Page 1477 - Cote clinical veterinary advisor dogs and cats 4th

752 Papillomas, Oral and Cutaneous

• Blood pressure (p. 1065): moderate to severe necessary treatments (e.g., ensuring adequate PEARLS & CONSIDERATIONS
hypertension possible with hyperthyroidism • Provide analgesia for perceived pain. Comments
hydration).
VetBooks.ir • Thoracic radiographs: evidence of heart, lung, • Reduce anxiety, and for short-term relief With the exception of cats that pant only under
or pheochromocytoma; mild hypertension
possible with severe anxiety
(e.g., panting during storms), consider use
predictable conditions of stress, all panting cats
or airway disease
• Pulse oximetry: SpO 2 < 95 mm Hg suggests of sedative or anxiolytic drugs (e.g., trazodone should be evaluated for underlying disease.
2-7 mg/kg PO q 8-24h [dog]) if animal is
respiratory disease with hypoxemia; arterial severely stressed. Technician Tips
blood gas can be used instead (PaO 2 of < • Manage recognized underlying disorders as • Until proved otherwise, assume panting cats
85 mm Hg) appropriate (e.g., antiarrhythmic therapy for require immediate care, including oxygen
• Serum T 4 (cats) to rule out hyperthyroidism ventricular tachyarrhythmias, bronchodilator supplementation.
for feline asthma, calcium supplementation • Ask owners of dogs that are panting on arrival
Advanced or Confirmatory Testing for eclampsia, transfusion for anemia). for care whether panting is also an issue at
Specific testing depends on history, exam, and home or it reflects the stress/excitement of
initial database. Chapters on specific disorders Chronic Treatment the veterinary visit.
provide diagnostic recommendations. Address underlying disorder.
SUGGESTED READING
TREATMENT Nutrition/Diet Hackner SG: Panting. In King LG, editor: Textbook
Initiate program for weight loss if the animal of respiratory disease in dogs and cats, St. Louis,
Treatment Overview is obese. 2004, Saunders, pp 46-48.
The goal is to treat the underlying condition. AUTHOR: Jeff D. Bay, DVM, DACVIM
PROGNOSIS & OUTCOME EDITOR: Leah A. Cohn, DVM, PhD, DACVIM
Acute General Treatment
• If hypoxemia is suspected or confirmed, give Highly variable, due to broad range of underly-
oxygen supplementation (p. 1146). ing causes.
• If hyperthermia is identified, institute
cooling measures (p. 421) as well as other

Papillomas, Oral and Cutaneous

BASIC INFORMATION CONTAGION AND ZOONOSIS Cats have at least three clinical presentations:
• Canine papilloma virus (CPV) is highly • Feline plaques
Definition contagious, resistant to many common dis- • Feline sarcoids (BPV1 and BPV2 associated)
Benign tumors of the skin and oral cavity caused infectants, and persists in the environment. • Bowenoid in situ carcinoma, invasive SCC
by infection with one of the numerous strains • Generally species specific (nonzoonotic),
of canine or feline papillomaviruses although bovine papilloma virus (BPV) HISTORY, CHIEF COMPLAINT
specifically has been implicated as the • Intraoral nodule(s); oral discomfort, dyspha-
Synonyms causative agent of equine and feline gia, halitosis, and ptyalism (dog or cat)
Warts, verrucae, cutaneous horns sarcoids. • Cutaneous nodule or plaque (dog or cat)
Epidemiology ASSOCIATED DISORDERS PHYSICAL EXAM FINDINGS
SPECIES, AGE, SEX • Association with malignant transformation • Canine oral papilloma virus (COPV or
• Lesions occur in young, adult, or older dogs, to squamous cell carcinoma (SCC) in the CPV1) infection presents with multiple
depending on the clinical syndrome. dog is controversial. growths in the oral cavity (few millimeters
• Immunocompromised dogs or cats may be • Increasing evidence that viral plaques may to 1 cm in diameter). They initially develop
predisposed. progress to SCC in situ or invasive SCC in as smooth, white nodules before progress-
cats ing to gray, pedunculated masses with
GENETICS, BREED PREDISPOSITION fronds.
• Cutaneous papillomas: cocker spaniels, Kerry Clinical Presentation • Cutaneous lesions in dogs are normally
blue terriers DISEASE FORMS/SUBTYPES solitary and can manifest as
• Multiple pigmented plaques: miniature Disease in dogs can be classified as a variety of ○ Pedunculated exophytic growth with
schnauzers and pugs clinical subtypes. Clinical presentation depends multiple fronds; found anywhere on the
on viral strain, individual immunocompetence, body (head, eyelids, and feet most com-
RISK FACTORS virulence, and other comorbidities. monly affected); rarely > 1 cm in diameter
• Young and immunologically naive indi- • Canine oral papillomatosis ○ Inverted endophytic papilloma with a
viduals with damaged skin or mucous • Cutaneous exophytic papilloma small central keratin pore (ventral trunk
membranes • Cutaneous endophytic papilloma and abdomen most common); typically
• Immunosuppressed or immunocompromised • Pigmented plaques 1-2 cm in diameter
individuals (e.g., glucocorticoids, oclacitinib, • In situ and invasive SCC (NOTE: majority ○ Pigmented, sessile plaques/nevi/lentigines
and/or oral cyclosporine; severe combined of SCCs in dogs and cats are not associated dispersed in numbers from 3 or 4 up to
immunodeficiency [dogs]) with papillomaviruses) 80, involving the ventral neck, trunk, and

www.ExpertConsult.com