Combined Resection of the Nasal Planum and Premaxilla in Three Dogs

Surgical techniques for removal of tumors that affect the nasal planum or the premaxilla have been described. For extensively invasive malignancies, these techniques may be inadequate if used alone to achieve wide surgical margins. An operative technique that combines resection of the nasal planum and premaxilla has been developed for extensive malignant tumors of the nasal planum or premaxilla. This technique was used in three dogs and resulted in an acceptable cosmetic appearance and good function and tumor control. Complications after surgery included minor bleeding and partial dehiseence of the suture lines in two dogs and stenosis of the nasal orifice in one dog.     

Use of a latissimus dorsi myocutaneous flap for one-stage reconstruction of the thoracic wall after en bloc resection of primary rib chondrosarcoma in five dogs

Objective— To describe a thoracic wall reconstructive technique using a latissimus dorsi myocutaneous flap after en bloc resection of primary rib chondrosarcoma and report outcome in 5 dogs.
Study Design— Retrospective study.
Animals— Dogs (n=5) with primary rib chondrosarcoma.
Methods— Medical records (2003–2005) were reviewed for signalment, staging investigations, surgical findings, complications, and outcomes. Owners and veterinary surgeons were contacted for outcome information.
Results— A latissimus dorsi myocutaneous flap provided an air-tight thoracic wall closure after chondrosarcoma resection. Paradoxical respiratory movement of the flap occurred; however, from physical examination and blood gas analysis (2 dogs), ventilation was adequate. All flaps survived, 1 had superficial skin necrosis distally and 2 had minor wound dehiscence. One dog without tumor-free margins died of tumor-related disease 56 days after surgery. Tumor recurrence did not occur in 4 dogs with tumor-free margins. One dog was euthanatized 10 months after surgery for unrelated disease; 3 dogs were alive at writing (median follow-up: 20 months; range, 18–27 months) and all had a satisfactory functional and cosmetic outcome.
Conclusions— Reconstruction of ventral thoracic wall defects using a latissimus dorsi myocutaneous flap yields a functional, cosmetic outcome.
Clinical Relevance— A latissimus dorsi myocutaneous flap can be used as a successful 1-stage reconstructive technique for ventral thoracic wall defects.     

A technique for resection of invasive tumors involving the trigone area of the bladder in dogs: preliminary results in two dogs

Objective— To describe a surgical technique for resection of the entire bladder neck, including the trigone and proximal urethra in dogs with invasive tumors causing life-threatening urinary tract obstruction.
Study Design— Clinical case reports.
Animals— Dogs (n=2) with bladder tumors.
Methods— Circumferential excision of the bladder neck and proximal urethra with preservation of the neurovascular pedicles was performed to remove a rhabdomyosarcoma (dog 1) and a transitional cell carcinoma (dog 2) involving the trigone and bladder neck that were causing urinary tract obstruction. Reconstruction of the bladder and proximal urethra included bilateral ureteroneocystostomy. Adjuvant chemotherapy was administered postoperatively to both dogs.
Results— Postoperatively, dogs 1 and 2 were continent after 7 and 17 days, respectively, and regained normal urinary function after resolution of a transient pollakiuria. Dog 1 had no evidence of local or regional recurrence; however, a large solitary pulmonary metastatic lesion was diagnosed 8 months later. The dog was euthanatized despite a lack of clinical signs. Dog 2 had at least 1 metastatic lesion in the abdominal wall 6 months later and was euthanatized at 580 days because of renal failure.
Conclusion— En-bloc removal of the bladder neck and proximal urethra with preservation of the dorsal vascular and nervous pedicles, although a technically challenging procedure, can be performed without associated urinary incontinence or bladder wall necrosis.
Clinical Relevance— In dogs with invasive bladder tumors causing life-threatening urinary tract obstruction, resection of the bladder neck and proximal urethra should be considered as a promising surgical alternative to urinary diversion.     

Clinical resolution of nasal aspergillosis following therapy with a homeopathic remedy in a dog

A 6 yr old, male, neutered Weimaraner was treated homeopathically for nasal aspergillosis after failing to respond to two treatments of topical (intranasal) clotrimazole and oral amoxicillin trihydrate/clavulanate potassium. Computed tomography, rhinoscopy, fungal culture, and cytology previously confirmed the diagnosis. At presentation for homeopathic treatment, the dog had aggressive left-sided sinusitis and rhinitis with destruction of nasal turbinates and severe bouts of epistaxis. Erosion and depigmentation of the nasal planum were evident. After two treatments with homeopathic aurum metallicum, resolution of clinical signs occurred and clearance of the aspergillosis organisms was documented by computed tomographic scan, rhinoscopy, and histopathology. Homeopathic aurum metallicum may be beneficial in treating cases of canine nasal aspergillosis.     

