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Mendez Valenzuela CR, Shin K, Weng HY, Plantenga JM, Vanhaezebrouck IF. Radiotherapy for Canine Apocrine Gland Anal Sac Adenocarcinoma: Survival Outcomes and Side Effects of a Palliative Treatment Protocol of 20 Gy in Five Consecutive Fractions. Vet Sci 2024; 11:219. [PMID: 38787191 PMCID: PMC11125963 DOI: 10.3390/vetsci11050219] [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: 03/02/2024] [Revised: 04/19/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
This research aims to evaluate the outcomes of a radiotherapy protocol, consisting of five fractions of 4 Gy each, resulting in a total dose of 20 Gy for apocrine gland anal sac tumors and local lymph nodes in canines. This protocol was assessed as a palliative treatment for macroscopic tumors alone, or in combination with additional therapies under different scenarios. Medical records from fifty canine patients met the inclusion criteria and were divided into different treatment groups: radiotherapy alone (n = 22, 44%), radiotherapy with chemotherapy or targeted therapy with toceranib (n = 18, 36%), surgery with radiotherapy (n = 5, 10%), and surgery with radiotherapy and chemotherapy or targeted therapy with toceranib (n = 5, 10%). Patients who received radiotherapy alone had a median survival time of 384 days (95% CI 198-569) and 628 days (95% CI 579-676) for RT + additional therapies. The median time to progression for patients with radiotherapy alone was 337 days (95% CI 282-391 days), and 402 days (95% CI 286-517 days) for radiotherapy plus additional treatments. Acute side effects were mild, with the majority having diarrhea (61%), and only one patient developed grade III late effects VRTOG v2 classification; however, this happened 22 months after the first radiotherapy protocol after re-irradiation. The results demonstrate that radiotherapy alone under this protocol provided a comparable median time to progression vs. radiotherapy plus additional treatments while maintaining acceptable side effects. The combination of this protocol with other treatment modalities offers attractive results for local disease control and survival while maintaining acceptable toxicities. Overall, these findings contribute to the growing evidence supporting the role of radiotherapy in managing apocrine gland anal sac adenocarcinoma in dogs.
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Affiliation(s)
| | - Kelly Shin
- College of Science, Purdue University, West Lafayette, IN 47907, USA
| | - Hsin-Yi Weng
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Jeannie M. Plantenga
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Isabelle F. Vanhaezebrouck
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
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Hall H, Williams T, Florey J, Moreno MP, Black V, Thompson D, Skelly B. Prevalence of hypercalcemia in primary hypoadrenocorticism in dogs: Multicenter, retrospective study. J Vet Intern Med 2023; 37:1685-1693. [PMID: 37382221 PMCID: PMC10472996 DOI: 10.1111/jvim.16786] [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: 10/08/2022] [Accepted: 05/21/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Hypoadrenocorticism is an important differential for hypercalcemia. The etiology of hypercalcemia in hypoadrenocorticism in dogs is unclear. OBJECTIVE To review the prevalence of hypercalcemia and use statistical models to identify clinical, demographic, and biochemical variables associated with hypercalcemia in dogs with primary hypoadrenocorticism. ANIMALS One hundred ten dogs with primary hypoadrenocorticism; 107 with recorded total calcium (TCa), 43 recorded ionized calcium (iCa). METHODS Multicenter retrospective observational study at 4 UK referral hospitals. Univariable logistic regression analyses were performed to assess the association between independent variables of signalment, hypoadrenocorticism type (glucocorticoid only deficient hypoadrenocorticism [GHoC] vs glucocorticoid and mineralocorticoid deficient hypoadrenocorticism [GMHoC]), clinicopathological variables and hypercalcemia. Hypercalcemia was defined as elevated TCa, an elevated iCa, or both elevated TCa and iCa (Model 1) or as elevated iCa (Model 2). RESULTS Overall prevalence of hypercalcemia was 34.5% (38/110). The odds of hypercalcemia (Model 1) were increased (P < .05) in dogs with GMHoC ([vs GHoC], OR [odds ratio] = 3.86, 95% confidence interval [CI] 1.105-13.463), higher serum creatinine (OR = 1.512, 95% CI 1.041-2.197), and higher serum albumin (OR = 4.187, 95% CI 1.744-10.048). The odds of ionized hypercalcemia (Model 2) were increased (P < .05) with reduced serum potassium concentration (OR = 0.401, 95% CI 0.184-0.876) and younger age (OR = 0.737, 95% CI 0.558-0.974). CONCLUSIONS AND CLINICAL IMPORTANCE This study identified several key clinical and biochemical variables associated with hypercalcemia in dogs with primary hypoadrenocorticism. These findings aid understanding of the pathophysiology and etiology of hypercalcemia in dogs with primary hypoadrenocorticism.
