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Swepson R, Hosgood G, Stander N, Thompson M. Retrospective application of a validated algorithm for estimation of adrenal gland volume after computed tomography on 46 dogs undergoing adrenalectomy. Aust Vet J 2024; 102:392-397. [PMID: 38663938 DOI: 10.1111/avj.13335] [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: 11/01/2023] [Revised: 03/10/2024] [Accepted: 04/01/2024] [Indexed: 08/03/2024]
Abstract
Canine adrenal gland volume can be predicted based on body weight and computed tomography (CT) measurements using a validated algorithm. Use of this algorithm to detect adrenal pathology, including hyperplasia, hypoplasia and neoplasia, in clinical cases has not been described. The objective of this study was to illustrate application of the algorithm by estimating subject-specific adrenal gland volume in a historical cohort of dogs with known adrenal disease. Forty-six dogs that underwent CT and subsequent adrenalectomy were included. Clinical records and CT images from dogs that underwent adrenalectomy and histologic examination of the excised adrenal gland(s) were reviewed. Normal adrenal gland volumes for each dog were estimated using the algorithm, and compared with measured volumes of the affected glands. Linear measurement of the largest lesion diameter was also recorded. Fifty-eight adrenal glands were removed from 46 dogs, with pathology confirmed in all glands. Pathology included 28 adenomas, 13 carcinomas, 11 pheochromocytomas and 6 other benign pathologies. The volume of all removed adrenal glands was measured to be larger than the expected normal volume estimated by the algorithm, ranging from 1.1 to 212.9 times larger than estimated. Adrenal glands with malignant and benign pathology showed variable volumes with overlapping ranges recorded. Assessment of the dimensions of any focal lesion against a cut-off of 20 mm failed to discriminate malignancy. This study illustrates and supports the application of a validated volumetric algorithm for estimation of subject-specific adrenal gland volume to identify the presence of pathology and as a tool to assist clinical decision-making.
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Affiliation(s)
- R Swepson
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - G Hosgood
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - N Stander
- Vet Imaging Specialists, The Animal Hospital at Murdoch University, Murdoch, Western Australia, Australia
| | - M Thompson
- School of Veterinary Science, University of Sydney, Camperdown, New South Wales, Australia
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2
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Yu SY, Lee S. Imaging guided adrenalectomy with Indocyanine green fluorescence in a dog with a pheochromocytoma. J Vet Sci 2024; 25:e53. [PMID: 39083205 PMCID: PMC11291434 DOI: 10.4142/jvs.24146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/25/2024] [Accepted: 06/25/2024] [Indexed: 08/03/2024] Open
Abstract
IMPORTANCE This case report presents the successful surgical removal of a pheochromocytoma in a dog using indocyanine green (ICG) fluorescence imaging. CASE PRESENTATION A 10-year-old, 6.87 kg, spayed female poodle was referred for an abdominal mass and eight episodes of vomiting. Computed tomography revealed masses in the spleen and left adrenal gland. Based on the plasma normetanephrine levels, the patient was diagnosed with pheochromocytoma. Subsequently, a total splenectomy and left adrenalectomy were performed. A dose of 5 mg/kg ICG was administered intravenously 24 h prior to surgery. Using ICG allowed visualization of tumor margins, aiding in complete resection and minimizing anesthesia-related risks. CONCLUSIONS AND RELEVANCE No evidence of recurrence or metastasis has been observed for 12 months. To our knowledge, this is the first report of the surgical removal of a pheochromocytoma using intraoperative ICG imaging in veterinary medicine. This case highlights the efficacy of ICG fluorescence imaging as a valuable tool for the surgical management of adrenal tumors in veterinary medicine.
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Affiliation(s)
- Seung-Yeon Yu
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Sungin Lee
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju 28644, Korea.
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3
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Recchia A, Digiaro S, Colella A, Greco B, Paradies P. Acute onset of hypertensive encephalopathy in a dog with right adrenal pheochromocytoma and neoplastic invasion of the caudal vena cava: Case report and review of the literature. Open Vet J 2024; 14:1716-1725. [PMID: 39175984 PMCID: PMC11338619 DOI: 10.5455/ovj.2024.v14.i7.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 06/03/2024] [Indexed: 08/24/2024] Open
Abstract
Background Canine pheochromocytomas (PCCs) are rare tumors of the adrenal medulla. Clinical signs are often vague, resulting in intermittent catecholamine over secretion or neoplastic invasion of adjacent structures. Case Description A 12-year-old Epagneul Breton dog with a 1-year history of chronic kidney disease, was examined for acute onset of severe neurological signs. Based on clinical and instrumental data, hypertensive encephalopathy was suspected. Cardiac and abdominal ultrasound were performed. Severe hypertensive cardiopathy and a right adrenal gland mass with invasion of the caudal vena cava were diagnosed. Computed tomography imaging confirmed the suspect of invasive malignant neoplasia. Emergency pharmacological therapy was started to reduce systemic pressure, improve clinical signs, and stabilize the dog in view of surgical resolution. After initial improvement, patient conditions abruptly worsened, and euthanasia was elected. Histology examination confirmed a right adrenal PCC, with caval invasion. Conclusion To the authors' conclusions, acute hypertensive encephalopathy is a peculiar manifestation of PCCs. Ultrasound is a useful, and rapid test to suspect PCC as it can detect adrenal alterations, caval invasion, metastasis, and cardiac sequelae consistent with the condition. PCC can mimic multiple affections, and be misinterpreted, especially when a concurrent disease has already been diagnosed. Veterinarians need to be aware that comorbidities could mask clinical signs and delay diagnosis. Furthermore, this clinical case reminds us to include PCC also in the differential diagnosis of dogs with an acute onset of severe neurological signs.
