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KMID : 1094020170340060441
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Journal of Veterinary Clinics
2017 Volume.34 No. 6 p.441 ~ p.444
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Metronomic Chemotherapy with Toceranib Phosphate for a Disseminated Histiocytic Sarcoma in a Miniature Schnauzer Dog
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Hong Hwa-Ran
Lim Seul-A
Shin Hye-Ri
Choi Ho-Jung
Lee Hae-Bum
Song Kun-Ho
Seo Kyoung-Won
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Abstract
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A 15-year-old spayed female Miniature Schnauzer was presented for unilateral foreleg lameness and pain. On physical examination, left elbow joint swelling and stiffness were identified. On a computed tomography (CT) scan, a periosteal reaction of the left humerus from the distal metaphysis to the epiphysis and cortical destruction of the medial condyle was observed. Based on blood tests, histopathology, and immunohistochemistry, it was concluded as a skeletal histiocytic sarcoma. Since the patient’s pain was not controlled despite application of a fentanyl patch, a left forelimb amputation was decided upon as part of the palliative therapy. Metronomic chemotherapy with toceranib phosphate and pamidronate was initiated. Toceranib was administered for 3 months without the development of any adverse effects except mild neutropenia. However, 3 months after initiating treatment, the toceranib was discontinued due to moderate gastrointestinal disturbances. Over the next 2 months, a left mandibular bone mass and cortical bone destruction in the bilateral tibia and tarsal joint were identified on CT. The patient became unwilling to eat and was noted to have severe skeletal pain. The anorexia and lethargy were progressively worsening and the owner decided to euthanize the patient. A necropsy was performed and the patient was definitively diagnosed with disseminated histiocytic sarcoma based on histopathologic and immunohistochemical analyses. This report describes a Miniature Schnauzer dog with DHS managed with surgical removal and metronomic chemotherapy with toceranib that survived with an improved quality of life for 7 months.
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KEYWORD
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disseminated histiocytic sarcoma, metronomic chemotherapy, toceranib phosphate, tyrosine kinase inhibitor
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