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  • Author or Editor: Michele A. Steffey x
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Abstract

Objective—To describe the clinicopathologic features of a cohort of dogs with adrenocortical masses that underwent laparoscopic adrenalectomy and to compare perioperative morbidity and mortality rates in these dogs with rates for dogs that underwent open adrenalectomy for resection of similarly sized (maximal diameter, ≤ 5 cm) adrenocortical masses.

Design—Retrospective case series.

Animals—48 client-owned dogs that underwent laparoscopic (n = 23) or open (25) adrenalectomy for noninvasive tumors (ie, tumors that did not invade the vena cava or other surrounding organs).

Procedures—Medical records were reviewed. History, clinical signs, physical examination findings, clinicopathologic findings, imaging results, and surgical variables were recorded. A 3- or 4-port approach was used for laparoscopic adrenalectomy. Surgical time, perioperative complications, postoperative and overall hospitalization times, and perioperative deaths were recorded and compared between groups.

Results—The surgical method for 1 dog was converted from a laparoscopic to an open approach. Perioperative death occurred in no dogs in the laparoscopic group and 2 dogs in the open adrenalectomy group. Surgical time was shorter for laparoscopic (median, 90 minutes; range, 40 to 150 minutes) than for open (median, 120 minutes; range, 75 to 195 minutes) adrenalectomy. Laparoscopic adrenalectomy was associated with shorter hospitalization time and more rapid discharge from the hospital after surgery, compared with the open procedure.

Conclusions and Clinical Relevance—With careful patient selection, laparoscopic adrenalectomy was associated with a low complication rate and low conversion rate for resection of adrenocortical masses as well as shorter surgical and hospitalization times, compared with open adrenalectomy.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To describe surgical techniques and perioperative management of dogs with von Willebrand disease (VWD) or factor VII (FVII) deficiency undergoing laparoscopic ovariohysterectomy or ovariectomy and evaluate outcomes.

DESIGN Retrospective case series.

ANIMALS 20 client-owned dogs with VWD (n = 16) or FVII deficiency (4).

PROCEDURES Dogs with VWD or FVII deficiency that underwent laparoscopic ovariohysterectomy or ovariectomy between 2012 and 2014 were retrospectively identified via a multi-institutional review of medical records.

RESULTS Median expression of von Willebrand factor was 19% (interquartile range, 18% to 30%). All 16 dogs with VWD were Doberman Pinschers, and all were pretreated with desmopressin; 4 also received cryoprecipitate. One of 4 dogs with FVII deficiency received plasma preoperatively, and 1 was treated with desmopressin; 2 dogs received no preoperative treatment. Laparoscopic ovariectomy was performed in 9 dogs with VWD and 2 dogs with FVII deficiency, laparoscopic ovariectomy with gastropexy was performed in 6 dogs with VWD and 1 dog with FVII deficiency, and laparoscopic-assisted ovariohysterectomy was performed in 1 dog with VWD and 1 dog with FVII deficiency. Iatrogenic splenic laceration requiring conversion to laparotomy occurred during trocar insertion in 1 dog with VWD. No postoperative complications, including signs of hemorrhage, were reported for any dogs.

CONCLUSIONS AND CLINICAL RELEVANCE Laparoscopic ovariohysterectomy or ovariectomy in dogs with VWD or FVII deficiency pretreated with desmopressin, cryoprecipitate, or plasma transfusions were not associated with clinical signs of hemorrhage, suggesting that minimally invasive ovariohysterectomy or ovariectomy may be considered in female dogs affected with these coagulopathies.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate sevoflurane as an inhalation anesthetic for thoracotomy in horses.

Animals—18 horses between 2 and 15 years old.

Procedure—4 horses were used to develop surgical techniques and were euthanatized at the end of the procedure. The remaining 14 horses were selected, because they had an episode of bleeding from their lungs during strenuous exercise. General anesthesia was induced with xylazine (1.0 mg/kg of body weight, IV) followed by ketamine (2.0 mg/kg, IV). Anesthesia was maintained with sevoflurane in oxygen delivered via a circle anesthetic breathing circuit. Ventilation was controlled to maintain PaCO2 at approximately 45 mm Hg. Neuromuscular blocking drugs (succinylcholine or atracurium) were administered to eliminate spontaneous breathing efforts and to facilitate surgery. Cardiovascular performance was monitored and supported as indicated.

Results—2 of the 14 horses not euthanatized died as a result of ventricular fibrillation. Mean (± SD) duration of anesthesia was 304.9 ± 64.1 minutes for horses that survived and 216.7 ± 85.5 minutes for horses that were euthanatized or died. Our subjective opinion was that sevoflurane afforded good control of anesthetic depth during induction, maintenance, and recovery.

Conclusions and Clinical Relevance—Administration of sevoflurane together with neuromuscular blocking drugs provides stable and easily controllable anesthetic management of horses for elective thoracotomy and cardiac manipulation. (Am J Vet Res 2000;61:1430–1437)

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in American Journal of Veterinary Research

Abstract

OBJECTIVE

To describe surgical technique, biopsy sample quality, and short-term outcome of minimally invasive small intestinal exploration and targeted abdominal organ biopsy (MISIETB) with use of a wound retraction device (WRD) in dogs.

ANIMALS

27 client-owned dogs that underwent MISIETB with a WRD at 1 of 4 academic veterinary hospitals between January 1, 2010, and May 1, 2017.

