Professor Nicholas James Bacon FRCVS
Academic and research departments
School of Veterinary Medicine, Faculty of Health and Medical Sciences.Publications
A 14-year-old, spayed female domestic shorthair cat was evaluated because of a right adrenal mass. The referring veterinarian had started treatment for hypokalemia and systemic arterial hypertension. During the initial evaluation the cat was alert and responsive, and serum potassium concentration was within the reference range. Serum concentrations of aldosterone and progesterone were increased. Atrophy of the contralateral adrenal and an exaggerated response of cortisol to stimulation with adrenocorticotropic hormone suggested hypersecretion of cortisol. Unilateral adrenalectomy was performed and recovery was uneventful. Histologic examination of the mass revealed an adrenocortical tumor. After surgery, clinical signs of hypercortisolism, hyperaldosteronism and hyperprogesteronism were no longer observed, and neither potassium supplementation nor antihypertensive treatment were needed. In cases with an adrenocortical tumor, clinicians should investigate whether the tumor hypersecretes glucocorticoids, mineralocorticoids, sex steroids or combinations of these. Hypersecretion of more than one adrenal hormone may occur in a cat with an adrenocortical tumor.
Objective: To define and compare clinical characteristics of canine primary appendicular hemangiosarcoma (HSA) and telangiectatic osteosarcoma (tOSA), including signalment, presentation, response to treatment, and prognosis. Study design: Multi-institutional retrospective study. Animals: Seventy dogs with primary appendicular HSA or tOSA. Methods: Patient data were obtained from institutions' medical records. Immunohistochemistry was applied to archived tissues to establish tumor type. Patient characteristics, treatment responses, and outcomes were described and compared by tumor type. Results: Forty-one HSA and 29 tOSA were identified. Dogs with HSA were more likely than dogs with tOSA to be male and have hind limb tumors; 78% of HSA occurred in hind limbs, particularly the tibia. Dogs with tOSA weighed a median of 9.9 kg (95% CI 4.6-15.3) more than dogs with HSA. Most dogs received antineoplastic treatment, predominantly amputation with or without adjuvant chemotherapy. Overall survival with local treatment and chemotherapy was 299 days (95% CI 123-750) for HSA and 213 days (95% CI 77-310) for tOSA. Younger age and more aggressive treatment were associated with longer survival in dogs with HSA but not tOSA. One-year survival rates did not differ between dogs with HSA (28%) and those with tOSA (7%). Conclusion: Distinct clinical features were identified between HSA and tOSA in this population. Both tumors were aggressive, with a high incidence of pulmonary metastases. However, local treatment combined with chemotherapy led to an average survival 7 months for tOSA and 10 months for HSA.
Hemangiosarcoma (HSA) of bone and telangiectatic osteosarcoma (tOSA) can appear similar histologically, but differ in histogenesis (malignant endothelial cells versus osteoblasts), and may warrant different treatments. Immunohistochemistry (IHC) for endothelial cell marker factor VIII-related antigen/von Willebrand factor (FVIII-RAg/vWF) is a well-documented ancillary test to confirm HSA diagnoses in soft tissues, but its use in osseous HSA is rarely described. Archived samples of 54 primary appendicular bone tumours previously diagnosed as HSA or tOSA were evaluated using combination routine histopathology (RHP) and IHC. Approximately 20% of tumours were reclassified on the basis of FVIII-RAg/vWF immunoreactivity, typically from an original diagnosis of tOSA to a reclassified diagnosis of HSA. No sample with tumour osteoid clearly identified on RHP was immunopositive for FVIII-RAg/vWF. RHP alone was specific but not sensitive for diagnosis of HSA, compared with combination RHP and IHC. Routine histopathological evaluation in combination with FVIII-RAg/vWF IHC can help differentiate canine primary appendicular HSA from tOSA.
Complex 'Big Data' questions that involve machine learning require large datasets for training. This is particularly problematic for Deep Learning methods in the biomedical imaging domain and specifically Digital Pathology. Transfer Learning has been shown to be a promising method for training classifiers on smaller sized datasets. In this work we investigate the effectiveness of aggregated Transfer Learning using VGG19 trained on ImageNet and then fine-tuning parameters with tissue histopathological patches from breast cancer metastatic tissue patches to classify soft tissue sarcoma patches. We compare results with and without transfer learning, and fine tuning applied to different layers. From the results, it is apparent that fine-tuning earlier VGG19 convolutional blocks with breast cancer patches and applying bottleneck feature extraction to soft tissue sarcoma can have an adverse effect on accuracy and other performance measures. Nevertheless, the aggregated approach is a promising method for digital pathology and requires much more investigation.
The relevance of regional lymph node (LN) assessment to quantify the metastatic spread of cancer is well recognized in veterinary oncology. Evaluation of LNs is critical for tumour staging. However, sampling the correct LN may not be possible without sentinel lymph node (SLN) mapping. Methods for diagnostic imaging and intraoperative detection of SLNs are well established in human medicine, in particular, the combination of lymphoscintigraphy and intraoperative application of blue dyes. Nevertheless, alternative imaging techniques are available and have gained increasing interest. Successful implementation of these techniques in dogs have been reported in both clinical and experimental studies. This review aims to provide an overview of SLN mapping techniques in human and veterinary medicine.
