Surgical treatment of an elbow hygroma utilizing microvascular free muscle transfer in a newfoundland

Microvascular free muscle transfer utilizing the rectus abdominis muscle, in combination with a mesh skin graft and transarticular external fixator, were used following the surgical excision of an elbow hygroma in a Newfoundland dog. Postoperatively, the dog did well with minimal complications and has yet to have a recurrence 10 months following surgery. This report describes the utility and successful use of the rectus abdominis free tissue transfer in the surgical correction of a difficult elbow hygroma in the dog.     

Intracutaneous cornifying epithelioma (keratoacanthoma) in the dog: a retrospective study of 25 cases.

The clinical, histopathologic, and behavioral features of 25 cases of intracutaneous cornifying epithelioma (ICE) in the dog were reviewed. A typical ICE consisted of a keratin-filled crypt in the dermis and subcutis that opened to the skin surface. Most of these tumors occurred on the back, neck, sides of the thorax, and the shoulders. Two distinct patterns existed-a solitary form (single growth) and a generalized form (up to 40 growths). The Norwegian Elkhound appeared to be a breed predisposed to the development of the generalized type. Breed predilection for the solitary form was not observed. The ICE was a benign neoplasm, and simple surgical excision was curative except in the generalized cases in which additional growths developed. Keratoacanthoma of man and ICE of the dog were compared, and it was concluded that although they are similar in many respects they are not identical entities.     

Spinal nephroblastoma in a miniature Dachshund

A 2-year-old castrated miniature Dachshund dog was presented to the Rakuno Gakuen Veterinary Teaching Hospital for diagnosis of progressive hindlimb paresis and ataxia. There was no thoracolumbar intervertebral disk hernia and magnetic resonance imaging revealed an intramedullary spinal cord lesion at the ninth and tenth thoracic vertebrae. Following surgical excision of the neoplasm, there was minor amelioration of neurological signs, but forelimb function was not recovered. The extracted tumor was histopathlogically diagnosed as spinal nephroblastoma.     

Phaeochromocytoma treated by en bloc resection including the suprarenal caudal vena cava in a dog

A 10-year-old, neutered male Cairn terrier was examined after experiencing intermittent vomiting of several months' duration and sudden onset of acute depression. Abdominal ultrasound examination revealed an adrenal mass invading the suprarenal part of the caudal vena cava. The vascular invasion could not be corrected so en bloc ligation/excision of the adrenal neoplasm and the suprarenal part of the vena cava was performed. Microscopic examination identified an adrenal phaeochromocytoma. The dog recovered well and had no significant vascular or renal dysfunction at follow-up 20 months after surgery. To the authors' knowledge, this is the first report of a dog surviving long term after resection of the suprarenal caudal vena cava.     

Brow suspension for treatment of ptosis and entropion in dogs with redundant facial skin folds

Brow suspension surgery was performed on 7 dogs with redundant facial skin folds, associated ptosis, and entropion. The surgical technique involved subcutaneous placement of polyester mesh strips to suspend the upper eyelid from the dorsal frontalis muscle and the underlying periosteum of the skull. Visual impairment associated with ptosis was resolved in all dogs at the 2 week reevaluation period. Upper eyelid position was maintained in 4 of 7 dogs available for long-term follow-up. One dog developed persistent draining tracts in the region of the implant, and removal of part of the implanted mesh was eventually required. Upper eyelid height in this dog, however, was maintained following mesh removal, probably because of fibrosis around the implant. Brow suspension is an option for surgical management of upper eyelid ptosis and entropion in dogs with redundant skin folds and avoids the need for facial skin fold excision.     