Use of the lip-to-lid flap for replacement of the lower eyelid in five cats

OBJECTIVE: To report outcomes after reconstruction of the lower eyelid following resection of squamous cell carcinoma (SCC). STUDY DESIGN: Retrospective study. ANIMALS: Five cats (6 eyelids). METHODS: Case records were reviewed for breed, sex, surgical findings, complications, and outcome. RESULTS: Six eyelids were reconstructed in 5 cats; functional outcome was excellent. Neither wound breakdown nor flap failure occurred. An area of superficial necrosis occurred in 1 cat; this spared the eyelid margin and healed by secondary intention without any cosmetic or functional effect. One cat was euthanatized 18 months later because of a nasal mass. The relationship between the nasal mass and the previously excised SCC was not established. CONCLUSIONS: Reconstruction of the lower eyelid using a lip-to-lid flap yields satisfactory functional and cosmetic results in cats. CLINICAL RELEVANCE: A lip to lid flap is a successful form of single-stage reconstruction after lower eyelid excision in cats.     

Intranasal melanoma treated with radiation therapy in three dogs

Three dogs were investigated for chronic unilateral nasal discharge. In all cases CT imaging showed an intranasal mass causing turbinate lysis and no evidence of metastasis. Cytology in cases 1 (a 14-year-old neutered male crossbreed dog) and 2 (a five-year-old neutered male German Shepherd dog) demonstrated a pleomorphic cell population with variable intracellular pigment suspicious of melanocytic neoplasia. Histopathology with immunohistochemistry (Melan-A and vimentin, plus PNL-2 in one case) confirmed the diagnosis of melanoma in all dogs. All dogs were treated with megavoltage radiotherapy using linear accelerators. Cases 1 and 3 (a nine-year-old neutered female beagle dog) received a hypofractionated (4 × 8 Gy) protocol and case 2 received a definitive (12 × 4 Gy) protocol. Complete remission was demonstrated on repeat CT scan five months after diagnosis in case 1 and seven months in case 2. Stable disease was documented on CT at four months for case 3; however, clinical signs in this dog remained controlled for 10 months in total. Case 1 died of unrelated causes five months after diagnosis, case 2 was euthanased due to the development of seizures 13 months after diagnosis, and case 3 was lost to follow-up 12 months after diagnosis. Melanoma should be considered as a rare differential diagnosis for primary nasal neoplasia in the dog and radiation therapy can be used as effective local therapy.     

Squamous cell carcinoma of the nasal planum in 17 dogs

Squamous cell carcinoma of the nasal planum was diagnosed in 17 dogs over a period of 11 years. Ulceration, bleeding and sneezing were the most common clinical signs. One dog had cytological evidence of metastasis to the local lymph node. The dogs were treated by surgical resection, fractionated megavoltage irradiation, or a combination of the two. Surgical resection gave the most favourable results; four of six dogs were cured but a recurrence of the tumour was predicted in the other two on the basis of incomplete or marginal resection. Radiotherapy alone was not as effective; one of four dogs was cured, and the tumour recurred in the others within 24 weeks (median eight weeks). Combined surgical resection and radiotherapy did not produce a cure in any of the seven remaining dogs, and the tumour recurred within 12 weeks (median nine weeks). Three dogs had cytological evidence of lymph node metastasis when the tumour recurred. The dogs' prognosis was adversely affected by the interval between their initial examination and treatment, but there was no apparent association between the histological grade of the tumour and the clinical outcome.     

Outcome and complication rate of nasal planectomy reconstructed with direct mucocutaneous apposition

Nasal planectomy is recommended in cases of squamous cell carcinoma of the nasal planum in dogs and can be curative if excision is complete. Due to the noticeable alteration in appearance inherent in nasal planectomy, several techniques are described for reconstruction. The goal of this study is to report the complication rate and owner satisfaction following nasal planectomy with repair by direct mucocutaneous apposition compared to other reported reconstruction techniques meant to be more cosmetic. Eleven dogs were identified that underwent nasal planectomy with reconstruction via mucocutaneous apposition. Complications were noted in 8/11 dogs: all minor. All dogs underwent CT preoperatively for surgical planning. Complete excision was noted in 10/11 cases. Results suggest that direct mucocutaneous apposition is a viable surgical option for reconstruction following nasal planectomy with favorable major complication rates and owner satisfaction. In addition, direct mucocutaneous apposition for closure following nasal planectomy should be considered, especially in cases in which bone is not resected, because of low complication rates and reasonable cosmetic outcome.     