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Affiliation(s)
- Harriet Hall
- Department of Veterinary Medicine, Queen's Veterinary School HospitalUniversity of CambridgeCambridgeUnited Kingdom
- Dick White Referrals, Six Mile BottomCambridgeshireUnited Kingdom
| | - Timothy Williams
- Department of Veterinary Medicine, Queen's Veterinary School HospitalUniversity of CambridgeCambridgeUnited Kingdom
| | - Jessica Florey
- Dick White Referrals, Six Mile BottomCambridgeshireUnited Kingdom
| | | | - Victoria Black
- Langford VetsBristol Veterinary School, Langford HouseLangford BS40 5DUUnited Kingdom
| | - Daniel Thompson
- Davies Veterinary Specialists, Manor Farm Business Park, Higham GobionHitchinUnited Kingdom
| | - Barbara Skelly
- Department of Veterinary Medicine, Queen's Veterinary School HospitalUniversity of CambridgeCambridgeUnited Kingdom
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3
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Canine Apocrine Gland Anal Sac Adenocarcinoma: A Review. Top Companion Anim Med 2022; 50:100682. [PMID: 35792243 DOI: 10.1016/j.tcam.2022.100682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 11/21/2022]
Abstract
Apocrine gland anal sac adenocarcinoma (AGASAC) is a relatively uncommon tumor in the dog and comprises approximately 17% of perianal malignancies; however, it is one of the most common causes of paraneoplastic hypercalcemia. Clinical signs in affected dogs most commonly are associated with mechanical obstruction caused by the primary tumor or enlarged regional metastatic lymph nodes and the effects of paraneoplastic hypercalcemia when present. Surgical excision of the primary tumor and metastasectomy of affected locoregional lymph nodes is the preferred initial treatment option for most dogs, although radiation therapy and adjuvant chemotherapy are commonly incorporated into multi-modality treatment plans. A significant role for the use of adjuvant chemotherapy has not been clearly demonstrated. Prolonged survival times are possible, especially for dogs with smaller primary tumors and for dogs that undergo further treatments for recurrent disease. In this article, we review the clinical signs, diagnosis, staging, treatment, and prognosis of AGASAC in the dog.
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Mullany A, Waddington A, Mellanby RJ. Hypercalcaemia in a dog with lymphoma without increases in parathyroid hormone, parathyroid hormone‐related protein and vitamin D metabolites concentrations. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | - Richard J Mellanby
- Royal (Dick) School of Veterinary Studies and The Roslin InstituteUniversity of EdinburghEaster Bush Veterinary CampusRoslinMidlothianUK
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Tørnqvist-Johnsen C, Schnabel T, Gow AG, Del-Pozo J, Milne E, Macklin V, Fisher C, Handel I, Mellanby RJ. Investigation of the relationship between ionised and total calcium in dogs with ionised hypercalcaemia. J Small Anim Pract 2020; 61:247-252. [PMID: 32043601 DOI: 10.1111/jsap.13109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 12/01/2019] [Accepted: 12/16/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate the relationship between total and ionised calcium concentrations in dogs with ionised hypercalcaemia and to evaluate how albumin influences this relationship. METHODS Initially, a reference interval for ionised and total calcium was established using a large population of healthy adult dogs. Our teaching hospital clinical database was searched to identify adult dogs with ionised hypercalcaemia between 2012 and 2017, a time frame when the same sample handling and analysis protocols were in place as for the healthy reference interval population. The relationship between ionised and total calcium concentrations was then examined in the ionised hypercalcaemia population. RESULTS Based on biochemical analysis of 351 healthy adult dogs, a reference interval of 1.18 to 1.53 mmol/L for ionised calcium and 2.24 to 2.85 mmol/L for total calcium was established. Using these reference intervals, 63 dogs with ionised hypercalcaemia were identified, of which 23 did not have total hypercalcaemia. Only seven of the 23 dogs with ionised hypercalcaemia and total calcium below the upper limit of the reference interval had hypoalbuminemia. The majority of dogs with ionised hypercalcemia and normal total calcium had a modest increase in ionised calcium. CLINICAL SIGNIFICANCE If relying on total calcium alone, more than one third of dogs with ionised hypercalcaemia will be classified as normocalcaemic and the majority of these dogs had normal serum albumin.