OBJECTIVE To describe the signalment, clinical signs, biological behavior, and outcome for cats with apocrine gland anal sac adenocarcinoma (AGASACA) that underwent surgical excision. DESIGN Retrospective case series. ANIMALS 30 client-owned cats. PROCEDURES Databases of 13 Veterinary Society of Surgical Oncology member-affiliated institutions were searched for records of cats with a histologic diagnosis of AGASACA that underwent tumor excision. For each cat, information regarding signalment, clinical signs, diagnostic test results, treatment, and outcome was extracted from the medical record. The Kaplan-Meier method was used to determine median time to local recurrence (TLR), disease-free interval (DFI), and survival time. Cox regression was used to identify factors associated with TLR, DFI, and survival time. RESULTS Perineal ulceration or discharge was the most common clinical sign in affected cats. Eleven cats developed local recurrence at a median of 96 days after AGASACA excision. Incomplete tumor margins and a high nuclear pleomorphic score were risk factors for local recurrence. Nuclear pleomorphic score was negatively associated with DFI. Local recurrence and a high nuclear pleomorphic score were risk factors for death. Median DFI and survival time were 234 and 260 days, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that, in cats, perineal ulceration or discharge should raise suspicion of AGASACA and prompt rectal and anal sac examinations. Local recurrence was the most common life-limiting event in cats that underwent surgery for treatment of AGASACA, suggesting that wide margins should be obtained whenever possible during AGASACA excision. Efficacy of chemotherapy and radiation therapy for treatment of cats with AGASACA requires further investigation.
To evaluate whole body computed tomography (CT) for staging canine appendicular osteosarcoma. Retrospective case series. Client-owned dogs diagnosed with appendicular osteosarcoma (n=39). Medical records for client-owned dogs diagnosed with appendicular osteosarcoma from August 2008 to July 2014 were reviewed. Dogs were included if they had a confirmed diagnosis of appendicular osteosarcoma and were staged using whole body CT. Data collected included signalment, body weight, primary tumor location, serum alkaline phosphatase (ALP) activity, findings on 3-view thoracic radiographs, cytologic or histologic results, and findings on CT. Thirty-nine dogs (median age 8.5 years; median body weight 37 kg) had osteosarcoma of the distal radius (n=17), proximal humerus (11) and other sites. Serum ALP activity was elevated in 14 dogs. Bone metastasis was not detected in any dog on whole body CT. Pulmonary metastasis was considered definitive on CT based on board certified radiologist assessment in 2/39 dogs (5%). Two additional dogs (2/39, 5%) had soft tissue masses diagnosed on CT, consistent with concurrent, non-metastatic malignancies. Bone metastases were not identified in any dog with whole body CT. Thoracic and abdominal CT detected lung lesions and concurrent neoplasia in dogs with primary appendicular osteosarcoma. Whole body CT may be a useful adjunct to other screening tests for disseminated malignancy.
The purpose of this retrospective study is to describe in detail a novel ventral approach for mandibulectomy and the results in 19 dogs. The medical records of 19 dogs that received a partial or total unilateral mandibulectomy with the new ventral approach were reviewed. Information obtained included signalment, tumour type, extent of mandibulectomy, removal of regional lymph nodes, intrasurgical complications, immediate postoperative complications, histopathological diagnosis and study of margins. Intrasurgical complication occurred in one dog (haemorrhage) and required a blood transfusion. Postoperative morbidity was minor and included transient ventral cervical swelling and self-limiting sublingual swelling (two dogs). All 19 animals were discharged between 24 and 48 hours of the procedure, and appetite was considered normal at discharge. Some perceived advantages of this procedure include easy identification of all the important anatomic structures in the area, including the inferior alveolar artery and temporo-mandibular joint, and the fact that osteotomy of the zygomatic arch is not necessary (in case of caudal mandibulectomy). In addition, dissection of both mandibular and retropharyngeal lymph nodes is easily achieved by caudal extension of the same skin incision.
An eight-year-old female neutered dachshund presented with a three-month history of a chronic swelling on her cranioventral abdominal wall. Antibiotic and anti-inflammatory therapy were ineffective. The swelling was 2 cm wide with a pinpoint open centre discharging purulent material. Contrast CT of the abdomen revealed an enlarged gall bladder, several cholecystoliths and a fistulous tract opening at a single site on the midline, just caudal to the xyphoid process. Cholecystectomy and removal of the entire fistulous tract via exploratory laparotomy resulted in rapid and complete resolution. Culture of the gall bladder content revealed presence of Pasteurella subspecies. One year after surgery, the dog had had no recurrence of the fistulous tract. Although the inciting cause of the biliary rupture is unclear, no evidence of neoplasia was found histologically. However, the cholecystocutaneous fistula was associated with, and contained, multiple cholecystoliths.
