RESUMO
OBJECTIVE: To compare the effects of constant rate infusions (CRI) of fentanyl or dexmedetomidine, combined with lidocaine and ketamine, on cardiovascular response during surgery, sevoflurane requirement and postoperative pain in dogs undergoing mastectomy. STUDY DESIGN: Prospective, randomized, blinded, clinical trial. ANIMALS: A total of 29 female dogs with mammary tumors. METHODS: Premedication consisted of intramuscular acepromazine and morphine. General anesthesia was induced with intravenous propofol and maintained with sevoflurane. Dogs were randomized to be administered intravenous DLK [dexmedetomidine 1 µg kg-1 loading dose (LD) and 1 µg kg-1 hour-1; lidocaine 2 mg kg-1 LD and 3 mg kg-1 hour-1; ketamine 1 mg kg-1 LD and 0.6 mg kg-1 hour-1; n = 14] or FLK (fentanyl 5 µg kg-1 LD and 9 µg kg-1 hour-1; same doses of lidocaine and ketamine; n = 15) during anesthesia. Cardiorespiratory variables and end-tidal sevoflurane (Fe'Sevo) were recorded during surgery. The number of dogs administered ephedrine to treat arterial hypotension [mean arterial pressure (MAP) < 60 mmHg] was recorded. Meloxicam was administered to both groups. Postoperative pain and rescue analgesia requirement were assessed for 24 hours using the short form of the Glasgow Composite Measure Pain Scale. Data were compared using a mixed effects model or a Mann-Whitney test. RESULTS: More dogs required ephedrine in FLK than in DLK (67% versus 7%). Heart rate was not significantly different between groups, whereas lower values of MAP (p ≤ 0.01) and Fe'Sevo (p = 0.018) were observed in FLK than in DLK. Rescue analgesia was administered to 2/15 dogs in FLK and 0/14 dogs in DLK. CONCLUSIONS AND CLINICAL RELEVANCE: Based on the cardiovascular response during surgery, intraoperative infusions of FLK and DLK provided adequate antinociception. Infusion of DLK provided greater stability of blood pressure. Both protocols resulted in minimal need for additional analgesia within 24 hours postoperatively.
Assuntos
Dexmedetomidina , Doenças do Cão , Fentanila , Ketamina , Lidocaína , Mastectomia , Dor Pós-Operatória , Sevoflurano , Animais , Cães/cirurgia , Dexmedetomidina/administração & dosagem , Dexmedetomidina/farmacologia , Feminino , Ketamina/administração & dosagem , Ketamina/farmacologia , Dor Pós-Operatória/veterinária , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Mastectomia/veterinária , Sevoflurano/administração & dosagem , Sevoflurano/farmacologia , Lidocaína/administração & dosagem , Lidocaína/farmacologia , Fentanila/administração & dosagem , Fentanila/farmacologia , Doenças do Cão/cirurgia , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/farmacologia , Infusões Intravenosas/veterinária , Neoplasias Mamárias Animais/cirurgia , Estudos Prospectivos , Anestésicos Inalatórios/administração & dosagemRESUMO
Mastectomy is the standard treatment for mammary gland tumors in dogs. In addition to traditional therapy, sodium dichloroacetate (DCA) can act as target therapy, as it may promote autophagy, reduce metastatic potential, and tumor proliferation in mammary tumor cell lines. This study aimed to analyze the effects of DCA as preoperative therapy for mammary tumors in bitches. Nineteen animals were selected, and they received DCA at a dose of 10 mg/kg orally every 12 hr, for 15 days. The periodic evaluation included hematological analysis (complete blood count and biochemical markers), evaluation of gastrointestinal adverse effects, evaluation of tumor volume, histopathological analysis, and immunohistochemical evaluation (Ki67 and cyclooxygenase-2/COX-2 markers). After treatment, there was a significant reduction in hematocrit (P=0.02) and leukocyte (P=0.04) means. Despite the variations for these two hematological parameters, the means remained within the reference range for the species. There were two cases of vomiting and one case of diarrhea. Most cases were classified as carcinoma in mixed tumor (n=7, 36.8%), followed by solid carcinoma (n=6, 31.6%). Nine cases (47.4%) showed reduced tumor volume, nine (47.4%) had stable disease, and one showed progressive disease. While there was no sample with a COX-2 score higher than 6, tumor samples with COX-2 scores 3 and 4 were significantly associated with stable disease or progression. DCA preoperative treatment for bitches with mammary gland tumors showed safety and potential cytoreduction in some cases.
Assuntos
Ácido Dicloroacético , Doenças do Cão , Neoplasias Mamárias Animais , Terapia Neoadjuvante , Animais , Cães , Feminino , Neoplasias Mamárias Animais/tratamento farmacológico , Neoplasias Mamárias Animais/cirurgia , Doenças do Cão/tratamento farmacológico , Ácido Dicloroacético/uso terapêutico , Terapia Neoadjuvante/veterináriaRESUMO
PURPOSE: Partial breast irradiation (PBI) and intraoperative radiation (IORT) represent alternatives to whole breast irradiation (WBI) following breast conserving surgery. However, data is mixed regarding outcomes. We therefore performed a pooled analysis of Kaplan-Meier-derived patient data from randomized trials to evaluate the hypothesis that PBI and IORT have comparable long-term rates of ipsilateral breast tumor recurrence as WBI. METHODS: In February, 2023, PubMed, EMBASE and Cochrane Central were systematically searched for randomized phase 3 trials of early-stage breast cancer patients undergoing breast-conserving surgery with PBI or IORT as compared to WBI. Time-to-event outcomes of interest included ipsilateral breast tumor recurrence (IBTR), overall survival (OS) and distant disease-free survival (DDFS). Statistical analysis was performed with R Statistical Software. RESULTS: Eleven randomized trials comprising 15,460 patients were included; 7,675 (49.6%) patients were treated with standard or moderately hypofractionated WBI, 5,413 (35%) with PBI and 2,372 (15.3%) with IORT. Median follow-up was 9 years. PBI demonstrated comparable IBTR risk compared with WBI (HR 1.20; 95% CI 0.95-1.52; p = 0.12) with no differences in OS (HR 1.02; 95% CI 0.90-1.16; p = 0.70) or DDFS (HR 1.15; 95% CI 0.81-1.64; p = 0.43). In contrast, patients treated with IORT had a higher IBTR risk (HR 1.46; 95% CI 1.23-1.72; p < 0.01) compared with WBI with no difference in OS (HR 0.98; 95% CI 0.84-1.14; p = 0.81) or DDFS (HR 0.91; 95% CI 0.76-1.09; p = 0.31). CONCLUSION: For patients with early-stage breast cancer following breast-conserving surgery, PBI demonstrated no difference in IBTR as compared to WBI while IORT was inferior to WBI with respect to IBTR.
