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- Author or Editor: Stephen J. Mehler x
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Abstract
Objective—To determine clinicopathologic features, surgical management, complications, and long-term outcome associated with diseases of the extrahepatic portion of the biliary tract treated via choledochal stent placement in dogs.
Design—Retrospective case series.
Animals—13 dogs.
Procedure—Data were obtained from medical records, and follow-up information was obtained via reexamination or telephone interview with owners or referring veterinarians.
Results—10 dogs had extrahepatic biliary obstruction (EHBO), 6 as a result of pancreatitis. Two dogs had rupture of the common bile duct associated with cholelithiasis. In 1 dog, a stent was placed prophylactically after gastroduodenostomy was performed for a perforated duodenal ulcer. Nine of 13 dogs survived the perioperative period and were discharged. No recurrence of EHBO or other complications developed in the discharged dogs while the stents were in place. Median follow-up period from surgery to last owner contact was 13.3 months. In 1 dog, the stent was removed endoscopically 10 months after surgery and EHBO recurred 9 months after stent removal because of cholangitis. In 4 of 5 dogs that were discharged from the hospital, in which the fate of the stent could be confirmed and the stent was secured to the duodenal wall with absorbable suture materials, the stents were passed in the feces 1 to 11 months after surgery.
Conclusions and Clinical Relevance—Choledochal tube stenting is an effective method of decompression of the extrahepatic portion of the biliary tract in dogs and provides a less complex alternative to traditional cholecystoenterostomy techniques in select cases.
Abstract
Case Description—A 19-year-old neutered male domestic shorthair cat was evaluated because of signs of urinary tract obstruction.
Clinical Findings—Physical examination findings were consistent with urethral obstruction, and a mass could be palpated in the region of the bladder neck. Abdominal ultrasonography and thoracic radiography revealed a mass in the trigone of the urinary bladder and a solitary mass in the left caudal lung lobe. Cytologic examination of the urine sediment, samples obtained by means of traumatic urethral catheterization, and fine-needle aspirates of the bladder mass did not result in a diagnosis.
Treatment and Outcome—A balloon-expandable metallic stent was placed in the proximal portion of the urethra to relieve the malignant obstruction. After stent placement, the cat had signs of urinary incontinence and detrusor atony, both of which resolved with medical treatment. The cat was euthanized 1 month after stent placement because of progressive azotemia. Histologic examination of necropsy samples revealed grade III urothelial carcinoma and papillary pulmonary adenocarcinoma.
Clinical Relevance—Findings suggested that stent placement may be a viable palliative treatment in cats with malignant urinary obstruction.
Abstract
Objective—To reexamine (via immunohistochemical techniques) canine tissue samples that had been previously classified as gastrointestinal leiomyosarcomas (GILMSs), identify and differentiate gastrointestinal stromal tumors (GISTs) from GILMSs, and compare the biological behavior and clinical course of GISTs and GILMSs in dogs.
Design—Retrospective case series.
Animals—42 dogs.
Procedures—Medical records of 42 dogs for which a histologic diagnosis of GILMS was confirmed were reviewed for signalment, clinical signs, physical examination findings, results of initial diagnostic tests, surgical findings, adjunctive treatment, location of the tumor, completeness of resection, and outcome after surgery. Archived tumor tissue specimens from each dog were restained via immunohistochemical techniques to differentiate tumor types. Long-term follow-up information was obtained from the medical record or through telephone interviews with owners and referring veterinarians.
Results—On the basis of immunohistochemical findings, 28 of 42 tumors were reclassified as GISTs and 4 were reclassified as undifferentiated sarcomas; 10 tumors were GILMSs. In dogs, GISTs developed more frequently in the cecum and large intestine and GILMSs developed more frequently in the stomach and small intestine. Median survival times for dogs with GISTs and GILMSs were 11.6 and 7.8 months, respectively; if only dogs surviving the perioperative period were considered, median survival times were 37.4 and 7.8 months, respectively. These differences, however, were not significant.
Conclusions and Clinical Relevance—In dogs, many previously diagnosed GILMSs should be reclassified as GISTs on the basis of results of immunohistochemical staining. The biological behavior of these tumors appears to be different.