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Affiliation(s)
- Alessandra Recchia
- Department DiMePre-J, Veterinary Section, University of Bari “Aldo Moro”, Bari, Italy
| | - Serena Digiaro
- Department DiMePre-J, Veterinary Section, University of Bari “Aldo Moro”, Bari, Italy
| | - Antonella Colella
- Department DiMePre-J, Veterinary Section, University of Bari “Aldo Moro”, Bari, Italy
| | - Beatrice Greco
- Department DiMePre-J, Veterinary Section, University of Bari “Aldo Moro”, Bari, Italy
| | - Paola Paradies
- Department DiMePre-J, Veterinary Section, University of Bari “Aldo Moro”, Bari, Italy
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van Bokhorst KL, Galac S, Kooistra HS, de Grauw JC, Teske E, Grinwis GCM, van Nimwegen SA. Laparoscopic vs. open adrenalectomy: perioperative data and survival analysis in 70 dogs with an adrenal tumor. Front Vet Sci 2023; 10:1156801. [PMID: 37662979 PMCID: PMC10468569 DOI: 10.3389/fvets.2023.1156801] [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: 02/01/2023] [Accepted: 07/25/2023] [Indexed: 09/05/2023] Open
Abstract
Adrenalectomy is the treatment of choice in case of functional adrenal tumors and malignant adrenal incidentalomas. Laparoscopic adrenalectomy (LA) in dogs has gained popularity in recent years, however, clinical studies on large patient populations are scarce. This retrospective study describes perioperative and recurrence data, survival, and prognostic factors in 70 dogs that underwent LA or open adrenalectomy (OA) in our hospital between 2008 and 2022. Diagnosis was based on history, clinical signs, endocrine function tests and advanced diagnostic imaging. Laparoscopic adrenalectomy was performed in 42 dogs (n = 27 naturally occurring hypercortisolism, n = 4 pheochromocytoma, n = 1 pheochromocytoma with concurrent hypercortisolism, n = 10 incidentaloma) and OA in 28 dogs (n = 22 hypercortisolism, n = 3 pheochromocytoma, n = 3 incidentaloma). Bilateral adrenalectomy was performed in 8/70 dogs. Surgical duration of LA and OA did not differ significantly in unilateral and bilateral procedures (P = 0.108 and P = 0.101, respectively). Systemic hypertension occurred in 7/41 and 1/28 dogs during LA and OA, respectively (P = 0.130). Hypotension occurred in 2/41 and 4/28 dogs during LA and OA, respectively (P = 0.214). A total of 40/42 dogs in the LA group and 27/28 in the OA group survived to discharge (P = 0.810). Mean hospital stay was significantly shorter (P = 0.006) after LA (1.5 days, range 1-3) than after OA (2.2 days, range 1-4). No significant differences were demonstrated between LA and OA groups in recurrence of adrenal-dependent endocrine disease (P = 0.332), disease-free period (P = 0.733) and survival time (P = 0.353). The disease-specific 1-, 2- and 3-year survival rates were 95, 89, and 89% after LA and 92, 88, and 81% after OA. Tumor size was significantly associated with the occurrence of a recurrence. In addition, tumor size had a negative effect on the disease-free period and survival time. This study shows a favorable outcome of both LA and OA in dogs. Based on low perioperative complication rate, short hospitalization time and long-term outcomes comparable to OA in selected cases, the less invasive laparoscopic approach is considered the preferred technique.
