SCINTIGRAPHIC DETECTION OF SUBCUTANEOUS METASTASIS IN A DOG WITH APPENDICULAR OSTEOSARCOMA

This report describes the detection of subclinical soft tissue metastasis of an appendicular osteosarcoma in a dog using bone scintigraphy. A 7-year-old spayed female Rottweiler was presented with a biopsy confirmed diagnosis of osteosarcoma. Initial radiographs revealed an aggressive bone lesion of the left distal radius. At presentation, there was no clinical or radiographic evidence of metastasis; however, a nuclear bone scan showed the primary bone lesion of the distal left radius and numerous soft tissue lesions consistent with diffuse soft tissue metastases. A left foreleg amputation was performed and cisplatin chemotherapy was given post-operatively. A second bone scan performed one month following initial presentation showed progression in size and number of soft tissue masses. Many of the lesions had become apparent on physical exam and survey radiographs. Excisional biopsy was performed on one of the soft tissue masses and a diagnosis of metastatic osteosarcoma was made. The dog was euthanized 2 months after initial presentation at the owners request due to deterioration of the animals physical condition.     

OSTEOSARCOMA WITH A PATHOLOGIC FRACTURE IN A SIX-MONTH-OLD DOG

This case history report describes the clinical, radiographic, and histopathologic features of an osteosarcoma with an associated pathologic fracture in a 6-month-old dog. A 6-month-old intact male Bloodhound was presented with a primary complaint of a right forelimb lameness of one month's duration. In radiographs, a minimally displaced transverse fracture of the proximal humeral metaphysis was seen. There was extensive cortical bone destruction at the fracture site and minimal periosteal new bone suggestive of a primary bone tumor with a pathologic fracture. Biopsy specimens demonstrated neoplastic mesenchymal cells producing osteoid compatible with a diagnosis of osteosarcoma. This case history report constitutes the youngest reported canine osteosarcoma.     

OSTEOSARCOMA IN THE MIDDIAPHYSIS OF THE RADIUS IN THE DOG

This case report describes the radiographic/clinical progression of a lesion in the middiaphysis of the radius in a dog. The lesion initially looked benign but progressed and eventually was diagnosed as an anaplastic osteosarcoma.     

PAROSTEAL OSTEOSARCOMA OF THE CERVICAL VERTEBRA IN A DOG

A 12-year-old Maltese terrier was evaluated for progressive tetraparesis and neck pain. On radiographs, there was a periosteal reaction involving the fourth cervical vertebra. Myelographically, there was extradural compression of the spinal cord associated with the lesion. The dog was euthanized and necropsied. Histopathologic diagnosis was parosteal osteosarcoma of the vertebra.     

SPONTANEOUS REGRESSION OF PULMONARY METASTASES IN A DOG*

Spontaneous regression of presumed lung metastases was diagnosed in an Irish Wolfhound which had a previous pelvic limb amputation for tibial fibrosarcoma. Literature on spontaneous regression in man is reviewed and implications of spontaneous tumor regression for animal patients are discussed.     

IMAGING DIAGNOSIS—ULTRASONOGRAPHIC APPEARANCE OF SKELETAL MUSCLE METASTASES IN A DOG WITH HEMANGIOSARCOMA

A 13‐year‐old spayed female German shepherd dog was presented for acute onset of lethargy, anorexia, and disseminated erythematous skin lesions. Thoracic radiographs and abdominal ultrasonographic findings were consistent with metastatic hemangiosarcoma. Multiple, ill‐defined, irregularly shaped hypoechoic nodules were also detected within the thoracic and abdominal wall. Hemangiosarcoma metastases to the skeletal muscle were confirmed based on histopathological examination. Multivisceral involvement was also confirmed by necropsy. Metastatic neoplasia should be considered as a differential diagnosis for dogs with ill‐defined, irregular, hypoechoic, intramuscular nodules.     

HEMANGIOSARCOMA IN THE MAIN PULMONARY ARTERY OF A DOG

The clinical, radiological and necropsy findings in a five-year old dog with a hemangiosarcoma in the main pulmonary artery are described. Hemangiosarcoma in this location has not been previously described in the dog, the typical location in the heart being the right atrium and auricle. The tumor in this dog caused both a perfusion deficit to the right lung and obstruction of right ventricular outflow, which eventually caused right heart failure.     