Assuntos
Braquiterapia , Neoplasias da Mama , Neoplasias Mamárias Animais , Humanos , Animais , Feminino , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Braquiterapia/métodos , Recidiva Local de Neoplasia/patologia , Mama/patologia , Intervalo Livre de Doença , Mastectomia Segmentar , Neoplasias Mamárias Animais/cirurgiaRESUMO
Mammary tumors are the most common in bitches, and bone and pulmonary metastases are not well described. Adenosquamous mammary carcinoma is a rare tumor that can be classified as a type of metaplastic tumor. This report describes the clinical and histopathological findings of this atypical presentation of mammary carcinoma in an 11-year-old, spayed, Poodle. Surgery was performed to remove malignant mammary nodules with a provisional diagnosis of carcinoma on cytologic examination. Thirteen months later, the dog returned showing left pelvic limb lameness that had persisted for 6 months prior to the consultation. The patient showed right pelvic limb lameness and a mass in the same limb. Radiographs of the affected limb revealed a pathological fracture in the femoral diaphysis and proliferation of the periosteum. After clinical staging, a left pelvic limb amputation was performed. A diagnosis of grade II adenosquamous mammary carcinoma was made through histopathology and immunohistochemistry. Although uncommon, bone and pulmonary metastases from mammary tumors, such as adenosquamous carcinoma, can be considered differential diagnoses for bony tumors. This report highlights the aggressive nature and significant metastatic potential of the adenosquamous carcinoma.
Os tumores mamários são os mais comuns em cadelas e as metástases ósseas e pulmonares não são bem descritas. O carcinoma mamário adenoescamoso é um tumor raro que pode ser classificado como um tipo de tumor metaplásico. Este relato descreve os achados clínicos e histopatológicos dessa apresentação atípica de carcinoma mamário em um Poodle de 11 anos de idade, castrado. A cirurgia foi realizada para remover nódulos mamários malignos com diagnóstico provisório de carcinoma no exame citológico. Treze meses depois, a cadela retornou apresentando claudicação do membro pélvico esquerdo que persistia por seis meses antes da consulta. O paciente apresentava claudicação do membro pélvico direito e uma massa no mesmo membro. A radiografia do membro afetado revelou fratura patológica na diáfise femoral, proliferação do periósteo e áreas de osteopenia. Após estadiamento clínico, foi realizada amputação do membro pélvico esquerdo. O diagnóstico de carcinoma adenoescamoso mamário grau II foi feito através da histopatologia e imunohistoquímica. Embora incomuns, as metástases ósseas e pulmonares de tumores mamários, como o carcinoma adenoescamoso, podem ser consideradas diagnósticos diferenciais para tumores ósseos. Este relatório destaca a natureza agressiva e significativo potencial metastático do carcinoma adenoescamoso.
Assuntos
Animais , Feminino , Cães , Neoplasias Mamárias Animais/cirurgia , Carcinoma Adenoescamoso/veterinária , Metaplasia/veterinária , Neoplasias Ósseas/veterinária , Imuno-Histoquímica/veterináriaRESUMO
Background: Mammary tumors, for which mastectomy is the main treatment, are the most common neoplasms in bitches. Mastectomy is painful and, in order to reduce the pain stimulus in the transoperative period, tumescent local anesthesia is associated with general inhalation anesthesia. However, despite the numerous benefits of tumescence, intraoperative hypothermia is the most common complication. In Medicine, especially in plastic and dermatological surgery, it is common to use a heated tumescence solution to prevent intraoperative hypothermia; however, in Veterinary medicine, no previous study has examined the advantages and disadvantages of using heated tumescence solution. Thus, this study aimed to investigate the transanesthetic cardiorespiratory effects of heated tumescence solution in bitches submitted to radical unilateral mastectomy. Materials, Methods & Results: Eight animals were treated with 0.1% lidocaine solution, warmed to 37-42°C, using a Kleins cannula for administration. Chlorpromazine (0.3 mg/kg) and meperidine (3 mg/kg) were used as pre-anesthetic medication intramuscularly, and induction was performed with intravenous propofol and maintenance with isoflurane. The data collection times were as follows: 15 min after starting isoflurane administration (M1), 5 min after tumescence (M2), after beginning of surgical incision (M3), during breast pullout (M4), after clamping of the superficial caudal epigastric vein, and artery (M5), after the beginning of the approximation of the subcutaneous tissue (M6), after the beginning of the intradermal suture (M7), and at the end of the surgical procedure (Mfinal). The heart...(AU)
Assuntos
Animais , Feminino , Cães , Mastectomia Simples/reabilitação , Mastectomia Simples/veterinária , Cuidados Pós-Operatórios/veterinária , Lidocaína/administração & dosagem , Neoplasias Mamárias Animais/cirurgia , Anestesia Local/veterinária , Anestésicos InalatóriosRESUMO
Background: Mammary tumors, for which mastectomy is the main treatment, are the most common neoplasms in bitches. Mastectomy is painful and, in order to reduce the pain stimulus in the transoperative period, tumescent local anesthesia is associated with general inhalation anesthesia. However, despite the numerous benefits of tumescence, intraoperative hypothermia is the most common complication. In Medicine, especially in plastic and dermatological surgery, it is common to use a heated tumescence solution to prevent intraoperative hypothermia; however, in Veterinary medicine, no previous study has examined the advantages and disadvantages of using heated tumescence solution. Thus, this study aimed to investigate the transanesthetic cardiorespiratory effects of heated tumescence solution in bitches submitted to radical unilateral mastectomy. Materials, Methods & Results: Eight animals were treated with 0.1% lidocaine solution, warmed to 37-42°C, using a Kleins cannula for administration. Chlorpromazine (0.3 mg/kg) and meperidine (3 mg/kg) were used as pre-anesthetic medication intramuscularly, and induction was performed with intravenous propofol and maintenance with isoflurane. The data collection times were as follows: 15 min after starting isoflurane administration (M1), 5 min after tumescence (M2), after beginning of surgical incision (M3), during breast pullout (M4), after clamping of the superficial caudal epigastric vein, and artery (M5), after the beginning of the approximation of the subcutaneous tissue (M6), after the beginning of the intradermal suture (M7), and at the end of the surgical procedure (Mfinal). The heart...
