Currently, intraoperative tumour margin imaging is not routinely utilized in veterinary medicine. Optical coherence tomography (OCT) allows for real‐time assessment of tissue morphology of 1–2 mm depth. The aims of this study were (1) to compare the histologic and OCT features of excised canine skin and subcutaneous specimens, and (2) to determine the diagnostic accuracy of OCT for surgical margin evaluation. The authors hypothesized that OCT imaging would correlate well with histopathology and that OCT would be sensitive for detection of incomplete margins. Eighty dogs were prospectively enrolled. Tumours were excised, and the surgical margins were imaged using a spectral domain OCT system. The tumour type and completeness of excision were determined by histopathology. Nine blinded observers received training in OCT image interpretation and were then given a set of OCT images and videos. The observers assigned each image/video a grade from 1 (no tumour) to 4 (tumour) and the results were compared to histopathology. The overall median sensitivity and specificity of OCT imaging for detection of incomplete margins were 86.7% and 84.6%, respectively. A potential limitation is that observers had varied experience with OCT image interpretation, ranging from no prior experience to participating in a previous OCT project. OCT is sensitive for detection of incomplete margins and could be a promising real‐time surgical margin imaging modality. Further study is needed to evaluate intraoperative applications of OCT and its impact on tumour recurrence and long‐term outcome.
Septic peritonitis is a life-threatening disease that can be caused by neoplasia, among other disease processes. There is no veterinary literature directly evaluating the outcome of patients with septic peritonitis caused by neoplasia. The objective of this study was to evaluate for differences in survival to discharge and complication rates between septic peritonitis caused by neoplastic and nonneoplastic disease in canine patients. A single-institution retrospective cross-sectional cohort study was performed, identifying dogs that were treated surgically for septic peritonitis between January 1, 2010, and November 1, 2020. A total of 86 patients were included, 12 with a neoplastic cause for septic peritonitis and 74 with another cause. The most common neoplastic lesions associated with septic peritonitis were gastrointestinal lymphoma and hepatocellular adenoma. Presence of neoplasia was not a significant factor for development of intraoperative or immediate postoperative complications, nor did it decrease chances of survival to discharge (P < .09). The diagnosis of a primary, localized, neoplastic lesion alone should not deter clinicians and owners from pursuing treatment for septic peritonitis.
An 8-year-old male neutered Domestic Long Hair cat was presented for a cervical swelling that was suspected to be an enlarged left retropharyngeal lymph node. In the absence of other lymphadenopathy, this was initially suspected to be Hodgkin's-like lymphoma. A positron emission tomography–computed tomography (PET/CT) scan was performed using 2-deoxy-2-[18F]-fluorodeoxyglucose (18F-FDG) to assess for evidence of disease in other locations to guide treatment. Multifocal increased radiopharmaceutical uptake was identified, indicating disease in multiple organs. High-grade lymphoma was confirmed on tissue biopsy. As such, systemic cytotoxic chemotherapy was recommended instead of lymph node extirpation surgery. The cat received a modified CHOP chemotherapy protocol and attained a temporary partial remission. After 2 months of treatment, the cat stopped responding to chemotherapy and was eventually euthanized due to a relapse of disease and decreased quality of life. This case describes the utility of PET/CT to guide treatment in a cat with a presentation consistent with Hodgkin's-like lymphoma.
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.
Case series summary Ear canal neoplasia is uncommon in cats. Ceruminous gland adenocarcinoma is the most frequently reported malignant neoplasm of the feline ear canal, and squamous cell carcinoma (SCC) is the most common malignant neoplasm diagnosed in the feline middle ear. However, limited information exists on the outcome of cats diagnosed with SCC of the ear canal, middle or inner ear. Therefore, the objective of this study was to describe the outcome of cats diagnosed with SCC affecting these locations. Medical records were reviewed at multiple institutions to identify cats with a definitive diagnosis of SCC. Twenty-five cats were identified. Eleven cats were treated with surgery, eight with medical management, two with coarse fractionated radiation therapy, two with a combination of coarse fractionated radiation therapy and chemotherapy, one with a combination of surgery and coarse fractionated radiation therapy, one cat with systemic chemotherapy and one cat received no treatment following diagnosis. The median survival time of cats treated with surgery was 168 days vs 85 days ( P = 0.28) for those treated palliatively with either medical management, radiation therapy, chemotherapy, or a combination of radiation therapy and chemotherapy. Relevance and novel information This case series documented that SCC of the ear canal, middle and/or internal ear is a locally aggressive tumor that carries an overall poor prognosis. The median survival time for cats treated with surgery was longer than that with any other modality, but this difference was not statistically significant.
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.
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