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Affiliation(s)
- Kirsten L van Bokhorst
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
- IVC Evidensia, Vleuten, Netherlands
| | - Sara Galac
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Hans S Kooistra
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Janny C de Grauw
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
- Clinical Sciences and Services, Royal Veterinary College, University of London, London, United Kingdom
| | - Erik Teske
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Guy C M Grinwis
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Sebastiaan A van Nimwegen
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
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5
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Burti S, Zotti A, Rubini G, Orlandi R, Bargellini P, Bonsembiante F, Contiero B, Bendazzoli M, Banzato T. Contrast-enhanced ultrasound features of adrenal lesions in dogs. Vet Rec 2023; 193:e2949. [PMID: 37138528 DOI: 10.1002/vetr.2949] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 03/02/2023] [Accepted: 03/22/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND The contrast-enhanced ultrasound (CEUS) features of adrenal lesions are poorly reported in veterinary literature. METHODS Qualitative and quantitative B-mode ultrasound and CEUS features of 186 benign (adenoma) and malignant (adenocarcinoma and pheochromocytoma) adrenal lesions were evaluated. RESULTS Adenocarcinomas (n = 72) and pheochromocytomas (n = 32) had mixed echogenicity with B-mode, and a non-homogeneous aspect with a diffused or peripheral enhancement pattern, hypoperfused areas, intralesional microcirculation and non-homogeneous wash-out with CEUS. Adenomas (n = 82) had mixed echogenicity, isoechogenicity or hypoechogenicity with B-mode, and a homogeneous or non-homogeneous aspect with a diffused enhancement pattern, hypoperfused areas, intralesional microcirculation and homogeneous wash-out with CEUS. With CEUS, a non-homogeneous aspect and the presence of hypoperfused areas and intralesional microcirculation can be used to distinguish between malignant (adenocarcinoma and pheochromocytoma) and benign (adenoma) adrenal lesions. LIMITATIONS Lesions were characterised only by means of cytology. CONCLUSIONS CEUS examination is a valuable tool for distinction between benign and malignant adrenal lesions and can potentially differentiate pheochromocytomas from adenocarcinomas and adenomas. However, cytology and histology are necessary to obtain the final diagnosis.
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Affiliation(s)
- Silvia Burti
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Alessandro Zotti
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | | | | | | | - Federico Bonsembiante
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Margherita Bendazzoli
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Tommaso Banzato
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
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6
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Büttelmann G, Harder LK, Nolte I, Wefstaedt P. Impact of body weight and sex in selected dog breeds on the canine adrenal gland dimensions measured by computed tomographic imaging. BMC Vet Res 2023; 19:99. [PMID: 37516850 PMCID: PMC10385925 DOI: 10.1186/s12917-023-03641-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 07/10/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND The present study aimed to investigate possible influences of body weight and sex on adrenal gland size in endocrinologically healthy dogs. Possible factors influencing the adrenal size are discussed in relation to a universal upper reference value from the literature of 7.4 mm as the thickness in the caudal pole of the adrenal gland. The adrenal size was measured by computed tomography (CT) from 66 normal dogs of six different breeds (Labrador Retriever (n = 16), German Shepherd (n = 10), Boxer (n = 8), Beagle (n = 14), Dachshund (n = 6) and Jack Russell Terrier (n = 12); male n = 38 (thereof neutered n = 23), female n = 28 (thereof neutered n = 17)) based on volume quantification and linear measurements using the data processing software Amira. For interbreed comparability, a ratio consisting of the third root of adrenal volume to aortic diameter (Ratio volume-aorta, RVA) was introduced. Additionally, breed-related attenuation values in contrast-enhanced CT data sets were measured. RESULTS The measured volumes ranged from 0.34 to 1.93 cm3 for the right and from 0.39 to 2.23 cm3 for the left adrenal gland. The present study was able to demonstrate a body weight effect on the adrenal volume as well as on length and height. In terms of adrenal size, no significant differences between male and female, nor between intact and neutered dogs were obtained due to the RVA. In addition, for the weight classes, a breed independent threshold for dogs less (left 1.4; right gland 1.5) or more than 20 kg body weight (left 1.1; right gland 1.2) based on RVA was defined. Breed-related significant differences with respect to attenuation were determined only for the left adrenal gland, with lower attenuation values in large dog breeds. CONCLUSION The present study points out the importance of weight-related data when assessing CT data of the canine adrenal gland regarding volume, size and attenuation. The use of a universal reference value for the assessment of adrenal size appears unsuitable considering weight-related volume and linear measurements. Sex seems not to affect adrenal gland size.
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Affiliation(s)
- Gerrit Büttelmann
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D- 30559, Hannover, Germany
| | - Lisa Katharina Harder
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D- 30559, Hannover, Germany
| | - Ingo Nolte
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D- 30559, Hannover, Germany.
| | - Patrick Wefstaedt
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D- 30559, Hannover, Germany
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7
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Park SW, Kim K, Kim OK, Ro WB, Lee CM. Case report: Successful medical management of adrenocortical carcinoma with metastasis in a Maltese dog. Front Vet Sci 2023; 10:1142418. [PMID: 37519993 PMCID: PMC10378588 DOI: 10.3389/fvets.2023.1142418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Adrenocortical carcinoma (ACC) with metastasis has a grave prognosis, and adrenalectomy is associated with a high perioperative mortality rate in dogs. A favorable outcome following trilostane treatment in patients with metastatic ACC confirmed by a decreased size of the adrenal tumor and metastatic lesions has not been reported in dogs. Case description A 12-year-old neutered male Maltese dog was diagnosed with a right adrenal tumor and a hepatic mass. Adrenal-dependent hyperadrenocorticism (ADH) was diagnosed based on clinical signs and an adrenocorticotropic hormone stimulation test (ACTHST). In addition, tests for plasma metanephrine and normetanephrine ruled out a pheochromocytoma. Based on cytology and computed tomography, unresectable metastatic ACC was confirmed. The dog was managed with trilostane due to the presence of distant metastasis. Medical management improved the clinical signs and post-ACTHST cortisol concentrations. One year after the first presentation, the clinical signs and ACTHST test showed a favorable outcome. In addition, computed tomography revealed a decreased size of the right adrenal tumor and resolution of the hepatic mass. Conclusions Trilostane could be considered as a treatment option for unresectable metastatic ACC. A decrease in tumor size following treatment with trilostane has not been reported in dogs. This case report is the first to demonstrate a favorable outcome of metastatic ACC following trilostane mono therapy for >1 year.
