LARYNGEAL ADENOCARCINOMA IN A DOG

Laryngeal adenocarcinoma was diagnosed in a 5-year-old golden retriever dog with no history of respiratory or pharyngeal difficulties. Radiographically the basihyoid bone was destroyed by the neoplasm, and extensive soft tissue mineralization ventral to the larynx was also present. Complete surgical resection was not possible due to diffuse involvement of the tongue and larynx. Cobalt-60 teletherapy was used for treatment of the tumor. There was no clinical evidence of tumor regrowth at approximately 12 months post treatment. This is an unusual example of primary laryngeal neoplasia due to the absence of clinical respiratory abnormalities and the aggressive destruction of the basihyoid bone.     

Laryngeal rhabdomyoma in a dog

A 3‐year‐old, female spayed Australian Shepherd dog was presented to Veterinary Healthcare Associates in Winter Haven, FL with a history of respiratory stridor, difficulty swallowing, and a change in bark for approximately 3 months. Radiographs revealed a soft tissue mass caudal to the epiglottis. Oral and computerized tomographic (CT) examinations were performed under general anesthesia and revealed a small firm mass in the caudal larynx on the right side. Cytologic evaluation of a fine‐needle aspirate of the mass revealed cells consistent with a rhabdomyoma, oncocytoma, or granular cell tumor. Histopathologic interpretation was rhabdomyoma or oncocytoma. Histochemical staining with periodic acid‐Schiff was mostly negative with a low number of weakly positive cells and with phosphotungstic acid‐hematoxylin was strongly positive with visible cross striations. Tumor cells did not express pancytokeratin AE1/AE3, were strongly immunoreactive for myoglobin and muscle‐specific actin, and did not express vimentin except for a low number of weakly immunoreactive cells. These findings confirmed a diagnosis of rhabdomyoma. Primary neoplasia of the larynx is rare, and widely varying types of neoplasms have been documented in this location. Due to the cytologic and histologic similarities between rhabdomyoma, oncocytoma, and granular cell tumor, these neoplasms should be differentiated using histochemical staining and immunohistochemical analysis.     

Obstructive inflammatory laryngeal disease in three cats

Three cats with upper respiratory tract obstruction due to laryngeal inflammation are presented. Cervical radiography showed the presence of a soft tissue mass in the laryngeal region in all cases, and laryngoscopy allowed direct visualization of a mass associated with the larynx. Laryngeal samples were obtained by a combination of fine needle aspiration, cutting biopsy forceps, by ventral laryngotomy, and at post-mortem. Histopathology of the laryngeal samples showed the presence of a predominantly granulomatous inflammation, with macrophage and lymphocyte infiltration. One case was euthanased due to severe dyspnoea. The remaining two cases underwent combined medical (corticosteroid and antibiotic) and surgical (permanent tracheostomy or excision of laryngeal tissue by ventral laryngotomy) treatment. One case died of an undetermined cause 15 weeks after surgery while the other case remains clinically well 20 months after diagnosis. Recognition of the existence of granulomatous laryngitis is important as clinical signs and radiographic findings are indistinguishable from laryngeal neoplasia.     

Clinical signs, clinicopathological findings, etiology, and outcome associated with hemoptysis in dogs: 36 cases (1990-1999)

Hemoptysis, the expectoration of blood or bloody mucus from the respiratory tract at or below the larynx, was retrospectively evaluated in 36 dogs. Cough, tachypnea, and dyspnea were common historical and physical examination signs. Anemia was documented in 11 dogs, but was severe in only one dog. Other clinicopathological findings reflected the underlying diseases. All thoracic radiographs obtained were abnormal; alveolar and interstitial patterns were most common. Diseases predisposing to hemoptysis included bacterial bronchopneumonia (n=7), neoplasia (n=5), trauma (n=5), immune-mediated thrombocytopenia (n=4), heartworm disease (n=4), rodenticide poisoning (n=3), lung-lobe torsion (n=1), left-sided congestive heart failure (n=1), pulmonary hypertension (n=1), and foreign-body pneumonia (n=1). Four additional dogs had more than one underlying disease process. Nine dogs were either euthanized or died in the hospital during the initial visit. While at least half of the 27 dogs discharged went on to completely recover, five dogs discharged were known to have either died or been euthanized as a result of their disease in <6 months.     