Assuntos
Feminino , Animais , Cães , Cuidados Pós-Operatórios/veterinária , Lidocaína/administração & dosagem , Mastectomia Simples/reabilitação , Mastectomia Simples/veterinária , Neoplasias Mamárias Animais/cirurgia , Anestesia Local/veterinária , Anestésicos InalatóriosRESUMO
The aim of this study was to evaluate renal hemodynamics, routine clinical and laboratory parameters used to estimate renal function, and clinical evolution during six months in bitches with mammary carcinomas that underwent mastectomy and were treated (TG) or not (CG) with carprofen for three months after surgery. Twenty-six bitches with mammary carcinoma were equally distributed into TG that received carprofen 4.4 mg/kg/day for 90 days and CG that did not receive anti-inflammatory medication. Renal artery Doppler flowmetry, contrast-enhanced ultrasound (CEUS) of renal parenchyma, haematological, biochemical and clinical analyses were obtained once a month. These data were compared between groups and time via analysis of variance (ANOVA) in a completely randomized design with repeated measures (P < 0.05). On B-mode ultrasound, the area of the renal artery was greater (P = 0.0003) in the TG. Regarding laboratory findings, haematocrit and haemoglobin were similar in both groups, showing a significant and gradual increase after three months of treatment; MCV, MHC, and MCHC were increased (P < 0.05) and lymphocyte and band counts decreased (P < 0.05) in the TG. Regarding biochemical tests, ALT was the only parameter with a significant difference, being higher (P = 0.0272) in the treated group. It can be concluded that the use of carprofen for 90 days causes minimal changes in renal perfusion, erythrocyte parameters and ALT activity, and reduces the proportion of blood inflammatory cells. Therefore, use of this medication can be carried out safely in patients who require auxiliary cancer treatment.
Assuntos
Carbazóis/administração & dosagem , Carbazóis/efeitos adversos , Carcinoma/tratamento farmacológico , Doenças do Cão/tratamento farmacológico , Rim/irrigação sanguínea , Rim/diagnóstico por imagem , Neoplasias Mamárias Animais/tratamento farmacológico , Circulação Renal/efeitos dos fármacos , Ultrassonografia Doppler , Animais , Carcinoma/fisiopatologia , Carcinoma/cirurgia , Doenças do Cão/fisiopatologia , Doenças do Cão/cirurgia , Cães , Feminino , Glândulas Mamárias Animais/cirurgia , Neoplasias Mamárias Animais/fisiopatologia , Neoplasias Mamárias Animais/cirurgia , Fatores de TempoRESUMO
OBJECTIVES: The aim of this study was to evaluate the effectiveness of ovariohysterectomy (OVH) on feline mammary fibroepithelial hyperplasia (FMFH) treatment, as well as the influence of previous injectable progestin on clinical signs and treatment of FMFH. METHODS: Seventy-nine female cats diagnosed with FMFH between 2014 and 2018 were included. The animals were distributed as follows: (1) treated only with OVH (TA) or OVH plus antiprogestin (TB); and (2) no administration (G1) or previous administration (G2) of injectable progestin before FMFH diagnosis. Data regarding clinical signs of FMFH, occurrence of persistent mammary growth after OVH, and time until complete remission of FMFH post-surgery were recorded and evaluated. RESULTS: Mastectomy was not performed in any cat during the study. TA was adopted in 71/79 (89.9%) cases, with 42/71 (59.2%) from G2 and 29/71 (40.8%) from G1. TB was adopted in 8/79 (10.1%) cats, all from G2. Total remission of FMFH was observed in 73/79 (92.4%) cats, with six animals from G2 having died (n = 6/79 [7.6%]). The time until complete remission of FMFH was higher (P <0.0001) in cats from G2 than from G1. Moreover, animals from G2 had a higher percentage of persistent mammary growth after OVH (P <0.001) and a tendency to higher mortality (P = 0.052) compared with G1. CONCLUSIONS AND RELEVANCE: Previous treatment with injectable progestin may result in a more complex clinical presentation of FMFH. Ovariohysterectomy is a good treatment option for FMFH when there is no interest in breeding the queen. Treatment with antiprogestin is recommended, especially if persistent mammary growth is detected after OVH.
