Oncology in senior animals. With clinical cases

BROCHURE Juan Carlos Cartagena Albertus Adriรกn Romairone Duarte

ONCOLOGY

in senior animals WITH CLINICAL CASES Juan Carlos Cartagena Albertus Adriรกn Romairone Duarte

ONCOLOGY in senior animals

9.00

PRESENTATION

US$84.99

ยฃ63.99

Juan Carlos Cartagena Albertus Adrián Romairone Duarte

While neoplastic processes can affect animals of any age, the risk is higher in senior animals. The purpose of this book is to review the most commonly diagnosed neoplasms in senior animals. After some general considerations on senior oncology, such as the specific characteristics of senior patients in the oncology consultation and paraneoplastic syndromes, the book describes in a detailed and practical manner the most common neoplasms in senior animals, arranged by systems.

Numerous images are included which reflect the authors’ extensive clinical experience. The last chapter features case studies showing some of the tumours most commonly seen in older cats and dogs.

Oncology in senior animals With clinical cases US$84.99

in senior animals WITH CLINICAL CASES Juan Carlos Cartagena Albertus Adrián Romairone Duarte

ONCOLOGY in senior animals

€69.00

ONCOLOGY

£63.99

PY091804_Oncology_senior_animals_cover_EDRA.indd Todas las páginas

The book Oncology in senior animals shows the neoplasms most commonly diagnosed in animals in the senior age range and describes their most common clinical signs, diagnostic approach, prognosis and treatment. It includes clinical cases.

eBook

available

20/9/19 8:31

TARGET AUDIENCE: RETAIL PRICE ✱✱ Small animal vets.

Oncology ✱✱ Veterinary students FORMAT: 22 × 28 cm NUMBER OF PAGES: 160 NUMBER OF IMAGES: 300 BINDING: hardcover ISBN: 978-84-17640-70-5

69 €

Authors JUAN CARLOS CARTAGENA ALBERTUS Veterinary surgeon at Broadway Veterinary Hospital in Peterborough, UK. Certified in oncology and soft tissue surgery by the Spanish Small Animal Veterinary Association. Postgraduate Certificate in Advanced Veterinary Practice (PgC Cert. AVP) from the Royal College of Veterinary Surgeons.

ADRIÁN ROMAIRONE DUARTE PhD in veterinary medicine from the University of León, Spain. Owner of Centro de Diagnóstico Veterinario, a clinic that specialises in the diagnosis of pets and birds of prey.

KEY FEATURES:

➜➜ C omprehensive review of the most common neoplasms in senior cats and dogs. ➜➜ Includes practical information about how to diagnose neoplasms and treat them in this age range. ➜➜ Written from the point of view of a specialist in oncology and a first-opinion veterinary surgeon.

Susan Schmitz/shutterstock.com

Oncology in senior animals

Presentation of the book Society is evolving towards a better understanding of diseases, and pathologies that used to be associated with death, such as cancer, are viewed in a less negative manner.

As occurs with people, this new attitude towards cancer can be seen in the veterinary practice, with owners who understand that neoplastic diseases must be diagnosed and treated to improve their pets’ quality of life.

The increase in the life expectancy of cats and dogs, thanks to better nutrition, routine health checks and cutting edge veterinary medicine, has contributed to a growing population of senior pets, and to the need for better diagnostic and treatment protocols in this age range.

Although cancer is not exclusive to older organisms, it can be said that senior animals are the group with the highest risk of developing all types of neoplasms.

This book on oncology in senior animals is an initiative to describe, in an educational manner, the clinical signs, prognosis and treatment of the most common tumours in older animals, from the point of view of a specialist in oncology and a first-opinion veterinary surgeon.

The authors Juan Carlos Cartagena Albertus Juan Carlos Cartagena Albertus graduated from the University of Zaragoza in 1987. He is a member of the Royal College of Veterinary Surgeons (RCVS), holds a Master of Science (MSc), and is certified in oncology and soft tissue surgery by the Spanish Small Animal Veterinary Association (AVEPA). He also holds a University Master in Veterinary Practice & Therapeutic Investigation, a General Practitioner Certificate (GP Cert.) in Ophthalmology, and a Postgraduate Certificate in Advanced Veterinary Practice (PgC Cert. AVP) from the Royal College of Veterinary Surgeons. He earned recognition as a university specialist in endoscopy and minimally invasive surgery from the University of Extremadura (Spain).

