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Objective

To compare outcome of surgical versus medical treatment of dogs with beta cell neoplasia.

Design

Retrospective study.

Animals

39 dogs with clinical signs of hypoglycemia and serum glucose and insulin concentrations consistent with a diagnosis of beta cell neoplasia.

Procedure

Information on signalment; clinical history; physical examination findings; results of CBC, serum biochemical analyses, and urinalysis; serum glucose and insulin concentrations; results of thoracic radiography and abdominal ultrasonography; treatment and treatment complications; survival time; and cause of death were obtained from medical records.

Results

26 dogs underwent exploratory celiotomy and partial pancreatectomy; 13 dogs were treated medically (ie, dietary change and prednisone). Median survival time was significantly longer for dogs treated surgically than for dogs treated medically. Significant differences were not found in mean age, body weight, duration of clinical signs prior to diagnosis, serum glucose and insulin concentration, or results of other serum biochemical tests between dogs treated surgically and dogs treated medically; also, there was no significant correlation between any of these parameters and survival time for either group of dogs.

Conclusions and Clinical Relevance

Results suggest that exploratory celiotomy and partial pancreatectomy are indicated once a tentative diagnosis of beta cell neoplasia is established in dogs. (J Am Vet Med Assoc 1999;215:226–230)

Free access
in Journal of the American Veterinary Medical Association

SUMMARY

Twelve ponies were used to evaluate the reliability of an abdominal adhesion model and the efficacy of intraperitoneal infusion of sodium carboxymethylcellulose in preventing abdominal adhesions. A celiotomy was performed on each of the 12 ponies and the serosa of the distal portion of the jejunum was abraded with a dry gauze sponge at 5 locations. In addition to the serosal damage, a single 2-0 chromic gut suture was placed through the seromuscular layer of the jejunum in the center of the abraded area. After closure of the celiotomy, a 1% solution of sodium carboxymethylcellulose (7 ml/kg of body weight) was infused into the peritoneal cavity of 6 ponies. The other ponies served as untreated controls. All ponies were euthanatized 14 days after surgery.

All ponies in the control group had abdominal adhesions at the time of necropsy. Four of the 6 ponies in the treatment group were free of adhesions. There was a significant (P < 0.0001) difference in the total number of adhesions between the 2 groups.

Free access
in American Journal of Veterinary Research

Summary

Pheochromocytoma was diagnosed in 4 dogs with pituitary-dependent hyperadrenocorticism and 2 dogs with hyperadrenocorticism caused by adrenocortical tumor. All dogs were examined initially because of clinical signs associated with hyperadrenocorticism. Pheochromocytoma was suspected in 2 dogs with pituitary-dependent hyperadrenocorticism that had ultrasonographic evidence of an adrenal gland mass, and in 1 dog suspected to have hyperadrenocorticism associated with an adrenocortical tumor after complications (systemic hypertension, cardiac arrhythmias) developed during induction of anesthesia. Pheochromocytoma was an unexpected finding at necropsy in the remaining 3 dogs. Two dogs collapsed suddenly and died before diagnostic tests could be performed; the other dog died during anesthesia for cobalt teletherapy of a pituitary macroadenoma. Hypertension, most notable during digital manipulation of the affected adrenal gland, developed during anesthesia and surgery in 3 dogs that underwent exploratory celiotomy.

Free access
in Journal of the American Veterinary Medical Association

Summary

Medical records of 9 cats with chylous ascites that underwent exploratory celiotomy were reviewed. In 7 cats, chylous ascites was associated with intra-abdominal neoplasia: 4 cats had an unresectable tumor (hemangiosarcoma, 3 cats; paraganglioma, 1 cat) within the mesenteric root; 2 had malignant lymphoma of the small intestine and mesenteric lymph nodes; and 1 had lymphangiosarcoma of the abdominal wall. In 2 cats, chylous ascites was associated with nonneoplastic diseases: 1 cat had severe biliary cirrhosis and an extrahepatic portosystemic shunt; the other had steatitis caused by vitamin E deficiency. Three cats were euthanatized or died at the time of surgery, and 5 cats were euthanatized within 3 months of surgery. One cat with malignant lymphoma responded well to chemotherapy and lived for 14 months after surgery.

Free access
in Journal of the American Veterinary Medical Association

Objective

To identify breed, age, sex, physical findings, history, and outcome of treatment in horses and other equids with enterolithiasis.

Design

Retrospective study.

Animals

900 equids with enterolithiasis.

Procedure

Medical records from equids with enterolithiasis admitted between 1973 and 1996 were reviewed. Data on signalment, history, physical examination and clinicopathologic findings, surgical findings, and outcome were compiled from records and from telephone interviews with owners. Sex and breed predilections were determined by comparison of the study population with the general hospital population of equids during the same time period.

