Evaluation of a two-centimeter lateral surgical margin for excision of grade I and grade II cutaneous mast cell tumors in dogs

OBJECTIVE: To evaluate completeness of excision and clinical outcome in dogs with cutaneous mast cell tumors (MCTs) excised with a lateral margin of 2 cm and a deep margin of 1 fascial plane. DESIGN: Prospective study. ANIMALS: 16 client-owned dogs with 1 or more cutaneous MCTs. PROCEDURE: Excision of MCTs was performed with a 2-cm lateral margin and a deep margin of 1 fascial plane. Histologic tumor grading was performed; surgical margins were categorized as complete or incomplete. Follow-up information was obtained via repeat examination of the dogs by veterinarians or client-completed questionnaires. RESULTS: 4 grade I and 19 grade II cutaneous MCTs were evaluated. Overall, 21 (91%) MCTs were completely excised; 2 grade II tumors had foci of mast cells at the 2-cm margin. Two dogs received adjunctive treatments following surgery. Follow-up information was available for all dogs (median follow-up period, 379 days; range, 51 to 538 days); no local recurrence was detected during this time. De novo MCTs were detected in 3 of 16 dogs at 37, 54, and 154 days after surgery. Via Kaplan-Meier analysis, median survival time and disease-free interval were both > 538 days (medians not yet reached). No prognostic variables were identified. CONCLUSIONS AND CLINICAL RELEVANCE: Excision with a 2-cm lateral margin and a deep margin of 1 fascial plane may result in satisfactory excision of grades I and II MCTs in dogs, with recurrence rates similar to those reported previously. Use of these margins may minimize complications associated with larger local tumor resection.     

Spinal mast cell tumor in a dog.

A 6-year-old, spayed female rottweiler was referred for left forelimb lameness followed by tetraparesis. A mast cell tumor compressing the spinal cord at the level of the sixth cervical to first thoracic (C6-T1) vertebrae was diagnosed based on cervical myelography and necropsy findings. This was considered a primary extracutaneous mast cell tumor, as no evidence of disease was found elsewhere. This is the first report of a primary mast cell tumor in this location.     

Recurrence rates and sites for grade II canine cutaneous mast cell tumors following complete surgical excision.

A retrospective study was performed on 31 dogs with completely excised, grade II, cutaneous mast cell tumors in order to determine recurrence rates and sites. Distant tumor recurrence developed in 22% of dogs, and local tumor recurrence developed in 11% of dogs; however, the vast majority of these animals were incompletely staged initially. Complete surgical excision of grade II mast cell tumors was associated with effective local control in 89% of these dogs. Therefore, adjuvant radiation therapy might not be indicated in the majority of dogs with complete surgical excision.     

Morphometric and anatomic study of the hind limb of a dog

OBJECTIVE: To obtain the anatomic and morphometric data required for biomechanical analysis of the hind limb in dogs. ANIMALS: A healthy adult mixed-breed 23-kg male dog. PROCEDURE: Following euthanasia of the dog, all muscles of the right hind limb were identified and meticulously removed. Physiologic cross-sectional areas (PCSA) and architectural indices (AI) were calculated. The coordinates for the origin and insertion of each muscle were determined, using orthogonal right-handed coordinate systems embedded in the pelvis, femur, and tibia. RESULTS: PCSA and AI were calculated for 29 muscles, and coordinates for the origins and insertions of these muscles were determined. CONCLUSIONS: Results provide the morphometric and anatomic data necessary for 3-dimensional biomechanical studies of the hind limb in dogs.     

Management of a proximal pelvic limb skin laceration in a dog using a skin flap and an external fixator

A nine-year-old, spayed female crossbred dog sustained a traumatic skin lesion to the right proximal pelvic limb, extending to the extensor surface of the stifle. Surgical management of the wound included primary closure using a body skin flap fashioned from the right caudolateral abdominal wall. To achieve closure and prevent tension on the wound, the coxofemoral and stifle joints on the affected side needed to be immobilised in flexion. Flexion immobilisation of the stifle was achieved using the anatomical principle of muscle reciprocation. The ipsilateral tarsal joint was immobilised in flexion using a uniplanar-bilateral (type II) transarticular external skeletal fixator and this resulted in the automatic flexion of the stifle. The fixator was removed six weeks postoperatively when the wound had healed. There were no apparent complications associated with the fixator either during its use or in the longer term following its removal.     

