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Objectives: To evaluate whether patient factors affect development of non-pulmonary soft-tissue metastases following treatment of canine appendicular osteosarcoma and to report and compare outcomes to those in dogs with pulmonary or osseous metastases., Animals and Procedure: The records of 3 veterinary teaching hospitals were reviewed to identify dogs that received definitive treatment for a primary appendicular osteosarcoma lesion and chemotherapy between January 2010 and June 2022. Dogs with non-pulmonary metastases following initial treatment were included. Descriptive statistics were calculated to summarize signalment information, and metastasis and survival times were compared between groups using Kaplan-Meier survival analysis and log-rank tests., Results: Thirty-six and 109 dogs developed non-pulmonary soft-tissue metastases and pulmonary or osseous metastases, respectively, following initial treatment. No patient factors were significantly associated with development of non-pulmonary soft-tissue metastases. The median times to non-pulmonary soft-tissue metastasis or initial pulmonary or osseous metastasis were 220 and 169 d, respectively ( P = 0.18); whereas overall median survival times were 250 and 270 d, respectively ( P = 0.36)., Conclusion: Dogs with non-pulmonary soft-tissue metastases had similar disease-free intervals and survival rates to dogs with typical pulmonary or osseous metastases., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Background: The objectives of this study were to: (i) Determine whether operable primary liver tumors were associated with prolongations in prothrombin time (PT) and activated partial thromboplastin time (aPTT) and (ii) determine if these secondary hemostatic abnormalities were more prevalent with specific liver tumors., Study Design: Multi-institutional retrospective study., Animal Population: Dogs (n = 359) undergoing liver lobectomy for a primary liver tumor with a preoperative coagulation panel., Methods: Data was identified via electronic medical record review at eight veterinary teaching hospitals. Baseline dog characteristics, coagulation panel values, platelet count, emergency versus non-emergency procedure, whether the dogs received transfusion(s) of a blood product, liver lobe removed, and histopathological diagnosis were extracted from the medical record. Chi-square analysis was used to compare categorical variables between groups. Continuous variables were assessed for normality using the Shapiro-Wilk test., Results: A total of 74 of 359 dogs (20.6%) had a prolongation in either PT or aPTT preoperatively. A total of 20 of 359 dogs (5.6%) were found to have prolongation of both PT and aPTT. Hemangiosarcoma was the only histopathological diagnosis associated with concurrent prolongations of both PT and aPTT (p < .001) in 6/16 (37.5%) dogs., Conclusion: Coagulation panels including PT and aPTT are unlikely to detect substantial deficiencies in secondary hemostasis in most dogs with primary liver tumors except in dogs with a histopathological diagnosis of hemangiosarcoma., Clinical Significance: PT and aPTT testing is low yield as an elective preoperative screening test in dogs with primary liver tumors except in dogs where there is a hemoabdomen or high suspicion for hepatic hemangiosarcoma., (© 2024 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.)

A 10-year-old spayed female mixed-breed dog was brought to the Ohio State University Veterinary Medical Center because of a suspected mass located to the right kidney. The mass was diagnosed by abdominal ultrasound following a recurrent lower urinary tract infection. Abdominal computed tomography revealed 2 isoattenuating, peripherally hypoattenuating, and centrally non-contrast-enhancing nodules in the right kidney; the larger one measured 1.9 cm. Initial attempts at fine-needle aspiration were unsuccessful. The dog was returned and the mass was aspirated using ultrasound guidance under heavy sedation. Cytology confirmed the presence of septic inflammation, consistent with a renal corticomedullary abscess. The dog was administered oral enrofloxacin (15 mg/kg, q24h) after diagnosis. Ultrasound guidance was used 2 wk later, under general anesthesia, to achieve percutaneous drainage of ~0.25 mL of fluid and instillation of 5.7 mg (0.25 mL) of enrofloxacin into the abscess capsule. Two weeks after percutaneous drainage, ultrasound examination showed complete resolution of the renal corticomedullary abscess. Urine culture confirmed resolution of the urinary tract infection. To the authors' knowledge, kidney-sparing medical management has never been successfully reported in a dog with a renal corticomedullary abscess. Key clinical message: Renal corticomedullary abscesses occur infrequently in dogs. Medical management is feasible and can result in complete resolution of clinical signs and imaging abnormalities., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Objective: To determine the rate of nodal metastasis in dogs with thyroid cancer and evaluate whether immunohistochemistry (IHC) identifies additional metastases beyond evaluation with H&E., Animals: 70 prospectively enrolled client-owned dogs with thyroid cancer managed with thyroidectomy., Methods: Dogs underwent thyroidectomy with concurrent elective bilateral medial retropharyngeal (MRP) ± deep cervical lymphadenectomy. Thyroid tumors and associated lymph nodes were reviewed by a single board-certified pathologist. Immunohistochemistry was used for all primary tumors (thyroid transcription factor-1 and calcitonin) to support a diagnosis of follicular or medullary carcinoma. Lymph nodes without evidence of metastasis after H&E review were labeled with the antibody associated with the wider uptake in the primary tumor., Results: 77 thyroid cancers were resected from the 70 dogs enrolled, including 61 (79.2%) follicular, 8 (10.7%) medullary, and 7 (9.3%) mixed follicular/medullary carcinomas, with 1 (1.3%) carcinosarcoma. Twelve dogs had evidence of nodal metastasis following H&E review. Occult micrometastasis was identified in 1 dog following nodal IHC, resulting in documented metastasis in 13 of 70 (18.6%) dogs. Metastasis was more common with medullary (5/8) and follicular/medullary carcinoma (3/7) than follicular carcinoma (5/61). All MRP metastases were ipsilateral (7/77 [9.1%]), without contralateral MRP metastases (0/62). Fourteen of 41 (34.1%) deep cervical lymph nodes were metastatic., Clinical Relevance: Nodal metastasis was uncommon for follicular carcinoma but was seen in > 50% of dogs with thyroid cancer involving a medullary component. Routine nodal IHC appears to be low yield for thyroid carcinoma. Extirpation of ipsilateral MRP and identifiable deep cervical lymph nodes is recommended with thyroidectomy until detailed preoperative risk stratification becomes available.

Objective: Thromboelastography (TEG) is a whole blood assay that yields global assessment of hemostasis, as it evaluates clot time, strength, and kinematics of clot formation and lysis. The main objective was to describe preoperative TEG findings in dogs that had an adrenalectomy performed and, secondarily, to describe TEG findings in the dogs with or without hyperadrenocorticism (HAC)., Animals: 30 dogs that had preoperative TEG and adrenalectomy performed., Methods: Medical records between 2018 and 2022 were reviewed. Signalment, diagnostic data, and perioperative treatment were abstracted., Results: 53% (16/30) of the dogs were hypercoagulable, and none were hypocoagulable. Based on histopathology, 6 of 9 dogs with adenocarcinoma were hypercoagulable, 4 of 8 with pheochromocytoma were hypercoagulable, and 6 of 10 with adenoma were hypercoagulable. None of the 3 dogs with other histopathologic diagnoses or combinations of diagnoses (adrenocortical hyperplasia, poorly differentiated sarcoma, and both adrenocortical adenocarcinoma and pheochromocytoma) were hypercoagulable. Of the 14 dogs tested preoperatively for HAC, 4 of 8 HAC dogs were hypercoagulable and 2 of 6 non-HAC dogs were hypercoagulable., Clinical Relevance: The present report describes for the first time TEG findings for dogs undergoing adrenalectomy and suggests that the majority of dogs with adrenal neoplasia are hypercoagulable based on TEG results.

Objective: To report the survival times in dogs diagnosed with adrenal tumors with vascular or soft tissue invasion that did not undergo adrenalectomy., Animals: Retrospective case series of 32 client-owned dogs., Methods: The medical records of a referral veterinary hospital were reviewed to identify dogs that were diagnosed with an invasive adrenal mass and did not undergo adrenalectomy between January 2013 and December 2022. Data collected included signalment, examination findings, and diagnostic results from the initial presentation. Descriptive statistics were calculated to summarize dog signalment information, and Kaplan-Meier survival analysis was performed for calculation of median survival time., Results: Most dogs (n = 28) had vascular invasion, primarily into the caudal vena cava. Surgery was offered but not pursued due to perceived risk of sudden death (n = 5), risk of hemorrhage (4), or concurrent diagnosis of disseminated intravascular coagulation (1). Only 1 dog pursued stereotactic body radiation therapy, and 1 was prescribed toceranib phosphate (Palladia). Of these 32 dogs, 30 (93.8%) died or were euthanized and 2 (6.2%) dogs survived. The median follow-up time was 49 days (range, 0 to 1,910 days). The median survival time was 50 days (95% CI, 4 to 194 days). The most common cause of death or euthanasia was hemoabdomen (n = 8)., Clinical Relevance: Nonsurgical management of invasive adrenal tumors was associated with short survival times in this case series.

