Objective—To develop laparoscopic-assisted techniques
for enterostomy feeding tube placement and
full-thickness biopsy of the jejunum in dogs.
Animals—15 healthy dogs.
Procedure—Dogs were anesthetized, and positive
pressure ventilation was provided. A trocar cannula
for the laparoscope was inserted on the ventral midline
caudal to the umbilicus. For enterostomy tube
placement, a second trocar cannula was placed lateral
to the right rectus abdominis muscle, and a
Babcock forceps was used to grasp the duodenum
and elevate it to the incision made for the cannula.
The duodenum was sutured to the abdominal wall,
and a feeding tube was inserted. For jejunal biopsy, a
third trocar cannula was placed lateral to the left rectus
abdominis muscle. A portion of jejunum was elevated
to the incision for the second or third cannula,
and a full-thickness biopsy specimen was obtained. A
second specimen was obtained from another portion
of jejunum, and retention sutures for the 2 biopsy
sites were tied so that serosal surfaces of the biopsy
sites were apposed to each other. Dogs were euthanatized
30 days after surgery.
Results—The enterostomy tube was properly positioned
and functional in all 8 dogs that underwent
laparoscopic-assisted enterostomy tube placement,
and sufficient samples for histologic examination
were obtained from all 7 dogs that underwent laparoscopic-assisted jejunal biopsy. None of the dogs had
any identifiable problems after surgery.
Conclusion and Clinical Relevance—Results suggest
that in dogs, laparoscopic-assisted procedures
for enterostomy tube placement and jejunal biopsy
are an acceptable alternative to procedures performed
during a laparotomy. (Am J Vet Res 2002;
Case Description—A 2-year-old 38.9-kg (85.58-lb) sexually intact male German Shepherd Dog was examined because of a 4-month history of severe nasal swelling and nasal mucosa congestion. The signs were slowly progressive.
Clinical Findings—Physical examination revealed that the dorsal aspect of the dog's nose was swollen and hard. Mucous membranes in both nostrils were hyperemic and edematous. Diagnostic investigation revealed severe nasal osteolysis and pyogranulomatous rhinitis and nasopharyngitis attributable to blastomycosis.
Treatment and Outcome—Oral administration of itraconazole was initiated (5 mg/kg [2.27 mg/lb], q 12 h for 5 days and then q 24 h). After a treatment period of 3 months, the nose had regained its normal appearance. After 5 months of treatment, the Blastomyces infection was eliminated as confirmed by results of rhinoscopy and biopsy specimen examination. No relapse was evident within 1 year after discontinuation of treatment.
Clinical Relevance—In dogs, nasal and nasopharyngeal blastomycosis can result in severe osteolysis of the nasal bone. Resolution of disease can be achieved with oral administration of itraconazole for a period of at least 5 months.
Case Description—A 7-year-old Quarter Horse gelding was evaluated because of sudden onset of severe left forelimb lameness of 4 days' duration.
Clinical Findings—Clinical evaluation and diagnostic perineural analgesia localized the lameness to the distal portion of the left forelimb. Radiography revealed a transverse fracture of the distal phalanx of the left forelimb.
Treatment and Outcome—The horse was treated conservatively with stall rest and stabilization of the hoof with fiberglass cast material and an elevated heel support. These treatments improved the lameness considerably. Over the following 4 months, the horse was exercised at an increasing level; external coaptation of the hoof was removed, and the horse was gradually shod in a flat shoe. At 6 months after injury, the horse had no signs of lameness when working at its previous performance level, but it was euthanized for reasons unrelated to orthopedic disease. Radiographically, the fracture was unapparent; however, results of magnetic resonance imaging and histologic examination of the cadaveric limb confirmed the presence of tissue changes consistent with a healing fracture.
Clinical Relevance—Conservative management of transverse fractures of the distal phalanx of a forelimb may be effective and enable affected horses to be returned to their intended use.