一例犬乳腺导管乳头状癌的诊断与治疗

犬乳腺导管乳头状癌是犬乳腺肿瘤的一种,为恶性肿瘤,多发于中老年未绝育母犬。临床症状为乳腺出现肿块,大小不等,生长快速,肿瘤可以在一个或多个腺体中发展。在晚期转移的情况下,癌变会扩散到淋巴结,肺,结肠,肾脏,有时还会扩散到骨骼,及早施行手术通常预后良好。本文对一例8岁母犬的乳腺导管内乳头状癌病例的临床诊断与手术治疗情况作详细介绍,以期为犬乳腺肿瘤的临床诊治提供参考。     

Feline mammary tumors

The characteristics of feline mammary cancer--that is, the rapid growth of primary mammary tumors, the high rate of tumor recurrence, and the poor survival statistics--demonstrate the need for (1) early diagnosis of the primary tumor; (2) immediate, aggressive surgical therapy; and (3) frequent follow-up examinations to detect early clinical signs of recurrent disease. A number of factors that influence prognosis have been described. As more information becomes available concerning the behavior of feline mammary tumors and the results of various forms of treatment, more effective protocols can be developed. Continued etiologic research may play a vital role in determining the direction of therapy.     

ULTRASONOGRAPHIC FEATURES OF PERITONEAL CESTODIASIS CAUSED BY MESOCESTOIDES SP. IN A DOG AND IN A CAT

Peritoneal infections caused by Mesocestoides spp. are rare in dogs and cats. Little data exist on the role of abdominal ultrasonography for diagnosis and therapy management of the disease. We describe the ultrasonographic features of peritoneal cestodiasis in a dog and in a cat. In the dog, abdominal ultrasound allowed both a presumptive diagnosis and the collection of tissue samples to confirm peritoneal larval infection. Ultrasound was also very useful for therapy management. In the second patient the ultrasonographic features of tetrathyridial infection in a cat in which the parasite was observed as an incidental finding during ovariohysterectomy are described.     

Principles of treatment for mast cell tumors

Mast cell tumors (MCT) are the most common malignant cutaneous tumors that occur in dogs. They are most commonly found on the trunk, accounting for approximately 50% to 60% of all sites. MCTs associated with the limbs account for approximately 25% of all sites. Cutaneous MCTs have a wide variety of clinical appearances. Histologic grade is the most consistent prognostic factor available for dogs. MCTs located at 'nail bed' (subungual), inguinal/preputial area, and any mucocutaneous area like perineum or oral cavity carry a guarded prognosis and tend to metastasize. MCTs usually exfoliate well and are cytologically distinct. The extent of staging procedures following fine-needle aspirate cytologic diagnosis is based on the presence or absence of negative prognostic indicators. Surgery is the treatment of choice for solitary MCTs with no evidence of metastasis. Reponses rates to chemotherapy, (partial response) as high as 78% have been reported, and preliminary evidence suggests that multiagent (prednisone and vinblastine) protocols may confer a higher response rate than single-agent therapy. MCTs are the second most common cutaneous tumor in the cat. There are two distinct forms of cutaneous MCTs in the cat. The more common form is the mastocytic form, and the less common is the histiocytic form. Unlike in the dog, the head and neck are the most common sites for MCTs in the cat followed by the trunk and limbs. Cats with disseminated forms of MCT often present with systemic signs of illness, which include depression, anorexia, weight loss, and vomiting. The diagnosis and staging of MCTs in cats is similar to that in the dog. As with dogs with cutaneous MCTs, surgery is the treatment of choice. Little is known about the effectiveness of adjunctive chemotherapy options for cutaneous MCTs. Adjunctive chemotherapy does not appear to increase survival times.     

Canine mammary gland tumors

An understanding of the known biologic facts of this disease and methodical evaluation of the individual patient are necessary prerequisites for outlining rational courses of therapy for dogs afflicted with mammary tumors. Because of the common occurrence of multiple tumors arising at various stages of development simultaneously and the heterogeneity of histology of the complex (mixed tissue types) tumors, presurgical biopsy is recommended only in cases in which mast cell tumor or anaplastic carcinoma is suspected. Although investigative work is being performed regarding the efficacy of chemotherapy, radiation therapy, and immunotherapy, surgery still remains the mainstay in treatment of this condition. No one surgical procedure fits the needs of all patients, although it seems logical to remove as much breast tissue as is reasonable in each circumstance owing to the multicentric nature of the disease. Ovariohysterectomy has not been demonstrated to be of value in treatment of dogs with mammary tumors, but it is a markedly effective method of preventing mammary tumors if it is performed before puberty; it is moderately effective if performed before the dog is 21/2 years of age.     