Objective: To determine the incidence of complications in the intraoperative and postoperative period for dogs undergoing nephrectomy for renal disease., Animals: 69 dogs., Methods: Medical records of dogs undergoing nephrectomies for renal disease were reviewed for signalment, date of surgery, results of blood analyses, and intra- and postoperative complications. Long-term follow-up was obtained via client telephone interview or referring veterinarian medical records. A Fisher exact test was used to assess the relationship between postoperative acute kidney injury and NSAID administration with long-term development of chronic kidney disease., Results: Complications occurred in 44.9% and 42.6% of dogs in the intraoperative and postoperative periods, respectively. Most of these were lower-grade complications, though a total of 7 dogs died during the postoperative period. An acute kidney injury was diagnosed in 12 dogs postoperatively, with 2 dogs euthanized due to the severity of the injury. Long-term follow-up was available for 53 dogs, with 24 (45.3%) dogs developing chronic kidney disease. Postoperative acute kidney injury (P = .385) and NSAID administration (P = .519) were not statistically associated with the development of chronic kidney disease in this population., Clinical Relevance: Unilateral nephrectomy is associated with high intraoperative and postoperative complication rates in dogs. Chronic kidney disease was diagnosed in almost 50% of the population with available long-term follow-up.

Objective: To report the clinical characteristics, treatments, and outcomes in a cohort of dogs with histologically confirmed retroperitoneal sarcoma (RPS) and to identify potential variables of prognostic significance., Animals: 46 client-owned dogs from 10 clinics with histopathologic diagnosis of a sarcoma originating from the retroperitoneal space., Methods: Medical records were retrospectively reviewed to obtain information regarding clinical characteristics, treatments, and outcomes. Recorded variables were analyzed to report descriptive data for all cases and overall survival time. Multivariate analysis was utilized to evaluate prognostic factors for overall survival., Results: Hemangiosarcoma was the most common histologic subtype diagnosed (76.1%). Cytoreductive and curative intent surgical excision of the RPS was attempted in 12 and 22 dogs, respectively; 12 dogs underwent no surgery or had an exploratory laparotomy with incisional biopsy only. Nineteen dogs received adjuvant chemotherapy, either injectable or metronomic, and 1 dog received adjuvant radiation therapy. Fourteen of the 34 (41.2%) surgically treated dogs developed evidence of local recurrence, but there was no difference in local recurrence when comparing dogs categorized as curative intent versus cytoreductive surgery. The median overall survival time was 238 days. On multivariable analysis, treatment approach was associated with survival with surgical excision (vs palliative treatment) and adjuvant chemotherapy following surgery being protective against death. A diagnosis of hemangiosarcoma was associated with a greater hazard of death., Clinical Relevance: This study demonstrates a substantially greater survival time than previously published and suggests a survival benefit from surgical excision and adjuvant chemotherapy.

Background: The most common haemostatic abnormality in dogs with cancer is hypercoagulability. A transient hypercoagulability has been documented in people with hepatocellular carcinoma (HCC) that resolves within weeks following hepatic tumour resection., Objective: The objective was to compare the haemostatic status of dogs with liver tumours and healthy control dogs, by comparing coagulation and thromboelastography (TEG) measurements at three time points., Methods: Liver tumour and healthy control dogs receiving surgery for liver lobectomy and ovariohysterectomy, respectively, were prospectively enrolled. All dogs had blood collected at three time points: pre-operative, 24 h post-operative and ~2 weeks post-operative. Haematological and haemostatic values were compared across time points in each group using repeated measures ANOVA tests., Results: Ten and eight dogs were enrolled for the liver and control groups, respectively. Platelet count was significantly higher in the liver group than the control group at all time points, but within the normal range (pre-operative: 438.7 vs. 300.9 × 10 9 /L, p = .0078; 24 h post-operative: 416.2 vs. 283.9 × 10 9 /L, p = .0123; 10-14 days post-operative: 524.6 vs. 317.3 × 10 9 /L, p = .0072). The measure of the overall coagulant state (G-value) was significantly increased for the liver group compared to the control group at all time points (pre-operative: 15.6 vs. 8.6 d/sc, p = .0003; 24 h post-operative: 18.3 vs. 11.2 d/sc, p = .039; 10-14 days post-operative: 15.1 vs. 9.6 d/sc, p = .015)., Conclusion: The liver group was hypercoagulable based on elevated G-values at all time points compared to the control group. This hypercoagulability was attributed to the effect of hepatic tumours alone, and not secondary to surgery and anaesthesia., (© 2023 The Authors. Veterinary and Comparative Oncology published by John Wiley & Sons Ltd.)

Adrenalectomies for canine adrenal tumours are associated with peri-operative morbidity and mortality. Objectives of this study included assessing the prognostic value of tumour- or surgery-related variables in predicting peri-operative mortality and overall survival in dogs undergoing adrenalectomies for primary adrenal tumours as well as pre-treatment with phenoxybenzamine on survival to discharge with pheochromocytomas specifically. A multi-institutional retrospective cohort study was performed across nine institutions. Electronic medical record searches identified 302 dogs which met the inclusion criteria. Data collected included dog-related, tumour-related, treatment-related, surgery-related, and outcome variables. Univariate and multivariable logistic regression and cox proportional hazards models were used to identify variables associated with death prior to discharge and tumour-related survival. Overall, 87% of dogs survived to discharge with a tumour-related survival time of 3.96 years. Post-operative complications were reported in 25%. Increased surgical time (p = 0.002) and pre-surgical medical treatment other than phenoxybenzamine (p = 0.024) were significantly associated with increased peri-operative mortality while ureteronephrectomy (p = 0.021), post-operative pancreatitis (p = 0.025), and post-operative aspiration pneumonia (p < 0.001) were significantly associated with decreased overall survival. Phenoxybenzamine pretreatment had no effect on peri-operative mortality. Thirty-seven of 45 (82%) dogs with pheochromocytomas not pretreated survived to discharge, and 50 of 59 (85%) dogs with pheochromocytomas pretreated with phenoxybenzamine survived to discharge (p = 0.730). This study provides information on risk factors for death prior to discharge and tumour-related survival that may help guide clinical management and owner expectations. In addition, the study findings challenge the previously reported benefit of phenoxybenzamine for pretreatment of dogs undergoing adrenalectomies for pheochromocytomas., (© 2023 The Authors. Veterinary and Comparative Oncology published by John Wiley & Sons Ltd.)

Objective: To conduct a retrospective multi-institutional study reporting short- and long-term outcomes of adrenalectomy in patients presenting with acute hemorrhage secondary to spontaneous adrenal rupture., Animals: 59 dogs and 3 cats., Methods: Medical records of dogs and cats undergoing adrenalectomy between 2000 and 2021 for ruptured adrenal masses were reviewed. Data collected included clinical presentation, preoperative diagnostics, surgical report, anesthesia and hospitalization findings, histopathology, adjuvant treatments, and long-term outcome (recurrence, metastasis, and survival)., Results: Median time from hospital admission to surgery was 3 days, with 34% of surgeries being performed emergently (within 1 day of presentation). Need for intraoperative blood transfusion was significantly associated with emergent surgery and presence of active intraoperative hemorrhage. The short-term (≤ 14 days) complication and mortality rates were 42% and 21%, respectively. Negative prognostic factors for short-term survival included emergent surgery, intraoperative hypotension, and performing additional surgical procedures. Diagnoses included adrenocortical neoplasia (malignant [41%], benign [12%], and undetermined [5%]), pheochromocytoma (38%), a single case of adrenal fibrosis and hemorrhage (2%), and a single case of hemangiosarcoma (2%). Local recurrence and metastasis of adrenocortical carcinoma were confirmed in 1 and 3 cases, respectively. Overall median survival time was 574 days and 900 days when short-term mortality was censored. No significant relationship was found between histopathological diagnosis and survival., Clinical Relevance: Adrenalectomy for ruptured adrenal gland masses was associated with similar short- and long-term outcomes as compared with previously reported nonruptured cases. If hemodynamic stability can be achieved, delaying surgery and limiting additional procedures appear indicated to optimize short-term survival.

