Immunohistochemical Expression of Human Epidermal Growth Factor Receptor 2 and Ki67 in Apocrine Gland Anal Sac Adenocarcinoma.

Apocrine gland anal sac adenocarcinoma is an aggressive neoplasm, and surgery remains the treatment of choice, although it is controversial in advanced cases. The prognostic factors are not well established. Human Epidermal Growth Factor Receptor 2 (HER2) is a membrane protein related to tumorigenesis, whereas Ki67 is a nuclear protein related to cell proliferation. Both are potential prognostic markers and therapeutic targets. This study aimed to evaluate the expression of HER2 and Ki67 markers in canine apocrine gland anal sac adenocarcinoma. The tumor samples were divided into four groups: largest tumor diameter less than 2.5 cm, largest tumor diameter greater than 2.5 cm, metastatic lymph nodes, and control group of non-neoplastic anal sacs. Each contained 10 samples. Immunohistochemistry was performed to verify the expression of HER2 and Ki67 markers. Positive HER2 staining was observed in 45% of the neoplastic cases and negative HER2 staining in 100% of the control group. The Ki67 expression had a median of 25% in all groups, except for the control group, which had a median of 8%. The HER2 and Ki67 expression was present in apocrine gland anal sac adenocarcinoma, making them potential therapeutic targets. However, it was not possible to determine the clinical value of either marker.

Bacterial microbiota and proinflammatory cytokines in the anal sacs of treated and untreated atopic dogs: Comparison with a healthy control group.

The pathogenesis of anal sacculitis has not been extensively investigated, although atopic dogs seem to be predisposed to the disease. The aim of this study was therefore to characterize and compare the bacterial microbiota and pro-inflammatory cytokines in the anal sacs of dogs from three groups (healthy dogs, untreated atopic dogs and atopic dogs receiving antipruritic treatment or allergen-specific immunotherapy) in order to determine whether changes could be at the origin of anal sacculitis in atopic dogs. Bacterial populations of anal sac secretions from fifteen healthy dogs, fourteen untreated and six treated atopic dogs were characterized by sequencing the V4 region of the 16S rRNA gene using Illumina technology. Proinflammatory cytokines were analyzed with the Luminex multiplex test. Community membership and structure were significantly different between the anal sacs of healthy and untreated atopic dogs (P = 0.002 and P = 0.003, respectively) and between those of untreated and treated atopic dogs (P = 0.012 and P = 0.017, respectively). However, the community structure was similar in healthy and treated atopic dogs (P = 0.332). Among the proinflammatory cytokines assessed, there was no significant difference between groups, except for interleukin 8 which was higher in the anal sacs of untreated atopic dogs compared to treated atopic dogs (P = 0.02), and tumor necrosis factor-alpha which was lower in the anal sacs of healthy dogs compared to treated atopic dogs (P = 0.04). These results reveal a dysbiosis in the anal sacs of atopic dogs, which may partially explain the predisposition of atopic dogs to develop bacterial anal sacculitis. Treatments received by atopic dogs (oclacitinib, desloratadine and allergen-specific immunotherapy) shift the microbiota of the anal sacs towards that of healthy dogs. Further studies are required to identify significant cytokines contributing to anal sacculitis in atopic dogs.

Histopathological diagnosis and surgical complications following bilateral anal sacculectomy for the treatment of unilateral canine apocrine gland anal sac adenocarcinoma: 35 cases (2019-2023).

OBJECTIVES: To report the histopathological diagnosis of both anal sacs in dogs undergoing bilateral anal sacculectomy for the treatment of unilateral apocrine gland anal sac adenocarcinoma and to compare the surgical complication rate associated with this procedure in this population with previously published literature. MATERIALS AND METHODS: Records were retrospectively reviewed for dogs that underwent bilateral anal sacculectomy for the treatment of apparently unilateral apocrine gland anal sac adenocarcinoma, at a single institute between 2019 and 2023. Clinical staging, surgical treatment, histological findings, intra- and postoperative complications were evaluated. RESULTS: Thirty-five dogs were included. Only five of 35 (14%) dogs were found to have histologically normal contralateral anal sacs. Non-neoplastic anal sac disease was found in 23 of 35 (66%) dogs and bilateral apocrine gland anal sac adenocarcinoma was seen in seven of 35 (20%) dogs. None of the dogs diagnosed with bilateral neoplasia had evidence of bilateral neoplasia before surgery despite a thorough work-up. Complications attributable to the primary tumour removal were seen in 9% of dogs intraoperatively and 14% of dogs postoperatively, commonly tumour capsule disruption and surgical site infection, respectively. CLINICAL SIGNIFICANCE: Bilateral anal sac disease was diagnosed histologically in the majority of presumed normal anal sacs, with 20% of cases being found to have bilateral apocrine gland anal sac adenocarcinoma. The surgical complication rates of this cohort were comparable to those reported for unilateral anal sacculectomy alone. These findings promote and encourage the use of bilateral anal sacculectomy in cases of suspected unilateral anal sac neoplasia.