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Affiliation(s)
- C Tørnqvist-Johnsen
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Midlothian, UK
| | - T Schnabel
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Midlothian, UK
| | - A G Gow
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Midlothian, UK
| | - J Del-Pozo
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Midlothian, UK
| | - E Milne
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Midlothian, UK
| | - V Macklin
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Midlothian, UK
| | - C Fisher
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Midlothian, UK
| | - I Handel
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Midlothian, UK
| | - R J Mellanby
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Midlothian, UK
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Coady M, Fletcher DJ, Goggs R. Severity of Ionized Hypercalcemia and Hypocalcemia Is Associated With Etiology in Dogs and Cats. Front Vet Sci 2019; 6:276. [PMID: 31508432 PMCID: PMC6714612 DOI: 10.3389/fvets.2019.00276] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 08/06/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Calcium disorders are common in small animals, but few studies have investigated the etiology of ionized hypercalcemia and hypocalcemia in large populations. This study aimed to determine the incidence of ionized calcium disorders in dogs and cats treated at a tertiary referral clinic and to describe the associated diseases. Methods: An electronic database of electrolyte analyses conducted at the Cornell University Hospital for Animals from 2007 to 2017 was searched. Dogs and cats with ionized hypercalcemia or hypocalcemia were identified based on institution reference intervals. Duplicate case entries were removed. Medical records were reviewed to identify the cause of the calcium abnormality. Chi-squared analysis with Bonferroni adjustment was performed to compare frequencies of disease processes between mild and moderate-severe disturbances. Results: The database included 15,277 dogs and 3,715 cats. Hypercalcemia was identified in 1,641 dogs and 119 cats. The incidence of canine and feline hypercalcemia was 10.7 and 3.2%, respectively. Hypocalcemia was identified in 1,467 dogs and 450 cats. The incidence of canine and feline hypocalcemia was 9.6% and 12.1%, respectively. The most common pathologic causes of hypercalcemia in dogs were malignancy-associated (12.9%), parathyroid-dependent (4.6%) and hypoadrenocorticism (1.7%). In cats, malignancy-associated hypercalcemia (22.7%), kidney injury (13.4%) and idiopathic hypercalcemia (12.6%) were most common. Dogs presenting with moderate-severe hypercalcemia vs. mild hypercalcemia were significantly more likely to have hyperparathyroidism, malignancy-associated hypercalcemia or hypervitaminosis D, whereas cats were significantly more likely to have malignancy-associated hypercalcemia or idiopathic hypercalcemia. The most common pathologic causes of hypocalcemia in dogs were critical illness (17.4%), kidney injury (10.4%) and toxicity (7.5%). In cats, kidney injury (21.6%), urethral obstruction (15.1%), and critical illness (14.7%) were most frequent. Dogs presenting with moderate-severe hypocalcemia were significantly more likely to have hypoparathyroidism, kidney injury, eclampsia or critical illness, whereas cats were significantly more likely to have kidney injury, soft tissue trauma or urethral obstruction. Conclusions: Mild calcium disturbances are most commonly associated with non-pathologic or transient conditions. Malignancy-associated hypercalcemia is the most common cause of ionized hypercalcemia in dogs and cats. Critical illness and kidney injury are frequent causes of ionized hypocalcemia in both species.