Use of the scrotum as a transposition flap for closure of surgical wounds in three dogs

OBJECTIVE: To describe use of the scrotum as a pedicle flap to cover defects created by tumor excision in the perineum or caudal and medial aspect of the thigh. STUDY DESIGN: Clinical study. ANIMALS: Three dogs. METHODS: After tumor excision and prescrotal castration, an incision was made around the base of the scrotum, leaving a pedicle on the side opposite the skin defect. After removal of the tunica dartos and abdominal fascia, the scrotal skin was stretched and shaped to the defect, then sutured in position with a simple interrupted pattern. Bandages that were changed every 48 hours compressed the flaps, and healing was observed until sutures were removed. RESULTS: Two dogs had first intention healing in 15 days, whereas 1 dog developed necrosis of 10% of the flap, and this area healed by second intention. CONCLUSION: In male dogs, the scrotal skin can be used as a pedicle flap for reconstructive surgery of wounds in the perineum and the proximomedial and caudal aspect of the thigh. CLINICAL RELEVANCE: The perineal region remains a surgical challenge because of the lack of the available skin for reconstruction of surgical wounds. The scrotal skin should be considered for use as a transposition flap to cover skin defects in this region.     

Surgical management of a subepiglottic thyroglossal duct cyst in a dog

A 2 yr old dog presented for dysphagia and coughing secondary to a 4 cm × 4 cm turgid subepiglottic mass. Cervical radiographs, an esophagram, and computed tomography confirmed the presence of a cystic mass that was not intimately associated with any surrounding structures. An incisional biopsy confirmed the cystic nature of the mass and helped to rule out a malignancy. A marginal surgical excision was performed via a ventral approach. Histopathology of the mass was consistent with a thyroglossal duct cyst. This is the first report of a thyroglossal duct cyst in this location in a dog. There was no recurrence of clinical signs 14 mo after surgery.     

Progression of cutaneous plasmacytoma to plasma cell leukemia in a dog

A 5‐year‐old male neutered Bernese Mountain Dog was presented for cutaneous plasmacytoma, which was treated by surgical excision. Four months later, the dog developed multiple skin masses, hyphema, pericardial and mild bicavitary effusions, myocardial masses, and marked plasmacytosis in the peripheral blood. Circulating plasma cells expressed CD34 and MHC class II by flow cytometry. Immunocytochemistry demonstrated that these cells were strongly positive for multiple myeloma oncogene 1/interferon regulatory factor 4 (MUM‐1) and weakly to moderately positive for Pax5. The dog was hypoglobulinemic but had a monoclonal IgA gammopathy detected by serum immunofixation electrophoresis. The PCR analysis of antigen receptor gene rearrangements (PARR) by fragment analysis using GeneScan methodology revealed that plasmacytoid cells in the original cutaneous plasmacytoma and peripheral blood had an identical immunoglobulin heavy chain gene (IgH) rearrangement, indicating that both populations were derived from the same neoplastic clone. Canine cutaneous plasmacytoma rarely progresses to a malignant form and plasma cell leukemia is rarely diagnosed in the dog. This report describes a case of cutaneous plasmacytoma progressing to plasma cell leukemia with a rapid and aggressive clinical course. This report also highlights the utility of flow cytometry, immunocytochemistry, immunofixation electrophoresis, and PARR by fragment analysis using GeneScan methodology in the diagnosis of this hematopoietic neoplasm.     

Necrotising fasciitis associated with Escherichia coli in a dog

CASE HISTORY: Lameness and limb pain associated with a laceration in the inner thigh of a Border Collie dog progressed over 4 days to extensive necrosis of the full-thickness of skin and subcutaneous (S/C) tissue. A successful outcome was achieved using surgical debridement and intensive supportive care, followed by limited local closure, axial pattern flap development, and free skin grafting. CLINICAL FINDINGS: Clinical findings included severe pain, depression, pyrexia and hypoalbuminaemia, and full-thickness loss of skin from the caudal thigh to the hock. Histopathologically, debrided tissue showed extensive necrosis of the dermis, adipose and muscle tissues, and the presence of numerous Gram-negative rods. Escherichia coli was cultured from deep tissue samples. DIAGNOSIS: Necrotising fasciitis (NF) associated with E. coli infection. CLINICAL RELEVANCE: NF associated with E. coli has not been previously reported in dogs. The importance of early diagnosis and surgical debridement is noted and the relevant medical literature is reviewed.     

