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  • Author or Editor: Deanna R. Worley x
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Abstract

Objective—To assess the outcome of extrahepatic portosystemic shunt (EHPSS) treatment in dogs aged 5 years and older.

Design—Retrospective case series.

Animals—17 client-owned dogs.

Procedures—Medical records for dogs (≥ 5 years old) that underwent surgical attenuation of an EHPSS (1992 through 2005) were evaluated; data, including clinical signs, clinicopathologic findings, surgical procedure, and outcome, were recorded. Follow-up information was obtained via patient examination or telephone interview with veterinarians and owners.

Results—Dogs (5 to 9 years old [median age, 6.6 years]) had neurologic (n = 12), urinary tract (8), and gastrointestinal tract (6) EHPSS-associated clinical signs. Serum bile acids and ammonia concentrations were abnormal in all evaluated dogs. Treatment of EHPSSs included complete (n = 6 dogs) or partial (2) suture attenuation or ameroid constrictor placement (9). Two dogs died following surgery. Follow-up information (6 to 120 months) was available for 13 dogs. Deaths were attributable to heart failure (n = 1), bacterial hepatitis (2; with pyelonephritis in 1 dog), and unknown causes (3). At a median of 23 and 25 months, serum bile acids concentrations had almost normalized in 5 of 8 dogs and ammonia concentrations were within reference limits in 3 of 5 dogs, respectively; dogs with abnormal liver function test results had no associated clinical signs. Median long-term survival time was 72 months.

Conclusions and Clinical Relevance—Attenuation of EHPSS in ≥ 5-year-old dogs ameliorated signs of liver dysfunction in surviving dogs, although return of normal liver function occurred less frequently than expected.

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in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To characterize and identify factors associated with intraoperative and postoperative complications of maxillectomy in dogs with oral tumors.

DESIGN Retrospective cohort study.

ANIMALS 193 dogs that underwent maxillectomy for oral tumor excision from 2000 through 2011.

PROCEDURES Data were extracted from the medical records regarding dog signalment, tumor location and size, histologic findings, clinical stage, maxillectomy category, surgical approach, and additional treatments provided. These factors were examined for associations with recorded intraoperative and postoperative outcomes.

RESULTS The most common intraoperative complication was excessive surgical bleeding (103/193 [53.4%]), for which 44 (42.7%) dogs received an intraoperative blood transfusion. These outcomes were both significantly associated with tumor size and location, maxillectomy type, and surgical approach. Dogs treated with a dorsolateral combined intraoral surgical approach were more likely to have excessive surgical bleeding (48/58 [83%]) and had a longer mean duration of surgery (106 minutes) than those treated with an intraoral approach (29/54 [54%] and 77 minutes, respectively). Complications developing within 48 hours after surgery included epistaxis (99/193 [51.3%]), excessive facial swelling (71/193 [36.8%]), facial pawing (21/193 [10.9%]), and difficulty eating (22/193 [11.4%]). Complications developing within 48 hours to 4 weeks after surgery included lip trauma (22/164 [13.4%]), oronasal fistula formation (18/164 [11.0%]), wound dehiscence (18/164 [11.0%]), and infection (13/164 [7.9%]).

CONCLUSIONS AND CLINICAL RELEVANCE Complications associated with maxillectomy in dogs were generally minor. Aggressive surgical planning, preparedness for hemorrhage and transfusion, careful tissue dissection, and comprehensive pain control are recommended, particularly for dogs with large, caudally located oral tumors requiring extensive excision.

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in Journal of the American Veterinary Medical Association

Abstract

Objectives—To describe preoperative, surgical, and postoperative findings and determine prognostic indicators and treatment recommendations in dogs treated surgically for gallbladder mucocele.

Design—Retrospective study.

Animals—22 client-owned dogs.

Procedures—Medical records of dogs with gallbladder mucoceles that were treated surgically were reviewed. History, clinical signs, results of selected clinicopathologic analyses and abdominal ultrasonography, surgical procedure performed, results of histologic examination of a liver biopsy specimen, and survival time were recorded. Followup information was obtained via telephone interview with owners and referring veterinarians.

Results—Dogs were 7 to 15 years of age and had nonspecific clinical signs (vomiting, anorexia, and lethargy). Physical examination findings included icterus, signs of depression, and signs of discomfort on palpation of the abdomen . Sixteen dogs had a definitive diagnosis and 6 dogs were strongly suspected of having a gallbladder mucocele on the basis of results of abdominal ultrasonography. Fifteen dogs survived after surgery; 3 of these dogs had bile-induced peritonitis, and 4 had pancreatitis. One dog was euthanatized as a result of severe pancreatitis, and 1 was euthanatized because of acute renal failure; 5 dogs died as a result of pancreatitis, cholecystitis, or bile-induced peritonitis. Hepatic abnormalities were detected histologically in all dogs.