Fungal infections of the central nervous system in the dog and cat

Fungal infections of the central nervous system (CNS) in dogs and cats are uncommon. The purpose of this paper is to review the clinical signs, diagnostic tests, and therapeutic options of fungal infections of the CNS in the dog and cat. Clinical signs are dependent on lesion location and are often multifocal. Extraneural involvement is common. Antemortem diagnosis can be difficult and is definitively made via cytology, biopsy, or culture of an affected organ or cerebrospinal fluid (CSF). Magnetic resonance imaging can support a diagnosis and may assist in therapeutic decisions. Fungal serology can support a diagnosis when direct visualization of the organism is not possible. Long-term azole maintenance therapy is suggested to enhance survival and prevent relapse. Serial cerebrospinal fluid evaluation and magnetic resonance imaging may identify early relapse.     

孕激素诱导的生长激素与犬的乳腺肿瘤

乳腺肿瘤是犬的最常见的肿瘤，约占母犬肿瘤总数的一半；乳腺肿瘤约有一半是恶性肿瘤，发生转移的比率很高。犬乳腺肿瘤的发病原因还不很明确，它的形成都受哪些因子调节还未完全确定。孕激素能够诱导乳腺组织生成并蓄积生长激素，使乳腺增生，最终导致犬乳腺肿瘤的形成。在此过程中，雌激素受体、孕激素受体、生长激素结合蛋白和生长激素受体在乳腺癌的形成、发展中起关键作用。从内分泌的角度对犬乳腺肿瘤发病机理作了简单综述，以期为激素治疗乳腺肿瘤提供一些理论依据。     

Histologic, immunohistochemical, and clinical features of 27 mammary tumors in 18 male dogs

Twenty-seven mammary tumors from 18 male (3 intact, 15 neutered) dogs were collected. The average age at diagnosis was 9.2 years (range, 2-14 years). Seven of the dogs were Cocker Spaniels. Five dogs had multiple mammary tumors. All tumors were benign. Twenty-six were simple adenomas with mixed acinar and papillary patterns. The acinar pattern was predominant in 17 cases. One adenoma was complex with a prominent myoepithelial component. The myoepithelial component of 25 of the 25 tumors was immunohistochemically positive for calponin and p63. In the cases for which relevant clinical information was available, there was no reported history of obesity, testicular tumors, or sex hormone therapy. Surgery was the only reported treatment for these tumors. Only 1 dog was reported to have developed an additional mammary tumor. None of the dogs for which case outcome was known died or was euthanatized as a result of mammary tumor. Although uncommon, mammary tumors do occur in male dogs. Although mammary tumors may be quite cellular, the presence of an intact myoepithelium, which can be demonstrated with immunohistochemistry for calponin and p63, indicates benignancy, as the clinical behavior documents.     

Endodontic decisions based on radiographic appearance

Endodontic disease or disease that affects the internal portion of the tooth is a frequently encountered oral problem of the cat and dog. There are many etiologies that can cause the tooth's health and longevity to be adversely affected. Trauma, tooth malformations of either congenital or acquired origin, and bacterial periodontal ascending infections all can lead to pulpal inflammation, necrosis, and tooth death. One must correlate history, physical exam and radiographic impressions of the tooth, and its supporting structures and adjacent teeth in determining proper treatment options and aftercare. Based on extent, timing, and involvement of adjacent structures, resulting pathology of the tooth may be endodontically treated with either a vital pulpectomy, standard root-canal therapy, surgical root-canal therapy, or when the disease is too extensive by extraction. Through a case presentation, we will discuss some of the decisions that enter into the therapy used to treat presenting pathology. It is the authors' intent to present a thought process for deriving a treatment plan to promote healing. There are many ways to achieve this healing, and therefore, there is no right or wrong plan, but rather one that is based on all the presenting factors.     

Olfactory neuroblastoma in a cat

CASE SUMMARY: A 12.5-year-old castrated male domestic shorthair cat was presented for evaluation of dyspnea. Physical examination suggested upper airway disease. Computed tomography revealed the presence of a nasopharyngeal mass. Biopsies obtained via rhinoscopy led to a diagnosis of olfactory neuroblastoma. CLINICAL CHALLENGES: Olfactory neuroblastoma (or esthesioneuroblastoma) is a rare malignant neoplasm that arises from olfactory neuroepithelium. It was first described in human medicine in 1924. Clinical signs are variable, and diagnosis may prove challenging as this tumor, which is a differential for spontaneous intranasal tumors in cats, may be mistaken for poorly differentiated carcinomas or round cell tumors. Given its rarity, treatment options for this neoplasm have not been thoroughly evaluated and there is no standard treatment protocol. LITERATURE REVIEW: A review of veterinary and human literature is provided, encompassing clinical signs, staging and grading systems, treatment options and prognostic factors.     

