Dermatology (1-12) Flashcards
this is the outer most layer of the skin;
multiple cell layers
Epidermis
name the 3 cell types found in the epidermis
- Keratinocytes
- Melanocyte
- Langerhan’s Cells
where is the stratum corneum & epidermis the thickest?
on nasal planum and footpads
where is the stratum corneym & epidermis the thinnest?
on ventral body
name the skin layer
this is the tough waterproof barrier of keratinised squames & intercellular sebum
stratum corneum
what cell type makes up the stratum corneum
keratinocytes
name the cell type
found in epidermis and hairs;
responsible for colour
melanocytes
name the skin layer
connective tissue (collagen and elastin);
increased cell infiltration in inflammation
dermis
are there blood vessels in the epidermis?
no
name the 3 parts of a hair bulb and shaft
- cuticle
- cortex
- medulla
name the 4 parts of hair growth cycle
- Catagen
- Telogen
- Exogen
- Anagen
what phase of hair growth are most dogs hair in
telogen
what phase of hair growth are non-shedding breeds hair in
anagen
name the term
lesions produced by self-trauma
excoriation & mutilation
name the term
hair loss without replacement (decreased coat density); OR
physiological shedding (coat density is normal)
alopecia
name the term
accumulation of keratinocytes;
primary = keratinisation disorder;
secondary = more common
scale
define the term
orthokeratosis
scale with NO nuclei
(non-specific)
define the term
parakeratosis
scale with RETAINED nuclei
(erosions)
name the term
thickening of the skin;
associated with chronic inflammation
Lichenification
name the term
split in heavily lichenified and/or crusted skin;
painful and vulnerable to infection
fissure
name the term
greasy accumulation of sebum and exudate;
often associated with scaling;
malodourous, esp. if infected & inflamed
Seborrhoea
name the term
solid & focal accumulation of cells
< 1cm
papule
name the term
solid & focal accumulation of cells >1cm
nodule
name the term
solid & focal accumulation of cells - flat topped
plaque
name the term
elevated patch of skin with dermal oedema;
should be pitting
wheal
name the term
subcutaneous oedema
angio-oedema
name the term
epithelial lined cavity with fluid or semi-fluid material;
usually neoplastic or developmental
cyst
name the term
pus filled lesion/cyst-like structure
pustule
name the term
fluid filled lesion/cyst-like structure <1cm
vesicle
name the term
fluid filled lesion/cyst-like structure >1cm
bulla
name the term
specific or exfoliative staphylococcal pyoderma
epidermal collarette
name the term
dried exudate (pus, blood, and/or serum)
crust
name the term
destructive lesion where the basement membrane is intact;
heals by re-epithelisation
erosion
name the term
destructive lesion where basement membrane is lost;
will scar
ulcer
name the term
replacement of normal skin by fibrous tissue;
smooth & thin with loss of hairs & pigment;
contraction may cause problems
scar
name the term
draining tracts connecting deeper tissues with surface;
often ulcerated and under-run;
usually infectious or immune-mediated
sinus
name the term
connects epithelial lined compartments
fistula
name the term
well-defined change in color of the skin <1cm
macule
name the term
well-defined change in color of the skin >1cm
patch
name the term
increased blood flow to the skin; blanches
erythema
name the term
dilated hair follicle plugged with epidermal and sebaceous debris;
keratinisation disorders, hyperadrenocorticism, Demodex
comedome
name the term
tight accumulation of scale around hair shaft;
highly specific for Demodex, follicular keratinisation diseases, sebaceous adenitis
follicular casts
name the term
thick accumulations of crust across hair shafts;
most common with Dermatophilus;
also seen with any dried exudate
paintbrush lesions
name the term
calcium phosphate deposits in skin & soft tissues;
highly specific for hyperadrenocorticicsm
Calcinosis cutis
how to rule out Sarcoptes as the cause of pruritis
trial therapy
OR
IgG Elisa
(can be hard to find)
what are the 3 main drug options for a trial ectoparasite therapy
- selamectin/moxidectin
- short acting isozazoline
- long acting isozazoline
name 3 diet choices for a food trial to treat pruritis
- home cooked novel protein
- commercial novel protein
- hydrolysed food
what is the minimum time a food trial should be used to see if it treats pruritis
8 weeks minimum
during what months are trees likely to cause pollen allergies
february - april
during what months are grasses likely to cause pollen allergies
June - August
during what months are flowering plants likely to cause pollen allergies
July - October
name the disease
inflammation of the hair follicle (hair follicle arrest);
malformation of the hair follicle (loss of the hair follicle)
alopecia
should you treat juvenile onset localised demodicosis?
