Veterinary Medicine News

Read the latest neuro news

Appointments for animals with suspected brain tumors or other neurological problems are always available through the Neurology/Neurosurgery service. The service is also happy to provide consultations and second opinions if your animal has been diagnosed with a brain tumor.

William R. Pritchard Veterinary Medical Teaching Hospital
Small Animal Clinic Telephone: 530.752.1393

Toni Beelard
Neurology / Neurosurgery Service Coordinator
Monday through Friday,
8 AM to 5 PM
Direct Phone Line 530.754.0606

 

Some usefull links:

American College of Veterinary Internal Medicine
http://www.acvim.org/websites
/acvim/index.php?p=2


European College of Veterinary Neurology
http://www.ecvn.org

Veterinary Neurology and Neurosurgery Online Journal
http://www.vin.com
/VNNJ/journal.plx


National Brain Tumor Foundation
http://www.braintumor.org
/GeneralMenu

 

Treatment of your animals brain tumor
at the VMTH

The Neurology/Neurosurgery service at the VMTH currently has 5 fulltime neurologist/neurosurgeons who are diplomats of the American College of Internal Medicine (Diplomate ACVIM Neurology). There are additionally 3 adjunct professors and 4 residents in specialty training. This provides our clients with a wealth of experience and expertise in the diagnosis and treatment of their pets brain tumors.

Neurology/Neurosurgery clinical and research publications on brain tumors

The Paul C. and Borghild T. Petersen Brain Tumor Laboratory is a research laboratory closely linked to the Neurology/Neurosurgery Service. The laboratory focuses on understanding the molecular and genetic causes of brain tumors in companion animals, and the development of novel treatments. It has a wide circle of caollaborations with basic science and clinical researchers in both veterinary and human universities.

Why bring your pet to the
Neurology/Neurosurgery service?

Diagnosis:

Diagnosing an animals problem as accurately as possible ensures that the most appropriate treatment options can be discussed. It is important that your animal has a complete neurological examination by an experienced clinician so that the location of the problem can be determined and appropriate possible diagnoses discussed.

It is important to perform initial diagnostic tests such as blood work, chest radiographs and abdominal ultrasound on animals where a brain tumor is suspected. Approximately 25% of animals with primary brain tumors will have other cancers, often unrelated, and many older animals will have other significant diseases that will affect the decisions on how to proceed with additional diagnostics and treatment.

Advanced Imaging:

Advanced imaging, particularly magnetic resonance imaging (MRI) is an important part of the diagnostic process for most animals with disease affecting the brain. The other imaging technique used to image the brain is computed tomography (CT). In most cases MRI is the preferred technique since it provides much more information and detail compared to CT.

Both MRI and CT imaging are available at the VMTH and an animals images will be reviewed by both specialist radiologists and specialist neurologist/neurosurgeons with many years of experience interpreting brain imaging.

 

CT Pict

CT Scanner

CT imaging is especially useful when looking at abnormalities affecting bone. In this case, a large bony tumor is invading into the skull and compressing the brain. These tumors can be effectively treated with surgery in many cases.

 

MRI pict

MRI Scanner (1.5T)

MRI provides much more detail than CT when looking at tumors arising within the brain. In this case the tumor (*) can be seen to be causing compression of other brain structures, as well as edema (arrow) in the surrounding brain.

Brain Biopsy

As with many other diseases, definitive diagnosis of a brain tumor is based on histological examination of a sample of the tumor under the microscope. Although MRI can be very suggestive of specific diseases, and even specific types of brain tumors, biopsy is often indicated when the suspected diagnosis is not clear.

Inappropriate diagnosis may result in expensive and potentially harmful treatments that are not indicated, or failure to provide appropriate treatment and the most informed discussion of an animals care options.

Stereotactic CT-guided brain biopsy:

Biopsy of abnormal brain tissue may be obtained during surgical resection, however in many cases surgery is not a realistic option.

