Primary perianal malignant melanoma in a dog - combination therapy

Background: Melanocytic neoplasm can arise from melanocytes in any location of the body. Malignant melanoma (MM)has a poor prognosis in dogs and presence of lymphvascular invasion, distant metastasis, or mitotic activity present prognostic value. Primary melanoma affecting the gastrointestinal tract has been rarely reported in veterinary literature, thusthe prognosis affecting gastrointestinal tract is unknown. Electrochemotherapy (ECT) is an effective local treatment whichcombines chemotherapeutic drugs mainly bleomycin or cisplatin followed by the delivery of permeabilizing electricalpulses However, other hydrophilic drugs seem to present an increase cytotoxic effect such as carboplatin.Case: A 9-year-old mixed-breed neutered dog was referred to a private clinic with a mass in the perianal region diagnosedas perianal melanoma. No metastasis was observed on abdominal ultrasound nor chest x-ray (3 views). Clinical signs notedwere tenesmus, hemorrhagic discharge, weight loss and hyporexia. Considering the tumor volume (16.0 x 10.0 cm), a neoadjuvant ECT session was proposed. The authors opted for carboplatin (300 mg/m2, intravenously), administered over 20min and cisplatin intratumorally (1 mg/cm3, equivalent to 1 mL/1cm3 total volume 20 mL) administered in the upper partsof the mass that could be reached while avoiding drug leakage. After administration, sequences of eight biphasic pulses,(100 microseconds), with a voltage ranging from 650-1,000V/cm (pulse generator Onkodisruptor®) using a hexagonal/single pair and plate electrode were delivered. At day 30th, a partial response was observed accordingly to RECIST system,with tumor size of 5.0 x 5.0 cm (65.4 cm3). A second ECT session was performed with the same previous protocol, butwith a decreased dosage of carboplatin (240 mg/m2 consistent with 20% reduction) due to adverse effects in the first session, resulting in stable disease at day 60th (30 days after second ECT). Then...(AU)

Primary perianal malignant melanoma in a dog - combination therapy

Background: Melanocytic neoplasm can arise from melanocytes in any location of the body. Malignant melanoma (MM)has a poor prognosis in dogs and presence of lymphvascular invasion, distant metastasis, or mitotic activity present prognostic value. Primary melanoma affecting the gastrointestinal tract has been rarely reported in veterinary literature, thusthe prognosis affecting gastrointestinal tract is unknown. Electrochemotherapy (ECT) is an effective local treatment whichcombines chemotherapeutic drugs mainly bleomycin or cisplatin followed by the delivery of permeabilizing electricalpulses However, other hydrophilic drugs seem to present an increase cytotoxic effect such as carboplatin.Case: A 9-year-old mixed-breed neutered dog was referred to a private clinic with a mass in the perianal region diagnosedas perianal melanoma. No metastasis was observed on abdominal ultrasound nor chest x-ray (3 views). Clinical signs notedwere tenesmus, hemorrhagic discharge, weight loss and hyporexia. Considering the tumor volume (16.0 x 10.0 cm), a neoadjuvant ECT session was proposed. The authors opted for carboplatin (300 mg/m2, intravenously), administered over 20min and cisplatin intratumorally (1 mg/cm3, equivalent to 1 mL/1cm3 total volume 20 mL) administered in the upper partsof the mass that could be reached while avoiding drug leakage. After administration, sequences of eight biphasic pulses,(100 microseconds), with a voltage ranging from 650-1,000V/cm (pulse generator Onkodisruptor®) using a hexagonal/single pair and plate electrode were delivered. At day 30th, a partial response was observed accordingly to RECIST system,with tumor size of 5.0 x 5.0 cm (65.4 cm3). A second ECT session was performed with the same previous protocol, butwith a decreased dosage of carboplatin (240 mg/m2 consistent with 20% reduction) due to adverse effects in the first session, resulting in stable disease at day 60th (30 days after second ECT). Then...

Laparoscopic-assisted approach to the pelvic flexure for surgical treatment of sand impaction in a horse

Background: Laparoscopy provides good visualization of horses abdominal cavity, besides providing minimal invasiveness and meticulous manipulation intra-abdominal organs. Laparoscopy is suitable for both diagnosing and treating acute abdomen in horses. The purpose of this study was to report a successful case of laparoscopic-assisted surgery for treating sand impaction in a horse.Case: A 3-year-old horse, weighing 460 kg, was admitted following chronic intermittent episodes of diarrhea and colic. Physical exam revealed mild abdominal pain and liquid/pasty diarrhea. There was negative survey of gastrointestinal helminthes and microbiological analyses. Fecal sedimentation test revealed sand impaction. Surgical approach was opted for both accomplishment of the abdominal exploration and resolution of the impactation. The patient was anesthetized and positioned in dorsal recumbency. Laparoscopy was performed through an 11-mm trocar placed right cranially to the umbilicus. There were no apparent adhesions, bowel inflammation nor visceral displacement. A 15-cm celiotomy was carried out caudally to the umbilicus, under laparoscopic guidance, for initial inspection of the gastrointestinal tract. Incision enlargement was required for exteriorizing the pelvic flexure. Afterwards, enterotomy was carried out for drainage of the impactating content, followed by enterorraphy. The pelvic flex...