no, don’t need to
(manage secondary infections)
name 5 treatment options for demodicosis
- systemic isoxalines
- lime sulphur dip
- imidacloprid/moxidectin
- systemic milbemycin oxime
- systemic ivermectin or moxidectin
how long should you treat demodicosis for?
until 2 neg plucks/scrapes & then for 1 month
name the 3 common species causing Dermatophytosis (ring worm)
- Microsporum canis
- Microsporum gypseum
- Trichophyton mentagrophytes
name 5 clinical signs of Dermatophytosis (ring worm)
- comedones
- follicular cysts
- rarely pruritic
4.nodules
5.paronychia
name 4 ways to diagnose Dermatophytosis (ring worm)
- Trichogram
- Woods lamp (M. canis)
- Fungal culture
- qPCR
what is the licensed treatment for dermatophytosis in cats
itraconazole
what is the licensed treatment for dermatophytosis in dogs
ketoconazole
how long should Dermatophytosis be treated for
until 2 neg cultures/PCR tests at least 7 days apart
name 6 systemic clinical signs of Leishmania
- lameness
- lymphadenopathy
- hepatomegaly/splenomegaly
- anaemia
- kidney failures
- muscle atrophy
name 5 dermatological clinical signs of Leishmania
- alopecia
- fine, silvery scaling
- depigmentation
- nodules
- erosions
name 3 treatments for Leishmania
- Meglumine antimoniate
- allopurinol
- miltefosine
what insect spreads Leishmania
Sandflies
name 5 immune mediated causes of alopecia
- sebaceous adenitis
- alopecia areata
- Lymphocytic mural folliculitis
- dermatomyositis
- injection site
name the immune mediated cause of alopecia
immune mediated destruction of the sebaceous glands;
follicular casting;
often starts around the head (look in the ears!);
poodles, akitas, spaniels predisposed
sebaceous adenitis
name the immune mediated cause of alopecia
involve extremities, periocular skin & bony prominences;
strophic alopecia & scarring;
muscle atrophy
Dermatomyositis & vasculitis
name the immune mediated cause of alopecia
usually local but can be remote;
glucocorticoids, vaccines, depot injections, drug reactions, reactions to spot-on preparations;
usualy regress;
may scar
injection site alopecia
name 3 endocrinopathies that cause hair follicle arrest
- hyperadrenocorticism
- hypothyroidism
- sex hormone alopecia
what causes calcinosis cutis / what treatment will make it much worse
steroids
name the derm condition
stress causes telogenisation of the coat;
exogen or grooming results in alopecia
telogen effluvium
name the derm condition
anagen interruption;
hair shaft breaks
anagen defluxation
name the derm condition
pruritic;
one or more typical reaction patterns:
1. symmetrical self induced alopecia
2. miliary dermatitis
3. head and neck pruritits
4. EGC
Resp. disease
feline atopic syndrome
name the derm condition
pustular disease of cats;
bilaterally symmetrical (eyes, ears, nose) crusting;
pus around the claw beds
Pemphigus foliaceus
name the feline derm condition
thymoma or non-thymoma ED;
often non-pruritic;
cytotoxic, interface dermatitis;
check for underlying disease
exfoliative dermatitis
name the feline derm condition
associated with abdominal tumour;
‘shiny’ ventral abdominal skin;
often have secondary Malassezia overgrowth on cytology
paraneoplastic alopecia
name the feline derm condition
well defined, pruritic, ulcerative and crusting lesions;
usually dorsal neck or shoulders;
injection site reaction, persistent antigen, bahviour and/or feline hyperaesthesia syndrome;
diagnosis on clinical signs and biopsy
feline ulcerative dermatitis
name the feline derm condition
acute & violent/frenzied self-trauma;
can be worse after handling;
mouth directed behaviour;
good response to neurological agents
feline hyperaesthesia syndrome
name the 3 species of Demodex that can (uncommonly) affect cats
- Demodex cati
- Demodex felis
- Demodex gatoi
name 4 possible glucocorticoids treatments for cats with skin diseases
- Prednisolone
- Dexamethasone
- Triamcinolone
- Depot steroids
name 8 possible adverse effects from glucocorticoids
- PU/PD
- weight gain
- diabetes mellitus
- bacterial cystitis
- hyperadrenocorticism
- dermatophytosis
- hypertension
- congestive heart failure
name 3 adverse effects of ciclosporin in cats
- GIT upsets
- decr. WBC counts
- insulin antagonism
name 2 adverse effects of Chlorambucil
- bone marrow suppression
- GI upsets
what drug should NOT be used to treat derm diseases in cats!
