Mitotane treatment in a dog with a recurring adrenocortical carcinoma--a case report]

In a 7 year old female poodle an adrenocortical tumor was diagnosed on basis of laboratory and ultrasonographic examinations. One year after adrenalectomy, a relapse was diagnosed, at that time the suspicion of metastases in the liver arose for the first time. By treatment with Mitotane in a dose aiming at completely destroying the adrenal cortex, a complete disappearance of the tumor as well as a dramatic reduction of the size of the metastases could be achieved. 12 months after the begin of the chemotherapy, the dog is in good general condition.     

Electrochemotherapy treatment for bilateral pleomorphic rhabdomyosarcoma in a cat

A 13-year-old male neutered cat was presented for the sudden growth of two nodular lesions close to the upper eyelid of both eyes. Fine-needle aspiration cytology was suggestive of mesenchymal neoplasia. The cat had conservative surgical excision in order to preserve the eyelids’ functionality; however, the histopathological report came with a diagnosis of incompletely excised bilateral pleomorphic rhabdomyosarcoma. Due to the local aggressiveness of this neoplasm, the cat was treated with two sessions of cisplatin-based electrochemotherapy, delivered 14 days apart. Systemic or local toxicities were not detected during the whole course of therapy. The cat is still in complete remission after 12 months. Electrochemotherapy is a safe and efficacious adjuvant therapy for aggressive sarcomas and warrants further investigations in order to standardise its protocols.     

Electrochemotherapy for the Treatment of Multiple Melanomas in a Horse

A 22-year-old Camargue mare was referred for showing signs of discomfort during chewing, building up of food in the mouth, and foul odor from the mouth. On physical examination, the mare presented bilateral pigmented labial masses affecting the upper and lower lips, more in the form of plaques at the mucocutaneous junction as well as multiple perivulvar and perianal lumps. The skin lesions were biopsied for histopathologic examination and the clinical suspect of melanoma was confirmed. The owner elected the lesions to be treated with electrochemotherapy using the drug cisplatin. After two sessions, the nodules were shrunk by 50% and the horse’s ability to feed normally was restored: at that time, the owner had the treatment discontinued because of financial issues. The horse is still in partial remission after 1 year from the end of the treatment. Electrochemotherapy can be successfully used to palliate large melanomas in horses.     

Radiation treatment for thymoma in a dog

A 10-year-old Toy Poodle was admitted for evaluation of a chronic cough caused by a cranial mediastinal mass. The mass was diagnosed, by needle biopsy, as a thymoma. Detection of serum acetylcholine receptor antibodies suggested that the dog had subclinical myasthenia gravis. The dog underwent orthovoltage radiation treatment, which resulted in an approximate 60% reduction in tumor mass and freedom from clinical signs for 6 months. Concurrent use of prednisolone may have been associated with disappearance of the acetylcholine receptor antibodies.     

Zoledronic acid for the treatment of appendicular osteosarcoma in a dog

A 10-year-old male intact Corso dog was referred for lameness and for a large neoplasm affecting the right foreleg. Physical examination of the patient revealed a 5 × 5 × 3 cm mass in the distal right foreleg. Histopathology was consistent with a diagnosis of appendicular osteosarcoma. The staging process found no evidence of metastasis. Because of the large size of the patient, the owners elected to treat their dog with antiresorptive therapy. The patient was treated with an infusion of zoledronic acid every 28 days. The tumour remained stable for 16 months and the lameness of the dog greatly improved. At that time, the patient returned for evaluation of a large rapidly growing prescapular mass. Biopsy confirmed lymph node metastasis and the dog was euthanased. Zoledronic acid showed remarkable palliation in our patient and possibly anti-tumour action and warrants further investigation.     

Ulnocarpal arthrodesis for the treatment of radial agenesis in a dog.

Forelimb deformity caused by radial agenesis was diagnosed in a one-year-old Shih Tzu dog. In contrast to most of the previously reported cases of radial agenesis, the humeroulnar joint was inherently stable. The deformity was treated by means of a one-stage ulnocarpal arthrodesis with the application of an eight hole dorsolateral arthrodesis bone plate and autogenous corticocancellous bone graft from the ilial wing. Radiographic evaluation at the eighth and sixteenth post-operative week showed evidence of union of the arthrodesis. At sixteen weeks post-operatively, the dog had much improved limb function. In humans afflicted with radial agenesis, ulnocarpal arthrodesis is used to restore forearm function by minimizing pain and decreasing the magnitude of angular deformity and instability at the level of the ulnocarpal joint. However, to our knowledge, this is the first report of treatment of radial agenesis in the dog by means of a one-stage, ulnocarpal arthrodesis.     

