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  • Author or Editor: Stanley E. Kim x
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Abstract

Objective—To determine the influence of stifle joint flexion angle, cranial cruciate ligament (CrCL) integrity, tibial plateau leveling osteotomy (TPLO), and cranial tibial subluxation on the distance between the location of the origin and insertion of the CrCL (CrCLd) in dogs.

Samples—4 pairs of pelvic limbs from adult dog cadavers weighing 23 to 34 kg.

Procedures—Mediolateral projection radiographs of each stifle joint were obtained with the joint flexed at 90°, 105°, 120°, 135°, and 150°. Radiopaque markers were then placed at the sites of origin and insertion of the CrCL. Afterward, radiography was repeated in the same manner, before and after CrCL transection, with and without TPLO. Following CrCL transection, radiographs were obtained before and after inducing overt cranial tibial subluxation. Interobserver variation in measuring the CrCLd without fiduciary markers was assessed. The effect of CrCL integrity, cranial tibial subluxation, flexion angle, and TPLO on CrCLd was also determined.

Results—Interobserver agreement was strong, with an intraclass correlation coefficient of 0.859. The CrCLd was significantly shorter (< 1 mm) at 90° of flexion; otherwise, flexion angle had no effect on CrCLd. Cranial tibial subluxation caused a 25% to 40% increase in CrCLd. No effect of TPLO on CrCLd was found, regardless of CrCL integrity, forced stifle joint subluxation, or flexion angle.

Conclusions and Clinical Relevance—Overt cranial tibial subluxation in CrCL-deficient stifle joints can be detected on mediolateral projection radiographs by comparing CrCLd on neutral and stressed joint radiographs at joint angles between 105° and 150°, regardless of whether a TPLO has been performed.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To compare initial leak pressure (ILP) between cadaveric canine and synthetic small intestinal segments that did and did not undergo enterotomy.

SAMPLE

Eight 8-cm grossly normal jejunal segments from 1 canine cadaver and eight 8-cm synthetic small intestinal segments.

PROCEDURES

Intestinal segments were randomly assigned to undergo enterotomy (6 cadaveric and 6 synthetic segments) or serve as untreated controls (2 cadaveric and 2 synthetic segments). For segments designated for enterotomy, a 2-cm full-thickness incision was created along the antimesenteric border. The incision was closed in a single layer with 4-0 suture in a simple continuous pattern. Leak testing was performed with intestinal segments occluded at both ends and infused with dilute dye solution (999 mL/h) until the solution was observed leaking from the suture line or serosal tearing occurred. Intraluminal pressure was continuously monitored. The ILP at construct failure was compared between cadaveric and synthetic control segments and between cadaveric and synthetic enterotomy segments.

RESULTS

Mean ± SD ILP did not differ significantly between cadaveric (345.11 ± 2.15 mm Hg) and synthetic (329.04 ± 24.69 mm Hg) control segments but was significantly greater for cadaveric enterotomy segments (60.77 ± 15.81 mm Hg), compared with synthetic enterotomy segments (15.03 ± 6.41 mm Hg).

CONCLUSIONS AND CLINICAL RELEVANCE

Leak testing should not be used to assess the accuracy or security of enterotomy suture lines in synthetic intestinal tissue. Synthetic intestinal tissue is best used for students to gain confidence and proficiency in performing enterotomies before performing the procedure on live animals.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To develop a device intended for gradual venous occlusion over 4 to 6 weeks.

SAMPLE Silicone tubing filled with various inorganic salt and polyacrylic acid (PAA) formulations and mounted within a polypropylene or polyether ether ketone (PEEK) outer ring.

PROCEDURES 15 polypropylene prototype rings were initially filled with 1 of 5 formulations and placed in PBSS. In a second test, 10 polypropylene and 7 PEEK prototype rings were filled with 1 formulation and placed in PBSS. In a third test, 2 formulations were loaded into 6 PEEK rings each, placed in physiologic solution, and incubated. In all tests, ring luminal diameter, outer diameter, and luminal area were measured over 6 weeks.

RESULTS In the first test, 2 formulations had the greatest changes in luminal area and diameter, and 1 of those had a greater linear swell rate than the other had. In the second test, 6 of 7 PEEK rings and 6 of 10 polypropylene rings closed to a luminal diamater < 1 mm within 6 weeks. Polypropylene rings had a greater increase in outer diameter than did PEEK rings between 4.5 and 6 weeks. In the third test, 11 of 12 PEEK rings gradually closed to a luminal diameter < 1 mm within 6 weeks.

CONCLUSIONS AND CLINICAL RELEVANCE A PAA and inorganic salt formulation in a prototype silicone and polymer ring resulted in gradual occlusion over 4 to 6 weeks in vitro. Prototype PEEK rings provided more reliable closure than did polypropylene rings.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To evaluate the closure rate and completeness of closure for a silicone–polyacrylic acid gradual venous occlusion device placed around an intra-abdominal vein to simulate gradual occlusion of an extrahepatic portosystemic shunt.

ANIMALS 3 purpose-bred cats and 2 purpose-bred dogs.

PROCEDURES The device was surgically placed around an external (cats) or internal (dogs) iliac vein. Computed tomographic angiography was performed at the time of surgery and 2, 4, and 6 weeks after surgery. Ultrasonographic examinations of blood flow through the vein within the device were performed at the time of surgery and at weekly intervals thereafter. Dogs were euthanized 6 weeks after surgery, and the external iliac veins were harvested for histologic examination.

RESULTS The prototype gradual venous occlusion device was successfully placed in all animals, and all animals recovered without complications following the placement procedure. The vessel was completely occluded in 2 cats by 6 weeks after surgery, as determined on the basis of results of CT and ultrasonography; there was incomplete occlusion with a luminal diameter of 1.5 mm in the other cat by 6 weeks after surgery. The vessel was completely occluded in both dogs by 6 weeks after surgery. Histologic examination of the external iliac veins obtained from the dogs revealed minimal inflammation of the vessel wall and no thrombus formation.

CONCLUSIONS AND CLINICAL RELEVANCE The prototype device induced gradual attenuation of an intra-abdominal vessel over a 6-week period. This device may provide another option for gradual occlusion of extrahepatic portosystemic shunts.

Full access
in American Journal of Veterinary Research