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Management of Primary Transmissible Venereal Tumor in Nasal Cavity of a Dog.

Abstract

An intact male Labrador retriever dog was presented with bilateral sanguinopurulent nasal discharge, sneezing with soft fleshy swelling occupying the nasal area. Haematology revealed leucocytosis with eosinophilia and biochemistry was within normal range. Radiography of nasal area showed soft tissue densities. Cytology of nasal discharge showed neoplastic population of round cells typical of transmissible venereal tumor. Chemotherapy with Vincristine sulphate resulted in complete resolution of clinical signs and recovery.

Keywords: Chemotherapy; cytology; intranasal; TVT; vincristine sulphate

Introduction

Canine transmissible venereal tumor also called transmissible venereal tumor (TVT) is a round cell tumor of histiocytic origin affecting dogs and other canids species such as wolf and coyote (Foster, 2007). It is most commonly seen in 2-5 years old dogs with no breed or sex predisposition (Das and Das, 2000) and is prevalent most commonly in tropical and sub-tropical countries where large population of freely roaming dogs with unrestricted sexual activity as well as inadequate Veterinary services are found (Batamuzi and Bittegeko, 1991 and Das and Das, 2000). The tumor is mainly transmitted by inoculation of intact neoplastic cells into injured mucous membrane or skin during mating but sometimes, social behaviour such as biting, sniffing and licking also reported to transmit the tumor (Gurel et al., 2002). The disease is generally considered as benign with predilection for external genitalia such as prepuce, penis and vagina (Rogers et al., 1998) but clinical reports of being metastasized into other body organ such as skin, oral and nasal cavity, conjunctiva, rectum and liver are also present (Gurel et al., 2002; Bastan et al., 2008; Chikweto et al., 2013 and Komnenou et al., 2015). Some reports also describe that TVT can occur primarily in extra-genital sites such as rectum, lips and eyes with no involvement of genital parts (Das and Das, 2000 and Komnenou et al., 2015). The present clinical report describe primary intranasal TVT in a dog.

History and Clinical Findings

A three year old male uncastrated Labrador retriever weighing 33 kg was brought with history of recurrent bilateral sanguinopurulent nasal discharge since last one year. The dog often sneezed. During excitement or handling of dog, blood in form of small clots came out from nares. Since last one month, the dog was not able to breathe and eat properly due to nasal swelling below the right eye. Physical examination revealed normal physiological parameters. A soft painful swelling was palpable at nasal area on right side of face (Fig. 1). Haematological parameters were: haemoglobin 11.6 gram%; total leucocyte count 19580 [mm.sup.3]; differential leucocyte count, neutrophils 76%, lymphocytes 14%, eosinophils 10%; total erythrocyte count 5.67 x [10.sup.6] [mm.sup.3]; packed cell volume 34% and platelet count 211 x [10.sup.3]. Roleaux formation of RBC's was also noted. Blood picture was negative for blood parasites. Biochemical parameters pertaining to liver and kidney were within normal range. Radiographic evaluation of head in lateral and ventro-dorsal plane showed soft tissue density with no air or any encapsulated mass. Cytological examination of nasal swab sample revealed large number of round cells (Fig. 2). Based on cytological findings, extragenital nasal TVT was diagnosed. Prepuce and penis of dog could not revealed any growth. Chemotherapy using Vincristine sulphate (0.025 mg/kg, intravenous) was initiated once weekly. Oral antibiotic (Amoxicillin and Clavulanic acid, BID), anti-inflammatory (Nimusulide, OD) and liver tonic (Syrup Liverolin (a), BID) were also administered for one week.

