Radiotherapy-induced myelosuppression in dogs: 103 cases (2002-2006)

Definitive radiotherapy refers to delivery of large doses, typically 48-62 Gray, of ionizing radiation over several weeks using a daily or alternate-day fractionation schedule. The impact of definitive radiotherapy alone on haematopoiesis in tumour-bearing dogs is unknown. Medical records from 103 dogs receiving definitive (60) Cobalt teletherapy for cancer over a 5-year period were reviewed for signalment, tumour type and location, total radiotherapy dose and fractionation scheme. Complete blood count data were collected before, halfway through, and at the end of radiation treatment, and analysed for changes associated with patient variables. The results demonstrate significant reductions in haematocrit, total white blood cell count, neutrophils, eosinophils, monocytes, lymphocytes and platelets occurred during definitive radiotherapy but remained within laboratory reference intervals. These data are important for anticipation of toxicity associated with combinations of radiotherapy and chemotherapy in dogs but do not support the routine monitoring of haematology parameters during definitive radiotherapy.     

Variables associated with outcome in dogs undergoing extrahepatic biliary surgery: 60 cases (1988-2002)

OBJECTIVE: To report clinical findings and define clinical variables associated with outcome in dogs undergoing extrahepatic biliary surgery. STUDY DESIGN: Retrospective study. ANIMALS: Sixty dogs that had extrahepatic biliary tract surgery. RESULTS: Primary diagnoses included necrotizing cholecystitis (36 dogs, 60%), pancreatitis (12 dogs, 20%), neoplasia (5 dogs, 8%), trauma (4 dogs, 7%), and gallbladder rupture from cholelithiasis without necrotizing cholecystitis (3 dogs, 5%). Bile peritonitis occurred in 19 (53%) dogs with necrotizing cholecystitis, 4 dogs with trauma, and 3 dogs with cholelithiasis without evidence of necrotizing cholecystitis. Cholecystectomy (37 dogs, 62%) and cholecystoduodenostomy (14 dogs, 23%) were the 2 most commonly performed procedures. Median hospitalization for survivors was 5 days (range, 1-15 days). There were 43 surviving dogs (72%) and 17 nonsurvivors (28%, 4 died, 13 euthanatized). Presence of septic bile peritonitis (P=.038), elevation in serum creatinine concentration (P=.003), prolonged partial thromboplastin times (PTTs; P=.003), and lower postoperative mean arterial pressures (P=.0001) were significantly associated with mortality. CONCLUSIONS: Extrahepatic biliary surgery is associated with high mortality and a relatively long hospitalization time for survivors. Cholecystectomy and cholecystoduodenostomy were the most common surgical procedures to treat the 4 major biliary problems (necrotizing cholecystitis, pancreatitis, neoplasia, and trauma) observed in this cohort of dogs. The relatively high mortality rate likely reflects the underlying diseases and their effects on the animal (septic bile peritonitis, higher serum creatinine, prolonged PTT, and lower postoperative mean arterial pressure) rather than complications of surgery. CLINICAL RELEVANCE: Septic bile peritonitis, preoperative elevated creatinine concentration, and immediate postoperative hypotension in dogs undergoing extrahepatic biliary tract surgery are associated with a poor clinical outcome. Adequate supportive care and monitoring in the perioperative period is critical to improve survival of dogs with extrahepatic biliary disease.     

Retroperitoneal sarcomas in dogs: 14 cases (1992-2002)

OBJECTIVE: To describe the clinical features, surgical and histologic findings, biological behavior, and outcome of dogs with retroperitoneal sarcomas. DESIGN: Retrospective study. ANIMALS: 14 dogs. PROCEDURES: Medical and pathology records from 1992 to 2002 of dogs with tumors originating in the retroperitoneal space were reviewed. Dogs with retroperitoneal tumors originating from the adrenal glands, kidneys, or ureters were excluded. Inclusion criteria included observation of a tumor arising from the retroperitoneal space during exploratory surgery or necropsy and histologic confirmation of tumor type. Details of clinical signs, diagnostic findings, surgical management, and outcome were determined from medical records and telephone interviews with veterinarians and owners. RESULTS: Retroperitoneal sarcoma was diagnosed in 14 dogs, 2 at necropsy and 12 during exploratory surgery. Hemangiosarcoma was the most common histologic diagnosis. Seven dogs had regional extension of the sarcoma into adjacent organs, and 4 dogs had metastatic disease. Grossly complete resection was possible in 6 dogs. Cytoreductive surgery or incisional biopsy was performed in the remaining dogs. Two dogs were treated with palliative radiation therapy (1 intraoperatively and 1 postoperatively). Three dogs received adjunctive chemotherapy, although none completed the targeted course because of development of local recurrence or metastatic disease. Local recurrence was reported in 2 of 12 dogs and metastasis in 10 of 14 dogs. Thirteen dogs died or were euthanatized as a result of the retroperitoneal sarcoma; 1 dog was alive and disease-free 410 days after surgery. Median survival time was 37.5 days. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs, retroperitoneal sarcomas are aggressive tumors with a high rate of local recurrence and metastasis, and a poor survival time.     

