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Culp WTN. Veterinary Interventional Oncology. Vet Clin North Am Small Anim Pract 2024; 54:491-500. [PMID: 38184437 DOI: 10.1016/j.cvsm.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2024]
Abstract
Interventional oncology (IO) is a rapidly growing field in veterinary medicine and has been accepted as a fourth pillar of treatment of neoplastic disease with other modalities including surgery, chemotherapy, and radiation therapy. The major categories of IO therapies in companion animals are focused on the use of locoregional therapies and stenting of malignant obstructions. Although significant assessment of veterinary IO techniques is still necessary, early evaluation of these varying techniques is demonstrating promising results.
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Affiliation(s)
- William T N Culp
- University of California-Davis, School of Veterinary Medicine, One Garrod Drive, Davis, CA 95616, USA.
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2
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Lea C, Kelly D. Single-step, non-surgical placement of permanent low-profile cystostomy tubes in dogs: 10 cases (2018-2023). J Small Anim Pract 2024. [PMID: 38616108 DOI: 10.1111/jsap.13732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/11/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVES Low-profile cystostomy tubes provide an alternative to conventional cystostomy tubes with external tubing. Previously, these have been placed surgically involving coeliotomy, cystotomy and cystopexy, or have been used as replacement tubes in existing stoma sites. The purpose of this study is to describe a technique for, and the outcomes of, single-step, non-surgical low-profile cystostomy tube placement. MATERIALS AND METHODS All cases that had single-step, non-surgical placement of low-profile cystotomy tube attempted at the authors' institutions were included in this study. Data, including success rates, outcomes and complications, were extracted from the medical records. RESULTS Ten client-owned dogs were inclided. Single-step, non-surgical placement was successful in eight out of 10 dogs, with placement being unsuccessful in two thus necessitating coeliotomy. The median duration that low-profile cystostomy tubes were in place was 7.0 months (range 4 days to 38 months). Seven of the eight dogs required replacement of their cystostomy tube. Mean time until first tube replacement was 103 days (range 13 to 363 days). CLINICAL SIGNIFICANCE Single-step, non-surgical placement of a low-profile cystostomy tube is a viable alternative to surgical placement. Lack of cystopexy does not appear to result in complications. Conversion to coeliotomy might be required if tube placement is not successful with this technique. Complications seen with non-surgical tube placement such as inadvertent tube removal were similar to those previously reported for surgically placed tubes.
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Affiliation(s)
- C Lea
- Southern Counties Veterinary Specialists, Ringwood, Hampshire, UK
| | - D Kelly
- Southern Counties Veterinary Specialists, Ringwood, Hampshire, UK
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3
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Kendall A, Byron JK, Westropp JL, Coates JR, Vaden S, Adin C, Oetelaar G, Bartges JW, Foster JD, Adams LG, Olby N, Berent A. ACVIM consensus statement on diagnosis and management of urinary incontinence in dogs. J Vet Intern Med 2024; 38:878-903. [PMID: 38217372 PMCID: PMC10937496 DOI: 10.1111/jvim.16975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/12/2023] [Indexed: 01/15/2024] Open
Abstract
Urinary incontinence (UI) is a disorder of micturition that can occur in dogs of any age, sex, and breed depending on the underlying cause and time of onset. Diagnosis and treatment for various causes of UI in dogs have been described by multiple comprehensive single author review articles, but large prospective clinical trials comparing treatment outcomes in veterinary medicine are lacking. The objectives of this consensus statement therefore are to provide guidelines on both recommended diagnostic testing and treatment for various causes of UI in dogs. Specifically, pathophysiology directly related to the canine urinary system will be reviewed and diagnostic and therapeutic challenges will be addressed. A panel of 12 experts in the field (8 small animal internists [L. Adams, J. Bartges, A. Berent, J. Byron, J. Foster, A. Kendall, S. Vaden, J. Westropp], 2 neurologists [J. Coates, N. Olby], 1 radiologist [G. Oetelaar], and 1 surgeon [C. Adin]) was formed to assess and summarize evidence in the peer-reviewed literature and to complement it with consensus recommendations using the Delphi method. Some statements were not voted on by all panelists. This consensus statement aims to provide guidance for management of both male and female dogs with underlying storage or voiding disorders resulting in UI.
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Affiliation(s)
- Allison Kendall
- Department of Veterinary Clinical SciencesNC State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Julie K. Byron
- Department of Veterinary Clinical SciencesThe Ohio State University College of Veterinary MedicineColumbusOhioUSA
| | - Jodi L. Westropp
- Department of Veterinary Medicine and EpidemiologyUniversity of CADavisCaliforniaUSA
| | - Joan R. Coates
- Department of Veterinary Medicine and SurgeryUniversity of Missouri College of Veterinary MedicineColumbiaMissouriUSA
| | - Shelly Vaden
- Department of Veterinary Clinical SciencesNC State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Chris Adin
- Department of Small Animal Clinical SciencesCollege of Veterinary Medicine, University of FloridaGainesvilleFloridaUSA
| | - Garrett Oetelaar
- VCA Canada Calgary Animal Referral and Emergency (CARE) CentreCalgaryAlbertaCanada
| | - Joe W. Bartges
- College of Veterinary MedicineUniversity of GeorgiaAthensGeorgiaUSA
| | | | - Larry G. Adams
- Department of Veterinary Clinical SciencesPurdue University College of Veterinary MedicineWest LafayetteIndianaUSA
| | - Natasha Olby
- Department of Veterinary Clinical SciencesNC State University College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Allyson Berent
- Service of Interventional Radiology and Interventional EndoscopyAnimal Medical CenterNew York CityNew YorkUSA
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Graczyk S, Pasławski R, Grzeczka A, Pasławska U, Świeczko-Żurek B, Malisz K, Popat K, Sionkowska A, Golińska P, Rai M. Antimicrobial and Antiproliferative Coatings for Stents in Veterinary Medicine-State of the Art and Perspectives. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6834. [PMID: 37959431 PMCID: PMC10649059 DOI: 10.3390/ma16216834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023]
Abstract
Microbial colonization in veterinary stents poses a significant and concerning issue in veterinary medicine. Over time, these pathogens, particularly bacteria, can colonize the stent surfaces, leading to various complications. Two weeks following the stent insertion procedure, the colonization becomes observable, with the aggressiveness of bacterial growth directly correlating with the duration of stent placement. Such microbial colonization can result in infections and inflammations, compromising the stent's efficacy and, subsequently, the animal patient's overall well-being. Managing and mitigating the impact of these pathogens on veterinary stents is a crucial challenge that veterinarians and researchers are actively addressing to ensure the successful treatment and recovery of their animal patients. In addition, irritation of the tissue in the form of an inserted stent can lead to overgrowth of granulation tissue, leading to the closure of the stent lumen, as is most often the case in the trachea. Such serious complications after stent placement require improvements in the procedures used to date. In this review, antibacterial or antibiofilm strategies for several stents used in veterinary medicine have been discussed based on the current literature and the perspectives have been drawn. Various coating strategies such as coating with hydrogel, antibiotic, or other antimicrobial agents have been reviewed.