Traumatic endotracheal intubation in the cat

BACKGROUND: Orotracheal intubation is a commonly performed procedure in the cat, but it is not without complications. Tracheal rupture has been reported in cats, but trauma to the arytenoids from intubation has not been documented. OBSERVATIONS: An otherwise healthy, 5-year-old male domestic shorthair cat presented for total ear canal ablation to resolve intractable otitis media and externa. The cat was premedicated with glycopyrrolate, hydromorphone, and acepromazine. Anesthesia was induced with diazepam and ketamine, and maintained with isoflurane in oxygen. During orotracheal intubation, the larynx was poorly visualized and excessive force was used to perform intubation. Subsequently, blood was observed in the larynx and laryngoscopy revealed a tear lateral to the patient's right arytenoid which had been created during intubation. The larynx was re-intubated normally and the cat suffered no obvious ill effects from the trauma to the larynx. CONCLUSIONS: Direct observation and proper technique must be employed during orotracheal intubation in cats in an attempt to avoid laryngeal trauma.     

Paralaryngeal Abscess with Laryngeal Hemiplegia and Fistulation in a Horse

A three year old Thoroughbred filly was examined because of bilateral nasal discharge and external swelling of the left laryngeal area. Endoscopy revealed an enlarged left arytenoid cartilage, left laryngeal hemiplegia and drainage of purulent material into the lumen of the larynx. Radiographs showed a large fluid and gas filled cavity overlying the caudal larynx and cranial trachea. Surgical drainage and debridement of the abscess led to complete healing by secondary intention. Laryngeal ventriculectomy was performed as a treatment for left laryngeal hemiplegia, but a grave prognosis for respiratory soundness was given due to the extensive laryngeal fibrosis. The etiology of the Staphylococcus aureus abscess is unknown but may have originated from oral trauma to the larynx.     

Observations on the mechanism of functional obstruction of the nasopharyngeal airway in the horse.

Fibreoptic endoscopy was used to study the movements of the larynx and pharynx during nasal occlusion in 10 horses, which showed signs consistent with functional pharyngeal obstruction (FPO) on exercise. Cine-endoscopic films were made on 3 such horses. Consideration of the anatomy of the region indicates that FPO may best be regarded as a subluxation of the nasopharyngeal and larygneal airways and it was found that a constant component of the movements which brought about this subluxation was a marked caudal retraction of the larynx. It is suggested that this caudal retraction of the larynx occurred as a result of the action of th sternothyrohyoid and omohyoid muscles and that removal of a portion of these muscles might prevent subsequent airway subluxation in horses prone to FPO on exercise.     

Evaluation of human recombinant tissue factor-activated thromboelastography in 49 dogs with neoplasia

BACKGROUND: Abnormal routine coagulation assay results have been reported to be common in veterinary patients with neoplasia, but the overall hemostatic functional state, including hypercoagulability, has not been described. HYPOTHESIS: The overall hemostatic functional state, including hypercoagulability, can be assessed in dogs with neoplasia by tissue factor (TF)-activated thromboelastography (TEG). ANIMALS: Thirty-six dogs with malignant neoplasia and 13 dogs with benign neoplasia presented to the Small Animal Veterinary Teaching Hospital, The University of Copenhagen, Frederiksberg, Denmark. METHODS: Prospective study evaluating the overall hemostatic functional state in dogs with neoplasia by a newly validated TF-activated TEG assay and routine coagulation parameters activated partial thromboplastin time (aPTT), prothrombin time (PT), platelet count, and D-dimer concentration. RESULTS: Hemostatic dysfunction was observed in 28/49 (57%) dogs with neoplasia. Twenty-four were dogs with malignant neoplasia, the majority of which 18/36 (50%) were hypercoagulable, whereas 6/36 (17%) were hypocoagulable. All hypocoagulable dogs had metastatic disease. The proportion of dogs with altered hemostasis was significantly different between dogs with malignant and benign neoplasia. CONCLUSIONS AND CLINICAL IMPORTANCE: TF-activated TEG detected hypercoagulable and hypocoagulable states in this population of dogs with neoplasia. The most common hemostatic abnormality in dogs with malignant neoplasia was hypercoagulability. These findings suggest that this novel hemostatic function test may be of value as a cage side method for the assessment of overall hemostatic function in dogs with cancer, including the detection of both hyper- and hypocoagulable states as well as mixed disorders.     