Objective: To compare the success rates for urethral catheterization in clinical patients using the traditional and 2-catheter techniques when placed by personnel of all experience levels., Animals: 38 female cats and dogs weighing less than 10 kg were prospectively enrolled., Methods: Enrolled animals were randomized to have a urethral catheter placed by the traditional technique or the 2-catheter method under sedation or general anesthesia. Any qualified hospital personnel of any experience level were allowed to place the catheter. If after 5 minutes the animal was not successfully catheterized, the alternate method was performed. The previous experience of the catheter placer, animal signalment, animal condition that necessitated catheter placement, time to successful placement, and which technique was successful was recorded., Results: The 2-catheter technique was more successful than the traditional method (60.5% and 34.2%, respectively) for urethral catheterization when used by a variety of hospital personnel. The 2-catheter technique was successful in 63.3% of dogs and 66.6% of cats, while the traditional method was successful in 36.6% of dogs and 33.3% of cats. Eight of 9 (88.9%) novice catheter placers that placed their first urinary catheter in this study succeeded with the 2-catheter technique and only 1 was successful with the traditional method., Clinical Relevance: The 2-catheter technique has a higher rate of success for placement of female urinary catheters in small patients that are unable to have concurrent digital palpation. This technique may also be helpful in the inexperienced catheter placer population to aid in guidance into the urethral papilla.

Objective: To report the short-term and long-term outcomes of dogs that underwent the modified closed and traditional closed anal sacculectomy procedures for the treatment of anal sac neoplasia., Animals: 90 client-owned dogs., Methods: The medical records of 2 tertiary referral hospitals were reviewed to identify dogs that underwent anal sacculectomy for treatment of anal sac neoplasia between January 2016 and December 2020. Data collected included signalment and preoperative diagnostic findings. The occurrence of intraoperative and postoperative complications, short-term outcomes, and long-term outcomes were also collected. Descriptive statistics were calculated to summarize dog signalment information, and recurrence, metastasis, and survival proportions were compared between techniques using Fisher exact tests., Results: 35 and 55 dogs, respectively, underwent the modified or traditional closed anal sacculectomy procedure. Minor postoperative complications that resolved with minimal intervention occurred in 5 of 35 (14.3%) modified approach dogs and 12 of 55 (21.8%) traditional approach dogs. Tumor recurrence was confirmed in 8 of 35 (22.9%) modified and 8 of 55 (26.4%) traditional approach dogs and was suspected in 3 of 35 (8.6%) and 6 of 55 (13.2%; P = .68), respectively. Confirmed metastatic disease was identified in 8 of 35 (22.9%) and 14 of 53 (26.4%) modified and traditional approach dogs, respectively, and was suspected in 4 of 35 (11.4%) and 7 of 53 (13.2%). Sixty-three (70%) dogs survived to study conclusion., Clinical Relevance: No benefits in complication rate or local recurrence were identified in dogs following the modified approach as opposed to the traditional closed anal sacculectomy technique.

Objective: To provide a video tutorial on how to perform an alternate method for urethral catheterization, the 2-catheter technique., Animals: Small female cats and dogs that are too small for concurrent digital palpation (generally < 10 kg)., Methods: A larger red rubber catheter (18 Fr in dogs, and 10 Fr in cats) is gently fed into the vaginal canal and reflected dorsally, then a smaller urethral catheter can be introduced ventrally, angling downwards at a 45° angle, into the urethral orifice for urinary catheterization., Results: The 2-catheter method is a useful alternative in petite female cats and dogs to improve rates of successful catheterization., Clinical Relevance: The inability to perform concurrent digital palpation in petite female dogs and cats can make urinary catheterization more challenging due to the inability to palpate locoregional anatomic landmarks and without the added manipulation of the catheter tip during placement. Using a second, larger catheter to occlude the vaginal canal similarly to how a finger would during digital palpation can aid in successful catheterization in this challenging subset of veterinary patients.

Objective: To describe the management of extensive hepatectomy in 2 dogs., Animals: A 10-year-old female intact mixed-breed dog (case 1) and an 11-year-old male castrated mixed-breed dog (case 2) were presented for surgical evaluation following diagnosis of a hepatic mass., Clinical Presentation, Progression, and Procedures: 16 months before presentation, case 1 had undergone a left lateral liver lobectomy, which resulted in an incomplete resection of hepatocellular carcinoma. Both dogs underwent surgical excision of the liver mass., Treatment and Outcome: In case 1, surgery consisted of the removal of the remaining left medial lobe, as well as the central division. Case 2 received a complete left and central division hepatectomy. Histopathology confirmed a diagnosis of hepatocellular carcinoma in both dogs. Liver enzyme resolution and lack of tumor recurrence were confirmed with chemistry panel and abdominal ultrasonography in both dogs., Clinical Relevance: This case report describes, for the first time, the clinical management and outcome of extensive hepatectomy in 2 dogs. We propose that extensive hepatectomy, staged or synchronous, is possible in a clinical setting.

Objective: To evaluate hearing loss in Cavalier King Charles Spaniels (CKCS), breed-specific brainstem auditory-evoked response (BAER) testing parameters are needed to help assess the Chiari-like malformation (CM) grade. The purpose of this study was to establish breed-specific BAER data and to determine if BAER indexes differed based on the CM grade. We hypothesized that there would be latency differences based on the CM grade., Animals: 20 CKCS without apparent hearing abnormalities as assessed by the owners., Procedures: Under general anesthesia, CKCS underwent a CT scan (to assess the middle ear), BAER testing, and MRI (to assess the grade of CM)., Results: No CKCS had CM0. Nine (45%) CKCS had CM1; 11 (55%) had CM2. All had at least 1 morphologic abnormality in waveforms. Absolute and interpeak latencies were reported for all CKCS and compared between CM grades. The median threshold for CKCS with CM1 was 39 and for CM2 was 46. Absolute latencies for CKCS with CM2 were consistently longer than those for CKCS with CM1 with the exception of waves II and V at 33 dB. Significant differences were found for wave V at 102 dB ( P = .04) and wave II at 74 dB (P = .008). Interpeak latency comparisons were inconsistent between CM1 and CM2., Clinical Relevance: Breed-specific BAER data for CKCS with CM1 and CM2 were established. The results suggest that CM impacts BAER latency results, but the influence of the malformation is not always statistically significant or predictable.

Objective: To investigate the CT features of cavitary pulmonary lesions and determine their utility to differentiate malignant from benign lesions., Animals: This retrospective study included cases from 5 veterinary medical centers between January 1 2010, and December 31, 2020. Inclusion criteria included having a gas-filled cavitary pulmonary lesion on thoracic CT and definitive diagnosis by either cytology or histopathology. Forty-two animals (27 dogs and 15 cats) were included in this study., Procedures: Medical records systems/imaging databases were searched, and cases meeting inclusion criteria were selected. The CT studies were interpreted by a third-year radiology resident, and findings were reviewed by a board-certified veterinary radiologist., Results: 7 of the 13 lesion characteristics investigated were not statistically associated with the final diagnosis of the lesion, whereas 6 were statistically associated. Those that were associated included the presence of intralesional contrast enhancement, type of intralesional contrast enhancement (heterogenous and homogenous analyzed separately), presence of additional nodules, wall thickness of the lesion at its thickest point, and wall thickness at the thinnest point., Clinical Relevance: Results from the present study showed that thoracic CT imaging of cavitary pulmonary lesions can be used to further refine the list of differential diagnoses. Based on this data set, in lesions that have heterogenous contrast enhancement, additional pulmonary nodules, and wall thickness > 40 mm at their thickest point, it would be reasonable to consider malignant neoplastic disease higher on the list of differentials than other causes.

Septic peritonitis is a life-threatening disease that can be caused by neoplasia, among other disease processes. There is no veterinary literature directly evaluating the outcome of patients with septic peritonitis caused by neoplasia. The objective of this study was to evaluate for differences in survival to discharge and complication rates between septic peritonitis caused by neoplastic and nonneoplastic disease in canine patients. A single-institution retrospective cross-sectional cohort study was performed, identifying dogs that were treated surgically for septic peritonitis between January 1, 2010, and November 1, 2020. A total of 86 patients were included, 12 with a neoplastic cause for septic peritonitis and 74 with another cause. The most common neoplastic lesions associated with septic peritonitis were gastrointestinal lymphoma and hepatocellular adenoma. Presence of neoplasia was not a significant factor for development of intraoperative or immediate postoperative complications, nor did it decrease chances of survival to discharge (P < .09). The diagnosis of a primary, localized, neoplastic lesion alone should not deter clinicians and owners from pursuing treatment for septic peritonitis., (© 2023 by American Animal Hospital Association.)