Conclusions and Clinical Relevance—No predictors of survival were identified. No associations between outcome of surgical treatment (survival vs nonsurvival) and preoperative findings, biliary rupture, surgical procedure performed, results of histologic examination of the liver, or development of pancreatitis were found. Cholecystoduodenostomy and cholecystectomy appear to be acceptable treatments for gallbladder mucocele. (J Am Vet Med Assoc 2004;225:1418–1422)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate the outcome of resection of simultaneous discrete bilateral mobile thyroid gland carcinomas (TGCs) in dogs.

Design—Retrospective case series.

Animals—15 dogs with resected simultaneous discrete bilateral mobile TGCs.

Procedures—Medical records (from 1994 to 2010) were searched for dogs with the appropriate diagnosis and treatment. Information collected included signalment, clinical signs, diagnostic test results, tumor mobility (mobile tumor identified by movement ≥ 1 cm in all planes during palpation), complications, adjuvant treatments, and outcome.

Results—Mobile, discrete, bilateral TGCs were removed in all dogs. Among the 15 dogs, complete parathyroidectomies were necessary in 9; parathyroid tissue was reimplanted in 4 and preserved in 2. Complications included hemorrhage and laryngeal nerve trauma, but without serious consequences. Thirteen dogs received calcitriol with or without supplemental calcium after surgery. In the immediate postoperative period, hypocalcemia developed and was corrected in 11 dogs. At the end of the study, 7 dogs continued to receive calcitriol with or without supplemental calcium, and 8 dogs required long-term thyroid hormone treatment. Six dogs received adjuvant chemotherapy. Local tumor recurrence or de novo distant metastasis was not detected at each dog's last follow-up examination. Median survival time was 38.3 months. Three dogs were lost to follow-up, 8 survived (4.3 to 77 months after surgery), and 4 died of unrelated causes.

Conclusions and Clinical Relevance—In dogs with TGCs undergoing bilateral thyroid lobectomies, a successful outcome can be expected, even when parathyroid gland tissue cannot be preserved. The role of adjuvant chemotherapy in treatment outcome was not clearly defined.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To determine survival times of selected dogs with metastatic (stage III) osteosarcoma, whether disease-free interval (DFI) was associated with survival time after diagnosis of stage III disease (ie, stage III survival time), and whether a survival benefit of metastasectomy existed.

DESIGN Retrospective case series with nested cohort study.

ANIMALS 194 client-owned dogs treated for histologically confirmed appendicular osteosarcoma from 1997 through 2009.

PROCEDURES Dogs were included if they had stage I or II osteosarcoma at the time of initial evaluation, had amputation of the affected appendage and ≥ 1 dose of chemotherapy afterward, and developed metastasis within the follow-up period or prior to death. Data collected from the medical records included signalment, primary tumor location, clinical and laboratory findings, whether metastasectomy was performed, and outcome. Various factors were examined for associations with outcome.

RESULTS Dogs that received no treatment for the metastasis had a median survival time between 49 and 57 days after diagnosis of stage III osteosarcoma. Duration of the preceding DFI had no association with this period. Metastasectomy alone was associated with a longer median stage III survival time (232 days) than no metastasectomy (49 days). Among all dogs identified as qualifying for pulmonary metastasectomy on the basis of < 3 pulmonary nodules visible on thoracic radiographs and a DFI > 275 days (n = 21), a survival advantage was also identified for those that actually received pulmonary metastasectomy (6).

CONCLUSIONS AND CLINICAL RELEVANCE Preceding DFI had no influence on survival time of dogs with stage III osteosarcoma. Metastasectomy was associated with an increase in survival time for selected dogs.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate the outcome in terms of progression-free interval (PFI) and overall survival time (ST) after curative-intent resection of oral melanoma in dogs.

Design—Retrospective case series.

Animals—70 client-owned dogs.

Procedures—An electronic medical record search and review was performed for dogs that underwent curative-intent resection of oral melanoma (May 1, 1998, to December 31, 2011). Information gathered included signalment, oral location of tumor, staging results, type of surgery, type of adjuvant therapy, findings on histologic evaluation, and outcome.

Results—36 (51.4%), 16 (22.9%), 13 (18.6%), and 1 (1.4%) of 70 dogs had tumors classified as stage I, II, III, and IV, respectively; tumor stage could not be determined for 4 (5.7%) dogs because of the lack of tumor size information. Fifty-one (72.9%) dogs had tumors completely excised. Twenty-nine (41.4%) dogs received adjuvant therapy. Median PFI and ST were 508 and 723 days, respectively. Thirty-two (45.7%) dogs had disease progression. Significant associations with PFI or ST were found for administration of adjuvant therapy, presence of metastatic disease at the time of diagnosis, higher tumor stage (III or IV), increased tumor size (> 3 cm), and sexually intact female dogs. Administration of adjuvant treatment was associated with a 130% increased hazard (hazard ratio, 2.3; 95% confidence interval [CI], 1.0 to 5.0) of disease progression; the presence of metastases at the time of diagnosis was associated with a 281% increased hazard (hazard ratio, 3.8; 95% CI, 1.5 to 9.6) of death.