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Affiliation(s)
- Sin-Wook Park
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR Program for Creative Veterinary Science Research Center, Chonnam National University, Gwangju, South Korea
| | - Keon Kim
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR Program for Creative Veterinary Science Research Center, Chonnam National University, Gwangju, South Korea
| | - Ock-Kyu Kim
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR Program for Creative Veterinary Science Research Center, Chonnam National University, Gwangju, South Korea
| | - Woong-Bin Ro
- Cat Vet Animal Hospital, Seongnam-si, Gyeonggi-do, South Korea
| | - Chang-Min Lee
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR Program for Creative Veterinary Science Research Center, Chonnam National University, Gwangju, South Korea
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Olimpo M, Ferraris EI, Parisi L, Buracco P, Rizzo SG, Giacobino D, Degiovanni A, Maniscalco L, Morello E. Diagnostic Findings and Surgical Management of Three Dogs Affected by Osseous Metaplasia Secondary to a Salivary Mucocele. Animals (Basel) 2023; 13:ani13091550. [PMID: 37174587 PMCID: PMC10177029 DOI: 10.3390/ani13091550] [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: 04/05/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Saliva is an irritant of the subcutaneous tissue, thus causing the development of a non-epithelial reactive pseudocapsule. Metaplastic ossification of the pseudocapsule is a condition rarely described in the veterinary literature. The main causes of calcification are trauma, tumours, various chronic inflammatory conditions and fibrodysplasia ossificans progressiva. The aim of the present case series was to describe three dogs affected by a calcified salivary mucocele. The medical records of dogs affected by a cervical sialocele were retrospectively evaluated, and three cases met the inclusion criteria. All the dogs in this study were referred to the Veterinary Teaching Hospital (VTH) of the Department of Veterinary Sciences of the University of Turin (Turin, Italy) for a large solid mass in the intermandibular region. The diagnosis of a mucocele was confirmed clinically by centesis and by radiography or CT. Complete excision of both the pseudocyst and the ipsilateral mandibular/monostomatic sublingual salivary gland was performed in all cases. The histological report showed large areas of bone metaplasia within the pseudocapsule and chronic sialadenitis. Based on this limited case series, complete excision of the pseudocyst and a concurrent sialoadenectomy provided an effective treatment for this rare salivary mucocele disorder.
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Affiliation(s)
- Matteo Olimpo
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
| | | | - Lorenza Parisi
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
| | - Paolo Buracco
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
| | - Sara Gioele Rizzo
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
| | - Davide Giacobino
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
| | - Andrea Degiovanni
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
| | - Lorella Maniscalco
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
| | - Emanuela Morello
- Department of Veterinary Sciences, University of Turin, 10095 Grugliasco, Italy
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Srisowanna N, Thanaboonnipat C, Pisamai S, Komin K, Choisunirachon N. The use of ultrasonographic adrenal dimensions and the adrenal dimension-to-aorta ratio in the diagnosis of benign and malignant adrenal diseases in dogs. Vet World 2023; 16:104-110. [PMID: 36855360 PMCID: PMC9967719 DOI: 10.14202/vetworld.2023.104-110] [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: 09/13/2022] [Accepted: 12/05/2022] [Indexed: 01/13/2023] Open
Abstract
Background and Aim Ultrasound (US) is a useful tool for detecting adrenal abnormalities. However, a definite reference range differentiating normal and diseased adrenal glands in dogs of varying body sizes is still lacking. The organ dimension-to-aorta (Ao) ratio of the dogs is correlated with their body weight (BW). Therefore, this study aimed to investigate the adrenal dimensions, including adrenal pole thickness and adrenal length, as well as the adrenal dimension-to-Ao ratio, to differentiate between dogs with normal, benign lesions such as pituitary-dependent hyperadrenocorticism (PDH) and malignant invasive adrenal tumors. Materials and Methods The medical records and US images of 39 dogs that were either normal (normal) (n = 15) or affected by PDH (n = 15) or malignant invasive adrenal tumors (tumor) (n = 9) were retrieved in this study. All the dogs had a transabdominal US on the sagittal plane. The adrenal dimensions and luminal Ao diameter at the peak of the systolic phase were recorded. The average adrenal dimensions, including the adrenal dimension-to-Ao ratio, were compared among the groups. Results Most of the dogs in each group were small-breed dogs with comparable ages, BW, and Ao values. Both adrenal dimensions and the adrenal dimension-to-Ao ratio were significantly lower in the normal group than in the PDH and tumor groups. To differentiate the PDH group from the tumor group, adrenal dimensions of pole thickness and length were more appropriate than the adrenal dimension-to-Ao ratio. Conclusion Adrenal dimensions and the adrenal dimension-to-Ao ratio can be used to diagnose adrenal diseases. However, in small-breed dogs, adrenal dimensions are suitable for differentiating PDH from tumor groups. Further research is required with a larger sample size and a wider range of canine body sizes.
