SouthPaws Oncology Updates
Sarah E. Sheafor, DVM, DACVIM (Oncology)

New Hope for Feline Vaccinal Sarcomas:
The published information for survival times of cats with this tumor type is quite dismal.  Traditional conservative or even modestly aggressive surgeries result in local recurrence within 6 months, with as many as one in four cats developing metastatic disease.  Innovations in radiation oncology are allowing more aggressive treatments for cats with advanced disease (deeply fixed), but long term cures are unlikely.  For the last five years, I have been a part of a multimodality approach to cats with moderately fixed vaccinal sarcomas of all sizes with the cooperation of Dr. Dan Brehm in the surgery department.  All cats have received a radical en bloc surgery to include all bone/soft tissue with 3cm margins (to include rib resection, dorsal vertebral spinal process removal, amputation) followed by four cycles of chemotherapy.  At this point, in over forty cats in whom we have two years or more follow-up time, we have NO local recurrences and a metastatic rate of only 13%.  The key to this success is early, aggressive surgery and the initiation of chemotherapy in all patients at the time of suture removal.  Clients have been pleased with the rapid return to full function, the cost savings compared to triple modality therapy (radiation/surgery/chemo), and the normal quality of life their cats maintain while receiving chemotherapy at SouthPaws.  Please call if you believe you have a cat with a soft tissue mass in the area where vaccines are administered to find out if this approach would be the best for your cat.

Cutting Edge Studies for Cancer Patients:

At SouthPaws, we are proud to be an integral part of several new and innovative drug trials for cancer patients.  Many of these studies offer partial or complete funding to enable clients to pursue aggressive cancer therapy.  Currently, we have three open studies available.
1)  For dogs with newly diagnosed, completely untreated (no corticosteroids at all) lymphoma, we can offer a single agent antimetabolite chemotherapy drug as part of a fully funded trial.  Owners can, of course, choose from traditional combination chemotherapy for their dogs with lymphoma (COP, ACOPA, or a new 19 week combination with no maintenance), if they would rather not be a part of the funded study.
2)  For dogs with newly relapsed lymphoma which

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Vestibular Disease
Michael Knoeckel, DVM DACVIM (Neurology)

Vestibular disease is an often seen disorder in small animal practice. Frequently, it is associated with external ear disease and as such, is often readily treated. If it is associated with idiopathic, or geriatric vestibular disease, (which causes signs of peripheral disease) it doesn't require any specific treatment at all and has a good prognosis for resolution of the vestibular signs.  If the signs are associated with a disorder of the central vestibular system, (the brainstem or the cerebellum) it may have an entirely different prognosis.  With this in mind, it is important to localize the disease process.  Not only  to choose the most appropriate diagnostic tests and treatment, but also to instruct the owner as to the potential course and prognosis of the disease process.

There are two basic concepts in localizing the process during the physical exam. One is through the characteristics of the vestibular signs themselves and the other is by the presence or absence of additional signs.

Typical vestibular signs include: A head tilt, ataxia and nystagmus. When severe, the animal may roll to one side. Not so much due to weakness on that side, but from  increased limb flexor tone to the direction of the roll and increased extensor tone on the other side. Nystagmus is characterized by it's direction. While the pathological movement is actually the slow drifting, by convention we name it based on the fast, corrective phase. It can be considered lateral, vertical or rotary. Sometimes rotary nystagmus looks rotary in one eye and almost vertical in the other.  In this situation, that eye appears to be almost vertical in movement.

Additional signs can often be associated with the location of the lesion and the proximal neurologic structures.  The sympathetic input to the eye and surrounding tissues is often affected by middle ear disease (causing a partial or complete Horner's Syndrome).  The seventh cranial nerve also passes along the middle ear and it's involvement in inflammatory or neoplastic processs can result in facial paresis or paralysis, as well as keratoconjunctivitis sicca.

With central disease affecting the brainstem, or the vestibular centers of the ventral cerebellum, we tend

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