Currently, intraoperative tumour margin imaging is not routinely utilized in veterinary medicine. Optical coherence tomography (OCT) allows for real-time assessment of tissue morphology of 1-2 mm depth. The aims of this study were (1) to compare the histologic and OCT features of excised canine skin and subcutaneous specimens, and (2) to determine the diagnostic accuracy of OCT for surgical margin evaluation. The authors hypothesized that OCT imaging would correlate well with histopathology and that OCT would be sensitive for detection of incomplete margins. Eighty dogs were prospectively enrolled. Tumours were excised, and the surgical margins were imaged using a spectral domain OCT system. The tumour type and completeness of excision were determined by histopathology. Nine blinded observers received training in OCT image interpretation and were then given a set of OCT images and videos. The observers assigned each image/video a grade from 1 (no tumour) to 4 (tumour) and the results were compared to histopathology. The overall median sensitivity and specificity of OCT imaging for detection of incomplete margins were 86.7% and 84.6%, respectively. A potential limitation is that observers had varied experience with OCT image interpretation, ranging from no prior experience to participating in a previous OCT project. OCT is sensitive for detection of incomplete margins and could be a promising real-time surgical margin imaging modality. Further study is needed to evaluate intraoperative applications of OCT and its impact on tumour recurrence and long-term outcome., (© 2022 The Authors. Veterinary and Comparative Oncology published by John Wiley & Sons Ltd.)

Apocrine gland anal sac adenocarcinoma (AGASAC) is a relatively uncommon tumor in the dog and comprises approximately 17% of perianal malignancies; however, it is one of the most common causes of paraneoplastic hypercalcemia. Clinical signs in affected dogs most commonly are associated with mechanical obstruction caused by the primary tumor or enlarged regional metastatic lymph nodes and the effects of paraneoplastic hypercalcemia when present. Surgical excision of the primary tumor and metastasectomy of affected locoregional lymph nodes is the preferred initial treatment option for most dogs, although radiation therapy and adjuvant chemotherapy are commonly incorporated into multi-modality treatment plans. A significant role for the use of adjuvant chemotherapy has not been clearly demonstrated. Prolonged survival times are possible, especially for dogs with smaller primary tumors and for dogs that undergo further treatments for recurrent disease. In this article, we review the clinical signs, diagnosis, staging, treatment, and prognosis of AGASAC in the dog., (Copyright © 2022. Published by Elsevier Inc.)

Local recurrence after surgical excision of canine massive hepatocellular carcinoma (HCC) has been poorly studied in veterinary medicine with scant information published regarding risk factors for and outcome following recurrence. The aim of this case-control study was to describe the time to recurrence, evaluate potential risk factors for recurrence, and report the outcome in dogs with massive HCC. Medical records for 75 dogs who developed recurrence and 113 dogs who did not develop recurrence were reviewed. Statistical analyses were performed to determine risk factors for recurrence as well as the median time to develop recurrence and overall survival time (OS). None of the risk factors evaluated were significant for the development of recurrence. The median time to develop recurrence was 367 days (range 32-2096 days). There was no significant difference in median OS for dogs who developed recurrence vs. those who did not (851 vs. 970 days). For dogs with recurrent HCC, treatment at recurrence trended toward prolonged OS but was not significantly different from dogs not undergoing treatment at recurrence. There was no significant difference in median OS for dogs with histologically complete vs. incomplete tumour excision (990 vs. 903 days). Although specific risk factors for recurrence were not identified, elevations in liver values were noted in patients with recurrent disease and could act as a noninvasive surveillance tool. Recurrence was noted earlier in dogs who had routine post-operative surveillance (228 vs. 367 days). Routine surveillance for recurrence is recommended especially in dogs where further intervention is possible and should extend beyond 1 year. Patients with massive HCC have a good long-term prognosis regardless of incomplete excision, pulmonary metastasis, or recurrent local disease., (© 2022 The Authors. Veterinary and Comparative Oncology published by John Wiley & Sons Ltd.)

Objective: To report intraoperative and immediate postoperative complications associated with removal of metastatic iliosacral lymph nodes in dogs with apocrine gland anal sac adenocarcinoma., Animals: There were 136 client-owned dogs in the study., Procedure: Retrospective multi-institutional study. The database of collaborating institutions was searched for dogs with metastatic apocrine gland anal sac adenocarcinoma that underwent lymphadenectomy for removal of one or more iliosacral lymph nodes. Information of signalment, hematological abnormalities, abdominal computed tomography or ultrasound findings, number and size of enlarged lymph nodes, intraoperative and postoperative complications, treatment and outcome were collected., Results: The overall complication rate associated with metastatic iliosacral lymphadenectomy was 26.1%. The only intraoperative complication recorded was hemorrhage and was reported in 24 (17.6%) surgeries, 11 (45.8%) of which received a blood transfusion. Postoperative complications were reported in 10.4% of surgeries, and included edema formation ( n = 4, 2.6%), unilateral or bilateral paraparesis ( n = 4, 2.6%), hypotension ( n = 3, 2.0%), surgical site infection ( n = 2, 1.3%), abdominal incision dehiscence ( n = 1, 0.6%), urinary incontinence ( n = 1, 0.6%), and death ( n = 1, 0.6%). The size of the iliosacral lymph nodes was significantly associated with a greater risk of complications, hemorrhage, and the need of transfusion during lymphadenectomy for metastatic apocrine gland anal sac adenocarcinoma., Conclusion: Complications associated with iliosacral lymphadenectomy for metastatic apocrine gland anal sac adenocarcinoma are relatively common and mostly relate to hemorrhage. These complications are significantly associated with the size of the extirpated metastatic lymph nodes., Clinical Relevance: This retrospective study provides information for the clinician regarding the potential surgical complications for extirpation of metastatic iliosacral lymph nodes. These complications, although not common, can be severe and should be discussed with owners before surgery., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Abdominal ultrasound with spleen and liver cytology is part of routine staging for canine mast cell tumors (MCTs). However, such tests are associated with increased morbidity and cost. Therefore, the objectives of this study were to determine if spleen cytology was predictive of liver cytology in canine MCTs and if any patient or tumor variables were associated with spleen and/or liver metastasis. Records of dogs with MCTs and cytology of spleen and liver were reviewed. Two hundred five patients were included. Overall, 22 (10.7%) patients had metastasis, with 21 (10.2%) and 13 (6.3%) having spleen and liver metastasis, respectively, and 12 (5.9%) having both. For patients with a positive (or negative) spleen cytology, the odds ratio of having a positive (or negative) liver cytology was 233.49. However, a negative spleen cytology had a higher predictive value (0.99) than a positive cytology (0.54). Finally, the presence of local and systemic signs and tumor size were associated with spleen, liver, and/or spleen or liver metastasis. These results suggest that spleen cytology is predictive of liver cytology in staging of canine MCTs, and increasing tumor size and presence of local or systemic signs are associated with an increased risk of visceral metastasis., (© 2022 by American Animal Hospital Association.)

Sertoli cell tumours are one of the most common canine testicular neoplasia. These tumours are significantly more likely to arise in cryptorchid dogs and are often functional, oestrogen-secreting tumours which can lead to fatal myelotoxicity. The goal of this study was to describe the outcome of dogs with oestrogen-induced bone marrow suppression secondary to Sertoli cell tumours in seven client-owned dogs. Medical records from April 1, 2011 through April 1, 2021 were reviewed to identify dogs that underwent surgical management of a Sertoli cell tumour with documented bone marrow suppression. Overall, 5/7 dogs required transfusion of blood products peri-operatively. Cases 1 and 6 received a transfusion of packed red blood cells (RBC) prior to surgery and case 5 required a transfusion of whole blood. Case 1 also required a transfusion of platelets before surgery. Post-operatively, cases 1 and 2 received packed RBC's and case 6 received two transfusions of whole blood. Case 3 required transfusions of both fresh frozen plasma and platelets post-operatively. All dogs survived to discharge and 6/7 dogs had documented improvement in haematopoietic values. Two dogs remained chronically thrombocytopenic. The median hospital stay was 4 days. One dog died within 4 weeks of surgery from worsening pancytopenia. Survival for greater than 1 year was documented in 4/7 dogs, and one dog was lost to follow-up 4 months post-operatively. One dog remained severely pancytopenic 4 weeks post-operatively and received oral lithium treatment. Improvements in all blood cell lines were observed within the 4 weeks and resolution of pancytopenia within 6 weeks. Historically, the prognosis for dogs with bone marrow suppression secondary to Sertoli cell tumours was guarded to poor. This report documented improved outcomes for dogs that underwent surgery, including one dog that received lithium chloride as treatment for Sertoli cell tumour-induced bone marrow suppression., (© 2021 John Wiley & Sons Ltd.)