Conclusions and Clinical Relevance—Results indicated that dogs with oral melanoma can have a long PFI and ST after resection with wide margins.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To describe the biological behavior, clinical outcome, and prognostic factors of osteosarcoma of the maxilla, mandible, or calvarium in dogs.

Design—Retrospective case series.

Animals—183 client-owned dogs with osteosarcoma of the maxilla, mandible, or calvarium.

Procedures—Medical records for dogs treated for osteosarcoma of the maxilla, mandible, or calvarium from 1986 through 2012 were reviewed. Dogs with a histopathologic diagnosis of osteosarcoma and treated for a primary tumor arising from these bones of the head were included.

Results—Mean age was 9.3 years, and body weight was 31.8 kg (70.0 lb). Most dogs (124/183 [67.8%]) were purebred, and the most common primary tumor site was the maxilla (80 [43.7%]). Treatments included palliative medical treatment only (11/183 [6.0%]), coarsely fractionated radiation therapy (RT; 12 [6.6%]), fractionated or stereotactic RT (18 [9.8%]), surgery (135 [73.8%]), and both surgery and fractionated RT (7 [3.8%]). Eighty-three (45.4%) dogs received adjuvant chemotherapy. Local recurrence or progression occurred in 80 of 156 (51.3%) dogs, and 60 of 156 (38.5%) dogs developed distant metastases. Median survival time for all dogs was 239 days. Dogs that underwent surgery had a median survival time of 329 days. Histologically tumor-free surgical margins were associated with significantly decreased hazards of progression or recurrence (hazard ratio [HR], 0.4) and death (HR, 0.5). Dogs with osteosarcoma of the calvarium had a significantly greater hazard of local recurrence or progression (HR, 2.0).

Conclusions and Clinical Relevance—In this study, tumor excision in dogs with histologically tumor-free margins resulted in better local control and longer survival time than did other treatment types.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To characterize biomechanical differences in gait between dogs with and without an amputated thoracic limb.

Animals—Client-owned dogs (16 thoracic-limb amputee and 24 quadruped [control] dogs).

Procedures—Dogs were trotted across 3 in-series force platforms. Spatial kinematic and kinetic data were recorded for each limb during the stance phase.

Results—Amputees had significant increases in stance duration and vertical impulse in all limbs, compared with values for control dogs. Weight distribution was significantly increased by 14% on the remaining thoracic limb and by a combined 17% on pelvic limbs in amputees. Braking ground reaction force (GRF) was significantly increased in the remaining thoracic limb and pelvic limb ipsilateral to the amputated limb. The ipsilateral pelvic limb had a significantly increased propulsive GRF. The carpus and ipsilateral hip and stifle joints had significantly greater flexion during the stance phase. The cervicothoracic vertebral region had a significantly increased overall range of motion (ROM) in both the sagittal and horizontal planes. The thoracolumbar vertebral region ROM increased significantly in the sagittal plane but decreased in the horizontal plane. The lumbosacral vertebral region had significantly greater flexion without a change in ROM.

Conclusions and Clinical Relevance—Compared with results for quadruped dogs, the vertebral column, carpus, and ipsilateral hip and stifle joints had significant biomechanical changes after amputation of a thoracic limb. The ipsilateral pelvic limb assumed dual thoracic and pelvic limb roles because the gait of a thoracic limb amputee during trotting appeared to be a mixture of various gait patterns.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate biomechanical gait adaptations in dogs after amputation of a pelvic limb.

Animals—Client-owned dogs (12 pelvic limb–amputee and 24 quadruped [control] dogs).

Procedures—Dogs were trotted across 3 in-series force platforms. Spatial kinematic and kinetic data were recorded for each limb during the stance phase.

Results—Pelvic limb amputees had increased peak braking forces in the contralateral thoracic limb and increased propulsive forces and impulses in both the ipsilateral thoracic limb and remaining pelvic limb. Time to peak braking force was significantly decreased, and time to peak propulsive force was significantly increased in all remaining limbs in amputees. Amputees had an increase in range of motion at the tarsal joint of the remaining pelvic limb, compared with results for the control dogs. Amputees had increased vertebral range of motion at T1 and T13 and increased vertebral extension at L7 within the sagittal plane. In the horizontal plane, amputees had increased lateral bending toward the remaining pelvic limb, which resulted in a laterally deviated gait pattern.

Conclusions and Clinical Relevance—Pelvic limb amputees adjusted to loss of a limb through increased range of motion at the tarsal joint, increased range of motion in the cervicothoracic and thoracolumbar vertebral regions, and extension of the lumbosacral vertebral region, compared with results for the control dogs. Amputees alternated between a laterally deviated gait when the pelvic limb was in propulsion and a regular cranially oriented gait pattern when either forelimb was in propulsion with horizontal rotation around L7.

Full access
in American Journal of Veterinary Research