The Prevalence of Malignant Neoplasia in Feline Renal-Transplant Recipients

OBJECTIVE: To determine the prevalence of malignant neoplasia in a group of feline renal-transplant recipients (FRTR). STUDY DESIGN: Retrospective clinical study. ANIMALS: Ninety-five consecutive client-owned FRTR treated at the University of California, Davis, between 1987 and 1997. METHODS: Medical records of the 95 cats were examined. The time to occurrence and type of malignant neoplasia, if present, was determined. RESULTS: Nine of 95 cats (9.5%) developed apparently de novo malignant neoplasia after receiving renal allografts. The predominant type of neoplasm was lymphoma. The median time to diagnosis of neoplasia in these 9 patients was 9.0 months after transplantation, whereas the median survival time was 14.0 months after transplantation. This compares with a median survival time of 22 months after transplantation for cats that died for reasons other than development of malignant neoplasia. CONCLUSIONS: Although these transplant recipients were not compared with a control population, it would appear that, as in humans, malignant neoplasia is encountered with greater-than-expected frequency after renal transplantation and immunosuppression in cats. CLINICAL SIGNIFICANCE: The apparent propensity to develop malignant neoplasia after renal transplantation and immunosuppression in cats is a fatal complication of which owners and clinicians should be aware.     

Spontaneous neoplasia in four captive greater hedgehog tenrecs (Setifer setosus)

Little information is available about diseases and pathology of species within the family Tenrecidae, including the greater hedgehog tenrec (Setifer setosus), a Madagascan insectivore. This report summarizes necropsy and histopathologic findings of neoplasia in four captive greater hedgehog tenrecs. Although only four animals are included in this report, neoplasia seems to be a common and significant source of morbidity and mortality in greater hedgehog tenrecs. Types of neoplasia identified include a thyroid follicular-solid carcinoma, two urinary bladder transitional cell carcinomas, uterine endometrial polyps, and multicentric B-cell lymphoma. Due to small sample size, no etiology could be determined, but genetics, viral infection, pesticide treatment, nutrition, or other environmental factors might contribute to the development of neoplasia in this species. This is the first report of neoplasia in greater hedgehog tenrecs.     

COMPLICATIONS IN EQUINE LARYNGEAL SURGERY

Surgery on the larynx as is seen in most cases today is either a laryngotomy in which the laryngeal saccules are removed or a laryngoplasty procedure in which the muscular process of the arytenoid cartilage is sutured to the cricoid cartilage or the combination of both. Continued research in this area might lead to a better surgical technique than laryngoplasty. At this time laryngoplasty has apparently increased the efficacy of surgery treatment on the larynx by at least 20% over the long advocated laryngeal saccule removal. It is of interest to note that in comparing the larynx of man and the horse that innervation and musculature are very similar. Perhaps in viewing laryngeal paralysis in man better understanding of the etiology and perhaps the surgical approach may be obtained. But, as pointed out by Cook¹, man is not judged by how fast he can run a mile as opposed to the horse.     

