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Biomedical subjects

C E Leifer

Publications and source records attributed to C E Leifer.

At least 19 recordsLinked to original sources

Use of splenectomy in the management of lymphoma in dogs: 16 cases (1976-1985).

Sixteen dogs with lymphoma underwent splenectomy to relieve signs of massive splenomegaly including splenic rupture. The most common preoperative hematologic abnormalities, anemia and thrombocytopenia, were reversed in all dogs surviving the initial postoperative period. Within 6 weeks after surgery, 5 dogs died because of disseminated intravascular coagulation and sepsis. The remaining 11 dogs underwent chemotherapy. These 11 dogs had a complete response rate of 66% at one month after surgery; the mean and median survival times were 9.3 and 5 months, respectively. In 7 dogs evaluated until death, the mean and median survival times were 13.4 months and 14 months, respectively.

Animals

Use of plasmapheresis and chemotherapy for treatment of monoclonal gammopathy associated with Ehrlichia canis infection in a dog.

Monoclonal gammopathy associated with Ehrlichia canis infection was diagnosed in a German Shepherd Dog. The dog was treated by use of chemotherapy and tetracycline and by plasmapheresis. The dog tolerated plasmapheresis and long-term drug therapy well, and clinical signs resolved over a 90-day period. The monoclonal gammopathy resolved after treatment, but specific antibody to E canis indicated suppression followed by a rebound to the initial high titer.

Animals

Chronic lymphocytic leukemia in the dog: 22 cases (1974-1984).

Chronic lymphocytic leukemia was diagnosed in 22 dogs. Diagnosis was based primarily on detection of lymphocytosis and bone marrow infiltration with small lymphocytes similar to those seen in the blood. More than 50% of the dogs had monoclonal gammopathy, and, of these, 40% had monoclonal light-chain (Bence Jones) proteinuria. Hyperviscosity syndrome was observed occasionally. Most dogs were treated with chemotherapy. For the 17 dogs treated greater than or equal to 30 days, the survival times ranged from 30 to 1,000 days.

Animals

Prognostic factors for multiple myeloma in the dog.

Multiple myeloma was diagnosed in 60 dogs. Diagnosis was confirmed in each case by observation of greater than 5% plasma cells on examination of a bone marrow aspirate and detection of monoclonal gammopathy of immunoglobulin (Ig) A or IgG. Treatment with melphalan, cyclophosphamide, and prednisone was associated with long-term survival (median, 540 days). Response to therapy was significantly related to prognosis (P less than 0.01), whereas hypercalcemia and Ig light chain proteinuria (Bence Jones) were associated with shorter median survival times.

Animals

Insulin-secreting tumor: diagnosis and medical and surgical management in 55 dogs.

Insulin-secreting tumor of the pancreas was diagnosed in 55 dogs. Diagnosis was based mainly on the increase of serum insulin concentrations in the presence of hypoglycemia. The use of the amended insulin/glucose ratio to diagnose the tumor, although providing less false-negative results than did increased serum insulin concentrations alone, appeared less specific and gave false-positive results in dogs without insulin-secreting tumors. Management of the disease included surgical intervention alone (26 dogs), surgery plus medical management with diazoxide (14 dogs), and medical management with diazoxide alone (4 dogs). Eleven dogs were euthanatized at the time of diagnosis. Diazoxide therapy controlled hypoglycemia in about 70% of the dogs.

Adenoma, Islet Cell

Uric acid and phosphorus excretion in dogs with lymphosarcoma.

Serum uric acid and phosphorus concentrations were determined for 27 dogs with multicentric lymphosarcoma before and after chemotherapy. Mean serum uric acid values in dogs before treatment were significantly higher (P less than 0.05) than those of a control group of healthy dogs. Serum uric acid values did not change after treatment. Of the 27 dogs, 13 had 24-hour urine collections to determine endogenous creatinine clearance and quantitation of uric acid and phosphorus excretion before and after treatment for lymphosarcoma. Mean values for 24-hour creatinine clearance before and after treatment were statistically similar in dogs with lymphosarcoma, although the values were lower than those in a normal range. Total urinary phosphorus excretions were increased significantly (P less than 0.01) after treatment without change in fractional excretion. Chemotherapeutic agents used accounted for the significant (P less than 0.05) increase in urine volume after treatment and may have affected the excretion of uric acid and phosphorus. Seemingly, dogs with uncomplicated lymphosarcoma rarely have renal dysfunction or clinically important alterations in uric acid or phosphorus excretion secondary to rapid tumor lysis. However, preexisting renal disease or systemic complications, such as hypercalcemia, may be associated with increased risk of further renal impairment during treatment.