SENSITIVITY OF RADIOGRAPHIC DETECTION OF LUNG METASTASES IN THE DOG

Thoracic radiographs were taken in right lateral recumbent (RLR), left lateral recumbent (LLR), and ventrodorsal (VD) projections in 80 dogs with known or suspected malignant tumors. Radiographs in each projection were interpreted, independently of those in the other two projections, by four veterinary radiologists, and classified as positive or negative for one or more lung metastases. The four radiologists then met, to agree on a diagnosis for each patient by simultaneously reviewing all three views. This panel diagnosis became the standard for subsequently classifying individual views as either true positive or true negative. As determined by a consensus of the panel, 25 dogs had at least one positive thoracic radiograph.
The three radiographic projections differed in sensitivity for the detection of lung metastases. In this study, the RLR view was the most sensitive, and the VD view the least sensitive. The sensitivity of detection improved significantly with multiple readers. From these data we recommend that, for detection of lung metastases in the dog, the RLR view be included in any diagnostic protocol; a minimum of two readers be used; and a three-view protocol be used if only one reader is available.     

IMAGING DIAGNOSIS—MULTIMODALITY FINDINGS IN AN ADULT DOG WITH PRIMARY SARCOMA OF THE PULMONARY ARTERY AND MYOCARDIAL METASTASES

Intravascular pulmonary artery sarcomas in combination with myocardial metastasis are rare in dogs. We describe the radiographic, echocardiographic, and electrocardiographic‐gated (ECG‐gated) computed tomographic angiography (CTA) findings in a dog with pulmonary artery sarcoma. All imaging studies demonstrated severe main pulmonary artery enlargement. Echocardiography and ECG‐gated CTA revealed a mass occluding the lumen of the right pulmonary artery. In addition, CTA revealed focal left ventricular myocardial contrast enhancement and parenchymal lung changes. Postmortem examination confirmed the presence of a large thrombus associated with arteriosclerosis and an intravascular sarcoma in the right pulmonary artery with metastases to the myocardium, lungs and brain.     

PULMONARY ACTINOMYCOSIS IN A DOG

A six-year-old spayed female mixed-breed dog was evaluated for coughing, dyspnea, exercise intolerance, and intermittent fever of four month's duration. Extensive alveolar, interstitial, and peribroncial infiltration was observed throughout the lung fields, Pulmonary actinomycosis was diagnosed by isolation of Actinomyces from anaerobic cuture of a transtracheal aspirate. Therapy for Actinomycs resulted in clinical remission; however, radiographic evidence of a severe pulmonary pathologic condition remained 45 days after the initiation of therapy. The dog was asymptomatic for pulmonary disease two years following treatment.     

PALLIATIVE RADIOTHERAPY OF APPENDICULAR OSTEOSARCOMA IN 95 DOGS

Ninety-five dogs with either a presumptive (n = 24) or biopsy confirmed diagnosis (n = 71) of osteosarcoma received palliative radiotherapy using 60Co photons. Parallel opposed beams were used with each dog receiving either 10 Gy on days 0, 7 and 21 (n = 58) or 8 Gy on days 0 and 7 (n = 37). The 8 Gy fractionation scheme was given with the intent of retreating upon relapse from pain relief. Only 9 of 37 (24%) dogs in the 8 Gy group returned for retreatment. Forty-seven of the 95 dogs (49%) received concurrent or sequential chemotherapy. Seventy of the 95 dogs (74%) experienced pain relief following treatment. In dogs experiencing pain relief the median duration of response was 73 days. Numerous clinical variables were evaluated as predictors of response. The only variable significantly related to achieving a response was the use of chemotherapy. The following variables were significantly related to the duration of response: extent of bone lysis, chemotherapy use, length of bone involved and tumor site (humerus). In a multivariate analysis (n = 73 dogs), after adjusting for chemotherapy use, extent of bone involvement (p = 0.01) and tumor site (p = 0.02) retained statistical significance, while degree of bone lysis did not (p = 0.11). No difference in response incidence or duration was found between 3 fractions of 10 Gy vs. 2 fractions of 8 Gy. Administration of a low initial dose with the intent of retreatment was not a successful strategy.     