PROCEDURES

Medical records were retrospectively reviewed, and data collected included signalment; medical history; findings from physical, ultrasonographic, laparoscopic, cytologic, and histologic evaluations; surgical indications, procedures, duration, and complications; and short-term (14-day) outcomes. The Shapiro-Wilk test was used to evaluate the normality of continuous variables, and descriptive statistics were calculated for numeric variables.

RESULTS

Laparoscopic exploration was performed through a multicannulated single port (n = 18), multiple ports (5), or a single 6-mm cannula (4). Median length of the incision for WRD placement was 4 cm (interquartile [25th to 75th percentile] range, 3 to 6 cm). All biopsy samples obtained had sufficient diagnostic quality. The 2 most common histologic diagnoses were lymphoplasmacytic enteritis (n = 14) and intestinal lymphoma (5). Twenty-five of 27 (93%) dogs survived to hospital discharge, and 3 (12%) dogs had postsurgical abnormalities unrelated to surgical technique.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that MISIETB with WRD was an effective method for obtaining diagnostic biopsy samples of the stomach, small intestine, pancreas, liver, and mesenteric lymph nodes in dogs. Prospective comparison between MISIETB with WRD and traditional laparotomy for abdominal organ biopsy in dogs is warranted.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To characterize clinical findings, surgical procedures, complications, and outcomes in dogs undergoing extirpation of masses from the cranial mediastinum via video-assisted thoracic surgery (VATS) and establish preliminary guidelines for case selection when considering VATS for thymectomy in dogs.

DESIGN Retrospective case series.

ANIMALS 18 client-owned dogs that underwent extirpation of a cranial mediastinal mass by means of VATS at 5 academic referral hospitals from 2009 through 2014.

PROCEDURES Medical records were reviewed and data extracted regarding signalment, clinical signs, physical examination findings, diagnostic imaging results, surgical approach and duration, cytologic and histologic examination results, complications, outcome, and cause of death, when applicable.

RESULTS 16 dogs had a thymoma, 1 had thymic anaplastic carcinoma, and 1 had hemangiosarcoma. Seven had both megaesophagus and myasthenia gravis. Median approximate tumor volume was 113.1 cm3 (interquartile range, 33.5 to 313.3 cm3). Median duration of VATS was 117.5 minutes (interquartile range, 91.5 to 136.3 minutes). Conversion to an open thoracic surgical procedure was required for 2 dogs, 1 of which died during surgery. Median survival time following VATS for dogs with thymoma and concurrent myasthenia gravis and megaesophagus was 20 days. Dogs with thymoma without paraneoplastic syndrome survived for ≥ 60 days, and none of these dogs died of disease-related causes.

CONCLUSIONS AND CLINICAL RELEVANCE VATS appeared to be an acceptable approach for extirpation of masses from the cranial mediastinum in dogs under certain conditions. Dogs with myasthenia gravis and megaesophagus had a poor postoperative outcome.

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in Journal of the American Veterinary Medical Association

Abstract

CASE DESCRIPTION A 4-year-old sexually intact male pet guinea pig (Cavia porcellus) was evaluated for a routine wellness examination.

CLINICAL FINDINGS During physical examination, a small mass was palpated in the cranial aspect of the abdomen. Abdominal radiographic and ultrasonographic findings were suggestive of a gastric mass. Cytologic evaluation of a fine-needle aspirate of the mass was indicative of spindle cell proliferation most consistent with a sarcoma.

TREATMENT AND OUTCOME The patient was anesthetized, and an exploratory laparotomy and partial gastrectomy were performed to resect the gastric mass. Histologic and immunohistochemical examinations of the mass revealed that it was a gastric leiomyoma. The patient recovered from surgery without complications. No evidence of mass recurrence was observed during an abdominal ultrasonographic examination performed approximately 19 months after surgery.

CLINICAL RELEVANCE To our knowledge, this was the first report of the clinical diagnosis and successful surgical treatment of a gastric neoplasm in a guinea pig. Gastric leiomyomas are not uncommon in guinea pigs, and although benign, they can cause clinical signs if they become large enough to impair gastric function. Gastrointestinal surgery should be considered as a treatment option for guinea pigs with similar gastric neoplasms.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To describe clinicopathologic features of dogs that underwent lung lobectomy for resection of primary lung tumors via video-assisted thoracoscopic surgery (VATS) or open thoracotomy (OT) and to compare short-term outcomes for dogs following these procedures.

Design—Retrospective cohort study.

Animals—46 medium- to large-breed dogs with primary lung tumors.

Procedures—Medical records of dogs that underwent a lung lobectomy via VATS (n = 22) or OT (24) for resection of primary lung tumors between 2004 and 2012 were reviewed. Dogs were included if they weighed > 10 kg (22 lb) and resection of a primary lung tumor was confirmed histologically. Tumor volumes were calculated from preoperative CT scans where available. Surgical time, completeness of excision, time in the ICU, indwelling thoracic drain time, postoperative and total hospitalization time, incidence of major complications, and short-term survival rate were evaluated.

Results—VATS was performed with a 3-port (n = 12) or 4-port (10) technique and 1-lung ventilation (22). In 2 of 22 (9%) dogs, VATS was converted to OT. All dogs survived to discharge from the hospital. There were no significant differences between the VATS and OT groups with regard to most variables. Surgery time was significantly longer for VATS than for OT (median, 120 vs 95 minutes, respectively).

Conclusions and Clinical Relevance—In medium- to large-breed dogs, short-term outcomes for dogs that underwent VATS for lung lobectomy were comparable to those of dogs that underwent OT. Further studies are required to evaluate the effects of surgical approach on indices of postoperative pain and long-term outcomes.

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in Journal of the American Veterinary Medical Association