Association between total hypercalcaemia and iliosacral lymph node metastasis in dogs diagnosed with anal sac adenocarcinoma using abdominal ultrasonography.

BACKGROUND: Anal sac adenocarcinoma (ASACA) in dogs is a malignant perianal tumour that often metastasizes to the iliosacral lymph nodes. Additionally, this tumour can be associated with hypercalcemia of malignancy. To date, no study has looked at the association between increased blood calcium levels and suspected or confirmed lymph node metastasis as a primary objective. OBJECTIVE: The objective of this study was to determine if increased total serum calcium level is associated with iliosacral lymph node metastasis in dogs diagnosed with ASACA. METHODS: Medical records of a single referral hospital were searched to identify dogs examined between 2011 and 2021 that had a diagnosis of ASACA via cytology or histopathology. Only dogs that had serum total calcium recorded and abdominal ultrasound were included in the study. All images were reviewed by a board-certified radiologist blinded to any patient identifiers. RESULTS: Of the 58 dogs, 33% (19/58) had total hypercalcaemia, and of these, 68% had confirmed or suspected iliosacral lymph node metastasis. Total hypercalcaemia was significantly associated with confirmed or suspected iliosacral lymph node metastasis (p < 0.01). However, 46% (11/24) of dogs with confirmed or suspected iliosacral lymph node metastasis were normocalcaemic. CONCLUSIONS: Based on these results, it is suggested that while the presence of total hypercalcaemia may increase the likelihood of concurrent lymph node metastasis, total hypercalcaemia alone cannot be used as a screening tool for lymph node metastasis. Dogs diagnosed with ASACA should undergo full staging regardless of total serum calcium values.

Stereotactic radiotherapy for advanced canine anal sac adenocarcinoma: an exploratory study.

For dogs with anal sac adenocarcinoma (ASAC), metastasis to intra-abdominal and pelvic lymph nodes occurs early in the disease course. Death is usually related to locoregional progression. Surgical excision is the treatment of choice, but may not be possible in advanced cases. Dogs treated with RT in the gross disease setting showed a 38%-75% overall response rate, but side effects to organs at risk in this area (especially the colon, bladder, and spinal cord) were reported. Stereotactic radiation therapy (SRT) utilizes highly conformal treatment planning with rapid dose fall-off and hypofractionation. SRT may help to reduce the risk of late side effects of radiation while also creating a larger biological effect on ASACs. A primary aim of this prospective, descriptive, exploratory study was to describe the safety and feasibility of an SRT protocol in a small sample of dogs with ASAC, using objective and subjective measures to monitor acute and late side effects. A secondary aim was to describe the anti-tumor response of the SRT protocol using CT at 3- and 6 months posttreatment. Five dogs completed the radiation protocol. Four had follow-up CT characteristics of complete response (1), partial response (2), and stable disease (1). Minimal acute side effects were observed. Despite some large tumor volumes, constraints for OAR were achieved in all but the spinal cord for one patient. Findings indicated that SRT is a safe and feasible treatment for dogs with ACAC. Future studies are warranted to compare patient outcomes for SRT versus other treatments.

Palmar-plantar erythrodysesthesia syndrome resulting from toceranib phosphate in a dog with apocrine gland anal sac adenocarcinoma: a case report.

