Indirect lymphography for sentinel lymph node detection in dogs with mast cell tumors.

Objective: The objective of this report is to describe the technique and diagnostic utility of indirect lymphography (IL) using water-soluble contrast for sentinel lymph node (SLN) mapping in dogs with mast cell tumors. Animals: Fifty-three dogs with 59 mast cell tumors were included. Procedure: Medical records were retrieved for dogs with a cytological diagnosis of mast cell tumor which also had IL performed for lymph node mapping. Dogs were excluded when surgery had been performed before presentation. Images were reviewed by a Board-certified radiologist for uptake of contrast within the sentinel lymph node. Results: Lymphography studies from 34 tumors (57.6%) were diagnostic (clearly identifiable lymphatics and sentinel lymph node). Lymphography studies from 12 tumors (20.3%) were partially diagnostic (identifiable lymphatics, but sentinel lymph node not highlighted). Lymphography studies from 13 tumors (22%) were non-diagnostic. Indirect lymphography studies were interpreted as either diagnostic or partially diagnostic in 77.9% of tumors. Conclusion: The results indicate that IL is a simple, available technique to allow for identification of a sentinel lymph node in dogs with mast cell tumors. Clinical relevance: Indirect lymphography is a simple and widely accessible technique for SLN mapping in dogs with mast cell tumors, particularly for the general practice environment.

Lymphographie indirecte pour la détection des ganglions lymphatiques sentinelles chez les chiens atteints de tumeurs mastocytaires. Objectif: L'objectif de ce rapport est de décrire la technique et l'utilité diagnostique de la lymphographie indirecte (IL) utilisant un contraste soluble dans l'eau pour la cartographie des ganglions lymphatiques sentinelles (SLN) chez les chiens atteints de tumeurs mastocytaires. Animaux: Cinquante-trois chiens avec 59 tumeurs mastocytaires ont été inclus. Procédure: Les dossiers médicaux ont été récupérés pour des chiens avec un diagnostic cytologique de tumeur mastocytaire qui ont également subi une IL pour la cartographie des ganglions lymphatiques. Les chiens ont été exclus lorsque la chirurgie avait été pratiquée avant la présentation. Les images ont été examinées par un radiologue certifié (ACVR) pour la prise de contraste dans le ganglion lymphatique sentinelle. Résultats: Les études de lymphographie de 34 tumeurs (57,6 %) étaient diagnostiques (lymphatiques clairement identifiables et ganglion sentinelle). Les études de lymphographie de 12 tumeurs (20,3 %) étaient partiellement diagnostiques (lymphatiques identifiables, mais ganglion sentinelle non mis en évidence). Les études de lymphographie de 13 tumeurs (22 %) étaient non diagnostiques. Les études de lymphographie indirecte ont été interprétées comme diagnostiques ou partiellement diagnostiques dans 77,9 % des tumeurs. Conclusion: Les résultats indiquent que l'IL est une technique simple et disponible pour permettre l'identification d'un ganglion lymphatique sentinelle chez les chiens atteints de tumeurs mastocytaires. Pertinence clinique: La lymphographie indirecte est une technique simple et largement accessible pour la cartographie du SLN chez les chiens atteints de tumeurs mastocytaires, en particulier dans le milieu de la pratique générale.(Traduit par Dr Serge Messier).

OUTCOME OF DOGS WITH INTRANASAL LYMPHOMA TREATED WITH VARIOUS RADIATION AND CHEMOTHERAPY PROTOCOLS: 24 CASES.

Tumors of the nasal cavity comprise approximately 1% of all neoplasms in dogs. Canine intranasal lymphoma is rare and reports evaluating the outcome of treatment are lacking. The goal of this observational, descriptive, multi-institutional study was to evaluate the overall median survival times (MSTs) in a group of dogs with intranasal lymphoma that were treated with irradiation and/or chemotherapy. Dogs meeting these inclusion criteria were retrospectively recruited from medical archives at multiple institutions. Eighteen cases of intermediate to high grade intranasal lymphoma and six cases of low-grade intranasal lymphoma were identified. The date of diagnosis, method of diagnosis, treatment received (radiation and/or chemotherapy protocols), and date of death were recorded. Kaplan-Meier survival analysis was performed on the intermediate to high grade group to calculate overall MST. Log-rank tests were performed to compare effects of treatment with radiation therapy ± chemotherapy and chemotherapy alone. Kaplan-Meier survival analysis was performed separately on the low-grade group. The overall MST was 375 days for the intermediate to high grade group. Cases treated with radiation ± chemotherapy had an MST of 455 days (n = 12) and those treated with chemotherapy alone (n = 6) had an MST of 157 days in the intermediate to high grade group. The MST was 823 days for the low-grade group. Results support the use of radiation therapy for treatment of canine intranasal lymphoma, however a randomized, controlled, clinical trial would be needed for more definitive recommendations. The role of adjunctive chemotherapy also may require further investigation.