Gallbladder mucocele in dogs: 30 cases (2000-2002)

OBJECTIVE: To determine long-term outcome of dogs with gallbladder mucocele. DESIGN: Retrospective study. ANIMALS: 30 dogs with gallbladder mucocele, including 23 that underwent cholecystectomy. PROCEDURE: Medical records were reviewed for signalment, history, and clinical, ultrasonographic, and surgical findings. Follow-up information was obtained for all dogs that survived the perioperative hospitalization period. RESULTS: 23 dogs had signs of systemic illness; 7 had no clinical signs. Median values for serum activities of alanine aminotransferase and alkaline phosphatase, serum total bilirubin concentration, and total WBC count were significantly higher among dogs with gallbladder rupture than among dogs without rupture. Sensitivity of sonography for detection of rupture was 85.7%. Overall perioperative mortality rate for dogs that underwent cholecystectomy was 21.7%; mortality rate was not significantly greater for dogs with rupture. Aerobic bacteria were isolated from the bile or gallbladder wall in 8.7% of dogs. All 18 dogs discharged from the hospital had complete resolution of clinical signs. In dogs that underwent in-hospital reexamination, serum liver enzyme activities were significantly decreased, compared with preoperative activities. Persistent increases in serum activities of 1 or more liver enzymes were detected in 9 of 12 dogs; 6 of 12 dogs had persistent abnormalities in hepatic echogenicity. Mean follow-up period was 13.9 months. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that cholecystectomy is an effective treatment for gallbladder mucocele. Although perioperative mortality rate is high, prognosis after discharge from the hospital is excellent. Rupture of the gallbladder warrants emergency surgical intervention but does not preclude a positive outcome.     

Pneumoperitoneum in dogs and cats: 39 cases (1983-2002)

OBJECTIVE: To identify the most common causes of pneumoperitoneum in dogs and cats and determine history, clinical features, and outcome of affected animals. DESIGN: Retrospective study. ANIMALS: 31 dogs and 8 cats. PROCEDURES: Medical records were reviewed for signalment; history; abnormal physical, clinicopathologic, and radiographic findings; results of cytologic analysis and bacterial culture of abdominal fluid; gross and histologic findings at surgery or necropsy; and outcome. RESULTS: Pneumoperitoneum was classified as spontaneous in 25 animals and traumatic in 14. Causes of traumatic pneumoperitoneum included vehicular impact, gunshot wounds, abdominal dog bite wounds, and iatrogenic pneumothorax. Spontaneous pneumoperitoneum was caused by gastrointestinal tract perforation in 23 animals; underlying causes included neoplasia, nonsteroidal anti-inflammatory drug administration, and corticosteroid administration. Two animals developed spontaneous pneumoperitoneum after bladder rupture. Animals with spontaneous pneumoperitoneum were significantly older and had clinical signs of longer duration than those with traumatic pneumoperitoneum. Sixteen animals survived, including 15 of 23 animals that underwent surgery. Animals that survived had significantly higher serum albumin concentrations than did animals that died or were euthanatized. CONCLUSIONS AND CLINICAL RELEVANCE: Although pneumoperitoneum is most often attributable to perforation of a hollow viscus, other causes do exist. Early exploration is recommended for diagnosis and treatment of the underlying condition.     

Idiopathic lymphoplasmacytic rhinitis in dogs: 37 cases (1997-2002)

