First description of a primary esophageal histiocytic sarcoma in a dog

An 11-year-old male Schnauzer dog was referred for investigation of cough and regurgitation of one month duration and gradual hyporexia for the previous five months. Complete blood count showed severe leukocytosis. On ventrodorsal and lateral thoracic radiographs a soft tissue mass was visible in the craniodorsal mediastinum. Endoscopy showed esophageal dilatation and an irregular, nodular, friable, exophytic mass in the thoracic esophagus, which was invasive, vascularized and had ulcerated areas. The mass occluded approximately 90% of the esophageal lumen. The mucosa in the orad portion of the thoracic esophagus was pale and the aborad portion was hyperemic (red) with hemorrhages. The mucosa of the cervical and abdominal esophagus was macroscopically unremarkeble. Multiple biopsies using endoscopic cup biopsy forceps were taken from the mass for histopathologic analysis and a percutaneous endoscopic gastrostomy was performed. Histopathologic analysis of the biopsy samples was inconclusive due to the marked necrosis. The poor clinical condition of the dog precluded a more invasive approach, and palliative and supportive treatment was continued. After 100 days of follow-up, clinical signs worsened, and that day the dog had a fatal cardiac arrest due to aspiration pneumonia and sepsis. Postmortem examination showed a multilobulated mass in the esophageal wall with infiltration into the overlying esophageal mucosa and pulmonary and renal metastases. Histological examination revealed a poorly differentiated sarcoma. On immunohistochemical examination, the neoplastic cells showed marked cytoplasmic staining for vimentin and Iba-1. The proliferative rate was approximately 30% by Ki-67. Histological and immunohistochemical examination revealed the esophageal mass to be a primary histiocytic sarcoma. Histiocytic sarcoma is an extremely rare primary esophageal neoplasm in humans, and so far, there is no description in dogs. To the best of the authors knowledge this is the first case of primary esophageal histiocytic sarcoma in dogs. The clinical information reported here should improve recognition and aid in diagnosis of future cases.

Presence of Gastrointestinal Paraneoplastic Syndrome at Diagnosis in Dogs With Cutaneous Mast Cell Tumors and Its Influence on Disease-Free Interval and Survival

Paraneoplastic syndrome (PNS) is a combination of signs unrelated to the physical presence of a tumor and/or its metastases. Its presence may result in poorer clinical outcomes and prognosis. Gastrointestinal ulceration is a well-known PNS in animals with cutaneous MCT. This retrospective study analyzed the occurrence of gastrointestinal (GI) PNS at the time of diagnosis. Using medical records, we attempted to correlate the occurrence of these GI signs with clinical and histologic criteria, as well as to evaluate their influence on the disease-free interval (DFI) and survival (ST) over a 6-year follow-up period (2013-2020). The medical records of 41 dogs with a confirmed diagnosis of cutaneous MCT treated between 2013 and 2014 were included. All dogs underwent surgical biopsy or tumor excision, endoscopic and histologic examination to evaluate possible GI lesions. The presence and severity of GI signs were recorded. Clinical data such as the history of recurrence, number of tumors, tumor size, presence of ulceration, local pruritus, edema and erythema, histopathological classification, and mitotic index were extracted from medical records. Clinical signs relating to the GI system were observed in 41.5% of the dogs and were classified as mild in 94.1% at the time of diagnosis. Endoscopic examination of the upper digestive tract showed evidence of inflammation, but histologic examination of the mucosa showed no serious lesions in any case. There was no significant association between the occurrence of clinical GI signs and any of the variables studied. Follow-up issues meant that only 38 dogs were included for evaluation of the ST and 32 for DFI analysis. DFI was 25.1 months for dogs with GI signs and 14.8 months for dogs without GI signs. At the end of the study, 71.1% of patients had died. Survival time for dogs with GI signs was 54.9 months and 48 months for dogs without GI signs. Over the 6 years of the study, no differences were observed between the ST and the DFI, and the presence or absence of GI PNS at the time of diagnosis.

