Canine hemangiosarcoma treated with standard chemotherapy and minocycline

Standard treatments for canine hemangiosarcoma include surgery and chemotherapy with doxorubicin, but in spite of treatment most dogs with this disease die within 6 months of diagnosis. Tumor growth and metastasis are angiogenesis dependent. Antiangiogenic drugs such as minocycline may provide therapeutic benefits in cancer patients. The purpose of this prospective study was to evaluate the efficacy of chemotherapy with doxorubicin and minocycline, an antiangiogenic agent, in dogs with hemangiosarcoma. Eighteen dogs with histologically confirmed hemangiosarcoma of any stage were treated with doxorubicin, cyclophosphamide, and minocycline. Complete staging was performed before and during the treatment period to assess remission status and response to therapy. No statistically significant difference was found in survival between the dogs treated with chemotherapy and minocycline, and historical controls consisting of dogs that received chemotherapy alone. Postmortem examination revealed widespread metastasis, suggesting that minocycline is ineffective as a single antiangiogenic agent in canine hemangiosarcoma.     

Hemangiosarcoma and squamous cell carcinoma in the third eyelid of a horse

A 12-year-old Belgian draft horse presented for a right eye third eyelid mass and red-tinged ocular discharge of 3 months' duration. The third eyelid was excised and submitted for histopathology. On histopathologic examination, the mass was composed of both hemangiosarcoma and squamous cell carcinoma. The horse developed thickened eyelids and hemorrhagic ocular discharge from the right eye approximately 16 months following surgery, and was euthanized. Necropsy and histopathology confirmed local recurrence and regional metastasis of the hemangiosarcoma. This was an unusual case because there were two distinct neoplastic processes composing the same mass that could not be differentiated grossly.     

Presumed primary ocular lymphangiosarcoma with metastasis in a miniature horse

A 7‐year‐old, 153.0‐kg American Miniature mare presented for evaluation of keratoconjunctivitis of the right eye (OD). A superior palpebral conjunctival mass and stromal keratitis were diagnosed. The incisional biopsy diagnosis was a presumptive corneal hemangiosarcoma. Transpalpebral enucleation was performed, and histopathologic evaluation confirmed angiosarcoma of the conjunctiva, cornea, and extraocular muscles. The horse developed progressive epistaxis and orbital swelling following surgery. A systemic workup was performed 3 months after enucleation, revealing regrowth within the orbit and marked cranial cervical lymphomegaly, suggestive of metastasis. Humane euthanasia was performed, and necropsy confirmed a locally invasive periorbital tumor with metastasis to the submandibular tissue, submandibular lymph node, and thoracic inlet. Histopathologic evaluation of necropsy specimens revealed polygonal to spindle neoplastic cells lining neoplastic vascular channels lacking erythrocytes. Immunohistochemically, the neoplastic cells labeled strongly positive for PROX‐1, vimentin, CD‐31, VEGF, weakly positive for factor VIII‐related antigen, and negative for collagen IV. Based on the clinical, histological, and immunohistochemical features of this tumor, a primary ocular lymphangiosarcoma with metastasis was diagnosed.     

IMAGING DIAGNOSIS—SPINAL EPIDURAL HEMANGIOSARCOMA IN A DOG

An 8‐year‐old, male Boxer was examined for an acute onset of ambulatory paraparesis. Neurologic examination was consistent with a T3‐L3 myelopathy. Myelography revealed an extradural spinal cord compression in the region of the T10‐T13 vertebrae. On magnetic resonance (MR) imaging, a well‐defined epidural mass lesion was detected. The mass was mildly hyperintense on T1‐weighted, hyperintense on T2‐weighted and STIR images compared to normal spinal cord and enhanced strongly and homogenously. Postmortem examination confirmed a primary epidural hemangiosarcoma. Findings indicated that the MRI characteristics of spinal epidural hemangiosarcoma may mimic other lesions including meningioma and epidural hemorrhages/hematomas of non‐neoplastic etiology.     