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Affiliation(s)
- Szymon Graczyk
- Institute of Veterinary Medicine, Department of Biological and Veterinary Sciences, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland; (R.P.); (A.G.); (U.P.)
| | - Robert Pasławski
- Institute of Veterinary Medicine, Department of Biological and Veterinary Sciences, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland; (R.P.); (A.G.); (U.P.)
| | - Arkadiusz Grzeczka
- Institute of Veterinary Medicine, Department of Biological and Veterinary Sciences, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland; (R.P.); (A.G.); (U.P.)
| | - Urszula Pasławska
- Institute of Veterinary Medicine, Department of Biological and Veterinary Sciences, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland; (R.P.); (A.G.); (U.P.)
| | - Beata Świeczko-Żurek
- Department of Biomaterials Technology, Faculty of Mechanical Engineering and Ship Technology, Gdansk University of Technology, Gabriela Narutowicza 11/12, 80-229 Gdansk, Poland; (B.Ś.-Ż.); (K.M.)
| | - Klaudia Malisz
- Department of Biomaterials Technology, Faculty of Mechanical Engineering and Ship Technology, Gdansk University of Technology, Gabriela Narutowicza 11/12, 80-229 Gdansk, Poland; (B.Ś.-Ż.); (K.M.)
| | - Ketul Popat
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA;
| | - Alina Sionkowska
- Department of Biomaterials and Cosmetic Chemistry, Faculty of Chemistry, Nicolaus Copernicus University in Torun, Gagarina 7, 87-100 Torun, Poland
| | - Patrycja Golińska
- Department of Microbiology, Nicolaus Copernicus University, ul. Lwowska 1, 87-100 Torun, Poland;
| | - Mahendra Rai
- Department of Chemistry, Federal University of Piaui (UFPI), Teresina 64049-550, Brazil;
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Ciriano Cerdà E, Zajc AL, Finotello R, Macdonald K, Lyseight F, Van Den Steen N, Sanchez Gonzalez K, Marrington M, Grant J. Meloxicam in Combination with Mitoxantrone or Vinblastine as First-Line Treatment for Non-Resectable Urothelial Cell Carcinoma in Dogs. Vet Sci 2023; 10:529. [PMID: 37624316 PMCID: PMC10458788 DOI: 10.3390/vetsci10080529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
Cyclooxygenase (COX) inhibitors have been demonstrated to have antitumour activity in canine urothelial cell carcinoma (UCC), given as a sole treatment or in combination with chemotherapy. The purpose of this retrospective multi-institutional study was to assess the efficacy of meloxicam in combination with mitoxantrone or vinblastine as a first-line treatment for non-resectable canine UCC. Gastrointestinal adverse effects (AEs) of these treatment combinations were also assessed. A total of 28 dogs met the inclusion criteria, 21/28 dogs received mitoxantrone and meloxicam, and 7/28 received vinblastine and meloxicam. Tumour response (TR) and AE were evaluated according to Veterinary Co-Operative Oncology Group (VCOG) criteria. The endpoint of the study was the time to tumour progression (TTP). The mitoxantrone-group induced 24% partial response and 62% stable disease, while the vinblastine-group induced 14% and 86%, respectively. Median TTP was 84 days (mitoxantrone and meloxicam, 70 days; and vinblastine and meloxicam, 178 days). The presence of metastatic disease significantly decreased TTP (p = 0.007). Gastrointestinal AEs were reported in 21.4% of the patients, with the most common being VCOG grade 1-2 diarrhoea. Meloxicam is a well-tolerated NSAID when combined with mitoxantrone or vinblastine as first-line treatment for non-resectable canine UCC.
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Affiliation(s)
- Estel.la Ciriano Cerdà
- Northwest Veterinary Specialists, Part of Linnaeus Veterinary Limited, Ashville Point, Beechwood, Sutton Weaver, Runcorn WA7 3FW, UK
| | - Alenka Lavra Zajc
- Northwest Veterinary Specialists, Part of Linnaeus Veterinary Limited, Ashville Point, Beechwood, Sutton Weaver, Runcorn WA7 3FW, UK
| | - Riccardo Finotello
- Department of Small Animal Clinical Sciences, Department of Veterinary Anatomy Physiology and Pathology, Institute of Infection Veterinary and Ecological Sciences, University of Liverpool, Chester High Rd, Neston CH64 7TE, UK; (R.F.)
| | - Kirsty Macdonald
- Department of Small Animal Clinical Sciences, Department of Veterinary Anatomy Physiology and Pathology, Institute of Infection Veterinary and Ecological Sciences, University of Liverpool, Chester High Rd, Neston CH64 7TE, UK; (R.F.)
| | - Filipa Lyseight
- Dick White Referrals, Station Farm, London Road, Six Mile Bottom, Cambridgeshire CB8 0UH, UK
| | - Nele Van Den Steen
- Cave Veterinary Specialists, George’s Farm, West Buckland, Nr. Wellington TA21 9LE, UK
| | - Katia Sanchez Gonzalez
- Southern Counties Veterinary Specialists, Forest Corner Farm, Hangersley, Ringwood BH24 3JW, UK
| | - Mary Marrington
- Northwest Veterinary Specialists, Part of Linnaeus Veterinary Limited, Ashville Point, Beechwood, Sutton Weaver, Runcorn WA7 3FW, UK
| | - Jessica Grant
- Northwest Veterinary Specialists, Part of Linnaeus Veterinary Limited, Ashville Point, Beechwood, Sutton Weaver, Runcorn WA7 3FW, UK
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Ghisoni G, Foglia A, Sabattini S, Agnoli C, Dondi F, Perfetti S, Marconato L. A Retrospective Clinico-Pathologic Study of 35 Dogs with Urethral Transitional Cell Carcinoma Undergoing Treatment. Animals (Basel) 2023; 13:2395. [PMID: 37508172 PMCID: PMC10376480 DOI: 10.3390/ani13142395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/23/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023] Open
Abstract
Chemotherapy and cyclooxygenase inhibitors (COXi) are primary treatments for canine urethral transitional cell carcinoma (uTCC), a tumor known for its aggressiveness and poor prognosis. This retrospective study aimed to evaluate the clinico-pathological characteristics, treatment modalities, and prognostic factors of 35 dogs with confirmed uTCC that received chemotherapy and COXi. Upon admission, urethral obstruction (UO) and urinary tract infection (UTI) were observed in seven (20%) dogs each. Gemcitabine (n = 20; 57.1%) and vinblastine (n = 10; 28.6%) were commonly used as first-line therapies, with four dogs also receiving radiation therapy. Based on RECIST, one (2.9%) dog achieved complete remission, nine (25.7%) partial remission, 20 (57.14%) showed stable disease, and five (14.3%) progressed. Among dogs with UO, six (85.7%) showed resolution or improvement after the first chemotherapy dose. The median time to local progression was 171 days (range: 107-235), and the median survival time was 333 days (range: 158-508). Dogs with UO upon admission had a higher risk of local progression, while both UO and UTI were associated with an increased risk of overall disease progression and tumor-related death. Additionally, gemcitabine significantly improved metastatic control. This study identified UO and UTI as negative prognostic factors, highlighting the importance of a multimodal approach in managing uTCC.
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Affiliation(s)
- Giulia Ghisoni
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Armando Foglia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Chiara Agnoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Simone Perfetti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
| | - Laura Marconato
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, 40064 Ozzano dell'Emilia, BO, Italy
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Graczyk S, Pasławski R, Grzeczka A, Litwińska L, Jagielski D, Pasławska U. Stents in Veterinary Medicine. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1480. [PMID: 36837110 PMCID: PMC9959717 DOI: 10.3390/ma16041480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Stenting in veterinary medicine has been a rapidly growing method of interventional surgery for several years. This procedure is usually performed in the respiratory and urinary tracts, but there are cases of stenting of blood vessels or gastrointestinal structures. It is based on maintaining the permeability of a given tubular structure, thus allowing the passage of gas or liquid. This procedure is often performed as a first-line treatment in situations where pharmacological agents do not work and as an alternative method, often cheaper than the classically performed ones. There are also cases where stenting is used as a palliative treatment, e.g., to enable defecation in colonic obstruction due to tumour infiltration of the colon wall. Stenting is often a life-saving or comfort-improving procedure for animals, but one should also be aware of possible postoperative complications and be prepared for any adversity. For this reason, this review provides an insight into the current knowledge in veterinary medicine about stenting and the consequences associated with this procedure.