Objective: To report perioperative care, postoperative management, and long-term outcomes in dogs undergoing bilateral adrenalectomy. Study Design: Retrospective case series. Animals: Dogs undergoing bilateral adrenalectomy from 2008 to 2013 (n=9). Methods: Data retrieved from the record, when available, included signalment, preoperative clinical signs, laboratory data, diagnostic imaging, blood pressure measurement, preoperative treatment for adrenal gland disease, intraoperative procedures, treatments and complications, postoperative treatment and diagnostics during hospitalization, diagnostics and management following discharge, histopathologic diagnosis, and survival. Results: Seven dogs underwent concurrent bilateral adrenalectomy and 2 dogs had staged adrenalectomy. Surgery was uncomplicated in most cases. All dogs received IV dexamethasone SP intraoperatively. Eight dogs received intramuscular desoxycorticosterone pivalate intraoperatively. Histopathology revealed adrenocortical adenoma (7 dogs), adrenocortical carcinoma (4), pheochromocytoma (6), and adrenocortical atrophy (1). One dog died perioperatively and the remainder died due to unrelated causes. Postoperative management of hypoadrenocorticism included oral prednisone and intramuscular desoxycorticosterone pivalate (6 dogs), oral prednisone and fludrocortisone (1), and oral fludrocortisone alone (1). The median survival time in dogs surviving to hospital discharge was 525 days (range 67-966 days). No dogs developed metastatic disease or died due to signs of hypoadrenocorticism. Conclusion: Based on the cases reported here, the perioperative mortality in dogs undergoing bilateral adrenalectomy may be lower than previously reported. Management of postoperative hypoadrenocorticism is both achievable and straightforward.
The scarcity of large histopathological datasets can be problematic for Deep Learning in medical imaging and digital pathology. However, transfer Learning has been shown to be promising for the effective training of classifiers on smaller datasets. ImageNet is a popular dataset that is commonly used for transfer learning in various domains. The features extracted from the ImageNet dataset are generalizable and can be applied to alternative tasks and datasets. Deep Learning typically requires a vast amount of data for training, however, in our study we interrogated two datasets with patches extracted from only 30 whole slide images (WSIs) and 60 WSIs respectively. As a consequence, we decided to extract features and feed them into separate classifier models such as a fully connected softmax layer, Support Vector Machines (SVM) and Logistic Regression. This study demonstrated that for the small dataset, the best pretrained feature extractor was DenseNet201, whereas the best model for training was a fully connected softmax layer with a reported accuracy of 88.20% and an average f1-score of 0.881. For the larger dataset size, the best feature extractor was InceptionResNetV2 where the highest accuracy and f1-score of 90.60% and 0.908 was produced when classified using a fully connected softmax layer. All models, apart from ResNet50 demonstrated an improvement in performance when pretraining using ImageNet for bottleneck feature extraction.
To document the outcome of dogs with appendicular primary bone tumors treated with stereotactic radiotherapy (SRT) and concurrent stabilization. Multi-institutional retrospective case series. Eighteen dogs with presumptive or definitive diagnosis of appendicular osteosarcoma. Medical records of dogs with appendicular primary bone tumors treated with SRT and stabilization were reviewed for signalment, preoperative staging and diagnostics, radiation dose, stabilization method, and outcome. The distal radius was affected in 13/18 cases. Osteosarcoma or sarcoma was confirmed cytologically or histologically in 15/18 cases. Seven dogs were diagnosed with a pathological fracture at the time of treatment, and 11 were considered at high risk for pathological fracture. Dogs received a single dose (n = 5) or 3 doses (n = 13) of SRT. Surgical stabilization was performed under the same anesthetic event as the final dose of SRT in 10 dogs. Stabilization was achieved with a bone plate (n = 15) or interlocking nail (n = 3). Seventeen dogs received adjuvant chemotherapy. Complications occurred in 16/17 dogs, 15/17 of those being considered major complications. Four dogs experienced more than one complication. Infection was the most common complication, diagnosed in 15/17 cases, and considered as a major complication in 13/15 cases. Postoperative fracture was recorded as a major complication in 3 cases. Nine dogs were amputated at a median of 152 days. The median survival time was 344 days. Treatment of bone tumors with SRT and concurrent stabilization was associated with a prohibitively high complication rate in dogs. Alternative methods for limb salvage should be considered for dogs at risk for pathologic fracture.
Performing a mitosis count (MC) is the diagnostic task of histologically grading canine Soft Tissue Sarcoma (cSTS). However, mitosis count is subject to inter- and intra-observer variability. Deep learning models can offer a standardisation in the process of MC used to histologically grade canine Soft Tissue Sarcomas. Subsequently, the focus of this study was mitosis detection in canine Perivascular Wall Tumours (cPWTs). Generating mitosis annotations is a long and arduous process open to inter-observer variability. Therefore, by keeping pathologists in the loop, a two-step annotation process was performed where a pre-trained Faster R-CNN model was trained on initial annotations provided by veterinary pathologists. The pathologists reviewed the output false positive mitosis candidates and determined whether these were overlooked candidates, thus updating the dataset. Faster R-CNN was then trained on this updated dataset. An optimal decision threshold was applied to maximise the F1-score predetermined using the validation set and produced our best F1-score of 0.75, which is competitive with the state of the art in the canine mitosis domain.