The accuracy of intraoperative cytopathological diagnosis compared with conventional histopathological diagnosis

To determine the accuracy of intraoperative cytopathological diagnosis compared with conventional histopathological diagnosis, the authors obtained 100 specimens from masses of various organ systems chosen randomly from 65 dogs, 30 cats, and five exotic animals. Of the 100 specimens, a specific diagnosis was obtained in 42%, the correct pathological process (i.e., mesenchymal neoplasia, epithelial neoplasia, round cell neoplasia, or inflammation) was identified in 41%, in 1% the diagnosis was deferred, and in 16% an incorrect diagnosis was obtained. The overall accuracy rate of intraoperative cytopathological examination was 83%, which increased to 90% by the exclusion of splenic masses. The accuracy rate of diagnosing neoplasia was 87%, with a sensitivity of 89% and a specificity of 100%. Intraoperative cytopathological examination is an accurate diagnostic method with good sensitivity and specificity for the identification of neoplasia.     

Bilateral thyrohyoideus muscle rupture in a dog

A whippet was referred to our hospital, for further assessment and treatment, two days after receiving bite wound to the neck. Physical examination and radiographs revealed caudal displacement of the larynx. At surgery, bilateral rupture of the thyrohyoideus muscle was discovered and repaired, returning the larynx to its normal position. The dog was discharged after 10 days and has only mild residual symptoms.     

Influence of lidocaine and diazepam on peri-induction intraocular pressures in dogs anesthetized with propofol–atracurium

The purpose of this study was to evaluate the effects on the intraocular pressure (IOP) of lidocaine or diazepam administered intravenously (IV) before induction of anesthesia with propofol-atracurium and orotracheal intubation in normal dogs, as well as the effects on the IOP of lidocaine applied topically to the larynx after induction with propofol-atracurium. We randomly assigned 32 random-source dogs, obtained from municipal pounds, to receive the following: lidocaine, 2 mg/kg IV, with saline, 0.1 mL/kg topically applied to the larynx (LIDOsal); saline, 0.1 mL/kg IV, with lidocaine, 2 mg/kg topically applied to the larynx (SALlido); diazepam (Valium), 0.25 mg/kg IV, with saline, 0.1 mL/kg topically applied to the larynx (VALsal); or saline, 0.1 mL/kg IV, with saline, 0.1 mL/kg topically applied to the larynx (SALsal). We measured arterial pressure directly, by means of an indwelling catheter placed in a peripheral artery. Anesthesia was induced with propofol, 8 mg/kg IV, until loss of jaw tone, followed by atracurium, 0.3 mg/kg IV. We measured the IOP in triplicate in each eye before premedication, before induction, before intubation, and after intubation. After induction, the IOP was significantly increased except in the VALsal group, in which the IOP was significantly lower than in the negative-control group before intubation. After intubation, the IOP was significantly elevated in all the groups compared with the values before induction. Cardiovascular parameters were essentially similar in all the groups, except for a significant increase in blood pressure after intubation in the SALlido group. Thus, propofol-atracurium anesthesia causes an increase in IOP that is blunted by diazepam. However, diazepam does not blunt the increase in IOP observed with intubation.     

Intraocular findings in three dogs and one cat with chronic glaucoma

Intraocular neoplasia may cause secondary glaucoma. If an intraocular prosthesis is placed in an eye with glaucoma secondary to intraocular neoplasia, the neoplasm frequently regrows around the prosthetic ball, resulting in recurrence of buphthalmos and signs of pain. Histologic examination of eviscerated intraocular contents of 4 animals resulted in diagnosis of intraocular neoplasia in 2 glaucomatous eyes and ruled out neoplasia as the cause of glaucoma in 2 eyes.     

Ultrasonographic imaging of the tongue and larynx in normal dogs

Ultrasonographic imaging of the tongue and larynx was performed in 10 dogs with no previous history of upper airway disease. The ultrasonographic findings were compared with the normal canine anatomy of this area and with the results described in the human literature. This study shows that the anatomical features of the canine larynx are adequately detectable using ultrasonography. This finding is In accordance with the findings described in the human literature. It is concluded that ultrasonography may offer a means of investigating canine laryngeal abnormalities.     

