Oncology Flashcards
Oral tumors - most common epithelial (3), melanocitic (1), mesenchymal (5) and miscellaneous (3)
Epithelial: Squamous Cell Carcinoma, intraosseous carcinoma and invasive nasal carcinoma
Melanocytic: Malignant Melanoma
Mesenchymal: fibrosarcoma, hemangiosarcoma, osteosarcoma, chondrosarcoma, multilobular osteochondrosarcoma
Miscellaneous: TVT, MCT, lymphoma
Odontogenic tumors - list one epithelial, one mesenchymal and three periodontal
odontogenic ameloblastoma (epithelial)
odontogenic fibroma (mesenchymal)
acanthomatous epulis (periodontal), ossifying epulis (periodontal), and fibromatous epulis (periodontal)
Describe the TNM staging system for canine oral tumors as proposed by the WHO
“Stage Characteristics
T – Primary tumour
T0 No evidence of tumour
Tis Carcinoma in situ
T1 <2cm (1a = no bony invasion, 1b = bony invasion)
T2 2–4cm (2a, 2b)
T3 >4cm (3a, 3b)
N – Regional lymph nodes
N0 No regional lymph node (RLN) involvement
N1 Movable ipsilateral RLN (N1a = no tumour cells, N1b = tumour cells)
N2 Movable contralateral or bilateral RLN (N2a, N2b)
N3 Fixed RLN
M – Distant metastasis
M0 No distant metastasis
M1 Distant metastasis”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
Briefly explain stereotactic radiation therapy
“Stereotactic radiation therapy involves three-dimensional localization of the neoplasm with imaging following immobilization of the part of the patient to be radiated.90 Multiple beams of radiation are administered from different directions to deliver a high dose to a more localized area (small lesions), typically as one to a few treatments.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
What are the four types of neoplasia affecting the central nervous system which are most likely to respond to chemotherapy?
“lymphoma, leukemias, multiple myeloma, and disseminated histiocytic sarcoma,”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
Discuss the primary use for bisphosphonates, mechanism of action and adverse effects
“Bisphosphonates may be useful in the treatment of neoplasms that cause bone lysis. These drugs inhibit bone resorption without inhibiting mineralization primarily through induction of osteoclast apoptosis, resulting in decreased osteolysis, stabilized or improved mineralization, and pain relief.48,110 In vitro studies of canine osteosarcoma have shown that bisphosphonates may have anticancer benefits as well.6,50,138 The most commonly used bisphosphonates in veterinary oncology are pamidronate (Aredia, Novartis Pharma) and zoledronate (Zometa, Novartis Pharma). Pamidronate is administered as an intravenous (IV) infusion every 4 weeks at a dose of 1 to 2 mg/kg. Pamidronate has been reported to cause both tubular and glomerular nephrotoxicity in people,133 and preclinical studies in dogs demonstrated a dose- and infusion-length–dependent nephropathy.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
What kind of non-spinal neoplasia is most likely to cause spinal cord disfunction? What is the most common type of tumor?
Vertebral neoplasia; osteosarcoma
Most vertebral tumors in dogs are primary tumors, with osteosarcoma (most common), fibrosarcoma and Chondrosarcoma comprising most cases.
What are the most common origins/types of secondary tumors that may affect the vertebral column?
“The most commonly identified metastatic neoplasms are either vascular in origin (e.g., hemangiosarcoma) or epithelial (thyroid, mammary, prostatic, and urinary [transitional cell]) in origin.58,114”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
What is the radiographic appearance of multiple myeloma affecting spinal vertebrae?
“Radiographically, multiple myeloma is characterized by multifocal well-circumscribed lytic lesions affecting multiple vertebrae (Figure 37.2).66,155”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
Typical MRI appearance of vertebral tumors on T1 and T2 weighed images
“In comparison to normal vertebrae, lesions are often hypointense on T1-weighted (T1W) images, hyperintense on T2-weighted (T2W) images, and demonstrate variability in enhancement after intravenous contrast administration.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
Is spinal lymphoma in the dog and in the cat most likely to be extradural, intradural-extramedullary or intramedullary? How can a presumptive diagnosis usually be achieved in these cases?
Extradural
“A presumptive diagnosis of lymphoma may be reached by identifying circulating neoplastic lymphocytes with routine hematology or observing neoplastic lymphocytes with cytological evaluation of bone marrow, affected organs, cerebrospinal fluid, or lymph node specimens.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
What is the etiology (cell line) of histiocytic sarcoma complex? Where are the cells typically found in where are they not naturally found?
“Histiocytic sarcoma is the neoplastic proliferation of cells of the dendritic or macrophage lineage. Because dendritic cells exist in all tissues and organs except the central nervous system (although found in the meninges), histiocytic sarcoma can arise in nearly every tissue and organ. ”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
From what tissue do myxomas (benign) and myxosarcomas (malignant) arrives?
Synovium
Where do myxosarcomas typically arise from when affecting the spinal cord?
Zygapophyseal joints
What are the three types of mineralization of soft tissues and their most common causes?
“Mineralization of the soft tissues can be classified into three types: metastatic, dystrophic, and idiopathic.
- Metastatic mineralization is secondary to abnormal calcium and/or phosphorous homeostasis; in general, mineralization of soft tissues is widespread.
- Dystrophic mineralization occurs in animals with normal calcium homeostasis in tissues that have been damaged by a pathological process (i.e., tissues devitalized by trauma, necrosis, inflammation/infection, or neoplasia).
- Idiopathic mineralization occurs in animals with normal calcium homeostasis in which mineralization occurs in normal tissues.
- Dystrophic and idiopathic mineralization occurs most commonly in animals. A fourth type, iatrogenic, has also been described in which the mineralization occurs secondary to a surgical procedure, suture material, or repeated injections at a single site. ”
What is the most common primary nervous system neoplasm of the spinal cord of the dog? What tissues does it typically arise from?
“Meningiomas arise from the meningothelial cells of the arachnoid membrane or pia mater. Meningioma is the most common primary nervous system neoplasm of the spinal cord in the dog.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
What is the typical biological behavior of nerve sheath neoplasms in the dog?
“In dogs, most nerve sheath neoplasms behave in a similar way to soft tissue sarcoma.85 Nerve sheath neoplasms are locally aggressive, infiltrating the nerve proximally and distally, but generally associated with a low rate of distant metastasis.16,19,24,84 Based on their biological behavior and histologic characteristics, most nerve sheath neoplasms in dogs are malignant.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
What is the typical Signalment and presentation for dogs with nerve sheath neoplasms?
Large breed, middle age to early senior, no gender predisposition
Progressive and typically unilateral limb lameness over a long period (typically over 6 months). The degree of discomfort may be variable from mild to severe. Clinical signs may be initially bilateral and then progressed to unilateral. Paresis/plegia may eventually develop but is less common. Pain or manipulation of the affected limb is common.
Thoracic limbs are most commonly affected. Scapular muscle atrophy may be present. A mass may be palpable in the axillary region.
If the lesion affects the pelvic limb, a mass may be rectally palpable on ventrolateral aspect of the sacrum.
What is the most commonly affected breed, age and location for Extrarenal nephroblastomas?
German Shepherd and retrievers, 6 to 18 months of age, T10-L2
What is the theory for why extrarenal nephroblastoma‘s most commonly present in the T10 L2 region?
“Given the histologic resemblance to primitive nephrons, these neoplasms may arise from mesonephric or metanephric embryologic remnants that become entrapped in the developing dura and spinal cord.168 This explanation of the histogenesis helps account for the near exclusive occurrence of the lesion between the T10 and L2 vertebrae. ”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
What are the 6 types of round cell neoplasms
HLMMPT
Histiocytic tumors
lymphoma
mast cell tumor
melanoma
plasma cell tumor
transmissible venereal tumor
Types of epithelial neoplasms
Carcinoma (nonglandular origin)
Adenocarcinoma (glandular)
What are the three tumors which if arising from the nailbed tend to be particularly aggressive and sometimes metastatic?
Squamous cell carcinomas, mast cell tumors, and melanomas arising in the subungual epithelium are aggressive and sometimes metastatic.
