Diagnostic accuracy of pre‐treatment biopsy for grading soft tissue sarcomas in dogs

Histologic grade is an important prognostic factor for both local recurrence and metastatic potential with canine soft tissue sarcoma (STS). Pre‐treatment biopsy with identification of tumour grade may aid in prognostication and determination of surgical margins necessary for local control. The purpose of this study was to evaluate the grading accuracy of various pre‐treatment biopsy techniques (wedge, punch, needle‐core) for STS in dogs. Medical records of 68 dogs diagnosed with a STS via pre‐treatment biopsy and confirmed by excisional biopsy were evaluated. The concordance in grade between excisional and pre‐treatment biopsies was 59%. Of the 41% that lacked concordance, 29% of pre‐treatment biopsies underestimated and 12% overestimated grade. The method of pre‐treatment biopsy did not significantly effect grade concordance. Based on these data, needle‐core biopsy appears to be similar in accuracy compared to open biopsy, however, grading determined by pre‐treatment biopsy in general should be interpreted with caution.     

Cutaneous soft tissue tumours in dogs: classification, differentiation, and histogenesis

Particular difficulty is regularly encountered in differentiating on routine morphological grounds between soft tissue tumours in dogs, especially fibrosarcoma, including myxosarcoma; haemangiopericytoma; and schwannoma. In this study we report the findings of the immunohistochemical examination of 74 canine tumours classified as soft tissue tumours by routine light microscopy. As a consequence, we propose that the morphologic diagnosis of cutaneous fibrosarcoma, haemangiopericytoma or schwannoma carries little precision in respect of tumour cell differentiation, and would support use of the term 'spindle cell tumour of canine soft tissue' to encompass this group of lesions.     

Detection of comorbidities and synchronous primary tumours via thoracic radiography and abdominal ultrasonography and their influence on treatment outcome in dogs with soft tissue sarcomas,primary brain tumours and intranasal tumours

Canine soft tissue sarcomas (STS), primary brain tumours and intranasal tumours are commonly treated with radiotherapy (RT). Given the low metastatic potential of these tumours, recommendations regarding imaging tests as staging are variable among institutions. The purpose of our study was to describe thoracic radiographic and abdominal ultrasonographic findings in dogs with these neoplasms and to investigate association of abnormal findings with alterations in recommended treatment. Medical records from 101 dogs, each having thoracic radiographs and abdominal ultrasound performed as part of their staging, were reviewed. In 98 of 101 (97%), imaging abnormalities were detected, 27% of which were further investigated with fine needle aspiration cytology or biopsy. Nine percent of the detected abnormalities were considered serious comorbidities that altered treatment recommendations, including 3 (3%) which were confirmed as synchronous primary neoplasms. These findings may influence recommendations regarding the decision to perform thoracic radiographs and abdominal ultrasound prior to initiation of RT.     

Palliative radiotherapy as treatment for non-resectable soft tissue sarcomas in the dog – a report of 15 cases

Fifteen dogs with various non‐resectable soft tissue sarcomas were treated with a palliative protocol of Cobalt⁶⁰ radiation. Twelve (80%) of the 15 tumours were fibrosarcomas and haemangiopericytomas. Total tumour radiation dose was 24 Gy, given in three 8 Gy fractions, on days 0, 7, 21 or weekly. Thirteen tumours (87%) responded with stable disease; median time to progression and median survival time were 263 and 332 days, respectively. Radiation toxicity was negligible. The survival and local control with this palliative protocol are almost comparable with curative intent primary radiotherapy.     

Outcome following treatment of soft tissue and visceral extraskeletal osteosarcoma in 33 dogs: 2008–2013

Extraskeletal osteosarcoma (EOS) is a rare, highly malignant mesenchymal neoplasm arising from viscera or soft tissues characterised by the formation of osteoid in the absence of bone involvement. Owing to the rarity of these neoplasms very little information exists on treatment outcomes. The purpose of this study was to describe the outcome following surgical treatment of non‐mammary and non‐thyroidal soft tissue and visceral EOS in dogs. Thirty‐three dogs were identified; the most common primary tumour site was the spleen. Dogs that had wide or radical tumour excision had longer survival times compared with dogs that had only marginal tumour excision performed [median survival time of 90 days (range: 0–458 days) versus median survival time of 13 days (range: 0–20 days)]. The use of surgery should be considered in the management of dogs with non‐mammary and non‐thyroidal soft tissue and visceral EOS.     