An 11-year-old neutered male Miniature Poodle with a stage 3 apocrine gland adenocarcinoma was started on chemotherapy with toceranib phosphate after surgery. Beginning on day 10 of toceranib, the dog's foot pads became erythematous and hyperkeratinized. The dog complained of pain, inability to walk, depression, and loss of appetite. The symptoms resolved when toceranib was discontinued and reappeared when toceranib was resumed. Grade 3 palmar-plantar erythrodysesthesia was identified as an adverse event of toceranib based on the VCOG-CTCAE and Naranjo scale. Although very rare in veterinary medicine, clinicians should consider that palmar-plantar erythrodysesthesia can occur after toceranib administration.

A retrospective study of treatment, outcome, recurrence and concurrent diseases in 190 dogs with anal sacculitis.

BACKGROUND: Few studies report the treatment and recurrence rate in anal sacculitis (AS). OBJECTIVES: Retrospective study reporting the management, recurrence and concurrent diseases in dogs with AS in a primary care practice. ANIMALS: One hundred and ninety privately owned dogs in Sweden. MATERIALS AND METHODS: Clinical records of dogs diagnosed with AS between 2018 and 2021 were reviewed, and management, time until clinical resolution, number of recurrent episodes and comorbidites were recorded. RESULTS: The 190 dogs developed 290 episodes of AS. The most common management, in 235 of 290 (81.0%) episodes, was flushing ± infusion of an antimicrobial product into the sacs ± prescription of a nonsteroidal anti-inflammatory drug (NSAID), providing resolution in 213 of 235 (90.6%) episodes. Median time to resolution was one week (range 1-16 weeks), with resolution seen within one week in 205 of 290 (70.7%) episodes. A single episode of AS developed in 126 of 190 (66.3%) dogs. Dogs with concurrent cutaneous allergic disease were more likely (p < 0.001) to have recurrence of AS when compared to dogs with other comorbidities. Cutaneous allergic disease occurred more often (p < 0.001) in dogs with AS than in the practice population. CONCLUSIONS AND CLINICAL RELEVANCE: Local treatment of the anal sacs ± systemic NSAID was the most common treatment, inducing clinical resolution in the majority of dogs. Cutaneous allergic disease was the most common concurrent diagnosis, with higher recurrence rate of AS compared to other diseases and occurring in higher prevalence than in the practice population. Further studies are needed to determine if management of cutaneous allergic disease would reduce the risk of AS.

Anal sac mast cell tumor in a dog.

An 11-year-old castrated mixed-breed dog was diagnosed with a unilateral anal sac mass. Anal sacculectomy was performed without complication. Histopathology of the mass was consistent with a well-differentiated mast cell tumor. Analyses for the Ki-67 protein, KIT expression pattern, and the presence of c-kit mutations were done. Recovery from surgery was unremarkable and repeat staging revealed no evidence of mast cell disease at 4, 8, and 12 mo after surgery. To the authors' knowledge, primary mast cell neoplasia of the anal sac has not previously been reported in the veterinary literature. Key clinical message: Although mast cell tumors of the perineal region are commonly encountered in veterinary practice, the anal sac represents a novel location for this disease. Cytology of anal sac masses can be a useful diagnostic tool to confirm the diagnosis, guide staging, and assist in treatment decisions.

Tumeur mastocytaire du sac anal chez un chien. Un chien de race mixte castré âgé de 11 ans a reçu un diagnostic de masse unilatérale du sac anal. La sacculectomie anale a été réalisée sans complication. L'histopathologie de la masse était compatible avec une tumeur mastocytaire bien différenciée. Des analyses de la protéine Ki-67, du modèle d'expression KIT et de la présence de mutations c-kit ont été effectuées. La récupération après la chirurgie était sans particularité et la répétition de la stadification n'a révélé aucun signe de maladie mastocytaire à 4, 8 et 12 mois après la chirurgie. À la connaissance des auteurs, la néoplasie primitive des mastocytes du sac anal n'a pas été signalée auparavant dans la littérature vétérinaire.Message clinique clé:Bien que les tumeurs mastocytaires de la région périnéale soient couramment rencontrées en pratique vétérinaire, le sac anal représente une nouvelle localisation pour cette maladie. La cytologie des masses du sac anal peut être un outil de diagnostic utile pour confirmer le diagnostic, guider la stadification et aider aux décisions de traitement.(Traduit par Dr Serge Messier).

Long-term outcomes associated with a modified versus traditional closed anal sacculectomy for treatment of canine anal sac neoplasia.

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.

Short- and long-term outcomes associated with anal sacculectomy in dogs with massive apocrine gland anal sac adenocarcinoma.