What kind of subungual tumor are black dogs predisposed to? What is the expected 1 year survival rate after digit amputation?
Squamous cells carcinoma, 45% to 100%
What is the median survival for patient diagnosed with subungual melanomas?
1 year
You are presented with a middle-age cat with digital tumors affecting two weight-bearing toes. What are the three most likely differential diagnosis? What is the prognosis?
Aside from squamous cell carcinoma and fibrosarcoma, digital tumors in cats can also be metastatic, most commonly from pulmonary adenocarcinoma. These tumors typically involve weight-bearing digits and can involve more than one toe. Cats with digital tumors should be carefully evaluated for primary disease. Prognosis for digital tumors in cats is guarded. Median survival in cats with digital squamous cell carcinoma is 73 days, whereas cats with metastatic lesions have similarly poor survival.
Canine eyelid neoplasms - from what structures do theytypically arise from? Are they most commonly benign or malignant? What is the most common benign tumor in the most common malignancies observed? Roughly what percentage of tumors are benign versus malignant?
Eyelid neoplasms in dogs are most often associated with the meibomian glands (see Figs. 16.1 and 16.5B), and 70% to 80% are benign. Sebaceous adenomas and epitheliomas are the most common eyelid tumor in dogs; they sometimes grow rapidly. Malignant eyelid tumors are less common and include squamous cell carcinoma, sebaceous adenocarcinoma, basal cell carcinoma, and fibrosarcoma. Of the eyelid melanomas, approximately 60% are benign and 40% are malignant.
Eyelid neoplasms in cats - most likely benign or malignant? What is the most common type in what are the other possibilities?
In cats, eyelid neoplasms tend to be malignant, and squamous cell carcinomas (~60% of cases) are the most common. Others include fibrosarcoma, adenocarcinoma, basal cell carcinoma, melanoma, and hemangiosarcoma.
What diagnostic technique should always be performed when evaluating a case of entropion? Why?
Topical anesthetic desensitization (proparacaine). This is important to evaluate for spastic entropion which resolves home tenuously and does not require surgery (Typically a result of discomfort).
What is a Leukoma?
A white corneal scar
Why should ketamine be avoided during ophthalmic procedures?
Because it may cause undesirable eye movements.
What are the two main indications for a third eyelid flap?
Bullous keratopathy and indolent corneal ulceration
What is Haw’s syndrome? What species does it affect and what is it typically associated with? How can you confirm it?
Bilateral exposure or protrusion of the nictitating membranes, only observed in cats. Associated with gastrointestinal disease although the mechanism is unknown. Confirmed via phenylephrine testing
Describe the Seidel test and it’s purpose
Perform a Seidel test to determine if a corneal ulcer has reached full-thickness and ruptured. Fill a 3-mL syringe with sterile eye wash or LRS after removing the plunger. Dip the stained tip of the fluorescein strip into the solution repeatedly until the solution is a dark, dense yellow. Have an assistant drip the fluorescein solution onto the cornea ulcer site while you watch the area with magnification and a cobalt light. Alternatively, moisten the tip of a fresh sterile fluorescein strip with a full drop of sterile eye wash, and allow this drop to fall onto the top of the globe; monitor the site in question under magnification with a cobalt light. Observe to see whether a clear rivulet of aqueous humor is seen running through the fluorescein stain. A positive Seidel test indicates aqueous humor leakage and that the corneal ulcer has ruptured. If a corneal perforation is leaking, referral to an ophthalmologist is indicated because accurate evaluation and repair requires use of specialized skills and an operating microscope.
The three bones that compose the orbit
frontal, lacrimal, and zygomatic bones
What is the typical clinical sign of severe extraocular muscles tearing as a result of ocular proptosis?
marked dorsolateral strabismus
Pupil size is not always considered a good predictor of vision in patients with globe proptosis. List three or more positive prognostic indicators
Positive prognostic indicators include a brachycephalic dog signalment, intact direct and consensual pupillary light reflexes, intact vision (indicated by tracking of a thrown cotton ball or head retraction when the eye is menaced), a normal fundus appearance, and short duration of proptosis before treatment.16
The prognosis for vision in proptosis globes is guarded to pour. Globe retention and acceptable cosmesis are quite possible depending on the degree of damage in the level of care provided. Approximately what percentage of dogs and cats become blind after proptosis?
Blindness occurs in approximately 60% to 70% of dogs and in 100% of cats.
In the order from the tympanic membrane to the semi circular canals, what are the names of the three otic ossicles?
Malleus, incus and stapes
Describe the surgical approach for a ventral bulla osteotomy
In dogs, make a 7- to 10-cm incision (3–5 cm in cats) parallel to the midline of the animal and centered 2 cm toward the affected side from where these imaginary lines intersect (see Fig. 17.14A). Incise the platysma muscle, retract the linguofacial vein if necessary, and deepen the incision by bluntly dissecting the digastricus muscle (lateral) from the hyoglossus and styloglossus muscles (medial). Avoid damaging the hypoglossal nerve, located on the lateral aspect of the hyoglossus muscle. Confirm the location of the bulla and use self-retaining retractors (e.g., Gelpi, Weitlaner)
What are the two most common tumors affecting the palatine tonsils in the dog?
Squamous cell carcinoma and lymphosarcoma
What are the four most common tumors affecting the tongue of the dog?
S-M-MYL-M
Squamous cell carcinoma
Malignant melanoma
Granular Cell myeloblastoma
Mast cell tumor
How much of the tongue can be amputated and still very well tolerated in dogs?
Nearly the entire free tongue can be amputated without major problems (40 to 60%).
What are the general epidemiological Facts regarding oral tumors in dogs and cats?
Fourth most common site of neoplasia and dogs and cats
2.6 times more likely to occur in dogs than cats
Males more commonly affected than females
What are the three most common oral tumors of dogs (in the order of most common to least common)
Malignant melanomas, squamous cell carcinoma, fibrosarcoma
What is the most common malignant oral tumor in dogs? Does it occur often in cats? Where in the mouth does it typically arise and what is the typical Signalment of affected dogs?
Melanoma
“• Most common malignant oral tumor in dogs (approximately 20%)
• Rare in cats
• Most common on gingiva
• More common in male dogs
• Mean age of affected animals is 9–11 years (average, 10.3 years)
• Breeds with pigmented oral mucosa, cocker spaniels, and German shepherds”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the most common oral tumor in cats? Does it happen in dogs? Where does it typically arise and what is the typical biological behavior?
“• Most common tumor in cats (approximately 70%)
• Second most common tumor in dogs (with fibrosarcoma) (approximately 15%)
• Occur on the gingiva, lip, tongue, or tonsil
• Biological behavior varies with location and species; regional lymph node involvement “is common with tongue and tonsillar squamous cell carcinomas”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are the main characteristics of oral fibrossarcomas in dogs?
“Second most common malignant oral tumors in dogs (with squamous cell carcinoma)
• Occur most commonly on the gingiva and hard palate
• More common in large breeds (>20 kg) and male dogs
• Younger dogs may be affected (mean age <7 years)
• Locally invasive; high metastatic potential in dogs <2 years of age”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are the main characteristics of the dog’s most common group of benign gingival tumor? What is the most common form?
“Most common oral tumor in dogs (approximately 30%)
• Mean age approximately 8.2 years
• More common in large-breed dogs (>20 kg)
• Do not metastasize
• Acanthomatous epulis is most common form”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What population is most commonly affected by ameloblastoma‘s? What is the biological behavior?
“Ameloblastomas (adamantinoma) are benign tumors that arise from the dental lamina. They usually occur in younger dogs and involve the rostral mandible. Ameloblastomas develop as intraosseous tumors and are locally invasive and nonmetastasizing.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are dentigerous cysts and what is their biological behavior?
“Dentigerous cysts appear as closed cavities or sacs with one or more teeth embedded in the cyst wall. They arise within islands of odontogenic epithelium and are described as benign, nonneoplastic lesions; however, they may represent an early stage of malignant epithelial tumor development.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the expected response to radiation therapy of SCC’s, fibrosarcoma and melanomas? What percentage of patients develop neoplasia secondary to radiation therapy?