Adrenal necrosis in a dog receiving trilostane for the treatment of hyperadrenocorticism

Clinical and biochemical changes suggestive of hypoadrenocorticism were observed in a 10-year-old male neutered Staffordshire bull terrier shortly after beginning therapy with trilostane for the treatment of hyperadrenocorticism. The dog's condition was stabilised with intravenous fluids, fludrocortisone and prednisolone. An exploratory laparotomy and excisional biopsy of the left adrenal gland were performed. Histopathological analysis showed adrenal cortical necrosis with reactive inflammation and fibrosis. Trilostane is a reversible inhibitor of steroid synthesis and this complication has not been reported previously. Clinicians should be aware that trilostane therapy may result in adrenal necrosis but that prompt treatment might correct a life-threatening situation.     

Lomustine for the treatment of gastrointestinal mast cell tumour in a dog

An eight-year-old, male boxer dog was referred for the treatment of a large (5.5 x 5 cm), unresectable visceral mast cell tumour. The dog had a surgical resection performed one month before referral, and it had widespread metastases to the abdominal lymph nodes. The patient was treated with lomustine and prednisone and showed a rapid improvement and increased level of activity, weight gain and consistent tumour reduction. The patient remained in partial remission (defined as a greater than 50 per cent reduction in tumour volume) for seven months. Toxicity was acceptable and was limited to moderate anaemia and two episodes of neutropenia. At the completion of the seven months of therapy, the dog experienced a chemotherapy-induced sepsis, and the owners elected for euthanasia due to financial concerns. At that time, the tumour was still in partial remission. This case report suggests that a combination of lomustine and prednisone is an effective protocol for the palliation of aggressive visceral mast cell tumours.     

Immunotherapy for treatment of multicentric cutaneous pythiosis in a dog

A 4-year-old Labrador Retriever was referred for evaluation of 2 ulcerative nodular cutaneous lesions. One lesion was located on the medial aspect of the right carpus; the other was located on the medial aspect of the left tarsus. The dog had spent its entire life in the southeastern part of the United States and approximately half of its time outdoors with free access to a nearby lake. Histologic examination of full-thickness wedge biopsy specimens from both lesions revealed severe, multifocal, puruloeosinophilic to pyogranulomatous deep dermatitis with intralesional filamentous structures, fibroplasia, and neovascularization. Examination of sections stained with Gomori methenamine silver stain revealed a moderate number of wide, bulbous, irregularly septate, branching hyphae. Results of an immunodiffusion test and an ELISA for anti-Pythium insidiosum antibodies were positive. Amputation was eliminated as a treatment option because lesions involved 2 limbs. Long-term systemic antifungal treatment was also rejected because of the cost, lack of therapeutic effect in many cases, and potential for adverse effects. The dog was treated with 2 doses of an anti-P insidiosum vaccine administered 2 weeks apart. One month later, the lesions were nearly completely healed, and values obtained via the immunodiffusion test and ELISA had decreased. Results of the immunodiffusion test and ELISA were negative 1 year later, and the dog had not had any recurrences.     

Bone cement treatment for aneurysmal bone cyst in a dog

An eighteen month old female Doberman pinscher dog was referred to teaching hospital of Adnan Menderes University, Faculty of Veterinary Medicine with the complaint of right forelimb lameness for a month. On the basis of clinical, radiographical, scintigraphical, computed tomographical and histopathological findings, aneurysmal bone cyst was diagnosed. Surgical curettage and bone cement treatment were applied. The patient recovered after 12 months. This case proves that aneurysmal bone cyst, without osteolysis and/or damages to the surrounding tissues, may result in a good prognosis if curettage and treatment with bone cement are done.     

Phallopexy for treatment of paraphimosis in the dog.

Three dogs with recurrent paraphimosis were surgically treated by creation of a phallopexy between the dorsal surface of the penis and the corresponding surface of the prepuce. Follow-up evaluation was performed 4 to 31 months postoperatively. Treatment was successful in each case, and no dog had any adverse sequelae.     

Pars plana vitrectomy for the treatment of ophthalmomyiasis interna posterior in a dog

Unilateral chorioretinitis caused by ophthalmomyiasis interna posterior in a 5-month-old, female spayed Dachshund is reported. Larva removal by pars plana vitrectomy was performed after an unsuccessful photocoagulation of the organism. The larva was intact after surgical removal and was identified as a first stage instar Cuterebra spp. larva. The eye remains visual and comfortable with no signs of residual or recurrent inflammation postoperatively. This report describes, for the first time, the successful surgical retrieval of an intravitreal fly larva in a dog using vitrectomy techniques without sacrificing either the globe or vision, and taxonomic identification of the parasite.     