Combined use of surgery and radiation in the treatment of an intradural myxoid liposarcoma in a dog

An intradural-extramedullary myxoid liposarcoma of the high cervical spine was diagnosed in a 9-year-old, spayed female Cavalier King Charles spaniel that was presented for a 2-month history of cervical pain and tetraparesis. Radiation therapy applied after surgery resulted in complete remission of the neurological deficits. The tumor recurred 18 months after surgical excision. A second surgery and another course of radiotherapy again resulted in complete remission of the clinical signs. The dog was euthanized 11 months after the second surgery because of tumor recurrence.     

Oesophageal leiomyosarcoma in dogs: surgical management and clinical outcome of four cases

Oesophageal leiomyosarcoma has yet to be reported in dogs. This retrospective case series describes the case management and clinical outcome of four dogs with oesophageal leiomyosarcoma treated by marginal excision alone. Histological features used to determine tumour grade included capsular invasion, percent necrosis, pleomorphism and mitotic rate. All tumours were designated grade 1 leiomyosarcoma. Excision of all grossly evident tumour tissue was achieved in two of the four cases; however, histopathologic evaluation showed tumour cells at the surgical margins in one of these two cases. Two dogs had grossly incomplete excision. Two dogs died from unrelated conditions, one 3 years and 5.5 months after surgery, the other at 65 days. One dog had persistent mega‐oesophagus and was lost to follow‐up 388 days after surgery and one dog is still alive (last follow‐up 405 days after surgery). Despite large tumour size and incomplete excision, surgical removal of low‐grade leiomyosarcomas can result in long‐term resolution of clinical signs.     

Moh’s micrographic surgery for the management of a periocular mast cell tumor in a dog

A 3‐year‐old neutered male boxer dog presented with a 6‐month history of a waxing and waning mass of the left dorsotemporal eyelid margin. Cytology and biopsy confirmed a diagnosis of mast cell neoplasia. Systemic staging of the dog failed to reveal any evidence of metastatic neoplasia. Owing to the location of the tumor within the eyelid margin and the wide surgical margins recommended for excision of mast cell tumors, Mohs micrographic surgery (MMS) was chosen for its potential to conserve tissues while providing intraoperative confirmation the tumor was completely excised. Utilizing MMS horizontal sectioning technique, 100% of the surgical margins were assessed prior to closure of the surgical wound. This represents the first time a comprehensive MMS protocol was used in a veterinary patient under general anesthesia.     

An intestinal neuroendocrine tumour associated with paroxysmal ventricular tachycardia and melaena in a 10-year-old boxer

A 10-year-old female neutered boxer was presented with a five-week history of episodic collapse and melaena. Twenty-four-hour electrocardiograph (Holter) analysis revealed the collapsing episodes to coincide with episodes of paroxysmal ventricular tachycardia. Investigation of the dog's melaena revealed a gastric ulcer which was treated medically and an ileocaecal mass which was surgically excised. Histopathological examination of the mass was consistent with a neuroendocrine (carcinoid) tumour. The patient's recovery after surgery was unremarkable. At six-week follow-up, there had been no further episodes of melaena or collapse and repeat Holter analysis did not show any significant abnormalities. In this dog the gastric ulceration and paroxysmal ventricular tachycardia could be attributed to a paraneoplastic syndrome as a result of circulating vasoactive substances released by the tumour; this is supported by the evidence that all clinical signs resolved after surgical excision of the mass and the dog was clinically well 18 months after surgery.     

A primary extraskeletal osteogenic sarcoma arising in the spleen of a dog

This paper describes a primary extraskeletal osteogenic sarcoma arising in the spleen of an 11-year-old, male, cross-bred Terrier. Initial diagnosis was made after surgical removal of a splenic mass, at which time the liver and other abdominal viscera appeared grossly normal. However, elevations in the activities of alanine aminotransferase and alkaline phosphatase in blood taken 7 days after laparotomy suggested that hepatic metastases were developing. This was confirmed when the dog died 3.5 months after surgery, with massive hepatic metastatic involvement. There appears to be no previous report of the spleen being the primary site of such a neoplasm in the dog.     

