Long-term management of a glaucomatous eye in a dog treated with medical therapy alone.

An acute open angle glaucoma of the right eye was diagnosed in an 8-year-old male Yorkshire terrier which was presented with anorexia, depression, and trembling. Abnormal findings of the right eye on admission included elevated intraocular pressure (IOP; 40 mmHg), the presence of fibrin and flare in the anterior chamber, and immature cataract. Morphological abnormalities of the iridocorneal angle were not detected, and an open angle was seen in the eye. Although an elevated IOP was observed at one year after admission, lowering IOP (< or = 24 mmHg) was maintained with medical therapy using dichlorphenamide (DCPA) and timolol maleate, DCPA alone, or no-treatment for 1973 days. This case suggests that lower IOP can be maintained with medical therapy alone for a long period in a patient with open angle glaucoma.     

Osseous metaplasia within a canine insulinoma

An 11‐year‐old male castrated mixed‐breed dog was presented for exercise intolerance, tetraparesis, and persistent hypoglycemia. Abdominal ultrasound examination revealed 2 nodules within the right limb of the pancreas. Cytology from one nodule was consistent with a carcinoma of neuroendocrine origin, with a primary differential diagnosis of insulinoma. Histologic evaluation and immunohistochemistry for synaptophysin and insulin confirmed the diagnosis of insulinoma. Additionally, there was a solitary nodule of mineralized compact bone composing approximately 60% of the mass. To the authors' knowledge, this is the first report of osseous metaplasia within an insulinoma (islet cell carcinoma).     

Evaluation of the long-acting somatostatin analogue Octreotide in the management of insulinoma in three dogs

The response of dogs with insulinoma to surgical and medical management is variable, with the majority developing intractable hypoglycaemia. A long-acting somatostatin analogue, Octreotide (SMS 201–995; Sandostatin) has been useful in the management of hypoglycaemia in humans with insulinoma, and preliminary reports suggest a beneficial clinical response in dogs with insulinoma. The present study objectively evaluated Octreotide in the management of three dogs with immunohistochemically confirmed insulinoma. Octreotide had no benefit over placebo, and little effect on circulating glucose and insulin concentrations despite clearly detectable plasma concentrations of Octreotide. No clinical improvement was apparent in two dogs given Octreotide over a period of two and three weeks. These results contrast with the positive clinical responses noted previously and indicate that further placebo controlled, objective studies are necessary before clear statements on the treatment of insulinoma with Octreotide are made.     

Treatment of insulinoma in a springer spaniel with streptozotocin

An eight-year-old, female springer spaniel was treated for metastatic insulinoma with a single intravenous dose of 500 mg/m2 streptozotocin (SZN), and pre- and post-treatment diuresis. A tapering dose of corticosteroids was also administered over a 28 day period. SZN and corticosteroid administration resulted in resolution of hypoglycaemia and subsequent development of diabetes mellitus. Further metastases caused cervical spinal pain and the dog was euthanased 118 days after SZN administration. SZN can be safely used for the treatment of canine insulinoma, but, when compared with other published cases, a marked variation in clinical response to this drug exists and further study is warranted.     

Long-term management of vaccine-induced refractory ischemic dermatopathy in a Miniature Pinscher puppy

A 2-month-old intact female Miniature Pinscher puppy presented with footpad swelling and crusted pustules of ear pinnae. The dog had been vaccinated with a polyvalent canine vaccine 5 days prior to the onset of clinical signs. With the history of recent vaccination, the clinical presentation and the histopathological observations were suggestive of ischemic dermatopathy. Treatment involved oral prednisolone, azathioprine, and other immune modulating drugs, which did not work. Chlorambucil plus cyclosporine therapy was initiated for vigorous immune suppression after rush therapy using intravenous immunoglobulin. Clinical signs again gradually improved with no relapse or side effects, even at a 4-month follow-up. The case report is suggested ischemic dermatopathy refractory to conventional therapy and suggests effective approaches to long-term management of the disease.     

