Post on 17-Aug-2015
“Elli” – History and Presentation
6 year old FN Rottweiler.
Intermittently lame on left hindlimb for several months.
2 weeks ago fell out of car. Pain unresponsive to analgesia.
Particularly stiff after rest.
“Elli” - Examination
3/5 lame on left hind.
Firm swelling left distal tibia medially.
No other abnormalities detected.
“Elli” - Investigations
Blood Sample All haematology and
biochemistry results within normal limits.
Radiography of the Lesion
Thoracic Radiography
Radiographs sent from the referring veterinary surgeons non-diagnostic.
“Elli” – Differential Diagnoses
Primary neoplasm Osteosarcoma
Chondrosarcoma, fibrosarcoma, liposarcoma
Bone metastases Commonly from mammary / prostatic tumours (unlikely in
this case!)
Osteomyelitis
Osteosarcoma – Overview
Most common bone tumour in dogs (85%) “Away from the elbow, towards the knee”
Middle aged and older large breeds Locally invasive Early metastasis
Osteosarcoma – History & Presentation
Present lame Often severe, acute onset
Pain due to microfractures or osteolysis
Swelling at the primary site
Osteosarcoma - Investigations
Radiography of the lesion “sunburst appearance”
“Codman’s triangle”
Thoracic Radiography 2 lateral views
Lung metastases
Abdominal Ultrasound
Core Biopsy
Osteosarcoma – Treatment Options
Euthanasia Palliative Treatment
Pharmacological (NSAIDs, bisphosphonates)
Radiotherapy
Amputation Limb Salvage Surgery
Chemotherapy Carboplatin
(Cisplatin)
(Doxorubicin)
“Elli” - Treatment
Analgesia Previcox & Famotidine
Amputation Chemotherapy
Carboplatin
Starting ~2 weeks following surgery
Take Home Messages - Osteosarcoma
Common bone tumour Large breed dogs predisposed Many treatment options
Choose on individual basis
Treatment not curative
References Blackwood, L., 1999. Bone Tumours in small animals. In Practice, 21(1), 31-37
Chun, R., Garrett, L.D., Henry, C., Wall, M., Smith, A., Azene, N.M. 2005. Toxicity and Efficacy of Cisplatin and Doxorubicin Combination Chemotherapy for the Treatment of Canine Osteosarcoma. Journal of the American Animal Hospital Association, 41(6) 382-387
Dernell, W.S., Ehrhart, N.P., Straw, R.C., Vail, D.M. (2007). Tumours of the Skeletal System. In: Withrow, S.J., Vail, D.M. Withrow and MacEwen's Small Animal Clinical Oncology. 4th ed. Missouri: Elsevier. 540-567.
Dobson, J., 1998. Options for the use of chemotherapy in small animals Part 2. Indications. In Practice. 20(9) 487-493
Elliot, J., 2014. Clinical evaluation of small animal cancer patients. In Practice, 36(5), 218-222
Naruse, T., Nishida, Y., Hosono, K., Ishiguro, N. 2005. Meloxicam inhibits osteosarcoma growth, invasiveness and metastisis by COX-2-dependent and independent routes. Carcinogenesis : Integrative Cancer Research, 27(3) 584-592
Polton, G., 2012. Chemotherapy protocols used in veterinary practice. In Practice, 34(7) 382-391
Phillips, B., Powers, B.E., Dernell, S., Straw, R.C., Khanna, C., Hogge, G.S., Vail, D.M. 2009. Use of Single-Agent Carboplatin as Adjuvant or Neoadjuvant Therapy in Conjunction With Amputation for Appendicular Osteosarcoma in Dogs. Journal of the American Animal Hospital Association. 45(1) 33-38