He is also a member of the European Society of Veterinary Oncology (ESVONC) and the AVEPA Oncology and Soft Tissue Surgery working groups.

He works at Broadway Veterinary Hospital in Peterborough, Cambridgeshire (UK).

Oncology in senior animals

Adriรกn Romairone Duarte Adriรกn Romairone Duarte graduated in veterinary medicine in 1987 from the General Pico Faculty of Veterinary Sciences at the National University of La Pampa in Argentina. His degree was recognized as equivalent to the Spanish Degree in Veterinary Medicine by the Spanish Ministry of Education and Sciences in 1990. He holds a diploma in advanced studies from the University of Leรณn (2007) and obtained his PhD from the same university in 2016.

He has worked as a veterinary surgeon since 1987. He is the owner of Centro de Diagnรณstico Veterinario, a clinic that specialises in the diagnosis of pets and birds of prey. He is also the owner and editor of the website www.diagnosticoveterinario.com.

His areas of interest include clinical oncology, diagnostic cytology, oncologic, trauma, and soft tissue surgery, and medical and surgical pathology applied to birds of prey in the wild and captivity (e.g., birds of falconry).

hkeita/shutterstock.com

He is particularly interested in necropsy as a tool for diagnosing common diseases in birds of prey and in forensic investigations of anthropogenic causes of death in these animals.

Table of contents 1. General aspects of senior oncology General aspects of senior oncology Oncology in senior animals Paraneoplastic syndromes

2. Most common neoplasms in senior oncology Cutaneous tumours Introduction Assessing a cutaneous tumour Most common cutaneous tumours

Digestive tumours in senior patients Oral tumours Gastrointestinal tumours

Eyelid and orbital tumours Introduction Eyelid tumours in senior dogs and cats Orbital tumours in senior dogs and cats

Musculoskeletal tumours in senior patients Osteosarcoma Soft tissue sarcomas

Haemolymphatic system tumours in senior patients Introduction Canine lymphoma Leukaemia Feline leukaemia

3. Common clinical cases in senior oncology Common clinical cases in senior oncology Anaemia due to hyperoestrogenism caused by a tumour Squamous cell carcinoma in senior cats Vaginal polyps in senior patients Oral canine melanoma Eyelid mast cell tumour in a cat Nasal lymphoma in a cat Mediastinal lymphoma in a cat

References

Plaza Antonio Beltrán Martínez, 1 Centro Empresarial El Trovador planta 8, oficina 50002 Zaragoza, España

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+34 976 461 480

ONCOLOGY

in senior animals WITH CLINICAL CASES Juan Carlos Cartagena Albertus Adriรกn Romairone Duarte

ONCOLOGY IN SENIOR ANIMALS

a

Figure 38. Histiocytoma on the side of the lip of a middle-aged French Bulldog.

b

Figure 39. Histiocytoma on the nasal plane of a senior dog. The ulceration suggested a poor prognosis, but it turned out to be due to continuous friction with the muzzle.

Figure 41. Plasmacytoma in the chin area adjacent to the labial mucosa (a). Lesion seen from the front (b).

Figure 40. Histiocytoma on the lateral aspect of the tarsal joint subsequently resolved by surgery.

Figure 42. Plasmacytoma on the paw, adjacent to the metacarpal pad.

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MOST COMMON NEOPLASMS iN SENiOr PATiENTS

02

Metastasis is uncommon. On rare occasions, cutaneous plasmacytoma occurs in association with multiple myeloma, and it can even precede the onset of the myeloma (Rakich, 1989).

It accounts for a low proportion of cutaneous tumours in dogs and is very rare in cats.

Fibrovascular papillomas

Figure 43. Plasmacytoma on the neck of a dog.

Figure 44. Plasmacytoma on the base of the tail of a senior tricolour Cocker spaniel.

Fibrovascular papillomas are epithelial outgrowths characterised by irregular epidermal hyperplasia and signs of papillomatosis. They grow slowly and show no signs of aggressiveness.

They are benign tumours that generally affect elderly patients. They are not clinically relevant unless pedunculated, as this is when they can tear at their site of attachment to the skin or get caught in something, causing abundant bleeding.

Large breeds are predisposed to fibrovascular papillomas, particularly in areas of the body prone to pressure injury, such as bony prominences (elbow, chest, and hip) (Figs. 45 and 46).