Assuntos
Doenças do Gato , Neoplasias Mamárias Animais , Animais , Doenças do Gato/tratamento farmacológico , Doenças do Gato/cirurgia , Gatos , Feminino , Hiperplasia/veterinária , Histerectomia/veterinária , Neoplasias Mamárias Animais/tratamento farmacológico , Neoplasias Mamárias Animais/cirurgia , Ovariectomia/veterinária , ProgestinasRESUMO
The present study aimed to evaluate the use of tumescent local anesthesia or epidural anesthesia associated with an intercostal nerve block in bitches submitted to mastectomy. Fourteen bitches from the clinical routine of the Veterinary Hospital of the Federal University of Pelotas were premedicated with acepromazine (0.03 mg/kg) and morphine (0.3 mg/kg) intramuscularly, then induced with propofol (2 to 6 mg/kg/IV) and maintained with 1,4V% isoflurane (calibrated vaporizer). The patients were randomly allocated into: GALT Group (n=7), which received tumescent local anesthesia (0.16%) at the dose of 15 mL/kg, and the GEBI Group (n=7) which received epidural anesthesia with lidocaine (5 mg/kg) and morphine (0.1 mg/kg) associated with an intercostal nerve block from the 6th to 12th intercostal space with lidocaine (2 mg/kg). An increase higher than 10% in heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were considered as possible signs of nociception, to which fentanyl was administered intravenously as rescue analgesia. Postoperative analgesia was evaluated by means of the modified Glasgow scale at 30, 60, 120, 240 and 360 minutes. There were no differences in physiological parameters (P>0.05) in the transoperative period intra-group and inter-group the groups. The GEBI Group required more frequent transoperative rescue analgesia (9) in comparison to the GALT Group (5), but with no statistical difference. During the postoperative period, there was no need for rescue analgesia in either group. Results suggest that epidural anesthesia associated with intercostal nerve block can be used as an alternative technique in patients with restrictions against the use of local tumescent anesthesia.(AU)
O presente estudo objetivou avaliar o uso da anestesia local tumescente ou da anestesia epidural associada ao bloqueio intercostal em cadelas submetidas à mastectomia. Foram utilizadas 14 cadelas, provenientes da rotina do Hospital de Clínicas Veterinária da Universidade Federal de Pelotas, pré-medicadas com acepromazina (0,03 mg/kg) e morfina (0,3 mg/kg) intramuscular, induzidas com propofol (2 a 6 mg/Kg/IV) e mantidas com isofluorano à 1,4 V% (vaporizador calibrado). Após essa etapa, foram alocadas aleatoriamente em grupo GALT (n=7), que recebeu a anestesia local tumescente 0,16% na dose de 15 mL/Kg e em grupo GEBI (n=7), que recebeu como tratamento a anestesia epidural com lidocaína (5 mg/kg) e morfina (0,1 mg/kg) associada ao bloqueio intercostal, do 6º ao 12º espaço intercostal, com lidocaína (2mg/kg). Os parâmetros avaliados para sinais de nocicepção transcirúrgica e realização de resgates analgésicos com fentanil foram: frequência cardíaca, frequência respiratória, pressão arterial sistólica, pressão arterial diastólica e pressão arterial média. No pós-operatório avaliou-se a analgesia pela escala de Glasgow Modificada aos 30, 60, 120, 240 e 360 minutos. Não houve diferenças entre os parâmetros clínicos (p > 0,05) no período transoperatório entre e dentro dos grupos. O GEBI apresentou maior quantidade de resgates analgésicos transoperatórios (9) em relação a GALT (5), porém sem diferenças estatísticas. No pós-operatório, nenhum animal de ambos os grupos atingiu pontuação máxima para resgate analgésico. Pode-se concluir que a anestesia epidural associada ao bloqueio intercostal é uma técnica alternativa para casos em que se tenham limitações para utilização da anestesia local tumescente.
Assuntos
Animais , Feminino , Cães , Músculos Intercostais , Anestesia Local/métodos , Anestesia Local/veterinária , Anestesia Epidural/métodos , Anestesia Epidural/veterinária , Analgésicos Opioides/administração & dosagem , Mastectomia/veterinária , Neoplasias Mamárias Animais/cirurgiaRESUMO
The present study aimed to evaluate the use of tumescent local anesthesia or epidural anesthesia associated with an intercostal nerve block in bitches submitted to mastectomy. Fourteen bitches from the clinical routine of the Veterinary Hospital of the Federal University of Pelotas were premedicated with acepromazine (0.03 mg/kg) and morphine (0.3 mg/kg) intramuscularly, then induced with propofol (2 to 6 mg/kg/IV) and maintained with 1,4V% isoflurane (calibrated vaporizer). The patients were randomly allocated into: GALT Group (n=7), which received tumescent local anesthesia (0.16%) at the dose of 15 mL/kg, and the GEBI Group (n=7) which received epidural anesthesia with lidocaine (5 mg/kg) and morphine (0.1 mg/kg) associated with an intercostal nerve block from the 6th to 12th intercostal space with lidocaine (2 mg/kg). An increase higher than 10% in heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were considered as possible signs of nociception, to which fentanyl was administered intravenously as rescue analgesia. Postoperative analgesia was evaluated by means of the modified Glasgow scale at 30, 60, 120, 240 and 360 minutes. There were no differences in physiological parameters (P>0.05) in the transoperative period intra-group and inter-group the groups. The GEBI Group required more frequent transoperative rescue analgesia (9) in comparison to the GALT Group (5), but with no statistical difference. During the postoperative period, there was no need for rescue analgesia in either group. Results suggest that epidural anesthesia associated with intercostal nerve block can be used as an alternative technique in patients with restrictions against the use of local tumescent anesthesia.