OBJECTIVE: To evaluate short- and long-term outcomes for dogs undergoing anal sacculectomy for massive (> 5 cm) apocrine gland anal sac adenocarcinoma (AGASACA). ANIMALS: 28 client-owned dogs with massive AGASACA. PROCEDURES: A retrospective multi-institutional study was performed. Pre-, intra-, and post-operative data was collected, and variables were statistically analyzed for associations with progression-free interval (PFI) and overall survival (OS). RESULTS: At the time of anal sacculectomy, 19 (68%) dogs underwent concurrent iliosacral lymph node extirpation, including 17 of 18 (94%) dogs with suspected nodal metastasis preoperatively. Five (18%) dogs experienced grade 2 intraoperative complications. Ten (36%) dogs experienced postoperative complications, including 1 grade 3 and 1 grade 4 complication. No dogs had permanent fecal incontinence, tenesmus, or anal stenosis. Nineteen dogs received adjuvant chemotherapy, radiation, or both. Local recurrence occurred in 37% of dogs. Dogs with lymph node metastasis at surgery were more likely than dogs without metastasis to develop new/progressive lymph node metastasis (10/17 [59%] vs 0/10 [0%]; P = .003) and distant metastasis (7/17 [41%] vs 0/10 [0%]; P = .026). Median PFI was 204 days (95% CI, 145 to 392). Median OS was 671 days (95% CI, 225 to upper limit not reached). Nodal metastasis at the time of surgery was associated with shorter PFI (P = .017) but not OS (P = .26). Adjuvant therapy was not associated with outcome. CLINICAL RELEVANCE: Dogs with massive AGASACA experienced prolonged survival following anal sacculectomy despite a high incidence of local recurrence and metastasis. Lymph node metastasis at the time of surgery was a negative prognostic indicator for PFI but not OS.

A relatively high proportion of dogs with small apocrine gland anal sac adenocarcinoma (AGASACA) primary tumours present with locoregional lymph node metastasis.

Apocrine gland anal sac adenocarcinoma (AGASACA) is a highly relevant disease in dogs, with a high rate of lymph node (LN) metastasis during the course of disease. A recent study showed that risk for death and disease progression was significantly associated with primary tumour size less than 2 and 1.3 cm, respectively. The objective of this study was to report the proportion of dogs that have primary tumours less than 2 cm in diameter, that are diagnosed with LN metastasis at presentation. This was a single site retrospective study of dogs that underwent treatment for AGASACA. Dogs were included if physical examination primary tumour measurements were available, abdominal staging was performed, and confirmation of abnormal lymph nodes by cytology or histology was done. Over a 5-year period, 116 dogs were included for review with 53 (46%) having metastatic LN at presentation. The metastatic rate for dogs with primary tumours <2 cm was 20% (9 of 46 dogs) compared to 63% (44 of 70 dogs) in dogs with primary tumours ≥2 cm. The association between tumour size group (<2 vs. ≥2 cm) and the presence of metastasis at presentation was significant (P < .0001) with an OR of 7.0 (95% CI: 2.9-15.7). Primary tumour size was significantly associated with LN metastasis at presentation but the proportion of dogs that presented with LN metastasis in the <2 cm group was relatively high. This data suggests that dogs with small tumours may still have aggressive tumour biology.

Complications associated with iliosacral lymphadenectomy in dogs with metastatic apocrine gland anal sac adenocarcinoma.

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.