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Affiliation(s)
- Naparee Srisowanna
- Small Animal Hospital, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Pathumwan, Bangkok, 10330, Thailand
| | - Chutimon Thanaboonnipat
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Pathumwan, Bangkok, 10330, Thailand
| | - Sirinun Pisamai
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Pathumwan, Bangkok, 10330, Thailand
| | - Kiatpichet Komin
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Pathumwan, Bangkok, 10330, Thailand
| | - Nan Choisunirachon
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Pathumwan, Bangkok, 10330, Thailand,Corresponding author: Nan Choisunirachon, e-mail: Co-authors: NS: , CT: , SP: , KK:
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10
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Jung JW, Lee E, Kim S, Park S, Lee SK, Hong S, Choi J. Computed tomography can differentiate vaginal-origin from uterine-origin lesions in bitches. Am J Vet Res 2022; 84:ajvr.22.03.0052. [PMID: 36434761 DOI: 10.2460/ajvr.22.03.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate typical computed tomography (CT) features for the differentiation of vaginal from the uterine origin in dogs. ANIMALS 7 healthy Beagles in the prospective study and 5 bitches in the retrospective study. PROCEDURES In the prospective study, dual-phase CT images were obtained from sexually intact female Beagles (n = 7) during anestrus and estrus. On the CT images, the vagina and uterine horns, body, and cervix were assessed for diameter, attenuation, and contrast enhancement pattern. In the retrospective study, CT features of large vaginal lesions (leiomyoma, leiomyosarcoma, adenocarcinoma, hematocolpos, and Gartner's duct cyst) were assessed in 5 bitches. RESULTS In normal bitches, the cervix was thicker with strong central enhancement compared to the uterus and vagina. The uterine artery, which enters the mesometrium at the level of the cervix, was clearly visualized and assisted in identifying the cervix. In bitches with large vaginal masses, uterine arteries were displaced by the lesions and could not be used to locate the cervix. In 4/5 dogs with vaginal masses, identification of the cervix allowed the determination of the organ of origin. In 1 dog with adenocarcinoma, CT vaginography was additionally required for determining the origin of mass. CLINICAL RELEVANCE Results from this study indicate that the cervix, recognized in CT as focal thickening of the uterus with central enhancement, may be used as a landmark for the differentiation between the uterus and vagina in bitches.
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Affiliation(s)
- Jin-Woo Jung
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Chonnam National University, Gwangju, South Korea
| | - Eunji Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Chonnam National University, Gwangju, South Korea
| | - Soyeon Kim
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Chonnam National University, Gwangju, South Korea
| | - Seungjo Park
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Chonnam National University, Gwangju, South Korea
| | - Sang-Kwon Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Kyungpook National University, Daegu, South Korea
| | - Sunghwa Hong
- Department of Veterinary Diagnostic Imaging, Helix Animal Medical Center, Seoul, South Korea
| | - Jihye Choi
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
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11
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Swepson R, Hosgood G, Stander N. Algorithmic estimation of adrenal volume based on body weight and CT landmarks in dogs. Vet Radiol Ultrasound 2022; 63:264-271. [PMID: 34997659 DOI: 10.1111/vru.13047] [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: 06/29/2021] [Revised: 10/04/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022] Open
Abstract
Computed tomographic (CT) methods for quantifying adrenal size are helpful for identifying and directing management of adrenal disease in dogs. This retrospective, observational study aimed to use CT to determine anatomic landmarks associated with adrenal gland volume in dogs, and subsequently develop an algorithm to estimate adrenal volume for individual subjects. Abdominal CT images from 150 dogs without adrenal disease were assessed. The volume of the left and right adrenals, as well as dimensions from anatomic structures, were measured. Predictive models for adrenal volume were examined with cross validation. A further 29 dogs were used for external validation and model fit. Dogs in the test cohort weighed from 3.1 to 67.5 kg (mean 24.4 kg) with left (VLA ) and right (VRA ) adrenal volume ranging from 0.23 to 2.84 cm3 (mean 1.22 cm3 ) and 0.14 to 2.97 cm3 (mean 1.11 cm3 ), respectively. A predictive model for each adrenal based on weight (W) and L1 height (HL1 ) best explained the adrenal volume, with external validation confirming model fit. The final models, adjusted for bias, were: VLA = 0.154 + (0.02 × W) + (0.07 × HL1 ) (adjR2 = 0.62); and VRA = -0.116 + (0.02 × W) + (0.06 × HL1 ) (adjR2 = 0.64). In dogs undergoing CT, these algorithms can be used to estimate expected adrenal volume and allow comparison with the actual volume measured on CT, facilitating interpretation of CT findings, and clinical decision-making.