Case summary A 13-year-old female domestic longhair cat was presented for further investigation of chronic sneezing combined with a right-sided nasal discharge. A CT scan of the head revealed a locally invasive, aggressive right nasal mass radiographically consistent with a malignant neoplastic process. Histopathology on rhinoscopically guided biopsies revealed an unusual pathology consistent with fibro-osseous hyperplasia/ dysplasia. Surgical treatment via a ventral rhinotomy and curettage was performed, and the diagnosis confirmed by repeat histopathology. The cat's clinical signs significantly improved postoperatively. Relevance and novel information This case report describes an unusual feline nasal pathology. To our knowledge, there are no previous reports of a non-neoplastic, non-inflammatory expansile feline nasal tumour. Also described are the CT and histological appearance of the mass, and the difficulties encountered obtaining the definitive diagnosis. Information regarding the prognosis following surgical removal of proliferative fibro-osseous lesions in cats is poor, especially from the nasal cavity where clean margins may well be impossible to obtain. In this case, surgical resection improved clinical signs and the cat remains well at 15 months post-procedure.
OBJECTIVE To compare erythrocyte recovery by a cell salvage device between swab-washing by manual agitation or filtration. SAMPLE 12 recently expired units of canine packed RBCs. PROCEDURE The packed RBC units underwent quality analysis before donation from a pet blood bank. Each unit was volume-expanded with anticoagulant and subsequently divided into 2 equal aliquots used to soak surgical swabs before washing. Two different swab-washing techniques were evaluated—standard swab-washing–manual agitation (SW-MA) and swab-washing–filtration (SW-F)—with a novel prototype device. The resulting bloody fluid was processed using the Cell Saver Elite Autotransfusion System (Haemonetics). The volume, manual PCV, CBC, and RBC mass, calculated as the product of the volume and PCV, were measured before and after salvaging. Last, the RBC mass recovery was recorded as a percentage. RESULTS The RBC mass recovered from SW-MA and SW-F averaged 85.73% and 83.99%, respectively. There was no significant difference in RBC recovery between the 2 methods (P = .52). CLINICAL RELEVANCE SW-MA and SW-F recovered a similar quantity of RBCs from blood-soaked swabs in an ex vivo setting.
To report outcomes after radical mandibulectomy in cats. Multi-institutional retrospective study. Eight cats were included. Medical records were searched for cats with confirmed oral neoplasia treated with radical mandibulectomy. Data collected included demographics, surgical procedure, histopathological diagnosis, postoperative management, and outcomes. Ages ranged from 8 to 17 years. All cats had 75% to 90% of the mandible removed and feeding tubes placed. Seven cats had squamous cell carcinoma, and one cat had a giant cell tumor. Six cats ate on their own postoperatively. Three cats had local recurrence and tumor-related died at 136 and 291 days. Six cats had no recurrence, with survival times of 156, 465, 608, and 1023 days, and two cats were still alive at 316 and 461 days after surgery. The three long-term survivors died of causes unrelated to oral neoplasia. One cat died at 156 days due to aspiration of food material. The overall estimated mean survival time was 712 days. After radical mandibulectomy, independent food intake was achieved in 6 of eight cats, and four cats lived longer than one year. Radical mandibulectomy should be considered for the treatment of extensive oral neoplasia in cats. Successful long-term outcomes are possible with aggressive supportive care perioperatively.
OBJECTIVES: To evaluate intraoperative irradiation (IORT) as a method of limb spare with preservation of the radiocarpal joint. STUDY DESIGN: Prospective case series. ANIMALS: Dogs (n=5) with stage II sarcoma of the distal aspect of the radius. METHODS: A bone segment containing the tumor was isolated surgically, treated by IORT, reimplanted, and secured by internal fixation. In 1 dog, the postradiation tumor bed was curetted and filled with bone cement. Dogs were administered alternating adriamycin and carboplatin starting 2 weeks after IORT and monitored at regular intervals. RESULTS: Four dogs had osteosarcoma and 1 had undifferentiated sarcoma. Implant failure (n=3), deep tissue infection (3), and pathologic fracture (3) resulted in amputation (3) or pancarpal plating (2). The dog with undifferentiated sarcoma was euthanatized because of suspected tumor recurrence 4 months postoperatively. Osteotomy healing was documented by radiography (1), histopathology (2), or by direct observation (2). CONCLUSIONS: A technique for limb-sparing surgery of the distal portion of the radius in dogs using IORT had advantages include healing of the autograft and a source for a perfectly fitting autograft but did not appear to offer any advantage with respect to infection rate. Long-term preservation of the radiocarpal joint was not successful. CLINICAL RELEVANCE: It was not possible to preserve the function of the radiocarpal joint and so this technique cannot be recommended currently. Further study is needed to evaluate whether or not IORT can be considered in combination with pancarpal plating and possibly curettage and cementation of the tumor to prevent subchondral bone collapse.
© 2015, Universidad de Antioquia. All rights reserved.Background: vascular access ports (VAPs) are designed to allow repeated access to the vascular system with minimum patient distress. Objective: to describe the surgical technique, care and complications of jugular VAPs currently used at the Veterinary Oncology Service of the University of Florida Small Animal Hospital. Conclusion: the VAPs can remain in site for long terms (months) with minimum complications, and its placement is a reliable technique that should be considered by veterinarians, particularly for a long-term treatment.