Objectif: Rapporter les complications peropératoires et postopératoires immédiates associées à l'ablation des ganglions lymphatiques ilio-sacrés métastatiques chez les chiens atteints d'un adénocarcinome des glandes apocrines des sacs anaux. Animaux: Il y avait 136 chiens appartenant à des clients dans l'étude. Procédure: Étude multi-institutionnelle rétrospective. La base de données des institutions collaboratrices a été recherchée pour les chiens atteints d'un adénocarcinome métastatique des glandes apocrines des sacs anaux qui ont subi une lymphadénectomie pour l'ablation d'un ou plusieurs ganglions lymphatiques ilio-sacrés. Des informations sur le signalement, les anomalies hématologiques, les résultats de la tomodensitométrie abdominale ou de l'échographie, le nombre et la taille des ganglions élargis, les complications peropératoires et postopératoires, le traitement et les résultats ont été recueillis. Résultats: Le taux global de complications associées à la lymphadénectomie ilio-sacrée métastatique était de 26,1 %. La seule complication peropératoire enregistrée était une hémorragie et a été rapportée dans 24 (17,6 %) chirurgies, dont 11 (45,8 %) ont reçu une transfusion sanguine. Des complications postopératoires ont été signalées dans 10,4 % des interventions chirurgicales et comprenaient la formation d'oedème (n = 4, 2,6 %), la paraparésie unilatérale ou bilatérale (n = 4, 2,6 %), l'hypotension (n = 3, 2,0 %), l'infection du site opératoire (n = 2, 1,3 %), la déhiscence de l'incision abdominale (n = 1, 0,6 %), l'incontinence urinaire (n = 1, 0,6 %) et le décès (n = 1, 0,6 %). La taille des ganglions ilio-sacrés était significativement associée à un risque accru de complications, d'hémorragie et à la nécessité d'une transfusion lors d'une lymphadénectomie pour un adénocarcinome métastatique des glandes apocrines des sacs anaux. Conclusion: Les complications associées à la lymphadénectomie ilio-sacrée pour l'adénocarcinome métastatique des glandes apocrines des sacs anaux sont relativement fréquentes et concernent principalement l'hémorragie. Ces complications sont significativement associées à la taille des ganglions lymphatiques métastatiques retirés. Pertinence clinique: Cette étude rétrospective fournit des informations au clinicien concernant les complications chirurgicales potentielles pour le retrait des ganglions lymphatiques ilio-sacrés métastatiques. Ces complications, bien que rares, peuvent être graves et doivent être discutées avec les propriétaires avant la chirurgie.(Traduit par Dr Serge Messier).

Immunolabelling of c-KIT and CAM5.2 in Canine Anal Sac Gland Adenocarcinoma.

The role of c-KIT receptor in anal sac gland adenocarcinoma (ASGAC) is unclear despite its importance in the development of tumours. In this preliminary study, the expression of c-KIT was investigated in rarely observed canine ASGAC. The potential use of CAM5.2 in distinguishing ASGAC from perianal gland tumours was also evaluated. ASGAC was diagnosed in five out of 25 examined perianal tumours. By immunohistochemistry, cytosolic (abnormal) c-KIT expression was seen in four of the five cases. CAM5.2 immunoreactivity was detected in neoplastic cells of all ASGAC cases examined, whereas it was not evident in any case of perianal gland tumour. The findings suggest that c-KIT expression and its cellular localization may be important in the oncogenesis of ASGAC and CAM5.2 can be used to distinguish between ASGAC and perianal gland tumours.

Canine Apocrine Gland Anal Sac Adenocarcinoma: A Review.

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.

Local treatment for canine anal sacculitis: A retrospective study of 33 dogs.

BACKGROUND: Little information has been published regarding treatment of canine anal sacculitis (AS). OBJECTIVES: Primary objective: determine the outcomes of AS local treatment at the referral dermatology service of the authors' institution. SECONDARY OBJECTIVE: determine signalment, body condition score (BCS), stool quality and comorbidities associated with AS. ANIMALS: Thirty-three dogs with AS presented to the referral dermatology service between 1 January 2010 and 31 March 2021. MATERIALS AND METHODS: An electronic medical record search was conducted. Information regarding sex, breed, age at disease onset, weight, BCS, stool quality, comorbidities, treatment and treatment outcome were collected. Treatment outcome was categorised as "resolved clinically", "clinical signs resolved per owner", "did not complete treatment" or "failed". Dogs were excluded if seen by another service, not treated for AS, or if perianal sinuses (fistulae), anal sac masses, or anal sac abscesses were identified. RESULTS: Nineteen dogs were male and 14 female. Twenty-four breeds were included. Average age at disease onset was 4.4 years. Average BCS was 5.8 of 9. Stool quality was "poor" in seven of 33 and normal in 23 of 33 cases. Atopic dermatitis was the most common comorbidity (12 of 33). Treatment typically consisted of anal sac flushing with saline followed by infusion using a commercially available steroid/antibiotic/antifungal ointment. Treatment was repeated on average 2.9 times. Resolution of AS was obtained in 24 of 33 cases, clinical signs resolved per owner in four of 33, five of 33 cases did not complete treatment, and no cases failed treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Local treatment with flushing and infusion is effective for treating AS in dogs.