Follow-up involved re-examination and telephone communication with the owner. After one week, nasal discharge decreased with slight reduction in nasal swelling. But dog developed nasal fistula (Fig. 3), coughing and inappetence. Sanguinopurulent discharge oozed out of nasal fistula. Radiography of chest revealed mild interstitial pattern in caudal lung lobe. Dog was put on injectable antibiotic (Ceftriaxone, BID) and anti-inflammatory (Flunixin Meglumine, OD) along with oral antihistaminic (Diphenhydramine, TID) and liver tonic (Syrup Liverolin (a), BID) for another one week. Owner was also advised to continue Vincristine sulphate at weekly interval for another three weeks. Marked improvement was noticed after two injections of Vincristine sulphate. Nasal swelling and fistula got completely cured along with absence of respiratory signs of nasal discharge and sneezing after four injections of Vincristine sulphate (Fig. 4).

Discussion

In naturally occurring TVT, canine genitalia is the most common primary site. Reports of primary TVT arising in extra-genital sites are few. In one of the study, Gupta and Sood (2012) reported primary TVT of mammary glands without evidence of TVT in external genitalia. More rarely, these tumors may also be found in lips, oral mucosa, peritoneum, tonsils, eye, liver, spleen, kidney, lung, and ovaries (Rogers et al., 1998; Bastan et al., 2008 and Komnenou et al., 2015). In absence of primary genital tumor, extra-genital TVT is considered either primary due to dog's social behaviour or metastatic if primary lesion had completely regressed before the dog was examined (Das and Das, 2000 and Komnenou et al., 2015). In present case, since no genital or extra-genital lesions were found following physical examination, diagnostic imaging and laboratory tests, nasal lesions were considered to be primary. Papazoglou et al. (2001) also reported primary TVT from nasal cavity in six dogs. Dogs of any age, sex and breed may be affected, whether they are sexually active or not (Das and Das, 2000 and Komnenou et al., 2015). In present report, although the dog was house kept but it oftenly roams outdoor, therefore might came in contact with stray dogs, which may explain the mode of tumor transmission.

Diagnosis was based on cytological examination of nasal discharge which clearly differentiates from other nasal tumors (Moulton, 1978). Clinical signs reported in this case are similar with those described by Papazoglou et al. (2001) with epistaxis and nasal discharge as the first signs. Sneezing and sanguinopurulent exudate was the most commonly observed signs; epistasis during excitement or handling was related to fragile nature of tumor. Clinical signs such as facial deformity (swelling), sneezing, dyspnea, bleeding through oral cavity, and ocular discharge may be present in some cases (Papazoglou et al., 2001 and Komnenou et al., 2015).

Various treatment options such as chemotherapy, immunotherapy, radiation therapy, thermal therapy and surgical excision are available for management of canine TVT (Rogers et al., 1998; Das and Das, 2000; Kangasniemi et al., 2004 and Nak et al., 2005), but chemotherapy is the most effective method of treating TVTs. Vincristine sulphate, a well tolerated and cost effective drug, is the most frequently used drug and complete remission of TVT usually occurs after 2-8 weekly injections (Nak et al., 2005). In our report, the dog recovered completely with 4 weekly injections of Vincristine sulphate. We have given a course of antibiotics to control secondary bacterial infection. Anti-inflammatory drugs along with anti-histaminic and hepatoprotectant drugs were also administered to correct clinical signs such as swelling, inappetence and coughing.

To conclude, in dogs with chronic symptoms related to upper respiratory tract, one must consider the possibility of intranasal TVT, even in absence of apparent tumor proliferation. Diagnosis could be made by cytological examination and chemotherapy with Vincristine sulphate exhibit complete remission of the disease.

References

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Raj Sukhbir Singh (1) and N.K. Sood (2)

Department of Teaching Veterinary Clinical Complex College of Veterinary Science Guru Angad Dev Veterinary and Animal Sciences University (GADVASU) Ludhiana - 141004 (Punjab)

(1.) Assistant Professor and Corresponding author. E-mail: rsbs_66@rediffmail.com

(2.) Professor

(a) - Brand of Zydus Animal Health Ltd., Ahmedabad
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Title Annotation:Short Communication
Author:Singh, Raj Sukhbir; Sood, N.K.
Publication:Intas Polivet
Article Type:Report
Date:Jul 1, 2016
Words:1646
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