Objective—To evaluate the effect of pneumoperitoneum on cardiorespiratory variables and working space during experimental induction of 3 intra-abdominal pressures (IAPs) in cats.
Animals—6 healthy young adult neutered male domestic shorthair cats.
Procedures—All cats were anesthetized through use of a standardized protocol. A catheter was placed in the right femoral artery for blood pressure and blood gas monitoring. A thermodilution catheter was placed in the right jugular vein via fluoroscopic guidance. Cardiopulmonary variables were measured before (baseline) and 2 and 30 minutes after initiation of pneumoperitoneum at IAPs of 4, 8, and 15 mm Hg; these were created through the use of a mechanical insufflator. At each IAP, abdominal dimensions (height, width, and circumference) were measured at a standardized location.
Results—At 4 mm Hg and 8 mm Hg IAP, no clinically important changes were identified in cardiorespiratory values. Heart rate, cardiac index, and stroke volume index remained unchanged throughout the study at all IAPs. Mean arterial blood pressure began to increase at 8 mm Hg and was significantly higher, compared with baseline, at both time points at 15 mm Hg. At 15 mm Hg, Paco2 was significantly higher and cats were more acidotic than at baseline. Working space was subjectively greater at 8 mm Hg than at 4 mm Hg IAP; however, at 15 mm Hg, no clinically important enlargement of the working space was identified, compared with at 8 mm Hg.
Conclusions and Clinical Relevance—Values of cardiopulmonary variables were largely unchanged by induction of pneumoperitoneum in healthy cats up to an IAP of 8 mm Hg, and no clinically important increases in working space were evident at an IAP of 15 versus 8 mm Hg. These findings provide little justification for use of IAPs > 8 mm Hg in healthy cats undergoing laparoscopic procedures; however, whether the situation is similar in diseased or elderly cats remains to be determined.
Objective—To compare leakage and maximum intraluminal pressures of intestinal anastomoses with and without serosal patch supplementation in dogs.
Sample—Healthy small intestine segments from cadavers of 2 dogs euthanized for reasons unrelated to the study.
Procedures—12 enterectomy constructs were created by anastomosis of intestinal segments with a standard simple continuous suture pattern. Half of the constructs were randomly selected for additional serosal patch support. Leakage and maximum intraluminal pressures were measured in and compared between patch-supplemented and nonsupplemented constructs.
Results—Mean ± SD leakage pressure was significantly greater for the patch-supplemented anastomoses (81.8 ± 6.7 mm Hg) than for the nonsupplemented anastomoses (28.0 ± 6.7 mm Hg). Maximum intraluminal pressures were not significantly different between the groups.
Conclusions and Clinical Relevance—Serosal patch–supplemented anastomoses were able to sustain a significantly higher pressure before leakage than were nonsupplemented anastomoses in intestinal specimens from canine cadavers. The serosal patch supplementation may protect against leakage immediately after enterectomy in dogs.
Objective—To determine the efficacy of decontamination and sterilization of a disposable port intended for use during single-incision laparoscopy.
Sample—5 material samples obtained from each of 3 laparoscopic surgery ports.
Procedures—Ports were assigned to undergo decontamination and ethylene oxide sterilization without bacterial inoculation (negative control port), with bacterial inoculation (Staphylococcus aureus, Escherichia coli, and Mycobacterium fortuitum) and without decontamination and sterilization (positive control port), or with bacterial inoculation followed by decontamination and ethylene oxide sterilization (treated port). Each port underwent testing 5 times; during each time, a sample of the foam portion of each port was obtained and bacteriologic culture testing was performed. Bacteriologic culture scores were determined for each port sample.
Results—None of the treated port samples had positive bacteriologic culture results. All 5 positive control port samples had positive bacteriologic culture results. One negative control port sample had positive bacteriologic culture results; a spore-forming Bacillus sp organism was cultured from that port sample, which was thought to be an environmental contaminant. Bacteriologic culture scores for the treated port samples were significantly lower than those for the positive control port samples. Bacteriologic culture scores for the treated port samples were not significantly different from those for negative control port samples.
Conclusions and Clinical Relevance—Results of this study indicated standard procedures for decontamination and sterilization of a single-use port intended for use during singleincision laparoscopic surgery were effective for elimination of inoculated bacteria. Reuse of this port may be safe for laparoscopic surgery of animals.
Objective—To compare the axial stiffness, maximum axial displacement, and ring deformation during axial loading of single complete and incomplete circular (ring) external skeletal fixator constructs.
Sample—32 groups of single ring constructs (5 constructs/group).
Procedures—Single ring constructs assembled with 2 divergent 1.6-mm-diameter Kirschner wires were used to stabilize a 60-mm-long segment of 16-mm-diameter acetyl resin rod. Construct variables included ring type (complete or incomplete), ring diameter (50, 66, 84, or 118 mm), and fixation wire tension (0, 30, 60, or 90 kg). Axial loading was performed with a materials testing system. Construct secant stiffness and maximum displacement were calculated from the load-displacement curves generated for each construct. Ring deformation was calculated by comparing ring diameter during and after construct loading to ring diameter prior to testing.