Canine and feline nasal and paranasal sinus tumors.

Tumors involving the nasal cavity and nearby sinuses are relatively rare in the dog and cat. Although the most common cause of unilateral epistaxis, facial deformity, and epiphora in the aged dog and cat is a malignant nasal or paranasal tumor, differentials must be considered. In each case, a definitive diagnosis is made on the basis of the signalment, history, physical examination findings, radiographs, and histologic evidence of malignant neoplasia. Although many treatment options exist, radiation therapy, with or without surgery, has been considered to be most effective.     

Cytologic examination of fine‐needle aspirates from mammary gland tumors in the dog: diagnostic accuracy with comparison to histopathology and association with postoperative outcome

Background: Mammary tumors are the most common neoplasms in female dogs. Malignant tumors may carry a poor prognosis and necessitate surgery. Few data are available on the value of cytologic examination as a diagnostic or prognostic tool for mammary tumors in dogs. Objectives: The objectives of this study were to determine whether cytologic findings in fine‐needle aspirate specimens of canine mammary tumors correlate with histopathologic results and whether the cytologic diagnosis is associated with postoperative outcome. Methods: In this prospective study, fine‐needle aspirate samples were obtained from 50 mammary tumors in 50 dogs. Results of cytologic and histopathologic examination were compared, using the histologic diagnosis as the reference method. Kaplan–Meier log rank analysis was used to evaluate univariate association of the cytologic diagnosis with duration of survival, local control, and metastasis‐free interval. Results: Adequate cytologic samples were obtained in 43/50 (86%) cases. The cytologic diagnosis correlated with the histologic diagnosis for benign and malignant tumors in 40/43 (93%) and 35/43 (81%) cases, respectively. Cytologic examination had a sensitivity of 88% and a specificity of 96% for the diagnosis of malignancy. The cytologic diagnosis had significant univariate association with duration of survival (P=.016), recurrence‐free interval (P=.003), and metastasis‐free interval (P=.014). Conclusions: Cytologic examination of mammary tumors in the dog has satisfactory accuracy, sensitivity, and specificity for the diagnosis of malignancy and is associated with postoperative outcome. Further studies on the diagnostic accuracy of cytology as well as multivariate analysis of its preoperative prognostic value in mammary tumors in the dog are warranted.     

Simultaneous Bilateral Mastectomy in the Dog

Current reports advise against attempting simultaneous bilateral mastectomy in the dog. However, total mastectomy may be the most logical treatment for all dogs with mammary tumors in view of newer evidence suggesting a multicentric origin for this disease. A surgical technique for simultaneous bilateral mastectomy was evaluated in 22 dogs with mammary tumors. The procedure was successfully performed in selected patients and healing occurred without serious complications. The technique, rationale, and recommendations for use of this procedure are presented.     

Parasitic miticidal therapy

Parasites are a common cause of dermatological disease in the dog and cat. Knowledge of different miticidal options for the common parasitic diseases is imperative when choosing the appropriate treatment for a patient. This is especially important with the recent advent of safer and more effective antiparasitic medications. Diagnostic and therapeutic methods for Cheyletiella spp., Demodex spp., Notoedres cati, Sarcoptes scabei, and Otodectes cyanotis are discussed, with emphasis on protocols for miticidal therapies, as well as safety concerns and side effects. This information will allow the practitioner to choose the safest and most efficient treatment for parasitic skin disease in their small animal patients.     

Oral pathology

Oral disease is exceedingly common in small animal patients. In addition, there is a very wide variety of pathologies that are encountered within the oral cavity. These conditions often cause significant pain and/or localized and systemic infection; however, the majority of these conditions have little to no obvious clinical signs. Therefore, diagnosis is not typically made until late in the disease course. Knowledge of these diseases will better equip the practitioner to effectively treat them. This article covers the more common forms of oral pathology in the dog and cat, excluding periodontal disease, which is covered in its own chapter. The various pathologies are presented in graphic form, and the etiology, clinical signs, recommended diagnostic tests, and treatment options are discussed. Pathologies that are covered include: persistent deciduous teeth, fractured teeth, intrinsically stained teeth, feline tooth resorption, caries, oral neoplasia, eosinophilic granuloma complex, lymphoplasmacytic gingivostomatitis, enamel hypoplasia, and "missing" teeth.     

