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Patients with neoplastic disease
/content/chapter/10.22233/9781905319916.chap15
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- BSAVA Manual of Canine and Feline Rehabilitation, Supportive and Palliative Care
- Chapter
Patients with neoplastic disease
- Author: Gerry Polton
- From: BSAVA Manual of Canine and Feline Rehabilitation, Supportive and Palliative Care
- Item: Chapter 15, pp 232 - 267
- DOI: 10.22233/9781905319916.15
- Copyright: © 2010 British Small Animal Veterinary Association
- Publication Date: January 2010
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. Case examples: 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
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Radiograph showing a lytic lesion affecting the proximal humerus, consistent with osteosarcoma.
Radiograph showing a lytic lesion affecting the proximal humerus, consistent with osteosarcoma. © 2010 British Small Animal Veterinary Association
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Radiograph showing a lytic lesion affecting the proximal humerus, consistent with osteosarcoma.
Radiograph showing a lytic lesion affecting the proximal humerus, consistent with osteosarcoma.
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The patient one day after amputation of her right forelimb.
The patient one day after amputation of her right forelimb. © 2010 British Small Animal Veterinary Association
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The patient one day after amputation of her right forelimb.
The patient one day after amputation of her right forelimb.
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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. © 2010 British Small Animal Veterinary Association
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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.
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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. © 2010 British Small Animal Veterinary Association
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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.
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Golden Retriever with peripheral lymphadenopathy due to multicentric lymphoma.
Golden Retriever with peripheral lymphadenopathy due to multicentric lymphoma. © 2010 British Small Animal Veterinary Association
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Golden Retriever with peripheral lymphadenopathy due to multicentric lymphoma.
Golden Retriever with peripheral lymphadenopathy due to multicentric lymphoma.
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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. © 2010 British Small Animal Veterinary Association
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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.
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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) © 2010 British Small Animal Veterinary Association
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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)
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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. © 2010 British Small Animal Veterinary Association
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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.
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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. © 2010 British Small Animal Veterinary Association
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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.
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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. © 2010 British Small Animal Veterinary Association
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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.
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Labrador Retriever with a large mass affecting the right hemimandible.
Labrador Retriever with a large mass affecting the right hemimandible. © 2010 British Small Animal Veterinary Association
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Labrador Retriever with a large mass affecting the right hemimandible.
Labrador Retriever with a large mass affecting the right hemimandible.
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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. © 2010 British Small Animal Veterinary Association
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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.
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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. © 2010 British Small Animal Veterinary Association
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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.
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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) © 2010 British Small Animal Veterinary Association
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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)
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Intraoperative photograph of partial pancreatectomy.
Intraoperative photograph of partial pancreatectomy. © 2010 British Small Animal Veterinary Association
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Intraoperative photograph of partial pancreatectomy.
Intraoperative photograph of partial pancreatectomy.
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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) © 2010 British Small Animal Veterinary Association
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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)
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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. © 2010 British Small Animal Veterinary Association
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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.
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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) © 2010 British Small Animal Veterinary Association
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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)
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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) © 2010 British Small Animal Veterinary Association
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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)
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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) © 2010 British Small Animal Veterinary Association
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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)
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Large interscapular tumour diagnosed on incisional biopsy as an injection site sarcoma.
Large interscapular tumour diagnosed on incisional biopsy as an injection site sarcoma. © 2010 British Small Animal Veterinary Association
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Large interscapular tumour diagnosed on incisional biopsy as an injection site sarcoma.
Large interscapular tumour diagnosed on incisional biopsy as an injection site sarcoma.
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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. © 2010 British Small Animal Veterinary Association
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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.
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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. © 2010 British Small Animal Veterinary Association
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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.
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Electroacupuncture may produce sedation in cats. (Courtesy of Samantha Lindley)
Electroacupuncture may produce sedation in cats. (Courtesy of Samantha Lindley) © 2010 British Small Animal Veterinary Association
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Electroacupuncture may produce sedation in cats. (Courtesy of Samantha Lindley)
Electroacupuncture may produce sedation in cats. (Courtesy of Samantha Lindley)
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The cat one week after surgery, on the day of discharge.
The cat one week after surgery, on the day of discharge. © 2010 British Small Animal Veterinary Association
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The cat one week after surgery, on the day of discharge.
The cat one week after surgery, on the day of discharge.
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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
) © 2010 British Small Animal Veterinary Association
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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
)
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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
) © 2010 British Small Animal Veterinary Association
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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
)
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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) © 2010 British Small Animal Veterinary Association
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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)