Results—Complete ring constructs had greater axial stiffness than did the 66-, 84-, and 118-mm-diameter incomplete ring constructs. As fixation wire tension increased, construct stiffness increased in the 66-, 84-, and 118-mm-diameter incomplete ring constructs. Maximum axial displacement decreased with increasing fixation wire tension, and complete ring constructs allowed less displacement than did incomplete ring constructs. Incomplete rings were deformed by wire tensioning and construct loading.
Conclusions and Clinical Relevance—Mechanical performance of the 66-, 84-, and 118-mm-diameter incomplete ring constructs improved when wire tension was applied, but these constructs were not as stiff as and allowed greater displacement than did complete ring constructs of comparable diameter. For clinical practice, tensioning the wires placed on 84- and 118-mm-diameter incomplete rings to 60 kg is recommended.
Objective—To compare leakage and maximum intraluminal pressures for a novel suture material with pressures for comparable suture material when used in closure of intestinal anastomoses in canine cadavers.
Sample—Healthy intestines from cadavers of dogs euthanized for reasons unrelated to the study.
Procedures—18 anastomoses were performed on intestinal sections within 72 hours after dogs were euthanized and intestinal samples collected. Anastomoses were performed with a simple continuous suture pattern. Leakage and maximum intraluminal pressures were measured and recorded for 6 control segments and 18 anastomosed sections. A barbed glycomer 631 suture (size 4–0 United States Pharmacopeia [USP]) was compared with glycomer 631 sutures (sizes 3–0 and 4–0 USP). Results for leakage and maximum intraluminal pressures were compared via an ANOVA.
Results—The barbed glycomer 631 suture material leaked at a significantly higher pressure than did the comparable glycomer 631 suture materials. Maximum intraluminal pressures were not significantly different among the suture materials.
Conclusions and Clinical Relevance—Barbed glycomer 631 4–0 USP suture material was as effective as glycomer 631 suture materials and may be a safe alternative for use in closure of enterectomies in dogs.
Objective—To characterize acute inflammatory and hemostatic surgical stress responses following castration in cats and to evaluate whether the addition of local anesthesia to the anesthetic protocol attenuates these responses.
Animals—39 male cats.
Procedures—Cats undergoing castration were randomly assigned to 2 groups: both groups underwent surgery with general anesthesia, and 1 group additionally received a local anesthetic (lidocaine [2.0 mg/kg in total, divided intratesticularly and SC]) prior to incision. Blood samples were collected after anesthetic induction (baseline) and 1, 5, and 24 hours later. Thromboelastography and coagulation variables (activated partial thromboplastin time [aPTT] and prothrombin time [PT]) were analyzed; fibrinolysis was assessed with plasma D-dimer concentrations. The acute-phase response was evaluated via measurement of plasma fibrinogen and serum amyloid A (last time point, 28 hours) concentrations. Hematologic variables were analyzed at baseline and 1, 5, and 24 hours later.
Results—Evidence of hemostatic and inflammatory activation after surgery was detected in both groups. Maximum amplitude and G (global clot strength) were significantly increased at 24 hours, and significant, but not clinically relevant, decreases were detected in aPTT at 5 and 24 hours and in PT at 24 hours, compared with baseline values. Serum amyloid A concentrations were significantly higher at 24 and 28 hours than at baseline, and plasma fibrinogen concentration was significantly increased at 24 hours; WBC and RBC counts and Hct were significantly increased at multiple time points. No differences between groups were detected for any variables.
Conclusions and Clinical Relevance—Castration appeared to induce hypercoagulability and an acute-phase inflammatory response in cats. Local anesthesia with lidocaine did not attenuate this response.
Objective—To compare effects of sterilization with hydrogen peroxide gas plasma (HPGP), ethylene oxide, and steam on bioadhesive properties of nylon and polyethylene lines used for stabilization of canine stifle joints.
Sample—Samples of a 36.3-kg test nylon leader line, 57.8-kg test nylon fishing line, and 2-mm ultrahigh–molecular weight polyethylene (UHMWPE) were used.
Procedures—In this in vitro study, samples of nylon leader line, fishing line, and UHMWPE sterilized by use of HPGP, ethylene oxide, and steam or unsterilized samples were used. Bacterial adherence on unsterilized and sterilized samples was tested with Staphylococcus epidermidis and Escherichia coli. Five samples were examined for each line type and sterilization condition, and final colony counts were obtained.
Results—Bacterial adherence was significantly affected by method of sterilization for all 3 line types. For most of the samples, bacterial adherence was similar or lower when HPGP sterilization was used, compared with results for sterilization via ethylene oxide and steam, respectively. Bacterial adherence was significantly higher for UHMWPE, compared with adherence for the nylon line, regardless of the sterilization method used. Bacterial adherence was higher for nylon fishing line than for nylon leader line for S epidermidis after ethylene oxide sterilization and for E coli after HPGP and ethylene oxide sterilization.
