Brazilian consensus for the diagnosis, treatment and prognosis of cutaneous mast cell tumors in dogs

Mast cell tumors represent the most common malignant skin tumor in the dog. This review outlines the incidence, etiology and clinical signs of mast cell tumors. Diagnostic tests, staging and treatments are also discussed. This study was performed by the Veterinary Oncology and Pathology of UNESP, Jaboticabal and the Service of Pathology Veterinary, of UNESP-Botucatu with the support of the Brazilian Association of Veterinary Oncology and the Brazilian Association of Veterinary Pathology

Effects of Heated Tumescence Solution in Bitches after Unilateral Mastectomy

Background: Mammary tumors, for which mastectomy is the main treatment, are the most common neoplasms in bitches. Mastectomy is painful and, in order to reduce the pain stimulus in the transoperative period, tumescent local anesthesia is associated with general inhalation anesthesia. However, despite the numerous benefits of tumescence, intraoperative hypothermia is the most common complication. In Medicine, especially in plastic and dermatological surgery, it is common to use a heated tumescence solution to prevent intraoperative hypothermia; however, in Veterinary medicine, no previous study has examined the advantages and disadvantages of using heated tumescence solution. Thus, this study aimed to investigate the transanesthetic cardiorespiratory effects of heated tumescence solution in bitches submitted to radical unilateral mastectomy.Materials, Methods & Results: Eight animals were treated with 0.1% lidocaine solution, warmed to 37-42°C, using a Klein’s cannula for administration. Chlorpromazine (0.3 mg/kg) and meperidine (3 mg/kg) were used as pre-anesthetic medication intramuscularly, and induction was performed with intravenous propofol and maintenance with isoflurane. The data collection times were as follows: 15 min after starting isoflurane administration (M1), 5 min after tumescence (M2), after beginning of surgical incision (M3), during breast pullout (M4), after clamping of the superficial caudal epigastric vein, and artery (M5), after the beginning of the approximation of the subcutaneous tissue (M6), after the beginning of the intradermal suture (M7), and at the end of the surgical procedure (Mfinal). The heart (HR) and respiratory (ƒ) rates, mean arterial pressure (MAP), end-tidal CO2 concentration (EtCO2), expired isoflurane concentration (EtISO), and rectal temperature (RT) were measured. The HR, ƒ, and EtCO2levels did not differ statistically. The mean EtISO presented in M2 (1.16 ± 0.41) was significantly lower than that in M3 (1.39 ± 0.40) and M4 (1.49 ± 0.49).Discussion: In the HR analysis, it was found that during all evaluation moments, the means remained within the reference range for the species. Moreover, the values during the breast pullout (M4) did not exceed 20% of those presented minutes before the beginning of the surgery (M2), which was indicative of analgesic rescue, suggesting that the animals did not experience pain. Hypoventilation resulted in an increase in EtCO2 values. Thus, it can be said that in this study, there was no respiratory depression during the transoperative period, as the values of the variables ƒ and EtCO2 were within the reference for the species. With regard to the EtISO variable, there was no reduction in the MAC of isoflurane with the use of heated tumescence solution, as reported by some authors (EtISO 0.8%). However, the EtISO values presented here are close to those found in the literature during breast pullout (EtISO between 1.3% and 1.52%), with the use of refrigerated tumescence solution. In addition, the values shown in M4 are within the equivalent of 1 MAC (1.41%) of isoflurane, proving that heated tumescent local anesthesia is a safe technique and an excellent adjunct to inhalation anesthesia, as it provides intraoperative analgesia. Therefore, heated tumescence solution is safe and an excellent adjuvant in general inhalational anesthesia for radical unilateral mastectomy as it did not increase inhaled anesthetic consumption during surgery.Keywords: tumescent local anesthesia, lidocaine, dogs, inhalation anesthesia, mammary tumors

Digital Measurement of the Diameter of the Collagen Fibers by Transmission Electron Microscopy for Diagnosis of Ehlers-Danlos Syndrome-Like in Small Animals

