Sentinel lymph node (SLN) biopsy is a well-established staging tool in canine oncology. This study aims to explore the feasibility of SLN biopsy in dogs with scars from prior excised solid malignancies that were referred for further tumor staging and/or adjuvant treatment options. Mapping was either performed using radiopharmaceutical, methylene blue, and/or near-infrared fluorescent (NIRF) imaging. Thirty-three dogs with 34 scars from prior excision of the mast cell tumor (MCT) (n = 29), soft tissue sarcoma (n = 2), oral melanoma (n = 1), subungual melanoma (n = 1), and mammary adenocarcinoma (n = 1) were retrospectively enrolled. Primary treatment consisted of curative intent/wide tumor excisions in 50.0% of dogs and marginal excision in the remaining 50.0%. The median time between tumor excision and SLN biopsy was 50 days (range 17–110 days). The procedure was successful in 31/34 scars, translating to a detection rate of 91.2%. The SLN did not correspond to the regional lymph node in 19/31 scars (61.3%). SLN metastases were histologically identified in 13/31 (41.9%) dogs, all of them affected by MCT. Based on our results, SLN biopsy using lymphoscintigraphy/methylene blue and/or NIRF is feasible in dogs presenting with scars from the prior surgical excision of solid tumors, and should be suggested for accurate nodal staging.
1 March 2017 in American Journal of Forensic Medicine & Pathology
We report a fatal case of Waterhouse-Friderichsen syndrome in a 64-year-old man. The diagnosis, suspected during the autopsy (performed 63 hours after death), was confirmed through the successful detection of Streptococcus pneumoniae DNA and antigens in samples (blood and liver) collected during the autopsy. These results conformed with blood cultures performed antemortem, which became available only the day after the autopsy. The case underlines the need to collect biological material (liver and blood samples) during autopsy for microbiological investigations, although the collection is performed a long time after the death, suggesting that a liver sample works for DNA and liver and blood work for Streptococcus pneumoniae antigen detection.
Factors involved in recurrence or incomplete resolution of clinical signs after surgical correction of perineal hernia (PH) have not been explored. This study aims to describe the histological features of the rectal wall in dogs with PH and the possible associations between rectal dilatation (RD) severity or histological features and persistence of clinical signs or recurrence in dogs surgically treated for PH. A case-control design was employed to compare the histopathological features of the rectal wall between PH and control dogs. All dogs underwent a full-thickness biopsy of the rectal wall, which was evaluated for inflammation, fibrosis, histomorphology of elastic fibers, and the number of myenteric ganglia. The same PH group was included in a cohort study. The RD was scored by digital rectal examination at T0 (preoperatively), T1 (immediately postoperatively) and T2 (60 days after surgery). A high RD score at T1 and T2 was found to be associated with a negative outcome, and both a high RD score at T1 and T2 and the fibrosis score were associated with recurrence. The histological evaluation revealed a significantly higher inflammation and fibrosis score in the PH group, and a more frequent regular orientation of elastic fibers in dogs belonging to the control group. Notably, the number of ganglia did not differ between the two groups; further studies should explore the neuromuscular efficiency of the rectal wall in dogs bearing PH. Histological assessment of the rectal wall may support veterinary surgeons in developing an accurate prognosis after surgical correction in clinical settings.
During tibial plateau leveling osteotomy (TPLO), the laceration of the cranial tibial artery (LCTA) may occur, and the ligation of the cranial tibial artery might lead to impaired blood supply to the osteotomy site. The present case-control study aimed to evaluate the effect of LCTA on TPLO healing and the occurrence of perioperative complications. The incidence and predisposing factors to LCTA were also investigated. Fourteen cases experiencing LCTA were retrospectively enrolled from medical records of two veterinary teaching hospitals (LCTA group), whereas 28 randomly selected TPLOs that did not experience LCTA were included in the control group. Signalment data, proximal tibial epiphysis conformation, osteotomy features, perioperative complications, and bone healing were compared between the two groups. Bone healing was evaluated using the modified radiographic union scale for tibial fracture and the visual analog scale. The mean incidence was 9.6%. Bodyweight was significantly higher in the LCTA group compared to the control group (P = 0.009). Dogs belonging to the LCTA groups were significantly younger (P = 0.01). Intraoperative hypotension was significantly overreported in the LCTA group (P = 0.0001). None of the other variables differed significantly between the two groups. Dogs' size seems to be a predisposing factor, with dogs weighing >15 kg having 22 times more chance of experiencing LCTA. Due to the well-developed collateral blood supply of the canine hindlimb, LCTA and the closure of the cranial tibial artery did not appear to delay the radiographic bone healing or affect the incidence of perioperative complications.
