Beal Matthew W, McGuire Lindsey D, Langohr Ingeborg M
Departments of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, 48824-1314.
J Vet Emerg Crit Care (San Antonio). 2014 Nov-Dec;24(6):751-8. doi: 10.1111/vec.12247.
To describe the clinical presentation, treatment, and outcome of a dog with an arterial tumor embolism.
An 11-year-old, neutered male Irish Setter presented with acute right forelimb lameness. The dog was unable to bear weight on the right forelimb, which was cool to the touch with no palpable pulses. Diagnosis of thromboembolism was confirmed using angiography, revealing a lack of blood flow to the right axillary artery. Balloon angioplasty, thrombosuction, and infusion of the thromboembolism with tissue plasminogen activator were used to achieve increased, but not complete, blood flow through the vasculature. Echocardiogram revealed vegetative mitral valve lesions consistent with endocarditis, thrombus, neoplasia, or a combination thereof. At the time of discharge, there was improvement in the temperature and motor function of the proximal limb but no conscious proprioception or deep pain sensation in the distal limb. Histopathologic analysis of the sample retrieved with thrombosuction was consistent with a diagnosis of myxosarcoma. A series of 3 rechecks showed continued improvement in neuromuscular function. Treatment for suspected mitral valve myxosarcoma was declined. The patient was lost to follow up until being presented for necropsy 16 months later. Necropsy confirmed myxosarcoma of the mitral valve with tumor emboli to the coronary arteries, lungs, and the right axillary artery.
To the authors' knowledge, there is no report of myxosarcoma originating on the mitral valve in dogs, although it has been reported in the human literature. To the authors' knowledge, there are also no reports of tumor embolism of the axillary artery in a dog. This case demonstrates a unique presentation of a dog that had a myxosarcoma tumor embolism. It also describes the use of angiography for diagnosis and localization of the vascular obstruction and a variety of interventional techniques for the treatment of thromboembolism.
描述一只患有动脉肿瘤栓塞犬的临床表现、治疗方法及预后。
一只11岁已绝育的雄性爱尔兰赛特犬出现右前肢急性跛行。该犬右前肢无法负重，触摸时发凉且无明显脉搏。通过血管造影确诊为血栓栓塞，显示右腋动脉无血流。采用球囊血管成形术、血栓抽吸术以及用组织型纤溶酶原激活剂灌注血栓栓塞部位，以增加血管系统的血流量，但未完全恢复。超声心动图显示二尖瓣赘生物性病变，与心内膜炎、血栓、肿瘤或其组合相符。出院时，近端肢体温度和运动功能有所改善，但远端肢体无本体感觉或深部痛觉。血栓抽吸获取样本的组织病理学分析结果与黏液肉瘤诊断相符。三次复诊显示神经肌肉功能持续改善。因怀疑二尖瓣黏液肉瘤而拒绝进一步治疗。该患者失访，直到16个月后进行尸检。尸检证实二尖瓣黏液肉瘤伴肿瘤栓塞至冠状动脉、肺和右腋动脉。
据作者所知，犬二尖瓣起源的黏液肉瘤尚无报道，尽管在人类文献中有相关报道。据作者所知，犬腋动脉肿瘤栓塞也无报道。本病例展示了一只患有黏液肉瘤肿瘤栓塞犬的独特表现。还描述了血管造影用于血管阻塞的诊断和定位以及多种介入技术治疗血栓栓塞的情况。