OBJECTIVE: To determine clinical signs and rhinoscopic, computed tomographic, and histologic abnormalities in dogs with idiopathic lymphoplasmacytic rhinitis. DESIGN: Retrospective case series. ANIMALS: 37 dogs. PROCEDURE: Clinical information was obtained from medical records. Nasal computed tomographic images and histologic slides of biopsy specimens were reviewed. RESULTS: Dogs ranged from 1.5 to 14 years old (mean, 8 years); most (28) were large-breed dogs. Nasal discharge was unilateral in 11 of 26 (42%) dogs and bilateral in 15 of 26 (58%) dogs. In dogs with unilateral disease, duration of clinical signs ranged from 1.5 to 36 months (mean, 8.25 months; median, 2 months), and in dogs with bilateral disease, duration of signs ranged from 1.25 to 30 months (mean, 6.5 months; median, 4 months). Computed tomography (n = 33) most often revealed fluid accumulation (27/33 [82%]), turbinate destruction (23/33 [70%]), and frontal sinus opacification (14/33 [42%]). Rhinoscopy (n = 37) commonly demonstrated increased mucus and epithelial inflammation; turbinate destruction was detected in 8 of 37 (22%) dogs. Bilateral biopsy specimens from all 37 dogs were examined. Four dogs had only unilateral inflammatory changes. The remaining 33 dogs had bilateral lesions; in 20, lesions were more severe on 1 side than the other. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggest that idiopathic lymphoplasmacytic rhinitis is a key contributor to chronic nasal disease in dogs and may be more common than previously believed. In addition, findings suggest that idiopathic lymphoplasmacytic rhinitis is most often a bilateral disease, even among dogs with unilateral nasal discharge.     

Massive hepatocellular carcinoma in dogs: 48 cases (1992-2002)

OBJECTIVE: To determine clinical signs, diagnostic findings, outcome, and prognostic factors in dogs treated surgically for massive hepatocellular carcinoma (HCC) and compare survival times of surgically and conservatively treated dogs. DESIGN: Retrospective study. ANIMALS: 48 dogs. PROCEDURE: Medical records were examined for clinical signs, diagnostic and surgical findings, and postoperative outcome. Dogs were allocated into surgery and nonsurgery groups depending on whether curative-intent liver lobectomy was performed. Data from the surgical and nonsurgical groups were analyzed to identify prognostic factors and determine and compare rates of tumor control and survival time. RESULTS: 42 dogs were treated surgically, and 6 were managed conservatively. In the surgery group, intraoperative mortality rate was 4.8% with no local recurrence, metastatic rate was 4.8%, and median survival time was > 1,460 days (range, 1 to 1,460 days). High alanine aminotransferase and aspartate aminotransferase activities were associated with poor prognosis. Median survival time for the nonsurgery group was 270 days (range, 0 to 415 days), which was significantly less than that of surgically treated dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Liver lobectomy is recommended for dogs with massive HCC because tumor-related mortality rate was 15.4 times higher in dogs in the nonsurgery group, compared with the surgery group. Tumor control was excellent after surgical resection with no local recurrence and a low metastatic rate. Prognostic factors were identified, but their clinical relevance was uncertain because only 9.5% of dogs in the surgery group died as a result of their disease.     

Infiltrative urethral disease in female dogs: 41 cases (1980-1987)

Forty-one cases of infiltrative urethral disease in female dogs were reviewed. The cause was epithelial neoplasia in 29 dogs, granulomatous (chronic active) urethritis in 10 dogs, and leiomyoma in 2 dogs. Clinical signs of disease were similar in dogs with neoplastic and inflammatory disease and included strangury (36/41), hematuria (30/41), pollakiuria (20/41), vaginal discharge (16/41), and complete urinary obstruction (7/41). Results of aspiration biopsy of the urethra correlated with those of surgical biopsy in 11 of 15 dogs. In 4 of 15 dogs, results of cytologic and histologic examinations differed. Granulomatous (chronic active) urethritis is an infiltrative urethral disease in female dogs. Clinical findings are similar, but the prognosis is more favorable than that in dogs with urethral epithelial neoplasia.     

Ultrasonographic findings in dogs with hyperammonemia: 90 cases (2000-2002)

OBJECTIVE: To determine ultrasonographic abnormalities in dogs with hyperammonemia. DESIGN: Retrospective study. ANIMALS: 90 client-owned dogs with hyperammonemia. PROCEDURE: Ultrasonography of the abdominal vessels and organs was performed in a systematic way. Dogs in which the ultrasonographic diagnosis was a congenital portosystemic shunt were included only if they underwent laparotomy or necropsy. Dogs in which the abdominal vasculature appeared normal and dogs in which the ultrasonographic diagnosis was acquired portosystemic shunts and portal hypertension were included only if liver biopsy specimens were submitted for histologic examination. RESULTS: Ultrasonography excluded portosystemic shunting in 11 dogs. Acquired portosystemic shunts were found in 17 dogs, of which 3 had arterioportal fistulae and 14 had other hepatic abnormalities. Congenital portosystemic shunts were found in 61 dogs, of which 19 had intrahepatic shunts and 42 had extrahepatic shunts. Intrahepatic shunts originated from the left portal branch in 14 dogs and the right portal branch in 5. Extrahepatic shunts originated from the splenic vein, the right gastric vein, or both and entered the caudal vena cava or the thorax. Ultrasonography revealed splenic-caval shunts in 24 dogs, right gastric-caval shunts in 9 dogs, splenic-azygos shunts in 8 dogs, and a right gastric-azygos shunt in 1 dog. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that ultrasonography is a reliable diagnostic method to noninvasively characterize the underlying disease in dogs with hyperammonemia. A dilated left testicular or ovarian vein was a reliable indicator of acquired portosystemic shunts.     

