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Bancroft S, Heinrich N, Wolf C. Otogenic intracranial abscessation secondary to an inflammatory polyp with chronic otitis media/interna in a cat. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Sara Bancroft
- McKeever Dermatology Clinics Eden Prairie Minnesota USA
| | | | - Christina Wolf
- Blue Pearl Veterinary Partners Eden Prairie Minnesota USA
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Morton BA, Selmic LE, Vitale S, Packer R, Santistevan L, Boudrieau B, Hinson W, Kent M, Hague DW. Indications, complications, and mortality rate following craniotomy or craniectomy in dogs and cats: 165 cases (1995-2016). J Am Vet Med Assoc 2022; 260:1048-1056. [PMID: 35417413 DOI: 10.2460/javma.21.04.0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the most common indications for cranial surgery and identify risk factors associated with the occurrence of complications and death in the perioperative period following cranial surgery. ANIMALS 150 dogs and 15 cats. PROCEDURES For this multi-institutional retrospective case series, medical records of dogs and cats that underwent cranial surgery at any of the 4 participating institutions between 1995 and 2016 were reviewed. Variables were evaluated included species, sex, age, neurolocalization, history of preoperative seizures, surgical approach, histological results, perioperative complications, and outcome. Logistic regression analysis was performed to assess for risk factors for complications. RESULTS The most common neurolocalization was the forebrain (110/165 [66.7%]), with 94 (57.0%) animals having had seizures preoperatively. The rostrotentorial (116/165 [70.3%]) and caudotentorial (32/165 [19.4%]) surgical approaches were most commonly reported. The most common indication was the treatment of meningioma (75/142 [52.8%]). Complications arose in 58 of the 165 (35.2%) cases within 24 hours and in 86 (52.1%) cases 1 to 10 days postoperatively. Perioperative complications included hypotension (38/165 [23.0%]) and anemia (27/165 [16.4%]). During the postoperative period, the most common complications were neurologic deficits, seizures, postoperative anemia, and aspiration pneumonia. The mortality rate with death or euthanasia perioperatively or ≤ 10 days postoperatively was 14.5% (24/165). Long-term complications occurred in 65 of the 165 (39.4%) animals, with seizures and neurologic deficits being the most common. CLINICAL RELEVANCE Cranial surgery was performed most commonly for the removal of neoplastic lesions in dogs and cats, and most complications were not life-threatening.
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Affiliation(s)
- Bridget A Morton
- 1Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Laura E Selmic
- 2Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - Samantha Vitale
- 1Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Rebecca Packer
- 3Department of Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Lawrence Santistevan
- 3Department of Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Beth Boudrieau
- 4Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Whitney Hinson
- 4Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Marc Kent
- 5Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA
| | - Devon W Hague
- 1Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
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Parker RL, Du J, Shinn RL, Drury AG, Hsu FC, Roberston JL, Cecere TE, Arendse AU, Rossmeisl JH. Incidence, risk factors, and outcomes for early postoperative seizures in dogs with rostrotentorial brain tumors after intracranial surgery. J Vet Intern Med 2022; 36:694-701. [PMID: 35170074 PMCID: PMC8965238 DOI: 10.1111/jvim.16391] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 12/28/2022] Open
Abstract
Background Seizures in the early postoperative period after intracranial surgery may affect outcome in dogs. Objectives To determine the incidence of early postoperative seizures (EPS) in dogs with brain tumors, identify specific risk factors for EPS, and determine if EPS affects outcome. Animals Eighty‐eight dogs that underwent 125 intracranial surgeries for diagnosis and treatment of rostrotentorial brain tumors. Methods Retrospective cohort study. All patients with a diagnosis of rostrotentorial brain tumor from 2006 to 2020 were included. Early postoperative seizures were diagnosed by observation of seizure activity within 14 days of neurosurgery. Previously diagnosed structural epilepsy, perioperative anticonvulsant drug (ACD) use, magnetic resonance imaging (MRI), and tumor characteristics were evaluated. Outcome measures included neurologic and nonneurologic complications, duration of hospitalization, and survival to discharge. Results Dogs with rostrotentorial brain tumors had EPS after 16/125 (12.8%) neurosurgical procedures (95% confidence interval [CI], 7%‐19%). Presence of previous structural epilepsy was not associated with EPS risk (P = 1). Perioperative ACD use also was not associated with EPS (P = .06). Dogs with EPS had longer hospitalization (P < .001), were more likely to have neurologic complications postsurgery (P = .01), and were less likely to survive to discharge (P = .01). Conclusions and Clinical Importance It is difficult to predict which dogs are at risk of EPS because the presence of previous structural epilepsy and the use of perioperative ACDs was not associated with EPS. However, seizures in the early postoperative period are clinically important because affected dogs had prolonged hospitalization, more neurologic complications, and decreased short‐term survival.