High induction doses of propofol (PPF) may cause adverse effects. Co-induction protocols can reduce doses and enhance the beneficial profile of each drug. This study compared the induction quality, clinical, and echocardiographic effects of two rapid co-inductions in healthy, unpremedicated dogs. Baseline cardiorespiratory and echocardiographic variables were recorded. Dogs randomly received rapid intravenous PPF (2.2 mg/kg) with either dexmedetomidine (3 µg/kg) (PROPODEX; n = 12) or butorphanol (0.4 mg/kg) (PROPOBUT; n = 12). Induction quality, additional PPF dose, intubation time, cardiorespiratory parameters (2, 5, 10, 15, 20 min), and recovery quality were recorded. A second echocardiography was performed 5 min after induction. Induction quality was significantly higher in PROPODEX, with significantly lower additional PPF requirements and shorter intubation time. In PROPODEX, heart rate significantly decreased from baseline and was significantly lower than PROPOBUT, while arterial blood pressures significantly increased in PROPODEX and decreased in PROPOBUT from baseline. PROPOBUT significantly reduced left ventricular (LV) diastolic volumes and increased E/A ratio, while PROPODEX significantly increased LV systolic diameter and volumes, and significantly decreased fractional shortening. Recovery was significantly faster and better in PROPODEX. PROPOBUT preserved cardiac function but caused hypotension. PROPODEX provided superior induction and recovery quality, and cardiorespiratory stability, with only mild systolic function depression.
Baboons’ management requires chemical restraint. Three intramuscular sedative protocols in captive hamadryas baboons (Papio hamadryas) undergoing health-check and male vasectomy were compared. Animals were assigned to TZD_G (n = 17; tiletamine/zolazepam 3 mg/kg + dexmedetomidine 20 μg/kg), KDM_G (n = 23; ketamine 6 mg/kg + dexmedetomidine 30 μg/kg + methadone 0.2 mg/kg), or MDM_G (n = 9; midazolam 2 mg/kg + dexmedetomidine 60 μg/kg + methadone 0.2 mg/kg). Propofol was titrated intravenously for anaesthetic induction and maintenance. Sedation time and quality and cardiopulmonary parameters were recorded. Atipamezole (TZD_G 0.2 mg/kg, KDM_G 0.3 mg/kg, MDM_G 0.6 mg/kg) and flumazenil (MDM_G 0.02 mg/kg) were administered intramuscularly post-procedure. Recovery time and quality were recorded. Data were reported as median (interquartile range) or regression coefficient (B). Sedation was deepest in TZD_G (20, 20–20; KDM_G 20, 19–20; MDM_G 19, 15–20; p = 0.017). MDM_G had a significantly higher heart rate (B = 10.27, p = 0.001), respiratory rate (B = 9.09, p < 0.001), and lower end-tidal carbon dioxide (B = −3.00, p = 0.03) than TZD_G, while KDM_G had a lower respiratory rate than TZD_G (B = −3.67, p = 0.02) and a higher temperature (B = 1.66 p = 0.001). TZD_G showed the longest recovery (minutes: 19, 11.5–30; KDM_G: 6, 4–12; MDM_G: 4, 2.5–5; p < 0.001), while MDM_G the best recovery (0, 0–0; TZD_G: 9, 6–12; KDM_G: 0, 0–6; p < 0.001). TZD produced deepest sedation but bad recovery; KDM offered optimal sedation and recovery, and cardiopulmonary stability; MDM provided lighter sedation and excellent recovery.