Clinical outcome in 23 dogs with exocrine pancreatic carcinoma

Exocrine pancreatic carcinoma is uncommon in the dog and the veterinary literature surrounding the disease is minimal. Twenty-three cases of canine exocrine pancreatic carcinoma were reviewed in a retrospective manner to obtain information on clinical presentation, behaviour and survival associated with the disease. Presenting clinical signs were nonspecific and included anorexia, lethargy, vomiting and abdominal pain. The overall median survival time was only 1 day but was confounded by the large number of dogs that were euthanized shortly after diagnosis. Metastatic disease was detected in 78% of cases at the time of diagnosis, attesting to the aggressive nature of the disease. Neither lymph node metastasis, tumour size nor tumour location had an impact on overall survival. Only one patient was a previous diabetic who is contrary to reports of the disease in people and felines. This retrospective study reaffirms the need for early detection measures to optimize disease control. However, the benefits of therapy with surgery or radiation and adjuvant chemotherapy remain to be elucidated in dogs with exocrine pancreatic carcinoma.

Characterization of 22 Canine Pancreatic Carcinomas and Review of Literature

Pancreatic carcinomas are rare in dogs and clinical signs are mostly non-specific. The literature on clinically and pathologically characterized canine exocrine pancreatic tumours is limited to 76 cases reported since 1963. This retrospective study analysed formalin-fixed samples of pancreatic carcinomas from 22 dogs, obtained during elective exploratory surgery (n = 16) or if the dog was humanely destroyed (n = 6). Tumours were diagnosed according to the World Health Organization classification of tumours of the pancreas of domestic animals. In seven cases, blood samples taken during or shortly before surgery were analysed for concentrations of alpha-amylase, 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester lipase (DGGR lipase), C-reactive protein (CRP), alanine aminotransferase, glutamate dehydrogenase, alkaline phosphatase (ALP), canine trypsin-like immunoreactivity (cTLI) and canine pancreatic lipase immunoreactivity (cPLI). Neutrophil and lymphocyte numbers were determined as part of a complete blood count. Clinical signs were non-specific and included vomiting, inappetence and diarrhoea. Acinar carcinomas were most common (19/22) and observed growth patterns included: solid (n = 14), acinar (n = 5), clear cell (n = 3), mucinous (n = 2), trabecular (n = 1) or rosette-like (n = 1), occurring as a single pattern or in combination. Ductal carcinomas were identified in three cases. Pancreatitis was a common additional histological finding; five dogs had mild and nine dogs had severe pancreatitis. cPLI, DGGR lipase, cTLI and CRP were elevated in 5/5 acinar carcinomas. All liver enzymes were elevated in three of these five animals and ALP was increased in 4/5 dogs. Two dogs with ductal pancreatic carcinomas showed normal cPLI concentrations. One had increased CRP, liver enzymes and leucocytosis with neutrophilia, the other had elevated DGGR lipase and cTLI concentrations. Clinical findings in canine pancreatic carcinomas were non-specific and simultaneous inflammation can mask the detection of the underlying neoplasm in clinical examination and laboratory testing.

Primary Solid and Cystic Tumours of the Exocrine Pancreas in Cats

Tumours of the exocrine pancreas are rare in cats and few cases are described in the literature. Cystic tumours of the pancreas are not included in the World Health Organization (WHO) international histological classification of tumours of domestic animals. The aim of this study was to characterize the pathology of primary epithelial tumours of the feline exocrine pancreas, with emphasis on cystic tumours. We reviewed tumours of the exocrine pancreas in 70 cats, including complete tumours or the entire pancreas (n = 18) and excisional biopsy samples of pancreatic tumours (n = 52). Macroscopically, the tumours were grouped as solid (n = 45) or cystic (n = 25). Solid tumours were subdivided into adenomas (n = 5) and carcinomas (n = 40) and cystic neoplasms into adenomas (n = 15), carcinomas (n = 7) and cases with diverse growth patterns (n = 3). All five grossly solid adenomas had acinar morphology, while the macroscopically solid carcinomas showed acinar (n = 17), tubular (n = 14) or mixed (n = 9) growth microscopically. Cystic adenomas had acinar (n = 2), tubular (n = 12) or mixed (n = 1) growth, while cystic carcinomas had exclusively tubular growth (n = 7). Three cases with cystic lesions showed diverse histopathological growth patterns. The clinical outcome was available in 57 cases. The majority of cats with carcinomas died or were humanely destroyed during or shortly after surgery (n = 32). However, 2/7 animals with cystic carcinomas showed longer survival times. Cats with cystic adenomas had survival times of up to 5 years. The results of this study show that cystic pancreatic tumours should be considered a differential diagnosis in cats with cystic intra-abdominal masses, even though these are not yet described in the WHO classification. Based on the relatively long survival times of cats with cystic adenomas, complete resection with subsequent histopathological examination is recommended.