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Affiliation(s)
- Rell L Parker
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - John Du
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Richard L Shinn
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Adam G Drury
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.,Comprehensive Cancer Center and Brain Tumor Center of Excellence, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - John L Roberston
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA.,Comprehensive Cancer Center and Brain Tumor Center of Excellence, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Thomas E Cecere
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - Avril U Arendse
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA
| | - John H Rossmeisl
- Veterinary and Comparative Neuro-oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA.,Comprehensive Cancer Center and Brain Tumor Center of Excellence, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Boudreau CE, Najem H, Ott M, Horbinski C, Fang D, DeRay CM, Levine JM, Curran MA, Heimberger AB. Intratumoral Delivery of STING Agonist Results in Clinical Responses in Canine Glioblastoma. Clin Cancer Res 2021; 27:5528-5535. [PMID: 34433652 PMCID: PMC8989401 DOI: 10.1158/1078-0432.ccr-21-1914] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/19/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Activation of STING (stimulator of interferon genes) can trigger a robust, innate antitumor immune response in immunologically "cold" tumors such as glioblastoma. PATIENTS AND METHODS A small-molecule STING agonist, IACS-8779, was stereotactically administered using intraoperative navigation intratumorally in dogs with spontaneously arising glioblastoma. The phase I trial used an escalating dose design, ascending through four dose levels (5-20 μg). Treatment was repeated every 4-6 weeks for a minimum of two cycles. Radiographic response to treatment was determined by response assessment in neuro-oncology (RANO) criteria applied to isovoxel postcontrast T1-weighted MR images obtained on a single 3T magnet. RESULTS Six dogs were enrolled and completed ≥1 cycle of treatment. One dog was determined to have an abscess and was removed from further analysis. One procedure-related fatality was observed. Radiographic responses were dose dependent after the first cycle. The first subject had progressive disease, whereas there was 25% volumetric reduction in one subject and greater than 50% in the remaining surviving subjects. The median progression-free survival time was 14 weeks (range: 0-22 weeks), and the median overall survival time was 32 weeks (range: 11-39 weeks). CONCLUSIONS Intratumoral STING agonist (IACS-8779) administration was well tolerated in dogs with glioblastoma to a dose of 15 μg. Higher doses of IACS-8779 were associated with radiographic responses.
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Affiliation(s)
- C Elizabeth Boudreau
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas.
| | - Hinda Najem
- Department of Neurosurgery, Northwestern University, Chicago, Illinois
| | | | - Craig Horbinski
- Department of Neurosurgery, Northwestern University, Chicago, Illinois
- Department of Pathology, Northwestern University, Chicago, Illinois
| | - Dexing Fang
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chase M DeRay
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Jonathan M Levine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Michael A Curran
- Department of Melanoma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Amy B Heimberger
- Department of Neurosurgery, Northwestern University, Chicago, Illinois.
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Giannasi S, Kani Y, Hsu F, Rossmeisl JH. Comparison of direct measurement of intracranial pressures and presumptive clinical and magnetic resonance imaging indicators of intracranial hypertension in dogs with brain tumors. J Vet Intern Med 2020; 34:1514-1523. [PMID: 32415794 PMCID: PMC7379039 DOI: 10.1111/jvim.15802] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/14/2020] [Accepted: 05/01/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Intracranial hypertension (ICH) is often presumptively diagnosed based on clinical or imaging findings. Clinical or imaging surrogates of ICH are not usually validated with reference standard direct intracranial pressure (dICP) recordings. HYPOTHESES Dogs with brain magnetic resonance imaging (MRI) or clinical features of presumed ICH would have higher dICP than dogs lacking those features. ANIMALS Twenty dogs with gliomas and 3 normal controls. METHODS Prospective, convenience study. Dogs were presumptively categorized with normal ICP or ICH from scores generated from described clinical and brain MRI indicators of ICH. dICP was recorded in anesthetized dogs using an intraparenchymal microsensor and compared between groups. RESULTS dICP was not different between control (10.4 ± 2.1 mm Hg) and dogs with glioma (15.6 ± 8.3 mm Hg), or between dogs in clinically predicted ICP groups. Compared with dogs with MRI-predicted normal ICP, MRI-predicted ICH dogs had higher dICP (10.3 ± 4.1 versus 19.2 ± 7.9 mm Hg, P = .004), larger tumors (1.45 ± 1.2 versus 5.71 ± 3.03 cm3 , P = .0004), larger optic nerve sheath diameters, and 14/14 (100%) displayed structural anatomical shifts on MRI. At a dICP threshold of 15 mm Hg, the sensitivity of MRI for predicting ICH was 90% and the specificity 69%. CONCLUSIONS AND CLINICAL RELEVANCE dICP measurements are feasible in dogs with brain tumors. MRI features including brain herniations, mass effect, and optic nerve size aid in the identification of dogs with ICH. Clinical estimation of ICP did not discriminate between dogs with and without ICH.
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Affiliation(s)
- Savannah Giannasi
- Veterinary and Comparative Neuro‐Oncology LaboratoryVirginia‐Maryland College of Veterinary Medicine, Virginia TechBlacksburgVirginiaUSA
| | - Yukitaka Kani
- Veterinary and Comparative Neuro‐Oncology LaboratoryVirginia‐Maryland College of Veterinary Medicine, Virginia TechBlacksburgVirginiaUSA
| | - Fang‐Chi Hsu
- Department of Biostatistics and Data Science, Comprehensive Cancer Center and Brain Tumor Center of ExcellenceWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - John H. Rossmeisl
- Veterinary and Comparative Neuro‐Oncology LaboratoryVirginia‐Maryland College of Veterinary Medicine, Virginia TechBlacksburgVirginiaUSA
- Department of Cancer Biology, Comprehensive Cancer Center and Brain Tumor Center of ExcellenceWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
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