Squamous cell carcinoma of the nasal planum in cats and dogs

The purpose of this article is to review the therapeutic options available for the treatment of squamous cell carcinoma of the nasal planum in cats and dogs. The techniques of complete and partial nasal planum resection in the cat are described in detail. Surgical treatment offers the greatest chance of cure, although several options are available for early, less invasive lesions.     

Successful management of suspected acorn (Quercus petraea) toxicity in a dog

A 7-year-old neutered male Labrador retriever dog was referred to a tertiary care veterinary hospital because of gastrointestinal signs and icterus. The dog developed a hepatopathy and acute kidney injury after ingesting acorns (Quercus petraea) 4 days prior to referral. The dog required hospitalization in an intensive care unit but made a full clinical recovery and was discharged after 6 days. This report documents that dogs can be affected by this toxicity and highlights the need for veterinarians to consider acorns as a potential cause of acute hepatotoxicity and renal injury. To the authors’ knowledge, this is the first reported case of acorn toxicity in a dog.     

Complications and management of a long-term pleural access port in a dog with chronic chylothorax associated with lung lobe torsion

A 2-year-old neutered male 35-kg golden retriever mixed breed dog was presented because of a 3-day history of increased respiratory effort. The patient was subsequently diagnosed with a lung lobe torsion and underwent lung lobectomy. Chylothorax developed after surgery and persisted for 3.5 y. Pleural access port (PAP) placement was used for long-term medical management. Several complications were encountered, including 2 episodes of PAP occlusion that were successfully treated with unfractionated heparin. The dog had a surgical site seroma and 2 episodes of pleuritis; euthanasia was elected after the second episode.Key clinical message:This case demonstrates successful long-term management of chylothorax with a pleural access port and management of 3 complications. Instead of the less accessible and more expensive tissue plasminogen activator, unfractionated heparin was used as an effective treatment for PAP occlusions.     

Leiomyoma in the nasal cavity of a dog

A 7‐year‐old, 34‐kg, neutered male Labrador retriever was presented with a 1‐year history of intermittent sneezing with occasional left‐sided epistaxis. CT revealed a mass in the left nasal cavity. Histopathological analysis of rhinoscopy‐guided tissue biopsies was consistent with chronic necrotic and ulcerative rhinitis. Surgical debridement by ventral rhinotomy was subsequently performed and histopathological diagnosis was leiomyoma. Complete resolution of the nasal discharge and reduced sneezing frequency were observed after surgery. Fourteen months postoperatively, CT detected no regrowth of the mass.     

Evaluation of strontium Sr 90 for the treatment of superficial squamous cell carcinoma of the nasal planum in cats: 49 cases (1990-2006)

OBJECTIVE: To determine progression-free and overall survival times of cats with squamous cell carcinoma (SCC) of the nasal planum following treatment with a single fraction of strontium Sr 90 ((90)Sr). DESIGN: Retrospective case series. ANIMALS: 49 cats with SCC of the nasal planum. PROCEDURES: Information including FIV infection status, diagnosis of SCC vs SCC in situ (ie, evidence that the tumor did or did not penetrate the epidermal basement membrane, respectively), (90)Sr dose and number of probe applications, treatment-related response and complications, and recurrence of SCC and new lesion development was obtained from medical records. The relationships of these variables with calculated progression-free and overall survival times were assessed. RESULTS: Of 49 cats that underwent (90)Sr plesiotherapy (median dose, 128 Gy), 48 (98%) had a response to treatment and 43 (88%) had a complete response. Median progression-free and overall survival times were 1,710 and 3,076 days, respectively. Treatment complications were infrequent (4 [8%] cats) and mild. Following treatment, the SCC recurrence rate was 20% (10/49 cats); 16 (33%) cats developed new lesions in other locations. Overall survival time was significantly longer for cats with a complete response to treatment than for those with a partial response. None of the other variables evaluated had a significant effect on progression-free or overall survival time. CONCLUSIONS AND CLINICAL RELEVANCE: Treatment of cats with SCC of the nasal planum with a single fraction of (90)Sr appeared to be effective and well tolerated. Initial response to treatment was predictive of overall survival time.     