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Affiliation(s)
- Michelle Coady
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Daniel J Fletcher
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
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Bean AD, Fisher PG, Reavill DR, Kiupel M. Hypercalcemia Associated with Lymphomas in the Ferret (Mustela Putorius Furo): Four Cases. J Exot Pet Med 2019. [DOI: 10.1053/j.jepm.2018.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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8
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Furtado ARR, Parrinello L, Merlo M, Di Bella A. Primary penile adenocarcinoma with concurrent hypercalcaemia of malignancy in a dog. J Small Anim Pract 2014; 56:289-92. [PMID: 25370307 DOI: 10.1111/jsap.12285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 07/22/2014] [Accepted: 08/07/2014] [Indexed: 11/28/2022]
Abstract
A 13-year-old male neutered Siberian husky crossbreed dog was presented with a 3-week history of haematuria and penile swelling. Clinical examination and computed tomography demonstrated a soft-tissue mass located at the base of the penis without signs of other primary tumours or metastasis. Clinicopathological findings revealed paraneoplastic hypercalcaemia. Fine-needle aspiration cytology of the mass suggested an epithelial tumour with several criteria of malignancy present. Following surgical excision of the mass, the hypercalcaemia resolved. Histopathology and immunohistochemistry revealed features consistent with an adenocarcinoma. Despite thorough examination, no perineal or anal sac tumour was found. To the authors' knowledge, this is the first reported case of a penile adenocarcinoma with hypercalcaemia of malignancy.
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Affiliation(s)
- A R R Furtado
- Animal Health Trust, Lanwades Park, Kentford, Newmarket CB8 7UU
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9
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Abstract
Paraneoplastic syndromes (PNSs) are neoplasm-associated alterations in bodily structure or function or both that occur distant to the tumor. They are an extremely diverse group of clinical aberrations that are associated with the noninvasive actions of the tumor. In many situations, the PNS parallels the underlying malignancy, and therefore, successful treatment of the tumor leads to disappearance of the PNS. Alternatively, recurrence of the PNS after successful treatment signals recurrence of the tumor, and the return of the PNS often significantly precedes the detectable recurrence of the tumor. This is often the case with paraneoplastic hypercalcemia, often referred to as hypercalcemia of malignancy (HM). The most common cause of hypercalcemia in dogs is cancer. Neoplasia is diagnosed in approximately two-thirds of dogs with hypercalcemia vs. approximately one-third in cats. A variety of tumors have been associated with HM. Lymphoma is the most common cause of HM, and the most common anatomical site for dogs with lymphoma-associated HM is the cranial mediastinum. Other tumors associated with HM in dogs and cats include anal sac apocrine gland adenocarcinoma, thyroid carcinoma, multiple myeloma, bone tumors, thymoma, squamous cell carcinoma, mammary gland carcinoma/adenocarcinoma, melanoma, primary lung tumors, chronic lymphocytic leukemia, renal angiomyxoma, and parathyroid gland tumors. As HM is a potential medical emergency, the primary goal in cases of HM is the elucidation of the underlying cause and thereby instituting the appropriate specific therapy.
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Neihaus SA, Winter JE, Goring RL, Kennedy FA, Kiupel M. Primary Clitoral Adenocarcinoma With Secondary Hypercalcemia of Malignancy in a Dog. J Am Anim Hosp Assoc 2010; 46:193-6. [DOI: 10.5326/0460193] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This report describes a primary clitoral adenocarcinoma in a dog with secondary hypercalcemia of malignancy. A 10-year-old, spayed female basset hound was evaluated for a mass protruding from the vulva. The mass was excised, and a histological diagnosis of clitoral adenocarcinoma was made. No evidence of metastasis on thoracic radiographs or abdominal ultrasound was seen. Preoperative hypercalcemia resolved following excision of the mass. Cellular features were similar to an apocrine gland anal sac adenocarcinoma, and immunohistochemistry exhibited features noted with apocrine gland anal sac adenocarcinoma. No further treatment was elected by the owner. Internal iliac lymph-node metastasis was identified 4 weeks postoperatively, and hypercalcemia recurred 8 weeks postoperatively. The dog was euthanized 22 weeks postoperatively for signs related to hypercalcemia, including polyuria/polydipsia, lethargy, and weakness. A necropsy was performed and confirmed the presence of internal iliac lymph-node metastasis. The colon, rectum, and anal sacs were grossly and histologically normal. To our knowledge, this is the first reported case of clitoral neoplasia in the dog.