Proximal ureteral ectopia causing hydronephrosis in a kitten

A 2-month-old, female cat was presented for abdomen dilation. The patient was undernourished, and severe left hydronephrosis was diagnosed after clinical, ultrasonographical and radiographical examination. Although pyelography was performed in order to visualise the ureteral course, surgery was necessary to reach a final aetiological diagnosis and treatment. At gross examination, the left ureter crossed the renal capsula at the level of the caudal renal pole, and the subcapsular ureteral segment was markedly dilated. Distal to the renal capsula, the left ureter was very thin when compared to the right. The parenchyma of the left kidney, as suggested by ultrasonographical evaluation, was extremely reduced in thickness. An ureteronephrectomy was performed. Histopathological evaluation revealed glomerular sclerosis and diffuse parenchymal fibrosis. Severe hydronephrosis derived from an altered renal pelvic anatomy and abnormal ureteral course determining functional stenosis. Diagnosis of congenital anomaly before development of complications such as hydronephrosis could have allowed a surgical renal capsulectomy and obstruction relief. To the author's knowledge, this is the first report of severe hydronephrosis associated to altered renal pelvic anatomy and proximal ureteral ectopia in cat.     

IMAGING DIAGNOSIS—RADIOGRAPHY AND ULTRASONOGRAPHY OF BILATERAL CONGENITAL URETEROVESICAL JUNCTION STENOSIS CAUSING HYDRONEPHROSIS AND HYDROURETER IN A FERRET (MUSTELA PUTORIUS FURO)

An 8‐month‐old neutered male ferret was presented for vaccination and preventive treatment for adrenal gland disease. Abdominal ultrasound revealed severe bilateral hydronephrosis and hydroureter. Excretory urography and negative contrast cystography showed bilateral ureterovesical junction stenosis. Positive retrograde cystography demonstrated right ureteral reflux. A subcutaneous ureteral bypass was placed in the left kidney; however, it had to be removed 3 months later due to an obstruction and persistent urinary tract infection. Bilateral ureteroneocystotomy was performed. Although congenital strictures are uncommon in veterinary patients, they should be included in the differential diagnosis in ferrets presenting with hydronephrosis and hydroureter of undetermined cause.     

Multiple skeletal metastases from a penile squamous cell carcinoma in a horse

A 21‐year‐old gelding with ventral abdominal and preputial oedema was evaluated for right hindlimb lameness. Partial phallectomy had been performed 3 years prior for treatment of squamous cell carcinoma. Regional analgesia did not localise the source of lameness and nuclear scintigraphy was recommended. The results of the scan revealed severe increased radiopharmaceutical uptake in the proximal femur. Radiographic and ultrasound examinations were inconclusive. The horse was discharged with recommendations of stall confinement and a 2 week course of nonsteroidal anti‐inflammatory drugs. Four weeks later the horse presented for an inability to elevate his neck and persistent hindlimb lameness. The owner elected humane euthanasia. Post mortem examination revealed metastatic squamous cell carcinoma in the proximal femur and fifth cervical vertebrae consistent with metastasis from the penile squamous cell carcinoma. To the authors’ knowledge, multiple site bone metastasis of squamous cell carcinoma has not been reported previously in the horse.     

The use of nuclear imaging for a mixed C cell microfollicular carcinoma of the thyroid gland in a mature horse

A 15‐year‐old Boerperd stallion presented for thyroid enlargement associated with inappetance. Ultrasonographic examination of the thyroid gland revealed an enlarged left lobe, which, on cytological examination, contained numerous anaplastic cells. A mixed C cell microfollicular thyroid carcinoma was diagnosed following histopathological examination of the excisional biopsy specimen. In order to determine metastasis, pulmonary radiographs revealed a poorly‐marginated soft tissue opacity caudo‐dorsal to the cardiac silhouette. Thyroid and pulmonary scintigraphy was performed comparing ^99mTc‐sestamibi with ^99mTc‐pertechnetate and no metastasis was detectable. Following hemithyroidectomy, the stallion made a full recovery without the need for neoadjuvant chemotherapy. Six months later, repeated thyroid and pulmonary scintigraphy using ^99mTc‐sestamibi was normal.     

A URINARY BLADDER FIBROSARCOMA IN A YOUNG DOG

A 14-month-old female dog, Gos d'Atura Catala was presented for a 7-month-history of reoccurring urinary tract infection. Using sonography, a focal multilobulated thickening of the urinary bladder wall was discovered. The solid mass was arising from the area of the ureteral papllDae and bulging into the lumen of the bladder neck. The wall of the urethra was uniformly thickened. These findings were not considered typical for a generalized urinary tract infection but more indicative of local severe inflammation, neoplasia or hyperplasia in the area of the ureteral openings. The thickening of the urethra was suggestive of urethritis or neoplastic infiltration. Signs of metastasis were not detected on the thoracic radiographs or in the remainder of the abdominal ultrasound examination. A surgical excision of the multilobulated mass was performed and histologic examination was conducted. A fibrosarcoma in the lamina propria of the urinary bladder wall was diagnosed. Because of reoccurence of hematuria and unresponsiveness to therapy the dog was euthanized. Postmortem examination confirmed the diagnosis of fiborsarcoma in the urinary bladder. Additionally, neoplastic infiltration of the urethral wall and metastasis in the lungs and liver were detected histopathologically.     

