Use of surgery and mitoxantrone chemotherapy in a dog with disseminated lymphangiosarcoma.

CASE DESCRIPTION: A 5-year-old sexually intact male Giant Schnauzer was evaluated because of difficulty breathing and left pelvic limb swelling. Eighteen months previously, the patient had had intermittent left pelvic limb swelling, but the owner declined further testing at that time. CLINICAL FINDINGS: Physical examination revealed severe pitting edema of the left pelvic limb and prepuce and muffled heart sounds on thoracic auscultation. Results of thoracic radiography and thoracocentesis were consistent with chylothorax, and CT imaging of the thorax and abdomen revealed a mass involving the whole left sublumbar area. TREATMENT AND OUTCOME: In an attempt to treat the chylothorax, pleural omentalization and pericardectomy were performed. Histologic evaluation of several biopsy specimens harvested in the abdominal and thoracic cavities revealed disseminated lymphangiosarcoma. The patient recovered well from surgery, and mitoxantrone chemotherapy was administered. As of 10 months after surgery, the dog was clinically normal except for mild pelvic limb edema. CLINICAL RELEVANCE: The combination of clinical signs, multiple imaging features, surgical findings, and histologic examination findings enabled the final diagnosis of lymphangiosarcoma. Clinical management that included medical and surgical treatments and chemotherapy resulted in improved quality of life and extended survival time in a dog with metastatic lymphangiosarcoma.

A comparison of computed tomography, computed radiography, and film-screen radiography for the detection of canine pulmonary nodules.

Computed tomography (CT) has become more widely available and computed radiography (CR) has replaced film-screen radiography for canine thoracic imaging in many veterinary practices. There are limited data comparing these modalities in a veterinary clinical setting to detect pulmonary nodules. We compared CT, CR, and film-screen radiography for detecting the presence, number, and characteristics of pulmonary nodules in dogs. Observer performance for a variety of experience levels was also evaluated. Twenty-one client-owned dogs with a primary neoplastic process underwent CT and CR; nine also received film-screen radiographs. Positive/negative classification by consensus agreed between the three modalities in 8/9 dogs and between CR and CT in the remaining 12. CT detected the greatest (P = 0.002) total number of nodules and no difference was seen between CR and films. The greatest number of nodules was seen in the right middle and both caudal regions, but only using CT (P < 0.0001). Significantly smaller nodules were detected with CT (P = 0.0007) and no difference in minimum size was detected between CR and films. Observer accuracy was high for all modalities; particularly for CT (90.5-100%) and for the senior radiologist (90.5-100%). CT was also characterized by the least interobserver variability. Although CT, CR, and film-screen performed similarly in determining the presence or absence of pulmonary nodules, a greater number of smaller nodules was detected with CT, and CT was associated with greater diagnostic confidence and observer accuracy and agreement.

Comparison of single-slice computed tomography protocols for detection of pulmonary nodules in dogs.

Two dogs (4 and 38 kg) with radiographic evidence of pulmonary nodules were evaluated using single-slice, helical computed tomography (CT). Each thorax was scanned using 12 combinations of examination parameters that included slice collimation width (3 and 5mm for the small dog and 5 and 7mm for the large dog), pitch (1, 1.5, and 2), and reconstruction interval (0.5 and 1). Sensitivity, specificity, and accuracy for nodule detection were evaluated for each protocol by three different observers, their results being compared with a consensus evaluation of images acquired with the protocol providing the best theoretic resolution (narrow collimation, pitch of 1, reconstruction interval of 0.5). For all observers, sensitivity and accuracy were significantly increased when using a protocol with narrow collimation (P < 0.0001-0.005 and P = 0.0003-0.005, respectively). Pitch and reconstruction interval did not significantly influence the accuracy, sensitivity, or specificity for at least two of the observers. Additionally, nodule size (< 3mm vs. > 3mm) did not significantly affect nodule detection. Interobserver repeatability was variable among protocols (K = 0.32-0.78), highlighting the fact that nodule detection may be more dependent on the observer than on the choice of the CT protocol. For single-slice CT, the results of this study suggest that narrow collimation (3-5 mm, depending on the animal's size), a pitch of 2 and a reconstruction interval of 1 should be used in dogs for the detection of pulmonary nodules.