Effect of histologic processing on dimensions of skin samples obtained from cat cadavers.

OBJECTIVE To determine changes in dimensions of feline skin samples as a result of histologic processing and to identify factors that contributed to changes in dimensions of skin samples after sample collection. SAMPLE Cadavers of 12 clinically normal cats. PROCEDURES Skin samples were obtained bilaterally from 3 locations (neck, thorax, and tibia) of each cadaver; half of the thoracic samples included underlying muscle. Length, width, and depth were measured at 5 time points (before excision, after excision, after application of ink to mark tissue margins, after fixation in neutral-buffered 10% formalin for 36 hours, and after completion of histologic processing and staining with H&E stain). Measurements obtained after sample collection were compared with measurements obtained before excision. RESULTS At the final time point, tissue samples had decreased in length (mean decrease, 32.40%) and width (mean decrease, 34.21%) and increased in depth (mean increase, 54.95%). Tissue from the tibia had the most shrinkage in length and width and that from the neck had the least shrinkage. Inclusion of underlying muscle on thoracic skin samples did not affect the degree of change in dimensions. CONCLUSIONS AND CLINICAL RELEVANCE In this study, each step during processing from excision to formalin fixation and histologic processing induced changes in tissue dimensions, which were manifested principally as shrinkage in length and width and increase in depth. Most of the changes occured during histologic processing. Inclusion of muscle did not affect thoracic skin shrinkage. Shrinkage should be a consideration when interpreting surgical margins in clinical cases. 945).

Cancer screening tests for small animals.

Cancer is increasingly more common. Several tests for the diagnosis and treatment of cancer in companion animals have been developed. Screening tests discussed include those for lymphoid neoplasia, hemangiosarcoma, and transitional cell carcinoma of the bladder. None of these tests should be used in isolation for diagnosis. Vincristine and doxorubicin are mainstays in the treatment of canine lymphoma. However, it is important and accepted practice to test individuals of predisposed breeds for this mutation before administering these drugs in a lymphoma protocol.

Hypercalcemia of malignancy associated with renal cell carcinoma in a dog.

A 10 yr old castrated male Siberian husky was evaluated for polyuria, polydipsia, a retroperitoneal mass, and urolithiasis. A marked elevation in Ca was noted on initial blood work, and results of additional testing were consistent with hypercalcemia of malignancy, including an elevated parathyroid hormone-related peptide (PTHrp) value. Based on clinical signs, blood work, diagnostic imaging, and cytology results, unilateral renal neoplasia was suspected. Following a complete right nephrectomy and cystotomy, histopathologic examination confirmed a diagnosis of renal cell carcinoma (RCC). Five days postoperatively, the hypercalcemia had nearly resolved and the PTHrp was zero. This is the first reported case of hypercalcemia of malignancy associated with RCC in a dog.

Survival times for canine intranasal sarcomas treated with radiation therapy: 86 cases (1996-2011).

Sarcomas comprise approximately one-third of canine intranasal tumors, however few veterinary studies have described survival times of dogs with histologic subtypes of sarcomas separately from other intranasal tumors. One objective of this study was to describe median survival times for dogs treated with radiation therapy for intranasal sarcomas. A second objective was to compare survival times for dogs treated with three radiation therapy protocols: daily-fractionated radiation therapy; Monday, Wednesday, and Friday fractionated radiation therapy; and palliative radiation therapy. Medical records were retrospectively reviewed for dogs that had been treated with radiation therapy for confirmed intranasal sarcoma. A total of 86 dogs met inclusion criteria. Overall median survival time for included dogs was 444 days. Median survival time for dogs with chondrosarcoma (n = 42) was 463 days, fibrosarcoma (n = 12) 379 days, osteosarcoma (n = 6) 624 days, and undifferentiated sarcoma (n = 22) 344 days. Dogs treated with daily-fractionated radiation therapy protocols; Monday, Wednesday and Friday fractionated radiation therapy protocols; and palliative radiation therapy protocols had median survival times of 641, 347, and 305 days, respectively. A significant difference in survival time was found for dogs receiving curative intent radiation therapy vs. palliative radiation therapy (P = 0.032). A significant difference in survival time was also found for dogs receiving daily-fractionated radiation therapy vs. Monday, Wednesday and Friday fractionated radiation therapy (P = 0.0134). Findings from this study support the use of curative intent radiation therapy for dogs with intranasal sarcoma. Future prospective, randomized trials are needed for confirmation of treatment benefits.

May-Hegglin anomaly in a dog.

