dog had confirmed local disease recurrence 290 days after surgery, and 1 had suspected local disease recurrence 203 days after surgery and was euthanized because of systemic disease progression.

CONCLUSIONS AND CLINICAL RELEVANCE

The modified closed anal sacculectomy was well tolerated in this sample of dogs, with minimal short-term complications. This study provided evidence to justify evaluation of the procedure in a larger number of dogs and assessment of the effects of procedural modifications on postoperative complication rates and time to local recurrence.

Open access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To determine the incidence of complications in the intraoperative and postoperative period for dogs undergoing nephrectomy for renal disease.

ANIMALS

69 dogs.

METHODS

Medical records of dogs undergoing nephrectomies for renal disease were reviewed for signalment, date of surgery, results of blood analyses, and intra- and postoperative complications. Long-term follow-up was obtained via client telephone interview or referring veterinarian medical records. A Fisher exact test was used to assess the relationship between postoperative acute kidney injury and NSAID administration with long-term development of chronic kidney disease.

RESULTS

Complications occurred in 44.9% and 42.6% of dogs in the intraoperative and postoperative periods, respectively. Most of these were lower-grade complications, though a total of 7 dogs died during the postoperative period. An acute kidney injury was diagnosed in 12 dogs postoperatively, with 2 dogs euthanized due to the severity of the injury. Long-term follow-up was available for 53 dogs, with 24 (45.3%) dogs developing chronic kidney disease. Postoperative acute kidney injury (P = .385) and NSAID administration (P = .519) were not statistically associated with the development of chronic kidney disease in this population.

CLINICAL RELEVANCE

Unilateral nephrectomy is associated with high intraoperative and postoperative complication rates in dogs. Chronic kidney disease was diagnosed in almost 50% of the population with available long-term follow-up.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To report the survival times in dogs diagnosed with adrenal tumors with vascular or soft tissue invasion that did not undergo adrenalectomy.

ANIMALS

Retrospective case series of 32 client-owned dogs.

METHODS

The medical records of a referral veterinary hospital were reviewed to identify dogs that were diagnosed with an invasive adrenal mass and did not undergo adrenalectomy between January 2013 and December 2022. Data collected included signalment, examination findings, and diagnostic results from the initial presentation. Descriptive statistics were calculated to summarize dog signalment information, and Kaplan-Meier survival analysis was performed for calculation of median survival time.

RESULTS

Most dogs (n = 28) had vascular invasion, primarily into the caudal vena cava. Surgery was offered but not pursued due to perceived risk of sudden death (n = 5), risk of hemorrhage (4), or concurrent diagnosis of disseminated intravascular coagulation (1). Only 1 dog pursued stereotactic body radiation therapy, and 1 was prescribed toceranib phosphate (Palladia). Of these 32 dogs, 30 (93.8%) died or were euthanized and 2 (6.2%) dogs survived. The median follow-up time was 49 days (range, 0 to 1,910 days). The median survival time was 50 days (95% CI, 4 to 194 days). The most common cause of death or euthanasia was hemoabdomen (n = 8).

CLINICAL RELEVANCE

Nonsurgical management of invasive adrenal tumors was associated with short survival times in this case series.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

Thromboelastography (TEG) is a whole blood assay that yields global assessment of hemostasis, as it evaluates clot time, strength, and kinematics of clot formation and lysis. The main objective was to describe preoperative TEG findings in dogs that had an adrenalectomy performed and, secondarily, to describe TEG findings in the dogs with or without hyperadrenocorticism (HAC).

ANIMALS

30 dogs that had preoperative TEG and adrenalectomy performed.

METHODS

Medical records between 2018 and 2022 were reviewed. Signalment, diagnostic data, and perioperative treatment were abstracted.

RESULTS

53% (16/30) of the dogs were hypercoagulable, and none were hypocoagulable. Based on histopathology, 6 of 9 dogs with adenocarcinoma were hypercoagulable, 4 of 8 with pheochromocytoma were hypercoagulable, and 6 of 10 with adenoma were hypercoagulable. None of the 3 dogs with other histopathologic diagnoses or combinations of diagnoses (adrenocortical hyperplasia, poorly differentiated sarcoma, and both adrenocortical adenocarcinoma and pheochromocytoma) were hypercoagulable. Of the 14 dogs tested preoperatively for HAC, 4 of 8 HAC dogs were hypercoagulable and 2 of 6 non-HAC dogs were hypercoagulable.