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Affiliation(s)
- Steven A. Neihaus
- Affiliated Veterinary Specialists–Orange Park, P.A. (Neihaus, Goring), 275 Corporate Way, Suite 100, Orange Park, Florida 32073
- Southeast Veterinary Oncology (Winter), 304 Corporate Way, Orange Park, Florida 32073
- Veterinary Pathology Service (Kennedy), 390 Waterfall Lane, Winter Park, Florida 32789
- Diagnostic Center for Population and Animal Health (Kiupel), Michigan State University, 4125 Beaumont Road, 152A, Lansing, Michigan 48910
- From the
| | - Jennifer E. Winter
- Affiliated Veterinary Specialists–Orange Park, P.A. (Neihaus, Goring), 275 Corporate Way, Suite 100, Orange Park, Florida 32073
- Southeast Veterinary Oncology (Winter), 304 Corporate Way, Orange Park, Florida 32073
- Veterinary Pathology Service (Kennedy), 390 Waterfall Lane, Winter Park, Florida 32789
- Diagnostic Center for Population and Animal Health (Kiupel), Michigan State University, 4125 Beaumont Road, 152A, Lansing, Michigan 48910
- From the
| | - Robert L. Goring
- Affiliated Veterinary Specialists–Orange Park, P.A. (Neihaus, Goring), 275 Corporate Way, Suite 100, Orange Park, Florida 32073
- Southeast Veterinary Oncology (Winter), 304 Corporate Way, Orange Park, Florida 32073
- Veterinary Pathology Service (Kennedy), 390 Waterfall Lane, Winter Park, Florida 32789
- Diagnostic Center for Population and Animal Health (Kiupel), Michigan State University, 4125 Beaumont Road, 152A, Lansing, Michigan 48910
- From the
| | - F. A. Kennedy
- Affiliated Veterinary Specialists–Orange Park, P.A. (Neihaus, Goring), 275 Corporate Way, Suite 100, Orange Park, Florida 32073
- Southeast Veterinary Oncology (Winter), 304 Corporate Way, Orange Park, Florida 32073
- Veterinary Pathology Service (Kennedy), 390 Waterfall Lane, Winter Park, Florida 32789
- Diagnostic Center for Population and Animal Health (Kiupel), Michigan State University, 4125 Beaumont Road, 152A, Lansing, Michigan 48910
- From the
| | - Matti Kiupel
- Affiliated Veterinary Specialists–Orange Park, P.A. (Neihaus, Goring), 275 Corporate Way, Suite 100, Orange Park, Florida 32073
- Southeast Veterinary Oncology (Winter), 304 Corporate Way, Orange Park, Florida 32073
- Veterinary Pathology Service (Kennedy), 390 Waterfall Lane, Winter Park, Florida 32789
- Diagnostic Center for Population and Animal Health (Kiupel), Michigan State University, 4125 Beaumont Road, 152A, Lansing, Michigan 48910
- From the
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Messinger JS, Windham WR, Ward CR. Ionized hypercalcemia in dogs: a retrospective study of 109 cases (1998-2003). J Vet Intern Med 2009; 23:514-9. [PMID: 19658207 DOI: 10.1111/j.1939-1676.2009.0288.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Serum hypercalcemia in dogs has been reported in association with a variety of diseases. Serum-ionized calcium (iCa) concentration is a more accurate measure of hypercalcemia than total serum calcium or corrected serum calcium concentrations. The severity of hypercalcemia has been utilized to suggest the most likely differential diagnosis for the hypercalcemia. HYPOTHESIS Diseases causing ionized hypercalcemia may be different than those that cause increases in total or corrected serum calcium concentrations. The severity of ionized hypercalcemia in specific diseases cannot be used to determine the most likely differential diagnosis for ionized hypercalcemia. ANIMALS One-hundred and nine client-owned dogs with a definitive cause for their ionized hypercalcemia evaluated between 1998 and 2003 were included in this study. METHODS Retrospective, medical records review. RESULTS Neoplasia, specifically lymphosarcoma, followed by renal failure, hyperparathyroidism, and hypoadrenocorticism were the most common causes of ionized hypercalcemia. Dogs with lymphoma and anal sac adenocarcinoma have higher serum iCa concentrations than those with renal failure, hypoadrenocorticism, and other types of neoplasia. The magnitude of serum-ionized hypercalcemia did not predict specific disease states. CONCLUSIONS AND CLINICAL IMPORTANCE Serum-ionized hypercalcemia was most commonly associated with neoplasia, specifically lymphosarcoma. Although dogs with lymphosarcoma and anal sac adenocarcinoma had higher serum iCa concentrations than dogs with other diseases, the magnitude of the serum iCa concentration could not be used to predict the cause of hypercalcemia. Total serum calcium and corrected calcium concentrations did not accurately reflect the calcium status of the dogs in this study.