Phacoemulsification for the management of Encephalitozoon cuniculi-induced phacoclastic uveitis in a rabbit

Phacoemulsification was performed on a New Zealand White rabbit with slowly progressive unilateral phacoclastic uveitis and cataract formation. The irrigating solution with lenticular contents were centrifuged and examined cytologically using Weber's chromotrope-based stain. Microsporidial spores were observed and positively identified as Encephalitozoon cuniculi via polymerase chain reaction. More than 1 year following surgical therapy, the rabbit is visual and comfortable without medications.     

Long-term management of sabulous cystitis in five horses

Five horses with sabulous cystitis were managed for up to three years. They were treated by emptying the bladder through a urinary catheter and saline lavage with cytoscopic guidance to remove residual sabulous material. The cystitis was treated with antimicrobial and anti-inflammatory medications, and bethanechol chloride was also administered. Frequent catheterisation and emptying of the bladder was an alternative to regular cystoscopic examination with saline lavage but it resulted in the development of a urethral stricture in one case. Four of the horses returned to work and one was retired owing to persistent incontinence.     

Long-term management of atopic disease in the dog

Canine atopy is a common dermatologic disorder. Because the disease most frequently strikes young dogs, lifetime management strategies are necessary. Consideration must be given to the treatment of pruritus and secondary manifestations of the allergy, such as pyoderma, otitis externa, and seborrhea, to manage these patients successfully. The use of glucocorticoid therapy and hyposensitization are discussed.     

The medical management of idiopathic chylothorax in a domestic long-haired cat

A 3-year-old, spayed female domestic long-hair was evaluated for a 2-week history of progressive tachypnea. Chylothorax was diagnosed through radiographic and pleural fluid evaluation. No primary cause was identified and the cat was managed medically. Thoracocentesis, dietary management, and oral rutin therapy resulted in substantial improvement of this idiopathic condition.     

Successful medical management of lumbar intervertebral disc prolapse in a ferret

Thoracolumbar disc herniation was diagnosed in a two-year-old ferret using a myelogram followed by a computed tomography scan. The ferret was paraplegic with no control over urination and defecation. Conservative treatment that included cage rest and passive range of motion exercises for three weeks followed by extensive physiotherapy and hydrotherapy resulted in full recovery two months after the onset of treatment. Although intervertebral disc disease has been reported previously in four ferrets, this is the first report in which a postmyelogram computed tomography was used to demonstrate the herniated disc, and physiotherapy was used as principal treatment modality.     

Diagnosis and management of a retrobulbar abscess of periapical origin in a domestic rabbit.

Retrobulbar abscessation is the most common orbital disease of rabbits, and the lesions are notoriously difficult to treat successfully. This article describes the diagnosis, surgical treatment, and long-term management of an extensive abscess located within the right maxilla and retrobulbar space of a domestic rabbit. Preoperative assessment and long-term monitoring were achieved with a combination of radiography, ophthalmic ultrasonography, and CT. Extraoral rigid endoscopy via a fenestration in the maxilla was used to facilitate surgical debridement of the lesion, and extraction of multiple cheek teeth has been fundamental to achieving control. The long-term use of topical and systemic antibiotic preparations and nonsteroidal anti-inflammatory medication is discussed.     

Use of a bipolar vessel-sealing device in resection of canine insulinoma

Objectives : To describe partial pancreatectomy using a bipolar vessel‐sealing device (BVSD) and compare this novel technique to the conventional suture‐fracture (SF) method for canine insulinoma. Methods : Pre‐, intra‐ and postoperative data of eight dogs with insulinoma, which underwent resection using the BVSD (LigaSure V), were prospectively collected and compared with those of eight randomly selected case‐matched patients that underwent resection using the conventional SF technique. Results : Mean surgical time was significantly (P=0·022) shorter in the BVSD (107 ±9 minutes) than in the SF (135 ±22 minutes) group. The BVSD technique was negatively associated with surgical time and duration of the hospitalisation period. Neither technique caused intraoperative complications, such as bleeding, collateral damage to adjacent tissues or problems with sealing or suturing the pancreatic tissue. Three dogs in the SF group and none in the BVSD group developed postoperative clinical signs associated with pancreatitis. Clinical Significance : BVSD is a safe and viable alternative to conventional methods of pancreatectomy for canine insulinoma. It provides the possibility to remove insulinomas in the pancreatic limbs and corpus with relative ease. BVSD pancreatectomy in dogs with insulinoma significantly decreases operative and hospitalisation times and is not associated with more clinical complications than SF pancreatectomy.     

