Unusual lumps

RE: Unusual lumps

Aine Seavers — Thu, 17 Sep 2015 01:28:07 GMT

angiomatosis is a vascular lesion in the skin- plus for a fascinating read ,investigate Propanolol- it truely is a incredible drug- many effects -so yes you have to know when not to use it or with what not to use it but that said it is a remarkable medication, easily accessible and very affordable. In the derm world both human and vet it is used in these angiomatosis and also haemangioma cases- in children being able to use a simple tablets for disfiguring facial lesions is a godsend. Some good links I found interesting I kept in a list so happy to share . The work on the human haemangioma revealed aspects of propanolol not well known, then when bacillary angiomatosis in animals began to really be considered, this drug was a natural option.

Propranolol for Severe Hemangiomas of Infancy

N Engl J Med 2008; 358:2649-2651June 12, 2008DOI: 10.1056/NEJMc0708819

Early, intermediate and long-term
effects of propranolol on IH can be attributed to three different
pharmacological targets. Early effects (brightening of the haemangioma
surface within 1-3 days after start of therapy) are attributable to
vasoconstriction due to decreased release of nitric oxide. Intermediate
effects are due to the blocking of proangiogenic signals (vascular
endothelial growth factor, basic fibroblast growth factor, matrix
metalloproteinase 2/9) and result in growth arrest. Long-term effects of
propranolol are characterized by induction of apoptosis in proliferating
endothelial cells, and result in tumour regression.

Bartonellosis has been reported in one case in an immunosuppressed dog recently (see Yager, J.A., Best, S.J., Maggi, R.G., Varanat, M., Znajda, N., Breitschwerdt, E.B., 2010. Bacillary angiomatosis in an immunosuppressed dog. Vet Dermatol 21, 420-428).

Ide, K., Uchida, N., Iyori, K., Mochizuki, T., Fukushima, R., Iwasaki, T., Nishifuji, K., 2013. Multi-system progressive angiomatosis in a dog resembling blue rubber bleb nevus syndrome in humans. J Small Anim Pract 54, 201-204.

Peavy, G.M., Walder, E.J., Nelson, J.S., Rosenberg, M., 2001. Use of laser photocoagulation for treatment of cutaneous angiomatosis in one dog and two cats. Journal of the American Veterinary Medical Association 219, 1094-1097.

Olivieri, L., Nardini, G., Pengo, G., Abramo, F., 2010. Cutaneous progressive angiomatosis on the muzzle of a dog, treated by laser photocoagulation therapy. Vet Dermatol 21, 517-521.

One of the comments I have read on the cases is the constant licking even after removal ( not follicular types which would appear from comments above to heal well so that is good to know) but those who licked after wards did not have such good outcomes. Hope that helps and would be good if you can update us all and share what happens with both your cases.

If any one wants any links for propanolol then happy to post them as well'

RE: Unusual lumps

Martin Atkinson — Mon, 14 Sep 2015 10:45:51 GMT

[quote user="Kate Richardson"]I don't think I would be reaching for propranolol without researching a lot further, and speaking to some specialists first, as its not a benign drug.[/quote]Indeed, last cardiac lecture I went to suggested it was contraindicated in cats. But I am struggling to see how a beta blocker is going to help in a skin problem - am I the only one?

RE: Unusual lumps

Tim Charlesworth — Mon, 14 Sep 2015 09:13:04 GMT

A Harmatoma is a non-neoplastic "mass" usually caused by some abnormality in cellular reproduction/development. We have seen several cases of angiomatosis but we have seen at least two (that I can remember) which actually turned out to be haemangiosarcoma once resected - just to warn you! The cases that I have seen presented with haemorrhage either into the viscus affected (eg colonic angiomatosis) or externally (distal limb/pad lesions). If the histopath is reliable then both types of lesion should be benign and shouldn't contribute towards any wound healing problems so I would at other factors if the animals are experiencing difficulties

RE: Unusual lumps

Aine Seavers — Sun, 13 Sep 2015 23:50:54 GMT

I did specify it was for the dog not the cat in the post. I am new to vetseruge so Really good to know Arlo can use this site to harvest practice based evidence, PBE it is what tends to push me to keep on journal publishing despite the time input and time lag to get things published- 2 papers now in on revision submission stage are on exactly that aspect done working with colleagues. Journal publication gets harder when ethics committees wont even allow blood drawn for investigation unless done at the time of something else the animal was having done, then you need power number of cases so it would be good to have clinical information pooled here that could rhen be published, On CCde, yes canine cogn disorder which clients call demenia/alx and in the absence of my knowing exactly the pathology I tend to let them. Some cat only clinics have used the inderal in cats with dementia with good effect- after ruling out hypert4 as the cause of the change in behaviour( as used to see that happen when inderal was used to stablisie hypert4 cats when anti-thyroid meds still in their feline infancy)

RE: Unusual lumps

Kate Richardson — Sun, 13 Sep 2015 13:36:09 GMT

This is a cat though, so given the incidence of sub clinical cardiac disease in this species, I would again caution against propranolol without strong justification.