Conclusions and Clinical Relevance—Effects of HPGP sterilization on bioadhesive properties of nylon and polyethylene lines compared favorably with those for ethylene oxide and steam sterilization. Also, nylon line may be a more suitable material than UHMWPE for suture prostheses on the basis of bacterial adherence properties.
Objective—To investigate the hemostatic response to surgery and compare the response for ovariohysterectomy with that for ovariectomy and to evaluate the usefulness of thromboelastography on plasma samples.
Animals—42 female dogs.
Procedures—Dogs were assigned to undergo ovariohysterectomy or ovariectomy. Blood samples were collected immediately before and 1, 6, and 24 hours after surgery and stored at −80°C for subsequent analysis. Plasma samples were subjected to thromboelastography after thawing. In addition, coagulation variables were measured, including concentrations of von Willebrand factor antigen, fibrinogen, antithrombin, and protein C; activity of factor VIII; activated partial thromboplastin time; prothrombin time; and thrombin time. The fibrinolytic response was assessed via concentrations of D-dimer, plasminogen, and α-2-antiplasmin (plasmin inhibitor).
Results—Substantial hemostatic and fibrinolytic activation was evident after surgery in both groups, as characterized by significantly increased global clot strength and an overall hypercoagulable state at 4 hours after surgery in addition to decreases in von Willebrand factor antigen and factor VIII concentrations and shortened prothrombin and thrombin times. The dogs also typically had activation of the fibrinolytic system, as evidenced by increased postoperative concentrations of D-dimer, plasminogen, and plasmin inhibitor. Differences between the 2 groups could not be detected for any variables.
Conclusions and Clinical Relevance—Elective surgery with limited tissue trauma induced hemostatic activation in dogs, which led to hypercoagulability after surgery. A difference between the ovariohysterectomy and ovariectomy groups was not detected. Thromboelastography can be used on plasma samples and may be useful for evaluating patterns over time.
Objective—To evaluate the refractive error induced by intraocular administration of silicone oil (SiO) in dogs.
Animals—47 client-owned dogs evaluated for blindness secondary to retinal detachment.
Procedures—3-port pars plana vitrectomy with perfluoro-octane and SiO exchange (1,000- or 5,000-centistoke SiO) was performed in 1 or both eyes for all dogs (n = 63 eyes), depending on which eye or eyes were affected. Dogs were normotensive, had complete oil filling of the eyes, and were examined in a standing position for retinoscopic examination of both eyes (including healthy eyes).
Results—The mean refractive error for SiO-filled phakic and pseudophakic eyes was 2.67 and 3.24 D, respectively. The mean refractive error for SiO-filled aphakic eyes was 6.50 D. Dogs in which 5,000-centistoke SiO was used had consistently greater positive refractive errors (mean, 3.45 D), compared with dogs in which 1,000-centistoke SiO was used (mean, 2.10 D); however, the difference was nonsignificant. There was no significant linear relationship between refractive error and the number of days between surgery and retinoscopy.
Conclusions and Clinical Relevance—Hyperopia was observed in all dogs that underwent SiO tamponade, regardless of lens status (phakic, pseudophakic, or aphakic). Aphakic eyes underwent a myopic shift when filled with SiO. Pseudophakic eyes appeared to be more hyperopic than phakic eyes when filled with SiO; however, additional investigation is needed to confirm the study findings.
Objective—To evaluate effects of the arytenoid lateralization technique and suture tension on airway pressure in the canine larynx.
Sample—7 canine cadaver larynges.
Procedures—Negative pressure was elicited aboral to the larynx. Airway pressure was measured at airflows of 15 to 120 L/min before and after thyroarytenoid lateralization (TAL), cricoarytenoid lateralization (CAL), and combined TAL and CAL (cricothyroarytenoid lateralization [CTAL]) at 100 and 500 g of suture tension and with sectioning of the sesamoid cartilage (SSC) and disarticulation of the cricothyroid joint (DCTJ). Rima glottidis area (RGA) was measured. Effects of technique, modification, and suture tension on pressure and RGA were evaluated statistically.
Results—Increased suture tension significantly reduced airway pressure for TAL at 30 L/min, CAL at 45 to 120 L/min, and CAL after SSC and DCTJ at 60, 75, and 105 to 120 L/min. The CAL and CTAL caused significantly lower airway pressures than did TAL > 30 L/min, but SSC and DCTJ did not significantly reduce pressure. All procedures, except TAL at 100 g of tension, resulted in a significant RGA increase from baseline. The CAL and CTAL caused a significantly greater RGA than did TAL. For TAL at 100 g of tension, SSC significantly increased RGA.
Conclusions and Clinical Relevance—CAL and CTAL caused lower airway pressures than did TAL. No significant pressure differences were detected between CAL and CTAL; SSC and DCTJ had little effect on pressure. Pressure may be a more sensitive indicator of airflow than is RGA in the larynx of canine cadavers.