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Abstract

Case Description—A 4-month-old Bernese Mountain Dog was examined because of shifting hind limb lameness and lethargy of 2 weeks' duration.

Clinical Findings—The lameness was attributed to hypertrophic osteodystrophy. Portosystemic shunting was suspected on the basis of low serum albumin concentration and high serum bile acids concentration, and an intrahepatic shunt was identified ultrasono-graphically. Celiotomy was performed, and the shunt was partially closed with a cellophane band. During follow-up ultrasonography 7 months later, dilation of the left renal pelvis and proximal portion of the left ureter was identified. During exploratory celiotomy, the left ureter was found to pass dorsal to the caudal vena cava, and circumcaval ureter was diagnosed.

Treatment and Outcome—The ureter was transected, repositioned ventral to the vena cava, and anastomosed. Follow-up ultrasonographic examinations revealed gradual resolution of the hydronephrosis and hydroureter.

Clinical Relevance—Findings suggest that circumcaval ureter should be considered in the differential diagnosis for hydronephrosis and hydroureter in dogs. Partial obstruction of the middle segment of the ureter on ultrasonograms or contrast radiographs should increase the index of suspicion for this condition.

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

Abstract

OBJECTIVE

To describe a novel presentation of paraneoplastic hypercalcemia caused by a canine salivary carcinoma.

ANIMAL

A 6-year-old intact male Husky with hypercalcemia and a spontaneous salivary carcinoma, stage III.

CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES

The dog presented with polyuria, polydipsia, and hypercalcemia. Physical examination revealed a 37 X 43-mm firm mass in the ventrolateral aspect of the right-hand side of the neck, caudal to the temporomandibular joint. Incisional biopsy was suspicious of metastatic carcinoma to the mandibular lymph node. A full-body CT scan found a large, heterogenous, contrast-enhancing mass on the right ventrolateral neck that appeared to be originating from either the mandibular lymph node or right mandibular salivary gland. Parathyroid hormone–related protein was considered within normal reference intervals, and both parathyroid glands appeared ultrasonographically normal.

TREATMENT AND OUTCOME

The patient was treated with a marginal surgical excision of the mass, without immediate complications. Histopathology confirmed the presence of a salivary carcinoma with narrow margins of excision and invasion of the mandibular lymph node. Twenty-four hours after surgery, ionized calcium returned to normal reference values and clinical signs completely resolved.

CLINICAL RELEVANCE

Hypercalcemia is an urgent pathology with important systemic implications requiring prompt diagnosis and intervention. In this case report, we identify the first salivary carcinoma associated with a paraneoplastic hypercalcemia, including this pathology as a new differential diagnosis. The hypercalcemia resolved with marginal surgical excision, but interestingly the parathyroid hormone–related protein was not overexpressed, meaning that this neoplasia could mediate hypercalcemia by another pathophysiological mechanism.

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in Journal of the American Veterinary Medical Association