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Affiliation(s)
- J S Messinger
- VCA Alameda East Veterinary Hospital, Denver, CO, USA
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12
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Gow AG, Gow DJ, Bell R, Simpson JW, Chandler ML, Evans H, Berry JL, Herrtage ME, Mellanby RJ. Calcium metabolism in eight dogs with hypoadrenocorticism. J Small Anim Pract 2009; 50:426-30. [DOI: 10.1111/j.1748-5827.2009.00757.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Zitz JC, Birchard SJ, Couto GC, Samii VF, Weisbrode SE, Young GS. Results of excision of thymoma in cats and dogs: 20 cases (1984–2005). J Am Vet Med Assoc 2008; 232:1186-92. [DOI: 10.2460/javma.232.8.1186] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Adler JA, Drobatz KJ, Hess RS. Abnormalities of Serum Electrolyte Concentrations in Dogs with Hypoadrenocorticism. J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb01933.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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15
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Mellanby RJ, Mellor P, Villiers EJ, Herrtage ME, Halsall D, O'Rahilly S, McNeil PE, Mee AP, Berry JL. Hypercalcaemia associated with granulomatous lymphadenitis and elevated 1,25 dihydroxyvitamin D concentration in a dog. J Small Anim Pract 2006; 47:207-12. [PMID: 16573764 DOI: 10.1111/j.1748-5827.2006.00019.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A seven-year-old Labrador was presented with weight loss and mild generalised lymphadenopathy. Histopathology of an excised lymph node by the referring veterinarian demonstrated granulomatous lymphadenitis. At the time of referral, fine-needle aspirates of the lymph nodes confirmed the presence of ongoing granulomatous inflammation. Further investigations revealed marked hypercalcaemia, a low parathyroid hormone concentration, a parathyroid hormone related protein concentration within the reference range, and an elevated serum concentration of 1,25 dihydroxyvitamin D. An underlying cause of the granulomatous lymphadenitis could not be identified. The clinical signs, hypercalcaemia and elevated serum concentrations of 1,25 dihydroxyvitamin D resolved following prednisolone treatment. In contrast to dogs, hypercalcaemia occurred secondarily to granulomatous disease and elevated 1,25 dihydroxyvitamin D concentrations is a well-recognised condition in human beings. To the authors' knowledge, this is the first case report to describe elevated serum calcium and 1,25 dihydroxyvitamin D concentrations in a dog with histologically confirmed granulomatous disease.
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Affiliation(s)
- R J Mellanby
- Queen's Veterinary School Hospital, University of Cambridge
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Abstract
OBJECTIVE To identify survival and morbidity information after surgery for metastases from apocrine gland anal sac adenocarcinomas (AGACA). STUDY DESIGN Retrospective study. ANIMALS Five dogs with AGACA. METHODS Medical records of dogs that had surgery for treatment of metastatic AGACA between 1993 and 2003 were reviewed. Criteria for inclusion required that dogs had lymphadenectomy, with or without further debulking, as part of their treatment for metastatic AGACA and that the tissue was histologically confirmed as consistent with the primary AGACA. Signalment, history, physical examination findings, clinicopathologic data, imaging findings, surgical complications, number of surgeries, survival times, and cause of death were recorded. All dogs had a complete blood count, serum biochemical profile, serum electrolytes, 3-projection thoracic radiographs, abdominal radiographs and/or abdominal ultrasonography, and histologic confirmation of metastatic AGACA invading the regional lymph nodes and caudal abdomen. RESULTS No surgical complications occurred. Three dogs were euthanatized; median survival, 20.6 months. One dog was alive for 19 months postoperatively. One dog had 5 sequential surgical procedures: 1 iliac lymphadenectomy and 4 debulking procedures of metastatic neoplastic tissue around and dorsal to the iliac vessels extending into the pelvic cavity, and was alive 54 months after initial surgery. CONCLUSION Dogs with anal sac adenocarcinoma metastases to the iliac lymph nodes can experience long-term survival after surgical excision of the metastatic lesion. CLINICAL RELEVANCE Lymphadenectomy may afford long-term survival to patients with metastatic anal sac adenocarcinoma.