Laparoscopic-assisted approach to the pelvic flexure for surgical treatment of sand impaction in a horse

Background: Laparoscopy provides good visualization of horses abdominal cavity, besides providing minimal invasiveness and meticulous manipulation intra-abdominal organs. Laparoscopy is suitable for both diagnosing and treating acute abdomen in horses. The purpose of this study was to report a successful case of laparoscopic-assisted surgery for treating sand impaction in a horse.Case: A 3-year-old horse, weighing 460 kg, was admitted following chronic intermittent episodes of diarrhea and colic. Physical exam revealed mild abdominal pain and liquid/pasty diarrhea. There was negative survey of gastrointestinal helminthes and microbiological analyses. Fecal sedimentation test revealed sand impaction. Surgical approach was opted for both accomplishment of the abdominal exploration and resolution of the impactation. The patient was anesthetized and positioned in dorsal recumbency. Laparoscopy was performed through an 11-mm trocar placed right cranially to the umbilicus. There were no apparent adhesions, bowel inflammation nor visceral displacement. A 15-cm celiotomy was carried out caudally to the umbilicus, under laparoscopic guidance, for initial inspection of the gastrointestinal tract. Incision enlargement was required for exteriorizing the pelvic flexure. Afterwards, enterotomy was carried out for drainage of the impactating content, followed by enterorraphy. The pelvic flex...(AU)

Laparoscopic adhesiolysis in a mini pony

Background: Intraperitoneal adhesions are common in equines, especially following exploratory celiotomy. Adhesiolysis is the treatment of choice for patients presenting postsurgical adhesions. Laparoscopic approach for adhesiolysis presents several advantageous aspects in human patients. The aim of the current study was to report a case of successful laparoscopic adhesiolysis in a mini pony horse. Case: A male Shetland Pony, weighing 140 kg, was admitted under complaint of right hind limb trauma and treated surgically for metatarsal fracture reduction. The patient has also had intermittent episodes of colic and was always treated clinically without major complications. The pony had no history of previous abdominal surgery and no episodes of acute abdomen were seen during hospital stay. Three months following ostheosynthesis, an exploratory laparoscopic approach was carried out to assess the possible cause or consequences of the episodes of acute abdomen. The patient was submitted to general anesthesia, positioned in dorsal recumbency and the abdomen was clipped and aseptically prepared for surgery. During the laparoscopic inspection, there were adhesions involving the ventral abdominal wall and a ventral mesogastric segment of duodenum. Laparoscopic adhesiolysis was performed using a two-port approach, by gently breaking the adhesion bands using meticulous traction with a 10-mm laparoscopic atraumatic Babcock forceps. Afterwards, the intestinal loop was rinsed with heparin sodium solution diluted in normal saline. The pneumoperitoneum was completely drained and the trocars sequentially withdrawn from the abdominal wall. The synthesis of the muscular layer was carried out using an interrupted cross mattress pattern, followed by synthesis of the skin with an interrupted cushion pattern. Total surgical time was 58 min. the patient was able to recover without complications. In the early postoperative period, the surgical recovery was considered excellent. No apparent adhesion involving the previously affected intestinal loop was found during the ultrasound exam following 15 days of surgery. Furthermore, the surgical wounds had healed completely, with no complications. Discussion: In the current case report, the primary cause of the acute abdomen episodes was not determined since the patient had never undergone abdominal surgery. It was hypothesized that an acute inflammation of the duodenal loop that was involved by the adhesion bands may have triggered the adhesiogenesis. Laparoscopy was efficient and presented a short operative time, due to magnification of image and adequate observation of structures surrounded by adhesion bands. Although the use of Babcock forceps is not usually recommended for adhesiolysis in the current literature, it was both effective in manipulating the bowel and performing the adhesiolysis. The heparin solution diluted in normal saline was effective in preventing the recurrence of new adhesions, which was evidenced by ultrasonography following 15 days. The laparoscopic approach usually minimizes the new formation of adhesions as trauma to the peritoneal surfaces is minimized by the use of delicate instruments, as observed in the current study. In addition, laparoscopy reduces the possibility of contact among the peritoneal surfaces and foreign bodies, such as gauze, glove powder and room air particles. Moreover, it maintains the abdominal surfaces in adequate humidity environment.