While the majority of canine osteosarcomas (OSA) arise from the medullary cavity, a subset arises from the surface of bone. In humans, surface OSA often has a more indolent disease course with better outcomes than medullary OSA. The aim of this retrospective case series was to evaluate the clinical outcome and potential prognostic factors of dogs with surface OSA. Medical records from 11 dogs previously diagnosed with surface OSA were included. Histopathology of cases was evaluated during case review by two veterinary anatomic pathologists. Median progression free interval (PFI) and overall median survival time (OST) were estimated using Kaplan-Meier methods. Intergroup comparisons were performed using log-rank tests. Six dogs were diagnosed with periosteal OSA, 4 dogs with parosteal OSA, and one dog with an unclassified surface OSA. Two dogs were found to have metastatic disease at the time of diagnosis and four developed metastatic lesions after treatment. The median PFI and median OST for all dogs with surface OSA was 425 and 555 days, respectively. The 6 dogs diagnosed with periosteal OSA had a median PFI of 461 days and median OST of 555 days, while the 4 dogs with parosteal OSA had a PFI of 350 days and the OST could not be calculated. Multiple prognostic factors (surgery, systemic adjunctive therapy, elevated alkaline phosphatase at diagnosis, appendicular vs axial location, mitotic count, and tumour grade) were evaluated and none were prognostic for PFI or OST. Dogs with surface OSA appear to have prolonged PFI and OST, consistent with humans with surface OSA., (© 2021 John Wiley & Sons Ltd.)

Background: While rare, multiple individual case reports have described mixed thyroid tumours in dogs containing both epithelial and mesenchymal neoplastic components., Objectives: In this retrospective case series, we describe the clinical presentation, treatment and outcome of 14 dogs of canine thyroid tumours with concurrent mesenchymal and epithelial neoplastic populations., Methods: Fourteen cases were retrospectively abstracted from nine institutions. Histopathologic samples and reports were collected from 10/14 dogs and reviewed by a single board-certified anatomic pathologist., Results: All 14 dogs had curative-intent surgery to remove the thyroid neoplasm. The most common surgery performed was a unilateral thyroidectomy (10/14 dogs). Postoperatively, systemic therapy was administered in eight dogs. Six dogs developed local recurrence with a median time to loco-regional recurrence of 53 days. Ten dogs developed metastatic disease with the most common metastatic site being the lungs (6/10 dogs), with a median time to metastasis of 93 days. Ten dogs were euthanised due to locoregional or distant progression of their mixed thyroid neoplasm. The overall median survival time was 156 days (95%CI: 49-244). The median survival time for dogs treated with adjuvant therapy was 189 days (95%CI: 24-244), whereas dogs without adjuvant therapy had a median survival time of 156 days (95%CI: 35-upper limit could not be calculated; p = 0.62)., Conclusion: The thyroid tumours with both mesenchymal and epithelial components in this small sample set were associated with a poor prognosis after surgical excision with or without adjunctive therapy., (© 2022 The Authors. Veterinary Medicine and Science published by John Wiley & Sons Ltd.)

Objective: To describe a modified approach to closed anal sacculectomy and report the short-term outcomes of dogs that underwent the procedure for treatment of neoplasia., Animals: 16 client-owned dogs., Procedures: Medical records of 1 referral hospital were reviewed to identify dogs that underwent modified closed anal sacculectomy for treatment of anal sac neoplasia between January 2018 and September 2020. Data collected included signalment, examination and diagnostic imaging findings, surgical details, intraoperative and postoperative complications, cytologic and histologic findings, adjuvant treatments, duration of follow-up, and short-term outcome., Results: 15 dogs had apocrine gland anal sac adenocarcinoma, and 1 had a collision tumor. No dogs had intraoperative complications; 1 dog had a minor postoperative complication (paraparesis) that resolved. The median duration of postoperative follow-up was 286 days (range, 67 to 777 days). One dog had confirmed local disease recurrence 290 days after surgery, and 1 had suspected local disease recurrence 203 days after surgery and was euthanized because of systemic disease progression., Conclusions and Clinical Relevance: The modified closed anal sacculectomy was well tolerated in this sample of dogs, with minimal short-term complications. This study provided evidence to justify evaluation of the procedure in a larger number of dogs and assessment of the effects of procedural modifications on postoperative complication rates and time to local recurrence.

Optical coherence tomography (OCT) is an optical imaging modality that has been investigated for real-time surgical margin evaluation in human breast cancer patients. Previous veterinary OCT studies have been limited to surgical margin imaging for soft tissue sarcoma (STS) tumours. To the authors knowledge, OCT has never been used to characterize or evaluate other types of neoplasia in dogs. The goal of this study was to characterize the OCT imaging appearance of apocrine gland anal sac adenocarcinoma (AGASACA) in excised ex vivo specimens from five client-owned dogs. All excised tissue surgical margins were imaged using a clinical spectral domain OCT system and two to four areas suspicious for incomplete surgical margins were selected. These areas were inked and sections were trimmed for histopathology. This enabled OCT imaging from each area of interest to be compared with corresponding H&E stained histology imaging from the same location. OCT was able to identify the presence of AGASACA at or within 1 mm of the surgical margin in all areas of interest. AGASACA, similar to the previously described canine STS, generated a dense, highly scattering image without any specific textural architecture. This study was able to validate the ability of OCT to accurately identify another type of tumour presence at or close to the surgical margin in the dog. Further study is needed to assess OCT accuracy at identifying other tumour types in dogs to understand its potential clinical applications., (© 2020 John Wiley & Sons Ltd.)

Soft tissue sarcoma (STS) is a locally aggressive and infiltrative tumour in dogs. Surgical resection is the treatment of choice for local tumour control. Currently, post-operative pathology is performed for surgical margin assessment. Spectral-domain optical coherence tomography (OCT) has recently been evaluated for its value for surgical margin assessment in some tumour types in dogs. The purpose of this study was to develop an automatic diagnosis system that can assist clinicians in real-time for OCT image interpretation of tissues at surgical margins. We utilized a ResNet-50 network to classify healthy and cancerous tissues. A patch-based approach was adopted to achieve accurate classification with limited training data (80 cancer images, 80 normal images) and the validation set (20 cancer images, 20 normal images). The proposed method achieved an average accuracy of 97.1% with an excellent sensitivity of 94.3% on the validation set; the quadratic weighted κ was 0.94 for the STS diagnosis. In an independent test data set of 20 OCT images (10 cancer images, 10 normal images), the proposed method correctly differentiated all the STS images. Furthermore, we proposed a diagnostic curve, which could be evaluated in real-time to assist clinicians in detecting the specific location of a lesion. In short, the proposed method is accurate, operates in real-time and is non-invasive, which could be helpful for future surgical guidance., (© 2021 John Wiley & Sons Ltd.)

Optical coherence tomography (OCT) is an imaging modality that provides real-time visualization of tissue microstructure. The goals of this study were to assess OCT image tissue depths (TD) with image processing, and other objective characteristics of tissue types at surgical margins in canine soft tissue sarcoma (STS). In this study, a single observer reviewed 248 images of four tissue types (sarcoma, skeletal muscle, adipose and fascia) collected from 24 dogs with STS. The observer evaluated for tissue characteristics and measured TDs utilizing ImageJ software. Images were evaluated in normal, Threshold and Binary conditions. Measurements were repeated 1 week later to evaluate for intra-observer variability. In all three image processing conditions, the order of TD from greatest to least light penetration was adipose, skeletal muscle, fascia and sarcoma tissue. Neovascularization was observed in 53.2% sarcoma, and lines of fascia surrounding muscle bundles was present in 93.5% of skeletal muscle images. These observed differences between tissue types in OCT images can be utilized to improve observer evaluation, aid in development of algorithms, and improve the accuracy of surgical margin assessment., (© 2021 John Wiley & Sons Ltd.)