Cardiac hemangiosarcoma in a dog

The case of a 11 year-old mix breed dog is being described. It initially presented for watery diarrhea and inappetence. During the diagnostic workup, the dog developed a sustained ventricular tachycardia. Echocardiography showed a mass extending from the wall of the right ventricle which filled up the ventricle almost completely. Histopathologic examination of the mass after euthanasia of the dog revealed a hemangiosarcoma.     

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.     

Primary penile adenocarcinoma with concurrent hypercalcaemia of malignancy in a dog

A 13‐year‐old male neutered Siberian husky crossbreed dog was presented with a 3‐week history of haematuria and penile swelling. Clinical examination and computed tomography demonstrated a soft‐tissue mass located at the base of the penis without signs of other primary tumours or metastasis. Clinicopathological findings revealed paraneoplastic hypercalcaemia. Fine‐needle aspiration cytology of the mass suggested an epithelial tumour with several criteria of malignancy present. Following surgical excision of the mass, the hypercalcaemia resolved. Histopathology and immunohistochemistry revealed features consistent with an adenocarcinoma. Despite thorough examination, no perineal or anal sac tumour was found. To the authors’ knowledge, this is the first reported case of a penile adenocarcinoma with hypercalcaemia of malignancy.     

Unusual metastatic behavior and clinicopathologic findings in eight cats with cutaneous or visceral hemangiosarcoma

Eight cats with visceral or cutaneous hemangiosarcoma were evaluated, and unusual metastatic and clinicopathologic behavior was evident in each. Cutaneous hemangiosarcoma is generally believed to be locally aggressive and slow to metastasize. These 8 cats with cutaneous hemangiosarcoma, however, developed metastatic disease after initial surgical resection; only 1 had local regrowth of the tumor. All cats with visceral hemangiosarcoma had metastasis at the time of diagnosis, which is consistent with cats of other reports. Three of 8 cats had evidence of disseminated intravascular coagulation, including increased prothrombin time and partial thromboplastin time, decreased number of platelets, and anemia. These potential complications need to be considered when planning diagnostic and treatment protocols.     

Dynamic left ventricular outflow tract obstruction secondary to hypovolemia in a German Shepard dog with splenic hemangiosarcoma

Dynamic left ventricular outflow tract obstruction (DLVOTO) is a common condition in cats and humans. In this case report, a dog is described with DLVOTO secondary to severe intra-abdominal hemorrhage caused by a hemangiosarcoma. The dog was a 9-year-old, 35.7-kg, spayed female German Shepard dog that presented with a history of tachypnea and collapse. A Levine II/VI systolic murmur was present at the heart base. Abdominal ultrasonography revealed a splenic mass and a large amount of ascites. Echocardiography showed a reduced left ventricular diameter and an increased aortic velocity caused by systolic anterior motion (SAM) of the mitral valve apparatus. The heart murmur and the SAM were resolved after treatment including a splenectomy and a blood transfusion.     

Renal pelvic rupture,intrapelvic haematoma and retroperitoneal haemorrhage associated with obstructive ureterolithiasis in a cat

A neutered female cat presented with a 9-day history of hyporexia and depression. The referring veterinarian had identified moderate non-regenerative anaemia, haematuria and suspected unilateral obstructive ureterolithiasis. Subsequent ultrasonography revealed moderate distension of the left renal pelvis with echogenic material, ureteral distension and ureterolithiasis. A partial ureteral obstruction was suspected. After 4 days of medical management, there was further distension of the renal pelvis with well-delineated echogenic material and an accumulation of perinephric fluid. A left nephroureterectomy was performed. Renal pelvic rupture with intrapelvic haematoma and retroperitoneal haemorrhage was confirmed by histopathology. Eighteen months following surgery, the cat remained clinically well with normal renal values.     