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Affiliation(s)
- Ryan Swepson
- Department of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Giselle Hosgood
- Department of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Nerissa Stander
- Vet Imaging Specialists, The Animal Hospital at Murdoch University, Perth, Australia
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12
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Hayes G. Update on Adrenalectomy. Vet Clin North Am Small Anim Pract 2022; 52:473-487. [DOI: 10.1016/j.cvsm.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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13
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Enright D, Dickerson VM, Grimes JA, Townsend S, Thieman Mankin KM. Short- and long-term survival after adrenalectomy in 53 dogs with pheochromocytomas with or without alpha-blocker therapy. Vet Surg 2022; 51:438-446. [PMID: 35141905 DOI: 10.1111/vsu.13771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/14/2021] [Accepted: 01/08/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report data related to the short- and long-term survival of dogs undergoing adrenalectomy for pheochromocytoma, and to determine the influence of preoperative alpha-blocker therapy. STUDY DESIGN Retrospective. ANIMALS Fifty-three dogs. METHODS Medical records were reviewed for dogs diagnosed with pheochromocytoma and treated with adrenalectomy between 2010 and 2020. Preoperative management, imaging studies, intraoperative cardiovascular instability, complications, and procedural information were recorded. When applicable, duration of survival and cause of death, time to recurrence or metastasis, and postoperative complications were recorded. RESULTS During anesthesia, a hypertensive episode was documented in 46/53 dogs and arrhythmias were recorded in 16/53 dogs. Of these, 37/46 hypertensive dogs and 11/16 dogs with arrhythmias were treated with an alpha-blocker before surgery. Intraoperative systolic blood pressures reached higher levels by a magnitude of nearly 20% in dogs that were treated preoperatively with an alpha-blocker (P = .01). All dogs survived surgery and 44 survived to discharge. Follow up ranged from 6 to 1653 days (median 450 days). Median survival time for dogs discharged from the hospital was 1169 days (3.2 years). Recurrence and metastasis were suspected in 3 and 8 dogs, respectively. CONCLUSION Most dogs survived the immediate postoperative period and achieved long-term survival with a low reported incidence of tumor recurrence or metastasis. Preoperative alpha-blocker therapy was not associated with increased survival. CLINICAL SIGNIFICANCE The favorable outcomes reported in this study should be taken into consideration when discussing treatment options for dogs with pheochromocytomas. This study provides no evidence to support preoperative alpha-blocker therapy.
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Affiliation(s)
- Dory Enright
- Department of Small Animal Veterinary Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Vanna M Dickerson
- Department of Small Animal Veterinary Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Janet A Grimes
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Sarah Townsend
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Kelley M Thieman Mankin
- Department of Small Animal Veterinary Clinical Sciences, Texas A&M University, College Station, Texas, USA
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14
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King SA, Bolton TA. What Is Your Diagnosis? J Am Vet Med Assoc 2022; 260:603-605. [PMID: 35113801 DOI: 10.2460/javma.20.09.0539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Gombert A, Diana A, Hecht S, Nicoli S, Fracassi F, Mortier J, Reyes-Gomez E, Pey P. Imaging features of retroperitoneal extra-adrenal paragangliomas in 10 dogs. Vet Radiol Ultrasound 2022; 63:393-402. [PMID: 35050528 PMCID: PMC9546460 DOI: 10.1111/vru.13063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/31/2021] [Accepted: 12/11/2021] [Indexed: 11/29/2022] Open
Abstract
Retroperitoneal paragangliomas are rare tumors of the neuroendocrine system. Only a few canine case reports are available with rare descriptions of their imaging features. The objectives of this multi‐center, retrospective case series study were to describe the diagnostic imaging features of confirmed retroperitoneal paragangliomas and specify their location. Medical records and imaging studies of 10 affected dogs with cytological or histopathologic results concordant with retroperitoneal paragangliomas were evaluated. Dogs had a median age of 9 years. Four of them had clinical signs and laboratory reports compatible with excessive production of catecholamines. Six ultrasound, four CT, four radiographic, and one MRI studies were included. The paragangliomas did not have a specific location along the aorta. They were of various sizes (median 33 mm, range: 9–85 mm of length). Masses had heterogeneous parenchyma in six of 10 dogs, regardless of the imaging modality. Strong contrast enhancement was found in all CT studies. Encircling of at least one vessel was detected in six of 10 masses, clear invasion of a vessel was identified in one of 10 masses. In five of 10 cases, the masses were initially misconstrued as lymph nodes by the on‐site radiologist. Retroperitoneal paragangliomas appear along the abdominal aorta, often presenting heterogeneous parenchyma, possibly affecting the local vasculature, and displaying strong contrast enhancement on CT. Clinical signs can be secondary to mass effects or excessive catecholamine production. Underdiagnosis and misdiagnosis of this tumor are suspected as they can be silent, of small size, or confused with other structures.