Interesting re its use in dogs though for behaviour issues, was not aware of this and will look into it more. (Whats ccd though?- canine cognitive disorder?)

Bacillary angiomatosis may be well accepted in derm circles, but I have never seen or heard of it, so is it really that common? maybe others will come forward with other cases. Not that me not having seen it means it isn't! And yes, some things are more common than reported, probably because they occur in GP practice and don't get written up or reported, something I think Arlo is keen to use this site for.

RE: Unusual lumps

Aine Seavers — Sun, 13 Sep 2015 11:42:17 GMT

re propanolol in dogs- it is very benign if you know when to not to use it- it is an extra-ordinary drug from PTSD in people and dogs, burns, behaviour without risk of agresssion as in so many behaviour meds in dogs, angiomatois, anxiety latter addressed esp is life changing for dogs with anxiety related to ccd- can take an old dog with Cdd and allow them as one client said 13 of 14 nights of rest compared to one night of rest in 14-days extends life about 18mths at the end which is significant and then move onto the dramatically more expensive vet registered drugs. Bacillary angiomatosis is well accepted in the veterinary dermoid community esp by the specialists so one should be able to check that and again where laser is used for this in the vet specialist world- .

Re bartonella not causing disease in cats- again would depend on one's location in the world and disease incidence -http://www.natvetlab.com/PDF/newsletters/NVLNewsLtrWinter-2015-Vol14-No1.pdf- if one thing living in Oz has taught me is never believe a condition doesnt exist esp where decades have gone without anyone checking the current status- the global movement of people and their reservoir cats see many diseases changing their distribution. I was told no FELV in Oz to any extent- but ill cats looking like London FELV cats would present to my clinic for 2nd opinion- everything tested but Felve and they looked like FELV and they were + on repeated serology- unless you look you will never find.

RE: Unusual lumps

Kate Richardson — Sun, 13 Sep 2015 11:19:29 GMT

I agree with Charlotte, follicular hamartoma is quite a common histo report I have had and I think from memory they are benign as well, and unlikely to cause a problem with wound healing, so I would suspect its due to location of surgery rather than the mass itself, but I would speak to the lab for more info.

Re bacillary angiomatosis, I have never heard of this before and no personal experience, but a quick google reveals it is a human term, essentially its a bacterial infection with bartonella species (cat scratch disease) characterised by vascular proliferation causing tumour like lesions in the skin or other organs. What did the lesion look like before surgery? Was there complete excision reported? As Aine says, doxycycline would be the antibiotic of choice, bartonella rarely causes disease in cats,

http://www.abcd-vets.org/Guidelines/Pages/en/1201/Feline_bartonellosis.aspx

It usually causes problems in people if they are immunocompromised, so something to consider in this cat (ie test for FIV, FELV, check haematology). Whether it the cause of problem with wound healing I don't know, so again I would consult with your pathologist.

I don't think I would be reaching for propranolol without researching a lot further, and speaking to some specialists first, as its not a benign drug.

And I personally wouldn't go near it with a laser either, contraindicated in neoplasia, and aslthough this isn't strictly speaking a neoplastic lesion, it is proliferative, so again I would speak to specialists/laser people about this if you were to consider it.

RE: Unusual lumps

Charlotte Marshall — Sun, 13 Sep 2015 10:19:29 GMT

I am pretty sure I have had dogs with follicular hamartoma before. I don't recall any particular problems with wound healing. I seem to recall the lab said they were benign. Or have I misremembered?

RE: Unusual lumps

Aine Seavers — Sun, 13 Sep 2015 07:37:25 GMT

the term bacillary angiomatosis often used- in cats doxycycline traditionally used,but dogs need to have 2nd antibiotic added in and for longer time -rifampin, was the favourite. Propanolol-Inderal also used in great success in children for this. Otherwise laser of the lesions. Are there any common links between both partients re location, humans, same vet clinic for op on same day etc? I would certainly start with inderal and doxy in the dog as my experience with inderal has made it a great fav super safe drug used long term in even the oldest dog with great results from CCD/Dementia to burns to mild behaviour disorders(with the usual caveat about know your drug interactions and co-morbidity diseases in any given patient)