only for dogs;
development of antibodies
Olcalcitinib
(Apoquel, Lokivetmab, Cytopoint)
name the medication
block mast cell activity;
reduces itch and alopecia;
reduces lesion score;
well tolerated in cats
aliamides
name 4 predisposing factors of dogs for otitis
- confromation
- environment
- iatrogenic
- swimming
name 7 possible primary triggers to otitis
- foreign bodies
- parasites
- hypersensitivity
- keratinisation disorders
- neoplasia
- inflammatory polyps
- endocrinopathies
name 5 perpetuating factors for otitis
- decreased cell migration
- epidermal/dermal/glandular hyperplasia
- fibrosis
- ear canal stenosis and mineralisation
- otitis media
name the 3 most common secondary infections/dysbiosis with otitis
- Staphylococci
- Malassezia
- Pseudomonas
what 4 things should you palpate the ear canal for in suspected otitis
- mobility
- pliability
- thickening
- pain
name the two syndromes of zinc responsive dermatosis
- diet-related
- zinc malabsorption
name the derm condition
destruction of cell membrane adhesion molecules;
pustules, scaling, and erosions of nose, face, pinnae, nipples, feet
pemphigus foliaceus
name the derm condition
breeds with pendulous ears;
often mistaken for vasculitis (scaling, fissures NOT necrosis, & no hypoxi/discolouration);
treatment similar to naso-digital hyperkeratosis
ear margin seborrhea
name the derm condition
normal protective mechanism;
alopecia and hyperkeratosis over bony prominences;
do NOT remove!
callus
name the derm condition
hereditary defect with incr. epidermal turnover;
thick, adherent scales, erythema, seborrhoea and otitis externa;
diffuse dry scaling
idiopathic keratinisation disorder
name the derm condition
immune-mediated loss of sebaceous glands;
dry scaling, follicular casts & alopecia;
diagnosis by skin biopsy
sebaceous adenitis
name the derm condition
dogs, cats, rabbits;
defect in collagens and elastins;
abnormal elasticity and fragility
Ehlers-Danlos syndrome
what are the two phases of treatment of immune-mediated diseases
- remission
- maintenance
what medications are the mainstay for remission of immune-mediated derm diseases
glucocorticoids
what medication is useful to treat vasculitis
Oclacitinib
name the derm condition
inflammation of subcutaneous fat;
nodules with fatty, haemorrhagic discharge;
ulceration, non-healing wounds
sterile panniculitis
name the disease
sloughing of claws;
onychodystrophy
Symmetric lupoid onychodystrophy
OR lupoid onychitis (SLO)
name the term
Abnormal changes in the shape, color, texture, and growth of the fingernails or toenails
onychodystrophy
name 3 comon problems of the anal sacs
- impaction & infection
- perianal gland hyperplasia
- anal sac adenocarcinoma
name the term
lowest concentration of antibiotic that prevented bacterial growth
MIC
what does a Breakpoint:MIC index < 1 mean
resistant
what does a Breakpoint:MIC index of 1 mean
incr. dose/frequency
name the 3 categories of ear cleaners
- Drying agents
- Ceruminolytics
- Antiseptics
name the ear cleaner
chelates metal ions in cell wall;
potentiates antibiotic killing;
administer 15-20min before antibiotic or with antibiotic
TrisEDTA
name the bacteria type
directly ototoxic;
risk factor for otitis media;
inherently resistant;
excellent biofilm producers;
readily acquire resistance
Pseudomonas spp.