Stereotactic CT-guided brain biopsy is a relatively non-invasive technique where a biopsy needle is guided, through a small drill hole in the skull, into the abnormal brain tissue using advanced imaging guidance. This technique was pioneered in veterinary patients at the VMTH by Dr Richard LeCouteur and Dr Philip Koblik and to date is one of a very few institutions routinely using this technique. The Neurology/Neurosurgery service has performed over 150 biopsies and has a dedicated team of neurosurgeons, neuropathologists and clinical pathologists to ensure the optimum likelihood of obtaining a diagnosis to guide future treatment.

CT pictThe MRI (left)shows an abnormal area of brain (arrow) in a dog presenting with a history of seizures.

CT image showing the biopsy equipment attached to the dogs skull.

 

 

 

 

Video showing a 3D reconstruction of the biopsy. The biopsy needle can be seen where it has been stereotactically directed into the abnormal tissue. This was diagnosed as a primary brain tumor (astrocytoma) and the dog went on to receive treatment specifically directed against this tumor.

Treatment:

Optimal treatment of animals with brain tumors depends on many factors including, the type and location of the tumor, the severity of the clinical signs, and importantly, the quality of life and preferences of the owner and animal. All treatment options will be discussed with an animal’s owners following individual case assessment by the many experts involved with both diagnosis and treatment at the VMTH.

What are the standard treatment options for brain tumors?

There are four main treatment options for most brain tumors:

1) Palliative treatment:
The tumor itself is not treated, however clinical signs resulting from the tumor such as seizures can often be controlled for significant periods of time. Clinical signs may also be reduced if swelling associated with the tumor (edema) is treated with corticosteroid drugs.

2) Surgery:

surgery

Two examples of brain tumors (meningiomas) involving the meninges (covering of the brain) that were successfully removed by surgery. Even with surgery alone survival time following successful procedures may be several years.

This aggressive brain tumor (oligodendroglioma) was growing within the brain. Successful removal of more than 90% of the tumor returned this dog to a normal life for several months. Additional treatment such as radiation therapy is often indicated in cases such as this.

Surgical resection or debulking of a brain tumor may be indicated, particularly for tumors that are more superficially located such as meningiomas. Survival following surgery alone for these tumors may be several years. Even tumors growing within the brain may be treated surgically, particularly when additional treatment methods such as radiation therapy or chemotherapy are used.

The Neurology/Neurosurgery service at the VMTH has many years of experience with surgical treatment of brain tumors. Successful outcomes depend not only on the experience of the surgeon, but also on availability of state of the art equipment such as ultrasonic aspirators (shown above) and a dedicated 24 hour intensive care unit and nursing facilities. Following surgery patients may also benefit from physical rehabilitation/physiotherapy which is provided at the VMTH by a dedicated rehabilitation service.

3) Radiation Therapy:
Radiation therapy has been shown to have a beneficial effect in a variety of brain tumor types, particularly when used in conjunction with other therapies. It is one of the treatments of choice for tumors that are not amenable to surgical resection. Several different types of radiation therapy are available including fractionated (multiple low dose treatments) radiation therapy, and stereotactic radiosurgery which commonly involves only 1 or 2 treatments at high doses. The VMTH has a dedicated Radiation therapy service with both standard and radiosurgery capabilities. If radiation therapy is considered to be a suitable treatment option for an animal, the neurologists and radiation oncologists work closely together to ensure the best outcomes for the patients.

4) Chemotherapy:
Standard chemotherapy, given orally or intravenously is indicated for some brain tumors, and can be effective in specific cases. Because the brain is normally protected from the rest of the body (by the blood-brain-barrier BBB) it can be difficult to treat many brain tumors using chemotherapy alone. Clinical trials to deliver large doses of chemotherapy directly into brain tumors are currently underway at the VMTH and may help to make chemotherapy a more effective treatment.

5) Novel therapies and clinical trials:
Many new and exciting treatments are becoming available both for dogs and humans with brain tumors. The Neurology/Neurosurgery Service and the Petersen Brain Tumor Laboratory in collaboration with human neurologists and researchers have ongoing clinical trials that may be suitable for your pet. For more details on current trials:

Brain Tumor - CPT-11 clinical trial

Brain Tumor - Toca 511 clinical trial

The Peterson Brain Tumor Research Laboratory