Canine protothecosis.

Canine protothecosis remains a difficult condition to manage. The paucity of clinical cases hinders the development of successful treatment strategies. The clinical signs associated with the disease are nonspecific, and the course is so insidious that, by the time a definitive diagnosis is reached, the organism has often disseminated throughout the body. At this point, the condition is beyond treatment, and death occurs owing to failure of any number of organ systems, including the gastrointestinal, cardiovascular, renal, and central nervous systems. It is of some encouragement that the few patients that have undergone aggressive early treatment have survived longer than patients presenting late in the disease course. Nevertheless, the outlook for any dog with protothecosis is grave, and it remains to be determined whether early diagnosis can truly provide a better long-term prognosis. By including protothecosis as a consideration for dogs initially brought in with a history of chronic diarrhea or acute blindness and with a subsequent finding of exudative retinal separation, early diagnosis is possible. This recognition potentially affords the opportunity for an immune status work-up and intervention with increasingly better treatment options.     

Molecular biological aspects on canine and human mammary tumors

The high incidence of mammary tumor disease reported in certain canine breeds suggests a significant genetic component, as has already been described in human familial breast cancer-in BRCA1- and BRCA2-associated breast cancer in particular. The identification of genetic risk factors is critical to improvements in the prevention, diagnosis, and treatment of these tumors. In recent years, there has been significant progress in developing the tools and reagents necessary to analyze the canine genome. This work has culminated in a high-quality draft genome sequence, as well as a single-nucleotide polymorphism map and single-nucleotide polymorphism arrays for genomewide association analysis. These tools provide an unprecedented opportunity to characterize the genetic influences in canine diseases such as cancer, eventually allowing for exploration of more effective therapies. Given the high homology between the canine genome sequence and its human counterpart--as well as the many similarities regarding the morphology, biological behavior, and clinical course of mammary tumors in both species--the dog has proven to be an excellent comparative model. This review highlights the comparative aspects regarding certain areas within molecular biology, and it discusses future perspectives. The findings in larger genomewide association analyses and cDNA expression arrays are described, and the BRCA1/BRCA2 complex is compared in detail between the 2 species.     

Equine recurrent uveitis: A review of clinical assessment and management

Equine recurrent uveitis (ERU) is a vision‐threatening ocular disease that practitioners must be able to identify and manage. Although not every case of acute uveitis will develop into ERU, if 2 or more episodes of uveitis are observed, a diagnosis of ERU can be made. Patient outcomes improve with early diagnosis, appropriate therapy and client education. Recent advances in surgical options and treatment of horses with ERU have improved success in managing this condition. New therapeutic strategies under investigation may further enhance results and reduce the development of complicating factors.     

Cognitive dysfunction in cats: a syndrome we used to dismiss as 'old age'

PRACTICAL RELEVANCE: Cognitive dysfunction syndrome (CDS) is a widely accepted diagnosis in dogs, with established treatment options. In cats, however, our understanding of cognitive dysfunction is still being shaped by ongoing research in the field, and limited treatment options are available. Recent clinical studies indicate that old age in the cat is accompanied by increased behavioural signs such as wandering, vocalization and night-time activity that are not attributable to identifiable medical problems. It is essential, therefore, that veterinarians include behavioural well-being in the routine care of senior cats. PATIENT GROUP: While the exact age of onset is not established, studies suggest that age-related behavioural changes consistent with cognitive dysfunction are prevalent in cats as early as 10 years of age and that prevalence increases significantly in older cats. CLINICAL CHALLENGES: The diagnosis of cognitive dysfunction requires the identification of geriatric behavioural changes that are not caused by other medical problems, although the two may not be mutually exclusive. Therefore, the practitioner must rely heavily on owner reports and history to ensure prompt diagnosis and treatment. The absence of any approved dietary or pharmaceutical interventions for cognitive dysfunction adds a further challenge, although several possibilities exist. EVIDENCE BASE: This article draws on recent research that has produced neuropathological, cognitive and behavioural evidence for cognitive dysfunction in aging cats. As an impetus to further our understanding of this disease and potential treatment options, the authors propose a behavioural checklist that might aid in the clinical diagnosis of feline CDS and discuss treatment options that have proven successful in the canine counterpart of this disease.