Results

Equids with enterolithiasis represented 15.1% of patients admitted for treatment of colic, and 27.5% of patients undergoing celiotomy for treatment of colic. Arabian and Arabian crosses, Morgans, American Saddlebreds, and donkeys were significantly overrepresented, and Thoroughbreds, Standardbreds, warmbloods, and stallions were significantly underrepresented in the study population, compared with the hospital population. The mean age of equids with enterolithiasis was 11.4 years. The most common historic findings were signs of intermittent colic (33.3%) and passage of enteroliths in the feces (13.5%). Physical examination findings were similar to those found in equids with other forms of nonstrangulating large colon obstructive disease. Fifteen percent (131) developed gastrointestinal tract rupture caused by an enterolith that necessitated euthanasia. Short-term and 1-year survival rates for equids undergoing celiotomy for treatment of enterolithiasis and recovering from anesthesia were excellent (96.2 and 92.5%, respectively), and postoperative complications were uncommon. Recurrence of enterolithiasis was identified in 7.7% of the study population.

Clinical Implications

Results indicated that short-term and 1-year survival rates for equids undergoing surgery for enterolithiasis are excellent. Identification of signalment, history, and management factors may help identify equids with a high risk for development of enterolithiasis. (J Am Vet Med Assoc 1999;214;233–237)

Free access
in Journal of the American Veterinary Medical Association

SUMMARY

Twenty-four horses were randomly allocated to 3 groups. All horses underwent a ventral midline celiotomy, and the large colon was exteriorized and instrumented. Group-1 horses served as sham-operated controls, group-2 horses underwent 6 hours of colonic ischemia, and group-3 horses were subjected to 3 hours of ischemia and 3 hours of reperfusion. Baseline blood samples were collected, then low-flow colonic ischemia was induced in horses of groups 2 and 3 by reducing colonic arterial blood flow to 20% of baseline. All horses were monitored for 6 hours. Citrated systemic venous ( sv ) blood samples were collected from the main pulmonary artery, and colonic venous (cv) samples were collected from the colonic vein draining the ventral colon. Samples were collected at 0, and 2, 3, 3.25, 4, and 6 hours for determination of one-stage prothrombin time, activated partial thromboplastin time, antithrombin III activity, and fibrinogen concentration. Data were analyzed statistically, using two-way anova for repeated measures, and post-hoc comparisons were made by use of Student Newman Keul's test. Statistical significance was set at P < 0.05. There were significant decreases in all hemostatic variables by 2 hours in sv and cv samples from horses of all 3 groups, but there were no differences among the 3 groups for any of these variables. These hemostatic alterations could have been secondary to a hypercoagulable state or to fluid therapy-induced hemodilution. Colonic ischemia-reperfusion was not the cause of these alterations because these alterations also were observed in the sham-operated control horses. Significant temporal alterations existed even after accounting for the hemodilution. The most plausible explanation for these alterations is that hemostatic activation was incited by the celiotomy and manipulation of the colon during exteriorization and instrumentation. Comparison of paired sv and cv samples for each hemostatic variable revealed significant differences for the absolute values of one-stage prothrombin time and fibrinogen concentration, but not for activated partial thromboplastin time or antithrombin III activity. This indicates that monitoring sv hemostatic variables does not necessarily provide an accurate assessment of hemostatic function in regional vascular beds. Largecolon ischemia with or without reperfusion did not alter hemostatic function.

Free access
in American Journal of Veterinary Research

Abstract

Objective—To characterize the texture, mineralogic features, and chemical features of enteroliths obtained from horses.

Sample Population—Enteroliths from 13 horses with colic.

Procedure—Enteroliths were harvested from 13 horses that underwent ventral midline celiotomy for treatment of colic or necropsy because of colonic obstruction and rupture caused by enteroliths. Dietary and environmental history were determined via questionnaires or evaluation of medical records. In 7 horses that underwent surgical treatment for enterolithiasis, samples of colonic contents were obtained via an enterotomy in the pelvic flexure. Colonic concentrations of magnesium (Mg), phosphorus (P), sulfur (S), sodium (Na), calcium (Ca), and potassium (K) were determined. Enteroliths were analyzed via electron microprobe analysis and X-ray diffraction.

Results—Enteroliths varied widely regarding degree of porosity, presence and distribution of radiating texture, and composition and size of the central nidus. A distinct concentric banding was identifiable in all enteroliths. Struvite was the predominant component of all enteroliths, although Mg vivianite was identified in 5 enteroliths, and there were variable quantities of Na, S, K, and Ca in the struvite within enteroliths. Despite an abundance of Ca in colonic fluids, Mgphosphate minerals were preferentially formed, compared with Ca-phosphates (apatite), in equine enteroliths.