Papillomas can be filiform, pedunculated, smooth, alopecic, or hyperkeratotic (Figs. 47 and 48).

They normally present as solitary nodules, but multiple nodules affecting different parts of the body may be seen.

They do not require aggressive or immediate treatment, unless they bleed or become ulcerated or are considered aesthetically displeasing by the owner. They can be removed by conventional surgery, an electric scalpel, cryosurgery, or laser surgery.

Basal cell carcinoma

Figure 45. Fibrovascular papilloma on the lateral aspect of the elbow of a male 10-year-old Mastiff.

Basal cell carcinoma (BCC) originates from basal cells in the epidermis and skin adnexa, such as hair follicles, sebaceous glands, and sweat glands (Medleau and Hnilica, 2007). They are uncommon, particularly in cats, and can affect animals of any age, even though they are more common in senior pets (Fig. 49). The mean age of onset for dogs and cats is 7–10 years.

BCCs are slow-growing and have a low potential for malignancy. It is not known what causes them, but based on experience with humans, there is probably some link to exposure to UV light, like in SCC. BCC affects males and females alike, and appears to be more common in certain breeds, such as Cocker Spaniels, Poodles, and Siberian Huskies.

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ONCOLOGY IN SENIOR ANIMALS

Figure 17. X-ray of an early-stage osteosarcoma.

Note the typical periosteal reaction (Codman triangle) and the incipient cortical osteolysis.

TABLE 1. Chemotherapy agents used in dogs with appendicular osteosarcoma (Morello et al., 2011).

Mean overall survival (days)

Survival at 1 year (%)

Survival at 2 years (%)

Thompson and Fugent, 1991

290

33

NR

Shapiro et al.,1988

301

NR

NR

Straw et al., 1991

262

38

18

Kraegel et al., 1991

413

62

NR

Berg et al., 1992

325

45.5

20.9

Chun et al., 2005

300

NR

NR

Mauldin et al., 1988

300

36.8

26.3

Berg et al., 1997

345

48

28

Berg et al., 1995

366

50.5

9.7

Moore et al., 2007

240

35

17

Bergman et al., 1996

321

35.4

NR

Phillips et al., 2009

307

36.8

18.7

Bacon et al., 2008

258

NR

NR

Bailey et al., 2003

235

NR

NR

Kent et al., 2004

320

48

18

Carboplatin + doxorubicin + piroxicam

Langova et al., 2004

450

NR

NR

Lobaplatin

Kirpensteijn et al., 2002

NR

31

NR

Drug

Cisplatin

Cisplatin and doxorubicin

Doxorubicin

Carboplatin

Carboplatin + doxorubicin

Study

NR, not recorded.

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MOST COMMON NEOPLASMS iN SENiOr PATiENTS

Bisphosphonates Osteoclast activity is responsible for the characteristic bone destruction (and pain) seen in osteosarcoma. Bis­ phosphonates regulate osteoclast activity and are very useful palliative agents for osteosarcoma. Their clini­ cal indications include treatment of malignant hyper­ calcaemia, control of bone metastases, and pain relief.

The most widely used bisphosphonates are zoledronic acid, pamidronate, and alendronate.

Wouda et al. (2018) described the benefits of combining short-term toceranib and carboplatin in different tumours, including canine osteosarcoma. This combination would appear to have significant potential in this setting.

Liptak et al. (2004), in turn, proposed combining metronomic chemotherapy with doxycycline, piroxicam, and cyclophosphamide to treat patients with multiple metastases or patients unable to undergo surgery.

Finally, immunotherapy (vaccines) is an emerging field that is opening the door to treatments with good safety profiles and very promising outcomes for osteosarcoma and other devastating tumours such as malignant melanoma.

Role of the c-kit receptor and tyrosine kinase inhibitors The c-kit receptor, a transmembrane protein with tyrosine kinase activity, appears to play a very important role in multiple physiological processes, such as haematopoiesis, fertility, pigmentation, and intestinal motility. There is also evidence that it is involved in allergic diseases and cancer.

In humans, the c-kit receptor has been linked to gastrointestinal stromal tumours, testicular tumours, lung cancer, acute myeloid leukaemia, and mast cell tumour. In veterinary medicine, its oncogenic role has been demonstrated for mast cell tumours.