Background: Ehlers-Danlos-Like Syndrome (EDS) is a rare disease in small animals, whose diagnosis is based on the clinical findings and histopathological examination. The definitive diagnosis may require transmission electron microscopy. Despite this, the ultrastructural changes are poorly described in the literature. The aim of the present study is to describe the ultrastructural findings of collagen fibers and fibroblasts present in the dermis of two animals with EDS, and to evaluate the digital measurement of the diameter of the collagen fibers by transmission electron microscopic images.Cases: Two animals were evaluated with EDS by transmission electron microscopy. The first animal was an 1-year-old mixed breed female cat, due to spontaneous skin laceration, increased skin elasticity and an extensibility index corresponding to 25%. The second animal evaluated was a 5-month-old Golden Retriever female dog due to articular hypermobility, increased skin elasticity and an extensibility index corresponding to 16.6%. After a skin biopsy of the interscapular and lumbar regions, the samples were fixed in formalin 10% and glutaraldehyde for, respectively, histopathological examination by HE staining, and transmission electron microscopy. The histopathology of the affected cat revealed collagen fibers shortened and sometimes fragmented. The histopathology of the affected dog revealed disarranged and more eosinophilic staining collagen fibers. The collagen fibers were also of unequal sizes, shortened and slightly undulate. At the transmission electron microscopy of the affected cat was evidenced a greater spacing of the collagen fibers of variable diameters. Further this, the fibroblasts showed elongated nuclei with heterochromatic regions, which was surrounded externally by scant cytoplasm. The cytoplasm showed elongated and discrete organelles. At the transmission electron microscopy of the affected dog was evidenced a greater spacing of the collagen fibers of variable diameters. Further this, fibroblasts exhibited intense cytoplasmic vacuolization with similar appearance to that found in the dying process by autophagy. In addition, the images obtained by transmission electron microscopy were submitted to digital analysis to measure the diameter of the collagen fibers using the software Image J. For this purpose, it was obtained the average of the diameter of 10 collagen fibers in cross-section into four quadrants of 1μm each. The digital analysis of collagen fibers revealed significant alterations in the ultrastructure of collagen. In addition, it was verified cellular changes, such as the large amount of intracytoplasmic vesicles and the small amount of collagen fibers dispersed around the cells.Discussion: Microscopic abnormalities visualized by HE staining in this present study were compatible with the literature Transmission electron microscopy is fundamental to confirm the suspicion, since it revealed dermal alterations in the ultrastructure of collagen and fibroblasts. These findings indicate possible failure mechanisms of secretion and release of cellular products, as well as collagen. The digital measurement of the diameter of the collagen fibers contributed to the confirmation of the disease, since it was made randomly and reduced the subjectivity inherent of the evaluator. However, there are no studies using this method to allocate a range of significance for the diameter of collagen fibers that may be considered suggestive for the syndrome in small animals

Perfil epidemiológico e clínico de pacientes internados na UTI com COVD-19 em hospital de referência do Centro-Oeste em 2020 e 2021

A pandemia da COVID-19, causada pela ampla disseminação a nível global pelo Sars-cov 2, foi inicialmente relatada em Wuhan, China, em 2019. Esta doença está associada ao desenvolvimento de distúrbios respiratórios, sendo estes os principais motivos da grande mortalidade, os quais puderam ser vistos com grande frequência nas unidades de terapia intensiva (UTI). O cenário da pandemia da COVID-19 foi um acometimento recente, por isso há uma limitação de estudos, devido a carência de informações nos prontuários e heterogeneidade do perfil clínico dos pacientes. Dessa forma, esse trabalho tem como objetivo: Identificar dados epidemiológicos e clínicos dos pacientes internados na Unidade de Terapia Intensiva (UTI) com COVID-19 em hospital de referência do Centro-Oeste: 2020 e 2021. Sendo assim, o seguinte trabalho trata-se de um estudo epidemiológico do tipo descritivo, observacional, transversal e retrospectivo, o qual será realizado no Hospital Albert Einstein, em Goiânia - GO, através da análise de prontuários eletrônicos de pacientes internados na UTI com COVID-19 em 2020-2021. Portanto, por meio deste artigo, espera-se obter dados relevantes sobre a eficácia de tratamentos, a identificação de fatores de risco, o monitoramento e a progressão de pacientes com COVID-19 internados no hospital de referência em Goiânia, a fim de impulsionar novos estudos sobre a doença e contribuir para o aprimoramento de diretrizes de tratamento da mencionada doença