Histopathologic surgical margin assessment in veterinary patients is an imprecise science with assessment limited to a small proportion of the surgical margin due to time and finances. Incomplete excision of canine mast cell tumours (MCTs) alters treatment recommendations and prognosis. Optical coherence tomography (OCT) is a novel imaging modality that has been reported in a single veterinary study for surgical margin assessment. Twenty-five dogs with 34 MCTs were enrolled in a prospective pilot-study to assess the imaging characteristics of canine MCTs with OCT and to evaluate the feasibility and utility of OCT-guided histopathology. All dogs underwent routine surgical excision of MCTs. OCT imaging was used to assess the entire surgical margin prior to placement in formalin. Either normal areas or areas suspected of incomplete MCT excision were inked. Standard histopathologic sectioning and tangential sectioning of inked areas were performed and compared to OCT results. OCT identified MCT near the surgical margin in 10 of 26 specimens (38.4%). Four specimens suspicious for incomplete margins on OCT had incomplete MCT excision that was missed on standard histopathologic sectioning. Six specimens had OCT-guided sections taken as suspicious, which did not show MCT on histopathology. OCT-guided pathology sections were able to detect incompletely excised MCT near the surgical margin with a sensitivity of 90% and specificity of 56.2% in this preliminary study. OCT imaging shows promise for guiding pathologists to areas of interest to improve the diagnostic accuracy of surgical margin assessment in excised canine MCTs., (© 2020 John Wiley & Sons Ltd.)

Optical coherence tomography (OCT) uses near-infrared light waves to generate real-time, high-resolution images on the microscopic scale similar to low power histopathology. Previous studies have demonstrated the use of OCT for real-time surgical margin assessment for human breast cancer. The use of OCT for canine mammary tumours (CMT) could allow intra-operative visualisation of residual tumour at the surgical margins. The purpose of this study was to assess OCT imaging for the detection of incomplete tumour resection following CMT surgery. We hypothesized that the OCT images would have comparable features to histopathological images of tissues at the surgical margins of CMT resections along with a high sensitivity of OCT detection of incomplete surgical excision of CMT. Thirty surgical specimens were obtained from nineteen client-owned dogs undergoing surgical resection of CMT. OCT image appearance and characteristics of adipose tissue, skin, mammary tissue and mammary tumour at the surgical margins were distinct and different. The OCT images of normal and abnormal tissues at the surgical margins were utilized to develop a dataset of OCT images for observer evaluation. The sensitivity and specificity for ex vivo images were 83.3% and 82.0% (observer 1) and 70.0% and 67.9% (observer 2). The sensitivity and specificity for in vivo images were 70.0% and 89.3% (observer 1) and 76.7% and 67.9% (observer 2). These results indicate a potential use of OCT for surgical margin assessment for CMT to optimize surgical intervention and clinical outcomes. Improved training and experience of observers may improve sensitivity and specificity., (© 2020 John Wiley & Sons Ltd.)

Excellent outcomes have been reported following thyroidectomy for thyroid carcinoma in dogs, but outcomes for thyroid carcinomas with gross vascular invasion are poorly described. This study describes the clinical outcomes and complications in dogs with thyroid carcinomas with gross vascular invasion undergoing thyroidectomy. Medical records of dogs that underwent thyroidectomy between January 1st 2010 and December 31st 2019 were reviewed at 10 hospitals. Signalment, diagnostic data, primary and adjuvant treatments performed, and outcome were abstracted. Survival was calculated using Kaplan-Meier analysis. Multiple logistic regression was used to identify variables associated with disease-specific survival. Seventy-three dogs were included, of which 58 underwent unilateral thyroidectomy and 15 underwent bilateral thyroidectomy. Complications were reported in five dogs (three major, two minor; 6.8%) intraoperatively and 12 dogs (two major leading to death, 10 minor; 16.4%) postoperatively. Seven (9.6%) dogs developed locoregional recurrence at a median of 238 days postoperatively (range: 15-730 days). Distant metastasis was suspected or confirmed in nine dogs (12.3%) at a median of 375 days postoperatively (range: 50-890 days). Twenty-seven dogs (37%) received adjuvant therapy (chemotherapy: n = 21; radiotherapy: n = 6). Thirty-nine dogs were euthanized or died, with 20 deaths related to disease (n = 10) or of unknown cause (n = 10), 19 due to unrelated causes, and nine lost to follow-up. Median overall and disease-specific survival were 621 days and not reached respectively. One-year disease-specific survival rate was 82.5%. No variables were associated with disease-specific survival in our dataset. Surgery may be considered for loco-regional therapy in dogs with thyroid carcinoma with gross vascular invasion., (© 2021 John Wiley & Sons Ltd.)

Objective: To provide updated information on the distribution of histopathologic types of primary pulmonary neoplasia in dogs and evaluate the effect of postoperative adjuvant chemotherapy in dogs with pulmonary carcinoma., Animals: 340 dogs., Procedures: Medical records of dogs that underwent lung lobectomy for removal of a primary pulmonary mass were reviewed, and histopathologic type of lesions was determined. The canine lung carcinoma stage classification system was used to determine clinical stage for dogs with pulmonary carcinoma., Results: Pulmonary carcinoma was the most frequently encountered tumor type (296/340 [87.1%]), followed by sarcoma (26 [7.6%]), adenoma (11 [3.2%]), and pulmonary neuroendocrine tumor (5 [1.5%]); there was also 1 plasmacytoma and 1 carcinosarcoma. Twenty (5.9%) sarcomas were classified as primary pulmonary histiocytic sarcoma. There was a significant difference in median survival time between dogs with pulmonary carcinomas (399 days), dogs with histiocytic sarcomas (300 days), and dogs with neuroendocrine tumors (498 days). When dogs with pulmonary carcinomas were grouped on the basis of clinical stage, there were no significant differences in median survival time between dogs that did and did not receive adjuvant chemotherapy., Clinical Relevance: Results indicated that pulmonary carcinoma is the most common cause of primary pulmonary neoplasia in dogs; however, nonepithelial tumors can occur. Survival times were significantly different between dogs with pulmonary carcinoma, histiocytic sarcoma, and neuroendocrine tumor, emphasizing the importance of recognizing the relative incidence of these various histologic diagnoses. The therapeutic effect of adjuvant chemotherapy in dogs with pulmonary carcinoma remains unclear and warrants further investigation.

This case report details a previously undescribed malignancy of the tendon sheath in a golden retriever. This dog originally presented with lameness of the left forelimb, at which point radiographs revealed a monostotic, lytic lesion of the distal radius with overlying soft-tissue swelling. A fine-needle aspirate was performed, and cytology was compatible with a sarcoma, with the primary differential being an osteosarcoma. After amputation, the leg was submitted for histopathology, which revealed inconsistencies with a typical osteosarcoma lesion, including lack of osteoid deposition. Second opinion histopathology showed a fibrosarcoma that appeared to have originated in the tendon sheath of an extensor tendon and then secondarily invaded the radius. At the time of publication, ∼17 mo after amputation, the dog continues to do well without any evidence of recurrent or metastatic disease., (© 2021 by American Animal Hospital Association.)

Objective: Determine the agreement between nonrecordable continuous ECG and Holter monitoring at estimating arrhythmia severity in hospitalized dogs., Design: Prospective, observational, cohort study., Setting: University teaching hospital., Animals: Ten dogs., Interventions: Heart rates and rhythms were simultaneously monitored using nonrecordable cage-side continuous ECG and Holter monitoring. Continuous ECG was assessed by ICU technicians for 1 min every hour, and heart rate and rhythm were recorded. A modified Lown score was used to grade arrhythmia severity (Grade 0 = sinus; Grade 1 = single ventricular premature complexes; Grade 2 = accelerated idioventricular; Grade 3 = bigeminy/trigeminy; Grade 4 = couplets/triplets; Grade 5 = ventricular tachycardia or R on T). Holter data were analyzed by a board-certified cardiologist, and arrhythmia grade was assigned to the same 1-min time period reported by ICU technicians. A 1-h arrhythmia grade was also determined from Holter data and was reported as the highest grade noted during the previous hour. Cohen's weighted kappa analysis was used to compare the agreement of ICU and Holter grade during the same 1-min time period and to compare 1-min Holter grade with the prior hour Holter grade., Measurements and Main Results: Weak agreement was found between ICU-reported grade and Holter grade (κ = 0.40), as well as weak agreement between 1-min Holter grade and hour Holter grade (κ = 0.39)., Conclusions: Results of this study indicate that arrhythmia grades assessed by ICU technicians and hourly 1-min observations weakly agree with recordable Holter monitoring in hospitalized dogs with ventricular arrhythmias., (© Veterinary Emergency and Critical Care Society 2021.)