II Simpósio Internacional do Colégio Brasileiro de Endoscopia e Videocirurgia Veterinária

Mensagem da Comissão Organizadora O Colégio Brasileiro de Endoscopia e Videocirurgia Veterinária (CBEVV) é o órgão máximo das especialidades em endoscopia e videocirurgia, além de outras áreas de mínima invasão na medicina veterinária. O CBEVV abrange profissionais endoscopistas, cirurgiões e imaginologistas, assim como os clínicos que atuam em gastroenterologia, otorrinolaringologia, pneumologia, nefrologia, urologia, oncologia, neurologia, entre outros. O Colégio vem há anos sendo planejado em reuniões dos profissionais da área e nasceu oficialmente em 2019. Mesmo ainda com poucos anos de criação oficial, o CBEVV promove várias ações na área, como eventos mensais, nas Jornada de Palestras e Mesas Redondas do CBEVV, já realizou o "I Simpósio do CBEVV" e o "I Congresso Internacional do CBEVV" nos anos de 2020 e 2021 respectivamente. O II Simpósio Internacional do Colégio Brasileiro de Endoscopia e Videocirurgia Veterinária (CBEVV) foi o primeiro evento presencial do CBEVV, com transmissão simultânea online, via plataforma Zoom, para todo os participantes, realizado na sede da UFAPE, no período de 17 a 19 de novembro de 2022, na cidade de São Paulo, SP, Brasil o qual agregou palestras com diferentes temas e palestrantes de altíssimo nível nacional e internacional além de apresentação de trabalhos (na forma de miniconferências e de pôsteres). Esse encontro marcou o retorno às atividades presenciais do Colégio e a comissão organizadora agradece a todos os participantes por tornarem o II Simpósio Internacional do CBEVV um dos maiores da área. Desejamos a todos, ótima leitura e esperamos encontrá-los brevemente em nosso próximo evento. Comissão organizadora: Pedro Paulo Maia Teixeira, Maurício Veloso Brun, Marco Augusto Machado Silva, Anelise Bonilla Trindade-Gerardi, Fabíola Dalmolin, Fabiana Azevedo Voorwald, Luís Cláudio Lopes Correia da Silva, León Simões Pinto Fontaine, Renato Leite Leonardo, Luísa Pucci Bueno Borges, José Pedro Herrera Reis Filho, Rogério Akio Nishimaru, Giovanna Bergozza Casagrande, Thiago da Silva Cardoso, Luis Gustavo e Silva Novais, Gabriela Melo Alves dos Santos, Pedro Yuri Erlacher, Beatriz Ibrahim Miranda Antunes & Adriana Ferreira e Ferreira

Immune-Mediated Hemolytic Anemia in a Bitch Triggered by Drugs

Background: Immune-mediated hemolytic anemia (IMHA) is characterized by an autoimmune response with production of auto-antibodies and destruction of erythrocytes resulting in anemia. Primary IMHA is referred to a condition when the cause is unknown (idiopathic), whereas secondary IMHA involves changes in red blood cells caused by the action of drugs, neoplasms, or infectious diseases. The diagnosis can be made through changes in the blood count, usually of a regenerative character, Coombs test, and autoagglutination test. The present study aimed to report a case of drug-induced hemolytic anemia, with emphasis on the clinical signs, diagnostic methods, and treatment, in a female dog.Case: A 9-year-old mixed-breed bitch weighing 29.6 kg was referred to the Veterinary Medical Teaching Hospital (HCV-UFRGS) with a previous diagnosis of gallbladder mucocele that was unresponsive to clinical treatment. After laboratory tests, cholecystectomy was performed, and the procedure required conversion from laparoscopic to open cholecystectomy. Therapy included administration of amoxicillin, dipyrone, tramadol hydrochloride, and meloxicam. Three days after surgery, the dog presented with apathy, lethargy, hyporexia, and a pale and subicteric mucosa. The patient developed hypochromic macrocytic anemia with reticulocytosis, spherocytosis, anisocytosis, and leukocytosis with neutrophilia. The result of the autoagglutination test was positive, confirming the diagnosis. All medications were suspended, and immunosuppressive treatment with dexamethasone was included, with a subsequent switch to prednisolone. After 10 days of treatment, the patient experienced significant improvement, and therapy was discontinued.Discussion: Based on the patient's history, the cause of the IMHA was secondary to drug administration, and it is not possible to distinguish if it was due to one or a combination of drugs, as they were all started and stopped simultaneously. The patient had hypothyroidism, which may have contributed to the production of antibodies against TSH receptors, blocking the hormone's action, thereby causing tissue damage due to T cell-mediated cytotoxicity and the effect of cytokines. The pale and subicteric mucosa, apathy, weakness, lethargy, exercise intolerance, and dyspnea resulted from extravascular hemolysis and bilirubin released from erythrocyte rupture with a subsequent decrease in the number of red blood cells, leading to oxygen transport deficiency. The diagnosis is based on the blood count and results of autoagglutination supported by the response to immunosuppressive therapy. Anemia results in increased production and release of precursor cells from the bone marrow, accompanied by reticulocytosis and increased mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC). The treatment of IMHA consists of supportive care and immunosuppressive therapy with corticosteroids to ensure suppression of the immune system, preventing response against erythrocytes. Initially, tramadol hydrochloride, dipyrone, and amoxicillin with potassium clavulanate were suspended to interrupt the cause of IMHA, and administration of dexamethasone in an immunosuppressive dose was started. Therefore, it is important to include drug-induced IMHA in the differential diagnosis of patients who present with anemia after using medications. Early diagnosis, initiation of therapy, and adequate care were important factors for the recovery of the animal.Título: Anemia hemolítica imunomediada medicamentosa em uma cadelaKeywords: dog, hypochromic macrocytic anemia, erythrocyte, hemoglobin, spherocyte.Descritores: cão, anemia macrocítica hipocrômica, eritrócito, hemoglobina, esferócito. 

