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.
Case Description—An 11-year-old castrated male Vizsla was evaluated for excision of a cranial mediastinal mass.
Clinical Findings—The dog had a 1-month history of a cough that had recently increased in frequency. On physical examination, the dog had a grade 2/6 left systolic heart murmur and multiple subcutaneous masses. A soft tissue mass was observed in the cranioventral aspect of the thorax on radiographs. Results of a CT scan revealed a well-defined, 2.8 × 3.2 × 3.9-cm soft tissue mass in the cranial mediastinum.
Treatment and Outcome—The dog underwent video-assisted thoracoscopic removal of the mediastinal mass and recovered routinely. Histologic examination of excised tissues revealed malignant thymoma. Approximately 6.5 months after surgery, the dog was evaluated because of polyuria, polydipsia, decreased appetite, and vomiting. On physical examination, masses were found in both axillary regions. Results of serum biochemical analysis indicated hypercalcemia. Thoracic ultrasonography revealed pulmonary metastases and a large mass in the right caudoventral region of the thorax. The dog received supportive care and medical treatment for hypercalcemia, but clinical signs recurred. Euthanasia was elected; necropsy and histologic examination revealed thymic carcinoma.
Conclusions and Clinical Relevance—Descriptions of the development of portal site metastasis in canine patients are rare. In this patient, portal site metastasis developed rapidly after thoracoscopic resection of a malignant thymic mass and was associated with hypercalcemia. As use of thoracoscopic procedures increases in veterinary medicine, it will be important to monitor the development of major complications such as those in the patient of this report. (J Am Vet Med Assoc 2015;247:793–800)
Objective—To determine clinicopathologic features, surgical management, complications, and long-term outcome associated with diseases of the extrahepatic portion of the biliary tract treated via choledochal stent placement in dogs.
Design—Retrospective case series.
Procedure—Data were obtained from medical records, and follow-up information was obtained via reexamination or telephone interview with owners or referring veterinarians.
Results—10 dogs had extrahepatic biliary obstruction (EHBO), 6 as a result of pancreatitis. Two dogs had rupture of the common bile duct associated with cholelithiasis. In 1 dog, a stent was placed prophylactically after gastroduodenostomy was performed for a perforated duodenal ulcer. Nine of 13 dogs survived the perioperative period and were discharged. No recurrence of EHBO or other complications developed in the discharged dogs while the stents were in place. Median follow-up period from surgery to last owner contact was 13.3 months. In 1 dog, the stent was removed endoscopically 10 months after surgery and EHBO recurred 9 months after stent removal because of cholangitis. In 4 of 5 dogs that were discharged from the hospital, in which the fate of the stent could be confirmed and the stent was secured to the duodenal wall with absorbable suture materials, the stents were passed in the feces 1 to 11 months after surgery.
Conclusions and Clinical Relevance—Choledochal tube stenting is an effective method of decompression of the extrahepatic portion of the biliary tract in dogs and provides a less complex alternative to traditional cholecystoenterostomy techniques in select cases.
Objective—To determine prevalence of a radiographic
caudolateral curvilinear osteophyte (CCO) on the
femoral neck in various breeds and age groups of
dogs and to evaluate its contemporaneous relationship
with degenerative joint disease (DJD) and distraction
Design—Cross-sectional prevalence study.
Animals—25,968 dogs, including 3,729 German
Shepherd Dogs, 4,545 Golden Retrievers, 6,277
Labrador Retrievers, and 1,191 Rottweilers.
Procedure—Data from the University of
Pennsylvania Hip Improvement Program database
were analyzed, including ventrodorsal hip-extended,
compression, and distraction radiographs. The CCO
and radiographic signs of DJD were considered independent
events and were interpreted as either present
or absent. Statistical methods were used to evaluate
the CCO as a possible risk factor for DJD and
assess its association with DI, as measured by use of
Results—When all breeds were pooled, DJD was
detected in 8.6% of dogs, and the CCO was detected
in 21.6% of dogs. Among dogs with a CCO,
25.1% had radiographic evidence of DJD. Among
dogs without a CCO, only 4% had DJD. Dogs with a
CCO were 7.9 times as likely to have DJD as were
those without a CCO. Additionally, DI, weight, and
age were significant risk factors for the CCO.
