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Abstract

OBJECTIVE

To determine the incidence of and potential risk factors for postoperative regurgitation and vomiting (PORV), postoperative nausea and vomiting (PONV), and aspiration pneumonia in geriatric dogs using premedication with maropitant and famotidine, intraoperative fentanyl, and postoperative fentanyl as part of an anesthetic protocol.

ANIMALS

105 client-owned geriatric dogs that underwent general anesthesia for a major surgical procedure between January 2019 and March 2020.

PROCEDURES

Medical records were reviewed to collect data on signalment, historical gastrointestinal signs, American Society of Anesthesiologists (ASA) score, indication for surgery, duration of anesthesia and surgery, patient position during surgery, mode of ventilation, and perioperative administration of maropitant, famotidine, anticholinergics, opioids, colloidal support, NSAID, corticosteroids, and appetite stimulants. The incidence of postoperative regurgitation, vomiting, nausea, and aspiration pneumonia was calculated, and variables were each analyzed for their association with these outcomes.

RESULTS

2 of 105 (1.9%) dogs regurgitated, 1 of 105 (1.0%) dogs developed aspiration pneumonia, 4 of 105 (3.8%) dogs exhibited nausea, and no dogs vomited. Identified possible risk factors included older age (≥ 13 years old) for postoperative regurgitation, regurgitation for postoperative aspiration pneumonia, and high ASA score (≥ 4) for both regurgitation and aspiration pneumonia.

CONCLUSIONS AND CLINICAL RELEVANCE

The use of an antiemetic protocol including maropitant, famotidine, and fentanyl in geriatric dogs resulted in very low incidences of PORV, PONV, and aspiration pneumonia. Future prospective studies are warranted to further evaluate and mitigate postoperative risks.

Open access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To describe a modified approach to closed anal sacculectomy and report the short-term outcomes of dogs that underwent the procedure for treatment of neoplasia.

ANIMALS

16 client-owned dogs.

PROCEDURES

Medical records of 1 referral hospital were reviewed to identify dogs that underwent modified closed anal sacculectomy for treatment of anal sac neoplasia between January 2018 and September 2020. Data collected included signalment, examination and diagnostic imaging findings, surgical details, intraoperative and postoperative complications, cytologic and histologic findings, adjuvant treatments, duration of follow-up, and short-term outcome.

RESULTS

15 dogs had apocrine gland anal sac adenocarcinoma, and 1 had a collision tumor. No dogs had intraoperative complications; 1 dog had a minor postoperative complication (paraparesis) that resolved. The median duration of postoperative follow-up was 286 days (range, 67 to 777 days). One dog had confirmed local disease recurrence 290 days after surgery, and 1 had suspected local disease recurrence 203 days after surgery and was euthanized because of systemic disease progression.

CONCLUSIONS AND CLINICAL RELEVANCE

The modified closed anal sacculectomy was well tolerated in this sample of dogs, with minimal short-term complications. This study provided evidence to justify evaluation of the procedure in a larger number of dogs and assessment of the effects of procedural modifications on postoperative complication rates and time to local recurrence.

Open access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To evaluate owner adherence to recommendations for follow-up examination of dogs and cats following orthopedic procedures and identify factors associated with adherence versus nonadherence.

SAMPLE

Medical records of 485 dogs and cats that underwent orthopedic surgery.

PROCEDURES

Cases were categorized as urgent or elective. Information obtained from the medical records consisted of species, age, body weight, proximity to the hospital, procedure cost, recommendations for coaptation, use of financial aid, and number of owners. Cases were considered adherent to follow-up recommendations if, at the latest visit or communication, no further visits were recommended. Cases were considered nonadherent if owners did not return for recommended follow-up visits.

RESULTS

Overall adherence to follow-up recommendations was 65.8% (319/485). Elective cases were 1.6 times as likely to be adherent to follow-up recommendations as were urgent cases, dog cases were 2.4 times as likely to be adherent as were cat cases, and cases with multiple owners listed were 2.1 times as likely to be adherent as were cases with 1 owner listed. Distance from the hospital had a statistically significant association with adherence, but the effect was not clinically important. Age, weight, coaptation, procedure cost, and use of financial aid were not significantly associated with adherence.

CONCLUSIONS AND CLINICAL RELEVANCE

The percentage of dogs and cats lost to follow-up following orthopedic surgery at an academic veterinary teaching hospital was substantial (166/485 [34.2%]). Efforts to improve follow-up adherence are especially indicated for animals undergoing urgent procedures, animals with single owners, and cats.

Open access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To evaluate the metastasis rate, survival time, and prognostic factors associated with appendicular or scapular osteosarcoma treated by limb amputation in cats.

ANIMALS

67 cats with histologically confirmed appendicular or scapular osteosarcoma treated by limb amputation.

PROCEDURES

This retrospective cohort study included cats with histologically confirmed appendicular or scapular osteosarcoma between January 1997 and December 2018. A questionnaire survey was conducted at veterinary clinics where limb amputation was performed. Distant metastasis, local recurrence, and lymph node metastasis rates and survival time were determined. Factors associated with distant metastasis and survival were investigated.

RESULTS

The distant metastasis rate after limb amputation was 41.9% (26/62). The overall distant metastasis rate was 46.3% (31/67), including 5 cats with distant metastasis at the time of amputation. Osteosarcoma of the humerus resulted in distant metastasis in 6 of 7 cases. Osteosarcoma of the humerus was significantly associated with distant metastasis in univariate and multivariate analyses (adjusted OR, 9.56). The rate of lymph node metastasis after limb amputation was 3.0% (2/66), and the local recurrence rate was 9.0% (6/67). The median survival time was 527 days. Age and tumor location were not significantly associated with survival time.