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8
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Weinekötter J, Gurtner C, Protschka M, von Bomhard W, Böttcher D, Schlinke A, Alber G, Rösch S, Steiner JM, Seeger J, Oechtering GU, Heilmann RM. Tissue S100/calgranulin expression and blood neutrophil-to-lymphocyte ratio (NLR) in dogs with lower urinary tract urothelial carcinoma. BMC Vet Res 2022; 18:412. [PMID: 36411489 PMCID: PMC9680134 DOI: 10.1186/s12917-022-03513-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/10/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Urothelial carcinoma (UC) is the most common neoplasm of the canine lower urinary tract, affecting approximately 2% of dogs. Elderly female patients of certain breeds are predisposed, and clinical signs of UC can easily be confused with urinary tract infection or urolithiasis. Diagnosis and treatment are challenging given the lack of disease-specific markers and treatments. The S100A8/A9 complex and S100A12 protein are Ca2+-binding proteins expressed by cells of the innate immune system and have shown promise as urinary screening markers for UC. The neutrophil-to-lymphocyte ratio (NLR) can also aid in distinguishing certain neoplastic from inflammatory conditions. Our study aimed to evaluate the tissue expression of S100/calgranulins and the blood NLR in dogs with UC. Urinary bladder and/or urethral tissue samples from dogs with UC (n = 10), non-neoplastic inflammatory lesions (NNUTD; n = 6), and no histologic changes (n = 11) were evaluated using immunohistochemistry. Blood NLRs were analyzed in dogs with UC (n = 22) or NNUTD (n = 26). RESULTS Tissue S100A12-positive cell counts were significantly higher in dogs with lower urinary tract disease than healthy controls (P = 0.0267 for UC, P = 0.0049 for NNUTD), with no significant difference between UC and NNUTD patients. Tissue S100A8/A9-positivity appeared to be higher with NNUTD than UC, but this difference did not reach statistical significance. The S100A8/A9+-to-S100A12+ ratio was significantly decreased in neoplastic and inflamed lower urinary tract tissue compared to histologically normal specimens (P = 0.0062 for UC, P = 0.0030 for NNUTD). NLRs were significantly higher in dogs with UC than in dogs with NNUTD, and a cut-off NLR of ≤ 2.83 distinguished UC from NNUTD with 41% sensitivity and 100% specificity. Higher NLRs were also associated with a poor overall survival time (P = 0.0417). CONCLUSIONS These results confirm that the S100/calgranulins play a role in the immune response to inflammatory and neoplastic lower urinary tract diseases in dogs, but the tissue expression of these proteins appears to differ from their concentrations reported in urine samples. Further investigations of the S100/calgranulin pathways in UC and their potential as diagnostic or prognostic tools and potential therapeutic targets are warranted. The NLR as a routinely available marker might be a useful surrogate to distinguish UC from inflammatory conditions.
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Affiliation(s)
- Jana Weinekötter
- grid.9647.c0000 0004 7669 9786Department for Small Animals, College of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103 Leipzig, SN Germany
| | - Corinne Gurtner
- grid.5734.50000 0001 0726 5157Institute of Animal Pathology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3001 Bern, BE Switzerland
| | - Martina Protschka
- grid.9647.c0000 0004 7669 9786Institute of Immunology, College of Veterinary Medicine, Biotechnological-Biomedical Center, Leipzig University, Deutscher Platz 5, 04103 Leipzig, SN Germany
| | - Wolf von Bomhard
- Specialty Center for Veterinary Pathology, Hartelstrasse 30, E80689 Munich, BY Germany
| | - Denny Böttcher
- grid.9647.c0000 0004 7669 9786Institute for Veterinary Pathology, College of Veterinary Medicine, Leipzig University, An Den Tierkliniken 33, E04103 Leipzig, SN Germany
| | - Annika Schlinke
- grid.9647.c0000 0004 7669 9786Department for Small Animals, College of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103 Leipzig, SN Germany
| | - Gottfried Alber
- grid.9647.c0000 0004 7669 9786Institute of Immunology, College of Veterinary Medicine, Biotechnological-Biomedical Center, Leipzig University, Deutscher Platz 5, 04103 Leipzig, SN Germany
| | - Sarah Rösch
- grid.9647.c0000 0004 7669 9786Department for Small Animals, College of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103 Leipzig, SN Germany ,grid.412970.90000 0001 0126 6191Small Animal Clinic, University of Veterinary Medicine Hannover Foundation, Bünteweg 9, 30559 Hannover, NI Germany
| | - Joerg M. Steiner
- grid.264756.40000 0004 4687 2082Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TAMU 4474, College Station, TX 77843-4474 USA
| | - Johannes Seeger
- grid.9647.c0000 0004 7669 9786Institute of Anatomy, Histology and Embryology, College of Veterinary Medicine, Leipzig University, An den Tierkliniken 43, 04103 Leipzig, SN Germany
| | - Gerhard U. Oechtering
- grid.9647.c0000 0004 7669 9786Department for Small Animals, College of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103 Leipzig, SN Germany
| | - Romy M. Heilmann
- grid.9647.c0000 0004 7669 9786Department for Small Animals, College of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103 Leipzig, SN Germany
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Marie Butty E, Forsyth B, Labato MA. Irreversible Electroporation Balloon Therapy for Palliative Treatment of Obstructive Urethral Transitional Cell Carcinoma in Dogs. J Am Anim Hosp Assoc 2022; 58:231-239. [PMID: 36049240 DOI: 10.5326/jaaha-ms-7160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 11/11/2022]
Abstract
Progression of transitional cell carcinoma (TCC) in dogs often leads to urinary obstruction. This observational pilot study aimed to evaluate the safety and efficacy of irreversible electroporation (IRE) balloon therapy for the palliative treatment of TCC with partial urethral obstruction. Three client-owned dogs diagnosed with TCC causing partial urethral obstruction were enrolled. After ultrasonographic and cystoscopic examination, IRE pulse protocols were delivered through a balloon catheter device inflated within the urethral lumen. After the procedure, the patients were kept overnight for monitoring and a recheck was planned 28 days later. No complication was observed during the procedure and postprocedural monitoring. After 28 days, one dog had a complete normalization of the urine stream, one dog had stable stranguria, and one dog was presented with a urethral obstruction secondary to progression of the TCC. On recheck ultrasound, one dog had a 38% diminution of the urethral mass diameter whereas the other two dogs had a mass stable in size. IRE balloon therapy seems to be a feasible and apparently safe minimally invasive novel therapy for the palliative treatment of TCC causing urethral obstruction. Further studies are needed to better characterize the safety, efficacy, and outcome of this therapy.
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Affiliation(s)
- Emmanuelle Marie Butty
- From the Department of Clinical Sciences, Small Animal Internal Medicine, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (E.M.B., M.A.L.)
| | - Bruce Forsyth
- Research and Development Interventional Oncology, Boston Scientific Corporation, Marlborough, Massachusetts (B.F.)
| | - Mary Anna Labato
- From the Department of Clinical Sciences, Small Animal Internal Medicine, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (E.M.B., M.A.L.)
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Brückner M. Urethral stenting in a dog due to compression and invasion by a liposarcoma. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Michael Brückner
- Evidensia Specialistdjursjukhuset Helsingborg Helsingborg Sweden
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11
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Rasteiro AM, Sá e Lemos E, Oliveira PA, Gil da Costa RM. Molecular Markers in Urinary Bladder Cancer: Applications for Diagnosis, Prognosis and Therapy. Vet Sci 2022; 9:vetsci9030107. [PMID: 35324835 PMCID: PMC8950778 DOI: 10.3390/vetsci9030107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/15/2022] [Accepted: 02/22/2022] [Indexed: 12/18/2022] Open
Abstract
Cancer of the urinary bladder is a neoplasm with considerable importance in veterinary medicine, given its high incidence in several domestic animal species and its life-threatening character. Bladder cancer in companion animals shows a complex and still poorly understood biopathology, and this lack of knowledge has limited therapeutic progress over the years. Even so, important advances concerning the identification of tumour markers with clinical applications at the diagnosis, prognosis and therapeutic levels have recently been made, for example, the identification of pathological BRAF mutations. Those advances are now facilitating the introduction of targeted therapies. The present review will address such advances, focusing on small animal oncology and providing the reader with an update on this field. When appropriate, comparisons will be drawn with bladder cancer in human patients, as well as with experimental models of the disease.
