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Patients with neoplastic disease

image of Patients with neoplastic disease
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Abstract

The field of oncology covers myriad presentation with ever increasing numbers of strategies for management. Important distinctions can be made between cancer that is managed by curative surgery and that which is managed by palliative therapy (including non-curative surgery, chemotherapy, radiotherapy or a combination of these). . This chapter observes Owner considerations; Intercurrent disease; Risks of systemic chemotherapy to the patient; and Waxing and waning course of disease. Osteosarcoma in a dog; Lymphoma in a dog; Oral tumour in a dog; Anal sac gland carcinoma and hypercalcaemia in a dog; Insulinoma in a dog; Leukaemia in a cat; Sarcoma in a cat; Pituitary tumour and acromegaly in a cat.

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Figures

Image of Radiograph showing a lytic lesion affecting the proximal humerus, consistent with osteosarcoma.
Radiograph showing a lytic lesion affecting the proximal humerus, consistent with osteosarcoma. Radiograph showing a lytic lesion affecting the proximal humerus, consistent with osteosarcoma.
Image of The patient one day after amputation of her right forelimb.
The patient one day after amputation of her right forelimb. The patient one day after amputation of her right forelimb.
Image of A chemo-proof long-sleeved gown or chemo-proof sleeves can be worn with suitable nitrile latex gloves, depending on the perceived risk of exposure.
A chemo-proof long-sleeved gown or chemo-proof sleeves can be worn with suitable nitrile latex gloves, depending on the perceived risk of exposure. A chemo-proof long-sleeved gown or chemo-proof sleeves can be worn with suitable nitrile latex gloves, depending on the perceived risk of exposure.
Image of Preparation of a chemotherapy agent (in this case doxorubicin) in a biological safety cabinet. A full-length gown is not necessary for this, so chemo-proof sleeves are more appropriate.
Preparation of a chemotherapy agent (in this case doxorubicin) in a biological safety cabinet. A full-length gown is not necessary for this, so chemo-proof sleeves are more appropriate. Preparation of a chemotherapy agent (in this case doxorubicin) in a biological safety cabinet. A full-length gown is not necessary for this, so chemo-proof sleeves are more appropriate.
Image of Golden Retriever with peripheral lymphadenopathy due to multicentric lymphoma.
Golden Retriever with peripheral lymphadenopathy due to multicentric lymphoma. Golden Retriever with peripheral lymphadenopathy due to multicentric lymphoma.
Image of Fine needle aspirate from the enlarged right prescapular lymph node, showing a population of atypical large lymphoid cells. Cellular pleomorphism, open chromatin, multiple nucleoli, bare nuclei and lymphoglandular bodies led to a diagnosis of lymphoma. Modified Wright’s stain; original magnification X1000.
Fine needle aspirate from the enlarged right prescapular lymph node, showing a population of atypical large lymphoid cells. Cellular pleomorphism, open chromatin, multiple nucleoli, bare nuclei and lymphoglandular bodies led to a diagnosis of lymphoma. Modified Wright’s stain; original magnification X1000. Fine needle aspirate from the enlarged right prescapular lymph node, showing a population of atypical large lymphoid cells. Cellular pleomorphism, open chromatin, multiple nucleoli, bare nuclei and lymphoglandular bodies led to a diagnosis of lymphoma. Modified Wright’s stain; original magnification X1000.
Image of This Golden Retriever with lymphoma was overweight and required dieting while on chemotherapy. Significant weight loss was achieved simply by cutting out tit-bits. (Courtesy of Penny Watson)
This Golden Retriever with lymphoma was overweight and required dieting while on chemotherapy. Significant weight loss was achieved simply by cutting out tit-bits. (Courtesy of Penny Watson) This Golden Retriever with lymphoma was overweight and required dieting while on chemotherapy. Significant weight loss was achieved simply by cutting out tit-bits. (Courtesy of Penny Watson)
Image of This Bedlington Terrier is receiving doxorubicin chemotherapy for multicentric lymphoma. The chemotherapy is being given through a Luer locking secure closed system, so there is no risk of exposure to the dog’s owner. Chemotherapy can be administered in this way in the presence of staff and owners, so long as the preparation of the dose is performed in a suitable biological safety cabinet (see Case 15.1). The presence of the owner frequently diminishes anxiety for the patient, leading to a better overall veterinary experience.
