ABSTRACT OF THE WEEK

Veterinary and comparative oncology
Volume 19 | Issue 1 (March 2021)

Clinical outcome in 23 dogs with exocrine pancreatic carcinoma.

Vet Comp Oncol. March 2021;19(1):109-114.

Christopher J Pinard¹, Samuel E Hocker², Kristen M Weishaar³

¹ Colorado State University Flint Animal Cancer Center, Fort Collins, Colorado, USA.; ² Ontario Veterinary College Mona Campbell Centre for Animal Cancer, University of Guelph, Guelph, Ontario, Canada.; ³ Colorado State University Flint Animal Cancer Center, Fort Collins, Colorado, USA.

Abstract

Exocrine pancreatic carcinoma is uncommon in the dog and the veterinary literature surrounding the disease is minimal. Twenty-three cases of canine exocrine pancreatic carcinoma were reviewed in a retrospective manner to obtain information on clinical presentation, behaviour and survival associated with the disease. Presenting clinical signs were nonspecific and included anorexia, lethargy, vomiting and abdominal pain. The overall median survival time was only 1 day but was confounded by the large number of dogs that were euthanized shortly after diagnosis. Metastatic disease was detected in 78% of cases at the time of diagnosis, attesting to the aggressive nature of the disease. Neither lymph node metastasis, tumour size nor tumour location had an impact on overall survival. Only one patient was a previous diabetic who is contrary to reports of the disease in people and felines. This retrospective study reaffirms the need for early detection measures to optimize disease control. However, the benefits of therapy with surgery or radiation and adjuvant chemotherapy remain to be elucidated in dogs with exocrine pancreatic carcinoma.

Companion Notes

Retrospective report on the clinical outcome of 23 dogs with exocrine pancreatic carcinoma

Introduction on exocrine pancreatic carcinoma (EPC) in the dog

- uncommon prevalence, with incidence rate under 0.5%

- in human medicine, 78%-80% die from the disease

- in feline medicine

- rare prevalence

- increasing age is predisposing risk factor (in dogs and cats)

- in a retrospective report of 34 cats

- high propensity for metastasis

- median survival time: 97 days

- in cats undergoing surgery ± chemotherapy: 165 days

- in canine medicine

- in 1 report, Airedale terrier at highest risk (R = 16.9)

Study design

- study population: dogs seen at Colorado State University (CSU)

- 23 dogs with exocrine pancreatic carcinoma

- inclusion criteria:

- cytologic or histopathologic diagnosis of a carcinoma of the pancreas

- with no endocrine appearance

- procedure: records from 02-17 retrospectively reviewed

Results

- history and signalment

- median age at diagnosis: 11 years with a range of 5-16 years

- median weight: 27.3 kg with a range of 5.5-50.9 kg

- breeds represented by 2 or more cases

- mixed breed dog, 6 cases

- golden retriever, 2

- English cocker spaniel, 2

- Labrador retriever, 2

- previous diagnosis of diabetes (well-controlled), 1 dog

- diabetes reported a predisposition for EPC in cats

- also reported a predisposition in 50% of humans with EPC

- median duration of clinical signs prior to presentation: 7 days; range: 0-60 days

- presenting clinical signs were nonspecific and included the following:

(in 3 dogs, pancreatic masses were found incidentally)

- lethargy, 14 of the 23 (61%)

- anorexia, 8

- vomiting, 8

- abdominal pain, 1

- CBC and serum biochemistry, performed in 9 cases

- inflammatory leukogram, 1

- increased alanine aminotransferase, 2

- increased alkaline phosphatase, 2

- increased amylase, 2, based on referral bloodwork

(CSU lab does not routinely assess pancreatic enzymes)

- increased lipase, 2, based on referral bloodwork

- diagnostic testing

- diagnosis of pancreatic carcinoma made via the following:

- necropsy, 11 (48%)

- cytology, 9 (39%)

- surgical biopsy, 3 (13%)

- tumor location in the 20 dogs with location recorded

- diffuse involvement of the pancreas, 8

- affecting right lobe, 6

- along body of the pancreas, 4

- affecting left lobe, 2

- outcome

- overall median survival time: 1 day

- confounded by large number of dogs euthanized shortly after diagnosis

- about 15 dogs were euthanized within 24 hours of diagnosis

- due to clinical decline or the diagnosis

- 3 dogs were euthanized due to another comorbidity

- before diagnosis of pancreatic carcinoma

- metastatic disease, detected in 78% (18 dogs) at diagnosis

- liver, 12 of the 23 (52%)

- 3 had metastasis to the liver only

- regional lymph nodes, 10

- spleen, 2

- diaphragm, 2

- more diffuse carcinomatosis, 2

- factors found to not affect overall survival

- lymph node metastasis

- tumor size

- tumor location

- treatment

- surgical excision or biopsy of pancreatic mass, 5

- 2 received adjuvant therapy postop

- 2 were euthanized at surgery

- one due finding of pancreatic mass

- one due to inoperable pancreatic tumor

- pancreaticoduodenectomy, 1 dog

- owner elected euthanasia 6 days postop

- due to complications and acute decline

- partial pancreatectomy, 1 dog surviving postop period

- lost to followup after 1^st dose of carboplatin 2 weeks postop

“Ultrasonographically, some patients with diffuse carcinoma had described changes and imaging diagnoses of pancreatitis or pancreatic oedema. This is important to note as there may be dogs that are clinically assessed as having pancreatitis but may ultimately be diagnosed with carcinoma.”

Keywords

canine; carcinoma; neoplasm; oncology; pancreas; small animal;

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