name 3 first line topical antibiotics for otitis caused by Pseudomonas
- Fluoroquinolones
- gentamicin
- polymixin B/miconazole
name 4 causes of Otitis media-Otitis interna
- extension of chronic otitis externa
- primary secretory otitis media (PSOM)
- feline inflammatory polyps
- feline respiratory disease
what is the treatment for Otitis media
(4 part treatment)
- flush out debris
- glucocorticoids (topical & systemic)
- antibiotics (if required)
- analgesia
name the term
a procedure to create a hole in the ear drum to allow fluid that is trapped in the middle ear to drain out OR to take a sample/cytology
myringotomy
name the 4 steps of a myringotomy (a procedure to create a hole in the ear drum to take a sample or cytology)
- clean external ear canal
- catheter/spinal needle
- take middle ear sample for culture
- take sample for cytology
name the condition
an abnormal collection of skin cells deep inside your ear;
can be congenital or acquired
cholesteatoma
name the condition
ceruminous hyperplasia (in the ear);
common in cats, very rare in dogs;
requires laser ablation;
topical steroids can reduce recurrence
cystomatosis
name the 7 parts of the “cycle of doom” associated with Chronic Pododermatitis with Interdigital Furunculosis (CPIF)
- hair follicle inflammation
- follicular rupture
- furunculosis & infection
- sinus tracts
- interdigital ‘cysts’
- scarring
- altered conformation & weight bearing
name 3 predisposing causes of Chronic Pododermatitis with Interdigital Furunculosis (CPIF)
- sltered weight bearing
- short hairs
- obesity
name 5 early changes associated with Chronic Pododermatitis with Interdigital Furunculosis (CPIF)
- weight bearing on haired skin
- comedones
- ingrown hairs
- cystic hair follicles
- sinus tracts
name 4 chronic changes associated with Chronic Pododermatitis with Interdigital Furunculosis (CPIF)
- fibrosis and scarring
- false pad formation
- conjoined pads
- tissue pockets & folds
name 3 ways to manage predisposing factors of Chronic Pododermatitis with Interdigital Furunculosis (CPIF)
- weight loss (4/9 BCS)
- boots
- lubricating barrier creams
name the hair structure
these give the optical illusion of a diluted coat (eg black to grey);
they can be large enough to distort the hair follicle and shaft resulting in colour dilution alopecia
macromolecules
name the hair structure
small & regular parcels of melanin synthesized by epidermal melanocytes and incorporated into skin and hair keratinocytes;
govern skin & hair colour
micromelanosomes
name the hair growth stage
i.e. resting;
most hairs in most dogs & ctas are in this phase most fo the time;
these are not affected by cytotoxic or chemotheraoy drugs
telogen
name the hair growth stage
i.e. growing;
more prominent in breeds that shed less but need trimming (e.g Poodles);
these re living hairs and vulnerable to cytotoxic & chemotherapy drugs;
a few are normal
anagen
what color does bacteria always stain on a diff-quick stain?
blue
name 3 non-rinsing formulations of topical therapy options for atopic dermatitis
- wipes
- foams
- spot-on preparations
name the atopic dermatitis maintenance therapy
to alleviate flares associated with allergen exposure;
no anti-inflammatory action;
not a substitute for induction therapy
allergen specific immunotherapy (ASIT)
name the atopic dermatitis maintenance immunotherapy protocol
one day hospital based protocol;
faster response;
no difference in clinical response;
slight increase in adverse effects;
Rush or conventional
subcutaneous immunotherapy (SCIT)
name the atopic dermatitis maintenance immunotherapy protocol
induction course given in vet clinic;
monthly for 6 doses;
can use U/S guidance;
effect may last 3-6 months
intralymphatic immunotherapy (ILIT)
name the atopic dermatitis maintenance immunotherapy protocol
avoids needles;
may be easier to administer;
treat twice daily every day;
fewer adverse effects (reverse sneezing, GIT upsets)
sublingual immunotherapy (SLIT)
name 4 anti-inflammatory therapies with good evidence of high efficacy for atopic dermatitis
- systemic & topical glucocorticoids
- ciclosporin
- oclacitinib (Apoquel)
- Lokivetmab (Cytopoint)
name 3 chronic adverse effects seen with glucocorticoids
- urinary tract infections
- hypertensions
- hyperadrenocorticism
name 3 strategies for safer use of glucocorticoids
- daily to remission (0.5-1.0 mg/kg)
- switch to every other day
- taper maintenance dose
name 2 topical diester glucocorticoids that can be used for atopic dermatitis
rapidly absorbed;
potent anti-inflammatory action;
metabolised within the dermis
- hydrocortisone aceponate
- Mometasone furoate
name 4 possible adverse effects of topical diester glucocorticoids
- thinning of abdominal skin
- local immunosuppression
- absorption (hyperadrenocorticism, depressed IDAT reactions)
- skin reactions
name 2 other uses of topical glucocorticoids (besides atopic dermatitis)
- otitis externa
- atopic conjunctivitis
what is cyclosporin metabolised through
cytochrome P450
name the drug for mangement of atopic dermatitis
calcineuron inhibitor;
well tolerated by most dogs;
transient vomiting most common;
monitor urinalyisis;
contraindicated in neoplasia;
could impair response to vaccination
ciclosporin
name the drug for mangement of atopic dermatitis
targeted JAK1 inhibitor;
inhibits IL-31 & other pro-inflammatory cytokines;
semi-broad spectrum activity;
will not reverse ear canal stenosis;
not advised for CPIF
Oclacitinib (Apoquel)
what 3 things is Oclacitinib (Apoquel) contraindicated in?