“SCC’s are radiosensitive and are successfully treated by radiotherapy. Piroxicam is sometimes helpful in treating SCC. Fibrosarcomas are radioresistant. Melanomas may be sensitive to radiotherapy, but distant metastasis frequently renders it ineffective. Radiation-induced tumors occur in up to 20% of the irradiated sites.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the prognosis for feline oral squamous cell carcinoma?
“Cats with oral SCC have a poor prognosis, with a median survival time of approximately 2 months regardless of the form of therapy. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the prognosis for a canine oral melanoma? What percentage of dogs is still disease-free 1 year postop?
“Melanomas have the poorest prognosis because they metastasize early. Fewer than 20% of affected animals are disease-free 1 year after surgery. Median survival times vary from 8 to 10 months. Tumors arising from the tongue have a poor prognosis. They are controlled locally in only approximately one-fourth of animals 1 year after resection or radiation therapy. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Esophageal tumors are generally rare Regards and cats. When observed, what are the three most common types of tumors? What non-neoplastic parasitic condition can mimic cancer?
Sarcomas, squamous cell carcinoma and Leiomyomas.
Spirocerca lupi
Regarding hiatal hernia’s:
Typically acquired or congenital?
Predisposed breeds?
Typical clinical signs?
Easy to diagnose via radiographs? Why?
What surgical steps are typically taken to correct the issue?
What patients are typically treated via surgery versus conservative management?
What preoperative step must be observed?
Is the prognosis good or bad after repair?
“Most are congenital rather than acquired
• Shar peis and English bulldogs are most commonly affected
• Some are asymptomatic
• Symptomatic animals often have regurgitation and esophagitis
• Herniation may be intermittent, making radiographic diagnosis challenging
• Herniorrhaphy includes hiatal reduction, esophagopexy, and left-sided gastropexy
• Surgery is usually most appropriate for younger symptomatic animals; older symptomatic animals are usually best treated medically
• Treat for esophagitis initially after surgery
• Prognosis is usually good after repair”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the likelihood of metastasis for gastric neoplasm‘s at the time of diagnosis? How does this apply to leiomyomas and leyomyosarcomas?
“Most neoplasms in the gastric body, except for leiomyomas and leiomyosarcomas, have metastasized by the time they are diagnosed. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
G.I. adenocarcinoma in dogs and cats: Most common location for each species, three morphologic forms, most common clinical signs, mode of metastasis
“Adenocarcinomas are locally invasive and slow-growing. They most commonly arise in the duodenum and colon of dogs and in the distal jejunum and ileum of cats. These tumors have three main morphologic forms: (1) infiltrative adenocarcinomas cause a thickened stenotic area that obstructs the intestinal lumen; (2) ulcerative adenocarcinomas have a deep indurated mucosal ulcer with raised edges; and (3) proliferative adenocarcinomas are lobulated, expanding intraluminal masses. Mucosal ulceration may cause chronic bleeding, melena, and iron deficiency anemia. The tumors spread to adjacent serosal surfaces, mesentery, omentum, and regional lymph nodes by local invasion and may metastasize distally to the lungs and liver. Mucinous intestinal adenocarcinomas extend transmurally to the mesentery with accumulation of variable amounts of mucin.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Intestinal lymphosarcoma in dogs and cats: typical etiology in cats; what are the two intestinal types?
“In cats, they may be caused by FeLV or feline immunodeficiency virus (FIV), but most are caused by unknown mechanisms. The etiology in dogs is unknown. Affected animals may have multicentric disease. Lymphomas have two intestinal types: diffuse and nodular. Diffuse infiltration of the lamina propria and submucosa with neoplastic lymphocytes causes malabsorption and occasional deep ulceration. Nodular lymphoma is an expanding intestinal mass that causes obstruction, often but not invariably in the ileocecocolic area. Involvement of regional lymph nodes and other organs is common. Cats in particular may have intestinal lymphoma and no gross or ultrasonographic evidence of intestinal disease. Dogs typically have lymphoblastic lymphoma, whereas there are multiple forms of lymphoma in cats including small cell lymphoma, lymphoblastic lymphoma, epitheliotropic lymphoma, and large granular lymphoma.42”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the typical biological behavior of canine intestinal leiomyosarcoma’s? Where do they typically occur? How does the tumor spread? Is metastasis slow or fast? What is the expected median survival after surgical resection with or without metastasis?
“Intestinal leiomyosarcomas are slow-growing, malignant smooth muscle tumors of older dogs that usually occur in the cecum and jejunum. Neoplastic spread is by local invasion, and metastasis is slow. Metastasis occurs to the mesentery, mesenteric lymph nodes, peritoneum, and liver. Median survival of approximately 2 years is expected after resection of a localized lesion. This is also true of animals with metastasis at the time of surgery. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Breeds predisposed to lymphoma, adenocarcinoma and leiomyosarcoma’s of the G.I. tract
“Boxers, collies, and German shepherds”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are the three most common G.I. tumors of cats?
“lymphosarcomas are most common followed by adenocarcinomas and mast cell tumors”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the prognosis for dogs with localized intestinal adenocarcinoma or leiomyosarcoma completely excised? Include median survival, one and two years post-op.
“The prognosis is good for patients with a localized intestinal adenocarcinoma or leiomyosarcoma if complete resection is possible. The median survival time is 10 months; the 1-year survival rate is 40.5%, and the 2-year survival rate is 33% for dogs with an adenocarcinoma or a leiomyosarcoma.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the prognosis for cats with intestinal adenocarcinoma surgically removed?
Excellent, over two years
What is the prognosis for cats with intestinal lymphoblastic lymphoma versus those with small cell lymphoma?
 “The prognosis associated with lymphoblastic lymphoma is poor; however, cats with small cell lymphoma can have survival times of years.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Where are intestinal tumors most likely in the dog versus the cat? What are the most commonly observed tumors?
Dogs: large intestines, adenocarcinoma
Cats: small intestines, lymphosarcoma
Adenocarcinoma’s are most commonly observed in the large intestine (mid rectum) of dogs and cats, although are overall rare. Where are the two most common locations within the anatomical structure of the colon?
Annular (intramural) and intraluminal
Most common type of cecal tumors in dogs and cats? What is the prognosis with early complete resection?
Leiomyosarcoma
Median survival with or without metastasis is approximately two years (excellent prognosis).
What is the most common surgical technique utilized in the treatment of Rectal adenocarcinoma ? What is the expected survival time?
“Adenocarcinoma was the tumor most commonly treated with rectal pull-through, and these dogs had a median survival time of 696 days (1006 days if the carcinoma was classified as in situ).
 Which canine epithelial tumor is frequently associated with hypercalcemia of malignancy? What clinical signs are typically associated with this syndrome?
Apocrine Gland Adenocarcinoma (anal sac)
Hypercalcemia is typically associated with polyuria, polydipsia, poor appetite and vomiting
Where do anal squamous cell carcinoma‘s typically arise? What is the typical clinical presentation and prognosis?
“Anal SCCs arise from the anocutaneous line. They are typically malignant and metastasize quickly. Extensive fistula or mucosal-cutaneous, ulcer-like lesions occur and are often covered with mucus. Anal function is impaired, and pain, tenesmus, and hemorrhage are typical. The prognosis is grave because of their malignant nature. Treatment is often discouraged.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Do cats develop perianal gland tumors?
No. “Cats do not have perianal or circumanal glands”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright. 
You are presented with an intact dog affected by multiple, large perianal Adenomas. What can be done to reduce the size of the tumors prior to excision?
Castration, wait six weeks and reevaluate.
What is the most important organ dysfunction associated with hypercalcemia of malignancy , such as caused by apocrine gland adenocarcinoma?
Renal dysfunction
Renal dysfunction secondary to hypercalcemia of malignancy (apocrine gland tumors) can be serious. What is the typical treatment and prognosis?