Use of the Kishigami Atlantoaxial Tension Band in Eight Toy Breed Dogs with Atlantoaxial Subluxation

Objective— To determine the applicability, complications, and long-term functional outcome of the Kishigami Atlantoaxial Tension Band (Kishigami AATB) for management of congenital and traumatic atlantoaxial (AA) instability in toy breed dogs.
Study Design— Case series.
Animals— Toy breed dogs (n=8) with congenital or traumatic AA instability.
Methods— The AA joint of each dog was surgically stabilized through a dorsal approach using the original or a modified version of the Kishigami AATB. Pre- and postoperative neurologic status, radiographs, and complications were reviewed. Follow-up examination was performed at 1 and 12 months.
Results— Functional improvement occurred in 5 dogs; 1 dog did not improve or worsen and 2 dogs were euthanatized at owner request. Adequate reduction and stabilization was achieved in 7 dogs based on immediate postoperative radiographs; failure of reduction was evident in 1 dog. No relevant complications occurred.
Conclusions— Kishigami AATB may be acceptable as an alternative method for dorsal stabilization of AA subluxation in toy breed dogs in which use of ventral screws or pins is challenging. Experience with this technique in a larger population is necessary to compare our results to those reported by ventral approach.
Clinical Relevance— The surgical technique described is effective, safe, and simple in the surgical treatment of AA subluxation in toy breed dogs.     

Canine atopic disease: investigations of eosinophils and the nasal mucosa

Blood eosinophil counts were comparable in dogs with and without canine atopic disease. Eosinophils were not observed in the nasal smears of any of the dogs studied. Of 46 dogs with atopic disease, a significant increase (P less than 0.001) in nasal airway resistance was observed in 2 dogs after nasal provocation with nebulized allergens of grasses and in 1 dog after provocation with summer weed extracts.     

Combined clotrimazole irrigation and depot therapy for canine nasal aspergillosis

OBJECTIVES: To evaluate the effect of short duration 1 per cent clotrimazole flush when combined with 1 per cent clotrimazole cream instilled into the frontal sinuses for the treatment of nasal aspergillosis in 14 dogs. METHODS: Fourteen dogs with clinical, radiological, serological and rhinoscopic findings consistent with nasal aspergillosis were treated by frontal sinus trephination and a short, five-minute flushing of 1 per cent topical clotrimazole solution followed by a 1 per cent clotrimazole cream instilled as a depot agent. RESULTS: Twelve of the 14 dogs (86 per cent) responded well to treatment and either had no clinical signs after treatment or had signs consistent with mild rhinitis during a minimum follow-up period of six months. Only one dog required multiple treatments. Treatment was well tolerated by all patients, with minimal complications. CLINICAL SIGNIFICANCE: This treatment compares favourably to previously published data using one-hour topical clotrimazole or enilconazole flushing treatment protocols. The treatment technique significantly reduced treatment time under anaesthesia.     

Nasal planum reconstruction after tumour resection using a lip-to-nose flap in a dog

Here we describe the use of a novel lip-to-nose flap technique for nasal planum reconstruction after tumour removal in a dog. A mast cell tumour involving the nasal planum was first resected by removing the roof and the wing of the left nasal vestibule. An interpolation subdermal plexus flap was derived from the left caudal lip with vascular contribution from the lateral nasal artery. This lip-to-nose flap was rotated into the defect via a bridging incision. The mucocutaneous junction of the lip was used to emulate the keratinised nasal planum and the buccal mucosa was sutured to be congruent with the mucosa of the vestibule. This resulted in the lip-to-nose flap successfully closing the surgical defect and giving an aesthetic appearance similar to the original nasal planum.     

The Effect of Laparoscopic Versus Open Ovariectomy on Postsurgical Activity in Small Dogs