Conclusion and Clinical Relevance—Results confirm
the contemporaneous association between the
CCO and DJD and that passive hip laxity, as measured
by use of the DI, is associated with both the CCO and
DJD. (J Am Vet Med Assoc 2002;220:472–476)
Objective—To determine outcome associated with intramural ureteral ectopia treated with 1 of 2 surgical techniques (neoureterostomy with ligation of the distal ureteral segment vs neoureterostomy with resection of the distal ureteral segment) and compare results of these 2 techniques in dogs.
Design—Multicenter retrospective case series.
Animals—36 dogs (15 treated with the ligation technique and 21 treated with the resection technique).
Procedures—Information was obtained from medical records. Long-term follow-up information was obtained by owner questionnaire.
Results—15 of 21 (71%) dogs in the resection group and 7 of 14 (50%) dogs in the ligation group still had urinary incontinence after surgery. Three of 20 (15%) dogs in the resection group and 4 of 14 (29%) dogs in the ligation group reportedly had multiple episodes of urinary tract infection following surgery. The outcome of surgery was judged to be excellent by the owners of 10 of 18 (56%) dogs in the resection group and 9 of 14 (64%) dogs in the ligation group. No significant differences were found between surgery treatment groups.
Conclusions and Clinical Relevance—Results of the present study suggest that although most owners of dogs that undergo surgery for treatment of intramural ureteral ectopia consider the outcome of surgery to be excellent, substantial proportions of dogs will continue to have urinary incontinence and recurrent urinary tract infections after surgery. Findings do not provide any support to the hypothesis that the resection technique is superior to the ligation technique for management of dogs with intramural ureteral ectopia.
To determine the optimal intercostal space (ICS) for thoracoscopic-assisted pulmonary surgery for lung lobectomy in cats.
8 cat cadavers.
Cadavers were placed in lateral recumbency. A 5-cm minithoracotomy incision was made in the middle third of ICS 4 through 7 on the left side and 4 through 8 on the right side, and a wound retractor device was placed. A camera port was made in the middle third of ICS 9. Each lung lobe was sequentially exteriorized at each respective ICS. A thoracoabdominal stapler was placed to simulate a lung lobectomy, and distance from the stapler anvil to the hilus was measured.
For the left cranial lung lobe, there was no significant difference in median distance from the stapler anvil to the pulmonary hilus for ICS 4 through 6. Simulated lobectomy of the left caudal lung lobe performed at ICS 5 and 6 resulted in a significantly shorter distance, compared with lobectomy performed at ICS 4 and 7. Simulated lobectomy of the right cranial and right middle lung lobes performed at ICS 4 and 5 resulted in a significantly shorter distance, compared with lobectomy performed at ICS 7. Simulated lobectomy of the accessory and right caudal lung lobes at ICS 5 and 6 resulted in a significantly shorter distance than for lobectomy performed at ICS 8.
CONCLUSIONS AND CLINICAL RELEVANCE
An optimal ICS for a minithoracotomy incision was determined for thoracoscopic-assisted lung lobectomy in cats.
Objective—To determine whether age, breed, sex,
weight, or distraction index (DI) was associated with
the risk that dogs of 4 common breeds (German
Shepherd Dog, Golden Retriever, Labrador Retriever,
Rottweiler) would have radiographic evidence of
degenerative joint disease (DJD) associated with hip
Design—Cross-sectional prevalence study.
Procedure—Hips of dogs were evaluated radiographically
by use of the ventrodorsal hip-extended view, the compression view, and the distraction view. The ventrodorsal hip-extended view was examined to determine whether dogs had DJD. For each breed, a multiple logistic regression model incorporating age, sex, weight, and DI was created. For each breed, disease-susceptibility curves were produced, using all
dogs, regardless of age, and dogs grouped on the basis of age.
Results—Weight and DI were significant risk factors
for DJD in all breeds. For German Shepherd Dogs, the
risk of having DJD was 4.95 times the risk for dogs of
the other 3 breeds combined. In all breeds, the probability
of having DJD increased with age.
Conclusions and Clinical Relevance—Results indicated
that the probability of having hip DJD increased
with hip joint laxity as measured by use of DI. This
association was breed-specific, indicating that breedspecific
information on disease susceptibility should be
incorporated when making breeding decisions and
when deciding on possible surgical treatment of hip
dysplasia. (J Am Vet Med Assoc 2001;219:1719–1724)
Objective—To describe the technique and evaluate the outcome of laparoscopic treatment of ovarian remnant syndrome (ORS) in dogs and cats.
Design—Retrospective case series.
Animals—7 client-owned dogs and cats.