All animals scheduled for urinary tract biopsy should undergo a complete historical and physical evaluation. Laparoscopic‐assisted percutaneous needle core biopsies may obtain more representative tissue than US‐guided biopsies, and the biopsy site can be watched for evidence of hemorrhage. Fine needle aspirate (FNA) and needle core biopsy (e.g. Trucut) are infrequently used to diagnose renal tumors, possibly due to the concerns of abdominal tumor seeding associated with biopsy bleeding or biopsy‐tract implantation. Incisional or wedge biopsies will yield large tissue samples for histopathology and are typically taken from the junction of normal and what appears to be abnormal kidney. The majority of urinary neoplasia is epithelial in origin, and urothelial carcinomas display aggressive malignant behavior. For tumors that involve the urethra or trigone of the bladder and that cause an obstruction, placing a cystostomy tube can be a palliative solution to allow emptying of the bladder by the owners.
Vacuum-assisted closure (VAC) is a wound management therapy that creates local negative pressure over a wound bed to promote healing. Benefits of VAC therapy include removal of fluid from the extravascular space, improved circulation, enhanced granulation tissue formation, increased bacterial clearance, and hastening of wound closure. This article describes the mechanism of action of VAC therapy, reviews application techniques, and lists potential complications and contraindications.
Abstract Intrahepatic splenosis is the heterotopic autotransplantation of splenic tissue secondary to splenic trauma or splenectomy. A 12‐year‐old Cairn terrier was referred due to lethargy, collapse and abdominal discomfort. Abdominal ultrasound and a computed tomography scan (CT) revealed an intrahepatic mass in the left medial liver lobe. The dog underwent surgery for liver lobectomy, and subsequent histopathology revealed intrahepatic splenosis. The dog had undergone splenectomy 3 years previously due to splenic rupture following an abdominal trauma.
CASE DESCRIPTION 4 dogs were examined because of pleural effusion and ventricular tachycardia, coughing and supraventricular tachycardia, appendicular osteosarcoma, and syncopal episodes. CLINICAL FINDINGS In all 4 dogs, a heart base tumor was identified by means of thoracic CT. TREATMENT AND OUTCOME In all 4 dogs, the heart base tumors were treated by means of stereotactic body radiation therapy. Dogs were anesthetized, and neuromuscular blockade was achieved with atracurium or vecuronium. A circle rebreathing system with 15 m (50 feet) of anesthetic tubing coursing through the vault wall was used to connect the patient to the anesthesia machine, which was located in the control room. After a brief period of hyperventilation, an inspiratory breath was held at 20 cm H2O for the duration of beam delivery. Each beam delivery lasted between 30 and 100 seconds. Immediately following the breath hold, assisted ventilation was resumed. Mean treatment delivery time for each patient was 26 minutes; mean total anesthesia time was 89 minutes. All patients recovered without complications. There was no evidence of hemoglobin desaturation or hypercapnia during the anesthetic procedure.
Background There is a paucity of veterinary literature on the safety or outcome of zoledronic acid (ZA) use in dogs for either bone pain or hypercalcemia. Hypothesis/Objectives The primary aim was to report the adverse events in dogs receiving intravenous administration of ZA. Animals Ninety-five dogs with ZA use. Methods A retrospective cohort study was performed; all dogs that received at least 1 dose of ZA and had a serum biochemistry profile performed before and after treatment were reviewed. Diagnosis, indication for treatment, adverse events and survival times were recorded. Results Ninety-five dogs met the inclusion criteria. Thirty-one (33%) received multiple intravenous infusions of ZA (range, 2-7), making a total of 166 administrations in all dogs. The dose range was 0.13 to 0.32 mg/kg, given at intervals of 4 to 6 weeks. Thirteen adverse events were recorded in 10 dogs: azotemia (n = 8), vomiting (n = 2), pancreatitis (n = 1), cutaneous ulceration (n = 1), and diarrhea (n = 1). Zoledronic acid could not be confirmed as the cause of azotemia in any case. The change in serum creatinine concentration from dose to dose was not related to the total dose received (P = .46). Five dogs (5%) changed Veterinary Comparative Oncology Group Common Terminology Criteria (VCOG-CTAE) renal/genitourinary grade after administration of ZA; their total dose 0.4 mg/kg (range, 0.26-0.66) was not significantly different to the group which did not change VCOG-CTAE renal/genitourinary grade 0.35 mg/kg (range, 0.2-1.50; P = .93). Conclusions and Clinical Importance Multiple doses of ZA were well tolerated in dogs within this study. A small number of dogs developed progressive azotemia which was not associated with cumulative dose.
Gene expression profiling has revealed molecular heterogeneity of diffuse large B cell lymphoma (DLBCL) in both humans and dogs. Two DLBCL subtypes based on cell of origin are generally recognized, germinal center B (GCB)-like and activated B cell (ABC)-like. A pilot study to characterize the transcriptomic phenotype of 11 dogs with multicentric BCL yielded two molecular subtypes distinguished on the basis of genes important in oxidative phosphorylation. We propose a metabolic classification of canine BCL that transcends cell of origin and shows parallels to a similar molecular phenotype in human DLBCL. We thus confirm the validity of this classification scheme across widely divergent mammalian taxa and add to the growing body of literature suggesting cellular and molecular similarities between human and canine non-Hodgkin lymphoma. Our data support a One Health approach to the study of DLBCL, including the advancement of novel therapies of relevance to both canine and human health.