O presente estudo objetivou avaliar o uso da anestesia local tumescente ou da anestesia epidural associada ao bloqueio intercostal em cadelas submetidas à mastectomia. Foram utilizadas 14 cadelas, provenientes da rotina do Hospital de Clínicas Veterinária da Universidade Federal de Pelotas, pré-medicadas com acepromazina (0,03 mg/kg) e morfina (0,3 mg/kg) intramuscular, induzidas com propofol (2 a 6 mg/Kg/IV) e mantidas com isofluorano à 1,4 V% (vaporizador calibrado). Após essa etapa, foram alocadas aleatoriamente em grupo GALT (n=7), que recebeu a anestesia local tumescente 0,16% na dose de 15 mL/Kg e em grupo GEBI (n=7), que recebeu como tratamento a anestesia epidural com lidocaína (5 mg/kg) e morfina (0,1 mg/kg) associada ao bloqueio intercostal, do 6º ao 12º espaço intercostal, com lidocaína (2mg/kg). Os parâmetros avaliados para sinais de nocicepção transcirúrgica e realização de resgates analgésicos com fentanil foram: frequência cardíaca, frequência respiratória, pressão arterial sistólica, pressão arterial diastólica e pressão arterial média. No pós-operatório avaliou-se a analgesia pela escala de Glasgow Modificada aos 30, 60, 120, 240 e 360 minutos. Não houve diferenças entre os parâmetros clínicos (p > 0,05) no período transoperatório entre e dentro dos grupos. O GEBI apresentou maior quantidade de resgates analgésicos transoperatórios (9) em relação a GALT (5), porém sem diferenças estatísticas. No pós-operatório, nenhum animal de ambos os grupos atingiu pontuação máxima para resgate analgésico. Pode-se concluir que a anestesia epidural associada ao bloqueio intercostal é uma técnica alternativa para casos em que se tenham limitações para utilização da anestesia local tumescente.
Assuntos
Feminino , Animais , Cães , Analgésicos Opioides/administração & dosagem , Anestesia Epidural/métodos , Anestesia Epidural/veterinária , Anestesia Local/métodos , Anestesia Local/veterinária , Músculos Intercostais , Mastectomia/veterinária , Neoplasias Mamárias Animais/cirurgiaRESUMO
Background: Mastectomy, a procedure with high pain stimulation, is the treatment of choice for bitches with breast cancer. Tumescent anaesthesia is widely used for transoperative and postoperative analgesia in bitches submitted to mastectomy, because facilitates tissue divulsion, also contributing significantly for the rapid recovery of patients. Although, there is no consensus as to which local anesthetic to use and at what concentration it should be used. Herein was investigated which local anesthetics, lidocaine or ropivacaine, when used in tumescent solutions, could provide a more lasting analgesic effect in the postoperative period in bitches submitted to radical unilateral mastectomy. Materials, Methods & Results: Sixteen bitches were sedated with chlorpromazine (0.3 mg/kg) and meperidine (3 mg/kg) followed by anesthesia with propofol and isofluorane. Then, bitches were randomly assigned to two groups (n= 8 each): LG group, infused with 15 mL/kg of tumescence solution containing 0.1% lidocaine; and RG group, infused with 15 mL/kg of tumescence solution with 0.1% ropivacaine. The study was conducted in a double-blind fashion. Control group did not include, because the patients would be submitted to severe or unbearable pain, according to the short-form of the Glasgow pain Scale (CMPS-SF). The heart (HR) and respiratory () rates, and systolic blood pressure (SBP) were measured in the pre-operative period and immediately after extubation (Mextub) and at 0.5 h, 1 h, 2 h, 4 h, 8 h, and 12 h after the extubation. Analgesic efficacy was assessed using the CMPS-SF and von Frey filaments. Both groups showed higher means for HR at 0.5 h (167 ± 7 in LG; 170 ± 7 in RG) than at 4 h (117 ± 7 in LG; 120 ± 7 in RG). CMPS-SF revealed higher medians (P = 0.038) at the Mextub and 12 h time points for the LG [5 (3-6) and 1 (0-2)] than for the RG [5 (2-5) and 0 (0-1)]. Discussion: Pain was excluded as a possible explanation...
Assuntos
Feminino , Animais , Cães , Anestésicos Combinados/análise , Lidocaína , Mastectomia/veterinária , Ropivacaina , Anestésicos Locais , Neoplasias Mamárias Animais/cirurgiaRESUMO
BACKGROUND: Dyslipidemias induce angiogenesis and accelerate the development and in vitro growth of breast tumors. The aim of this study was to assess the lipid and metabolic profile of female dogs with mammary carcinomas and their correlations with body condition score and degree of tumor malignancy, as well as to study the effect of dietary fish oil supplementation on these animals. RESULTS: Overweight or obese dogs had more aggressive carcinomas and higher triglyceride (p = 0.0363), VLDL (p = 0.0181), albumin (p = 0.0188), globulin (p = 0.0145) and lactate (p = 0.0255) concentrations. There was no change in the lipid profile after supplementation with fish oil at any concentration. However, in relation to the metabolic profile, glucose (p = 0.0067), total protein (p = 0.0002) and globulin (p = 0.0002) concentrations were increased when 90% omega-3 fish oil was used as a dietary supplement. CONCLUSION: Obese dogs showed altered lipid and metabolic profiles and more aggressive tumors, suggesting an important relationship between dyslipidemia and tumor aggressiveness. Supplementation with fish oil, rich in omega-3 fatty acids, may alter metabolic parameters in cancer patients.