Transcatheter glue arterial embolization of a mass in the hind limb of a dog

This article reports the use of transarterial glue embolization in the treatment of a soft-tissue mass in the hind limb of a dog that was referred for a > 15-cm diameter soft tissue mass in the caudal thigh. Clinical improvement showed that the percutaneous therapeutic cyanoacrylate glue embolization procedure was technically feasible and useful.     

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.     

In vitro inhibitory effect of trichostatin A on canine grade 3 mast cell tumor

Mast cell tumor (MCT) is one of the most prevalent neoplasms that affect skin and soft tissue in dogs. Because mast cell tumors present a great variety of clinical appearance and behavior, their treatment becomes a challenge. Trichostatin A (TSA), an antifungal antibiotic, has shown inhibitory effects on the proliferation and induction of apoptosis in various types of cancer cells. In order to evaluate the potential of trichostatin A as a therapeutic drug, cells of grade 3 MCT were cultured and treated with concentrations of 1 nM to 400 nM of TSA. MTT assay and trypan blue exclusion assays were performed to estimate cell growth and cell viability, and cell cycle analysis was evaluated. TSA treatment showed a reduction in numbers of viable cells and an increase of cell death by apoptosis. The cell cycle analysis showed an increase of hypodiploid cells and a reduction of G0/G1 and G2/M –phases. According to these results, trichostatin A may be an interesting potential chemotherapeutic agent for the treatment of canine MCT.     

Use of skin stretchers to elongate a peninsular thoracodorsal axial pattern flap for antebrachial wound closure in a dog

Objective: To describe preoperative use of skin stretchers to elongate a peninsular thoracodorsal axial pattern flap to close a large antebrachial wound on a dog. Study Design: Case report. Animals: A 21 kg, 7‐year‐old, male intact mixed breed dog. Methods: Two skin stretchers were applied to the site of the thoracodorsal axial pattern flap 4 days before surgery. The elastic cables connecting the adhesive pads were tightened daily to increase the skin available for a peninsular thoracodorsal axial pattern flap, which was created and rotated 180° to cover an antebrachial defect to a level 2 cm proximal to the carpus. Results: The entire flap survived; there was a small amount of incisional separation at the distal margin of the flap that healed without further treatment. Conclusion: Preoperative skin stretching provided additional skin for the axial pattern flap used.     

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.     

Prognostic significance of surgical margin, Ki-67 and cyclin D1 protein expression in grade II canine cutaneous mast cell tumor

The prognosis for canine cutaneous mast cell tumor (CCMT) is thought to be correlated with histopathological grading. However, the wide variety of histopathologic types of grade II is one of the most troublesome and difficult points for prognosis. The objective of this study is to determine the prognostic value of surgical margin, ki-67 and cyclin D1 protein expression in grade II tumor. Surgically resected specimens of solitary grade II CCMT from 48 dogs with follow-up periods over 360 days (median was 1080 days) were used in this study. The expression of cyclin D1 and ki-67 proteins was determined by morphometrically using slides stained immunocytochemically, and the correlations among the results, survival rate, and recurrence and/or metastasis rate of each dog were analyzed statistically. The recurrence and/or metastasis and mortality rate in the incomplete surgical excision group within 30 months postoperatively were higher than that of the complete surgical excision group. In the incomplete surgical excision group, dogs with low positive staining of ki-67 had a significantly better survival, but the recurrence and metastasis rate and ki-67 positivity failed to show a significant correlation. Only a small number of cases showed cyclin D1-positive tumor cells, but most of them had a poor outcome with a high recurrence rate. In grade II CCMT, incomplete excision induced a relatively high metastasis rate and poor prognosis. Ki-67 positivity is a marker for the estimation of overall survival in incomplete surgical excision cases. Cyclin D1 positivity was low and may not have a prognostic role.     

