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Management of commonly encountered feline cancers

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Abstract

This chapter will focus on the management of the most important forms of neoplasia encountered in feline practice: lymphoma, squamous cell carcinoma, cutaneous and visceral mast cell tumours and injection site sarcomas. : Lymph node excision; Chemotherapy for lymphoma; Pinnectomy.

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Figures

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21.1 A 4-year-old female unneutered Maine Coon that presented with facial distortion and epistaxis 12 weeks after kittening. Intraoral dorsoventral radiographs revealed a soft tissue or fluid opacity throughout the left nasal chamber. On endoscopy, a choanal mass was evident. Assessment of impression smears from biopsy samples revealed a monomorphic population of lymphoblasts, and a diagnosis of nasal lymphoma was made. Radiotherapy was declined by the owner. Treatment with COP chemotherapy resulted in complete remission for 8 months before recurrence of sneezing.
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21.4 A 6-year-old male neutered DSH cat receiving strontium plesiotherapy for a superficial SCC of the nasal planum, diagnosed by incisional biopsy. Strontium plesiotherapy was chosen as the lesion was superficial (graded T1 histologically) and because it produces an excellent cosmetic result. Five treatments were administered on an every other day basis. Following treatment, while the treated area remained hairless, the cat was free of disease.
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21.5 Multiple mast cells (round cells with round nuclei and cytoplasm that is filled with purple granules) in a Buffy coat smear prepared from a cat with splenic MCT. To prepare a Buffy coat smear: centrifuge EDTA- anticoagulated blood and, with a fine-tipped pipette, gently aspirate the Buffy coat layer with minimal contamination of erythrocytes or plasma; a drop of this aspirate can then be smeared and stained in a similar fashion to whole blood. Alternatively, a microhaematocrit tube containing centrifuged whole blood can be scored and cut at the level of the Buffy coat, and a smear made from a drop of the Buffy coat that is tapped out on to the slide. (Modified Wright’s stain; original magnification X1000.) (Courtesy of Roger Powell)
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21.6 A 4-year-old male neutered Bengal presented with a firm plum-sized dorsal mass, noted 2 months after routine vaccination. Incisional biopsy confirmed FISS. Neo-adjuvant epirubicin resulted in a halving of the size of the mass and it was noticeably softer on palpation. Despite its discrete appearance, contrast CT revealed cranial extension. Surgical margins of 3 cm were inked around the mass, with a further 3 cm margin rostrally, given the occult extension of disease detected on CT. To achieve a deep margin of excision, the trapezius and rhomboideus muscles, with portions of the latissimus dorsi and the tips of the dorsal vertebral spinous processes, were removed. Closure of the large deficit required careful deadspace management and a layered anatomical closure. Following surgical excision, a further course of adjuvant chemotherapy was administered. The patient was in excellent health, without evidence of recurrence, 24 months after the final dose of chemotherapy.
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Image of Aerosolization and contamination of clothing represent the greatest risks for staff carrying out chemotherapy. Whenever possible a facemask and visor, an impervious gown (specifically manufactured for use when administering chemotherapy) with elasticated cuffs, and nitrile gloves should be worn to minimize exposure.
Aerosolization and contamination of clothing represent the greatest risks for staff carrying out chemotherapy. Whenever possible a facemask and visor, an impervious gown (specifically manufactured for use when administering chemotherapy) with elasticated cuffs, and nitrile gloves should be worn to minimize exposure. Aerosolization and contamination of clothing represent the greatest risks for staff carrying out chemotherapy. Whenever possible a facemask and visor, an impervious gown (specifically manufactured for use when administering chemotherapy) with elasticated cuffs, and nitrile gloves should be worn to minimize exposure.
Image of Appropriate equipment for the safe administration of cytotoxic drugs, on an absorbent mat. A Smart-Site vented vial access device allows withdrawal of cytotoxic drug into a syringe capped with a Texium needle-free injection device in a closed manner, preventing aerosolization and self-injection. A Smart-Site needle-free T connector is attached to the patient’s intravenous cannula to allow drug administration in a similarly closed manner. Prior to drug administration, the intravenous cannula is flushed copiously with normal saline.
Appropriate equipment for the safe administration of cytotoxic drugs, on an absorbent mat. A Smart-Site vented vial access device allows withdrawal of cytotoxic drug into a syringe capped with a Texium needle-free injection device in a closed manner, preventing aerosolization and self-injection. A Smart-Site needle-free T connector is attached to the patient’s intravenous cannula to allow drug administration in a similarly closed manner. Prior to drug administration, the intravenous cannula is flushed copiously with normal saline. Appropriate equipment for the safe administration of cytotoxic drugs, on an absorbent mat. A Smart-Site vented vial access device allows withdrawal of cytotoxic drug into a syringe capped with a Texium needle-free injection device in a closed manner, preventing aerosolization and self-injection. A Smart-Site needle-free T connector is attached to the patient’s intravenous cannula to allow drug administration in a similarly closed manner. Prior to drug administration, the intravenous cannula is flushed copiously with normal saline.
Image of Administration of vincristine to an 11-year-old Siamese with lymphoblastic alimentary lymphoma. Note that the operator’s gloves are pulled over the elasticated cuffs. All dressings have been removed from the cannula site and the cat’s leg has been extended. Use of a Y connector allows freedom for the cat to move slightly. A bolus of intravenous fluids is being administered concurrently.
Administration of vincristine to an 11-year-old Siamese with lymphoblastic alimentary lymphoma. Note that the operator’s gloves are pulled over the elasticated cuffs. All dressings have been removed from the cannula site and the cat’s leg has been extended. Use of a Y connector allows freedom for the cat to move slightly. A bolus of intravenous fluids is being administered concurrently. Administration of vincristine to an 11-year-old Siamese with lymphoblastic alimentary lymphoma. Note that the operator’s gloves are pulled over the elasticated cuffs. All dressings have been removed from the cannula site and the cat’s leg has been extended. Use of a Y connector allows freedom for the cat to move slightly. A bolus of intravenous fluids is being administered concurrently.
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Image of The pinnae have both been clipped and draped in preparation for bilateral surgery.
The pinnae have both been clipped and draped in preparation for bilateral surgery. The pinnae have both been clipped and draped in preparation for bilateral surgery.
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Image of Appearance of a different cat several weeks after bilateral pinnectomy. (Courtesy of Dr S Kuan)
Appearance of a different cat several weeks after bilateral pinnectomy. (Courtesy of Dr S Kuan) Appearance of a different cat several weeks after bilateral pinnectomy. (Courtesy of Dr S Kuan)

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