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Affiliation(s)
- Howard Phil Hobson
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4474, USA
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17
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German AJ, Foster AP, Holden D, Hotston Moore A, Day MJ, Hall EJ. Sterile nodular panniculitis and pansteatitis in three weimaraners. J Small Anim Pract 2003; 44:449-55. [PMID: 14582659 DOI: 10.1111/j.1748-5827.2003.tb00104.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The clinical and pathological findings in three unrelated weimaraners with pyrexia and multiple subcutaneous nodules are reported. Abdominal pain was an additional feature in two of the dogs and clinical investigations revealed inflammation of subcutaneous, mesenteric and falciform fat. Histopathological findings were consistent with pansteatitis. In the third dog, lesions were apparently limited to the subcutis and, hence, a diagnosis of nodular panniculitis was made. Microbiological examination of tissues was negative in all dogs, and there was no evidence of pancreatic disease. This report thus describes a presumed sterile and idiopathic panniculitis/pansteatitis complex in weimaraner dogs. Although the aetiology is unknown, this may represent an immune-mediated disorder.
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Affiliation(s)
- A J German
- Department of Clinical Veterinary Science, University of Bristol, Langford House, Bristol BS40 5DU
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Williams LE, Gliatto JM, Dodge RK, Johnson JL, Gamblin RM, Thamm DH, Lana SE, Szymkowski M, Moore AS. Carcinoma of the apocrine glands of the anal sac in dogs: 113 cases (1985–1995). J Am Vet Med Assoc 2003; 223:825-31. [PMID: 14507100 DOI: 10.2460/javma.2003.223.825] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize the signalment, clinical signs, biological behavior, and response to treatment of carcinoma of the apocrine glands of the anal sac in dogs. DESIGN Retrospective study. ANIMALS 113 dogs with histologically confirmed carcinoma of the apocrine glands of the anal sac. PROCEDURE Data on signalment, clinical signs, and staging were reviewed and analyzed along with treatment modality for potential association with survival time. RESULTS Sex distribution was approximately equal (54% female, 46% male). One hundred four dogs underwent treatment consisting of surgery, radiation therapy, chemotherapy, or multimodal treatment. Median survival for treated dogs was 544 days (range, 0 to 1,873 days). Dogs treated with chemotherapy alone had significantly shorter survival (median, 212 days) than those receiving other treatments (median, 584 days). Dogs not treated with surgery had significantly shorter survival (median, 402 days) than those that underwent surgery as part of their treatment (median, 548 days). Dogs with tumors > or = 10 cm2 had significantly shorter survival (median, 292 days) than dogs with tumors < 10 cm2 (median, 584 days). Hypercalcemia was identified in 27% (n = 29) of dogs, and those dogs had significantly shorter survival (median, 256 days), compared with those that were normocalcemic (median, 584 days). Dogs with pulmonary metastasis had significantly shorter survival (median, 219 days) than dogs without evidence of pulmonary metastasis (median, 548 days). CONCLUSIONS AND CLINICAL RELEVANCE Unlike most previous reports, this study revealed an approximately equal sex distribution, and results suggest a more favorable prognosis.
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Affiliation(s)
- Laurel E Williams
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
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Bennett PF, DeNicola DB, Bonney P, Glickman NW, Knapp DW. Canine Anal Sac Adenocarcinomas: Clinical Presentation and Response to Therapy. J Vet Intern Med 2002. [DOI: 10.1111/j.1939-1676.2002.tb01613.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
Abnormal electrolyte concentrations occur commonly in hospitalized patients and may produce a variety of clinical symptoms, cause lack of response to therapeutics for primary clinical conditions, and affect clinical outcome. Recognition of electrolyte disturbances requires a high index of suspicion by the clinician for such a disturbance and prompt therapy to ensure a positive and timely outcome for the patient. This article discusses electrolyte abnormalities that occur in critically ill patients, with a review of diseases commonly associated with each electrolyte disturbance, and their recommended management.
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Affiliation(s)
- A M Manning
- Emergency and Critical Care Services, Angell Memorial Animal Hospital, Boston, Massachusetts, USA.
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Savary KCM, Price GS, Vaden SL. Hypercalcemia in Cats: A Retrospective Study of 71 Cases (1991-1997). J Vet Intern Med 2000. [DOI: 10.1111/j.1939-1676.2000.tb02234.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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22
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Dobson JM, Gorman NT. Canine multicentric lymphoma 1: Clinico-pathological presentation of the disease. J Small Anim Pract 1993. [DOI: 10.1111/j.1748-5827.1993.tb02584.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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