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Affiliation(s)
- Ana Mafalda Rasteiro
- CEDIVET, Laboratório Clínico Veterinário, 4200-071 Porto, Portugal; (A.M.R.); (E.S.e.L.)
- Garden Veterinary Group, Chippenham SN15 1NQ, UK
| | - Eva Sá e Lemos
- CEDIVET, Laboratório Clínico Veterinário, 4200-071 Porto, Portugal; (A.M.R.); (E.S.e.L.)
| | - Paula A. Oliveira
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Inov4Agro, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal;
| | - Rui M. Gil da Costa
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Inov4Agro, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal;
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center (Porto. CCC), 4200-072 Porto, Portugal
- Postgraduate Programme in Adult Health (PPGSAD), Department of Morphology, University Hospital (HUUFMA), Federal University of Maranhão (UFMA), São Luís 65080-805, Brazil
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- Correspondence:
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Prządka P, Liszka B, Antończyk A, Gąsior L, Kiełbowicz Z. Novel surgical approach to neoplastic lesions in the distal part of the urethra: A pilot cadaver study comparing open and hybrid techniques. Vet Comp Oncol 2022; 20:336-345. [PMID: 34978370 PMCID: PMC9306823 DOI: 10.1111/vco.12798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 11/27/2022]
Abstract
Tumours of the distal urethra in female dogs are often difficult to treat, and the surgical methods described thus far have technical limitations. This study aimed to present a novel approach to the surgical treatment of distal urethral tumours. This study used dog cadavers to evaluate the technical feasibility of surgically removing neoplastic lesions in the distal urethra and compared surgical outcomes of open surgery with those of hybrid surgery (combination of laparoscopy and open surgery). Open intact, open spayed, hybrid intact, and hybrid spayed dog cadaver groups underwent surgery (n = 6 per group). The novel surgical method was based on vulvovaginectomy (ovariohysterectomy in intact dogs), resection of the distal part of the urethra, and pre-pubic urethrostomy. Outcomes of interest included technical feasibility of each procedure, using both surgical techniques, wound length, time required to complete the procedure, and the incidence of intraoperative ureter and rectum injuries. Surgical technique and reproductive status affected operating time. Technique choice affected wound length; the surgical wound was longer in the open group than in the hybrid group. Macroscopic evaluation of the rectum did not reveal any damage to the wall. There was no evidence of ureter leakage or obstruction in any case. The present findings suggest that both open and hybrid surgery can be used to treat distal urethral tumours.
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Affiliation(s)
- Przemysław Prządka
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Bartłomiej Liszka
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Agnieszka Antończyk
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Ludwika Gąsior
- Department of Internal Diseases and Diagnosis, Faculty of Veterinary Medicine and Animal Sciences, Poznan University of Life Sciences, Poznan, Poland
| | - Zdzisław Kiełbowicz
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
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13
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Palm CA, Canvasser NE, Culp WTN. Stenting of Malignant Urinary Tract Obstructions in Humans and Companion Animals. Vet Sci 2021; 9:vetsci9010013. [PMID: 35051097 PMCID: PMC8780232 DOI: 10.3390/vetsci9010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/23/2021] [Accepted: 12/25/2021] [Indexed: 11/30/2022] Open
Abstract
Urine retention secondary to neoplastic obstructions of the upper and lower urinary tracts is a life-threatening condition in both humans and companion animals. Stents can be placed to temporarily or permanently open obstructed urinary tract lumens and are often able to be placed using minimally invasive techniques with guidance via ultrasonography or fluoroscopy. The literature for these techniques is vast for humans and growing for companion animals. The below review provides a discussion of the principles of stenting and types of ureteral and urethral stents, as well as the techniques for placing these stents in humans and companion animals.
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Affiliation(s)
- Carrie A. Palm
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA
- Correspondence: (C.A.P.); (W.T.N.C.)
| | - Noah E. Canvasser
- Department of Urologic Surgery, University of California-Davis Medical Center, Sacramento, CA 95817, USA;
| | - Willian T. N. Culp
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA
- Correspondence: (C.A.P.); (W.T.N.C.)
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14
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Prządka P, Liszka B, Lachowska S, Dzimira S, Ciaputa R, Tunikowska J, Juźwiak Ł, Kucharski P, Rudno-Rudzińska J, Kiełbowicz Z. Case report laparoscopy-assisted pre-pubic urethrostomy as a palliative procedure for resection of distal urethral tumor in a female dog. BMC Vet Res 2021; 17:309. [PMID: 34556100 PMCID: PMC8461897 DOI: 10.1186/s12917-021-03024-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/15/2021] [Indexed: 11/29/2022] Open
Abstract
Background This paper presents the first described case of laparoscopy-assisted prepubic urethrostomy and laparoscopic resection of a tumor of the distal part of the urethra in a female dog as a palliative treatment. Case presentation An intact, 11 -year-old, mixed breed female dog,
weighing 15 kg, was admitted with signs of urinary obstruction and difficulty
with catheterization. Vaginal, rectal, and endoscopic examinations revealed a firm
mass in the pelvic cavity at the level of the pelvic urethra. Ultrasound and
computed tomography examination showed enlargement of the urethral wall (5.5 cm
width and 3 cm thick), which was significantly restricting the patency of the
urethra. The lesion affected only the distal part of the urethra without the
presence of local or distant metastatic changes. The affected portion of the urethra was laparoscopically removed while performing pre-pubic urethrostomy with laparoscopy. The patient regained full consciousness immediately after the end of anesthesia, without signs of urinary incontinence. Histopathological examination of the removed urethra revealed an oncological margin only from the side of the bladder. In the period of 2.5 months after the procedure, the owner did not notice any symptoms that could indicate a postoperative recurrence, which was diagnosed three months after the procedure. Conclusions Pre-pubic urethrostomy can be successfully performed with the assistance of laparoscopy. The use of minimally invasive surgery will allow, in selected cases, removal of the urethral tumor, and in inoperable cases, to perform a minimally invasive palliative pre-pubic urethrostomy.
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Affiliation(s)
- Przemysław Prządka
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Pl. Grunwaldzki 51, 50-366, Wroclaw, Poland.
| | - Bartłomiej Liszka
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Pl. Grunwaldzki 51, 50-366, Wroclaw, Poland
| | - Sonia Lachowska
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Pl. Grunwaldzki 51, 50-366, Wroclaw, Poland
| | - Stanisław Dzimira
- Department of Pathology, Division of Pathomorphology and Veterinary Forensics, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 31, 50-375, Wroclaw, Poland
| | - Rafał Ciaputa
- Department of Pathology, Division of Pathomorphology and Veterinary Forensics, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 31, 50-375, Wroclaw, Poland
| | - Joanna Tunikowska
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Pl. Grunwaldzki 51, 50-366, Wroclaw, Poland
| | - Łukasz Juźwiak
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Pl. Grunwaldzki 51, 50-366, Wroclaw, Poland
| | - Paweł Kucharski
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Pl. Grunwaldzki 51, 50-366, Wroclaw, Poland
| | - Julia Rudno-Rudzińska
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Borowska 213, 50-556, Wrocław, Poland
| | - Zdzisław Kiełbowicz
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Pl. Grunwaldzki 51, 50-366, Wroclaw, Poland
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15
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Allevi G, Spediacci C, Marchesi E, Trovatelli M. Laparoscopic-assisted cutaneous ureterostomy in a canine patient with prostatic carcinoma. Vet Med Sci 2021; 7:1483-1487. [PMID: 34237193 PMCID: PMC8464254 DOI: 10.1002/vms3.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
A 9‐year‐old neutered male Dachshund dog was assessed for stranguria. An enlarged prostate was identified on physical examination, and a diagnosis of prostatic carcinoma confirmed by cytology. Due to a neoplastic lower urinary tract obstruction, palliative surgical urinary diversion treatment was performed with laparoscopic assisted cutaneous ureterostomy (LACU). The dog recovered well without any major complications. Adjuvant chemotherapy was maintained and continued for post‐surgical medical therapy. This report describes a novel minimally invasive assisted technique in canine patients for palliative treatment of prostatic neoplasia.