Conclusions and Clinical Relevance—Enteroliths comprise 2 major Mg phosphates: struvite and Mg vivianite. There is wide variability in macrotexture and ionic concentrations between and within enteroliths. (Am J Vet Res 2001;62:350–358)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine the effect of experimental intraluminal distention on microvascular perfusion of the small colon in horses.

Animals—6 mixed-breed healthy horses (mean age [± SD], 9.1 ± 2 years).

Procedure—Under general anesthesia, the small colon was exposed by celiotomy and 3 segments were demarcated. In 1 of these segments, intraluminal obstruction was created by placement of a latex balloon inflated to a pressure of 40 mm Hg (obstructed segment). The other segments were the sham-operated segment and the control segment. Microvascular perfusion was evaluated in the mucosal, submucosal, muscular, and serosal layers by injection of 15-µm-diameter colored microspheres into branches of the caudal mesenteric artery. Recovery of microspheres was performed by tissue digestion, washing, and centrifugation. Distribution of microspheres in the intestinal layers was evaluated by direct observation of stained frozen sections by light microscopy.

Results—A significant reduction was observed in total microvascular perfusion of obstructed segments, which was 26.4% of that of control segments. This reduction was not evident in the mucosal layer.

Conclusion and Clinical Relevance—Intraluminal distention of the equine small colon wall can promote ischemia by a reduction in microvascular perfusion in the intestinal wall. Intestinal layers do not seem to be affected to the same extent, because the absolute value for mucosal perfusion did not decrease in the obstructed segment. (Am J Vet Res 2002;63:1292–1297)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To report the postoperative outcome in horses undergoing jejunoileal anastomosis performed with a 2-layer simple continuous technique.

Design—Retrospective study.

Animals—7 horses.

Procedure—Information regarding signalment, clinical signs, findings at surgery, and postoperative complications was obtained from medical records of horses that underwent exploratory ventral midline celiotomy, small intestinal resection, and jejunoileal anastomosis to correct various small intestinal strangulating lesions. Follow-up information was obtained via telephone conversations with owners or trainers.

Results—Six males and 1 female of various breeds aged 10 months to 27 years and weighing 312 to 785 kg (686.4 to 1,727 lb) were included. The most common complications were mild to moderate tachycardia and mild to moderate signs of abdominal pain. Two horses developed incisional infections and soft, fluctuant swelling at the incision site following resolution of the infection. Follow-up time ranged from 7 to 17 months after surgery. Owners reported no further colic episodes and no diet change necessary following surgery. All horses had returned to their intended level of use.

Conclusions and Clinical Relevance—Advantages to the jejunoileal technique include maintaining the normal ileocecal valve and a postoperative recovery period similar to that described following other small intestinal anastomoses. Jejunoileal anastomosis is a viable alternative to ileal bypass. This technique appears to result in a postoperative complication rate similar to that reported following jejunojejunostomy procedures. (J Am Vet Med Assoc 2002;221:541–545)

Full access
in Journal of the American Veterinary Medical Association

Abstract

CASE DESCRIPTION

A 1-year-old spayed female domestic shorthair cat was evaluated for a sternal defect and ventral abdominal wall hernia.

CLINICAL FINDINGS

The cat appeared healthy. Palpation revealed a sternal defect, and the heart could be observed beating underneath the skin at the caudoventral aspect of the thorax. A 3-cm-diameter freely movable mass, consistent with a hernia, was also palpated at the cranioventral aspect of the abdomen. Thoracic radiographic and CT images revealed a sternal cleft, cranial midline abdominal wall hernia, and peritoneopericardial diaphragmatic hernia (PPDH).

TREATMENT AND OUTCOME

Thoracotomy and celiotomy were performed. The sternal cleft was repaired with a porcine small intestinal submucosa graft, titanium contourable mesh plate, and interrupted 25-gauge cerclage wires. A diaphragmatic herniorrhaphy was used to correct the PPDH. Thoracic radiographs were obtained immediately after surgery to confirm repair of the sternal cleft, abdominal wall hernia, and PPDH and at 1 and 3 months after surgery to assess the surgical implants, which had not migrated and were intact with only mild bending at the cranial and caudal margins of the mesh plate. At both recheck examinations, the cat appeared healthy with no complications reported by the owner.

CLINICAL RELEVANCE

A novel surgical technique was used to successfully repair a large sternal cleft in an adult cat with no postoperative complications reported. This technique may be useful for the treatment of sternal clefts in other cats. This was the first report to describe an adult cat with congenital defects consistent with incomplete pentalogy of Cantrell.

Full access
in Journal of the American Veterinary Medical Association