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Multiple Myeloma and Plasma Cell Tumors 663

○ Hypomyelination: if clinical improvement ○ Hypertonicity syndrome: clinical signs Technician Tips
is to occur, it typically is observed before worsen initially then stabilize; severity Movement disorders and seizures can look alike.
VetBooks.ir ○ Idiopathic head tremor: 50%-66% remis- ○ Canine multiple system degeneration: event is essential; if the patient responds to Diseases and Disorders
Assessing the patient’s mentation during the
of signs can affect quality of life
1 year.
affected animal often euthanized due to
you, it is more likely a movement disorder. If
sion rate
○ Opsoclonus-myoclonus
spontaneous remission syndrome: severity of clinical signs possible, take a video of any observed episodes.
○ Paroxysmal dyskinesia: remission reported PEARLS & CONSIDERATIONS Client Education
in Jack Russell terriers and Labrador Movement disorders are likely to cause imbal-
retrievers Comments ance and falls. Keep the pet away from stairs
• Fair to good prognosis depending on severity Obtaining video of a movement disorder is or sharp-edged furniture to avoid self-trauma.
of clinical signs an important diagnostic tool because it often Maintain a diary of the events, noting context,
○ Idiopathic postural tremor (worsening clarifies the state of consciousness of the patient event duration, and any mentation change.
with age possible) and differentiates it from a seizure disorder.
○ Orthostatic tremor When in doubt, seek consultation with a SUGGESTED READING
○ Myoclonus due to canine distemper virus veterinary neurologist. Lowrie M, et al: Classification of involuntary
○ Paroxysmal dyskinesia movements in dogs: paroxysmal dyskinesias. Vet
○ Dancing Doberman disease Prevention J 220:65-71, 2017.
○ Idiopathic blepharospasm (focal dystonia) If a movement disorder occurs in a specific
○ Stiff dog syndrome context (stress, noise, exercise, hot/cold AUTHOR: Julien Guevar, DVM, MVM, DECVN, MRCVS
EDITOR: Karen R. Muñana, DVM, MS, DACVIM
• Poor to guarded prognosis weather), these potential triggers should be
○ Hyperekplexia avoided.
○ Myoclonic epilepsy

Multiple Myeloma and Plasma Cell Tumors Client Education
Sheet

BASIC INFORMATION ASSOCIATED DISORDERS loss, lethargy). Other signs similar to those
MM: seen in dogs may rarely occur.
Definition • Hyperviscosity syndrome • Cutaneous PCT
• Multiple myeloma (MM) is a disease of • Bence Jones proteinuria ○ Raised nodule on the trunk, limbs, head,
plasma cells derived from one clone in the • Pathologic fracture or in the oral cavity
bone marrow. It is a systemic disease, and • Bleeding diathesis • EMP
multiple bone marrow sites are involved. • Increased susceptibility to infection; ○ Typically occur in the gastrointestinal
Immunoglobulins (Igs) are produced by immunosuppression (GI) tract and cause weight loss, anorexia,
malignant plasma cells: IgM or IgG in the • Heart failure nausea, vomiting, and/or diarrhea
dog and IgA in the cat. • Renal disease • SOP
• Plasma cell tumors (PCTs) are solitary tumors • Visual/ocular disturbances ○ Single lesion in bone; can cause bony
composed of plasma cells originating in sites • Amyloidosis swellings, lameness, neurologic deficits,
other than bone marrow (i.e., extramedullary • Cryoglobulinemia (precipitation of Ig at and/or skeletal pain
tissue). PCTs can arise from skin, soft tissues, colder temperatures vs. cold agglutinin
or bone. Serum Ig levels are often normal disease [erythrocyte clumping at colder PHYSICAL EXAM FINDINGS
in this localized form of disease. temperatures]) • Skeletal pain, fractures
• Weight loss (MM, EMP)
Synonyms Clinical Presentation • Lethargy (MM, EMP)
Plasmacytoma, myeloma-related disorder DISEASE FORMS/SUBTYPES • Visual disturbances (MM)
(MRD) • MM • Depression, seizures, abnormal reflexes (MM)
• Waldenström’s macroglobulinemia: IgM is • Epistaxis, gingival bleeding, ecchymoses
Epidemiology the Ig type produced. • Pallor, weak pulses, heart murmur, increased
SPECIES, AGE, SEX • Cutaneous PCT lung sounds (MM)
• Uncommon disorder of older dogs and • Extramedullary PCT (EMP) • Signs of congestive heart failure such as
cats • Solitary osseous PCT (SOP) dyspnea (MM)
• Male predominance in noncutaneous PCT; • Soft-tissue or bony masses
no sex predisposition in MM HISTORY, CHIEF COMPLAINT • Abdominal organomegaly
• Extramedullary involvement (i.e., spleen, • MM
liver, and skin) at initial presentation is ○ Dogs usually present with lameness or skel- Etiology and Pathophysiology
common in cats with MM. etal pain. Bleeding (epistaxis, ecchymoses, • Malignant plasma cells produce large
mucosal hemorrhage), polyuria/polydipsia, amounts of one type of Ig.
GENETICS, BREED PREDISPOSITION central nervous system signs (seizures, • The entire Ig can be produced or just a portion
• MM: German shepherd dementia), and visual disturbances may of it (e.g., light chain). The Ig or portion is
• PCT: Airedale terrier, cocker spaniel, also occur. referred to as the M protein; concentration
Kerry blue terrier, Scottish terrier, standard ○ Cats tend to present with an insidious is typically proportional to tumor burden in
poodle onset of nonspecific signs (anorexia, weight MM but not in PCT (low levels).

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