Objective— To describe a technique for laparoscopic ovariectomy (LapOVE) in small dogs, and compare the surgical time, complications, and postoperative activity of dogs undergoing LapOVE to those undergoing conventional traditional open ovariectomy (OOVE).
Study Design— A randomized, controlled clinical trial.
Animals— Intact small breed (<10 kg) female dogs (n=20).
Methods— Ventral median celiotomy was performed for OOVE. A 2-midline portal technique using a 3.5 mm laparoscope port and a 6 mm instrument portal was used for LapOVE. An accelerometer was attached to the collar of each dog to record 24-hour preoperative and 48-hour postoperative activity. Total activity counts recorded before surgery were compared with total counts recorded after surgery. The percent change in counts after surgery was compared between OOVE- and LapOVE-treated dogs.
Results— No major complications occurred and surgical time for LapOVE was significantly longer than for OOVE cases ( P =.005). Dogs in the LapOVE group had a 25% decrease in total activity counts after surgery (95% confidence interval [CI]: 11–38%), whereas dogs in the OOVE group had a 62% decrease in total activity counts after surgery (95% CI: 48–76%).
Conclusions— Both procedures were performed with reasonable surgical times and without major complication. Postoperative activity, as measured by accelerometry, was significantly different between the 2 groups.
Clinical Relevance— Laparoscopy is a safe method for ovariectomy in small dogs and results in increased postoperative activity counts when compared with an open technique.     

CT-GUIDED BRAIN BIOPSY USING A MODIFIED PELORUS MARK III STEREOTACTIC SYSTEM: EXPERIENCE WITH 50 DOGS

This report describes the results of CT-guided stereotactic brain biopsies performed on 50 consecutive dogs using a modified Pelorus Mark III Stereotactic System. Based on available histopathologic samples (stereotactic biopsy [n = 50], surgery [n = 17], necropsy [n = 9]) the patient population consisted of 34 dogs with primary brain tumors, 2 with invasive nasal adenocarcinomas, and 13 with non-neoplastic brain lesions. Brain tissue was not obtained from one dog. In 22 dogs a final diagnosis was made from tissue subsequently obtained from surgical resection or at necropsy. The final diagnosis was in agreement with the stereotactic biopsy diagnosis in 20 of these 22 dogs. In 17 other dogs without follow-up, stereotactic biopsy provided a diagnosis of a specific primary brain tumor subtype. Postoperative complications associated with the biopsy procedure were assessed in 41 dogs. The other 9 dogs either went directly to surgery (n = 7) or were killed (n = 2) immediately after the biopsy procedure. Thirty-six dogs recovered without apparent clinical complications. Postoperative clinical complications in the remaining 5 dogs included transient epistaxis (1 dog), transient exacerbation of cerebellar signs (1 dog), obtundation progressing to coma (1 dog), and medically uncontrollable seizures (2 dogs). The latter 3 dogs with severe neurologic complications all had large primary brain tumors and had been receiving high doses of phenobarbital and glucocorticoids to control seizures at the time of biopsy. These results suggest that this CT-guided biopsy procedure can provide an accurate pathologic diagnosis of brain lesions detected by CT and MR neuroimaging. Further refinement of both technique and case selection is expected to reduce the rate of clinical complications and to improve the accuracy of the procedure.     

Percutaneous Cementoplasty in the Palliative, Multimodal Treatment of Primary Bone Tumors of the Distal Aspect of the Radius in Four Dogs

Objective— To (1) evaluate the analgesic effect of percutaneous cementoplasty (PC) in dogs with primary bone tumor (PBT) of the distal aspect of the radius and (2) evaluate the impact on the course of disease by adding PC to a palliative, multimodal treatment protocol in these dogs.
Study Design— Prospective pilot study.
Animals— Dogs (n=4) with PBT of the distal aspect of the radius.
Methods— Tumor lesions were filled percutaneously with polymethylmethacrylate under fluoroscopic guidance. Pamidronate was administered once in a week before PC. Radiotherapy and chemotherapy were initiated 2 and 6 weeks after PC, respectively. Force plate analysis was performed immediately before 2, and 6 weeks after PC. Survival time was defined from PC to euthanasia.
Results— Two dogs had a significant increase in peak vertical force 2 weeks after PC ( P =.043) and remained free of lameness for 18 and 20 weeks, respectively. One dog had an acute relapse after an initially lame-free period of 10 days. The remaining dog failed to improve ( P =.686). Three dogs developed at least 2 complications including transient worsening of the lameness after PC, cement leakage, wound infection and suspected thromboembolism in combination with cough and anemia. Median survival was 4.8 months (range, 1–5.7 months).
Conclusions— PC in combination with pamidronate significantly improved lameness in 2 dogs; however, PC is not risk-free. Deep wound infection, intraarticular cement leakage, and venous thrombosis were the main complications.
Clinical Relevance— PC might be a useful addition to established palliative, multimodal treatment protocols in dogs with PBT; however, because of the complications encountered PC warrants further study before routine use can be considered.