“Although the renal dysfunction is initially mild and reversible, it can become severe, oliguric, and irreversible if therapy is delayed. Therefore it is important to be sure the patient is not oliguric. Prednisolone may be given (Box 18.62) to help lower the serum calcium. Severely affected animals (total serum calcium concentration greater than 16 mg/dL) may also be treated with alkalinizing agents (e.g., sodium bicarbonate) and bone resorption inhibitors (i.e., pamidronate disodium). Pamidronate disodium (1–2 mg/kg IV) has been used in dogs that were hypercalcemic from different causes, and it quickly lowered serum calcium concentrations. However, pamidronate is expensive. Peritoneal dialysis may be performed in oliguric patients but is of uncertain value.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
When is recurrence of perianal malignant tumors typically observed?
Three months post-surgery
Name 4 epithelial and 4 mesenchimal primary hepatic tumors
Epithelial
• Hepatocellular carcinoma
• Hepatocellular adenoma
• Cholangiocellular carcinoma
• Cholangiocellular adenoma
• Hepatic carcinoids
Mesenchymal
• Hemangiosarcoma
• Fibrosarcoma
• Extraskeletal osteosarcoma
• Leiomyosarcoma”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the typical metastatic behavior of epithelial Vs. mesenchymal hepatic tumors?
“Epithelial tumors most often metastasize to the regional lymph nodes and lungs. Mesenchymal tumors most often metastasize to the spleen.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the overall prognosis for he[atocellular carcinoma treated via surgical excision alone?
“Malignant primary hepatic tumors have typically been considered to be highly metastatic; however, long-term survival is common after lobectomy for hepatocellular carcinoma. The median survival time in cats undergoing surgery for hepatocellular carcinoma was 2.5 years in a 2016 study.2”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the most common tumor to metastasize to the liver? What other tumors frequently metastasize to the liver?
Lymphosarcoma
“Other tumors that commonly metastasize to the liver are pancreatic adenocarcinomas, hemangiosarcomas, insulinomas, and tumors of the alimentary and urinary tracts.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Where are hepatic tumors most commonly observed? (Lobes)
“Hepatocellular tumors are most commonly found in the left medial and left lateral liver lobes.
”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What clinical signs are typically associated with pheochromocytomas?
“Pheochromocytomas may cause vague, intermittent signs of weakness or panting due to episodic hypertension and tachycardia.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
 What drugs can be used as part of the medical management of hypertension caused by pheochromocytoma?
“Adrenergic blockage (e.g., phenoxybenzamine, phentolamine, prazosin)”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What cardiovascular concerns could you expect in a patient with pheochromocytoma? How should this be addressed prior to surgery?
“Particular emphasis should be placed on preoperative examination of the cardiovascular system for evidence of arrhythmias or congestive heart failure in animals with pheochromocytomas. If cardiac arrhythmias are present, a β-blocker may be added, but only after the phenoxybenzamine dosage (see under Anesthesia) has been determined to be adequate and blood pressure has returned to normal. Both α- and β-blockade will allow the return of a normal fluid volume; however, they may unmask renal insufficiency and anemia. α-Adrenergic blockade has been shown to drastically reduce the incidence of severe perioperative hypertension, thereby reducing mortality (Table 22.1).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Dogs with adrenocortical tumors are particularly predicposed to this life-threateninc post-op complication
Thromboembolism
What is the prognosis for dogs undergoing adrenalectomy for the removal of adrenal neoplasia? What factors affect prognosis and what is the median survival?
“Although there can be significant perioperative complications, median survival for dogs that survive to discharge exceeds 10 months. In a study of 52 dogs undergoing adrenalectomy, survival time was significantly shorter in dogs with carcinoma, tumors with a major axis length greater than 5 cm, thrombosis, metastasis, and when adrenalectomy was combined with another abdominal surgical procedure.9 Dogs in this study had a median survival of 953 days, with more than 65% living for more than 1 year.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What prognostic factors are considered favorable for survival in dogs undergoing adrenalectomy for removal pf pheochromocytomas?
“Prognostic factors for improved survival for pheochromocytoma include preoperative use of phenoxybenzamine, younger age, lack of intraoperative arrhythmias, and decreased surgical time.13”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the average perioperative mortality rate for dogs and cats undergoing adrenalectomy (regardless of cause)?
20%
What warning would you provide the owner of a dog with pheochromocytoma before and during surgery?
“Warn owners that animals with pheochromocytoma may die suddenly as a result of arrhythmias and hypertension.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Ptuitary tumors - stats…
% of functional vs non-functional
Correlation between size and neuro signs?
Most common tumor type
60% functional (main cause of HAC)
40 % non-functional
No correlation between size and neuro signs
Microadenoma (< 1cm) - 70% of tumors
Four breeds predisposed to PDH due to hypophyseal microadenoma
PMDB
“Poodles, Malteses, dachshunds, and boxers may be predisposed to PDH.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What structures can be compressed by hypophyseal tumors, leading to neurologic abnormalities?
“Large pituitary tumors often grow dorsally into the brain because the diaphragm of the sella is incomplete. Such tumors may cause clinical signs by impinging on adjacent brain tissue (e.g., optic chiasm, hypothalamus, thalamus, infundibular recess, and third ventricle). Size of the tumor and development of neurologic signs do not always correlate.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List the signalment and typical clinical signs presented by a dog with functional hypophyseal microadenoma growing beyond the sella turcica?
Poodle, Maltese, Dachshund, Boxer; Middle-age to senior;
“Most dogs are presented for evaluation of typical signs of HAC (polyuria, polydipsia, polyphagia, abdominal enlargement, endocrine alopecia, muscle wasting, weakness, lethargy, panting, and/or hyperpigmentation). Concurrent neurologic signs (e.g., seizures, visual deficits, ataxia, incoordination, facial hemiplegia, head tilt, somnolence, compulsive walking, depression)”
Mental depression/stupor are the most common abnormalities.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Therapy for microadenoma Vs. Macroadenoma of the pituitary gland?
Microadenoma: hypophysectomy
Macroadenoma: external beam radiation
What consideration should be made prior to considering hypophysectomy for the therapy of PDH in a breeding dog?
“Hypophysectomy should not be considered in animals intended for breeding purposes because it renders them infertile. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Three drugs typically needed for the first two weeks post-hypophysectomy
Desmopressin Acetate
Hydrocortisone
Levothyroxine
What is the median survival for patients with insulinoma who are surgically treated?
“If metastasis is not apparent at surgery, survival of longer than 1 year may occur, even though cures are unlikely.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
“Zollinger-Ellison syndrome refers specifically to gastrinomas arising in the pancreas (non–β-cell tumors). What is the expected biological behavior of these tumors?
 “Pancreatic gastrin-secreting tumors are usually locally invasive into adjacent parenchyma and frequently metastasize to regional lymph nodes or the liver or both.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List 6 differential diagnosis for a cystic ventral cervical mass in a dog
branchial cyst
thyroglossal cyst
thyroid cyst
thyroid cystadenoma
parathyroid cyst
parathyroid cystadenoma
thyroid carcinoma
salivary mucocele
abscess
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the most common thyroid tumor in dogs versus cats? biologic behavior?
Carcinomas are more common in dogs. “Carcinomas are generally rapidly growing, highly invasive tumors that frequently metastasize to the draining lymph nodes and lungs. ”
Functional adenomas are more common in cats
What is the prognosis for thyroid carcinomas treated via surgical excision or irradiation?
“The prognosis is good following surgical treatment of mobile thyroid tumors and irradiation of fixed thyroid carcinomas, with median survival times greater than 3 years. Median survival time for dogs with local or regional tumors (i.e., stage II or III) was significantly longer (839 days) than median survival time for dogs with metastasis (366 days). ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are lymphangiomas?
“Lymphangiomas are rare, nonmalignant abnormalities originating from lymphatic capillaries that present as fluid-filled spaces or masses in the skin or deeper tissues.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the typical biological behavior of lymphangipsarcomas?
“Lymphangiosarcomas (Fig. 23.2) are malignant tumors that arise from lymphatic capillaries. They are locally aggressive, and metastasis to regional lymph nodes, lungs, spleen, kidneys, and bone marrow has been reported. Even without metastasis, the local invasiveness of this tumor may necessitate amputation or euthanasia.4”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the typical biological behavior of renal tumors? What are the four distinct origins (types) in what tumors are most commonly observed in dogs versus cats?