Contexte - Peu d'informations ont été publiées concernant le traitement de la sacculite anale canine (SA). Objectifs - Objectif principal : déterminer les résultats du traitement local de la SA au service de dermatologie des auteurs. Objectif secondaire : déterminer le signalement, le score d'état corporel (BCS), la qualité des selles et les comorbidités associées à la SA. Animaux - Trente-trois chiens SA présentés au service de dermatologie entre le 1er janvier 2010 et le 31 mars 2021. Matériels et méthodes - Une recherche dans le dossier médical électronique a été effectuée. Des informations concernant le sexe, la race, l'âge au début de la maladie, le poids, le BCS, la qualité des selles, les comorbidités, le traitement et les résultats du traitement ont été recueillies. Le résultat du traitement a été classé comme « résolu cliniquement ¼, « signes cliniques résolus par le propriétaire ¼, « n'a pas terminé le traitement ¼ ou « échec ¼. Les chiens ont été exclus s'ils étaient vus par un autre service, non traités pour la SA, ou si des sinus périanaux (fistules), des masses du sac anal ou des abcès du sac anal étaient identifiés. Résultats - Dix-neuf chiens étaient des mâles et 14 des femelles. Vingt-quatre races ont été incluses. L'âge moyen au début de la maladie était de 4,4 ans. Le BCS moyen était de 5,8 sur 9. La qualité des selles était « mauvaise ¼ dans sept cas sur 33 et normale dans 23 cas sur 33. La dermatite atopique était la comorbidité la plus fréquente (12 sur 33). Le traitement consistait généralement en un rinçage du sac anal avec une solution saline suivi d'une perfusion à l'aide d'une pommade stéroïde/antibiotique/antifongique disponible dans le commerce. Le traitement a été répété en moyenne 2,9 fois. La résolution de la SA a été obtenue dans 24 des 33 cas, les signes cliniques ont disparu dans quatre des 33 cas, cinq des 33 cas n'ont pas terminé le traitement et aucun cas n'a échoué au traitement. Conclusions et pertinence clinique - Le traitement local par rinçage et perfusion est efficace pour traiter la SA chez le chien.

Introducción- se ha publicado poca información sobre el tratamiento de la saculitis anal canina (AS). Objetivos - Objetivo primario: determinar los resultados del tratamiento local de la AS en el servicio de referencia dermatológica de la institución de los autores. Objetivo secundario: determinar la presentación clínica, la puntuación de la condición corporal (BCS), la calidad de las heces y las comorbilidades asociadas a la AS. Animales - Treinta y tres perros con AS presentados al servicio de dermatología de referencia entre el 1 de enero de 2010 y el 31 de marzo de 2021. Materiales y métodos - Se realizó una búsqueda en la historia clínica electrónica. Se recopiló información sobre sexo, raza, edad de inicio de la enfermedad, peso, BCS, calidad de las heces, comorbilidades, tratamiento y resultado del tratamiento. El resultado del tratamiento se clasificó como "resuelto clínicamente", "signos clínicos resueltos por propietario", "no completó el tratamiento" o "fracasó". Los perros fueron excluidos si fueron vistos por otro servicio, no tratados por AS, o si se identificaron senos perianales (fístulas), masas en los sacos anales o abscesos en los sacos anales. Resultados- diecinueve perros eran machos y 14 hembras. Se incluyeron veinticuatro razas. La edad promedio de inicio de la enfermedad fue de 4,4 años. BCS promedio fue 5.8 de 9. La calidad de las heces fue "mala" en siete de 33 y normal en 23 de 33 casos. La dermatitis atópica fue la comorbilidad más común (12 de 33). El tratamiento generalmente consistía en enjuagar el saco anal con solución salina seguido de una infusión usando un ungüento de esteroide/antibiótico/antifúngico disponible en el mercado. El tratamiento se repitió un promedio de 2,9 veces. La resolución de AS se obtuvo en 24 de 33 casos, los signos clínicos se resolvieron por propietario en cuatro de 33, cinco de 33 casos no completaron el tratamiento y ningún caso fracasó en el tratamiento. Conclusiones y relevancia clínica- el tratamiento local con lavado e infusión intrasacular es eficaz para tratar la AS en perros.