Micropapillary carcinoma in a dog: case report

Mammary neoplasms in female dogs present a high incidence. Several histological types are observed, among them, micropapillary carcinoma is considered one of the most aggressive because it is related to vascular invasion, metastases and low survival time. Aimed to describe a case of micropapillary breast carcinoma, with cutaneous metastasis, in a dog. A canine, female, 14 years old, 8kg, not defined breed, uncastrated, nulliparous, with pseudocyesis and no contraceptives administration history was attended at the Veterinary Reproduction and Obstetrics Service from "Governador Laudo Natel” Hospital, FCAV, UNESP, Jaboticabal, presenting a breast ulcerated nodule, with one month estimated evolution. After stabilization and preoperative exams, radical unilateral mastectomy and ipsilateral axillary and inguinal lymphadenectomy were performed. Histopathologic diagnosis revealed micropapillary carcinoma and free surgical margins from neoplasm, however, there were metastasis in both lymph nodes. The tutors did not adhere to antineoplastic chemotherapy. In 60th post-surgical day, there was inflammatory reaction in the surgical scar region, with small cutaneous ulceration, where the elastogram  revealed  rigidity and shear velocity of 7.84m/s. Skin biopsy revealed metastasis of micropapillary breast carcinoma. There was progression of ulcerations, compromising animal’s welfare and its physiological activities, when on the 110th post-surgical day, it was decided to euthanize the patient.  The correct diagnosis and knowledge of tumor biological behavior are importants points to choose the correct treatment. The adjuvant chemotherapy treatment can impact on average survival time and ARFI elastography is an accurate predictor of rapid and non-invasive diagnosis of micropapillary carcinoma recurrence.Mammary neoplasms in female dogs have a high incidence. Among the several histological types observed, micropapillary carcinoma is considered one of the most aggressive due to vascular invasion, metastases, and short survival time. The present objective was to describe a case of mammary gland micropapillary carcinoma, with cutaneous metastasis, in a dog. A 14-year-old intact nulliparous mixed-breed bitch, weighing 8kg, with a history of pseudocyesis and no history of contraceptive administration, presented to the Veterinary Reproduction and Obstetrics Service from "Governador Laudo Natel” Hospital, FCAV, UNESP, Jaboticabal, with an ulcerated nodule in the mammary gland for approximately one month. After stabilization of clinical parameters and preoperative exams, a radical unilateral mastectomy and ipsilateral axillary and inguinal lymphadenectomy were performed. Histopathology revealed micropapillary carcinoma with clear surgical margins, however, there were metastases in both lymph nodes. Antineoplastic chemotherapy was refused by the owners. On the 60th day after surgery, there was an inflammatory reaction in the surgical scar region, with a small cutaneous ulceration, where elastography showed rigidity and shear velocity of 7.84m/s. Skin biopsy revealed metastasis of the micropapillary carcinoma. Even with continued treatment since the patient was first examined, the ulcerations progressed, compromising the animal’s welfare and physiological activities, and on the 110th day after surgery, euthanasia was decided on. A correct diagnosis and knowledge of tumor biological behavior are important points for choosing the correct treatment. Acoustic Radiation Force Image (ARFI) elastography has been shown to be a fast and non-invasive diagnostic method for detection of recurrent micropapillary carcinoma

Diagnosis, Prognosis and Treatment of Canine Cutaneous and Subcutaneous Mast Cell Tumors

Mast cell tumors (MCTs) are hematopoietic neoplasms composed of mast cells. It is highly common in dogs and is extremely important in the veterinary oncology field. It represents the third most common tumor subtype, and is the most common malignant skin tumor in dogs, corresponding to 11% of skin cancer cases. The objective of this critical review was to present the report of the 2nd Consensus meeting on the Diagnosis, Prognosis, and Treatment of Canine Cutaneous and Subcutaneous Mast Cell Tumors, which was organized by the Brazilian Association of Veterinary Oncology (ABROVET) in August 2021. The most recent information on cutaneous and subcutaneous mast cell tumors in dogs is presented and discussed

Aspectos clinico-epidemiológicos das neoplasias mamárias em cadelas atendidas pela UNESP - Câmpus de Jaboticabal