“Approximately 85% of renal tumors are malignant, and thoracic metastatic disease is common. Renal tumors are of four distinct origins (types): renal tubular, transitional cell, nephroblastic, and nonepithelial. In dogs, carcinomas (also known as renal tubular carcinoma and renal tubular adenocarcinoma) are most common, followed by sarcomas (Box 24.4). Lymphoma is the most common renal neoplasm in cats and may be primary or metastatic (associated with alimentary lymphoma).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Generalized nodular Dermatofibrosis is a disorder seen in German Shepherd dogs in association with white malignant neoplasm?
“Generalized nodular dermatofibrosis, a skin disorder seen in German shepherd dogs, is associated with renal cystadenocarcinomas and other neoplasms.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Nephroblastomas – typical Signalment and associated musculoskeletal disorder
“Nephroblastomas are rare tumors of juvenile and adult dogs that are associated with hypertrophic osteopathy (see p. 1297). Most are malignant, and these tumors are thought to arise from embryonic tissue ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List the 7 most common malignant tumors affecting the canine kidneys
“Carcinomas
Hemangiosarcomas
Fibrosarcomas
Leiomyosarcomas
Nephroblastomas
Squamous cell carcinomas
Undifferentiated carcinomas”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Ureteral tumors in dogs – how frequently do they occur? Typically benign or malignant?
“Ureteral tumors are very uncommon; only 17 cases have been documented in the veterinary literature. Most ureteral tumors are benign; however, there are three reports of ureteral sarcoma in dogs.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Dogs affected by renal tumors are typically geriatric. What’s the most likely exception to this rule?
“with the exception of hereditary multifocal renal cystadenocarcinomas in German shepherd dogs.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Rare benign neoplasm that affects the kidneys of young dogs
“Teratomas are rare but may occur in the kidneys of young dogs.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What kinds of renal tumors are most likely to cause gross hematuria?
“Gross hematuria may occur with mesenchymal tumors (e.g., anaplastic sarcomas, fibromas, hemangiosarcomas, lymphosarcomas) and transitional cell tumors; however, microscopic hematuria is more common.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Abdominal ultrasonography is the most useful diagnostic tool for renal neoplasia, in allows ultrasound guided biopsy. In what situations should this kind of biopsy not be pursued? Why?
“Abdominal ultrasonography is the most useful diagnostic tool for renal and ureteral neoplasia. Ultrasound-guided biopsy (see p. 654) can be performed if the kidney does not appear fluid filled; however, biopsy may cause peritonitis or uncontrollable hemorrhage, or it may seed the abdomen with tumor cells.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Briefly explain the pathophysiology of feline perirenal pseudocysts. How are they treated and what’s the prognosis?
“Perirenal pseudocysts have been reported in cats and are formed when fluid accumulates between the parenchyma of the kidney and the renal capsule owing to underlying parenchymal disease. Resection of the pseudocyst wall is effective in eliminating signs but does not necessarily stop the progression of renal disease. The prognosis for cats with pseudocysts is related to the degree of renal dysfunction at the time of diagnosis.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the median survival for dogs with renal carcinomas versus Sarcomas versus nephroblastomas? what is the effect of chemotherapy on overall survival? 
- renal carcinomas: 16 months (range, 0–59 months)
- sarcomas: 9 months (range, 0–70 months)
- nephroblastomas: 6 months (range, 0–6 months)
Although long-term survival (i.e., >2 years) with nephroblastoma is possible, dogs with renal tumors receiving adjunctive chemotherapy do not survive a significantly longer period than dogs not receiving chemotherapy. With benign neoplasia, nephrectomy is usually curative.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
How does the diagnosis of a benign mammary tumor in a dog affect her chance of developing a malignant tumor?
“Dogs with benign mammary tumors have more than a threefold risk of developing malignant mammary tumors.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the recommended surgical therapy for feline inflammatory mammary carcinoma?
“Do not excise inflammatory carcinomas; the prognosis is too poor.”
“Inflammatory carcinomas are extremely aggressive, and surgery is of no value in controlling or palliating the disease. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the biological behavior and overall prognosis for a cat with a mammary adenocarcinoma?
90% of feline mammary tumors are adenocarcinoma’s
Grow rapidly and metastasized to local lymph nodes and lungs early in the course of the disease
Not as well circumscribed as the canine counterpart
Often firm and ulcerated
Must be differentiated from lobular hyperplasia and fibroepithelial hyperplasia
Expected survival is less than one year
What are the two main benign differentials for a feline mammary tumor?
“Feline mammary tumors must be differentiated from lobular hyperplasia and fibroepithelial hyperplasia.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the published thoracic metastasis rate for dogs with malignant mammary tumors at the time of diagnosis?
“Thoracic metastasis occurs in 25% to 50% of dogs with malignant mammary tumors by the time of diagnosis.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Besides the lungs, what other area should be checked for metastatic lesions associated with caudal mammary tumors?
“Abdominal radiographs should be evaluated for iliac lymph node enlargement with caudal tumors. Abdominal ultrasonography may detect abdominal metastasis. CT and MRI imaging may facilitate evaluation of invasive tumors and metastasis.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Has postoperative adjunctive chemotherapy been shown to affect the survival of dogs and cats with mammary tumors (as an adjunctive to surgery)?
“Postoperative adjunctive chemotherapy has not been shown to improve outcomes or survival times in dogs or cats”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the recommended surgical approach for a cat with unilateral mammary adenocarcinoma?
“local recurrence is decreased in cats when unilateral mastectomy is performed rather than lumpectomy.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the recommended surgical therapy for a dog with multiple mammary masses?
“Separate mammary masses on the same dog may be of different histologic types; therefore excise all masses and submit them for histologic examination. Be sure to mark them so that you can determine which mass originated from which site when the biopsy report returns.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Describe the major blood vessels supplying the mammary glands of dogs and cats
“Mammary Glands 1 and 2
Ventral and lateral branches of the intercostal, internal thoracic, and lateral thoracic vessels
Mammary Glands 2 and 3
Cranial superficial epigastric vessels
Mammary Glands 4 and 5
Caudal superficial epigastric vessels”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the reported local recurrence post surgery in dogs with mammary gland neoplasia?
“In dogs, local recurrence occurs within 2 years and varies from 20% to 73%. (Depends on various factors)
“The prognosis for dogs with malignant tumors is variable and depends on several factors, including tumor type, tumor stage, tumor size, OHE status, and the presence of metastasis.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
How does tumor size affect the prognosis for cats with mammary adenocarcinoma?
“Cats with mammary carcinoma greater than 3 cm have a median survival of 6 months, whereas those with tumors less than 2 cm have a median survival of approximately 3 years. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
How does spaying at the time of mastectomy affect the prognosis for dogs with mammary tumors?
“2016 study found dogs with grade 2 mammary carcinoma, ER-positive tumors, or perioperative increased serum E2 concentration had a decreased hazard of relapse when undergoing OHE at the time of mammary tumor removal compared with dogs not receiving OHE.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are the most common types of vulvar/vaginal tumors in bitches?
“The most common types of vulvar-vaginal tumors are fibroleiomyoma, lipoma, leiomyosarcoma, squamous cell carcinoma, and transmissible venereal tumor (TVT).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List five cytologic criteria of malignancy
“Variation in nuclear and nucleolar size
Variable and increased nuclear cytoplasmic ratio
Nuclear molding
Abnormal mitotic figures
Coarsely clumped chromatin”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Discuss the medical management of prosthetic neoplasia in dogs. Are they responsive to chemotherapy? How about radio therapy? What other drug class has been shown to be helpful at improving clinical signs and why?
“Chemotherapeutic protocols are not successful in the management of prostatic neoplasia. Radiation therapy can be used to decrease prostate size but does not improve survival times. COX inhibitors (e.g., piroxicam 0.3 mg/kg PO [orally] q24–48h or carprofen 2.2 mg/kg PO q12h) have been shown to improve survival in dogs with prostatic carcinomas, probably because of their binding to COX receptors. Concurrent administration of omeprazole (1–2 mg/kg PO q12h), pantoprazole (1 mg/kg IV q12–24h) or misoprostol (2–5 µg/kg PO q8–12h) may help ameliorate adverse effects associated with chronic use of NSAIDs. Proton pump inhibitors have fewer side effects than misoprostol and are probably as effective.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What active substances are present in the cytoplasmic granules of mast cells? What difference is typically observed in the cytoplasmic granule composition between low-grade versus high-grade MST?