Computed Tomography and MRI of the Hepatobiliary System and Pancreas

MRI and computed tomographic (CT) imaging are becoming more common in the diagnosis of hepatobiliary and pancreatic disorders in small animals. With the advent of multislice CT scanners, sedated examinations in veterinary patients are feasible increasing the use of this imaging modality. CT and MRI provide additional information for dogs and cats with hepatobiliary and pancreatic diseases because of lack of superimposition of structures, operator dependence, and through intravenous contrast administration. This added value provides more information for diagnosis, prognosis, and surgical planning.

Canine sterile nodular panniculitis: a retrospective study of 39 dogs

BACKGROUND

Canine sterile nodular panniculitis (SNP) is an inflammatory disease of the panniculus that is typically managed with immunomodulatory or immunosuppressive treatments. It has been reported to be a cutaneous marker of an underlying systemic disease.

HYPOTHESIS/OBJECTIVES

To assess the presence or absence of concurrent systemic diseases associated with canine SNP and to document breed predispositions.

ANIMALS

Thirty nine dogs presented to a veterinary teaching hospital from 1990 to 2012 which met inclusion criteria.

METHODS

Inclusion in this retrospective study required a diagnosis of SNP via histopathological analysis and negative special stains for infectious organisms. Breed distributions of affected dogs were compared to all other dogs examined at this hospital during the study period. Correlations between the histological pattern of panniculitis and the histological presence of dermatitis, clinical presentation of lesions, dog breed and therapeutic outcomes were assessed.

RESULTS

Australian shepherd dogs, Brittany spaniels, Dalmatians, Pomeranians and Chihuahuas were significantly over-represented, but correlations between inflammatory patterns of panniculitis and other histological and clinical factors were not identified. Based on the information available in medical records, 32 dogs (82.1%) had no concurrent systemic diseases identified. Four dogs had concurrent polyarthritis, which may be related to SNP through unknown mechanisms.

CONCLUSIONS/CLINICAL IMPORTANCE

This study identified several novel breed predilections for SNP; it failed to find any clear correlations with associated systemic diseases other than polyarthritis. The histological inflammatory pattern of SNP does not predict therapeutic outcome.

Description of the use of contrast-enhanced ultrasonography in four dogs with pancreatic tumours

Canine pancreatic tumours are rare compared to human medicine and the detection and differentiation of pancreatic neoplasia is challenging with B-mode ultrasonography, which often leads to late clinical diagnosis and poor prognosis. This case report describes the findings of contrast-enhanced ultrasonography in four dogs with pancreatic adenocarcinoma or insulinoma. B-mode ultrasonography of the pancreas revealed a hypoechoic nodule in three dogs and heterogenous tissue in one dog. Contrast-enhanced ultrasonography was able to differentiate between two tumour types: adenocarcinomas showed hypoechoic and hypovascular lesions, whereas insulinomas showed uniformly hypervascular lesions. Contrast-enhanced ultrasonography findings were confirmed by cytology and/or histopathology. The results demonstrated that contrast-enhanced ultrasonography was able to establish different enhancement patterns between exocrine (adenocarcinoma) and endocrine (insulinoma) tumours in dogs.

Acinar cell carcinoma of exocrine pancreas in two horses

Two horses were presented with non-specific clinical signs of several weeks' duration and were humanely destroyed due to a poor prognosis. At necropsy examination, both horses had multiple small, white nodules replacing pancreatic tissue and involving the serosal surface of the abdominal cavity, the liver and the lung. Microscopically, neoplastic cells were organized in acini and contained abundant (case 1) or sparse (horse 2) intracytoplasmic zymogen granules. Immunohistochemically, both tumours expressed amylase and pan-cytokeratin, but not insulin or neuron-specific enolase. In case 2, a low percentage of neoplastic cells expressed glucagon and synaptophysin. The presence of zymogen granules was confirmed in both cases by electron microscopy and occasional fibrillary or glucagon granules were observed in cases 1 and 2, respectively. A diagnosis of pancreatic acinar cell carcinoma was established in both horses.