Mast cell tumor in the nasal cavity of a dog

An 11-year-old male Shetland sheepdog displayed epistaxis and nasal discharge from the left nasal foramen. Cytological examination of a smear sample obtained by rhinotomy revealed neoplastic mast cells in the nasal cavity, a definitive diagnostic sign of mast cell tumor. The case was treated by surgery combined with radiotherapy and chemotherapy. Eighteen days after the last treatment, marked enlargement of the mandibular lymph nodes and facial edema developed, and the dog was euthanized at the owner's request. At necropsy, metastatic proliferation of mast cells was confirmed in the lymph nodes and liver, but no neoplastic mast cells were observed in the nasal cavity.     

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.     

Establishment and characterization of a new canine mast cell tumor cell line

A new cell line (CoMS) was established from a 3-year-old male mongrel dog with mast cell tumor of the oral mucosa. CoMS cells grow in suspension with a doubling time of 27.0 +/- 0.7 hr. The cytoplasmic granules were formalin-sensitive, showed diverse appearances in their ultrastructural findings and contained heparin proteoglycan and neutral protease chymase. Calcium ionophore A23187, substance P and concanavalin A caused significant histamine release from CoMS cells, while compound 48/80 failed to release histamine. This cell line will make an available source for studies on canine mast cell tumors.     

Use of a pedicled rectus abdominis muscle flap for repair of a failed vesicourethral anastomosis in a dog

A 10-year-old mixed breed dog underwent a prostatectomy for an adenocarcinoma. Within three days the dog had signs of a uroperitoneum. Re-exploration revealed that a portion of the vesicourethral anastomosis had failed. Primary suturing of the tissue along the site of dehiscence following debridement of the devitalised tissue was impossible. A rectus abdominis muscle flap was created and successfully used to repair the site of leakage.     

Concurrent use of a medial saphenous fasciocutaneous free tissue flap and external skeletal fixation for treatment of a distal antebrachial injury in a dog

OBJECTIVE: To report the surgical management of a traumatic distal antebrachial wound using a medial saphenous fasciocutaneous free tissue flap and a type I external skeletal fixator (ESF). STUDY DESIGN: Case report. ANIMALS: A 7-year-old spayed, female Labrador retriever. RESULT: Wound coverage and pancarpal arthrodesis were accomplished during a single anesthetic episode using a medial saphenous fasciocutaneous free tissue flap and type I ESF. A second surgical procedure was performed to expedite healing of part of the original wound that was initially left to heal by second intention. CONCLUSIONS: Free tissue transfer can be used in combination with an ESF for repair of distal antebrachial wounds, allowing orthopedic repair and soft tissue coverage in a single anesthetic episode. CLINICAL RELEVANCE: Concurrent use of free tissue transfer and carpal arthrodesis with an ESF could be used for repair of complex antebrachial wounds without need for multiple procedures, extended hospitalization, and increased cost.     

Mixed germ cell tumor in the eye of a dog.

A 3-year-old female neutered Staffordshire Bull Terrier presented with a mixed germ cell tumor involving the base of the iris and the ciliary body of the right eye. The tumor mass was composed primarily of packeted vacuolated, polygonal (hepatoid) cells and small round cells; epithelial cells lining tubuloacinar structures were a less prominent component. The hepatoid and round cells stained positively for alpha-fetoprotein and cytokeratin. The epithelial cells stained positively for cytokeratin only, and some contained cytoplasmic mucin droplets. The polygonal cells were interpreted as a hepatoid variant of yolk sac tumor, and the epithelial cells were considered a teratomatous component. Trabeculae of bone were observed within the mass and may have been metaplastic or a teratomatous element. Extragonadal germ cell tumors are rare in dogs and have previously been reported only in the suprasellar region. This is the first report of this tumor type in the eye of a nonhuman species.     

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.