Procedures—Medical records of dogs and cats with ORS that were treated laparoscopically at 3 large veterinary teaching hospitals were reviewed. Laparoscopic ovarian remnant resection was performed by means of either a 3-port or single-port technique with the patient in dorsal recumbency. The area caudal to both kidneys was thoroughly inspected for evidence of ovarian tissue by tilting the patient laterally. Any ovarian remnant tissue in these areas was resected with a bipolar vessel sealer.
Results—5 female dogs and 2 female cats that had previously undergone ovariectomy or ovariohysterectomy were included in the study. Six procedures were performed with a standard 3-port technique, and 1 was performed with a single-port technique. Median surgery time was 90 minutes (range, 50 to 150 minutes). No patient required conversion to laparotomy. Six of the 7 patients had complete resolution of clinical signs after surgery. One patient underwent laparotomy 7 weeks after surgery for management of stump pyometra, but no further ovarian tissue was detected.
Conclusions and Clinical Relevance—Laparoscopic management of ORS in this cohort of dogs and cats was associated with minimal morbidity. Laparoscopic treatment of ORS in dogs and cats may be recommended for appropriately selected patients.
OBJECTIVE To describe the operative technique, complications, and conversion rates for laparoscopic liver biopsy (LLB) in dogs and evaluate short-term clinical outcome for dogs that underwent the procedure.
DESIGN Retrospective case series.
ANIMALS 106 client-owned dogs.
PROCEDURES Medical records were reviewed to identify dogs that underwent an LLB with a single-port or multiport technique at either of 2 veterinary teaching hospitals from August 2003 to September 2013. Demographic and laboratory data, preoperative administration of fresh frozen plasma, procedural and diagnostic information, intraoperative complications, and survival to discharge were recorded. The LLB specimens were obtained with 5-mm laparoscopic biopsy cup forceps and a grasp-and-twist technique.
RESULTS Prior to surgery, 25 of 94 (27%) dogs had coagulopathy (prothrombin time or partial thromboplastin time greater than the facility reference ranges, regardless of platelet count). Twenty-one dogs were thrombocytopenic, 14 had ascites, and 14 received fresh frozen plasma transfusion before surgery. In all cases, biopsy samples collected were of sufficient size and quality for histopathologic evaluation. Two dogs required conversion to an open laparotomy because of splenic laceration during initial port placement. One hundred one of 106 dogs survived to discharge; 5 were euthanized during hospitalization owing to progression of liver disease and poor prognosis.
CONCLUSIONS AND CLINICAL RELEVANCE Single-port and multiport LLB were found to be effective, minimally invasive diagnostic techniques with a low rate of complications. Results suggested LLB can be safely used in dogs with underlying coagulopathies and advanced liver disease.
Objective—To describe and evaluate the short- and long-term outcomes in female dogs after cystoscopic-guided laser ablation of ectopic ureters (CLA-EU).
Design—Prospective case series.
Animals—32 incontinent female dogs with intramural ectopic ureters.
Procedures—A diagnosis of intramural ectopic ureters was made via cystoscopy and fluoroscopy in all patients. Transurethral CLA-EU (via diode laser [n = 27] or Holmium:yttrium aluminum garnet laser ) was performed to relocate the ectopic ureteral orifice cranially into the urinary bladder. All vaginal anomalies were treated with the laser concurrently. Follow-up evaluation was standardized and included urinary continence scoring, serial bacteriologic culture of urine samples, and a follow-up cystoscopy 6 to 8 weeks after CLA-EU.
Results—Ectopic ureteral orifices of all dogs were initially located in the urethra. Eighteen of 30 dogs had bilateral ectopic ureters, and 12 had unilateral ectopic ureters. All dogs had other concurrent urinary anomalies. At the time of last follow-up (median, 2.7 years after CLA-EU, [range, 12 to 62 months]), 14 of 30 (47%) dogs did not require any additional treatments following CLA-EU to maintain urinary continence. For the 16 residually incontinent dogs, the addition of medical management, transurethral bulking-agent injection, or placement of a hydraulic occluder was effective in 3, 2, and 4 dogs, respectively, improving the overall urinary continence rate to 77% (23/30 dogs). One dog had evidence of polypoid cystitis at the neoureteral orifice 6 weeks after CLA-EU that was resolved at 3 months.
Conclusions and Clinical Relevance—CLA-EU provided an effective, safe, and minimally invasive alternative to surgery for intramural ectopic ureters in female dogs.