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Affiliation(s)
- Alexis Gombert
- University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Alessia Diana
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | | | - Federico Fracassi
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
| | - Jeremy Mortier
- Department of Small Animal Clinical Sciences, University of Liverpool, Neston, UK
| | - Edouard Reyes-Gomez
- Histology and Anatomical Pathology Unit, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.,Ecole Nationale Vétérinaire d'Alfort, U955-IMRB, Inserm, UPEC, Maisons-Alfort, France
| | - Pascaline Pey
- Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Italy
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16
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Imaging techniques in Veterinary Medicine. Part I: Radiography and Ultrasonography. Eur J Radiol Open 2021; 8:100382. [PMID: 34712745 PMCID: PMC8529508 DOI: 10.1016/j.ejro.2021.100382] [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: 07/10/2021] [Accepted: 10/06/2021] [Indexed: 12/12/2022] Open
Abstract
In Veterinary Medicine all the Imaging techniques are used and described but, due to organizational, managerial and, mostly, economical reasons, Radiography and Ultrasonography are the most used. Veterinary Radiology teaching has a relatively small number of educational credits in the degree courses but, nowday, educational opportunities are remarkably increased thanks to a number of post-degree courses and masters, organized both by the universities and private veterinary associations. The relevance of Diagnostic Imaging is particularly true in Veterinary Medicine, in which Radiology could be considered “indispensable” for diagnosis, prognosis and follow up. Furthermore, it should not be forgotten that the diagnostic image represents a “document” and, has a relevant role in legal medical debats. In this first part, Radiography and Ultrasonography are described.
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Nagumo T, Ishigaki K, Yoshida O, Iizuka K, Tamura K, Sakurai N, Terai K, Seki M, Edamura K, Asano K. Utility of contrast-enhanced ultrasound in differential diagnosis of adrenal tumors in dogs. J Vet Med Sci 2020; 82:1594-1601. [PMID: 32968037 PMCID: PMC7719881 DOI: 10.1292/jvms.20-0427] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This prospective case study aimed to clarify the clinical significance of contrast-enhanced ultrasound (CEUS) for the differential diagnosis of canine adrenal tumors. Forty-three client-owned dogs with adrenal tumors were included. All dogs underwent CEUS, which was evaluated qualitatively and quantitatively. The peak signal intensity (PI), time to peak signal intensity (TPI), mean transit time (MTT), upslope, and downslope were calculated for each time-intensity curve. The histopathological diagnosis of each resected mass was compared with the CEUS findings and parameters. Enhancement distribution, vascularity, tortuous nourishing vessels, enhancement pattern, and late-phase enhancement did not differ significantly between adrenal cortical adenoma (CA), adenocarcinoma (CAC), and pheochromocytoma (PHEO) in qualitative assessment. In PHEO, the TPI was significantly more rapid compared with that in CA (P=0.0287) and CAC (P=0.0404). The MTT in PHEO was significantly shorter than that in CA (P=0.0016) and CAC (P=0.0003). Upslope in PHEO was larger than that in CAC (P=0.0406). Downslope in PHEO was significantly larger than that in CA (P=0.0048) and CAC (P=0.0018). A receiver operating characteristic curve analysis demonstrated that the area under the MTT curve yielded 0.91 for distinguishing PHEO from adrenocortical tumors in dogs; an MTT cut-off value less than 6,225 msec yielded a sensitivity of 69%, specificity of 94%, and likelihood ratio of 12.46. CEUS appears to be clinically applicable for the differential diagnosis between cortical and medullary origins of primary adrenal tumors in dogs.
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Affiliation(s)
- Takahiro Nagumo
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1886 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Kumiko Ishigaki
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1886 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Orie Yoshida
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1886 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Keigo Iizuka
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1886 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Kei Tamura
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1886 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Naoki Sakurai
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1886 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Kazuyuki Terai
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1886 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Mamiko Seki
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1886 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Kazuya Edamura
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1886 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Kazushi Asano
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1886 Kameino, Fujisawa, Kanagawa 252-0880, Japan
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18
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Appelgrein C, Hosgood G, Drynan E, Nesbitt A. Short-term outcome of adrenalectomy in dogs with adrenal gland tumours that did not receive pre-operative medical management. Aust Vet J 2020; 98:449-454. [PMID: 32583433 DOI: 10.1111/avj.12991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Review medical records of dogs that underwent adrenalectomy without pre-operative medical management, to examine the peri-operative morbidity and mortality. DESIGN Case series of 65 dogs. METHODS Medical records were reviewed. Features recorded included the histologic diagnosis, intra-operative hypertension or tachycardia, requirement for cavotomy, administration of intra- and post-operative corticosteroids, performance of additional surgery and the occurrence of peri-operative complications. Dogs requiring emergency surgery were excluded. RESULTS Of the 65 dogs, 49 had adrenocortical tumours (11 bilateral), 13 had pheochromocytomas (one bilateral) and three dogs had tumours in both adrenal glands of a different tumour type. Five dogs had caudal vena cava invasion and 33 had additional procedures performed at the same time. Mortality occurred in 1/65 dogs (1.5%; 95% CI 0.03%-8.2%), major complications were identified in 1/65 dogs (1.5%; 95% CI 0.03%-8.2%) and minor complications occurred in 10/53 dogs (15%; 95% CI 8.6%-26%). CONCLUSION Based on the limited peri-operative complications and low mortality in this pre-operatively untreated cohort, and based on critique of the available literature, the added value afforded by pre-operative treatment is questioned. With appropriate management, adrenal tumours can be removed with few peri-operative complications and low mortality.