Comparative Pancreatic Pathology

Spontaneous pathologies of the pancreas are important causes of morbidity and mortality in some veterinary species and rare in others. As in human beings, the pancreas of most domestic and exotic animals is a composite organ with both endocrine and exocrine functions. The similarities between structure and function of porcine, canine, and human pancreata are such that the pig and dog serve as valuable models in basic and translational studies, most recently for efforts aimed at modeling pancreatitis and diabetes, developing functional and sustainable replacement of endocrine functions, and in imaging and manipulation studies.

This article will provide a brief review of spontaneous veterinary diseases and their underlying mechanisms and the morphological features that reflect these alterations. Several species- or breed-specific conditions and the effects of selected systemic diseases on the pancreas are also discussed. The contributions to our knowledge of pancreatic physiology and pathology by small mammal (rodent) and engineered animal models and the in-depth mechanisms homologous to those in the human pancreas are covered in other sections of this article.

Pituitary Metastasis of Pancreatic Origin in a Dog Presenting with Acute-Onset Blindness

Pituitary metastases have rarely been recorded in dogs, and to date, none of those reported have been of pancreatic origin. MRI findings are available for only one of those cases. Herein the authors present an 11 yr old English springer spaniel diagnosed with pituitary metastasis of pancreatic origin with a 24 hr history of blindness and only a single lesion on MRI. Neurologic and ophthalmologic examinations localized the lesion to the optic nerves, optic tracts, or optic chiasm. MRI showed a single lesion characterized by a well-circumscribed pituitary mass with extrasellar extension, causing compression of the optic chiasm. Signal intensity was unusual as enhancement could not be appreciated after contrast administration. The dog was euthanized without further diagnostic tests. Histopathologic examination revealed a poorly differentiated exocrine pancreatic carcinoma with widespread metastasis involving the pituitary gland. To the authors’ knowledge, this is the first such case reported in a dog. Pituitary metastases should be included as a differential diagnosis for dogs presenting with acute-onset blindness and for single brain masses affecting the pituitary gland.

Unusual Systemic Signs in a Dog with Sterile Neutrophilic-Macrophagic Lymphadenitis and Nodular Panniculitis

A 7 mo old female English springer spaniel was presented with diarrhea, vomiting, apathy, and hyperthermia. Further examinations revealed generalized lymphadenomegaly consistent with sterile neutrophilic-macrophagic lymphadenitis and pulmonary involvement. Subcutaneous nodules developed one day after presentation. Histology was consistent with sterile idiopathic nodular panniculitis and vasculitis. No infectious organism was isolated. The dog responded to prednisolone, but relapsed during medication tapering. Cyclosporine had to be added to control the disease. No further relapse had occurred 98 wk after the first presentation. This is an unusual presentation of a systemic sterile neutrophilic-macrophagic lymphadenitis with nodular panniculitis and vasculitis associated with gastrointestinal and pulmonary signs.

Expression of claudin-5 in canine pancreatic acinar cell carcinoma - An immunohistochemical study

Claudin-5 is an endothelium-specific tight junction protein. The aim of the present study was to detect the expression pattern of this molecule in intact pancreatic tissues and in well-differentiated and poorly differentiated pancreatic acinar cell carcinomas from dogs by the use of cross-reactive humanised anticlaudin-5 antibody. The necropsy samples taken from dogs included 10 nonneoplastic pancreatic tissues, 10 well-differentiated pancreatic acinar cell carcinomas, 10 poorly differentiated pancreatic acinar cell carcinomas, 5 intrahepatic metastases of well-differentiated and 5 intrahepatic metastases of poorly differentiated acinar cell carcinomas. A strong lateral membrane claudin-5 positivity was detected in exocrine cells in all intact pancreas samples. The endocrine cells of the islets of Langerhans and the epithelial cells of the ducts were negative for claudin-5. The endothelial cells of vessels and lymphatic channels in the stroma of the intact pancreas showed strong membrane positivity for this claudin. All well-differentiated exocrine pancreas carcinomas and all poorly-differentiated pancreatic acinar cell carcinoma samples showed a diffuse loss of claudin-5 expression. The claudin-5-positive peritumoural vessels and lymphatic channels facilitated the detection of vascular invasion of the claudin-5-negative cancer cells. In liver metastasis samples, the pancreatic carcinomas were negative for claudin-5. It seems that the loss of expression of claudin-5 may lead to carcinogenesis in canine exocrine pancreatic cells.