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Affiliation(s)
| | - Carlotta Spediacci
- Department of Veterinary Medicine, Università degli Studi di Milano, Milano, Italy
| | | | - Marco Trovatelli
- Department of Veterinary Medicine, Università degli Studi di Milano, Milano, Italy
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16
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de Vlaming A, Mathews KG, Hash JA, Keenihan EK, Sommer S, Borst L, Vaden SL. Creation of a Continent Urinary Bladder Reservoir Vascularized by Omentum as a Possible Surgical Option for Canine Trigonal/Urethral Urothelial Carcinoma. J INVEST SURG 2020; 35:481-495. [PMID: 33371755 DOI: 10.1080/08941939.2020.1864797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Surgical procedures that maintain continence with minimal complication following resection of trigono-urethral urothelial carcinoma (UC) are limited in canines; therefore, palliative options are often pursued. A feasible tumor resection option may improve disease control and survival. The study's objective was to evaluate a continent urine reservoir created from the urinary bladder body and vascularized solely by omentum. We hypothesized that a viable urine reservoir could be created, and staged omentalization would provide improved vascularity. Nine normal female Beagles were randomized to one of three groups. Group A urinary bladders were transected cranial to the ureteral papillae to create a closed bladder vesicle which was concomitantly omentalized. Group B underwent omentalization two weeks prior to vesicle creation. Based on Group A and B results, Group C underwent neoureterocystostomy and omentalization followed by neoreservoir formation and tube cystostomy 2 weeks later. Serial ultrasounds and histopathology confirmed adequate omental neovascularization in Groups B and C with continent Group C neoreservoirs maintained for 2 months. Some pylectasia and ureteral dilation was documented in all Group C dogs at variable timepoints. Progressive hydroureteronephrosis developed in 2/6 kidneys. Transient azotemia was noted in only 1 Group C dog, although all developed treatable urinary tract infections. The sample size is limited, and the efficacy of this technique in providing disease control for UC is unknown. However, this novel option could allow for primary UC resection while providing continence and limiting complications. Postoperative local or systemic adjuvant therapy, ultrasonographic neoreservoir monitoring, and BRAF analysis would be indicated.
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Affiliation(s)
- Annemarieke de Vlaming
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Kyle G Mathews
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Jonathan A Hash
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Erin K Keenihan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Samantha Sommer
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Luke Borst
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Shelly L Vaden
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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17
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Malfassi L, Fidanzio F, Sala M, Marcarini S, Mazza G, Carrara N, Pavesi S, Gnudi G, Urso G, Dolera M. A combined protocol with piroxicam, chemotherapy, and whole pelvic irradiation with simultaneous boost volumetric modulated arc radiotherapy for muscle-invasive canine urinary transitional cell carcinoma: First clinical experience. J Vet Med Sci 2020; 83:695-704. [PMID: 32963177 PMCID: PMC8111339 DOI: 10.1292/jvms.19-0662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The aims of this pilot study were to evaluate the feasibility and efficacy of high-dose hypofractionated volumetric modulated arc radiotherapy (VMAT) applied to whole pelvic region radiotherapy (WPRT) with multilevel simultaneous integrated boost (MLSIB) combined with piroxicam and chemotherapy for the treatment of canine transitional cell carcinoma (TCC) of the lower urinary tract with muscle invasion TCC. Twelve dogs were enrolled, according to stage, in two groups: group 1, TCC confined to the urinary tract; group 2, TCC with metastasis. The planning target volume dose was tailored from 36 to 42 Gy in 6 fractions. All dogs were prescribed piroxicam and radiosensitizing carboplatin, and six received chemotherapy after radiotherapy. Serial follow-ups with computed tomography and magnetic resonance imaging were performed. Disease control and toxicity effects were evaluated according to the Response Evaluation Criteria in Solid Tumors and Veterinary Radiation Therapy Oncology Group criteria. The treatment was well tolerated, and no high-grade side effects were reported. The median overall survival times for groups 1 and 2 were 1,230 and 150 days, respectively. A considerable percentage of patients in group1 (50%) were still alive at the time of writing this paper, and a longer follow-up could enable a more accurate survival analysis. This preliminary analysis shows that VMAT applied to the WPRT with MLSIB is an effective and safe option for dogs with lower urinary TCC, although the presence of metastases worsens the prognosis.
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Affiliation(s)
- Luca Malfassi
- "La Cittadina" Foundation for Veterinary Studies and Research, Road to the "La cittadina", 26014, Romanengo (Cr), Italy
| | - Francesca Fidanzio
- Department of Veterinary Medical Science, University of Parma, Taglio 8 road, 43100, Parma, Italy
| | - Massimo Sala
- "La Cittadina" Foundation for Veterinary Studies and Research, Road to the "La cittadina", 26014, Romanengo (Cr), Italy
| | - Silvia Marcarini
- "La Cittadina" Foundation for Veterinary Studies and Research, Road to the "La cittadina", 26014, Romanengo (Cr), Italy
| | - Giovanni Mazza
- "La Cittadina" Foundation for Veterinary Studies and Research, Road to the "La cittadina", 26014, Romanengo (Cr), Italy
| | - Nancy Carrara
- "La Cittadina" Foundation for Veterinary Studies and Research, Road to the "La cittadina", 26014, Romanengo (Cr), Italy
| | - Simone Pavesi
- "La Cittadina" Foundation for Veterinary Studies and Research, Road to the "La cittadina", 26014, Romanengo (Cr), Italy
| | - Giacomo Gnudi
- Department of Veterinary Medical Science, University of Parma, Taglio 8 road, 43100, Parma, Italy
| | - Gaetano Urso
- Medical Physics Department, Local Health Authority of Lodi, A. Fleming 1 road, 26841, Casalpusterlengo (Lo), Italy
| | - Mario Dolera
- "La Cittadina" Foundation for Veterinary Studies and Research, Road to the "La cittadina", 26014, Romanengo (Cr), Italy
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18
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Kim S, Hosoya K, Takagi S, Okumura M. Outcomes following balloon dilation for management of urethral obstruction secondary to urothelial carcinoma in dogs: 12 cases (2010-2015). J Am Vet Med Assoc 2020; 255:330-335. [PMID: 31298635 DOI: 10.2460/javma.255.3.330] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe outcomes for dogs that underwent balloon dilation for palliative treatment of urethral obstruction caused by urothelial carcinoma. ANIMALS 12 client-owned dogs. PROCEDURES Medical records were searched to identify dogs with urothelial (bladder, urethra, or prostate) carcinoma that underwent balloon dilation for treatment of urethral obstruction between April 2010 and December 2015. Information regarding history, signalment, clinical signs, diagnostic imaging findings, balloon dilation technique, clinical outcomes, complications, and additional treatments was obtained by review of medical records. RESULTS Improvement in clinical signs of urethral obstruction was observed after the initial dilation procedure for 9 of 12 dogs. Urethral obstruction was known to recur in 5 dogs 48 to 296 days after the initial procedure. Three of these dogs underwent a second dilation procedure, with clinical improvement in all 3 dogs for 41 to 70 days. One of 2 dogs that had a third procedure after the second reobstruction had clinical improvement in urinary tract signs until subsequent death from metastatic disease 22 days later. Complications included hematuria, urinary incontinence, and dysuria; these resolved within a few days after treatment. CONCLUSIONS AND CLINICAL RELEVANCE Urethral balloon dilation was a minimally invasive procedure that provided relief of urethral obstruction from urothelial carcinoma in most dogs of the study population. Prospective studies are needed to identify optimal techniques for balloon dilation in dogs with neoplastic urethral obstructions and to identify patients that are likely to benefit most from the treatment.