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Affiliation(s)
- C Appelgrein
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - G Hosgood
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - E Drynan
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - A Nesbitt
- School of Veterinary Medicine, Murdoch University, Perth, Australia
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19
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Invasion of Pheochromocytoma from the Caudal Vena Cava to the Right Ventricular Cavity in a Dog. Case Rep Vet Med 2020; 2020:5382687. [PMID: 32095312 PMCID: PMC7036100 DOI: 10.1155/2020/5382687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/27/2019] [Accepted: 09/04/2019] [Indexed: 12/04/2022] Open
Abstract
Pheochromocytomas are catecholamine-secreting tumors that are composed of neuroectoderm-derived chromaffin cells. An 8-year-old miniature dachshund with abdominal distension was diagnosed with a neuroendocrine tumor with invasion from the caudal vena cava to the right ventricular cavity. The dog died due to hypotensive shock from the vagal reflex, and on autopsy, an extra-adrenal pheochromocytoma (paraganglioma) was diagnosed in the caudal abdomen. At autopsy, the tumor plug of the caudal vena cava was confirmed. To the best of our knowledge, this is the first case report that echo-captured the extension of pheochromocytoma in the right ventricle and shows it in a figure and video file.
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20
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Bennaim M, Shiel RE, Mooney CT. Diagnosis of spontaneous hyperadrenocorticism in dogs. Part 2: Adrenal function testing and differentiating tests. Vet J 2019; 252:105343. [PMID: 31554584 DOI: 10.1016/j.tvjl.2019.105343] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 07/07/2019] [Accepted: 07/19/2019] [Indexed: 02/06/2023]
Abstract
Hyperadrenocorticism is a relatively common endocrine disorder in dogs that has been extensively described. However, its diagnosis remains challenging because there is no true reference standard test, and a myriad factors can affect the diagnostic performance of the commonly used adrenal function tests. Ultimately, the diagnosis is based on a combination of signalment, history and clinical findings, and a variety of diagnostic test results. The second part of this review aims to appraise available data on diagnostic performance of adrenal function tests in naturally occurring canine hyperadrenocorticism.
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Affiliation(s)
- Michael Bennaim
- Section of Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Ireland.
| | - Robert E Shiel
- Section of Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Ireland
| | - Carmel T Mooney
- Section of Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Ireland
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21
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Fowler KM, Frank LA, Morandi F, Whittemore JC. Extended low-dose dexamethasone suppression test for diagnosis of atypical Cushing's syndrome in dogs. Domest Anim Endocrinol 2017; 60:25-30. [PMID: 28371654 DOI: 10.1016/j.domaniend.2017.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/28/2017] [Accepted: 03/04/2017] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to evaluate extension of the low-dose dexamethasone suppression (LDDS) test from 8 h to 12 h to detect possible hypercortisolemia associated with atypical hyperadrenocorticism (AHAC). Twelve client-owned dogs were enrolled in the study: 6 healthy dogs (group 1) and 6 dogs with suspected AHAC (group 2). Baseline EDTA plasma samples were collected for endogenous ACTH determination using an immunoradiometric assay. Serum samples were collected before and at 4, 8, 10, and 12 h post-administration of 0.01 mg/kg dexamethasone IV for cortisol concentration determination via chemiluminescent assay. Mean endogenous ACTH concentration did not differ between groups (group 1: 22.4 pg/mL, group 2: 20.0 pg/mL; P > 0.2). Mean baseline cortisol concentration also did not differ significantly between groups (group 1: 3.03 μg/dL, group 2: 4.95 μg/dL; P > 0.2) nor was there any difference in mean cortisol concentration between the groups at any other time point (P > 0.2). The cortisol concentration from 1 dog in group 2 suppressed to 0.7 μg/dL at 8 h but increased to 1.5 μg/dL at 10 h and 3.7 μg/dL at 12 h post-dexamethasone. Based on results of this study, use of an extended LDDS test could not differentiate between healthy dogs and dogs with AHAC. Diagnosis of AHAC should continue to be based on prior established criteria until new testing has been identified.
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Affiliation(s)
- K M Fowler
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996, USA
| | - L A Frank
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996, USA.
| | - F Morandi
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996, USA
| | - J C Whittemore
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996, USA
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