“Cytoplasmic granules in mast cells contain heparin, histamine, platelet-activating factor, and eosinophilic chemotactic factor. The number and type of granules in MCTs depend on the degree of tumor differentiation. Well-differentiated MCTs contain more heparin, whereas undifferentiated tumors have more histamine. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Regarding scrotal tumors, what is the most common type and biological behavior?
“In dogs, 50% of MCTs are malignant, especially those in the preputial, inguinal, and perineal areas. Regional lymph nodes, spleen, liver, and bone marrow are common metastatic sites. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the most common distant adverse effect of cutaneous mast cell tumor’s? What is the potential impact of heparin and proteolytic enzyme release as it pertains to surgery and surgical healing?
“Gastroduodenal ulcers occur in up to 80% of dogs with MCTs because of histamine release. Ulcers may cause anorexia, vomiting, diarrhea, or melena (see p. 428). Heparin and proteolytic enzyme release may prolong coagulation and delay wound healing after resection.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the typical biological behavior of skin melanomas?
“Tumors originating in the skin tend to be benign.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List 5 commonly reported scrotal tumors in dogs
Mast cell tumor (54%)
Malignant melanoma
Hemangiosarcoma
Vascular hemartoma
Hemangioma

What is the biological behavior of neoplasia arising from normally positioned testicles (older dogs) versus cryptorchid testicles?
“Tumors involving scrotal testes are usually benign, whereas those in cryptorchid testes may be malignant. Metastases are slow-growing but are occasionally detected in lumbar, deep inguinal, and external iliac lymph nodes. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the biological behavior of Sertoli cell tumors? Where are they most commonly observed?
“Dogs with Sertoli cell tumors often have signs of hyperestrogenism (Box 26.33), especially those with large tumors. Signs regress with castration and tumor removal. Persistence or recurrence of clinical signs suggests estrogen-producing metastasis. Sertoli cell tumors have a higher rate of metastasis than other testicular tumors.”
“They are more common in cryptorchid than scrotal testes. ”
“Sertoli cell tumors producing excess estrogens may cause squamous metaplasia of the prostate, feminization, and/or myelotoxicity.”
List 8 clinical signs associated with hyperestrogenism due to Sertoli cell tumors
“Bilateral symmetrical alopecia
Brittle hair
Poor hair regrowth
Thin skin
Hyperpigmentation
Nipple elongation
Mammary enlargement
Penile atrophy
Preputial swelling and sagging
Squatting micturition
Reduced libido
Male attraction
Testicular atrophy
Prostatic atrophy or cystic enlargement
Anemia
Thrombocytopenia or neutropenia”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Interstitial cell tumors (Leydig) Are typically benign, soft encapsulated and rarely ever exceed 2 cm in diameter. What clinical signs / concomitant disorders are typically associated with these tumors?
“Dogs with interstitial cell tumors may be infertile. These tumors produce androgens or contribute to androgenic hormone imbalance. Perineal hernia, perianal adenomas and hyperplasia, and prostatic disease have been associated with interstitial cell tumors.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What tumors are cryptorchid dogs predisposed to? How many more times are these dogs likely to develop testicular tumors as compared to non-cryptorchid dogs?
“Cryptorchidism predisposes to Sertoli cell tumors and seminomas. Cryptorchid dogs are 13.6 times more likely to develop testicular tumors than normal dogs. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What dog breeds are particularly predisposed to scrotal mast cell tumors?
“Dogs predisposed to scrotal MCTs include English bulldogs, English bull terriers, boxers, Boston terriers, and American pit bull terriers.14”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Sertoli cell tumors and seminoma‘s because hyperestrogenism. What clinical pathologic abnormalities can you expect as a result of this paraneoplastic syndrome?
“Hematology, serum biochemistry panel, and urinalysis are indicated in animals with scrotal or testicular tumors. Nonregenerative anemia, leukopenia, and thrombocytopenia may be associated with hyperestrogenism and myelotoxicosis. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
How is TVT treated?
“TVTs are treated with vincristine (0.5 mg/m2 IV or 0.025 mg/kg up to 1 mg IV) weekly for 3 to 6 weeks. Alternatively, radiation therapy is effective against TVTs resistant to chemotherapy and at metastatic sites.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What CBC abnormalities are frequently associated with cardiac or splenic hemangiosarcoma?
“increased numbers of circulating nucleated red blood cells or large numbers of acanthocytes are suggestive of cardiac or splenic hemangiosarcoma. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the biological behavior of canine chemodectomas? What is the prognosis with versus without pericardiectomy?
“Chemodectomas are slow-growing tumors, and long-term palliation with pericardiectomy and primary mass excision is possible. Regardless of the presence or absence of pericardial effusion at the time of surgery, dogs with aortic body tumors survive significantly longer if a pericardiectomy is performed (median survival, 730 days) than if one is not done (median survival, 42 days).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are the two most common cardiac neoplasms in dogs?
“right atrial hemangiosarcoma and heart base chemodectoma”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are the two most common cardiac neoplasms in cats?
“Lymphosarcoma and metastatic neoplasia are the most frequent causes of cardiac neoplasia in cats.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the most common clinical consequence of chemodectomas? Is there a risk factor known to predispose a patient the development of this condition? When are these tumors typically diagnosed?
“Residence at altitude and chronic hypoxia probably increase the risk for developing these tumors. Chemodectomas can cause pericardial effusion, which probably accounts for the most common clinical presentation of this disease. However, chemodectomas just as often are an incidental finding in older dogs undergoing thoracic radiography or echocardiography for other reasons.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the reported median survival for dogs with right atrial hemangiosarcoma treated via surgery alone?
“Median survival after surgery alone is approximately 4 months.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List 8 radiographic features of appendicular osteosarcomas
“Features of an aggressive bony lesion may include one or all of the following (see Figure 21.1A–D): a
- loss of fine trabecular detail of the metaphyseal bone due to lysis, - - discontinuity of the cortex, periosteal new bone formation
- Codman’s triangle
- palisading mineralization perpendicular to the bone shaft (‘sunburst effect’)
- extension of a mass into the adjacent soft tissues
- indistinct transitional zone between tumour and normal bone
- inappropriate areas of sclerosis
- pathological fracture
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
Specificity and sensitivity of Jamshidi bone biopsy for appendicular osteosarcoma
92% specific
82% sensitive
What is the sensitivity and specificity of FNA cytology for osteosarcoma according to Britt et al 2007?
“sensitivity of 97% and a specificity of 100% in 32 of 36 cases. When a diagnosis of sarcoma was made on cytology (Figure 21.4), ALKP staining indicated OSA, with a sensitivity of 100% (Britt etal 2007).”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
What is the reported response (improved limb function) for dogs with appendicular osteosarcoma treated via radiotherapy? What is the median duration of improvement?
“Response (improvement in limb function) occurs in 75–92%, for variable durations (Green etal 2002, Ramirez etal 1999). Reported response duration ranges from 17 to 288 days (median 130 days).”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
How does chemotherapy affect the MST of patients with appendicular OSA?
“irrespective of the protocol employed, the MST remains in the order of 300–365 days with 2-year survival times at 20–25% (Berg et al, 1992 and Berg, Gebhardt, Rand, 1997, Bergman etal 1996, Chun etal 2005, Kent etal 2004, Mauldin etal 1988). ”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
Most common site of metastasis for nasal tumors
“The most common site of metastasis is the brain, followed in decreasing order of frequency by regional lymph nodes, lungs, and liver. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are the four basic radiographic projections required for the initial evaluation of nasal tumors?
“Lateral, dorsoventral, open-mouth ventrodorsal, and frontal sinus views are suggested. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What precaution regarding airways should always be observed before obtaining nasal tumor biopsies?
