Veterinary Medicine - September 2008 - (Page 490)

Practical Matters clinical advice and reminders from your colleagues Consider cross-sectional imaging before surgery for feline injectionsite sarcomas PEER-RE VIE WED PEER-RE VIE WED Do not institute calcium supplementation during canine pregnancy I P njection-site sarcomas are associated with high recurrence rates, even with wide surgical excision. The strongest prognostic factor for survival after excision is the state of the surgical margin: Cats with tumor-free margins have signiﬁcantly longer survival times than do cats with dirty margins (> 16 months vs. 9 months, respectively).1 Conservative (marginal, debulking) surgeries are strongly discouraged for feline injection-site sarcomas. The median time to ﬁrst tumor recurrence is signiﬁcantly shorter with a marginal ﬁrst excision (79 days) than with a radical ﬁrst excision (325 days).2 Cross-sectional imaging with computed tomography (CT) or magnetic resonance imaging (MRI) before any surgical intervention is strongly recommended to accurately identify which cats will likely beneﬁt most from surgery. This imaging helps deﬁne the gross extent of the tumor and aids in planning the extent of the resection.3 A study performed at Cornell University found that the volume of tumor detected by using CT was, on average, twice the size of the tumor detected by physical palpation and measured with calipers.4 The disease-free interval has also been shown to be signiﬁcantly shorter when the surgery is performed by a general practitioner rather than a board-certiﬁed surgeon.2 This ﬁnding likely reﬂects surgeon expertise and access to advanced imaging modalities, such as CT or MRI. When evaluating a cat with a possible injection-site sarcoma, practitioners should consult a board-certiﬁed surgeon with access to advanced imaging modalities and an oncologist for treatment options, which may include radiation therapy, chemotherapy, or other therapies in addition to radical surgical excision. REFERENCES Amy K. LeBlanc, DVM, DACVIM (oncology) Department of Small Animal Clinical Sciences College of Veterinary Medicine The University of Tennessee Knoxville, TN 37996 ostpartum hypocalcemia, also called eclampsia or puerperal tetany, is a metabolic condition most commonly seen in small-breed dogs nursing large litters two or three weeks after whelping. It is characterized by ataxia, mydriasis, disorientation, tachycardia, and neglect of pups, with possible progression to seizures. Clients with dogs that have suffered from eclampsia often want to supplement the bitches with calcium during subsequent pregnancies; however, calcium supplementation during pregnancy is contraindicated. Parathyroid hormone is secreted in response to decreased serum calcium concentrations. The hormone increases calcium concentrations by promoting osteoclastic activity and increasing calcium uptake from the gastrointestinal tract. Oral calcium supplementation causes persistent serum calcium elevation with subsequent downregulation of parathyroid hormone. When the bitch whelps and begins lactating, it is difﬁcult for oral supplementation alone to provide enough calcium since it is poorly absorbed through the gastrointestinal tract. Because the parathyroid hormone has been downregulated in dogs receiving oral calcium, bone calcium stores cannot be accessed and hypocalcemia results. 1. Davidson EB, Gregory CR, Kass PH. Surgical excision of soft tissue brosarcomas in cats. Vet Surg 1997;26(4):265-269. 2. Hershey AE, Sorenmo KU, Hendrick MJ, et al. Prognosis for presumed feline vaccine-associated sarcoma after excision: 61 cases (1986-1996). J Am Vet Med Assoc 2000;216(1):58-61. 3. Lidbetter DA, Williams FA, Krahwinkel DJ, et al. Radical lateral body-wall resection for brosarcoma with reconstruction using polypropylene mesh and a caudal super cial epigastric axial pattern ap: a prospective clinical study of the technique and results in 6 cats. Vet Surg 2002;31(1):57-64. 4. McEntee MC, Page RL. Feline vaccine-associated sarcomas. J Vet Intern Med 2001;15(3):176-182. Margaret V. Root Kustritz, DVM, PhD, DACT Department of Veterinary Clinical Sciences College of Veterinary Medicine University of Minnesota St. Paul, MN 55108 Instead of calcium supplementation, pregnant bitches should be fed a well-balanced puppy or performance food during the latter half of gestation. Calcium supplementation during lactation will not cause iatrogenic hypocalcemia, so supplementation may be instituted at whelping. 490 September 2008 VETERINARY MEDICINE Getty Images

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Veterinary Medicine - September 2008 Contents Leading Off Practical Matters Idea Exchange A Challengin Case: Thymic Cyst and Recurrent Chylothorax in a Cat 10 Life-Threatening Behavior Myths CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - September 2008

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