A 16-year-old 4.4-kg (9.7-lb) spayed female domestic longhair cat was examined by a referring veterinarian because of ptyalism. Upon examination, a left-sided oral swelling or mass was identified. Skull radiography revealed a lytic and proliferative lesion associated with the left mandible; findings of thoracic radiography were unremarkable. Additional patient history included hyperthyroidism; inflammatory bowel disease; cutaneous mast cell tumors with hepatic and splenic metastases, which had been treated with 8 doses of vinblastine-based chemotherapy and splenectomy; chronic kidney disease (International Renal Interest Society1 stage 2); and hypertrophic cardiomyopathy. Medical management of the cat's concurrent maladies had maintained
CASE DESCRIPTION 5 dogs between 9 and 11 years of age were evaluated for treatment of primary (n = 2) or metastatic (3) hepatic neoplasia.
CLINICAL FINDINGS Patients were evaluated on an elective (n = 3) or emergency (2) basis. Two dogs with primary hepatic neoplasia were evaluated because of lethargy and inappetence. One dog was referred after an enlarged anal sac was detected via palpation per rectum during a routine physical examination. Two dogs were evaluated on an emergency basis because of lethargy and weakness, and hemoabdomen in the absence of a history of trauma was detected. All 5 dogs underwent thoracic radiography and abdominal ultrasonography, with CT performed in both dogs with primary hepatic neoplasia. All dogs had preoperative evidence of abdominal neoplasia, and none had evidence of thoracic metastasis.
TREATMENT AND OUTCOME All dogs underwent ventral midline laparotomy and had diffuse hepatic neoplasia that precluded complete resection. Locoregional treatment with MWA was applied to hepatic lesions (0.5 to 2.5 cm diameter) without procedural complications. Histopathologic diagnoses were biliary adenocarcinoma (n = 1), hemangiosarcoma (2), hepatocellular carcinoma (1), and apocrine gland adenocarcinoma (1).
CLINICAL RELEVANCE MWA is being increasingly used as an adjunct in the surgical treatment of human patients with primary and metastatic liver disease. Results of the present small case series suggested that MWA is feasible and potentially effective as an adjunctive treatment for appropriately selected dogs with nonresectable hepatic tumors. Further investigation is indicated.
To determine the optimal energy profile for and to assess the feasibility and efficacy of ultrasonographic and laparoscopic guidance for microwave ablation (MWA) of clinically normal canine ovaries.
44 extirpated ovaries from 22 healthy dogs.
In the first of 2 trials, 13 dogs underwent oophorectomy by routine laparotomy. Extirpated ovaries underwent MWA at 45 W for 60 (n = 11) or 90 (12) seconds; 3 ovaries did not undergo MWA and served as histologic controls. Ovaries were histologically evaluated for cell viability. Ovaries without viable cells were categorized as completely ablated. Histologic results were used to identify the optimal MWA protocol for use in the subsequent trial. In the second trial, the ovaries of 9 dogs underwent MWA at 45 W for 90 seconds in situ. Ultrasonographic guidance for MWA was deemed unfeasible after evaluation of 1 ovary. The remaining 17 ovaries underwent MWA with laparoscopic guidance, after which routine laparoscopic oophorectomy was performed. Completeness of ablation was histologically assessed for all ovaries.
2 ovaries were excluded from the trial 1 analysis because of equivocal cell viability. Six of 11 ovaries and 10 of 10 ovaries that underwent MWA for 60 and 90 seconds, respectively, were completely ablated. In trial 2, laparoscopic-guided MWA resulted in complete ablation for 12 of 17 ovaries. Dissection of the ovarian bursa for MWA probe placement facilitated complete ablation.
CONCLUSIONS AND CLINICAL RELEVANCE
Laparoscopic-guided MWA at 45 W for 90 seconds was feasible, safe, and effective for complete ablation of clinically normal ovaries in dogs.