Paraneoplasitc Syndromes Flashcards
Paraneoplastic syndroms alteration in
Structure / function occurring distant to the tumor
Causes of paraneoplastic syndrome
Production of small molecules released into circulation and immune cross reactivity between malignant and normal tissues
How do you treat PNS
Treat tumor
Hypercalcemia value
iCal > 1.6
Most common paraneoplastic syndrome
Hypercalcemia
Hypercalcemia of malignancy is less common in
Cats
Tumor associated with hypercalcemia of malignancy in dogs
lymphoma
Tumors associated with hypercalcemia of malignancy in feline
Lymphoma
Malignancy panel can diagnose
Hyperparathyroidism
Abscess of PTHrP does not mean
Pet is cancer free
2/3 dog with high calcium are diagnoses with
Cancer
Consider hospitalization when
Ionized calcium is greater than 1.8, Ca x Phos > 70, clinical signs - azotemia and dehydration
Rehydration does with hypercalcemia with
0.9 % NaCl
Rehydration does with hypercalcemia with
0.9 % NaCl
How do you treat hypercalcemia once rehydrated
Furosemide
After using furosemide what can be used in treatment
Biphosphates
Biphosophonates
Inhibit osteoclasts - Zoledronate
Causes of feline hypercalcemia
SHIRT
Shirt
Spurious, hyperparathyroidism, idiopathic, renal disease, tumors
c/s hypercalcemia
Vomiting, lethargy, anorexia, Melena
Lab findings with hypercalcemia
Anemia, increased BUN, decreased Albumin
What causes GI ulceration from hypercalcemia
Mast celll degranulation leads to excess histamine
How do you treat GI ulceration from hypercalcemia
Treat tumor, omperazole, ,sucralfate
Hyperviscocity syndrome
Increase blood components - increase blood viscosity
HVS causes
End organ damage
What organs are affected by HVS
Brain, arteries, retina, kidney, heart
Multiple myeloma
Cancer of plasma cells that make excess Ig
What are the TP and globulin in multiple myeloma
Increase TP and increase globulin
Clinical signs of multiple myeloma
Lameness, epitaxy’s, PU/PD, neuro, cytopenias, increased calcium
Need what for myeloma diagnosis
2/4
M LOM
Monoclonal gammopathy, light chains, osteoblasts, marrow Plasmacytosis
Monoclonal gammopathy
Increase globulins and spe
Light chains significance in myeloma
Spill over into urine, not detected on dipstick
Osteolysis significance in myeloma
Punched out lesions or osteopenia and rare in cats
Marrow significance with myeloma
Marrow plasmacytosis - rare in cats
Hyperestrogenism causes
Bone marrow hypoplasia, alopecia and feminization syndrome
What can cause hyperestrogenism
Serotolli cell tumor and cryptorchism
10% of dogs with malignant tumors have
DIC
What is the most common tumor causing DIC
Hemangiosarcoma
Myasthenia gravis
Antibodies to AChR block transmission at NM junction
Myasthenia Gravis is associated with
Thymoma
C/s of myasthenia gravis
Intermittent muscle weakness, exercise intolerance, regurgitation, megaesophagus, Dysphagia
Thymoma is more common in
Older dogs and cats
Thymoma
Cranial mediastinal mass
Do Thymoma usually spread
No
TX of Thymoma
Surgical removal, radiation, cholinestrase inhibitor
Hypertrophic osteopathy
Overproduction of periosteum
Hypertrophic osteopathy preferentially affect
Long bones
How do you DX hypertrophic osteopathy
Radiographs, nodular, radiating 90 degree from long axis of affected bone
Hypertrophic osteopathy cause neoplasia
Primary lung tumor or pulmonary metastasis
How do you treat hypertrophic osteopathy
Remove underlying, multimodal pain control, euthansia