FEMORAL OSTEOMYELITIS AND OSTEOSARCOMA IN A DOG

An eight-year-old, female, spayed Golden Retriever was referred to the University of Missouri Veterinary Teaching Hospital for a persistent lameness of 9 days duration. The initial diagnosis made by cytology and culture was Clostridium spp osteomyelitis of the right femoral head and neck. After approximately 1 month of treatment with ampicillin, it was noted radiographically that the lesion was progressing. An excision arthroplasty was done. Histological examination of the surgical specimen revealed osteogenic sarcoma. This case documents the importance of bone biopsy in differentiating osteomyelitis from a primary bone tumor.     

BONE SCINTIGRAPHY FOR METASTASIS DETECTION IN CANINE OSTEOSARCOMA

The purpose of this study was to assess the usefulness of serial bone scintigraphy in the detection of skeletal and extraskeletal metastases in dogs with appendicular osteosarcoma. Twenty-six dogs with primary, appendicular osteosarcoma were entered into a limb-sparing protocol. Bone scintigraphy was performed upon presentation, after neoadjuvant therapy but prior to surgery and at selective intervals after limb-sparing surgery to evaluate for the presence of metastasis. Thoracic radiographs, and radiographs of other sites, were also made at the time of each bone scan. All dogs had a complete necropsy. No dog had bone or lung metastases detected prior to treatment. The bone scans, medical records, and radiographs of each dog were reviewed retrospectively. All but one dog developed metastatic disease. Bone metastatic sites were confirmed at necropsy in 12 of the 26 dogs. Seven of these 12 dogs had bone metastatic sites which were not producing clinical signs, i.e. an occult metastasis. In five of the seven dogs, the occult site was the first metastatic site detected. Extraskeletal metastases were identified scintigraphically in six of the 26 dogs, but these were clinically apparent prior to bone scintigraphy in each dog. Suspected malignant scintigraphic lesions were proven benign in six dogs. In five dogs with malignant bone lesions at necropsy the last bone scan prior to euthanasia was normal. The time interval between scintigraphy and necropsy was variable in these five dogs. All dogs without bone metastases at necropsy had normal bone scans. This study validates the usefulness of bone scintigraphy for detection of occult bone metastasis and improved ability for tumor staging in dogs with appendicular osteosarcoma.     

CORRELATION OF ULTRASOUND FINDINGS,LIVER AND SPLEEN CYTOLOGY,AND PROGNOSIS IN THE CLINICAL STAGING OF HIGH METASTATIC RISK CANINE MAST CELL TUMORS

Cytologic sampling of the ultrasonographically normal spleen and liver is not implemented routinely in the clinical staging of canine cutaneous mast cell tumors and normal ultrasound findings are often accepted as sufficient evidence for ruling out splenic or liver metastasis. Our objective was to define the specificity and sensitivity of ultrasound findings for diagnosis of mast cell infiltration when verified with cytologic evaluation, and to define the prognostic role of cytologic evaluation of liver and splenic aspirates. Dogs with a diagnosis of clinically aggressive grade II, or grade III mast cell tumor treated with a combination vinblastine/CCNU chemotherapy protocol, were selected retrospectively based on availability of cytologic evaluation of spleen plus or minus liver for staging. Out of 19 dogs, 10 dogs had a grade II tumor and nine a grade III tumor. Seven dogs had mast cell infiltration of the spleen, liver, or both. The sensitivity of ultrasound for detecting mast cell infiltration was 43% for the spleen and 0% for the liver. Dogs with positive cytologic evidence of mast cell infiltration to spleen, liver, or both had significantly shorter survival (100 vs. 291 days) than dogs without evidence of mast cell infiltration (P<0.0001). Routine splenic aspiration should be performed regardless of ultrasonographic appearance in dogs with a clinically aggressive mast cell tumor.     

OSSEOUS METAPLASIA IN THE RENAL PELVIS OF A DOG WITH HYDRONEPHROSIS

A 3-year-old male Sheltie dog was presented with abdominal distension, diarrhea, and vomiting. Hematologic and blood chemistry studies revealed a mild anemia and a few leukocytes in the urine. Radiographic examination was made, and a large mass with calcified trabeculae was present in the ventral right cranial quadrant of the abdomen. Exploratory celiotomy was performed, and a mass identified as the right kidney was removed. The excised kidney was cystic and multiloculated, and contained areas of bone and cartilage. This mass weighed 1120 g and was in excess of ten percent of the dog's body weight. Transitional epithelium can stimulate osseous metaplasia. The presence of both tissues in a biopsy specimen might indicate urinary tract disease.     

