title: Acute severe hemorrhage secondary to arterial invasion in a dog with thyroid carcinoma.
abstract: A 7-year-old spayed female Labrador Retriever was referred because of progressive swelling and bruising of the neck, hemothorax, a possible mediastinal mass, and stridor. At the time of admission, the dog was recumbent, mentally dull, tachycardic, and hypothermic. Fluid therapy with hydroxyethyl starch and a balanced electrolyte solution was administered because of presumed hypovolemic shock secondary to hemorrhage; multiple units of packed RBCs and fresh frozen plasma were also administered. On the basis of the computed tomographic images, extensive subcutaneous, subfascial, and cranial mediastinal hemorrhage; hemothorax; prescapular lymphadenopathy; and a contrast-enhancing mass in the left cranioventral aspect of the neck were diagnosed. Exploratory surgery of the neck was performed. All subcutaneous structures were encased in a large blood clot. During dissection of the clot, pulsatile bleeding was observed just caudal to and to the left of the larynx; ligation of the left common carotid artery resulted in immediate cessation of the pulsatile bleeding. Further surgical exploration revealed a 2.5 x 2.5-cm mass adhered to the left common carotid artery at the level of the branching to the left cranial thyroid artery. The mass was removed; the histologic diagnosis was thyroid carcinoma. Three weeks after surgery, treatment with a combination of radiation and chemotherapy (doxorubicin and carboplatin) was begun. Thirteen months after surgery, the dog continued to be free from clinical signs of disease.
authors.affiliation: Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010, USA.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Slensky
authors.forename: Susan W
authors.initials: SW
authors.lastname: Volk
authors.forename: Tobias
authors.initials: T
authors.lastname: Schwarz
authors.forename: Lili
authors.initials: L
authors.lastname: Duda
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Mauldin
authors.forename: Deborah
authors.initials: D
authors.lastname: Silverstein
mesh_terms: D000818:Animals; D001803:Blood Transfusion / Q000662:veterinary; D002277:Carcinoma / Q000150:complications / Q000473:pathology / Q000628:therapy / Q000662:veterinary*; D017536:Carotid Artery, Common / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D004283:Dog Diseases / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D004285:Dogs; D017707:Erythrocyte Transfusion / Q000662:veterinary; D005260:Female; D005440:Fluid Therapy / Q000662:veterinary; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy / Q000662:veterinary*; D008026:Ligation; D009361:Neoplasm Invasiveness; D010949:Plasma; D012769:Shock / Q000209:etiology / Q000628:therapy / Q000662:veterinary; D013964:Thyroid Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy / Q000662:veterinary*; D014057:Tomography, X-Ray Computed