Objective To determine the ability of a cell salvage device to recover canine erythrocytes by direct aspiration of diluted packed red blood cells (pRBC) and saline rinse from blood-soaked surgical swabs. Study design Experimental study. Sample population Twelve recently expired units of canine pRBC. Methods pRBC units donated from a pet blood bank (after quality analysis) were diluted with anticoagulant, divided into two equal aliquots, and subsequently harvested by direct suction (Su), or soaked into swabs, saline-rinsed and suctioned (Sw). The volume of product, manual packed cell volume (PCV), and red blood cell mass (rbcM) were measured and compared before and after salvaging. The rbcM recovery was recorded as percentage ([rbcM post salvage]/[rbcM presalvage]x100). Statistical analysis of all measured values was performed (significance p
The purpose of this retrospective study was to compare the accuracy of computed tomographic angiography (CTA) and abdominal ultrasonography in detecting and characterizing portosystemic shunts (PSS) in dogs. Medical records of 76 dogs that underwent CTA and/or abdominal ultrasonography suspected to have PSS were reviewed. Presence or absence, and characterization of PSS (when present) on CTA were reviewed by a board-certified veterinary radiologist that was blinded to the clinical findings. The abdominal ultrasonography findings were reviewed from the medical records. Visualization and description of the origin and insertion of PSS on CTA and abdominal ultrasonography were related with laboratory, surgical, or mesenteric portographic confirmation of the presence or absence of PSS. The sensitivity for detection of PSS with CTA (96%) was significantly higher than abdominal ultrasonography (68%; P < 0.001). The specificities for CTA and abdominal ultrasonography were 89% and 84%, respectively (P = 0.727). Computed tomographic angiography detected the correct origin in 15 of 16 dogs and correct insertion in 15 of 16 dogs with congenital PSS. Abdominal ultrasonography detected the correct origin in 24 of 30 dogs and correct insertion in 20 of 33 dogs with congenital PSS. Multiple acquired PSS were seen in four of five dogs and in one of six dogs on CTA and abdominal ultrasonography, respectively. Computed tomographic angiography was 5.5 times more likely to correctly ascertain the presence or absence of PSS when compared to abdominal ultrasonography (P = 0.02). Findings indicated that CTA is a noninvasive diagnostic modality that is superior to abdominal ultrasonography for the detection and characterization of PSS in dogs.
© 2013 John Wiley & Sons, Ltd.The parathyroid glands in dogs and cats are tan-colored ovoid structures closely associated with each thyroid gland. Parathyroid hormone (PTH) release is controlled by calcium receptors on the chief cells in the parathyroid glands in response to hypocalcemia. PTH has a short half-life (3-5 min) in serum and so a steady rate of secretion is necessary to maintain serum PTH concentrations. Natural variations in PTH concentration occur in healthy dogs. Exploratory surgery with parathyroidectomy in dogs with primary hyperparathyroidism serves as both a diagnostic test and definitive therapy. Surgery should be advocated to reduce the risk of urolithiasis and urinary tract infection, as well as improving the clinical signs seen with hypercalcemia such as polydipsia, polyuria, weakness, and decreased appetite. Surgical excision alone is the most widely performed treatment for primary hyperparathyroidism and a cure rate of 94% is reported if all autonomously functioning parathyroid tissue is removed.
CASE DESCRIPTION A 7-year-old sexually intact female rabbit was admitted to the hospital be- cause of a 6-month history of chronic right pelvic limb lameness. CLINICAL FINDINGS Clinical examination revealed a prominent right pelvic limb lameness and signs of pain on manipulation of the right hip joint, with a focal, well-defined soft tissue mass palpable in the right pelvic area. Pelvic radiography revealed a lytic hip joint lesion and CT detailed an expansile lesion within the proximal portion of the femur with an appearance consistent with a soft tissue mass. Histologic evaluation of incisional biopsy samples of the soft tissue mass revealed a poorly differentiated sarcoma. TREATMENT AND OUTCOME A hemipelvectomy was performed, and histologic evaluation of the soft tissue mass confirmed the diagnosis, with tumor-free margins achieved. The patient recovered well from surgery and had good mobility. The patient survived 21 months after surgery and died of a non-cancer-related disease. Anatomic dissection was described in a cadaver rabbit to aid future surgeries. CLINICAL RELEVANCE To the authors' knowledge, this was the first report of a hemipelvectomy performed in a rabbit. Hemipelvectomy is more routinely performed in canine and feline patients, but with the right candidate and owner commitment to aftercare, it may be safely and successfully performed in rabbits.
A 10.5-year-old crossbreed dog was presented with a history of hypoglycaemic episodes and elevated serum insulin concentration. A pancreatic mass was removed at surgery along with an enlarged draining lymph node. An unresectable hepatic nodule was also present. Immunohistochemistry confirmed the pancreatic and lymph node masses as functional mixed acinar-endocrine carcinoma, previously unreported in domestic species. Persistent hypoglycaemia and hyperinsulinaemia post-operatively was highly suggestive of the hepatic mass being a functional metastasis. The dog was managed on prednisolone and remained asymptomatic 9 months post-operatively. This tumour type has only been rarely reported in human patients and may highlight the need for more rigorous immunohistochemical staining of pancreatic masses in veterinary species to identify the prevalence of this tumour type.