Assuntos
Carcinoma/veterinária , Óleos de Peixe/farmacologia , Lipídeos/sangue , Neoplasias Mamárias Animais/metabolismo , Metaboloma , Animais , Carcinoma/metabolismo , Suplementos Nutricionais , Cães , Feminino , Óleos de Peixe/administração & dosagem , Neoplasias Mamárias Animais/cirurgia , Mastectomia/veterinária , Obesidade , Ovariectomia/veterináriaRESUMO
As neoplasias mamárias são proliferações progressivas, não funcionais, compostas de células que não apresentam respostas apropriadas aos mecanismos que controlam o crescimento celular. É importante para o médico veterinário conhecer a anatomia das glândulas mamárias, a irrigação sanguínea e o sistema linfático, para escolha das medidas terapêuticas eficazes, a etiologia, epidemiologia, sinais clínicos para identificação precoce da patologia, os métodos diagnósticos, e principalmente as técnicas cirúrgicas existentes para o tratamento das neoplasias mamárias levando em consideração que a cirurgia é a conduta terapêutica de escolha em praticamente todos os casos. É importante também o reconhecimento da profilaxia.
Mammary neoplasms are progressive, nonfunctional, proliferations composed of cells that do not presente appropriate responses to the mechanisms that control cell growth. It is important for the veterinarian to know the anatomy of the mammary glands, blood irrigation and the lymphatic system, to choose effective therapeutic measures, etiology, epidemiology, clinical signs for early identification of pathology, diagnostic methods, and especially surgical techniques existing for the treatment of breast neoplasias taking into consideration that surgery is the therapeutic choice of choice in practically all cases. Recognition of prophylaxis is also important.
Assuntos
Feminino , Animais , Cães , Neoplasias Mamárias Animais/cirurgia , Neoplasias Mamárias Animais/diagnóstico , Neoplasias Mamárias Animais/diagnóstico por imagem , Neoplasias Mamárias Animais/terapia , Procedimentos Cirúrgicos Profiláticos/veterináriaRESUMO
As neoplasias mamárias são proliferações progressivas, não funcionais, compostas de células que não apresentam respostas apropriadas aos mecanismos que controlam o crescimento celular. É importante para o médico veterinário conhecer a anatomia das glândulas mamárias, a irrigação sanguínea e o sistema linfático, para escolha das medidas terapêuticas eficazes, a etiologia, epidemiologia, sinais clínicos para identificação precoce da patologia, os métodos diagnósticos, e principalmente as técnicas cirúrgicas existentes para o tratamento das neoplasias mamárias levando em consideração que a cirurgia é a conduta terapêutica de escolha em praticamente todos os casos. É importante também o reconhecimento da profilaxia.(AU)
Mammary neoplasms are progressive, nonfunctional, proliferations composed of cells that do not presente appropriate responses to the mechanisms that control cell growth. It is important for the veterinarian to know the anatomy of the mammary glands, blood irrigation and the lymphatic system, to choose effective therapeutic measures, etiology, epidemiology, clinical signs for early identification of pathology, diagnostic methods, and especially surgical techniques existing for the treatment of breast neoplasias taking into consideration that surgery is the therapeutic choice of choice in practically all cases. Recognition of prophylaxis is also important.(AU)
Assuntos
Animais , Feminino , Cães , Neoplasias Mamárias Animais/diagnóstico por imagem , Neoplasias Mamárias Animais/diagnóstico , Neoplasias Mamárias Animais/cirurgia , Neoplasias Mamárias Animais/terapia , Procedimentos Cirúrgicos Profiláticos/veterináriaRESUMO
The objective of this study was to evaluate the effect of low-dose naltrexone (LDN) as a carboplatin chemotherapy-associated drug in female dogs with mammary carcinoma in benign mixed tumors (MC-BMT) after mastectomy and to assess its association with quality of life and survival rates. Sixty female dogs were included in this study, all of which had histopathological diagnosis of MC-BMT and were divided into three groups: G1 (control), consisting of animals submitted only to mastectomy with or without regional metastasis; G2, composed of treated animals that did not present with metastasis; and G3, treated dogs that presented with metastasis. G2 and G3 were also subdivided according to the treatment administered: chemotherapy alone (MC-BMT(-) C/MC-BMT(+) C) or LDN and chemotherapy (MC-BMT(-) C+LDN/MC-BMT(+) C+LDN). All animals were subjected to clinical evaluation, mastectomy, peripheral blood lymphocyte immunophenotyping, beta-endorphin and met-enkephalin quantification, and evaluation of survival rates and quality of life scores. The results showed higher serum concentrations of beta-endorphin and met-enkephalin, fewer chemotherapy-related side effects, and better quality of life and survival rates in the LDN-treated groups than in LDN-untreated groups (P < 0.05). Evaluation of clinical and pathological parameters indicated a significant association between the use of LDN and both prolonged survival and enhanced quality of life. These results indicate that LDN is a viable chemotherapy-associated treatment in female dogs with MC-BMT, maintaining their quality of life and prolonging survival rates.