- dogs <12 months
- Demodex and infections
- concurrent neoplasia
name the drug for mangement of atopic dermatitis
anti-IL31 monoclonal antibody;
very safe (potential for anti-drug antibodies);
species specific
Lokivetmab (Cytopoint)
name the drug for mangement of atopic dermatitis
rapid H1R blockade;
poor efficacy (treatment sparing);
use before allergen challenge;
very safe (may be sedating)
antihistamines
most skin-related tumours arise from what tissues?
epithelial tissues
name 6 known causes of skin tumours
- UV radiation
- Chemical carcinogens
- irradiation
- physical agents
- viruses
- inflammation
nsme 5 features of skin tumours that suggest malignancy
- rapid growth
- fixation
- invasion into overlying skin or deep tissues
- ulceration
- poorly defined margins
name 7 contraindications for excisional biopsy for skin and subcutaneous masses
- rapidly growing masses
- ill-defined or poorly demarcated lesion
- peritumoural oedema or erythema
- skin ulceration
- injection site masses in cats
- FNA suspicious for MCT or STS
- non-diagnostic FNA
name the epithelial tumour
young dogs;
viral
usually regress;
malignant transformation to SCC possible
canine papilloma
name the epithelial tumour
older animals;
median age 10-12y;
nasal planum, pinnae;
UV exposure from sunlight (UVB);
develops in areas of thin/unpigmented hair in non-white cats
feline Squamous Cell Carcinoma (SCC)
name the stage of feline SCC
pre-cancerous, dysplasia due to chronic UV exposure
actinic keratosis (a)
name the stage of feline SCC
cancer cells have not penetrated basement membrane
carcinoma in situ (b)
name the stage of feline SCC
penetration of basement membrane
invasive SCC (C)
name 6 treatment options for feline cutaneous SCC
- surgical excision!
- radiotherapy
- photodynamic therapy
- intralesional chemotherapy
- electrochemotherapy
- topical imiquimod
name the treatment option for feline cutaneous SCC
best possible approach;
wide margins provide long term control;
cosmetic
surgical excision
(pinnectomy, nosectomy)
name the treatment option for feline cutaneous SCC
for early stage (superficial) tumours;
Strontium 90 plesiotherapy;
orthovoltage;
electrons
radiotherapy
name the treatment option for feline cutaneous SCC
local or systemic administration of a photsensitiser;
administration of light of an appropriate wavelength to activate the drug several hours later;
generally reasonably well tolerated;
small, non-invasive, early stage tumours only
photodynamic therapy
name the treatment option for feline cutaneous SCC
usually systemic bleomycin;
high response rates but variable destruction, possible significant local side effects
electrochemotherapy
how to prevent feline cutaneous SCC?
