Treatment of Canine Multicentric Lymphoma Through Vascular Access Port vs. Peripheral Venous Catheter*

16 de junho de 2020

Autores:

Brunna de Souza Barni, José Ricardo Herrera Becerra, Silvana Bellini Vidor, Mariana Pires de Oliveira, Luciane Cristina Vieira, Calvin Braga Gnoatto, Stella de Faria Valle, Cristiano Gomes, Giordano Cabral Gianotti, Emerson Antonio Contesini

Abstract:

Background: Vascular access port (VAP) was developed for the administration of chemotherapeutic agents, minimizing
local drug reactions and complications associated with migration of peripheral venous catheter (PVC) in humans. The
device is widely used in human oncology and has gained importance in veterinary oncology, especially in long treatment
regimens, as in the case of canine lymphoma. VAP favors therapy and the animals life quality. The aim of this study was
to describe the use of VAP in dogs, comparing to PVC access, during canine lymphoma chemotherapeutic treatment.

Materials, Methods & Results: Eleven dogs with multicentric lymphoma which required chemotherapy were selected
for the study. The dogs were randomly allocated to two groups with five and six animals, and each group received the
chemotherapy protocol through the PVC (n= 5) or VAP (n= 6). For the sake of standardization, assessments were made
whenever the dogs received vincristine sulfate, despite the use of the infusion system in all sessions of the MadisonWisconsin protocol. A VAP was implanted into the right external jugular vein of six dogs under inhalational anesthesia,
using the Seldinger technique. Systolic blood pressure (SBP) levels and handling time during chemotherapy sessions were
compared in both groups in three time periods during the procedures: 10 min after arrival to each chemotherapy (P1);
immediately after placement of the PVC or puncture of the VAP reservoir (P2); and at the end of chemotherapy (P3). The
arithmetic mean of five consecutive assessments was used in each time period. In the chemotherapy sessions, the mean of
SBP variation decreased statistically significant in the VAP group compared to PVC group. SBP decreased from P1 to P2
and from P1 to P3 in all sessions (S1, S2, and S3) in the VAP group, and increased in the PVC group. The handling time
of VAP group was 110.6 ± 8.4 s, compared to 219.2 ± 24.7 s (mean ± standard error) in the PVC group, showing statistically significant difference (P < 0.001). VAP surgical implantation time averaged 37 min, decreasing gradually from the
first (55 min) to the last patient (21 min).

Discussion: SBP levels suggest that the VAP group was calmer from the beginning to the end of the sessions, showed
lower SBP levels, and required shorter handling time than did the PVC group. Blood pressure is one of the most objective ways to assess welfare or stress in dogs. When dog feels threatened or scared, its body automatically enters a state of
emergency and, among several changes, blood pressure increases. VAP surgical implantation in dogs have easy learning,
as previously described, proven by implantation time progressive reduction. The Seldinger technique is the method of
choice for catheter implantation in humans. Dissection of the jugular vein is an alternative, however, the technique with
a single incision and venipuncture is less invasive than its modifications. The jugular vein was used because is the site of
choice for central accesses in veterinary practice, with a shorter path to the right atrium and smaller rates of catheter misplacement, reducing the risk of pneumothorax, venous thrombosis, and pinch-off syndrome. VAP surgical implantation in
dogs have easy learning, proven by the implantation time progressive reduction. The study confirmed that VAP promoted
animal welfare, shortened chemotherapy sessions, and caused less discomfort to dogs treated for multicentric lymphoma,
as indicated by the reduction in SBP, when compared to the PVC group.

Keywords:

antineoplastic therapy, canine, oncology, port-a-cath.

Palavras chaves:

terapia antineoplásica, oncologia canina, cateter

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