Type I immune-mediated polyarthritis in dogs: 39 cases (1997-2002)

OBJECTIVE: To determine clinical signs, laboratory findings, relationship to vaccination, and response to treatment for type I immune-mediated polyarthritis (IMPA) in dogs. DESIGN: Retrospective study. ANIMALS: 39 dogs PROCEDURE: Clinical records and radiographic reports from 3 university referral hospitals were reviewed. Clinical signs, laboratory and investigative findings, relationship to vaccination, and response to treatment were evaluated. RESULTS: Clinical signs and initial laboratory and clinical investigative findings were frequently abnormal but were nonspecific and not associated with likelihood of recovery. Time of vaccination was not associated with onset of disease. Chemotherapeutic immunosuppression resulted in complete cure in 56% of dogs. Continuous medication was required in 18% (7/39) of dogs, relapses were treated successfully in 13% (5/39) of dogs, and 15% (6/39) of dogs died or were euthanatized as a result of disease. CONCLUSIONS AND CLINICAL RELEVANCE: The possible involvement of vaccination in type I IMPA was not made clear from this study because of the small population size. Signalment, clinical signs, and results of diagnostic tests other than multiple synovial fluid analyses were generally nonspecific. Most dogs with type I IMPA responded to initial immunosuppressive treatment, but 31% (12/39) of dogs relapsed, required further treatment, or both.     

Radiographic findings in dogs with pulmonary blastomycosis: 125 cases (1989-2006)

OBJECTIVE: To identify radiographic patterns in dogs with pulmonary blastomycosis and radiographic factors associated with outcome. DESIGN: Retrospective case series. ANIMALS: 125 dogs with pulmonary blastomycosis. PROCEDURES: Medical records were reviewed, and for each lung lobe, the primary radiographic pattern and percentage of lobar involvement at the time of initial examination were recorded. RESULTS: 79 dogs survived, 38 died, and 8 were euthanized without treatment. The initial radiographic pattern was variable and not significantly associated with outcome. Mean half-time for radiographic resolution of pulmonary infiltrates was 41.4 days for all patterns except masses, for which mean half-time to resolution was 90.8 days. Transient radiographic worsening was seen in 20 of 87 (23%) dogs but was not associated with a poor prognosis. Pulmonary bullae were seen in 20 (16%) dogs, most often in association with an alveolar pattern. Accuracy of using percentage of right caudal lung lobe involvement ( 20%) to predict outcome was 74.4%; accuracy of using number of affected lobes (< 4 vs >or= 4) to predict outcome was 65.8%. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that a nonuniform distribution of pulmonary infiltrates was equally as likely as a diffuse nodular interstitial pattern in dogs with pulmonary blastomycosis. On the basis of half-time for resolution of pulmonary infiltrates, follow-up radiography should be performed no more often than every 4 to 6 weeks in clinically stable patients. Transient radiographic worsening that occurred during the initial weeks of treatment was not associated with a poorer prognosis.     

Porcupine quill injuries in dogs: a retrospective of 296 cases (1998-2002)

The purpose of this retrospective study was to identify factors associated with quill injury in dogs. A second objective was to determine the risk of complications and any factors that would predict the likelihood of complications. Hospital records of 296 porcupine quill injuries in dogs from 1998 to 2002 were studied. There was an increased occurrence of porcupine encounters in the spring and fall months; Siberian huskies, rottweilers, and German shepherd crosses were significantly overrepresented for quill injuries. There was no association between risk of complications and either number of quills or antimicrobial use. Increasing time between quill injury and presentation was associated with an increased risk of complications. Because of the increased frequency of complication with a longer interval until presentation, clients should be strongly encouraged to bring the dog in as soon as the quill injury is discovered. Patients presented after 24 hours should be monitored closely during the first 3 weeks after injury, as most complications occurred during this time.     