“Finding a mass that is not fungal (e.g., cryptococcosis) is strongly suggestive of neoplasia. Biopsies of these masses are sometimes associated with hemorrhage, and a cuffed endotracheal tube is mandatory. Bleeding typically stops within 5 minutes, but the back of the pharynx should be manually cleaned out before the endotracheal tube is removed. Rare tumors (e.g., intravascular lymphoma) can bleed so severely as to be life-threatening.”
“If the hemorrhage is worrisome, insert a nasal tampon into the affected nostril for 10 to 15 minutes. Be sure that hemorrhage has stopped before waking the patient, and clean out the pharynx before removing the endotracheal tube.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is Feline lung-digit syndrome?
Caused by primary bronchial or bronchioalveolar adenocarcinomas. Metastasis found on the distal phalanges of multiple digits and in multiple limbs, particularly weight-bearing digits.
Common clinical signs associated with pulmonary neoplasia
Non-productive cough
Lameness (HO in dogs; lung-digit syndrome in cats)
Weight loss
Hemostysis
Exercise intolerance
From a diagnostic point of view, what are the recommended diagnostic modalities to diagnose primary and metastatic neoplasia in dogs and cats?
3-view radiography (VD, LR, LL)
CT (ideal)
FNA cytology (US or CT-guided)
Recommended surgical treatment for solitary lung tumor
Lung lobectomy with lymph node biopsy
Partial lobectomy only recommended when tumor located on the periphery of the lobe.
Prognosis for primary, well-differentiated, non metastasized lung tumors in dogs Vs cats
Dogs: favorable if no LN metastasis. Two year MST 50%
Cats: poor because most tumors are aggressive. MST 150 days of already exhibiting clinical signs at the time of diagnosis Vs 500-700 days if still asymptomatic.
What is the prognosis for dogs with rib osteosarcoma following wide surgical excision and adjuvant chemotherapy.
Guarded (MST 300 days)
Prognosis for dogs with rib chondrosarcoma treated with surgery alone
Good
What is the most common SECONDARY digital tumor of cats? Prognosis?
“Aside from squamous cell carcinoma and fibrosarcoma, digital tumors in cats can also be metastatic, most commonly from pulmonary adenocarcinoma. These tumors typically involve weight-bearing digits and can involve more than one toe. Cats with digital tumors should be carefully evaluated for primary disease. Prognosis for digital tumors in cats is guarded. Median survival in cats with digital squamous cell carcinoma is 73 days, whereas cats with metastatic lesions have similarly poor survival.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Most common digital tumors of dogs and average MST
“Squamous cell carcinomas, malignant melanomas, soft tissue sarcomas, osteosarcomas, and mast cell tumors are common digital tumors. Squamous cell carcinomas, mast cell tumors, and melanomas arising in the subungual epithelium are aggressive and sometimes metastatic. Black dogs are predisposed to subungual squamous cell carcinomas. The 1-year survival rate after digital amputation varies from 45% to 100%, depending on the tumor type; digital melanomas have a median survival of 1 year.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Overall prognosis and MST for canine mammary inflammatory carcinoma
“Inflammatory carcinomas warrant a very poor prognosis, with a median survival time (MST) of 25 days with palliative care ”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
What is the percentage influence of spaying in the development of mammary neoplasia?
“The risk of developing mammary cancer if spayed prior to first heat is 0.05%, 8% after 1st, and 26% after 2nd, compared to intact dogs (Schneider etal 1969). OHE after four or more cycles or greater than 2.5 years of age has little or no protective effect on the development of malignant mammary tumours (Misdorp 1988, Schneider etal 1969)”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
Tissue origin, biological behavior and prognosis for Lymphangiosarcoma
“Lymphangiosarcomas are malignant tumors that arise from lymphatic capillaries. They are locally aggressive, and metastasis to regional lymph nodes, lungs, spleen, kidneys, and bone marrow has been reported. Even without metastasis, the local invasiveness of this tumor may necessitate amputation or euthanasia.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Origin and typical biological behavior of lymphangiomas
“Lymphangiomas are rare, nonmalignant abnormalities originating from lymphatic capillaries that present as fluid-filled spaces or masses in the skin or deeper tissues. In humans, they are generally diagnosed before the age of 2 years and are most commonly found on the head and neck. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the overall prognosis for dogs with ovarian tumors?
“The prognosis of all types of ovarian tumors is very similar. When single, nonmetastasized tumors are completely excised, the prognosis is good. Chemotherapy may lengthen survival times in canine patients with metastatic disease”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
Feline ovarian tumors - most common, typical biological behavior, prognosis
“As with dogs, feline ovarian tumors are of epithelial, germ cell, or sex cord stromal origin. Sex cord stromal tumors are most commonly reported, and more than 50% of granulosa cell tumors are malignant in cats.218,289,352 As in dogs, feline granulosa cell tumors are often large and unilateral and produce hormones. They metastasize to peritoneum, lumbar lymph nodes, omentum, diaphragm, kidney, spleen, liver, and lungs.9,154,289 Dysgerminomas constitute approximately 15% of feline ovarian tumors. They are not hormone producing and are slow to metastasize but do so in up to 33% of cases.154 Epithelial tumors are rare in cats.154,289 The prognosis in cats with ovarian tumors is unknown but is likely similar to other species.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
The reported incidence of uterine tumors among intact dogs is 0.4%. What are the most common benign and malignant uterine tumors in dogs? Approximate incidence of each and prognosis?
“The majority of canine uterine tumors are benign and of mesenchymal origin. Leiomyomas represent 90% of the mesenchymal tumors, and leiomyosarcomas represent most of the remaining 10%. Rarely, other mesenchymal or epithelial tumors are reported, including fibroma, lipoma, liposarcoma, primary lymphoma, uterine adenocarcinoma, and endometrial carcinoma.
“The prognosis for benign uterine tumors in dogs is excellent because ovariohysterectomy is curative. For malignant tumors the prognosis is good unless metastatic disease is present or the tumor is not completely excised, in which case the prognosis is grave.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
Most common uterine tumor of cats, including biological behavior and prognosis
“In contrast to those in dogs, uterine tumors in cats are generally adenocarcinomas or of endometrial origin. Benign and malignant mesenchymal and round cell tumors have also been reported.352 Clinical signs may include vaginal discharge and abnormal estrus. General signs such as polydipsia, polyuria, and vomiting have also been observed.218 Cats are more likely to have metastatic disease than dogs, and preoperative staging with thoracic radiographs and abdominal ultrasonography is indicated. Metastasis in cats has been reported to the brain, eyes, ovaries, adrenal glands, lungs, liver, kidneys, bladder, colon, diaphragm, and regional lymph nodes. Disease is often advanced at the time of diagnosis, and the prognosis in cats is guarded because of the risk for metastasis. Adjunctive treatment has not been evaluated.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
What precaution should be taken when biopsying oral masses?
“Avoid areas of superficial necrosis when obtaining biopsies; sample deeper, viable tissues instead.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Most common tonsilar tumors of dogs and cats. Response to surgical resection as sole method of treatment?
“Squamous cell carcinoma (SCC) and lymphosarcoma are the most common tumors of the tonsils, and neither are generally cured.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Most common lingual tumors of dogs (4)
“The most common lingual tumor is SCC (Fig. 18.14), but others include malignant melanoma, granular cell myeloblastoma, and mast cell tumor.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Most common salivary gland tumors of dogs and cats. Glands most commonly affected
“Neoplasms (usually adenocarcinomas or carcinomas) occur most frequently in the parotid (~50% dogs, ~20% cats) and the mandibular (~30% dogs, ~60% cats) salivary glands. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List 4 tumors frequently associated with HO
“HO can affect all four limbs. It can be a paraneoplastic syndrome (e.g., primary and metastatic lung tumors, esophageal carcinoma, rhabdomyosarcoma of the bladder, anal sac adenocarcinoma, renal transitional cell carcinoma, nephroblastoma)”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=1367916984
This material may be protected by copyright.
Prognosis for Hypertrophic Osteopathy
“The prognosis depends on the possibility for complete resolution of the underlying disease process. If the primary disease can be resolved, the secondary HO often resolves. Although clinical signs often disappear within 1 to 2 weeks after treatment, bone lesions may take months to remodel.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=1367916984
This material may be protected by copyright.