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19
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Culp WTN, Johnson EG, Giuffrida MA, Palm CA, Mayhew PD, Kent MS, Rebhun RB, Burton JH. Use of transrectal ultrasonography for assessment of the size and location of prostatic carcinoma in dogs. Am J Vet Res 2020; 80:1012-1019. [PMID: 31644342 DOI: 10.2460/ajvr.80.11.1012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the use of transrectal ultrasonography (TRUS) for the assessment of prostatic tumors in dogs and to compare results for TRUS with results for other imaging modalities. ANIMALS 10 client-owned male dogs. PROCEDURES Client-owned dogs identified with prostatic carcinoma were enrolled. Fluoroscopy, transabdominal ultrasonography (TAUS), TRUS, and MRI were performed on all dogs. Tumor measurements, urethral penetration (identification of abnormal tissue within the urethral lumen), and tumor extension into the urinary tract were recorded for all imaging modalities. Agreement between results for MRI (considered the criterion-referenced standard) and results for other modalities were compared. RESULTS Median body weight of the 10 dogs was 26.3 kg (range, 9.4 to 49.5 kg). No complications were encountered during or after TRUS. Significant moderate to good agreements (intraclass correlation coefficients, 0.60 to 0.86) among TAUS, TRUS, fluoroscopy, and MRI were identified for tumor length and height. Assessments of urethral penetration and tumor extension into the bladder with TRUS did not differ significantly from those made with MRI and were superior in terms of absolute agreement with MRI when compared with those for TAUS. CONCLUSIONS AND CLINICAL RELEVANCE TRUS was successfully and safely used to evaluate prostatic carcinoma in dogs. There was moderate to good agreement with MRI results for tumor height and length measurements, and TRUS was found to be superior to TAUS for some assessments. Transrectal ultrasonography can be considered an adjunctive imaging modality for the performance of prostatic interventional procedures or assessment of response to treatment.
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20
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Abstract
Primary renal tumors are an uncommon diagnosis in small animals. Presentation, treatment, and prognosis depend on tumor type. Surgery with or without chemotherapy are the mainstays of treatment. Transitional cell carcinoma is the most common tumor of the urinary system. Clinical signs include hematuria, stranguria, and pollakiuria. Metastatic disease can develop over time within medial iliac lymph nodes, lungs, and vertebrae. Treatment of transitional cell carcinoma centers on chemotherapy with mitoxantrone, vinblastine, or carboplatin. Other agents used with success, include toceranib phosphate and chlorambucil. Interventional surgery, such as stenting and laser ablation, is used in a palliative setting addressing urinary obstruction.
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Affiliation(s)
- Kristine Elaine Burgess
- Department of Clinical Science, Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, MA 01536, USA.
| | - Carol J DeRegis
- Piper Memorial Veterinary Center, 730 Randolph Road, Middletown, CT 06457, USA
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21
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Abstract
Minimally invasive interventional therapies are the new standard of care in veterinary medicine. In comparison with standard surgical procedures, they are associated with minimal tissue injury, leading to shorter, smoother recovery and decreasing the perioperative morbidity and mortality. A thorough understanding of the therapeutic options available is essential to properly educate and inform clients. Proper equipment, technical expertise, and experience are essential prerequisites to many of these procedures.
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Affiliation(s)
- Emmanuelle Butty
- Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Rd, North Grafton, MA 01536, USA
| | - Catherine Vachon
- Centre Hospitalier Universitaire Vétérinaire, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Marilyn Dunn
- Centre Hospitalier Universitaire Vétérinaire, Faculty of Veterinary Medicine, University of Montreal, 1525 Rue des Vétérinaires, Saint-Hyacinthe, QC J2S 8H5, Canada.
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22
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Griffin MA, Culp WTN, Rebhun RB. Lower Urinary Tract Neoplasia. Vet Sci 2018; 5:vetsci5040096. [PMID: 30486368 PMCID: PMC6313859 DOI: 10.3390/vetsci5040096] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/16/2018] [Accepted: 11/19/2018] [Indexed: 11/16/2022] Open
Abstract
Lower urinary tract neoplasia in companion animals is a debilitating and often life-threatening disease. Tumors of the bladder, urethra, and prostate often occur independently, although extension of these tumors into adjacent regions of the lower urinary tract is documented frequently. The most common lower urinary tract tumor in dogs and cats is transitional cell carcinoma (TCC). In both dogs and cats, TCC affecting the urinary bladder is generally considered to be highly aggressive with both local and metastatic disease potential, and this disease poses unique treatment challenges. Whereas much literature exists regarding the TCC disease process, treatment options, and prognosis in dogs, relatively few studies on feline TCC have been published due to the lower incidence of TCC in this species. Prostate tumors, most commonly adenocarcinomas, occur less commonly in dogs and cats but serve an important role as a comparative model for prostate neoplasia in humans. This article serves as a review of the current information regarding canine and feline lower urinary tract neoplasia as well as the relevance of these diseases with respect to their human counterparts.
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Affiliation(s)
- Maureen A Griffin
- School of Veterinary Medicine, University of California-Davis, 1 Garrod Drive, Davis, CA 95616, USA.
| | - William T N Culp
- School of Veterinary Medicine, University of California-Davis, 1 Garrod Drive, Davis, CA 95616, USA.
| | - Robert B Rebhun
- School of Veterinary Medicine, University of California-Davis, 1 Garrod Drive, Davis, CA 95616, USA.
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23
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Interventional Radiology Management of Nonresectable Neoplasia. Vet Clin North Am Small Anim Pract 2018; 48:891-898. [DOI: 10.1016/j.cvsm.2018.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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24
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Abstract
Lower urinary tract (LUT) emergencies are common reasons for small animal patients to be presented to their veterinarians. Patient stabilization and management of life threatening problems is a priority in this population. Urethral obstruction is a common LUT emergency. Urethral stent placement has gained popularity over the past decade allowing for a minimally invasive, image-guided method for relief of urethral obstruction in some patient populations. This article focuses on candidate selection, diagnostic workup, stent placement technique, and the expected outcome and complications for patients undergoing urethral stent placement and addresses some additional strategies for interventional management of LUT emergencies.
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Affiliation(s)
- Matthew W Beal
- Department of Small Animal Clinical Sciences, Michigan State University, 736 Wilson Road, East Lansing, MI 48824-1314, USA.