Objective: To provide information about complication rates and the risk factors for complications with mandibulectomy and maxillectomy procedures in dogs., Animals: 459 client-owned dogs that underwent a mandibulectomy or maxillectomy between January 1, 2007, and January 1, 2018., Procedures: Inclusion criteria included a complete medical record that contained an anesthesia record, surgical report, available histopathology results, and results of CBC and serum biochemical analysis before surgery. A minimum follow-up of 90 days after surgery was required., Results: 271 complications occurred in 171 of 459 (37.3%) dogs. Eighteen complications were not given a severity description. Of the remaining 253 complications, most were considered minor (157/253 [62.1%]). Multivariable logistic regression analysis revealed that only increased surgical time had a significant (OR, 1.36; 95% CI, 1.12 to 1.54) association with the occurrence of ≥ 1 complication. For each additional hour of surgery, the odds of complications increased by 36%. Preoperative radiation therapy or chemotherapy increased the odds of incisional dehiscence or oral fistula formation (OR, 3.0; 95% CI, 1.3 to 7.2). Additionally, undergoing maxillectomy, compared with mandibulectomy, increased the odds of incisional dehiscence or oral fistula formation (OR, 1.8; 95% CI, 1.1 to 3.1). Two hundred forty-four of 271 (90.0%) complications occurred in the perioperative period (0 to 3 months after surgery)., Conclusions and Clinical Relevance: Compared with mandibulectomy, performing maxillectomy increased the risk for incisional dehiscence or oral fistula formation. Mandibulectomy and maxillectomy had a moderate risk for a complication.

Cavitary pulmonary lesions can result from the localized breakdown of pulmonary parenchyma or be caused by the expulsion of a necrotic part of a mass. The objectives of this study were to describe the clinical and computed tomographic characteristics for cases of cavitary pulmonary adenocarcinoma and find associations between the features and those identified in human pulmonary cavitary soft tissue lesions. Five cases were identified that had a cavitary pulmonary mass on thoracic computed tomography (CT) and histopathology of the lesions. Three dogs and 2 cats had cavitary pulmonary adenocarcinoma. Common features of CT in these cases included lesions in the caudal lung lobes, lobular and spiculated lesion margins, air bronchograms within the mass, pleural tags, heterogeneous contrast enhancement, and ground glass opacity in the surrounding parenchyma. The findings of this case series suggest there are similarities in the CT characteristics of malignancy in human and animal cavitary pulmonary masses., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Background: Comprehensive reporting of clinical trials is essential to allow the trial reader to evaluate the methodological rigor of the trial and interpret the results. Since publication of the updated Consolidated Standards of Reporting Trials (CONSORT) guidelines for reporting of parallel clinical trials in humans, extensions for reporting of abstracts and crossover trials have been published., Objectives: To describe the types of trials using dogs and cats published from 2015 to 2020 and to evaluate the quality of reporting of a sample of recently published parallel and crossover trials., Animals: None., Methods: A comprehensive search was conducted to identify parallel or crossover design clinical trials using dogs and cats published from January 1, 2015 onwards. Quality of reporting was evaluated on a subset of trials published during 2019. The reporting of items recommended in the CONSORT reporting guidelines for abstracts, parallel trials, and crossover trials was evaluated independently by 2 reviewers using standardized forms created for this study. Disagreements among reviewers were resolved by consensus. Results were tabulated descriptively., Results: The frequency of reporting of trial features varied from low to high. There remain deficiencies in the quality of reporting of key methodological features and information needed to evaluate and interpret trial results., Conclusions and Clinical Importance: There is still a need for authors, peer-reviewers, and editors to follow reporting guidelines such as CONSORT to maximize the value of clinical trials and to increase confidence in the validity of the trial results., (© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

The updated VCOG-CTCAE v2 guidelines contain several important updates and additions since the last update (v1.1) was released in 2011 and published within Veterinary and Comparative Oncology in 2016. As the Veterinary Cooperative Oncology Group (VCOG) is no longer an active entity, the original authors and contributors to the VCOG-CTCAE v1.0 and v1.1 were consulted for input, and additional co-authors sought for expansion and refinement of the adverse event (AE) categories. VCOG-CTCAE v2 includes expanded neurology, cardiac and immunologic AE sections, and the addition of procedural-specific AEs. It is our intent that, through inclusion of additional authors from ACVIM subspecialties and the American College of Veterinary Surgery, that we can more comprehensively capture AEs that are observed during clinical studies conducted across a variety of disease states, clinical scenarios, and body systems. It is also our intent that these updated veterinary CTCAE guidelines will offer improved application and ease of use within veterinary practice in general, as well as within clinical trials that assess new therapeutic strategies for animals with a variety of diseases. Throughout the revision process, we strived to ensure the grading structure for each AE category was reflective of the decision-making process applied to determination of dose-limiting events. As phase I trial decisions are based on these criteria and ultimately determine the maximally tolerated dose, there is impact on standard dosing recommendations for any new drug registration or application. This document should be updated regularly to reflect ongoing application to clinical studies carried out in veterinary patients., (© 2021 The Authors. Veterinary and Comparative Oncology published by John Wiley & Sons Ltd. This article has been contributed to by US Government employees and their work is in the public domain in the USA.)

Purpose: The mTOR pathway has been identified as a key nutrient signaling hub that participates in metastatic progression of high-grade osteosarcoma. Inhibition of mTOR signaling is biologically achievable with sirolimus, and might slow the outgrowth of distant metastases. In this study, pet dogs with appendicular osteosarcoma were leveraged as high-value biologic models for pediatric osteosarcoma, to assess mTOR inhibition as a therapeutic strategy for attenuating metastatic disease progression., Patients and Methods: A total of 324 pet dogs diagnosed with treatment-naïve appendicular osteosarcoma were randomized into a two-arm, multicenter, parallel superiority trial whereby dogs received amputation of the affected limb, followed by adjuvant carboplatin chemotherapy ± oral sirolimus therapy. The primary outcome measure was disease-free interval (DFI), as assessed by serial physical and radiologic detection of emergent macroscopic metastases; secondary outcomes included overall 1- and 2-year survival rates, and sirolimus pharmacokinetic variables and their correlative relationship to adverse events and clinical outcomes., Results: There was no significant difference in the median DFI or overall survival between the two arms of this trial; the median DFI and survival for standard-of-care (SOC; defined as amputation and carboplatin therapy) dogs was 180 days [95% confidence interval (CI), 144-237] and 282 days (95% CI, 224-383) and for SOC + sirolimus dogs, it was 204 days (95% CI, 157-217) and 280 days (95% CI, 252-332), respectively., Conclusions: In a population of pet dogs nongenomically segmented for predicted mTOR inhibition response, sequentially administered adjuvant sirolimus, although well tolerated when added to a backbone of therapy, did not extend DFI or survival in dogs with appendicular osteosarcoma., (©2021 American Association for Cancer Research.)

Objective: To determine the influence of normograde (NG) versus retrograde (RG) catheterization of the cystic duct and common bile duct (CBD) in dogs with gallbladder mucoceles (GBM) treated with open cholecystectomy., Study Design: Retrospective study., Animals: Dogs (n = 117) with GBM., Methods: Medical records were reviewed for signalment, history, clinical laboratory and diagnostic imaging findings, details of surgery including catheterization method, complications, and outcome. Long-term follow-up data were obtained by telephone or electronic communication. Relationships between catheterization method and clinical variables and outcome were evaluated., Results: Dogs catheterized RG were more likely to experience any postoperative complication (p = .0004) including persistence of gastrointestinal signs (p = .0003). Survival to discharge and long-term survival did not differ by group (p = .23 and p = .49). Total bilirubin (TB) decreased by 70.3% after NG catheterization compared to 39.1% after RG catheterization (p = .03) and increased in 14.9% dogs catheterized NG and 38.0% dogs catheterized RG (p = .004). The presence of a diplomate surgeon at surgery resulted in decreased incidences of any perioperative or postoperative complication (p = .003 and p = .05)., Conclusion: Retrograde catheterization was associated with more postoperative concerns than NG catheterization, but similar survival times. Surgery should be performed by diplomates experienced in biliary surgery to minimize complications., Clinical Significance: Although both NG and RG techniques to catheterize the cystic duct and CBD are options for treatment of GBM with low mortality, results of this study provide some evidence to recommend NG over RG catheterization., (© 2021 The American College of Veterinary Surgeons.)