RELATIONSHIP BETWEEN PROSTATOMEGALY, PROSTATIC MINERALIZATION, AND CYTOLOGIC DIAGNOSIS

Canine prostatic disease is commonly evaluated with abdominal ultrasound and radiographs. Mineralization of the prostate is often reported, but the clinical relevance of this finding is currently not known. The purpose of this study was to characterize the relationship between ultrasonographic and radiographic prostate mineralization and the final diagnosis. Medical records of 55 dogs with evidence of prostatomegaly or prostatic mineralization and a cytologic diagnosis were evaluated. Radiographs and ultrasound images were assessed for caudal retroperitoneal lymphadenopathy, vertebral lesions, or other signs of metastasis, and mineralization was assessed semiquantitatively. Twenty-two of 55 (40%) dogs had prostatic neoplasia. Regarding neoplasia, mineralization in neutered dogs had a positive predictive value (PPV) of 100%, a negative predictive value (NPV) of 50%, and a sensitivity and specificity of 84% and 100%, respectively. Mineralization in intact dogs had a PPV of 22%, an NPV of 96%, and a sensitivity and specificity of 67% and 77%, respectively. All neutered dogs with prostatomegaly but not prostatic neoplasia had bacterial prostatitis and were castrated within the previous 3 months. Intact dogs with prostatomegaly and mineralization but not neoplasia had paraprostatic cysts ( n =3), benign prostatic hyperplasia ( n =2) or prostatitis ( n =2). Mineralization score was not indicative of neoplasia. In conclusion, neutered dogs with prostatic mineralization were very likely to have prostatic neoplasia. Intact dogs were unlikely to have prostatic neoplasia if no mineralization was found on radiographs or ultrasound.     

Effect of Head Position on Radiographic Assessment of Laryngeal Tie‐Forward Procedure in Horses

Objective— To assess the effect of head position on relative position of the larynx and hyoid apparatus in horses with palatal dysfunction, and to define a standard position for radiographic assessment of laryngeal tie‐forward. Study Design— Prospective clinical study. Animals— Adult horses (n=9) with palatal dysfunction. Methods— Left lateral radiographs of the larynx were obtained pre and postoperatively for 3 different head positions (flexed=90°; neutral=100°; extended=115°). Distance between thyrohyoid bone and thyroid cartilage was measured. Data were analyzed to investigate differences between head positions, and to compare differences between pre‐ and postoperative measurements. Results— Head position had a significant effect on relative position of the larynx and hyoid apparatus preoperatively. There was no significant difference in postoperative measurements of the 3 head positions. A significant difference between pre‐ and postoperative measurements was found with the head in the neutral or extended position whereas there were no significant differences between pre‐ and postoperative measurements using the flexed position. Conclusions— Head position affects the relationship between the hyoid apparatus and larynx preoperatively, with greatest distance occurring when the head is extended. In a flexed position, it is not possible to ascertain whether laryngeal position has changed postoperatively. Clinical Relevance— A standardized head position is necessary when assessing the laryngeal tie‐forward procedure radiographically. An extended head position is most useful for this assessment.     

Innervation of the equine intrinsic laryngeal muscles

The nerve supply to the intrinsic laryngeal muscles of the horse was studied by gross dissection and by electromyography which was carried out before, during and after section of various intralaryngeal nerve branches. The anatomical relationships and passage of the laryngeal nerves throughout the larynx were defined. Unlike the dog and man there was no evidence of the passage of motor nerve fibres from one side of the larynx to the other.     

Primary malignant pulmonary neoplasia in two horses

Although primary malignant pulmonary neoplasia of horses is rarely encountered, this diagnosis was confirmed in 2 horses on the basis of necropsy and histopathologic findings. One horse, with cystic mucinous adenocarcinoma, had respiratory tract and neurologic signs directly attributable to the neoplasm, and a tentative antemortem diagnosis of pulmonary neoplasia was made. The other horse, with anaplastic bronchogenic carcinoma, did not have clinical signs of pulmonary neoplasia.