Computed tomographic appearance of masticatory myositis in dogs: 7 cases (1999-2006)

OBJECTIVE: To document computed tomography (CT) features in dogs with masticatory myositis. DESIGN: Retrospective case series. ANIMALS: 7 dogs with an immunologic diagnosis of masticatory myositis and an absence of clinical abnormalities of any skeletal muscles other than the masticatory muscles. PROCEDURES: History; clinical, hematologic, biochemical, immunologic, cytologic, and histologic findings; and pre- and postcontrast CT imaging features of masticatory muscles and head and neck lymph nodes were extracted from medical records. RESULTS: On CT images, changes in size (atrophy or swelling) were common for all masticatory muscles except the digastricus muscles, which were involved only in 1 dog. Pre-contrast attenuation changes, most often hypoattenuation with varied distribution patterns, were seen in masticatory muscles of 4 dogs. Contrast enhancement with a predominantly inhomogeneous distribution pattern was seen in the temporalis, masseter, and pterygoid muscles of all dogs. Head and neck lymph nodes were enlarged in all but 1 dog and had contrast enhancement with predominantly central or homogeneous distribution patterns. Muscle biopsy was performed in 6 dogs, with biopsy specimens obtained from areas that had the most obvious contrast enhancement on CT images. For all 6 dogs, biopsy specimens had histologic features indicative of masticatory myositis. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that CT may be a useful adjunct in the diagnosis of masticatory myositis in dogs, including selection of sites for diagnostic muscle biopsy.     

Eastern Diamondback Rattlesnake (Crotalus adamanteus) envenomation of dogs: 31 cases (1982-2002)

The medical records of 31 dogs treated for envenomation by the Eastern Diamondback Rattlesnake (Crotalus adamanteus) were reviewed. Twenty-four of 25 dogs that survived were hospitalized for an average of 4.3 days. The most common presenting signs were tachycardia, swelling/edema, depressed mentation, tachypnea, and bleeding puncture wounds. Thirteen (42%) of the 31 dogs were presented with or developed cardiac arrhythmias, predominantly ventricular premature contractions. Hematological disorders, including defibrination, elevated fibrin split products, hemolytic anemia, thrombocytopenia, and prolonged clotting times, were recorded in 81% of the dogs. Polyvalent crotalid antivenin was administered (mean of 4.0 vials per dog) to 88% of the surviving dogs and 50% of the nonsurviving dogs.     

Mandibular periostitis ossificans in immature large breed dogs: 5 cases (1999-2006)

This case series describes clinical, radiographic, and histopathological features of mandibular swellings in 5 immature, large breed dogs. The dogs originated from different regions of the United States. In each case, intraoral dental radiography of the jaw swelling revealed a two-layered (double) ventral mandibular cortex. Biopsy was performed in 4 of the 5 puppies, revealing periosteal new bone formation. Resolution of the mandibular swelling was spontaneous in the 4 dogs available for follow-up examination. The authors postulate that the clinical, radiographic, and histopathological presentation of mandibular swelling in these 5 dogs is a distinct pathological entity consistent with an inflammatory condition of the maturing human mandible known as periostitis ossificans.     

Evaluation of environmental risk factors for leptospirosis in dogs: 36 cases (1997-2002)

OBJECTIVE: To identify environmental risk factors for leptospirosis. DESIGN: Retrospective study. ANIMALS: 36 dogs with leptospirosis and 138 dogs seronegative for leptospirosis as determined by microscopic agglutination test for antibodies against Leptospira spp. PROCEDURES: Medical records of dogs evaluated for leptospirosis from 1997 though 2002 were identified. Owner address was used to geocode locations of dogs, and location-specific environmental risk factor data were obtained by use of a geographic information system. Risk of leptospirosis was estimated by odds ratios, controlling for potential confounding by dog age, sex, and breed. RESULTS: Leptospirosis in 19 of the 30 dogs in which an infecting Leptospira serovar could be identified was associated with Leptospira kirschneri serovar grippotyphosa infection. Dogs in which a diagnosis of leptospirosis was made, and dogs with leptospirosis caused by L kirschneri serovar grippotyphosa, were more likely to have addresses located in areas classified as rural in 1990 but urban in 2000. By use of information on recent urbanization and a logistic regression model, the status of 81.6% and 89.8% of dogs with leptospirosis and leptospirosis caused by serovar grippotyphosa, respectively, were correctly classified. Other environmental variables (proximity to streams, recreational areas, farmland, wetlands, areas subject to flooding, and areas with poor drainage; annual rainfall; and county cattle or pig population) did not significantly improve accuracy of classification. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs in periurban areas are at greater risk of leptospirosis. Vaccination of dogs in these areas to protect against leptospirosis should be considered.