CLINICAL RELEVANCE

The present report describes for the first time TEG findings for dogs undergoing adrenalectomy and suggests that the majority of dogs with adrenal neoplasia are hypercoagulable based on TEG results.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To describe the management of extensive hepatectomy in 2 dogs.

ANIMALS

A 10-year-old female intact mixed-breed dog (case 1) and an 11-year-old male castrated mixed-breed dog (case 2) were presented for surgical evaluation following diagnosis of a hepatic mass.

CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES

16 months before presentation, case 1 had undergone a left lateral liver lobectomy, which resulted in an incomplete resection of hepatocellular carcinoma. Both dogs underwent surgical excision of the liver mass.

TREATMENT AND OUTCOME

In case 1, surgery consisted of the removal of the remaining left medial lobe, as well as the central division. Case 2 received a complete left and central division hepatectomy. Histopathology confirmed a diagnosis of hepatocellular carcinoma in both dogs. Liver enzyme resolution and lack of tumor recurrence were confirmed with chemistry panel and abdominal ultrasonography in both dogs.

CLINICAL RELEVANCE

This case report describes, for the first time, the clinical management and outcome of extensive hepatectomy in 2 dogs. We propose that extensive hepatectomy, staged or synchronous, is possible in a clinical setting.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To investigate the CT features of cavitary pulmonary lesions and determine their utility to differentiate malignant from benign lesions.

ANIMALS

This retrospective study included cases from 5 veterinary medical centers between January 1 2010, and December 31, 2020. Inclusion criteria included having a gas-filled cavitary pulmonary lesion on thoracic CT and definitive diagnosis by either cytology or histopathology. Forty-two animals (27 dogs and 15 cats) were included in this study.

PROCEDURES

Medical records systems/imaging databases were searched, and cases meeting inclusion criteria were selected. The CT studies were interpreted by a third-year radiology resident, and findings were reviewed by a board-certified veterinary radiologist.

RESULTS

7 of the 13 lesion characteristics investigated were not statistically associated with the final diagnosis of the lesion, whereas 6 were statistically associated. Those that were associated included the presence of intralesional contrast enhancement, type of intralesional contrast enhancement (heterogenous and homogenous analyzed separately), presence of additional nodules, wall thickness of the lesion at its thickest point, and wall thickness at the thinnest point.

CLINICAL RELEVANCE

Results from the present study showed that thoracic CT imaging of cavitary pulmonary lesions can be used to further refine the list of differential diagnoses. Based on this data set, in lesions that have heterogenous contrast enhancement, additional pulmonary nodules, and wall thickness > 40 mm at their thickest point, it would be reasonable to consider malignant neoplastic disease higher on the list of differentials than other causes.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To report the short-term and long-term outcomes of dogs that underwent the modified closed and traditional closed anal sacculectomy procedures for the treatment of anal sac neoplasia.

ANIMALS

90 client-owned dogs.

Methods

The medical records of 2 tertiary referral hospitals were reviewed to identify dogs that underwent anal sacculectomy for treatment of anal sac neoplasia between January 2016 and December 2020. Data collected included signalment and preoperative diagnostic findings. The occurrence of intraoperative and postoperative complications, short-term outcomes, and long-term outcomes were also collected. Descriptive statistics were calculated to summarize dog signalment information, and recurrence, metastasis, and survival proportions were compared between techniques using Fisher exact tests.

RESULTS

35 and 55 dogs, respectively, underwent the modified or traditional closed anal sacculectomy procedure. Minor postoperative complications that resolved with minimal intervention occurred in 5 of 35 (14.3%) modified approach dogs and 12 of 55 (21.8%) traditional approach dogs. Tumor recurrence was confirmed in 8 of 35 (22.9%) modified and 8 of 55 (26.4%) traditional approach dogs and was suspected in 3 of 35 (8.6%) and 6 of 55 (13.2%; P = .68), respectively. Confirmed metastatic disease was identified in 8 of 35 (22.9%) and 14 of 53 (26.4%) modified and traditional approach dogs, respectively, and was suspected in 4 of 35 (11.4%) and 7 of 53 (13.2%). Sixty-three (70%) dogs survived to study conclusion.

CLINICAL RELEVANCE

No benefits in complication rate or local recurrence were identified in dogs following the modified approach as opposed to the traditional closed anal sacculectomy technique.

Full access
in Journal of the American Veterinary Medical Association

Abstract

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.

Open access
in Journal of the American Veterinary Medical Association