Efficacy and Toxicity of VAC Chemotherapy (Vincristine, Doxorubicin, and Cyclophosphamide) in Dogs with Hemangiosarcoma

Fifteen dogs with hemangiosarcoma were treated with a combination of vincristine, doxorubicin, and cyclophosphamide after incisional or excisional biopsy. The median survival for all fifteen dogs was 172 days (mean survival = 316 days). The median survival for those dogs with splenic hemangiosarcoma was 145 days (mean survival = 271 days) as compared with previously published median survival times in dogs with splenic hemangiosarcoma treated with surgery alone of 19 to 65 days. Toxicities included neutropenia (11/15), severe gastroenteritis (4/15), cardiotoxicity (3/15), and sepsis (2/15). The authors conclude that vincristine, doxorubicin, and cyclophosphamide chemotherapy may be an efficacious treatment modality in dogs with hemangiosarcoma and is associated with acceptable toxicity.     

P‐59 Three cases of opportunistic dermatoses associated with internal diseases in cats

Opportunistic dermatoses can occur in case of immunosuppressive diseases. The first case was a 12‐year‐old domestic short‐haired cat suffering from diabetes with a phaeohyphomycosis due to Scytalidium spp.associated with cutaneous hemangiosarcoma. A painless and ulcerated nodule was observed on a digit with fistulous tracts over the metatarsal joint. Histopathological examination of the nodule revealed a hemangiosarcoma in which brownish fungal colonies were found. Itraconazole (5 mg/kg twice daily), then amputation, allowed 12 months of survival (pulmonary metastases). The second case concerned a 13‐year‐old Siamese cat with cheyletiellosisassociated with spontaneous Cushing's disease and diabetes mellitus. This cat exhibited scales and miliary dermatitis on the trunk associated with polyuria, polydipsia and a pot‐belly. Acetate tape impression showed Cheyletiella blakei mites and eggs. Blood analysis revealed diabetes mellitus and spontaneous hyperadrenocorticism. The owner refused treatment. The third case was a 14‐year‐old domestic short‐haired cat with generalized demodicosis associated with iatrogenic Cushing's disease and diabetes mellitus. Long‐acting glucocorticoids had been used for treatment of plasma cell stomatitis for 5 years. This cat exhibited erythema, scales, self‐induced alopecia, thin skin and moderate pruritus associated with polyuria and polydipsia. Cutaneous lesions principally developed on the abdomen and flanks. Skin scrapings and trichogram showed numerous Demodex cati mites. Routine blood work demonstrated diabetes mellitus and iatrogenic Cushing's disease. Treatment was based on insulin therapy, milbemycin oxime (1 mg/kg once daily) and chlorambucil (0.2 mg/kg once daily). The demodicosis was cured after 4 months, but the cat died of cutaneous and ocular herpesvirus infection 10 months later. Funding: Self‐funded.     

Ultrasonographic features of splenic hemangiosarcoma in dogs: 18 cases (1980-1986)

The medical records of 18 dogs in which ultrasonography was useful in making a diagnosis of splenic hemangiosarcoma were reviewed. Splenic ultrasonography revealed masses with echo patterns that ranged from anechoic fluid to hyperechoic tissue. In 7 dogs, metastasis was detected ultrasonographically as anechoic to hypoechoic lesions in the liver.     

IMAGING DIAGNOSIS—COMPUTED TOMOGRAPHY FINDINGS IN A DOG WITH SPONTANEOUS TRANSMURAL MIGRATION OF A TEXTILOMA INTO THE CECUM

A 3‐year‐old spayed female dog was presented with 3‐month history of severe bilateral uveitis subsequent to previous ovariohysterectomy. Physical examination revealed moderate abdominal pain. Computed tomography showed a nonobstructive heterogeneous mass‐like lesion with a speckled gas pattern (spongiform pattern) within the cecum. Exploratory laparotomy revealed a surgical swab in the lumen of the cecum with severe adhesions. Histopathological examination demonstrated a chronic inflammatory pyogranulomatous reaction to the retained swab embedded within the intestinal wall, consistent with transmural migration of the swab from the peritoneal cavity into the cecum.     

Congenital kyphosis secondary to lumbar vertebral hypoplasia causing paraparesis in a Friesian foal

A 5‐day‐old Friesian colt was presented with a history of severe bilateral pelvic limb weakness since birth. Clinical examination revealed a painful dorsal deviation of the spinous processes of the lumbar vertebrae, pelvic limb paraparesis and grade 4/5 ataxia. Radiographic examination revealed kyphosis due to hypoplasia and malformation of the 5 lumbar vertebrae present. At myelography performed immediately after euthanasia, dorsal deviation of the myelographic contrast column was demonstrated at the level of T18–L4 with suspected spinal cord compression noticeable at L1. There was no lateral deviation of the spinal cord or scoliosis of the vertebrae visible.