OVARIAN CANCER DIAGNOSIS AND TREATMENT IN A GERIATRIC BITCH: CHALLENGES IN TREATING AN ELDER PET AGGRAVATED BY COVID-19 PANDEMIC RESTRICTIONS

Abstract

Ovarian tumors are considered rare in dogs but pose a diagnostic challenge, requiring oncological expertise to establish diagnosis and accurate treatment. Diagnostic imaging is crucial to cancer diagnosis and treatment follow-up but, as in Medicine, this service was impacted by quarantine imposed by COVID-19 pandemic. This report aimed to describe a senior canine patient diagnosed with ovarian adenocarcinoma in a Brazilian country town during COVID-19 lockdown, evaluating the decision-making process in the absence of a veterinary oncology specialist, complicated by pandemic restrictions. A 15-year-old, nonspecific breed, intact bitch presented apathy and emesis. Abdominal palpation revealed increased epigastric volume. Ultrasonography suggested tumoral mass of unknown origin. Exploratory laparotomy was performed and a unilateral ovarian mass was removed. Patient recovered well from surgery. Histopathological evaluation revealed ovarian adenocarcinoma with lymphatic vascular invasion. No further treatment was indicated. Semesterly revisions were scheduled but metastasis developed in less than a year, after first revision. By this time, thoracic radiography was unavailable in owner’s town, impairing metastasis screening and prognosis. Chemotherapy was offered only after metastasis detection but was declined by the owner. Patient was lost in follow-up. This present case illustrates the importance of a prompt diagnosis and suitable treatment for ovarian cancer-bearing patients based on veterinary oncology expertise. It also emphasizes how pandemic lockdown prejudicated imaging exam availability, especially in country towns, similar to what was observed in human patients, reflecting an undeniable One Health issue.

Diagnoza in zdravljenje raka jajčnikov pri stari psici: izzivi pri zdravljenju stare hišne živali, ki so se poslabšali zaradi omejitev povzročenih s pandemijo COVID-19

Tumorji jajčnikov so pri psih redki, vendar predstavljajo diagnostični izziv, saj za postavitev diagnoze in natančno zdravljenje je potrebno onkološko znanje. Diagnostične slikovne tehnike so ključnega pomena za diagnozo raka in spremljanje zdravljenja, vendar je bila ta storitev, tako kot v medicini, prizadeta zaradi karantene, uvedene zaradi pandemije COVID-19. Klinični primer opisuje starejšo psico, pri kateri je bil med zaprtjem zaradi pandemije COVID-19 v brazilskem podeželskem mestu diagnosticiran adenokarcinom jajčnikov. Primer opisuje proces odločanja v odsotnosti veterinarskega onkologa zaradi omejitev, ki so bile uvedene zaradi pandemije. 15-letna nesterilizirana psica je bila apatična in bruhala. Ob palpaciji trebuha je bil ugotovljen povečan volumen epigastrija. Ultrazvok je nakazoval tumor neznanega izvora. Opravljena je bila diagnostična laparotomija, pri kateri je bila odstranjena masa na jajčniku. Psica je po operativnem posegu dobro okrevala. Histopatološka preiskava je razkrila adenokarcinom jajčnikov z invazijo limfatičnih žil. Nadaljnje zdravljenje ni bilo potrebno. Načrtovani so bili pregledi vsakih šest mesecev, vendar so se metastaze razvile v manj kot enem letu po prvem pregledu. V tem času v mestu lastnika ni bilo na voljo rentgenske preiskave prsnega koša, kar je onemogočilo odkrivanje metastaz in prognozo. Kemoterapija je bila predlagana šele po odkritju metastaz, vendar jo je lastnik zavrnil. Psica je poginila v času nadaljnjega spremljanja. Ta primer ponazarja pomembnost hitre diagnoze in ustreznega zdravljenja psic z rakom na jajčnikih na podlagi veterinarsko-onkološkega znanja. Poudarja tudi, kako je pandemija omejila dostopnost slikovne diagnostike, še posebej v podeželskih krajih, podobno kot je bilo opaženo pri ljudeh, kar nesporno odraža problem pri konceptu »Eno zdravje«.

Ključne besede: rak jajčnikov pri psih; zaprtje zaradi pandemije COVID-19; metastatski adenokarcinom; ovariohisterektomija; pljučne metastaze