This Bedlington Terrier is receiving doxorubicin chemotherapy for multicentric lymphoma. The chemotherapy is being given through a Luer locking secure closed system, so there is no risk of exposure to the dog’s owner. Chemotherapy can be administered in this way in the presence of staff and owners, so long as the preparation of the dose is performed in a suitable biological safety cabinet (see Case 15.1). The presence of the owner frequently diminishes anxiety for the patient, leading to a better overall veterinary experience. This Bedlington Terrier is receiving doxorubicin chemotherapy for multicentric lymphoma. The chemotherapy is being given through a Luer locking secure closed system, so there is no risk of exposure to the dog’s owner. Chemotherapy can be administered in this way in the presence of staff and owners, so long as the preparation of the dose is performed in a suitable biological safety cabinet (see Case 15.1 ). The presence of the owner frequently diminishes anxiety for the patient, leading to a better overall veterinary experience.
Image of Contaminated sharps and syringes are disposed of as ‘cytotoxic sharps’ without separation prior to disposal.
Contaminated sharps and syringes are disposed of as ‘cytotoxic sharps’ without separation prior to disposal. Contaminated sharps and syringes are disposed of as ‘cytotoxic sharps’ without separation prior to disposal.
Image of Non-sharp cytotoxic waste from preparing and administering chemotherapy is kept separately. In this case all individual waste packages are in separate sealed bags within the separate waste bin, which is in a separate outbuilding.
Non-sharp cytotoxic waste from preparing and administering chemotherapy is kept separately. In this case all individual waste packages are in separate sealed bags within the separate waste bin, which is in a separate outbuilding. Non-sharp cytotoxic waste from preparing and administering chemotherapy is kept separately. In this case all individual waste packages are in separate sealed bags within the separate waste bin, which is in a separate outbuilding.
Image of Labrador Retriever with a large mass affecting the right hemimandible.
Labrador Retriever with a large mass affecting the right hemimandible. Labrador Retriever with a large mass affecting the right hemimandible.
Image of This overweight Cocker Spaniel was diagnosed with anal sac gland carcinoma and hypercalcaemia.
This overweight Cocker Spaniel was diagnosed with anal sac gland carcinoma and hypercalcaemia. This overweight Cocker Spaniel was diagnosed with anal sac gland carcinoma and hypercalcaemia.
Image of Radiography showed sublumbar lymph node enlargement. This was due to metastasis from the primary anal sac gland carcinoma.
Radiography showed sublumbar lymph node enlargement. This was due to metastasis from the primary anal sac gland carcinoma. Radiography showed sublumbar lymph node enlargement. This was due to metastasis from the primary anal sac gland carcinoma.
Image of This Golden Retriever is receiving intravenous fluid support and nursing care. (Courtesy of Liz Mullineaux)
This Golden Retriever is receiving intravenous fluid support and nursing care. (Courtesy of Liz Mullineaux) This Golden Retriever is receiving intravenous fluid support and nursing care. (Courtesy of Liz Mullineaux)
Image of Intraoperative photograph of partial pancreatectomy.
Intraoperative photograph of partial pancreatectomy. Intraoperative photograph of partial pancreatectomy.
Image of Short training exercises can help minimize frustration for dogs that cannot exercise freely. (© Janet Van Dyke)
Short training exercises can help minimize frustration for dogs that cannot exercise freely. (© Janet Van Dyke) Short training exercises can help minimize frustration for dogs that cannot exercise freely. (© Janet Van Dyke)
Image of There is a predominance of mature lymphocytic cells in this peripheral blood sample from a cat with chronic lymphocytic leukaemia. Wright’s stain; original magnification X400.
There is a predominance of mature lymphocytic cells in this peripheral blood sample from a cat with chronic lymphocytic leukaemia. Wright’s stain; original magnification X400. There is a predominance of mature lymphocytic cells in this peripheral blood sample from a cat with chronic lymphocytic leukaemia. Wright’s stain; original magnification X400.
Image of A cardboard box can be used to fashion a hiding place within a cat’s cage. (Courtesy of Rachel Lumbis)
A cardboard box can be used to fashion a hiding place within a cat’s cage. (Courtesy of Rachel Lumbis) A cardboard box can be used to fashion a hiding place within a cat’s cage. (Courtesy of Rachel Lumbis)
Image of Hiding areas should be available at various levels, including at low level if the cat cannot climb. (© Samantha Elmhurst)
Hiding areas should be available at various levels, including at low level if the cat cannot climb. (© Samantha Elmhurst) Hiding areas should be available at various levels, including at low level if the cat cannot climb. (© Samantha Elmhurst)
Image of This cat is being fed via an oesophagostomy tube. (Courtesy of Rachel Lumbis)
This cat is being fed via an oesophagostomy tube. (Courtesy of Rachel Lumbis) This cat is being fed via an oesophagostomy tube. (Courtesy of Rachel Lumbis)