Little is known on the expression profile of this protein in canine or feline osteosarcoma. Wolfesberger et al. (2016) investigated differences in expression levels in the tissue of osteosarcomas and normal healthy bone, and also analysed whether these levels differed between dogs and cats, as the tumour follows a different clinical course in both animals.

Their findings indicated that canine osteosarcoma could be

02

added to the list of c-kit-positive tumours. This was not the case for feline osteosarcoma, however, as none of the tumours showed positive immunohistochemical staining for c-kit.

Tyrosine kinase inhibitors are a very promising treatment option for canine osteosarcoma. The best-known agents are masitinib and toceranib and they are the only inhibitors currently authorised for the treatment of canine mast cell tumour.

Because both drugs inhibit multiple tyrosine kinase receptors (like c-kit), they target key factors involved in tumour cell growth and survival.

The fact that most of the canine osteosarcomas yet none of the feline osteosarcomas expressed c-kit in the study by Wolfesberger et al. could be because so few feline tumours were available for study. Nevertheless, it is also possible that c-kit expression could contribute to the greater malignancy of canine osteosarcoma, which has a much worse prognosis than its feline counterpart.

Finally, the failure to detect c-kit expression in normal bone cells in both dogs and cats also suggests that this protein has a pathogenic role.

Immunotherapy in canine osteosarcoma Data from populations of dogs with osteosarcoma suggest genetics and altered bone metabolism as risk factors. Standard treatment options include amputation, chemotherapy, radiation therapy, and control of metastases from the primary tumour. None of these treatments are curative, possibly because the tumour cells are resistant or because there are undetected metastases (Fan, 2016).

New treatments for canine osteosarcoma target the activation of the immune system, and in particular the detection and destruction of tumour cells.

Immunotherapy is designed to induce, boost, or modulate the immune system. There are two types: passive and active.

■ Passive immunotherapy consists of administering immune system components, such as antibodies, complement, and cytokines. These components are produced in vitro and are administered in the hope of stimulating an antitumour response in the patient.

■ Active immunotherapy, by contrast, seeks to stimulate intrinsic responses using vaccines, activated dendritic cells, or low-molecular-weight immune response modifiers.

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ONCOLOGY IN SENIOR ANIMALS

Eyelid mast cell tumour in a cat Clinical history The patient was a 14-year-old castrated domestic shorthair cat called Fifi. Her owners had brought her in because they had noticed a nodular mass on the lower eyelid. The mass was slightly pink, well delimited, and showed a tendency towards alopecia (Fig. 1).

Clinical examination No complications were observed in the anterior segment of the eye during the examination. The owners reported no history of fights or trauma.

Diagnostic tests A preliminary diagnosis of mast cell tumour was made based on the gross appearance of the tumour. The Darier sign was positive (localised swelling due to compression). A fine-needle aspiration biopsy specimen was collected for cytology.

Fast-acting corticosteroids (methylprednisolone) may be necessary to reduce the local reaction and prevent a generalised response in the case of nodules with a strongly positive Darier sign.

Diagnosis Cytology showed round cells containing abundant granules. This, combined with the previous clinical observations, strongly suggested a mast cell tumour. This diagnosis was subsequently confirmed by histology.

Cytology findings are, per se, important but they can also help to plan surgery as a simple nodulectomy could leave positive margins.

a

b

Figure 1. Patient during initial evaluation (a). Detail of lesion showing its extension and characteristics (b).

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The publishing strength of Grupo AsĂ­s Grupo AsĂ­s, with its imprints Servet and Edra, has become one of the reference publishing companies in the veterinary sector worldwide. More than 15 years of experience in the publishing of contents about veterinary medicine guarantees the quality of its work. With a widenational and international distribution, the books in its catalogue are present in many different countries and have been translated into nine languages to date: English, French, Portuguese, German, Italian, Turkish, Japanese, Russian and Chinese.

Its identifying characteristic is a large multidisciplinary team formed by doctors and graduates in Veterinary Medicine and Fine Arts, and specialised designers with a great knowledge of the sector in which they work. Every book is subject to thorough technical and linguistic reviews and analyses, which allow the creation of works with a unique design and excellent contents.

Grupo AsĂ­s works with the most renowned national and international authors to include the topics most demanded by veterinary surgeons in its catalogue. In addition to its own works, Servet also prepares books for companies and the main multinational companies in the sector are among its clients.

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