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25
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Henry CJ, Flesner BK, Bechtel SA, Bryan JN, Tate DJ, Selting KA, Lattimer JC, Bryan ME, Grubb L, Hausheer F. Clinical Evaluation of Tavocept to Decrease Diuresis Time and Volume in Dogs with Bladder Cancer Receiving Cisplatin. J Vet Intern Med 2017; 32:370-376. [PMID: 29080252 PMCID: PMC5787204 DOI: 10.1111/jvim.14848] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/14/2017] [Accepted: 08/29/2017] [Indexed: 01/28/2023] Open
Abstract
Background Transitional cell carcinoma is the most common bladder cancer of dogs. Cisplatin combined with piroxicam provides superior response rates, but unacceptable rates of nephrotoxicity. Tavocept is a chemoprotectant that has mitigated cisplatin toxicity and decreased the required infusion/diuresis volume in clinical trials in humans. Hypothesis/Objectives We hypothesized that Tavocept would decrease diuresis volume and time and facilitate safe administration of a cisplatin/piroxicam protocol to dogs with bladder cancer. Secondary objectives were to compare response rate and survival times to an historical comparator group treated without Tavocept. Animals Fourteen client‐owned dogs were prospectively enrolled. Methods Tumor volume was measured by computed tomography at days 0, 42, and 84. Dogs received combination Tavocept/cisplatin with a shortened diuresis protocol. A total of 4 doses was planned, with concurrent administration of piroxicam. Serial biochemical analyses were evaluated for azotemia. Results A 90‐minute infusion/diuresis time was used for all dogs. Three dogs (21%) had concurrent increases in serum creatinine (>2.0 mg/dL) and BUN (>42 mg/dL) concentrations; 2 of these dogs were isosthenuric. This frequency of nephrotoxicity is significantly less (P = 0.0406) than that of an historical control group treated without Tavocept. Overall response rate was 27%. Median survival time was comparable to historical controls (253 vs. 246 days). Conclusions and Clinical Importance Tavocept decreased the required diuresis time with cisplatin from > 6 hours to 90 minutes, while also decreasing occurrence of azotemia. Survival time was comparable, but the response rate was inferior to an historical comparator group. Further evaluation in other tumors susceptible to platinum agents is warranted.
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Affiliation(s)
- C J Henry
- College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - B K Flesner
- College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - S A Bechtel
- College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - J N Bryan
- College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - D J Tate
- College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - K A Selting
- College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - J C Lattimer
- College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - M E Bryan
- Department of Statistics, University of Missouri, Columbia, MO
| | - L Grubb
- TriviumVet, Waterford, Ireland
| | - F Hausheer
- BioNumerik Pharmaceuticals, Inc., San Antonio, TX
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26
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Kilpatrick S, Hill T. Submucosal Collagen Injection for Management of Urinary Incontinence Following Urethral Stent Placement. Top Companion Anim Med 2017; 32:55-57. [PMID: 28992904 DOI: 10.1053/j.tcam.2017.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/19/2017] [Indexed: 11/11/2022]
Abstract
An 8-year-old, entire, male British Bulldog was referred for a week-long history of severe stranguria and dysuria. A prostatic wash was diagnostic of prostatic carcinoma. A transluminal urethral stent was placed in the proximal urethra, which resulted in resolution of the urinary obstruction, however, the dog developed severe urinary incontinence after the procedure. Cystoscopically-guided submucosal collagen injections were performed immediately proximal to the os penis. The dog's incontinence resolved with a single collagen injection for the 10-month follow-up period.
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Affiliation(s)
- Scott Kilpatrick
- The Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, Midlothian, UK
| | - Tracy Hill
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
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Taylor S, Rozanski E, Sato AF, Rush JE. Vascular stent placement for palliation of mass-associated chylothorax in two dogs. J Am Vet Med Assoc 2017; 251:696-701. [DOI: 10.2460/javma.251.6.696] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Radhakrishnan A. Urethral Stenting for Obstructive Uropathy Utilizing Digital Radiography for Guidance: Feasibility and Clinical Outcome in 26 Dogs. J Vet Intern Med 2017; 31:427-433. [PMID: 28132405 PMCID: PMC5354040 DOI: 10.1111/jvim.14652] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 10/23/2016] [Accepted: 12/06/2016] [Indexed: 01/15/2023] Open
Abstract
Background Urethral stent placement is an interventional treatment option to alleviate urethral outflow obstruction. It has been described utilizing fluoroscopy, but fluoroscopy is not as readily available in private practice as digital radiography. Objectives To describe the use of digital radiography for urethral stent placement in dogs with obstructive uropathy. Animals Twenty‐six client‐owned dogs presented for dysuria associated with benign and malignant causes of obstructive uropathy that underwent urethral stent placement. Methods Retrospective study. Results Causes of obstructive uropathy included transitional cell carcinoma, prostatic carcinoma, hemangiosarcoma, obstructive proliferative urethritis, compressive vaginal leiomyosarcoma, and detrusor‐sphincter dyssynergia. Survival time range was 1–48 months (median, 5 months). All dogs were discharged from the hospital with urine outflow restored. Intraprocedural complications included guide wire penetration of the urethral wall in 1 dog and improper stent placement in a second dog. Both complications were successfully managed at the time of the procedure with no follow‐up problems noted in either patient. Conclusion and Clinical Importance Urethral stent placement can be successfully performed utilizing digital radiography. The complications experienced can be avoided by more cautious progression with each step through the procedure and serial radiography. The application of digital radiography may allow treatment of urethral obstruction to become more readily available.
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Rippy SB, Gardner HL, Nguyen SM, Warry EE, Portela RA, Drost WT, Hostnik ET, Green EM, Chew DJ, Peng J, London CA. A pilot study of toceranib/vinblastine therapy for canine transitional cell carcinoma. BMC Vet Res 2016; 12:257. [PMID: 27855679 PMCID: PMC5114733 DOI: 10.1186/s12917-016-0882-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 11/08/2016] [Indexed: 02/06/2023] Open
Abstract
Background Effective therapies for transitional cell carcinoma (TCC) are limited, with objective response rates to most chemotherapeutic regimens below 20%. The purpose of this study was to investigate the biologic activity of combined toceranib phosphate and vinblastine chemotherapy for treatment of TCC. A secondary objective was to compare the utility of Computed Tomography (CT) and abdominal ultrasound (AUS) in tumor response assessments. Results Dogs with TCC received vinblastine at 1.6 mg/m2 every 2 weeks and toceranib at 2.5–2.75 mg/kg on Monday/Wednesday/Friday. Tumor monitoring was achieved through CT and AUS. Five patients completed the 16-week study. Based on AUS assessments, 3 dogs experienced biologic response to therapy including partial responses (PR, n = 2) and stable disease (SD, n = 1). Based on CT, 5 dogs experienced a biologic response (n = 2 PR, n = 3 SD). Both imaging modalities (ultrasound and CT) were found to provide repeatable measurements between operators, however agreement between operator measurements was greater when CT images were used to assess tumor size. Conclusions The combination of toceranib and vinblastine did not result in improved response rates. While agreement in tumor volume assessments between both AUS and CT were excellent between operators, this did not extend to assessment of tumor response. The higher rate of concordance between operators when assessing response to treatment with CT suggests that CT should be considered for future clinical trials involving canine bladder TCC to improve the accuracy and repeatability of tumor measurement. The data suggest that response to therapy as assessed by AUS or CT do not predict duration of clinical response.
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Affiliation(s)
| | - Heather L Gardner
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | | | - Emma E Warry
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | | | - William Tod Drost
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | - Eric T Hostnik
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | - Eric M Green
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | - Dennis J Chew
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA
| | - Juan Peng
- Department of Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Cheryl A London
- Departments of Veterinary Clinical and Biosciences, The Ohio State University, 454 Veterinary Medical Academic Building, 1925 Coffey Rd., Columbus, OH, 43210, USA.