Image of Large interscapular tumour diagnosed on incisional biopsy as an injection site sarcoma.
Large interscapular tumour diagnosed on incisional biopsy as an injection site sarcoma. Large interscapular tumour diagnosed on incisional biopsy as an injection site sarcoma.
Image of Cat receiving chemotherapy for an injection site sarcoma. Note the totally enclosed needle-free, Luer lock system. The larger syringe contains (colourless) physiological saline for dilution of the epirubicin and for flushing the catheter before and after administration of the drug. The total volume of fluid administered over 25 minutes is 25 ml.
Cat receiving chemotherapy for an injection site sarcoma. Note the totally enclosed needle-free, Luer lock system. The larger syringe contains (colourless) physiological saline for dilution of the epirubicin and for flushing the catheter before and after administration of the drug. The total volume of fluid administered over 25 minutes is 25 ml. Cat receiving chemotherapy for an injection site sarcoma. Note the totally enclosed needle-free, Luer lock system. The larger syringe contains (colourless) physiological saline for dilution of the epirubicin and for flushing the catheter before and after administration of the drug. The total volume of fluid administered over 25 minutes is 25 ml.
Image of Anthracycline agents such as epirubicin, and other chemotherapeutics, are known to induce taste changes in humans and it is believed that they do the same in veterinary species. In the cat shown here, chemotherapy triggered marked ptyalism starting approximately 3 minutes into every treatment and finishing promptly once the infusion was complete. Other patients show a reduced appetite, which can last up to 5 days after chemotherapy administration.
Anthracycline agents such as epirubicin, and other chemotherapeutics, are known to induce taste changes in humans and it is believed that they do the same in veterinary species. In the cat shown here, chemotherapy triggered marked ptyalism starting approximately 3 minutes into every treatment and finishing promptly once the infusion was complete. Other patients show a reduced appetite, which can last up to 5 days after chemotherapy administration. Anthracycline agents such as epirubicin, and other chemotherapeutics, are known to induce taste changes in humans and it is believed that they do the same in veterinary species. In the cat shown here, chemotherapy triggered marked ptyalism starting approximately 3 minutes into every treatment and finishing promptly once the infusion was complete. Other patients show a reduced appetite, which can last up to 5 days after chemotherapy administration.
Image of Electroacupuncture may produce sedation in cats. (Courtesy of Samantha Lindley)
Electroacupuncture may produce sedation in cats. (Courtesy of Samantha Lindley) Electroacupuncture may produce sedation in cats. (Courtesy of Samantha Lindley)
Image of The cat one week after surgery, on the day of discharge.
The cat one week after surgery, on the day of discharge. The cat one week after surgery, on the day of discharge.
Image of Sagittal MRI scan image of a cat with pituitary macroadenoma (T1W, post-gadolinium). (Reproduced from Littler et al., 2006)
Sagittal MRI scan image of a cat with pituitary macroadenoma (T1W, post-gadolinium). (Reproduced from Littler et al., 2006) Sagittal MRI scan image of a cat with pituitary macroadenoma (T1W, post-gadolinium). (Reproduced from )
Image of The cat 4 months after completion of the treatment course; enthusiasm for outdoor life has returned. (Reproduced from Littler et al., 2006)
The cat 4 months after completion of the treatment course; enthusiasm for outdoor life has returned. (Reproduced from Littler et al., 2006) The cat 4 months after completion of the treatment course; enthusiasm for outdoor life has returned. (Reproduced from )
Image of Photographs of a 7-year-old neutered male DSH cat, taken before (top) and after weight loss. Starting bodyweight was 10.30 kg (BCS 9/9), the final weight was 6.45 kg (BCS 5/9), and percentage weight loss was 37%. The weight loss programme took 490 days, and the mean rate of weight loss was 0.53% per week. (Courtesy of The Royal Canin Weight Management Clinic, University of Liverpool)
Photographs of a 7-year-old neutered male DSH cat, taken before (top) and after weight loss. Starting bodyweight was 10.30 kg (BCS 9/9), the final weight was 6.45 kg (BCS 5/9), and percentage weight loss was 37%. The weight loss programme took 490 days, and the mean rate of weight loss was 0.53% per week. (Courtesy of The Royal Canin Weight Management Clinic, University of Liverpool) Photographs of a 7-year-old neutered male DSH cat, taken before and after weight loss. Starting bodyweight was 10.30 kg (BCS 9/9), the final weight was 6.45 kg (BCS 5/9), and percentage weight loss was 37%. The weight loss programme took 490 days, and the mean rate of weight loss was 0.53% per week. (Courtesy of The Royal Canin Weight Management Clinic, University of Liverpool)

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