An 8-year-old female spayed Pug dog was presented for evaluation of cutaneous lesions occurring secondary to immunosuppressive treatment of presumed immune-mediated thrombocytopenia. Abnormal hematologic findings included persistent thrombocytopenia, macrothrombocytes, and variably shaped, often fusiform, blue cytoplasmic inclusions in neutrophils. May-Hegglin anomaly (MHA) was suspected based on the morphologic appearance of platelets and neutrophils. Examination of cells by transmission electron microscopy revealed normal platelet ultrastructure; neutrophil inclusions had features similar to those reported for inclusions in human MHA. Neutrophil function was within normal limits based on flow cytometric analysis. Thrombelastography indicated a prolonged clotting time (r), and PlateletMapping showed a lack of response to 2 µM ADP compared with a moderate response in the control dog. Immunocytochemical staining of blood smears using 2 commercially available antibodies against MYH9 protein (nonmuscle myosin heavy chain II) yielded negative results. However, genomic DNA sequencing analysis of the dog's MYH9 gene identified a single point mutation, resulting in substitution of lysine for glutamine at the 1841 amino acid position; this mutation is identical to one identified in people with MHA. To our knowledge, this is the first report of an MYH9 mutation in the dog. MHA-associated macrothrombocytopenia may be mistaken for immune-mediated thrombocytopenia.

Resistance of canine lymphoma cells to adenoviral infection due to reduced cell surface RGD binding integrins.

Recombinant adenovirus vectors (Ad) have been recognized as effective in vivo gene delivery vehicles and utilized as gene therapy agents for a number of cancers. The elucidation of viral entry mechanisms has allowed the development of recombinant vectors that exploit existing cell surface receptors to achieve entry into the cell. B lymphocytes are normally resistant to infection by adenovirus 5, likely due to the lack of the Coxsackie and Adenovirus receptor (CAR). Using reverse-transcriptase PCR and flow cytometry, the CD40 receptor has been shown to be expressed on many lymphoma cells. We exploited this finding to develop a gene therapy strategy for treatment of canine B cell lymphoma. Ad5 was targeted to cells expressing CD40 via CD40 ligand (CD40L) and was effective in infecting CD40-expressing control cells; however, both primary canine lymphoma cells and cell lines demonstrated limited evidence of transduction. Following receptor binding, adenovirus entry into cells may require interaction with α(v)ß(3/5) integrins; we demonstrate that canine lymphoma cells are deficient in these integrins. Reduced α(v)ß(3) integrin expression may render these cells incapable of internalizing Ad vectors. Thus, any viral targeting approaches for treatment of canine lymphoma must also take into account the potential lack of internalization signals.

Asparaginase-associated pancreatitis in a dog.

A dog with lymphosarcoma was evaluated for vomiting, lethargy, and abdominal pain 48 h after treatment with L-asparaginase. Based on drug administration, clinical signs, bloodwork, and elevated canine pancreatic lipase immunoreactivity, L-asparaginase-associated pancreatitis was diagnosed. This is an acknowledged toxicity; however, its pathophysiology and incidence rate in veterinary patients are unknown and sparsely documented.

Flow cytometric evaluation of multidrug resistance proteins on grossly normal canine nodal lymphocyte membranes.

OBJECTIVE: To demonstrate efficacy of flow cytometric evaluation of expression and activity of P-glycoprotein (P-gp) and multidrug resistance-associated protein (MRP) efflux pumps and characterize and correlate their expression and activity in grossly normal canine nodal lymphocytes. SAMPLE POPULATION: Nodal lymphocytes from 21 clinically normal dogs. PROCEDURES: Pump expression was assessed by use of fluorescent-labeled mouse antihuman P-gp (C494) and MRP1 (MRPm6) antibodies and expressed as median values (antibody value divided by isotype control value). The P-gp and MRP activities were assessed by measuring cellular retention of rhodamine 123 and 5(6)-carboxyfluorescein diacetate in the absence and presence of inhibitors (verapamil and PSC833 for P-gp, probenecid and MK-571 for MRP). Protein activity was expressed as median fluorescence of cells with inhibitors divided by that without inhibitors. RESULTS: Expression of P-gp was (mean +/- SEM) 50.62 +/- 13.39 (n = 21) and that of MRP was 2.16 +/- 0.25 (13). Functional activity was 1.27 +/- 0.06 (n = 21) for P-gp and both inhibitors and 21.85 +/- 4.09 (21) for MRP and both inhibitors. Function and expression were not correlated. CONCLUSIONS AND CLINICAL RELEVANCE: Use of flow cytometry effectively assessed P-gp and MRP expression and activity in canine lymphocytes. Optimization of the flow cytometric assay was determined for evaluating activity and expression of these pumps in canine lymphoid cells. Evaluation of expression or activity may offer more meaning when correlated with clinical outcome of dogs with lymphoproliferative diseases. Cell overexpression of P-gp and MRP can convey drug resistance.