Hemangiopericytoma in the eyelid of a horse

Hemangiopericytoma (HP) is a well-recognized neoplasm arising from vascular pericytes that has been reported only in the dog and man. In this study, we describe a 14-year-old female Arabian horse that was presented for surgical excision of a 2-cm-diameter expansile subcuticular mass in the right lower eyelid. Histologically, the mass consisted of loosely arranged interlacing streams and storiform bundles of spindle cells that often formed distinct whorls around a central capillary and bundles of collagen (Antoni A-like pattern). Immunohistochemical analysis revealed strong diffuse cytoplasmic immunoreactivity for vimentin and focal immunoreactivity for smooth muscle actin, whereas neoplastic cells did not stain for Factor VIII-related antigen, Glial fibrillary acidic protein (GFAP), or S100. On the basis of histomorphology and immunohistochemical reactivity, the present tumor was diagnosed as HP. To our knowledge, this is the first report describing a HP in a horse.     

Vertebrectomy, bone allograft fusion, and antitumor vaccination for the treatment of vertebral fibrosarcoma in a dog

OBJECTIVE: To describe the surgical technique of vertebrectomy with bone allograft fusion and the use of antitumor vaccine for the treatment of a primary vertebral neoplasm in a dog. STUDY DESIGN: Case Report. ANIMALS OR SAMPLE POPULATION: A 3 year old 32 kg female spayed mixed breed dog with progressive paraplegia. METHODS: Myelography was performed to identify an L5 lytic lesion with spinal cord compression. A dorsal laminectomy was performed to decompress the spinal cord and obtain biopsies. Pathologic fracture of the vertebral body two days later was treated with L5 vertebrectomy, cortical allograft implantation, and bilateral plating from L4 to L6. Tumor samples were used to create an autologous cytokine-gene-engineered tumor cell vaccine. Recheck radiographs and neurologic examinations were obtained 1, 2, 7, and 13 months after surgery. RESULTS: The histopathologic diagnosis was fibrosarcoma. Although slight osteopenia of the allograft was noted thirteen months after surgery, the allograft and plate fixation remained stable. The patient tolerated the antitumor vaccination protocol well. Two years after the procedures the dog was able to ambulate normally but remained urinary and fecal incontinent. CONCLUSIONS AND CLINICAL RELEVANCE: Vertebrectomy and cortical allograft implantation with plating permitted this patient to return to a functional lifestyle with its owners.     

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.     

Treatment of canine oral papillary squamous cell carcinoma using definitive‐intent radiation as a monotherapy—a case series

Canine oral papillary squamous cell carcinoma (COPSCC) is a rare neoplasm and although locally invasive it carries a favourable prognosis following wide surgical excision. Radiotherapy has been reported to be effective as an adjunct treatment to surgery. However, limited information is available on the role of radiotherapy as single treatment. This single‐institution retrospective study describes a series of 10 dogs diagnosed with macroscopic COPSCC that were treated with definitive‐intent radiotherapy (DRT) as a monotherapy. These dogs had a median age of 4 years (range: 0.4‐9.6 years). The tumour was located in the rostral oral cavity in all cases with a median tumour size of 2.5 cm (range: 0.8‐6.8 cm). No local or distant metastases were identified. All dogs were treated with electron beam DRT (>32Gy, 10‐16 daily fractions of 3.2Gy). The median follow‐up time was 961 days (range: 333‐3.498 days) with nine dogs achieving a complete response and one dog a partial response. The dog with the partial response developed disease progression at 228 days after initiation of radiotherapy. Two dogs died from non‐tumour‐related causes. The remaining seven dogs were still alive and in complete remission at the time of last follow‐up. Median progression‐free survival time and median survival time were not reached. DRT was generally well tolerated, but all dogs experienced self‐limiting acute radiation mucositis (grade 2‐3) and/or dermatitis (grade 1). No late radiation toxicity was observed. Macroscopic COPSCC appears to be a radiosensitive tumour that can be successfully treated with DRT eliminating the need for aggressive surgery in advanced cases.     

Anatrichosoma sp infection in a dog

Embryonated, double-operculated eggs were observed during routine examination of a fecal specimen from a 5-month-old dog. Similar eggs were found on a skin scraping of a raised, flaking, erythematous nodule on the dorsal midline in the lumbar region. Eggs were identified as being similar to those of Anatrichosoma spp. After surgical excision, histologic examination of the nodule revealed nematodes with morphologic features consistent with those of Anatrichosoma spp.