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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To describe short-term outcomes of dogs and cats undergoing surgery for traumatic bile peritonitis.

ANIMALS

13 dogs and 4 cats.

METHODS

Multi-institutional, retrospective study. Medical records from 6 institutions were reviewed for cases of traumatic bile peritonitis between 2006 and 2022. Clinical presentation, additional injuries, surgical treatment, and outcome were recorded.

RESULTS

Trauma occurred a median of 2 (range, 1 to 22) and 4 (range, 1 to 22) days prior to presentation in dogs and cats, respectively. Total bilirubin was increased in 11 of 13 dogs and 2 of 4 cats. Rupture occurred at the common bile duct (CBD) in 10 dogs and 1 cat, gallbladder in 3 dogs, cystic duct in 2 cats, and hepatic duct in 1 dog and 1 cat. The most common surgeries were cholecystoduodenostomy and CBD repair in dogs and cholecystectomy in cats. Eleven of 13 dogs and all cats survived to hospital discharge (88.2% overall survival). Median follow-up in surviving dogs and cats was 35 days (range, 14 to 401) and 30 days (range, 14 to 90), respectively. One dog that underwent cholecystectomy experienced recurrent bile peritonitis 20 days postoperatively. Short-term survival following surgical treatment of traumatic bile peritonitis was excellent and recurrence appears uncommon. The most frequent site of rupture was the CBD in dogs and the cystic duct in cats.

CLINICAL RELEVANCE

Measurement of peritoneal bilirubin should be considered in dogs and cats with peritoneal effusion following trauma. Surgeons should be prepared to identify and address ruptures in locations other than the gallbladder.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To evaluate the efficacy, complications, and outcome of Dumon silicone stent placement for dogs with grade IV tracheal collapse.

ANIMALS

12 client-owned dogs.

CLINICAL PRESENTATION

Each dog was diagnosed with grade IV TC unresponsive to medical therapy and had severe obstructive respiratory failure.

RESULTS

12 dogs were included in the study. By the end of the study, 5 of 12 (41.7%) remained alive, while 7 of 12 (58.3%) dogs died. Survival times after stent placement ranged from 97 to 1,310 days (mean, 822.43 days; median, 810 days). Three of the 12 (25%) dogs died spontaneously, while 4 of 12 (33.3%) were euthanized. The cause of death was determined for 6 of 7 (85.7%) dogs and was TC related for 3 of 7 (50%). Causes of death related to TC were progressive airway collapse (2/3 [66.6%]) and incoercible cough (1/3 [33.4%]). Complications occurred in 9 of 12 (75%) cases and included granulation tissue growth (3/12 [25%]), incoercible cough (2/12 [16.7%]), stent migration (1/12 [8.3%]), and stent deformation (1/12 [8.3%]). Reduction of obstructive dyspnea and episodes of asphyxiation was achieved after Dumon silicone stent placement.

CLINICAL RELEVANCE

The placement of an intraluminal Dumon silicone stent was a successful salvage treatment for TC in dogs that did not respond to medical management. Disease progression is inevitable, but substantial improvement of respiratory function may be achieved for months to years.

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

Abstract

OBJECTIVE

To assess the predictability of the hemangiosarcoma likelihood prediction (HeLP) score and the Tufts Splenic Tumor Assessment Tool (T-STAT) for hemangiosarcoma and malignancy, respectively.

ANIMALS

261 dogs undergoing splenectomy for a splenic mass.

METHODS

Medical records were retrospectively reviewed; variables for the HeLP score and T-STAT were collected, and scores were assigned. Area under the curve (AUC) was calculated for each score.

RESULTS

The HeLP score included 141 dogs; hemangiosarcoma was diagnosed in 87 (61.7%) dogs. The median cumulative HeLP score was 51 (range, 17 to 82; IQR, 39 to 58) for dogs with hemangiosarcoma and 28 (range, 0 to 70; IQR, 17 to 41) for dogs without hemangiosarcoma. The categorical HeLP score was low (28; 32.2%), medium (31; 35.6%), and high (28; 32.2%) for dogs with hemangiosarcoma and was low (41; 75.9%), medium (9; 16.7%), and high (4; 7.4%) for dogs without hemangiosarcoma. The AUC of the cumulative and categorical HeLP scores for diagnosis of hemangiosarcoma were 0.79 (95% CI, 0.71 to 0.86) and 0.73 (95% CI, 0.65 to 0.82), respectively. The T-STAT included 181 dogs. Lesions were benign in 95 (52.5%) and malignant in 86 (47.5%) dogs. The median T-STAT score was 62% (range, 5% to 98%; IQR, 36% to 77%) for dogs with malignant lesions and 38% (range, 5% to 91%; IQR, 24% to 59%) for dogs with benign lesions. The T-STAT had an AUC of 0.68 (0.60 to 0.76) for diagnosis of malignancy.

CLINICAL RELEVANCE

The HeLP score had acceptable performance, and the T-STAT had poor performance for diagnosis prediction. A tool with excellent or outstanding discrimination is needed to more reliably predict the presence of hemangiosarcoma or a malignant lesion preoperatively.

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in Journal of the American Veterinary Medical Association