S-adenosyl-L-methionine (SAMe) for the treatment of acetaminophen toxicity in a dog

An 8-month-old, spayed female Shetland sheepdog presented 48 hours after ingesting acetaminophen (1 gm/kg body weight). On presentation, the dog was laterally recumbent and hypovolemic. The dog had brown mucous membranes, severe Heinz-body hemolytic anemia, bleeding tendencies, and a red blood cell (RBC) glutathione (GSH) concentration that was 10% of reference values, despite a regenerative erythroid response. Treatment with s-adenosyl-l-methionine (SAMe) as a GSH donor successfully rescued this dog, despite the animal's late presentation after drug ingestion. A loading dose (40 mg/kg body weight) of a stable SAMe salt per os was followed by a maintenance dose (20 mg/kg body weight) sid for 7 days. Additional therapeutic interventions included an intravenous (i.v.) infusion of one unit of packed RBCs (on admission), i.v. fluid support (3 days), and famotidine (7 days) to reduce gastric acidity. Sequential assessment of RBC GSH concentrations and RBC morphology documented response to antidote administration within 72 hours. This case suggests that SAMe may provide a therapeutic option for treatment of acetaminophen toxicosis in dogs capable of retaining an orally administered antidote and maintaining adequate hepatic function for metabolism of SAMe to its thiol substrates.     

Cutaneous saphenous nerve graft for the treatment of sciatic neurotmesis in a dog

CASE DESCRIPTION: A 2-year-old Griffon Vendéen was examined because of a 1-month history of right hind limb lameness after a traumatic injury. CLINICAL FINDINGS: Neurologic examination revealed monoplegia and anesthesia of the right hind limb distal to the stifle (femorotibial) joint except for the area supplied by the cutaneous saphenous nerve. Results of electromyographic testing were consistent with a severe lesion of the tibial and peroneal nerves at the level of the stifle joint. TREATMENT AND OUTCOME: Exploratory surgery revealed an 80-mm-long gap in both the peroneal and tibial branches of the right sciatic nerve. A section of the left cutaneous saphenous nerve was interposed to graft the nerve defects. The dog received joint mechanotherapy and electrophysiologic therapy during the reinnervation process. Ten months after surgery, the dog had recovered almost completely. Neurologic examination revealed diminished flexion of the tarsal and digital joints. Repeat electromyographic testing revealed no abnormal spontaneous electrical activity in the right hind limb musculature, and small compound muscle action potentials were recorded in the right interosseous and cranial tibial muscles. CLINICAL RELEVANCE: Without surgical treatment, neurotmesis injury results in poor recovery of motor and sensory functions and may result in amputation. If a nerve defect exists, nerve grafting should be considered, even if the procedure is delayed until well after the injury. The sensory portion of the cutaneous saphenous nerve is a potential source of peripheral nerve for grafting in dogs. Reinnervation is a long-term process and physiologic support and owner involvement are necessary, but nearly complete functional recovery is possible.     

Use of strontium-90 plesiotherapy for the treatment of a lingual plasmacytoma in a dog

A 12-year-old, 25 kg, intact male St Bernard crossbreed was presented for treatment of a 538 mm ulcerated tumour on the dorsal tongue. Fine-needle aspiration cytology revealed a plasmacytoma. The dog staged negative for evidence of local metastatic or systemic disease. Histopathology confirmed the diagnosis. Treatment with one 150 Gy dose of radiation delivered with strontium-90 plesiotherapy was performed. Side effects were not noted and there was no visible evidence of tumour remaining at 2 months and 1 year after therapy.     

Lateral orbitotomy for treatment of an orbital abscess in a dog

A two‐year‐old Jack Russell terrier was diagnosed with a retrobulbar abscess and orbital cellulitis. The diagnosis was confirmed by ultrasound, magnetic resonance imaging examination and ultrasound‐guided fine‐needle aspiration. Transoral ventral drainage was attempted but was unsuccessful. The abscess was successfully treated by open drainage through a lateral orbitotomy. Despite the exposure of the orbital structures, the orbital soft tissues healed by second intention without further complications. The open drainage was well tolerated and resulted in immediate reduction of inflammation and pain, allowing a quick recovery. This report describes the diagnosis and, surgical management and the long‐term (3 years) follow‐up of an unusual case of orbital abscess associated with diffuse periorbital cellulitis successfully treated by open drainage through a lateral orbitotomy.     

Percutaneous balloon valvuloplasty for treatment of pulmonic stenosis in a dog

A 2.5-year-old dog with congenital pulmonary valve dysplasia was treated by percutaneous balloon dilation of the stenotic orifice. Clinical and hemodynamic improvement was apparent immediately and for 9 months after the valvuloplasty procedure.     

Nontraditional treatment of mycosis fungoides in a dog

A 14-year-old Dachshund with plaque-stage mycosis fungoides was treated and kept free of lesions for 25 months, using combination drug therapy of a placental lysate and low-dose prednisone. Mycosis fungoides has a poor prognosis and has had a history of poor response to treatment. Placental lysate with low-dose prednisone may offer an alternate therapeutic regimen in this disease.