Estudos clinico-epidemiológicos reúnem informações importantes a respeito do comportamento de uma doença e do conhecimento e postura dos tutores em relação à essa doença, desta forma, revelam a realidade de uma região em um determinado período. Em cadelas, as neoplasias mamárias são as mais frequentes, sendo prevenidas pela realização da castração precoce. A proposta deste trabalho foi avaliar os aspectos clínicos e epidemiológicos das cadelas com tumor de mama. Foram obtidos dados clínicos e epidemiológicos de 54 pacientes mediante questionário aplicado aos tutores e, adicionalmente, foram analisados os laudos histopatológicos. Das 54 pacientes selecionadas foram identificadas 21 raças, sendo o SRD foi prevalente (29,63%), a idade média foi de 10,3 anos, a maioria das pacientes (68,52%) não foi submetida à ovariohisterectomia, e as que foram (31,48%), foram realizadas após 2,5 anos de idade. O tempo médio de evolução da doença foi de 12 meses. Das pacientes, 44 (81,48%) apresentavam lesões múltiplas, em 38 (70,37%) acometiam ambas as cadeias mamárias. Foram analisadas 163 lesões, sendo 84 (51,53%) localizados na cadeia mamária esquerda, e, a mama mais acometida foi a mama inguinal (34,97%). Das 163 lesões analisadas 21 (12,88%) eram lesões não neoplásicas, 21 (12,88%) eram lesões benignas e 121 (74,24%) eram lesões malignas, e, a maioria (78,53%) era de tamanho menor que 3 cm. Das lesões classificadas em grau tumoral, 49 (56,98%) foram classificadas em grau 1, 29 (33,72%) em grau 2 e 8 (9,3%) em grau 3. Foram identificados 24 tipos histológicos distintos. Das pacientes estudadas 13 (24,07%) apresentaram metástase em linfonodos regionais (inguinal e/ou axilar). Conclui-se que as cadelas não castradas até 2,5 anos de idade, com cio irregular e que apresentaram pseudogestação pertencem ao grupo de risco para desenvolvimento de tumor mamário. No Brasil, a taxa de malignidade das neoplasias mamárias é superior quando comparadas às descritas internacionalmente. Há necessidade de padronização da técnica cirúrgica de mastectomia com recomendação de retirada com ampla margem de segurança e dos linfonodos regionais.clinical and epidemiological studies gather important information about the behavior of a disease and the knowledge and posture of the tutors in relation to this disease, thus, they reveal the reality of a region in a determinated period. In bitches, the most frequent neoplastic process is the breast tumor that can be prevented through the execution of early neutering (before two and a half years old). The purpose of this study was to evaluate the clinical and epidemiological aspects of female dogs with breast tumor. It was obtained clinical and epidemiological data from 54 patients through a questionnaire applied to tutors and in addiction histopathological reports were analyzed. We selected 54 patients, 21 races were identified, the prevalent was mixed breed (29.63%), the average age was 10.3 years, the majority (68.52%) was not submitted to spaying and the other (31.48%) the procedure was performed after 2.5 years of age. The average time of disease the evolution was 12 months. From the total of 54 patients, 44 (81.48%) had multiple lesions, in 38 (70.37%) both mamary chains were affected. We analyzed 163 lesions and 84 (51.53%) were located in the left mammary chain and the most affected breast was the inguinal breast (34.97%). We identified 21 (12,88%) non pre-neoplasic lesions, the same rate for benign lesions, 121 (74.24%) were malignant lesions, and the majority of the tumors had less than 3 cm (78.53%). The lesions that were classified by the tumor grade, 49 (56.98%) were classified as grade 1, 29 (33.72%) grade 2 and 8 (9.3%) grade 3. In our study it was identified 24 distinct histological types. From all the patients of this study, 13 (24.07%) had metastases in the regional lymph nodes (inguinal and / or axillary). We conclude that bitches not spayed to 2,5 years old, with irregular estrus and pseudopregnancy belong to the risk group for breast tumor development. In Brazil, the rate of malignancy of breast cancer is higher when compared to those described internationally. There is a need to standardize the surgical technique of mastectomy with recommendation of removal with wide safety margins and regional lymph nodes.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

CD34 immunoexpression in canine skin follicular tumors and basal cell carcinomas: case series report

Back ground: Basal cell carcinomas and follicular tumors are relatively common skin neoplasms both in veterinary and human medicine. Currently, it is believed that stem cells are important for skin tumor development. Hypothesis/objective: the objective of the study was to characterize CD34 expression in canine follicular tumors and basal cell carcinoma in order to investigate the possible role of these cells in skin tumorigenesis. Animals & Methods: eleven skin tumors including basal cell carcinomas and follicular tumors were submitted to immunohistochemistry using the stem cell marker CD34. Results: CD34 labelling was characterized by a fine, granular and diffuses brown cytoplasmic staining both in control (endothelial cells) and neoplastic cells. Two BCC and one trichoepithelioma displayed positive neoplastic cells and/or fibroblast-like stromal cells. Conclusion: preliminary results described here should be confirmed by large scale studies in order to clarify the potential role of stem cells on human and canine skin tumors

Brazilian consensus for the diagnosis, treatment and prognosis of cutaneous mast cell tumors in dogs

Mast cell tumors represent the most common malignant skin tumor in the dog. This review outlines the incidence, etiology and clinical signs of mast cell tumors. Diagnostic tests, staging and treatments are also discussed. This study was performed by the Veterinary Oncology and Pathology of UNESP, Jaboticabal and the Service of Pathology Veterinary, of UNESP-Botucatu with the support of the Brazilian Association of Veterinary Oncology and the Brazilian Association of Veterinary Pathology