Contexto - Poucas informações foram publicadas sobre o tratamento da saculite anal (SA) canina. Objetivos - Objetivo primário: determinar os desfechos do tratamento tópico localizado da SA em um serviço especializado de dermatologia veterinária da instituição do autor. Objetivo secundário: determinar as manifestações clínicas, escore de condição corporal (ECC), qualidade das fezes e comorbidades associadas à SA. Animais - Trinta e três cães com SA apresentados ao serviço de dermatologia entre 1° de janeiro de 2010 e 39 de março de 2021. Materiais e métodos - Realizou-se um levantamento de prontuários eletrônicos. Foram coletadas informações sobre sexo, raça, idade no surgimento da doença, peso, ECC, qualidade das fezes, comorbidades, tratamentos e desfecho do tratamento. O desfecho do tratamento foi categorizado como "resolvido clinicamente", "sinais clínicos resolvidos de acordo com o tutor", "não completou o tratamento" ou "falhou". Os cães foram excluídos do estudo se tivessem sido tratados em outro serviço, não tivessem sido tratados para SA, ou se fossem identificados abscessos, massas ou fístulas nos sacos anais. Resultados - Dezenove cães eram machos e 14 fêmeas. Vinte e quatro raças foram incluídas. A idade média no surgimento da doença foi de 4,4 anos. O ECC médio foi 5,8 em 9. A qualidade das fezes foi ruim em sete de 33 cães e normal em 22 de 33 casos. A dermatite atópica foi a comorbidade mais comum (12 de 33). O tratamento tipicamente consistiu de lavagem dos sacos anais com solução salina seguido de infusão de uma solução comercial contendo esteroide/antibiótico/antifúngico. O tratamento foi repetido em média 2,9 vezes. Resolução da SA foi alcançada em 24 de 33 casos, os sinais clínicos se resolveram de acordo com o tutor em quatro de 33 casos, cinco de 33 casos não completaram o tratamento e em nenhum caso houve falha terapêutica. Conclusões e relevância clínica - Tratamento tópico com lavagem e infusão é eficaz para tratar SA em cães.

Updated Concepts in Oncologic Surgery: Apocrine Gland Anal Sac Adenocarcinoma and Mast Cell Tumors.

Advancements within the field of veterinary surgical oncology are constantly presenting themselves, especially with continued development of comprehensive cancer programs. With the use of more advanced imaging techniques within veterinary medicine, tumor staging is improving and techniques novel to veterinary medicine are being evaluated for potential clinical application. Recommended tumor staging and treatment approach for apocrine gland anal sac adenocarcinoma in dogs has evolved, with the anticipation of good long-term patient outcomes. Preoperative staging for mast cell tumors and recommendations for surgical margins to obtain for wide surgical excision is being reassessed by surgeons.

Retrospective assessment of radiation toxicity from a definitive-intent, moderately hypofractionated image-guided intensity-modulated protocol for anal sac adenocarcinoma in dogs.

A recent calculation study predicted acceptable toxicity in pelvic organs at risk for a new definitive-intent, moderately hypofractionated radiation therapy (RT) protocol (12 x 3.8 Gy), when used with image-guided intensity-modulated radiation therapy (IG-IMRT). We hypothesized this protocol to result in clinically acceptable radiation toxicities. Dogs diagnosed with and irradiated for anal sac adenocarcinoma (ASAC) were retrospectively assessed. Eleven dogs were included, six had prior surgery. Before any therapy, staging according to Polton et al. resulted in the following distribution: stage 1 (n = 1), stage 2 (n = 1), stage 3a (n = 6), stage 3b (n = 3). We scored radiation toxicities at the end of therapy, at weeks 1, 3 and every 3 months after RT according to Veterinary Radiation Therapy Oncology Group radiation toxicity criteria. Clinical follow-up was maintained on regular intervals combined with computed tomography (n = 3). Median follow-up time for dogs still alive was 594 days (range: 224-972 days). Within 1 week post treatment, eight dogs (73%) developed grade 2 and four dogs (36%) grade 1 acute toxicity in the perianal region. All acute toxicities resolved or improved to grade 1 within 3 weeks after treatment. Late toxicity, for example, chronic colitis/diarrhoea, ulcerations, strictures or myelopathies was not observed in any patient. Five dogs were euthanized 105, 196, 401, 508 and 908 days after RT and six dogs were still alive, one in spite of progressive disease. The median progression-free survival was 908 days (95%CI: 215; 1602). The previous theoretically described definitive-intent, moderately hypofractionated protocol using IG-IMRT for the treatment of advanced ASAC showed clinically acceptable acute and late toxicities.