CLINICAL RELEVANCE

Distant metastasis occurs in approximately 40% of cats with appendicular or scapular osteosarcoma after limb amputation. In addition, osteosarcoma of the humerus has a particularly high incidence of distant metastasis. Detailed follow-up is therefore necessary, even after limb amputation, especially in cases of osteosarcoma of the humerus.

Open access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To determine whether premature death occurred among dogs with nonmalignant splenic histopathologic findings after splenectomy for nontraumatic hemoabdomen.

ANIMALS

197 dogs with nontraumatic hemoabdomen that underwent splenectomy and histopathologic evaluation between 2005 and 2018.

PROCEDURES

Information was obtained from electronic medical records, dog owners, and referring veterinarians to determine patient characteristics, histopathologic findings, survival information, and cause of death. Dogs were grouped based on histopathological diagnosis and outcome, and median survival times (MSTs) and risk factors for death were determined.

RESULTS

Histopathologic findings indicated malignancy in 144 of the 197 (73.1%) dogs with nontraumatic hemoabdomen. Hemangiosarcoma was diagnosed in 126 dogs (87.5% of those with malignancies and 64.0% of all dogs). Nine of 53 (17%) dogs with nonmalignant histopathologic findings had an adverse outcome and premature death, with an MST of 49 days. Risk factors for this outcome included low plasma total solids concentration, an elevated hemangiosarcoma likelihood prediction score, and a medium or high hemangiosarcoma likelihood prediction score category.

CONCLUSIONS AND CLINICAL RELEVANCE

This study showed that there is a group of dogs with nontraumatic hemoabdomen due to splenic disease that have nonmalignant histopathologic findings after splenectomy, but nonetheless suffer an adverse outcome and die prematurely of a suspected malignancy. Further evaluation of potential at-risk populations may yield detection of otherwise overlooked malignancies.

Open access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To test clinical and analgesic effects of a single-injection caudal thoracic paravertebral block (TPVB) after localization of the thoracic paravertebral space with a loss-of-resistance to air injection technique in female dogs undergoing unilateral radical mastectomy.

ANIMALS

14 client-owned dogs.

PROCEDURES

Dogs were premedicated with methadone, anesthetized with propofol and sevoflurane, and randomly assigned to receive a TPVB or no block preoperatively. Rescue analgesia with fentanyl and methadone was provided on the basis of cardiovascular responses during surgery and postoperative pain scores assigned with a validated pain scale. Required dose of rescue opioids; mean end-tidal sevoflurane concentration; episodes of hypotension, bradycardia, and other complications; quality of recovery scores; and postoperative pain scores were compared between groups.

RESULTS

Median intraoperative fentanyl doses were 0 µg/kg (range, 0 to 2 µg/kg) and 4 µg/kg (range, 2 to 6 µg/kg) for the TPVB and control groups, respectively. Median postoperative methadone doses were 0 mg/kg (range, 0 to 0.2 mg/kg) and 0.6 mg/kg (range, 0.4 to 0.6 mg/kg) for the TPVB and control groups, respectively. Recovery scores and pain scores assigned at the time of and 1 hour after extubation were significantly lower in the TPVB group than in the control group.

CONCLUSIONS AND CLINICAL RELEVANCE

A single-injection caudal TPVB improved pain control and recovery quality in female dogs undergoing unilateral radical mastectomy. Because the TPVB involves only a single injection, does not take long to perform, and requires only readily available low-cost equipment, the technique may be a valuable option in both referral and first-opinion practice.

Open access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

CASE DESCRIPTION

Outbreaks of sudden death in apparently healthy weaned dairy calves due to Strongyloides papillosus parasitism were diagnosed on 2 separate and independent New York (NY) dairies.

CLINICAL FINDINGS

Most calves were found dead; however, 1 calf observed while dying showed signs of tachycardia, tachypnea, vocalization, and convulsions shortly before death. In 6 affected heifers that underwent post-mortem examination, precocious bilaterally symmetric mammary gland enlargement was seen. A portion of their parasitized living cohorts also demonstrated similar mammary gland enlargement. A diagnosis of S papillosus hyperinfection was made based upon the presence of high numbers of S papillosus ova in feces, and confirmation by S papillosus–specific PCR assays. Consistent histopathological findings in affected calves included generalized mammary gland vascular congestion, interstitial edema and hemorrhage with ductal hyperplasia. Mild multifocal cardiomyocyte degeneration was found in 5 of 14 calves examined. Factors believed to contribute to the parasite’s environmental amplification and host hyperinfection included group housing on wood shavings and high environmental temperatures and humidity.

TREATMENT AND OUTCOME

Treatment of calves with doramectin pour-on stopped mortality and resolved the udder enlargement.

CLINICAL RELEVANCE

Similar outbreaks have previously been described in Japan and South Bohemia (Czech Republic), where researchers hypothesized that sudden death may be due to fatal arrhythmia caused by a parasite-associated cardiotoxin. This report highlights the importance of including S papillosus among the differential diagnoses for sudden death alone or together with precocious udder enlargement in calves kept in confinement housing.

Restricted access
in Journal of the American Veterinary Medical Association