Thromboelastographic results and hypercoagulability in dogs with surgically treated hepatocellular adenoma and carcinoma: A Veterinary Society of Surgical Oncology prospective study

Background

The most common haemostatic abnormality in dogs with cancer is hypercoagulability. A transient hypercoagulability has been documented in people with hepatocellular carcinoma (HCC) that resolves within weeks following hepatic tumour resection.

Objective

The objective was to compare the haemostatic status of dogs with liver tumours and healthy control dogs, by comparing coagulation and thromboelastography (TEG) measurements at three time points.

Methods

Liver tumour and healthy control dogs receiving surgery for liver lobectomy and ovariohysterectomy, respectively, were prospectively enrolled. All dogs had blood collected at three time points: pre-operative, 24 h post-operative and ~2 weeks post-operative. Haematological and haemostatic values were compared across time points in each group using repeated measures ANOVA tests.

Results

Ten and eight dogs were enrolled for the liver and control groups, respectively. Platelet count was significantly higher in the liver group than the control group at all time points, but within the normal range (pre-operative: 438.7 vs. 300.9 × 10⁹/L, p = .0078; 24 h post-operative: 416.2 vs. 283.9 × 10⁹/L, p = .0123; 10–14 days post-operative: 524.6 vs. 317.3 × 10⁹/L, p = .0072). The measure of the overall coagulant state (G-value) was significantly increased for the liver group compared to the control group at all time points (pre-operative: 15.6 vs. 8.6 d/sc, p = .0003; 24 h post-operative: 18.3 vs. 11.2 d/sc, p = .039; 10–14 days post-operative: 15.1 vs. 9.6 d/sc, p = .015).

Conclusion

The liver group was hypercoagulable based on elevated G-values at all time points compared to the control group. This hypercoagulability was attributed to the effect of hepatic tumours alone, and not secondary to surgery and anaesthesia.     

Soft tissue sarcoma in dogs: A treatment review and a novel approach using electrochemotherapy in a case series

Canine soft tissue sarcomas (STSs) are locally invasive mesenchymal neoplasms. Electrochemotherapy (ECT) is an antitumour local ablative treatment that uses electric pulses to enhance the intracellular delivery of cytotoxic drugs. The aim of this retrospective study was to review the current treatment for STSs and to evaluate the efficacy and safety of ECT with bleomycin in canine STSs. Fifty‐two dogs with 54 STSs were included. Three groups were arranged: (a) ECT alone, (b) intra‐operative ECT and (c) adjuvant ECT. Signalment, tumour size, location, histological grade and margins and ECT parameters were collected. Recurrence rate (RR) and disease‐free interval (DFI) were calculated. Treatment toxicity was assessed using a 6‐point scale. STSs were mostly located on limbs (77.8%). Median tumour size was 4.3 cm (range 0.4‐17.0 cm). Most STSs were grade I (47.7%) and II (50.0%), and histological margins were incomplete in 94.5% of cases. Two complete remissions, one partial remission and one stable disease were recorded in group 1. Group 2 and 3 were similar for tumour location, size and grade, histological margins, treatment toxicity, pulse frequency and voltage. Moreover, RR and DFI were similar between group 2 and 3 (23% and 25%, 81.5 and 243 days, respectively). Local toxicity post ECT was mild (score ≤ 2) in 66.7% of cases. Higher toxicity score was associated with higher pulse voltage (1200 vs 1000 V/cm) (P = 0.0473). ECT coupled with bleomycin resulted safe and efficient in tumour local control and should be considered as an option for treatment of canine STSs.     

Association of prognostic features and treatment on survival time of dogs with systemic mastocytosis: A retrospective analysis of 40 dogs

Systemic mastocytosis is a rare phenomenon, with limited information regarding prognostic features and effective treatment of canine patients with this disease. The objective of this study is to determine the impact of certain features and treatments on dogs with systemic mastocytosis. The medical records of 40 dogs from 4 northeastern US veterinary hospitals, with evidence of systemic mast cell disease, were evaluated retrospectively. Variables analysed with relation to overall survival and prognostic significance included treatment protocol used, substage, presence of a cutaneous or visceral tumour, presence of multiple cutaneous Mast cell tumours, grade of the primary tumour and metastatic site(s). Dogs with metastatic disease confined to distant lymph nodes lived longer than those with circulating mast cells in the blood (P = .001), and those with metastatic disease evident in more than 2 sites had a worse prognosis than those with disease in a single location (P = .005). Additionally, administration of chemotherapeutic agents led to increased survival over prednisone therapy alone (P = .008), with the combination of lomustine, vinblastine and prednisone prolonging survival over the tyrosine kinase inhibitor, toceranib phosphate (P = .002). Presence of mast cells in the blood and/or evidence of disease in more than 2 sites indicate widespread dissemination suggesting their use as negative prognostic features. Furthermore, a chemotherapy protocol including combination lomustine and vinblastine therapy may be more effective than toceranib phosphate for the treatment of dogs with disseminated mast cell disease. Overall, patients with systemic mastocytosis have a grave prognosis and more effective treatment options are needed.     