Physical examination and radiographic findings in patients with HO
“Physical Examination Findings
Affected limbs are warm and swollen. Because this condition occurs secondary to diseases elsewhere in the body, an effort should be made to identify the underlying causative factors. A thorough physical examination is essential when evaluating affected animals.
Diagnostic Imaging
Radiographs of the limbs reveal a uniform periosteal proliferation, which is seen initially on the phalanges and metacarpal and metatarsal bones (Fig. 36.3). As the disease progresses, periosteal proliferation progresses proximally (i.e., radius/ulna and tibia/fibula). Articular surfaces of long bones are usually spared and appear normal.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Craniomandibular osteopathy - most commonly affected breeds and associations
“The cause of craniomandibular osteopathy is unknown. It is most often recognized in West Highland white terriers, Cairn terriers, and Scottish terriers. A genetic predisposition is suspected in many breeds; in West Highland white terriers, it is thought to have an autosomal recessive inheritance pattern. A similar syndrome (calvarial hyperostotic syndrome) has been reported in bullmastiffs. Craniomandibular osteopathy has been associated with canine leukocyte adhesion deficiency in Irish setters. A link to canine distemper virus has been postulated but is not supported by epidemiologic studies.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Multiple cartilaginous exostosis (MCE or osteochondromatosis) - when is it typically observed in cats Vs dogs?
“Multiple cartilaginous exostosis (MCE, or osteochondromatosis) is a histologically benign disease of cats that occurs after skeletal maturity, in contrast to dogs, in which the disease occurs before growth plate closure ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
OSA accounts for what percentage of all bone tumors?
“75% of all bone tumors”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Name 4 benign bone tumors of dogs and cats
osteoma
ossifying fibroma
multilobular osteomas
Chondromas
osteochondromas
enchondromas
chondromas
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Axial OSA -
- biological behavior
- site where it tends to be less metastatic
- typical recommended therapy
- prognosis (median survival and one year MST)
- Highly metastatic, local recurrence except for mandible, which is slower to metastasize
- Local resection of tumor (i.e., mandible and rib) + Carboplatin, local radiation as adjunct to surgery to reduce local recurrence
- Median survival time is ~22 wk, 1-y survival is ~25%, rate of tumor recurrence is ~67%”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is the biological behavior, overall prognosis and recommended therapy of chondrosarcoma and fibrosarcoma?
Accounts for 5 to 10% of skeletal tumors
Slow to metastasize
Treatment typically involves amputation or limb sparing procedures. Chemotherapy (doxorubicin) may be a benefit after metastatic fibrosarcoma
Prognosis fibrosarcoma is poor, but may be fair for a low-grade tumors
Prognosis chondrosarcoma is good with surgical treatment
Most common primary bone tumor of cats, recommended therapy and prognosis
Osteosarcoma (70-80% of primary bone tumors)
Amputation
MST 12-50 months
Multiple cartilaginous exostosis (osteochondromatosis) in cats - causes, typical signalment, presentation, prognosis
Cause: Uncommon, usually feline leukemia virus (FeLV) positive (benign physeal lesion in dogs)
Presentation: Multiple sites common; scapula, vertebra, mandible in cats, (physeal in dogs). Affects adult cats (juvenile in dogs)
Treatment: Palliative removal of painful lesions
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Canine appendicular OSA - % of patients with pulmonary metastasis at diagnosis Vs at time of euthanasia at 1 year
“Although fewer than 15% of affected dogs have radiographically detectable thoracic metastases at presentation, 90% die or are euthanized within 1 year of diagnosis because of complications associated with pulmonary metastasis.4,6 Improved chances for survival are possible with amputation (see p. 1303) or limb-sparing procedures (see p. 1305) combined with chemotherapy.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Typical signalment for dogs with OSA
Large- and giant-breed dogs have the greatest incidence of appendicular bone neoplasia. The median age of dogs with osteosarcoma is 7 years; however, a small, early peak is seen in dogs 18 to 24 months of age.
Large size is a greater determinant of risk than breed, although greyhounds, Rottweilers, and Great Danes have been shown to be at increased risk.
Males may be slightly more commonly affected than females. Primary bone tumors of the axial skeleton are more common than appendicular tumors in small breed dogs; the median age of affected animals is 8 to 9 years.
The mean age of osteosarcoma in cats is 8 to 10 years.
No apparent breed or sex predilection has been identified in either species for tumors of the axial skeleton.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Common clinical presentation and sites for MCE in cats
“MCE may result in pain and rapidly progressive swelling. Common sites for MCE include the spine, scapula, and mandible.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Radiographic abnormalities associated with appendicular OSA
“Radiographic signs of osteosarcoma include cortical and trabecular bone lysis, periosteal bone proliferation, and soft tissue swelling”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What us the sensitivity of radiographs for pulmonary nodules in patients with OSA? What other diagnostic modality is considered more sensitive if available?
“Systemic staging is critical for proper decision making in animals with skeletal neoplasia. Thoracic radiography or CT is indicated. Pulmonary nodules must be 6 to 8 mm in diameter to be detected by radiography; CT is more sensitive in the detection of pulmonary disease ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Canine appendicular OSA - is regional LN sampling considered part of standard clinical staging?
“Spread to regional lymph nodes is rare, and fine-needle aspiration is not indicated unless an enlarged lymph node is recognized clinically.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List 6 differential diagnosis for suspected primary bone cancer like OSA
bacterial osteomyelitis
fungal osteomyelitis
metastatic bone tumor (e.g., prostatic carcinoma)
direct extension of soft tissue tumors (e.g., nail bed carcinomas)
hypertrophic pulmonary osteopathy
bone infarcts
hypervitaminosis A
periosteal response to trauma
aneurysmal bone cysts
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What condition is radiographically indistinguishable from OSA? What diagnostic should be performed before considering amputation?
“Perform fine-needle aspiration or another biopsy technique before amputating a leg because fungal and neoplastic lesions can be radiographically indistinguishable.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List 5 important principles pertaining to bone biopsies
• Obtain samples from the radiographic center of tumors
• Obtain multiple samples
• Take radiographs after biopsy to confirm biopsy site.
• Using Jamshidi needles may reduce the risk of pathologic fracture.
• Have pathologists with expertise in evaluating bone biopsies perform histology.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Eyelid tumors in dogs - usually malignant or benign? List 4 of the most common eyelid tumors in dogs, overall percentage of malignancies and most common types.
“Roberts etal (1986) reported that 88% of eyelid neoplasms in dogs were sebaceous tarsal gland adenomas, benign melanomas or papillomas, and that malignant tumours (melanoma, adenocarcinoma, basal cell carcinoma, mast cell tumour, squamous cell carcinoma, haemangiosarcoma and myoblastoma) comprised only 8.2%. Other malignant eyelid tumours in dogs include lymphoma (LSA) and fibrosarcoma (FSA).”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
Adrenal tumors in cats - most common clinical presentation and tumor types; prognosis (MST) with surgery is operable
Clinical signs typically derive from hyperaldosteronism, leading to severe hypokalemia and hypernatremia. Most common clinical signs include weakness, cervical ventroflexion, dysphagia, hyphema, retinal hemorrhages and blindness (due to hypertension caused by hypernatremia)
Most commonly adenomas or carcinomas
MST w/surgery for adenoma: 45 months
MST w/surgery for carcinoma: 7 months
Name five common BENIGN lip neoplasms of dogs
• benign ceruminous gland adenoma
• basal cell tumor
• hemangioma
• histiocytoma
• cornifying epithelioma.
Name four common MALIGNANT lip neoplasms of dogs
• melanoma
• quamous cell carcinoma
• mast cell tumor
• various types of sarcomas.
Oral tumors - most common epithelial (3), melanocitic (1), mesenchymal (5) and miscellaneous (3)
Epithelial: Squamous Cell Carcinoma, intraosseous carcinoma and invasive nasal carcinoma
Melanocytic: Malignant Melanoma
Mesenchymal: fibrosarcoma, hemangiosarcoma, osteosarcoma, chondrosarcoma, multilobular osteochondrosarcoma
Miscellaneous: TVT, MCT, lymphoma