Charles Kuntz

Hi, Charles Kuntz here. I am a specialist veterinary surgeon in Melbourne and subspecialty-trained in surgical oncology (cancer surgery). I published that largest collection of soft tissue sarcomas in dogs (including schwannomas). I am not "blowing my own horn" but just giving you my experience with these tumours. I have personally removed about 700 soft tissue sarcomas in dogs and cats. Schwannomas are more correctly known as soft tissue sarcomas. Collectively, they are fairly common and account for 15% of skin and subcutaneous tumours in dogs. They uncommonly spread to other organs- lungs particularly (but not rarely) and commonly recur (in the same place). The best predictor of whether or not they will spread is the grade of the tumour. They are graded I,II and III. Grades I and II spread in about 10% of cases. Grade III tumours spread in 50% of cases. Chemotherapy has been shown definitely NOT to prevent spread. The best predictor of recurrence of the tumour in the same site is the COMPLETENESS OF SURGICAL MARGINS. This relates to whether or not the surgeon got the whole thing out. They should be removed with 2 cm margins in all directions. Clean margins recur in 5% of cases in 5 years (A good surgeon gets clean margins in 95% of cases). Dirty margins recur in 75% of cases in 5 years. Radiation therapy is really effective at preventing recurrence in cases with dirty margins. (20% recurrence in 5 years with radiation compared to 75% recurrence without radiation). There are two facilities providing dedicated radiation therapy to animals in Australia. These are highly curable tumours if treated appropriately and early. Charles Kuntz

Hi, Charles Kuntz here. I am a specialist veterinary surgeon in Melbourne. I have just been contacted by Axtrim Group, a company that plans to introduce stem cell implants for dogs with arthritis in Australia. I met with them to discuss the benefits of the procedure, and whether or not I would be interested in participating. There is no one actively doing stem cell implants in dogs in Australia. I have not "jumped on the bandwagon" at this time. As far as evidence that it works, there are a lot of anecdotal reports, but few controlled studies. I did review one study from the US which is authored by some very reputable people, two of which are friends of mine. They reported 20 dogs which showed a significant improvement in function in dogs with hip dysplasia treated with stem cells. This was a "double blinded" controlled study which adds to its credibility. There were some statistical problems with the study as I saw it, but in general, it does support the use of stem cells for the treatment of arthritis in dogs. The reported mechanism of action is that the stem cells may "immunomodulate" the joint meaning that they can suppress nasty chemicals in the joint that occur with inflammation and enhance nice chemicals. It is also possible that they may allow healthy cells to graft into the joint. The study is by Black etal, Veterinary Therapeutics Vol 8 No 4 WInter 2007. Effect of Adipose-derived mesenchymal stem and regenerative cells on lameness in dogs with chronic osteoarthritis... Incidentally, the guys at Monash Vet Clinic are not orthopaedic specialists. They are just great vets. Charles Kuntz

Hi, Charles Kuntz here. I am a specialist surgeon in Melbourne and I thought I would put my two cents in. Medial patellar luxation is a problem that usually occurs in pure breed small dogs, although large pure breed dogs are affected as well. Mostly, they are congenital, but may be exacerbated by trauma. Medial patellar luxation is best described by the grade of the luxation. THey are graded 1,2,3 and 4. 1 is just loose. 2 is normally in but can be popped out, 3 is normally out but can be popped back in and 4 is always out. There was a study that showed that in dogs with bilateral (both sides) luxations, with only one side repaired, the function was significantly improved in the affected limb with surgery. There was no difference in radiographic signs of arthritis down the road. The decision is based on the grade of luxation and on the age of the dog (and to some degree, the extent of lameness). Young dogs with grade 2 or above should generally have surgery. Older dogs that have a luxation with no debilitation can probably manage with conservative management. If the surgery is done properly, the success rate is very very high. I strongly recommend that the surgery include repositioning of the tibial crest because that is the primary problem (poor alignment of the tibial crest which drags the patella out of the groove). Revision of the trochlea (groove) is not usually recommended by me because of the extent of damage that it does to the joint cartilage). SOft tissue procedures alone ("tightening" the joint) are destined to fail. There are great specialists around in Perth. The ones I know are at the vet school. Hope this helps. Charles