Case Description—A 12-year-old castrated male Labrador Retriever was evaluated for clinical signs associated with colorectal obstruction.
Clinical Findings—The dog had a 2-week history of tenesmus and hematochezia. On rectal examination, an annular colorectal mass was palpable extending orad into the pelvic canal. The original diagnosis of the colorectal mass was a mucosal adenoma. The dog was maintained on a low-residue diet and fecal softeners for a period of 13 months after initial diagnosis. At that time, medical management was no longer effective.
Treatment and Outcome—Placement of a colonic stent was chosen to palliate the clinical signs associated with colorectal obstruction. By use of fluoroscopic and colonoscopic guidance, a nitinol stent was placed intraluminally to open the obstructed region. Placement of the stent resulted in improvement of clinical signs, although tenesmus and obstipation occurred periodically after stent placement. At 212 days after stent placement, the patient had extensive improvement in clinical signs with minimal complications; however, clinical signs became severe at 238 days after stent placement, and the dog was euthanized. Histologic evaluation of the rectal tumor from samples obtained during necropsy revealed that the tumor had undergone malignant transformation to a carcinoma in situ.
Clinical Relevance—A stent was successfully placed in the colon and rectum to relieve obstruction associated with a tumor originally diagnosed as a benign neoplasm. Placement of colorectal stents may be an option for the palliation of colorectal obstruction secondary to neoplastic disease; however, clinical signs may persist, and continuation of medical management may be necessary.
Objective—To identify causative organisms, treatment, outcome, and prognosis for dogs < 1 year old with community-acquired infectious pneumonia.
Design—Retrospective case series.
Procedures—Dogs were considered to have community-acquired infectious pneumonia if they had clinical signs of primary respiratory tract disease in conjunction with radiographic evidence of alveolar disease and positive results following bacterial culture of tracheal wash fluid.
Results—Most dogs were hypoxemic at the time of initial examination, with pulmonary function becoming worse during the first few days of hospitalization before improving; 57 (88%) dogs survived to discharge. Bordetella bronchiseptica was isolated from tracheal wash fluid from 32 (49%) dogs, and other organisms, predominantly gram-negative enteric bacteria, were isolated from the other 33 (51%). Dogs with Bordetella pneumonia were significantly younger (median, 14 vs 21 weeks), were significantly more likely to have been obtained from a pet store (19/31 vs 7/32), had been owned for a significantly shorter time prior to the onset of illness (median, 18 vs 90 days), had significantly higher PvCO2 values at initial examination (median, 48.7 vs 41.3 mm Hg), were significantly more likely to receive supplemental oxygen (25/32 vs 16/33), and had significantly longer hospitalization times (mean, 7.2 vs 4.9 days) than did dogs with pneumonia caused by any other organism.
Conclusions and Clinical Relevance—Results suggested that a type of community-acquired infectious pneumonia could be identified in dogs < 1 year old, with disease being more severe in dogs with Bordetella pneumonia than in dogs with pneumonia caused by other bacterial organisms.
4 cats (6 to 9 months old) were evaluated because of clinical signs consistent with a portosystemic shunt (PSS).
Among the 4 cats, 3 had neurologic abnormalities including ataxia, head pressing, disorientation, and obtundation. One cat was evaluated because of urethral obstruction; a retrieved urethral stone was determined to have urate composition. Clinicopathologic findings (hypoproteinemia, low BUN concentration, and high serum bile acids concentration) were consistent with a PSS in all cats. A diagnosis of intrahepatic PSS (IHPSS) was made for all cats on the basis of ultrasonographic and CT findings.
TREATMENT AND OUTCOME
All cats underwent percutaneous transvenous coil embolization (PTCE). No major intraprocedural complications were encountered, and all cats were discharged from the hospital. For the 3 cats that were presented with neurologic signs, an evaluation performed at 12, 14, or 48 months after the procedure revealed resolution of the neurologic signs, and owners reported that the behavior of each cat appeared normal. One cat that initially had neurologic and gastrointestinal signs had lower urinary tract signs after PTCE and developed an acquired extrahepatic PSS.
Although IHPSSs in cats are uncommon, the outcomes of PTCE for the 4 cats of the present report suggested that this treatment may benefit cats with an IHPSS. No short-term complications were encountered, and all cats had improvement in clinical signs following PTCE, although an acquired extrahepatic PSS was later identified in 1 cat. Further investigation of the use of endovascular techniques for the treatment of IHPSSs in cats and other species is warranted.
Objective—To describe the clinical signs, diagnostic findings, surgical management, and outcome in dogs with splenic liposarcoma.
Design—Retrospective case series.
Animals—13 client-owned dogs with splenic liposarcoma.
Procedures—Medical and pathology records of dogs with a histopathologic diagnosis of splenic liposarcoma from 2002 to 2012 were reviewed for the following data: clinical signs, CBC, biochemical profile, thoracic and abdominal imaging, surgical management, histologic grade, and outcome (local recurrence, distant metastasis, and survival time). Telephone interviews were conducted with referring veterinarians.