Abstract Background Peripheral nerve sheath tumors (PNSTs) are a group of neoplasms originating from Schwann cells or pluripotent cell of the neural crest. Therapeutic options and prognosis are influenced by their degree of malignancy and location. Hypothesis/Objectives Identify magnetic resonance imaging (MRI) features predictive of PNST histologic grade. Animals Forty‐four dogs with histopathological diagnosis of spinal PNSTs and previous MRI investigation. Methods A multicenter retrospective study including cases with (a) histopathologic diagnosis of PNST and (b) MRI studies available for review. Histologic slides were reviewed and graded by a board‐certified pathologist according to a modified French system (FNCLCC) for grading soft tissue sarcomas. The MRI studies were reviewed by 2 board‐certified radiologists blinded to the grade of the tumor and the final decision on the imaging characteristics was reached by consensus. Relationships between tumor grade and histological and MRI findings were assessed using statistical analysis. Results Forty‐four cases met inclusion criteria; 16 patients were PNSTs Grade 1 (low‐grade), 19 were PNSTs Grade 2 (medium‐grade), and 9 were PNSTs Grade 3 (high‐grade). Large volume ( P = .03) and severe peripheral contrast enhancement ( P = .04) were significantly associated with high tumor grade. Degree of muscle atrophy, heterogeneous signal and tumor growth into the vertebral canal were not associated with grade. Conclusions and Clinical Importance Grade of malignancy was difficult to identify based on diagnostic imaging alone. However, some MRI features were predictive of high‐grade PNSTs including tumor size and peripheral contrast enhancement.
Objective: The aim of this study was to investigate the prevalence of pulmonary nodules at presentation in cases of soft tissue sarcoma (STS) in dogs with no previous thoracic imaging. Animals: Client-owned dogs with a histologic diagnosis of STS. Procedures: Dogs were retrospectively included in this study if the first thoracic imaging performed was at the time of presentation to our referral center. De novo and recurrent tumors were included, and information regarding tumor grade, history (primary mass vs scar vs recurrence), duration, location and size was also collected. Results: One hundred and forty-six dogs were included. Routine staging was performed with computed tomography (131 dogs, 89.7%) or 3-view thoracic radiographs (15 dogs, 10.3%). STS were grade 1 in 55.5% of dogs, grade 2 in 27.4% and grade 3 in 17.1%. Pulmonary nodules suggestive of metastasis were present in 11.7% of cases overall and in 6.5%, 5.6% and 37.5% of grade 1, grade 2 and grade 3 STS cases, respectively. Tumor grade (low/intermediate versus high) and tumor duration ( 3 months) were significantly associated with presence of pulmonary nodules at presentation. Conclusions and Clinical Relevance: This is the first large study reporting prevalence of pulmonary nodules at presentation in dogs with STS having had no previous thoracic imaging. The prevalence of pulmonary nodules suggestive of metastasis at presentation is low (
Necrosis seen in histopathology Whole Slide Images is a major criterion that contributes towards scoring tumour grade which then determines treatment options. However conventional manual assessment suffers from inter-operator reproducibility impacting grading precision. To address this, automatic necrosis detection using AI may be used to assess necrosis for final scoring that contributes towards the final clinical grade. Using deep learning AI, we describe a novel approach for automating necrosis detection in Whole Slide Images, tested on a canine Soft Tissue Sarcoma (cSTS) data set consisting of canine Perivascular Wall Tumours (cPWTs). A patch-based deep learning approach was developed where different variations of training a DenseNet-161 Convolutional Neural Network architecture were investigated as well as a stacking ensemble. An optimised DenseNet-161 with post-processing produced a hold-out test F1-score of 0.708 demonstrating state-of-the-art performance. This represents a novel first-time automated necrosis detection method in the cSTS domain as well specifically in detecting necrosis in cPWTs demonstrating a significant step forward in reproducible and reliable necrosis assessment for improving the precision of tumour grading.
The definitive diagnosis of canine soft-tissue sarcomas (STSs) is based on histological assessment of formalin-fixed tissues. Assessment of parameters, such as degree of differentiation, necrosis score and mitotic score, give rise to a final tumour grade, which is important in determining prognosis and subsequent treatment modalities. However, grading discrepancies are reported to occur in human and canine STSs, which can result in complications regarding treatment plans. The introduction of digital pathology has the potential to help improve STS grading via automated determination of the presence and extent of necrosis. The detected necrotic regions can be factored in the grading scheme or excluded before analysing the remaining tissue. Here we describe a method to detect tumour necrosis in histopathological whole-slide images (WSIs) of STSs using machine learning. Annotated areas of necrosis were extracted from WSIs and the patches containing necrotic tissue fed into a pre-trained DenseNet161 convolutional neural network (CNN) for training, testing and validation. The proposed CNN architecture reported favourable results, with an overall validation accuracy of 92.7% for necrosis detection which represents the number of correctly classified data instances over the total number of data instances. The proposed method, when vigorously validated represents a promising tool to assist pathologists in evaluating necrosis in canine STS tumours, by increasing efficiency, accuracy and reducing inter-rater variation.