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Noël S, Billen F, Bolen G, Hamaide A. Management of a postoperative vaginal stricture by perendoscopic balloon dilation in a dog. VETERINARY RECORD CASE REPORTS 2016. [DOI: 10.1136/vetreccr-2016-000302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Stéphanie Noël
- Department of Clinical SciencesFaculty of Veterinary MedicineUniversity of LiègeLiègeBelgium
| | - Frederic Billen
- Department of Clinical SciencesFaculty of Veterinary MedicineUniversity of LiègeLiègeBelgium
| | - Geraldine Bolen
- Department of Clinical SciencesFaculty of Veterinary MedicineUniversity of LiègeLiègeBelgium
| | - Annick Hamaide
- Department of Clinical SciencesFaculty of Veterinary MedicineUniversity of LiègeLiègeBelgium
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Weisse C. Veterinary interventional oncology: From concept to clinic. Vet J 2015; 205:198-203. [DOI: 10.1016/j.tvjl.2015.03.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 03/22/2015] [Accepted: 03/23/2015] [Indexed: 10/23/2022]
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Interventional urology: endourology in small animal veterinary medicine. Vet Clin North Am Small Anim Pract 2015; 45:825-55. [PMID: 26002798 DOI: 10.1016/j.cvsm.2015.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The use of novel image-guided techniques in veterinary medicine has become more widespread, especially in urologic diseases. With the common incidence of urinary tract obstructions, stones disease, renal disease, and urothelial malignancies, combined with the recognized invasiveness and morbidity associated with traditional surgical techniques, the use of minimally invasive alternatives using interventional radiology and interventional endoscopy techniques has become incredibly appealing to owners and clinicians. This article provides a brief overview of some of the most common procedures done in endourology in veterinary medicine to date, providing as much evidence-based medicine as possible when comparing with traditional surgical alternatives.
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Management of transitional cell carcinoma of the urinary bladder in dogs: a review. Vet J 2015; 205:217-25. [PMID: 25747698 DOI: 10.1016/j.tvjl.2015.01.017] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 12/16/2014] [Accepted: 01/19/2015] [Indexed: 01/13/2023]
Abstract
Transitional cell carcinoma (TCC), also referred to as urothelial carcinoma, is the most common form of urinary bladder cancer in dogs, affecting tens of thousands of dogs worldwide each year. Canine TCC is usually a high grade invasive cancer. Problems associated with TCC include urinary tract obstruction, distant metastases in >50% of affected dogs, and clinical signs that are troubling both to the dogs and to their owners. Risk factors for TCC include exposure to older types of flea control products and lawn chemicals, obesity, female sex, and a very strong breed-associated risk. This knowledge is allowing pet owners to take steps to reduce the risk of TCC in their dog. The diagnosis of TCC is made by histopathology of tissue biopsies obtained by cystoscopy, surgery, or catheter. Percutaneous aspirates and biopsies should be avoided due to the risk of tumor seeding. TCC is most commonly located in the trigone region of the bladder precluding complete surgical resection. Medical treatment is the mainstay for TCC therapy in dogs. Although TCC is not usually curable in dogs, multiple drugs have activity against it. Approximately 75% of dogs respond favorably to TCC treatment and can enjoy several months to a year or more of good quality life. Many promising new therapies for TCC are emerging and with the close similarity between TCC in dogs and high grade invasive bladder cancer in humans, new treatment strategies found to be successful in canine studies are expected to help dogs and to be subsequently translated to humans.
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Allstadt SD, Rodriguez CO, Boostrom B, Rebhun RB, Skorupski KA. Randomized phase III trial of piroxicam in combination with mitoxantrone or carboplatin for first-line treatment of urogenital tract transitional cell carcinoma in dogs. J Vet Intern Med 2015; 29:261-7. [PMID: 25619518 PMCID: PMC4858101 DOI: 10.1111/jvim.12533] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 11/19/2014] [Accepted: 12/01/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Reported response rates of transitional cell carcinoma (TCC) in dogs to piroxicam in combination with either mitoxantrone or carboplatin are similar; however, it is unknown whether either drug might provide superior duration of response. HYPOTHESIS/OBJECTIVES To determine if the progression-free interval (PFI) of dogs with TCC treated with mitoxantrone and piroxicam was different than that of dogs receiving carboplatin and piroxicam. The hypothesis was that the efficacy of mitoxantrone is no different from carboplatin. ANIMALS Fifty dogs with TCC without azotemia. METHODS Prospective open-label phase III randomized study. Either mitoxantrone or carboplatin was administered every 3 weeks concurrently with piroxicam with restaging at 6-week intervals. Twenty-four dogs received carboplatin and 26 received mitoxantrone. RESULTS Response was not different between groups (P = .56). None of the dogs showed complete response. In the mitoxantrone group, there were 2 (8%) partial responses (PR) and 18 (69%) dogs with stable disease (SD). In the carboplatin group, there were 3 PR (13%) and 13 (54%) dogs with SD. The PFI was not significantly different between groups (mitoxantrone = 106 days; carboplatin = 73.5 days; P = .62; hazard ratio 0.86; 95% confidence interval 0.47-1.56). Dogs with prostatic involvement experienced a shorter survival (median, 109 days) compared to dogs with urethral, trigonal, or apically located tumors; this difference was significant (median 300, 190, and 645 days, respectively; P = .005). CONCLUSIONS AND CLINICAL IMPORTANCE This study did not detect a different in outcome in dogs with TCC treated with either mitoxantrone or carboplatin in combination with piroxicam.
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Affiliation(s)
- S D Allstadt
- Department of Veterinary Surgical and Radiological Sciences, University of California, Davis, CA
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Hill TL, Berent AC, Weisse CW. Evaluation of urethral stent placement for benign urethral obstructions in dogs. J Vet Intern Med 2014; 28:1384-90. [PMID: 25066355 PMCID: PMC4895573 DOI: 10.1111/jvim.12412] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 04/16/2014] [Accepted: 06/11/2014] [Indexed: 11/27/2022] Open
Abstract
Background Benign urethral obstructions (BUO) in dogs result in substantial morbidity because of challenges with conventional therapies. Treatment of malignant urethral obstructions with intraluminal urethral stents is reported to successfully relieve obstructions. Hypothesis/Objectives To evaluate the efficacy and outcome of urethral stent placement for treatment of BUO in dogs. Animals Eleven client‐owned animals with urethral stents placed for treatment of BUO. Methods Retrospective study in which medical records were reviewed in dogs diagnosed with BUO and treated with a metallic urethral stent. Data collected included signalment, cause of benign obstruction, procedure time, size and type of stent, complications, and short‐ and long‐term outcome. Results Eleven dogs with 15 urethral stents were included. Intraluminal urethral stent(s) relieved the obstructions in all dogs. Four dogs had 2 stents placed in separate procedures because of incomplete patency after treatment (n = 1), inadvertent compression of the stent (n = 1), or tissue ingrowth through the stent (n = 2). The median continence score after stent placement was 10 of 10 (range 3–10) with 6 dogs being continent, 3 mildly incontinent, and 1 each moderately and severely incontinent. All owners considered their dog to have an excellent long‐term clinical outcome with long‐term urethral patency. The median follow‐up time was 24 months (range 4–48). Conclusions and Clinical Importance Urethral stents appear to be an effective treatment for benign urinary obstructions. Moderate to severe incontinence developed in a minority (12.5%) of dogs. Stents relieved obstructions in all dogs with an excellent long‐term outcome.
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Affiliation(s)
- T L Hill
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
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Brace MA, Weisse C, Berent A. Preliminary Experience With Stenting for Management of Non-Urolith Urethral Obstruction in Eight Cats. Vet Surg 2013; 43:199-208. [DOI: 10.1111/j.1532-950x.2013.12089.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Accepted: 11/01/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Megan A. Brace
- Department of Surgery; VCA Boston Road Animal Hospital; Springfield Massachusetts 01119
| | - Chick Weisse
- Department of Surgery; The Animal Medical Center; New York New York 10065
- Department of Interventional Radiology/Endoscopy; The Animal Medical Center; New York New York 10065
| | - Allyson Berent
- Department of Interventional Radiology/Endoscopy; The Animal Medical Center; New York New York 10065
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