Tracheal Adenocarcinoma in a Cat

Background: Primary tracheal adenocarcinoma is a rare neoplasm in cats. The clinical signs often are indicative of upper airway obstruction accompanied with dyspnea, stridor, wheezing, exercise intolerance, and cough. The severity of the clinical signs is related to the size of the mass and consequently, the proportion of the tracheal lumen that is obstructed. The diagnosis is made using thoracic radiography and tracheobronchoscopy by collecting fragments for histopathological analysis and removing the mass. The present study aimed to report the case of a cat with tracheal adenocarcinoma.Case: A 17-year-old Persian female cat presented with clinical signs of dyspnea and progressive weight loss. Emergency therapy was started with bronchodilators, antibiotics, and corticosteroids, but there was no response to treatment. Complementary blood and imaging tests were performed. Thoracic radiography revealed soft tissue opacity overlying the dorsal trachea from the third to the fourth rib, bronchial pattern, and pulmonary hyperinflation. Tracheoscopy showed an irregular intraluminal thoracic trachea mass, occluded by approximately 95% of the airway lumen. The mass was biopsied multiple times with endoscopic cup biopsy forceps, followed by removal of approximately 50% of the mass lesion with an endoscopic wire snare. The patient was in intensive care, and since her clinical condition worsened 48 h after the endoscopic procedure, euthanasia was performed. Necropsy revealed a remanescent mass located in the trachea lumen 8 x 3 mm and a nodule in the right caudal pulmonary lobe with 8 mm of diameter . Histological examination showed epitelian cuboidal neoplastic cells with acinar patterns. Only a few mitosis and moderate anysocitosis were observed. The final diagnosis was primary tracheal adenocarcinoma with pulmonary metastasis.Discussion: The initial oxygen therapy associated with bronchodilators and antibiotics can be explained by the history of asthma. Tracheal tumors in cats are considered to be rare, which makes the diagnosis challenging. The suspicion of tracheal neoplasia was only raised after radiographic examination, but it was not possible to state whether it was intra- or extratracheal. The bronchial pattern reported herein can be observed both in inflammatory diseases such as asthma and bronchitis as well as aging-related diseases in animals. Pulmonary hyperinflation, with a caudal displacement of the diaphragm, is seen in bronchial diseases and in cases of tracheal neoplasms, with the latter justified by the retention of air in the pulmonary lobes. Dehydration and weight loss in the animal are justified by severe dyspnea, which makes it difficult to consume food and water. The tracheoscopy procedure was essential to confirm intraluminal tracheal neoplasia with almost complete lumen obstruction. An attempt was made to remove the neoplasms with polypectomy endoscopic forceps. However, because 95% of the trachea was obstructed, the manipulation led to local edema and bleeding, which promoted complete obstruction of the air passage to the lungs. The obstruction impaired the patient's oxygenation, justifying procedure suspension. The instability and worsening of the clinical picture persisted in the subsequent days, which prevented further intervention, culminating in the animal's euthanasia. Adenocarcinoma, in the present case, was in the advanced stage, evidenced by the presence of pulmonary metastasis. Dyspnea severity was related to neoplasm size, proportion of tracheal lumen obstruction, and presence of pulmonary metastasis. The tumor size associated with the presence of metastasis was a determining factor for the classification of neoplasia in the advanced stage, making more invasive interventions impossible and worsening the patient prognosis.