Skin-fold advancement flaps for closing large proximal limb and trunk defects in dogs and cats

OBJECTIVE: To describe the use of skin-fold advancement flaps for covering large skin defects in dogs and cats. STUDY DESIGN: Clinical study. ANIMALS: Eight client-owned animals: 6 dogs and 2 cats. METHODS: Six dogs and 2 cats underwent reconstruction of soft-tissue wounds resulting from traumatic, neoplastic, or infectious lesions. Skin-fold flaps were created by division of the medial and lateral attachment to the proximal limb or the dorsal and ventral attachment to the trunk, enabling closure of adjacent defects on the trunk or proximal limb, respectively. RESULTS: Skin-fold flaps proved effective for closing defects in all animals. Necrosis of a portion of the flap occurred in 2 dogs due to technical errors, but the resultant defects remained amenable to primary closure. All wounds ultimately healed primarily, without major complications. CONCLUSION AND CLINICAL RELEVANCE: The skin-fold advancement flap is a versatile technique that lends itself to use in a variety of locations, depending on which attachments are divided. The clinical results are comparable with those reported for axial pattern and subdermal plexus flaps.     

Dermoid cyst in the tongue of a dog

A German Shepherd Dog presented with recurrent intermandibular and intralingual swelling. Cytological and microbiological findings on fluid aspirated from the mass were consistent with an infected cyst lined by epithelium. The sinus was explored and an epithelium-lined cystic structure was extirpated from the frenulum and body of the tongue. This structure was diagnosed histologically as a dermoid cyst.     

Hemidiaphragmatic reconstruction with a transversus abdominis muscle flap after resection of a solitary diaphragmatic mesothelioma in a dog

CASE DESCRIPTION: A 2-year-old Siberian Husky was evaluated because of a 2-week history of coughing and gagging and decreased appetite and activity level. CLINICAL FINDINGS: Radiography, surgery, and immunohistochemical examination revealed a solitary sclerosing mesothelioma extending from the left thoracic diaphragmatic surface that was adherent to the pericardium and the caudal mediastinum. TREATMENT AND OUTCOME: The tumor was resected along with most of the left hemidiaphragm, and the left transversus abdominis muscle was used to reconstruct the diaphragm. The 13th rib formed the base of the muscle flap. The muscle flap was transposed into the defect so that the mesothelium-lined surface faced the thoracic cavity and the deep aspect of the muscle formed the abdominal surface of the diaphragm. To minimize risk of adhesions, the exposed raw aspect of the abdominal surface was covered with porcine small intestinal submucosa. Recovery was uncomplicated, and the dog's appetite and activity level soon returned to normal. Evaluation 54 days after surgery revealed 2 subcutaneous masses on the thorax and masses in the liver and both kidneys; histologic and immunohistochemical analyses revealed metastasis of the original tumor. The dog was euthanatized. CLINICAL RELEVANCE: Hemidiaphragmatic reconstruction with a transversus abdominis muscle flap after resection of a diaphragmatic tumor was successful. The muscle flap was easily harvested and transposed into the diaphragmatic defect.     

Outcomes and prognostic variables associated with primary abdominal visceral soft tissue sarcomas in dogs: A Veterinary Society of Surgical Oncology retrospective study

Primary abdominal visceral soft tissue sarcomas (STSs) are rare tumours in dogs with little information available on outcomes. The goal of this retrospective, multi‐institutional study was to describe the common tumour types, location and prognostic factors associated with primary abdominal visceral STSs. Medical records were searched for dogs with primary abdominal visceral STSs at six institutions and were retrospectively reviewed. Tumours were graded using the previously described grading scheme for STSs of the skin and subcutis when information in the histopathology report contained adequate details. Forty‐two dogs were included in the study. Five dogs had grade I tumours, 11 had grade II and 15 had grade III tumours. The most common tumour type was leiomyosarcoma (38.1%). The most common tumour locations were the spleen (47.6%) and small intestine (23.8%). The local recurrence rate was low (4.7%). Metastasis was present at the time of surgery in 23.8%, and the overall metastatic rate was 40.4%. Mitotic index of ≥9 was associated with significantly shorter survival time (MST 269 days) compared with a mitotic index of <9 (MST not reached). The MST for grade I STSs was not reached, was 589 days for grade II and 158 days for grade III. Dogs with grade III tumours were more likely to develop metastatic disease. Neither location of the primary tumour nor the histologic subtype was associated with survival time. Histologic grading of abdominal visceral STSs using the previously described scheme is prognostic and should be provided on histopathology reports.     

Primary renal neoplasia of dogs

BACKGROUND: Primary renal tumors are diagnosed uncommonly in dogs. HYPOTHESIS: Signs and survival will differ among different categories of primary renal tumors. ANIMALS: Data were collected from the medical records of 82 dogs with primary renal tumors diagnosed by examination of tissue obtained by ultrasound-guided biopsy, needle aspiration, surgery, or at postmortem examination. METHODS: This was a multi-institutional, retrospective study. RESULTS: Forty-nine dogs had carcinomas, 28 had sarcomas, and 5 had nephroblastomas. The dogs were geriatric (mean 8.1 years; range: 1-17) with a weight of 24.9 kg (range: 4.5-80). Tumors occurred with equal frequency in each kidney with 4% occurring bilaterally. Initial signs included one or more of hematuria, inappetance, lethargy. weight loss, or a palpable abdominal mass. Pain was reported more frequently in dogs with sarcomas (5/28). The most common hematologic abnormalities were neutrophilia (22/63), anemia (21/64), and thrombocytopenia (6/68). Polycythemia was present in 3 dogs and resolved with treatment. Hematuria (28/49), pyuria (26/49), proteinuria (24/50), and isosthenuria (20/56) were the most frequently observed abnormalities on urinalysis. Pulmonary metastases were noted on thoracic radiographs in 16% of dogs at diagnosis. Seventy-seven percent of dogs had metastatic disease at the time of death. Median survival for dogs with carcinomas was 16 months (range 0-59 months), for dogs with sarcomas 9 months (range 0-70 months), and for dogs with nephroblastomas 6 months (range 0-6 months). CONCLUSIONS AND CLINICAL IMPORTANCE: Primary renal tumors in dogs are generally highly malignant with surgery being the only treatment that improves survival.     

Radiation therapy for canine appendicular osteosarcoma

Radiation therapy (RT) for the management of canine appendicular osteosarcoma (OSA) can be described as either palliative‐ or curative intent. Palliative RT uses coarsely fractionated external beam RT or radiopharmaceuticals to provide relief of pain and lameness associated with OSA while resulting in minimal, if any, radiation‐induced acute adverse effects. Limb amputation and chemotherapy are considered (together) the standard of care for curative‐intent treatment of canine appendicular OSA. When limb amputation is not possible, RT can be used for limb sparing and is supplemented with chemotherapy for presumed micrometastatic disease. Fractionated tumour irradiation with curative intent appears to be ineffective and local disease control can more likely be achieved when stereotactic radiosurgery or intra‐operative extracorporeal irradiation is combined with strict case selection and adjunctive chemotherapy. The availability of limb‐sparing RT is limited by experience and availability of specialised equipment. When planned and administered appropriately, radiation‐associated adverse effects are often mild and self‐limiting.