Assuntos
Carboplatina/administração & dosagem , Carboplatina/farmacologia , Linfócitos/metabolismo , Neoplasias Mamárias Animais/tratamento farmacológico , Naltrexona/administração & dosagem , Animais , Cães , Sinergismo Farmacológico , Encefalina Metionina/metabolismo , Feminino , Imunofenotipagem , Neoplasias Mamárias Animais/imunologia , Neoplasias Mamárias Animais/cirurgia , Mastectomia/veterinária , Naltrexona/farmacologia , Metástase Neoplásica , Qualidade de Vida , Análise de Sobrevida , Resultado do Tratamento , beta-Endorfina/metabolismoRESUMO
Mammary gland tumors are the most common type of tumors in bitches but research on survival time after diagnosis is scarce. The purpose of this study was to investigate the relationship between survival time after mastectomy and a number of clinical and morphological variables. Data was collected retrospectively on bitches with mammary tumors seen at the Small Animal Surgery Clinic Service at the University of Brasília. All subjects had undergone mastectomy. Survival analysis was conducted using Cox's proportional hazard method. Of the 139 subjects analyzed, 68 died and 71 survived until the end of the study (64 months). Mean age was 11.76 years (SD=2.71), 53.84% were small dogs. 76.92% of the tumors were malignant, and 65.73% had both thoracic and inguinal glands affected. Survival time in months was associated with age (hazard rate ratios [HRR] =1.23, p-value =1.4x10-4), animal size (HRR between giant and small animals =2.61, p-value =0.02), nodule size (HRR =1.09, p-value =0.03), histological type (HRR between solid carcinoma and carcinoma in a mixed tumor =2.40, p-value =0.02), time between diagnosis and surgery (TDS, with HRR =1.21, p-value =2.7x10-15), and the interaction TDS*follow-up time (HRR =0.98, p-value =1.6x10-11). The present study is one of the few on the subject matter. Several important covariates were evaluated and age, animal size, nodule size, histological type, TDS and TDS*follow up time were identified as significantly associated to survival time.
Os tumores da glândula mamária são o tipo mais comum de tumores em cadelas, porém, estudos sobre o tempo de sobrevida após o diagnóstico são escassos. Objetivou-se investigar a relação entre o tempo de sobrevida após a mastectomia, bem como variáveis clínicas e populacionais. Coletaram-se dados retrospectivos referentes a cadelas com tumores mamários atendidos no Serviço de Clínica Cirúrgica de Pequenos Animais da Universidade de Brasília e submetidas à mastectomia. A análise de sobrevida foi realizada mediante o método de Cox de risco proporcional. Dos 139 animais incluídos neste estudo, 68 morreram e 71 sobreviveram até ao final da conclusão deste traballho (64 meses). A média de idade foi de 11,76 anos (DP=2,71), 53,84% dos cães eram pequenos. Dentre os tumores, 76,92% eram malignos, e 65,73% tiveram as duas glândulas torácicas e a inguinal afetadas. O tempo de sobrevida em meses foi associado à idade (taxa de razão de risco [HRR] =1,23, p valor =1.4x10-4), o tamanho do animal (HRR entre animais gigantes e pequenos = 2,61, p=0,02), tamanho do nódulo (HRR=1,09, p valor =0,03), tipo histológico (HRR entre carcinoma sólido e carcinomas em tumor misto =2,40, p=0,02), tempo decorrido entre o diagnóstico e a cirurgia (TDC, com HRR =1,21, p valor =2,7 x10-15), e a interação TDC*tempo de seguimento (HRR = 0,98, p valor = 1.6x10-11). O presente estudo é um dos poucos sobre o assunto. Várias covariáveis importantes foram avaliadas e idade, tamanho do animal, o tamanho do nódulo, tipo histológico, TDC e TDC*tempo de seguimento foram identificados como significativamente associado ao tempo de sobrevida.
Assuntos
Animais , Feminino , Cães , Mastectomia/veterinária , Neoplasias Mamárias Animais/cirurgia , Neoplasias Mamárias Animais/diagnóstico , Neoplasias Mamárias Animais/epidemiologia , Cirurgia Geral/métodos , Diagnóstico , Prognóstico , SobrevidaRESUMO
Mammary gland tumors are the most common type of tumors in bitches but research on survival time after diagnosis is scarce. The purpose of this study was to investigate the relationship between survival time after mastectomy and a number of clinical and morphological variables. Data was collected retrospectively on bitches with mammary tumors seen at the Small Animal Surgery Clinic Service at the University of Brasília. All subjects had undergone mastectomy. Survival analysis was conducted using Cox's proportional hazard method. Of the 139 subjects analyzed, 68 died and 71 survived until the end of the study (64 months). Mean age was 11.76 years (SD=2.71), 53.84% were small dogs. 76.92% of the tumors were malignant, and 65.73% had both thoracic and inguinal glands affected. Survival time in months was associated with age (hazard rate ratios [HRR] =1.23, p-value =1.4x10-4), animal size (HRR between giant and small animals =2.61, p-value =0.02), nodule size (HRR =1.09, p-value =0.03), histological type (HRR between solid carcinoma and carcinoma in a mixed tumor =2.40, p-value =0.02), time between diagnosis and surgery (TDS, with HRR =1.21, p-value =2.7x10-15), and the interaction TDS*follow-up time (HRR =0.98, p-value =1.6x10-11). The present study is one of the few on the subject matter. Several important covariates were evaluated and age, animal size, nodule size, histological type, TDS and TDS*follow up time were identified as significantly associated to survival time.(AU)