Animals

Plasmapheresis in five dogs with systemic immune-mediated disease.

Five dogs with signs referable to systemic immune-mediated disease, four with systemic lupus erythematosus, and one with probable lupus myopathy were treated with plasmapheresis in combination with low-dose immunosuppressive drug therapy. Previous treatment with conventional dosages of prednisone was not satisfactory and was associated with adverse side effects. Two dogs had short-term responses to combined therapy, and 3 dogs had sustained responses. Clinical remission was associated with normalization of serum complement levels and decreases in antinuclear antibody titers. Toxicosis potentially related to plasma component depletion was observed in 2 dogs. Acute clinical illness and disease states refractory to conventional immunosuppressive therapy should be considered indications for plasmapheresis.

Adrenal Cortex Hormones

Plasmapheresis as adjuvant therapy for autoimmune hemolytic anemia in two dogs.

Severe, acute, autoimmune hemolytic anemia in 2 dogs was treated, using prednisone, cyclophosphamide, plasmapheresis, and blood transfusion. In 1 case, splenectomy was performed successfully after plasmapheresis and blood transfusion. Antibody removal by means of plasmapheresis effected short-term stabilization to severe hemolysis in both dogs, but was suspected to have contributed to the death of 1 dog.

Anemia, Hemolytic, Autoimmune

Hypoglycemia associated with nonislet cell tumor in 13 dogs.

Hypoglycemia associated with nonislet cell tumor was found in 13 dogs. In each dog, clinical signs were related directly to adrenergic and neuroglucopenic effects of hypoglycemia and included collapsing episodes, tremors, restlessness, weakness, and grand mal seizures that were responsive to glucose administration. Eight of the dogs had hepatocellular carcinoma; surgical resection of the tumor achieved remission of clinical signs in 3 of these dogs. Other hepatic tumors associated with hypoglycemia included leiomyosarcoma and hemangiosarcoma involving solitary lobes of the liver. Nonhepatic tumors included splenic hemangiosarcoma, diffuse metastatic melanoma, and salivary gland adenocarcinoma.

Adenocarcinoma

Lymphoid leukemia in the dog. Acute lymphoblastic leukemia and chronic lymphocytic leukemia.

True lymphoid leukemia of bone-marrow origin may present as two distinct clinical forms in the dog. Acute lymphoblastic leukemia is a rapidly progressive disease associated with proliferation of malignant, undifferentiated lymphoblasts. Chronic lymphocytic leukemia is a more insidious form of malignancy associated with abnormal proliferation of small lymphocytes. Recognition of these clinically distinct forms of leukemia and their differentiation from lymphosarcoma are important in considering prognosis and approach to therapy.

Animals

Immunoglobulin-producing tumors.

Multiple myeloma and macroglobulinemia are the most common immunoglobulin-producing neoplasms seen in the dog. Treatment with the alkylating agents in combination with prednisone may significantly prolong survival. Supportive management of associated complications is imperative to ensure that the individual case receives optimal care. The use of clinical staging seems to be of value in establishing prognosis; however, response to therapy may be more significant, for many dogs present with advanced disease. In the high-risk patient, one should consider using investigational combination drug protocols which are available at a referral center. Although a "cure" is unlikely, the prospect of the animal having a fairly normal, healthy life for an extended period of time (over a year in the majority of cases) should encourage veterinarians to recommend evaluation for treatment in dogs with multiple myeloma and macroglobulinemia.

Alkylating Agents

Hypoglycemia.

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Adenoma, Islet Cell

Acute lymphoblastic leukemia in the dog: a review of 30 cases.

Acute lymphoblastic leukemia was diagnosed in 30 dogs. Diagnosis was confirmed by examination of blood smears and bone marrow aspirates. The most common clinical signs were lethargy, anorexia, splenomegaly, and pallor of mucous membranes. Three dogs were not treated, 3 dogs were treated with prednisone, and 3 dogs were treated with cyclophosphamide; survival times in these 9 dogs ranged from 1 to 60 days. Twenty-one dogs were treated with vincristine and prednisone; of these, complete remission was achieved in 4 dogs and partial remission was achieved in 4 dogs, with survival times ranging from 8 to 241 days.

Animals

Chronic myelogenous leukemia in the dog.

Chronic myelogenous leukemia was diagnosed in 7 dogs. In each case, marked neutrophilia in the absence of infection was observed in association with nonspecific illness. Diagnosis was based on morphologic cytology of blood smears, bone marrow aspirates, and in 1 case, a lymph node biopsy specimen. In 5 cases, treatment with hydroxyurea was successful in lowering circulating WBC counts, but was of questionable value in the prevention of leukemic blast crisis.

Animals