Computed tomographic staging of dogs with anal sac adenocarcinoma.

OBJECTIVES: To describe the CT appearance of anal sac adenocarcinoma lesions in a population of dogs including the relations between primary tumour, and locoregional and distant metastasis. MATERIALS AND METHODS: Retrospective review of dogs with confirmed anal sac adenocarcinoma and available CT images of the thorax, abdomen and pelvis. RESULTS: A population of 70 dogs were included in the study. No association was found between anal sac mass size and presence or absence of iliosacral lymph node enlargement. The prevalence of local metastatic disease characterised by iliosacral lymphadenomegaly in this study was 71%, with pulmonary metastases identified in 11% of cases. There were no cases of distant pulmonary metastasis without concurrent locoregional lymphadenomegaly. CLINICAL SIGNIFICANCE: In our population of dogs local metastatic spread of anal sac adenocarcinoma was common, with a relatively low prevalence of pulmonary metastasis. The study demonstrates the importance of thorough rectal examination and/or imaging to assess the iliosacral lymph centre in this disease irrespective of the size of the anal sac mass.

Canine anal sac gland carcinoma with regional lymph node metastases treated with sacculectomy and lymphadenectomy: Outcome and possible prognostic factors.

The staging system commonly used in canine anal sac gland carcinoma (ASGC) is a revised Tumour-Node-Metastasis (TNM) system published in 2007. This staging system consists in four stages and, for dogs with nodal metastases, the size of the metastatic lymph node (mLN) defines the N stage. However, we hypothesise that (1) the mLN size has no prognostic significance when the mLN can be excised, (2) a high number of mLNs is associated with poorer prognosis and (3) the measurement of the mLN on imaging is not reproducible. To investigate these hypotheses, medical records and diagnostic images of dogs with ASGC and mLN, treated with sacculectomy and lymphadenectomy, with or without chemotherapy, were reviewed. Interobserver variability for mLN measurement was assessed. Prognostic factors including mLN size and number were investigated. Time to documented progression (TDP) and disease-specific survival (DSS) were evaluated. Progression-free interval (PFI) was analysed with interval-censored data analysis. Fifty-seven dogs were included. The median PFI, TDP and DSS were 110 (95%CI 61.5-185.5), 196 (95%CI 162-283) and 340 days (95%CI 321-471), respectively. For measurement of the largest mLN, interobserver agreement was excellent but limits of agreement reached 39.7%. Neither the size of the largest mLN nor the use of adjuvant chemotherapy were associated with outcome. The number of mLNs was associated with outcome and having more than four mLNs was associated with shorter PFI (p < .001), TDP (p = .004) and DSS (p < .001). While mLN size measurement was not consistently reproducible and did not influence outcome in our cohort, number of mLNs did. Further studies are required for development of a revised staging system.

Outcomes and complications of anal sacculectomy for non-neoplastic anal sac disease in cats: 8 cases (2006-2019).

OBJECTIVES: To describe the features of non-neoplastic anal sac disease in cats, the surgical procedure, complications, surgical outcome and prognosis compared to well-established data for anal sacculectomy in canine patients. MATERIALS AND METHODS: A retrospective review of medical records of cats undergoing anal sacculectomy for non-neoplastic disease between 2006 and 2019. RESULTS: Eight cats were included in the study of which four of eight developed minor and self-limiting complications including defaecatory complications in three cases and superficial corneal ulceration in one case. No cat developed permanent faecal incontinence. No long-term postoperative complication was recorded. Median surgical time was 35 minutes (range, 20 to 42). Median hospitalisation time was 1.5 days (range, 1 to 4). The incidence of short-term minor complications is higher than previously reported in dogs, although this might be in agreement with a reported higher incidence in dogs smaller than 15 kg. CLINICAL SIGNIFICANCE: Anal sacculectomy for non-neoplastic anal sac disease is a safe procedure in cats with relatively high rate of short-term but self-limiting, minor, postoperative complications.