Photodynamic hyperthermal chemotherapy with indocyanine green: a novel cancer therapy for 16 cases of malignant soft tissue sarcoma

Sixteen cases of malignant soft tissue sarcoma (STS; 10 canines and six felines) were treated with a novel triple therapy that combined photodynamic therapy, hyperthermia using indocyanine green with a broadband light source, and local chemotherapy after surgical tumor resection. This triple therapy was called photodynamic hyperthermal chemotherapy (PHCT). In all cases, the surgical margin was insufficient. In one feline case, PHCT was performed without surgical resection. PHCT was performed over an interval of 1 to 2 weeks and was repeated three to 21 times. No severe side effects, including severe skin burns, necrosis, or skin suture rupture, were observed in any of the animals. No disease recurrence was observed in seven out of 10 (70.0%) dogs and three out of six (50.0%) cats over the follow-up periods ranging from 238 to 1901 days. These results suggest that PHCT decreases the risk of STS recurrence. PHCT should therefore be considered an adjuvant therapy for treating companion animals with STS in veterinary medicine.     

Factors influencing complete tumor excision of mast cell tumors and soft tissue sarcomas: a retrospective study in 100 dogs

The recommended treatment for soft tissue sarcomas (STS) and mast cell tumors (MCT) is complete surgical removal, provided that the tumor is amenable to surgical excision. The objective of this study was to evaluate possible risk factors for incomplete surgical excision of skin and subcutaneous STS and MCT in 100 dogs treated with wide excision with curative intent. Decreased body weight was a risk factor (P = 0.03, odd's ratio = 0.96) as well as increased tumor size (1.4% increase in risk of incomplete excision per cm(2); P = 0.02). Gender, age, breed, location, grade, tumor type, re-excision, and level of surgeon's training (P = 0.0711) were not significant. Veterinary surgery residents were at increased risk of incompleteness of excision compared with ACVS surgeons and ACVS surgeons with additional training in surgical oncology.     

Diseases associated with hypercobalaminemia in dogs in United Kingdom: A retrospective study of 47 dogs

Cobalamin concentration is often assessed in clinical practice but little is known about the significance of hypercobalaminemia. The objective of this retrospective study was to identify the conditions associated with hypercobalaminemia in dogs and to investigate association with clinicopathological variables. Medical records of dogs having serum cobalamin measured between 2016 and 2018 were reviewed. One hundred sixty dogs were included and 47 (29%) showed hypercobalaminemia. Dogs with hypercobalaminemia had gastrointestinal (57%), hepatic (11%), neurological (11%), endocrine (9%), renal (4%), pancreatic (2%), and miscellaneous (6%) diseases. Overall, 11% had neoplasia. This distribution was not significantly different from that for hypocobalaminemic and normocobalaminemic dogs. There were significantly more dogs with hyperfolatemia in the hypercobalaminemia group. These results suggest that in clinical practice hypercobalaminemia is commonly identified in gastrointestinal and hepatic disease in dogs, but can also be seen with endocrine and neurological conditions. The frequency of hyperfolatemia alongside hypercobalaminemia may reflect common metabolic pathways.     

A retrospective study of 30 cases of frozen lamellar corneal graft in dogs and cats

Frozen lamellar corneal grafts and nictitating membrane flaps were used in 18 dogs and 12 cats to repair deep corneal defects. In all dogs either melting corneal ulcers or descemetoceles were present. In the 12 cats, nine had either a melting corneal ulcer or descemetocele, two animals had acute bullous keratopathy, and one cat had corneal sequestrum. Initial vascularization with gradual clearing of the graft occurred during the first 45 days postoperatively. At 60 days postoperatively, all eyes were visual. Frequent postoperative complications included: focal dehiscence of the wound ( n  = 9); melting of part of the graft ( n  = 7); and pigmentation of the graft ( n  = 4). The frozen lamellar corneal graft was a very safe technique, and restored the tectonic and the optical function of the cornea. It provided the best results in corneas with nonperforating corneal defects. This technique provides poorer results when the cornea was perforated prior to surgery or during the surgical procedure.