avoid sunlight
(UV light-blocking film/sunblock)
name the treatment option for feline cutaneous SCC
immunomodulator;
antitumour and antiviral effects;
for Bowenoid carcinoma in situ (SCC which has not penetrated the basement);
side effects: local erythema, incr. liver enzymes, hyporexia and vomiting
topical imiquimod
what are the 3 most common locations for canine SCC
- nasal planum
- nailbed (subungual)
- ventrum
what is the latency period of feline injection site sarcomas (FISS)
few months - several years
what is the 3-2-1 rule for investigation of firm cutaneous or subcutaneous masses
(possible FISS)
3 - any mass present for 3 months or longer
2 - any mass greater than 2 cm in diameter
1- any mass that continues to increase in size 1 month after injection
name 3 types of round cell cutaneous/SC tumours
- histiocytic tumours
- mast cell tumours
- lymphoma
name the histiocytic skin lesion
arise from epidermal Langerhan dendritic cell;
benign
canine cutaneous histiocytoma
name the histiocytic skin lesion
arises from activated interstitial dendritic cell
reactive histiocytosis
(cutaneous or systemic)
name the histiocytic skin lesion
14% of all skin tumours;
usually young dogs;
raised, often hairless lesions, may grow rapidly;
cytology usually diagnostic (pleomorphic round cells and lymphoid infiltrate) ;
boxers, dachshunds, cocker spaniels, and bull terriers
canine cutaneous histiocytoma
what are the 3 most common sites of metastases by canine mast cell tumours (in order)
- local lymph node
- regional nodes
- spleen & liver
what is the most important prognostic factor in Mast Cell Tumours (MCTs)
histological grade
name the 2 systems for histopathological grading of MCTs
- Patnaik
- Kiupel
name the histological grade of MCT based on the critera (Patnaik)
monomorphic round cells with distinct cytoplasm, medium sized intracytoplasmic granules, no mitotic figures noted;
compact groups or rows of neoplastic cells confided to dermis
grade 1
well differentiated
name the histological grade of MCT based on the critera (Patnaik)
some pleopmorphic cells - round to ovoid shape;
some cells having less distinct cytoplasm with large and hyperchromatic intracytoplasmic granules but others have distinct cytoplasm with fine granules;
areas of oedema or necrosis are noted;
mitotic figures are 0-2 per high power field;
tumour infiltrating lower dermis/subcutaneous tissue
grade 2
intermediately differentiated
name the histological grade of MCT based on the critera (Patnaik)
dense sheets of pleomorphic cells with indistinct cytoplasm with fine or not obvious intracytoplasmic granules;
mitotic figures 3-6 per high power field;
oedema, haemorrhage, necrosis and ulceration common;
tumour infiltrating lower dermis/subcutaneous tissue
grade 3
poorly differentiated
diagnosis of high-grade MCTs using Kiupel method is based on the presence of any one of what 4 criteria
- at least 7 mitotic figures in 10 high-power fields (hpf)
- at least 3 multinucleated cells in 10 hpf
- at least 3 bizarre nuclei in 10 hpf
- karyomegaly
name the system of MCT histopathological grading
well established so limitations well known;
most grade 1 good and grade III bad;
subjective;
does not allow classification of subcutaneous tumours
Patnaik
name the system of MCT histopathological grading
limitations becoming apparent;
up to 15% of low grade tumours metastasise;
less subjective
Kiupel
what is the treatment of choice for a mast cell tumour
surgery
what must the lateral margin be for surgical excision of a MCT
3cm plus deep fascia
name 3 proven chemotherapy agents for canine mast cell tumours
- pred
- vinblastine
- lomustine
(possible chlorambucin)
name the chemotherapy drug that can be used for canine MCTs
plant alkaloid (inhibiton of microtubule formation, interferes with amino acid metabolism);
M phase specific;
hepatic metabolism;
faecal excretion;
more myelosuppressive than vincristine;
GI effects rare;
EXTREME perivascular irritant
vinblastine
name the chemotherapy drug that can be used for canine MCTs
alkylating agent;
CCPNS;
hepatic metabolism;
urinary excretion;
myelosuppressive (can be severe, delayed, and cumulative);
hepatotoxic
lomustine
(CCNU)
what are the two forms of cutaneous MCTs in cats
- Mastocytic
- Atypical
name the feline cutaneous MCT form
generally seen in older cats;
histologically subdivided (compact v. diffuse, well differentiated v. poorly differentiated, pleomorphic v. anaplastic);
mitotic count prognostic
mastocytic form
name the feline cutaneous MCT form
often Siamese breed;
young cats;
spontaneously resolve over several months;
no effect of corticosteroids on the time course of the disease
atypical form
what is the best treatment option for single cutaneous feline MCTs
surgery
what is the treatment of choice for a splenic MCT in a cat
splenectomy