Lameness, new swelling, or mass occurrence are the most common reasons for presentation when neoplasia affects the limbs. Tumors of the skin or subcutaneous tissues, joints, muscles, bones, or digits of the forelimb are reported. Diagnosis with fine needle aspiration or biopsy is necessary before treatment to allow staging, planning of treatment, and prognostication. The planning of surgical treatment of limb tumors is essential to maximize the chance of a complete resection on the first surgery, given that less skin is available for primary closure in subsequent revision or recurrence surgeries., Competing Interests: Disclosure The authors have no conflicts of interest or funding to disclose., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To identify which classification systems have been used for tumor margin reporting and to determine whether factors (publication year, tumor type, and specialty of the contributing authors) influenced trends in margin reporting within literature describing canine soft tissue sarcoma (STS) and cutaneous mast cell tumors (MCT)., Study Design: Systematic literature review., Methods: Eligible articles were identified through electronic database searches performed for STS and MCT. Data abstracted from relevant studies included publication year, author list, specialty of contributing authors, criteria used to report the planned surgical margins, and the status of histologic margins. Categorization of papers was based on the classification systems used to report surgical and histologic tumor margins., Results: Fifty-three articles were included, 11 on STS, 37 on MCT, and five that included both tumor types. Criteria for classifying the planned surgical margins were described in only 50.9% of studies. Articles that listed a veterinary surgeon as a contributing author (P = .01) and STS articles compared to MCT papers (P = .01) were more likely to report surgical margins. Most (56.6%) studies reported the status of histologic margins dichotomously as "complete" or "incomplete." Although a previously published consensus statement recommended that quantitative criteria be used to report histologic margins, only 7.5% of articles used quantitative methods., Conclusion: Classification systems used for reporting tumor margins were highly variable among studies., Clinical Significance: The findings of this review provide evidence that a standardized classification system for reporting surgical and histologic tumor margins is required in veterinary medicine. A universal system may support more consistent reporting of neoplastic biopsy specimens and allow for more meaningful comparisons across research studies., (© 2020 American College of Veterinary Surgeons.)

Objective: To determine the diagnostic accuracy of optical coherence tomography (OCT) to assess surgical margins of canine soft tissue sarcoma (STS) and determine the influence of observer specialty and training., Study Design: Blinded clinical prospective study., Animals: Twenty-five dogs undergoing surgical excision of STS., Methods: In vivo and ex vivo surgical margins were imaged with OCT after tumor resection. Representative images and videos were used to generate a training presentation and data sets. These were completed by 16 observers of four specialties (surgery, radiology, pathology, and OCT researchers). Images and videos from data sets were classified as cancerous or noncancerous., Results: The overall sensitivity and specificity were 88.2% and 92.8%, respectively, for in vivo tissues and 82.5% and 93.3%, respectively, for ex vivo specimens. The overall accurate classification for all specimens was 91.4% in vivo and 89.5% ex vivo. There was no difference in accuracy of interpretation of OCT imaging by observers of different specialties or experience levels., Conclusion: Use of OCT to accurately assess surgical margins after STS excision was associated with a high sensitivity and specificity among various specialties. Personnel of all specialties and experience levels could effectively be trained to interpret OCT imaging., Clinical Significance: Optical coherence tomography can be used by personnel of different specialty experience levels and from various specialties to accurately identify canine STS in vivo and ex vivo after a short training session. These encouraging results provide evidence to justify further research to assess the ability of OCT to provide real-time assessments of surgical margins and its applicability to other neoplasms., (© 2020 American College of Veterinary Surgeons.)

Objective: To evaluate the feasibility and safety of microwave ablation (MWA) as a modality to induce tumor necrosis within distal radial osteosarcoma (OSA)., Study Design: Pilot study., Animals: Six client-owned dogs with distal radius OSA confirmed by cytological examination., Methods: Dogs underwent computed tomography for surgical planning before general anesthesia for fluoroscopy-guided ablation. Computed tomography was repeated 48 hours after MWA, before amputation. The ablated tumor was evaluated with histopathology., Results: Six dogs underwent MWA of distal radius OSA. A lower power setting (30 W) was selected for the first two dogs to avoid collateral soft tissue damage. The power was increased to 75 W for the last four dogs. The temperature was maintained between 45°C and 55°C (113 °F-131 °F) at the bone/soft tissue interface. Tumor necrosis varied between 30% and 90% (median, 55%) according to histopathology. No intraoperative or periprocedural complications were observed., Conclusion: Microwave ablation induced variable tumor necrosis and did not induce immediate postablation complications in these six dogs with distal radius OSA., Clinical Significance: These results justify further evaluation of MWA as a potential modality to treat primary bone lesions in dogs., (© 2020 The American College of Veterinary Surgeons.)

Background: Oral neoplasia has been reported to account for 6-7% of all canine cancer and 3% of all feline cancers. To the authors' knowledge the last epidemiologic analysis of general oral cancer in dogs and cats was published in 1976., Objectives: The goal of this study was to report contemporary demographic information regarding oral tumors in dogs and cats., Methods: Information was collected from cats or dogs diagnosed with oral neoplasia from the Veterinary Medical Data Base. Medical records representing cases that presented to one of 26 veterinary teaching hospitals from January 1, 1996 through December 31, 2017 were included., Results: A total of 1,810 dogs and 443 cats were identified. A total of 962 cases (53.6%) of canine oral tumors were classified as malignant and 455 cases as benign (25.4%). The majority of feline oral tumors were classified as malignant (257 cases, 58.1%) and only a few benign (11 cases, 2.5%). The incidence of oral tumors was calculated to be 4.9 per 1,000 dogs (0.5%) and 4.9 per 1,000 cats (0.5%)., Conclusions: This incidence of oral tumors is considerably higher than previously reported in both dogs and cats. These results provide valuable information for generation of hypotheses for future investigations of breed-based and pathology-based oral neoplastic studies., Competing Interests: The authors declare no conflicts of interest., (© 2020 The Korean Society of Veterinary Science.)

Objective: To determine outcome and prognostic factors in small breed dogs in which hemangiosarcoma was diagnosed and whether outcomes differed between small and large breed dogs with splenic hemangiosarcoma., Study Design: Bi-institutional retrospective study., Animals: Forty-three small breed (<20 kg) and 94 large breed client-owned dogs., Methods: Medical records were reviewed to identify dogs treated with splenectomy for splenic hemangiosarcoma. Data acquired included signalment, preoperative staging, bloodwork results, surgical findings, histopathologic findings, administration of chemotherapy, presence/absence of metastatic disease, and survival time (ST). Cox proportional hazards regression analysis was performed to assess prognostic factors associated with survival., Results: The overall median ST was 116 days and 97 days for small and large breed dogs, respectively. The ST for dogs treated with surgery and chemotherapy was 207 and 139 days for small and large breed dogs, respectively. The disease-free interval (DFI) was 446 and 80 days for small and large breed dogs, respectively. Dog size was associated with DFI (P = .02) but not with ST (P = .09). The presence of metastasis at diagnosis was associated with decreased ST in small (P = .03) and large (P = .0009) breed dogs. Administration of chemotherapy (P = .02) was associated with increased ST (P = .02) in small breed dogs., Conclusion: The ST was not different in small and large breed dogs with splenic hemangiosarcoma treated with splenectomy and chemotherapy., Clinical Significance: Prognosis remains poor despite aggressive therapies in small and large breed dogs., (© 2020 The American College of Veterinary Surgeons.)

Objective: The objectives of this study were to report the contemporary demographical information, provide the incidence of and to assess sex and breed predisposition of salivary gland neoplasia in dogs and cats., Materials and Methods: Information was collected from cats or dogs with salivary neoplasia (cases) and controls from the 26 university veterinary teaching hospitals within the Veterinary Medical Data Base. A total of 56 dogs and 24 cats were identified as having been diagnosed with salivary neoplasia., Results: The incidence of salivary neoplasia in this population was calculated to be 15.3 per 100,000 dogs and 26.3 per 100,000 cats. The specific anatomic location of the salivary neoplasia was unable to be determined in 90.8% of cases in both dogs and cats. Results of the univariable conditional logistic regression models revealed no increased risk of salivary neoplasia in dogs or cats of any sex or neuter status (dogs: p = .26; cats: p = .45). There was no breed disposition within the feline species for salivary neoplasia. However, in the conditional logistic regression for dogs, poodles (toy and standard) trended towards significance (p = .075) with an odds ratio of 6.83 (95% CI: 1.16-40.10) compared to mixed breeds., Conclusions and Clinical Relevance: The present study's results differ from previous conclusions made in regards to predisposed breeds and tumour location. Additional epidemiological studies should be performed to help in determining risk factors for salivary gland neoplasia., (© 2019 The Authors. Veterinary Medicine and Science Published by John Wiley & Sons Ltd.)