Os tumores da glândula mamária são o tipo mais comum de tumores em cadelas, porém, estudos sobre o tempo de sobrevida após o diagnóstico são escassos. Objetivou-se investigar a relação entre o tempo de sobrevida após a mastectomia, bem como variáveis clínicas e populacionais. Coletaram-se dados retrospectivos referentes a cadelas com tumores mamários atendidos no Serviço de Clínica Cirúrgica de Pequenos Animais da Universidade de Brasília e submetidas à mastectomia. A análise de sobrevida foi realizada mediante o método de Cox de risco proporcional. Dos 139 animais incluídos neste estudo, 68 morreram e 71 sobreviveram até ao final da conclusão deste traballho (64 meses). A média de idade foi de 11,76 anos (DP=2,71), 53,84% dos cães eram pequenos. Dentre os tumores, 76,92% eram malignos, e 65,73% tiveram as duas glândulas torácicas e a inguinal afetadas. O tempo de sobrevida em meses foi associado à idade (taxa de razão de risco [HRR] =1,23, p valor =1.4x10-4), o tamanho do animal (HRR entre animais gigantes e pequenos = 2,61, p=0,02), tamanho do nódulo (HRR=1,09, p valor =0,03), tipo histológico (HRR entre carcinoma sólido e carcinomas em tumor misto =2,40, p=0,02), tempo decorrido entre o diagnóstico e a cirurgia (TDC, com HRR =1,21, p valor =2,7 x10-15), e a interação TDC*tempo de seguimento (HRR = 0,98, p valor = 1.6x10-11). O presente estudo é um dos poucos sobre o assunto. Várias covariáveis importantes foram avaliadas e idade, tamanho do animal, o tamanho do nódulo, tipo histológico, TDC e TDC*tempo de seguimento foram identificados como significativamente associado ao tempo de sobrevida.(AU)
Assuntos
Animais , Feminino , Cães , Neoplasias Mamárias Animais/diagnóstico , Neoplasias Mamárias Animais/epidemiologia , Neoplasias Mamárias Animais/cirurgia , Mastectomia/veterinária , Diagnóstico , Prognóstico , Sobrevida , Cirurgia Geral/métodosRESUMO
Background: Mammary tumors are extremely common in cats and have high metastatic rates with poor prognosis. The main objective of the present study was to evaluate the disease free interval and survival in cats undergoing radical mastectomy as sole therapy. Materials, Methods & Results: Twenty cats with mammary tumors and no evidence of distant metastasis were studied. General health and concomitant diseases were assessed by clinical and hematological examination. Thoracic radiographs and abdominal ultrasonography were performed to evaluate thoracic and abdominal metastases. All cats underwent chain mastectomy, which was unilateral when tumor was present in one mammary chain, and bilateral in steps if tumors were present in both mammary chains. Intact cats were spayed. An elliptical incision was made around the mammary chain with a three centimeter margin around tumor. Regional lymph node was removed. Mean age was ten years, and 14 cats were mixed breed, three were Persian and two were Siamese. Fifteen cats were spayed at tumor diagnosis, but only three had been spayed before one year old. The inguinal mammary glands were the most affected, followed by abdominal and thoracic glands. Histopathology diagnosed well-differentiated adenocarcinoma in eight cases, moderately differentiated adenocarcinoma in nine cases, poorly differentiated adenocarcinoma in two cases [...](AU)
Assuntos
Animais , Gatos , Neoplasias Mamárias Animais/cirurgia , Adenocarcinoma/veterinária , Análise de Sobrevida , Mastectomia/veterinária , Indução de Remissão , Ultrassonografia/veterinária , Carcinoma/veterináriaRESUMO
Background: Mammary tumors are extremely common in cats and have high metastatic rates with poor prognosis. The main objective of the present study was to evaluate the disease free interval and survival in cats undergoing radical mastectomy as sole therapy. Materials, Methods & Results: Twenty cats with mammary tumors and no evidence of distant metastasis were studied. General health and concomitant diseases were assessed by clinical and hematological examination. Thoracic radiographs and abdominal ultrasonography were performed to evaluate thoracic and abdominal metastases. All cats underwent chain mastectomy, which was unilateral when tumor was present in one mammary chain, and bilateral in steps if tumors were present in both mammary chains. Intact cats were spayed. An elliptical incision was made around the mammary chain with a three centimeter margin around tumor. Regional lymph node was removed. Mean age was ten years, and 14 cats were mixed breed, three were Persian and two were Siamese. Fifteen cats were spayed at tumor diagnosis, but only three had been spayed before one year old. The inguinal mammary glands were the most affected, followed by abdominal and thoracic glands. Histopathology diagnosed well-differentiated adenocarcinoma in eight cases, moderately differentiated adenocarcinoma in nine cases, poorly differentiated adenocarcinoma in two cases [...]
Assuntos
Animais , Gatos , Adenocarcinoma/veterinária , Análise de Sobrevida , Neoplasias Mamárias Animais/cirurgia , Carcinoma/veterinária , Indução de Remissão , Mastectomia/veterinária , Ultrassonografia/veterináriaRESUMO
The aim of this randomised placebo-controlled, observer-blinded study was to evaluate the analgesic effects of botulinum toxin type A (BoNT-A) as an adjunct for postoperative pain control in dogs. Sixteen dogs undergoing bilateral radical mastectomy for treatment of mammary tumours were enrolled. Twenty-four hours before surgery, the subjects were distributed into two groups of eight dogs each: 7 iu/kg BoNT-A (BoNT-A) or saline (Control) was administered subcutaneously in each mammary gland. Following sedation with intramuscular 0.03 mg/kg acepromazine and 0.3 mg/kg morphine, anaesthesia was induced intravenously with 4 mg/kg propofol and maintained with isoflurane/O2. Postoperative analgesia was evaluated for 72 hours after extubation using the Visual Analogue Scale (VAS) and modified Glasgow Composite Measure Pain Scale (modified-GCMPS). Rescue analgesia was provided with intramuscular morphine (0.5 mg/kg). Data were analysed using analysis of variance, Tukey's test, Mann-Whitney U test and Friedman test (P<0.05). The pain scores were significantly lower in the BoNT-A than in the Control from 8 hours to 60 hours and from 12 hours to 60 hours after extubation, based on the VAS and modified-GCMPS, respectively. Rescue analgesia was required by significantly more dogs in the Control (7/8) compared with the BoNT-A (2/8) (P=0.022). Pre-emptive BoNT-A appears to be effective as an adjuvant for postoperative pain management in dogs undergoing bilateral radical mastectomy.