TESTICULAR ULTRASOUND IN THE NORMAL DOG

The testicles of ten dogs presented for routine castration were imaged with real time ultrasound. A scanning technique using multiple imaging planes (sagittal, transverse, and dorsal planes) was developed to image the testicles and epididymi. The testes were characterized by a coarse medium echo pattern. The mediastinum testis was consistently seen as a 0.2 cm wide linear hyperechoic structure in the central long axis of the testis. The ability to identify and the appearance of the epididymis was variable. The tail was consistently seen as an anechoic to hypoechoic structure. Ultrasound images were compared for anatomical structure with frozen gross sections. Ultrasonic and gross measurements were made and analyzed. Individual gross and ultrasonic measurements compared favorably. Linear regression coefficients between body surface area versus testicular length and diameter were 0.73 and 0.58 respectively. A Wilcoxin signed rank test for similarity p = 0.33 value was found when comparing the right to the left testicle.     

DIPHOSPHONATE TREATMENT OF A PRIMARY OSTEOSARCOMA IN A DOG: A CASE REPORT

The following sequence of treatments was administered to a Saint Bernard dog with a primary distal right radius osteosarcoma: 54 days of daily disodium 1-hydroxyethylidenediphosphonate (HEDP) subcutaneous injections; 53 days of HEDP per os ; one ³²P-HEDP intravenous injection. During the pretreatment period, there was an extensive increase in calcific tumor growth and osteoblastic proliferation. After the subcutaneous HEDP treatment, almost complete tumor necrosis was seen. After the oral HEDP treatment, only the deepest tumor portion contained active osteoblasts, calcific growth of the tumor was completely blocked, and uptake of ^99mTc-Sn-HEDP was reduced to one fourth of the pretreatment uptake. After a single ³²P-HEDP dose, large areas of tumor necrosis were evident histopathologically. However, subsequent resumption of cellular activity occurred in the tumor, and the uptake of ^99mTc-Sn-HEDP increased to pretreatment values. These data suggest that systemically administered HEDP should be studied further for its possible therapeutic potential in the treatment of osteosarcoma and indicate a need for further study of ³²P-HEDP or possibly ³³P-HEDP.     

A RETROSPECTIVE EVALUATION OF THE RADIOGRAPHIC EVIDENCE OF PULMONARY METASTATIC DISEASE ON INITIAL PRESENTATION IN THE DOG

Thoracic radiographs of 346 dogs, diagnosed as having primary neoplasms, were reviewed for radiographic changes associated with pulmonary metastatic disease at the time of initial presentation. Dogs having radiographic changes of single or multiple interstitial nodular opacities, in the absence of concurrent intrathoracic disease, were considered to have pulmonary metastatic disease. The frequency of metastasis associated with each histologic tumor type was compared by chi-squared analysis. Dogs having primary thyroid carcinomas and transitional cell carcinomas demonstrated the greatest frequency of radiographic changes, 62.5% and 26% respectively. In dogs having a variety of other neoplasms, including nasal adenocarcinomas and cutaneous neoplasms, thoracic radiography proved useful in delineating intercurrent disease and staging, as well as the extent of neoplastic involvement. These results indicate early radiographic evaluation of the thorax should be performed on all dogs with confirmed or suspected primary neoplasms.     

DENTAL RADIOGRAPHY IN THE DOG WITH A CONVENTIONAL X-RAY DEVICE

This study describes a method of using a conventional x-ray device and film-positioning system for dental radiography in dogs. This system is economical, safe and results in high quality dental radiographs.     

PRIMARY OSTEOSARCOMA OF THE STERNUM OF A DOG

Primary osteosarcoma of the fifth sternebra is reported in a 6-year-old male Great Dane. Presenting signs were suggestive of myocarditis and pulmonary congestion. Electrocardiography revealed R waves of low and variable amplitude and the plasma alpha-hydroxibutyrate dehydrogenase level was elevated. Radiography revealed neoplasia of the fifth sternebra with extensive bilaterial pulmonary metastases. Histologically the neoplasm showed typical osteosarcoma with plentiful osteoid production.