Results—The median survival time (MST) was 623 days (range, 1 to 1,283 days). In 5 dogs that died of splenic liposarcoma, survival times ranged from 42 to 369 days. Metastasis at the time of surgery was a negative prognostic indicator: the MST was 45 days for dogs with metastasis and 767 days for dogs without metastasis. Dogs with grade 1 splenic liposarcoma had a significantly greater MST (1,009 days), compared with dogs with grade 2 or 3 splenic liposarcoma (MST, 206 and 74 days, respectively).
Conclusions and Clinical Relevance—Results confirmed that splenic liposarcoma is a rare differential diagnosis in dogs with a splenic mass. Survival time was influenced by preoperative clinical stage and histologic grade.
To report the fluoroscopic removal or repositioning of urinary tract implants in dogs and cats by use of an endovascular snare system (ESS) and to report procedural usefulness and complications in dogs and cats.
3 cats and 14 dogs.
A medical records review was performed to identify dogs and cats that underwent removal or repositioning of urinary tract foreign bodies or implants by use of an ESS with fluoroscopic guidance at a veterinary teaching hospital from 2013 to 2019.
Dogs had a median weight of 25 kg (55 lb) with a range of 3.5 to 60.6 kg (7.7 to 133.3 lb), and cats had a median weight of 5 kg (11 lb) with a range of 4.2 to 5.4 kg (9.2 to 11.9 lb). By use of an ESS, 12 patients (2 cats and 10 dogs) underwent transurethral retrieval of retained vesicourethral implants or ureteral stents, 2 dogs underwent transurethral ureteral stent repositioning, 1 cat and 2 dogs underwent transnephric retrieval of ureteral stents, and 1 dog underwent cystoscopic-assisted transureteral ureteral stent retrieval. All procedures were successfully performed, and there were no associated procedural complications.
CONCLUSIONS AND CLINICAL RELEVANCE
Retained vesicourethral implants or ureteral stents were successfully retrieved by use of an ESS in dogs and cats transurethrally or with an open or percutaneous transnephric approach and fluoroscopic guidance. These techniques should be considered as an alternative or adjunct to more invasive methods for implant retrieval or manipulation.
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)
An 8-month-old 41.2-kg (90.6-lb) sexually intact male Dogue de Bordeaux with urinary incontinence and signs of nausea was referred for further evaluation and treatment of bilateral hydronephrosis, hydroureter, and ectopic ureters.
Clinicopathologic analyses revealed urine specific gravity and serum concentrations of urea nitrogen and creatinine within reference limits. Abdominal ultrasonography and CT revealed unilateral abdominal cryptorchidism, ureters that bilaterally passed dorsal to and appeared compressed by the external iliac arteries (retroiliac ureters), and bilateral hydronephrosis, hydroureter, and ectopic ureters. On CT, minimal uptake of contrast medium by the right kidney indicated either a lack of renal function or ureteral obstruction.
TREATMENT AND OUTCOME
The dog underwent exploratory laparotomy, right ureteronephrectomy, left neoureterocystostomy, bilateral castration, and incisional gastropexy without complication and was discharged 2 days postoperatively. Eleven days after surgery, the dog had improved but continued urinary incontinence, improved left hydronephrosis and hydroureter, and serum concentrations of urea nitrogen and creatinine within reference limits. At 24 months after surgery, the dog was reportedly clinically normal, other than having persistent urinary incontinence.
To our knowledge, this was the first report of a dog with retroiliac ureters and compression-induced ureteral obstruction with secondary hydroureter and hydronephrosis. Retroiliac ureters should be considered as a differential diagnosis in young dogs with ureteral obstruction. Our findings indicated that a good outcome was possible for a dog with retroiliac ureters treated surgically; however, the presence of additional congenital anomalies should be considered and may alter the prognosis in dogs with retroiliac ureters.
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.
To describe outcomes of small- and toy-breed dogs with a congenital intrahepatic portosystemic shunt (IHPSS) treated with percutaneous transvenous coil embolization (PTCE).
20 small- and toy-breed dogs with an IHPSS.
All dogs underwent CT angiography for shunt evaluation as well as PTCE. Medical records were reviewed for pertinent data, and owners and primary veterinarians were contacted for long-term follow-up information.
Dogs ranged from 1.5 to 10.0 kg (mean ± SD, 6.32 ± 2.57 kg) in weight. The equipment used to perform PTCE tended to be smaller than that previously described for larger breed dogs. Intra- and postoperative complication rates were 20% (4/20) and 5% (1/20), respectively, and included hypotension, bradycardia, hypercapnia, ventricular premature contractions, hypothermia, and regurgitation. Dogs were discharged a median of 3 days (range, 1 to 3 days) after surgery, and all dogs survived to discharge. Clinical signs resolved in 95% (19/20) of the dogs a median of 21 days after the procedure. One- and 2-year survival rates were 92%. Three dogs had died by the time of data collection; 2 of these dogs died of causes related to the IHPSS 267 and 1,178 days, respectively, after the procedure.
Percutaneous transvenous coil embolization was a safe and effective option for treatment of IHPSS in small- and toy-breed dogs and offered a minimally invasive alternative to open surgical techniques. Complication and survival rates in this cohort were similar to or better than those reported in previous studies evaluating PTCE and open surgical techniques for treatment of IHPSS in dogs.