Hypoglycemia and irreversible neurologic complications in a cat with insulinoma

A 14-year-old spayed female domestic shorthair cat was evaluated for weakness, lethargy, decreased appetite, diarrhea, weight loss, and seizures. On physical examination, the cat appeared disoriented and had an inconsistent menace response. An insulinoma was diagnosed on the basis of normal serum insulin activity in conjunction with profound hypoglycemia and histologic examination (with immunohistochemical staining for chromogranin A and insulin) of a pancreatic mass that was removed surgically. Blood glucose concentration was within reference limits after surgery. However, neurologic abnormalities persisted, and the cat was euthanatized. Chronic hypoglycemia, associated with insulinomas, can cause irreversible neuronal changes in cats; therefore, rapid diagnosis and treatment of hypoglycemic conditions are of critical importance.     

Surgical and medical management of rhinophycomycosis (conidiobolomycosis) in a horse

A horse had severe granulomatous lesions of the upper airways that were attributable to Conidiobolus coronatus. Therapeutic success was documented by clinical examination of the horse 4 years after treatment by surgical extirpation and intralesional and topical use of amphotericin B.     

Improved survival in a retrospective cohort of 28 dogs with insulinoma

OBJECTIVES: To determine the survival times for a cohort of dogs with insulinoma and to describe the impact of medical therapy both in non-surgical cases and in surgical cases following relapse. METHODS: A retrospective study of dogs with insulinoma is presented. The Kaplan-Meier method is used to evaluate the survival characteristics of this population. RESULTS: Twenty-eight dogs were included in the study. The median survival time for all dogs was 547 days. Nineteen patients underwent partial pancreatectomy. The median survival time for this group was 785 days and for those subsequently receiving prednisolone therapy on relapse it was 1316 days. Perioperative complications are discussed. CLINICAL SIGNIFICANCE: Survival times in this study exceed those in other studies published previously. In part, this is explained by an improved remission duration following surgery compared with previous reports. More striking though is the longevity of patients following institution of medical therapy. These data give strong objective support to the role of medical therapy in the management of canine insulinoma, including following relapse after surgically induced remission.     

Ultrasonographic features of insulinoma in six ferrets

Insulinoma is a functional, insulin‐secreting tumor, arising from the beta islet cells of the pancreas. It is one of the most common neoplasms in ferrets and has been associated with clinical signs of hypoglycemia, such as ptyalism, pawing at the mouth, seizures, lethargy, and coma. The ultrasonographic features of insulinoma in ferrets have not been previously reported. The purpose of this retrospective case series study was to describe the ultrasonographic features of confirmed insulinoma in a group of ferrets. Inclusion criteria were abdominal ultrasound examination and histological confirmed insulinoma by surgical biopsy. Six ferrets met the inclusion criteria, all of which had multiple hypoglycemic episodes. Ultrasonographic images were reviewed and the characteristics of the pancreatic nodules were recorded. Twenty‐eight pancreatic nodules were observed in the six ferrets and were primarily hypoechoic (89.3%, 25/28) and homogenous (46.4%, 13/28) with a smooth margin (78.6%, 22/28). The distribution of the pancreatic nodules was 46.4% in the left lobe, 50% in the right lobe, and 3.6% in the body of the pancreas. The sizes of the pancreatic nodules varied from 1.5 × 1.5 to 4.1 × 5.6 mm. All of the pancreatic nodules removed from surgery were histopathologically confirmed as insulinoma. The findings indicated that insulinoma in ferrets could be detected through ultrasonography, which may facilitate diagnosis and preoperative surgical planning.