OBJECTIVE: To evaluate clinical outcome of dogs with appendicular osteosarcoma (OSA) treated with stereotactic radiosurgery (SRS) and subsequent internal fixation of a pathologic fracture. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs with spontaneous-occurring appendicular OSA (n = 6). METHODS: Medical records (May 2002-January 2008) of dogs that had SRS for appendicular OSA were reviewed. Dogs were included if they had a pathologic fracture either before or after SRS and were treated with internal fixation. Signalment, history, physical examination findings, clinicopathologic data, diagnostic imaging findings, biopsy results, surgical complications, number of surgeries, adjuvant therapy, development of metastatic disease and cause of death were recorded. RESULTS: Six dogs met the inclusion criteria. Two dogs had a pathologic fracture at admission and 4 dogs developed a fracture after SRS with a mean ± SD time to fracture development of 6.25 ± 1.65 months. The first 3 fractures were repaired using an open approach and the latter three using minimally invasive percutaneous osteosynthesis (MIPO). Infection occurred in 5 dogs and implant failure in 3. Limb function was subjectively assessed as good in all dogs when the implants were stable and infections were subclinical. Survival times ranged from 364-897 days; 1 dog was lost to follow-up. CONCLUSIONS: Fracture repair using internal fixation should be considered a viable limb-sparing alternative for pathologic fractures that have been treated with SRS.
Objective: The aim of this study was to investigate the prevalence of pulmonary nodules at presentation in cases of soft tissue sarcoma (STS) in dogs with no previous thoracic imaging. Animals: Client-owned dogs with a histologic diagnosis of STS. Procedures: Dogs were retrospectively included in this study if the first thoracic imaging performed was at the time of presentation to our referral center. De novo and recurrent tumors were included, and information regarding tumor grade, history (primary mass vs scar vs recurrence), duration, location and size was also collected. Results: One hundred and forty-six dogs were included. Routine staging was performed with computed tomography (131 dogs, 89.7%) or 3-view thoracic radiographs (15 dogs, 10.3%). STS were grade 1 in 55.5% of dogs, grade 2 in 27.4% and grade 3 in 17.1%. Pulmonary nodules suggestive of metastasis were present in 11.7% of cases overall and in 6.5%, 5.6% and 37.5% of grade 1, grade 2 and grade 3 STS cases, respectively. Tumor grade (low/intermediate versus high) and tumor duration ( 3 months) were significantly associated with presence of pulmonary nodules at presentation. Conclusions and Clinical Relevance: This is the first large study reporting prevalence of pulmonary nodules at presentation in dogs with STS having had no previous thoracic imaging. The prevalence of pulmonary nodules suggestive of metastasis at presentation is low (
Vacuum-assisted closure (VAC) is a wound management system that exposes a wound bed to local negative pressure to promote healing. Benefits of VAC therapy include removal of fluid from the extravascular space, improved circulation, enhanced granulation tissue formation, and increased bacterial clearance. VAC therapy has been used extensively in human patients to treat a variety of acute and chronic wound conditions. This article reviews the use of VAC therapy in a variety of wound conditions and describes our experiences with using VAC therapy in dogs and cats at the University of Florida. © Copyright 2010 MediMedia Animal Health.
Yunnan Baiyao is a Chinese herbal medicine that has been utilized for its anti-inflammatory, haemostatic, wound healing and pain relieving properties in people. It has been utilized in the veterinary profession to control bleeding in dogs with hemangiosarcoma (HSA) and has been anecdotally reported to prolong survival times in dogs with this neoplasm. This study evaluated the in vitro activity of Yunnan Baiyao against three canine HSA cell lines after treatment with increasing concentrations of Yunnan Baiyao (50, 100, 200, 400, 600 and 800 µg mL(-1) ) at 24, 48 and 72 h. Mean half maximum inhibitory concentration (IC50 ) at 72 h for DEN, Fitz, SB was 369.9, 275.9 and 325.3 µg mL(-1) , respectively. Caspase-3/7 activity increased in correlation with the IC50 in each cell line which was confirmed by the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL, APO-BRDU Kit; BD Biosciences, San Jose, CA, USA) assay. VEGF in cell supernatant was also quantified. Overall, the study found that Yunnan Baiyao causes dose and time dependent HSA cell death through initiation of caspase-mediated apoptosis, which supports future studies involving Yunnan Baiyao.
Vacuum-assisted closure (VAC) is a wound management system that exposes a wound bed to local negative pressure to promote healing. Benefits of VAC therapy include removal of fluid from the extravascular space, improved circulation, enhanced granulation tissue formation, and increased bacterial clearance. VAC therapy has been used extensively in human patients to treat a variety of acute and chronic wound conditions. This article reviews the use of VAC therapy in a variety of wound conditions and describes our experiences with using VAC therapy in dogs and cats at the University of Florida.
Primary hyperparathyroidism is rare, comprising 0.5% cases referred to one large academic institution. All clinical signs associated with primary hyperparathyroidism are related to the hypercalcemia secondary to the elevation in parathyroid hormone. Primary hyperparathyroidism is rare in cats, with few cases described to date. Since most hyperfunctioning parathyroid tissue occurs in the normal location of the parathyroid glands, cervical ultrasound is economical and readily available, and so is commonly the first line of imaging modality. Chronic renal failure is commonly associated with hyperparathyroidism through parathyroid gland hyperplasia. Exploratory surgery with parathyroidectomy in dogs with primary hyperparathyroidism serves as both a diagnostic test and definitive therapy. Preoperative treatment of hypercalcemia is contentious and there are no published standards. The greatest postoperative concern, reportedly occurring in 8–63% dogs, is hypocalcemia due to chronic suppression of the remaining parathyroid glands through negative feedback from the hypersecretory tumor.