Case Description—A 2-month-old male degu was treated for preputial damage and lateral penile displacement that occurred during attempted castration.
Clinical Findings—Bruising and swelling of the prepuce and severe edema to the left of the prepuce were evident. The penis could not be extruded from the prepuce. Radiography revealed a large bladder. Contrast medium injected into the prepuce filled the peripreputial subcutaneous tissues.
Treatment and Outcome—During surgical exploration through a peripreputial approach, the penis was found to be completely separated from the prepuce and located in the adjacent subcutaneous tissue. The penis was repositioned in the prepuce and anchored with a suture at its base. The following day, the preputial orifice was crusted over, urine was leaking from the incision, and the penis could not be extruded from the prepuce. The anchoring suture was removed, and the tip of the penis was sutured to the preputial orifice so that the penis protruded slightly from the prepuce. Urination was normal after the second surgery. Two years later, the preputial orifice remained adhered to the distal portion of the penis and the exposed penile tissue was healthy.
Clinical Relevance—Penile displacement from the prepuce is an unusual complication of castration in degus. The surgical technique used in this animal may be an effective means of repair. Permanent exposure of the tip of the penis may be well-tolerated in degus.
Objective—To determine clinical outcome of permanent tracheostomy in cats with upper airway obstruction.
Design—Retrospective case series.
Procedures—Medical records were reviewed for information on history, signalment, clinical signs, results of preoperative clinicopathologic testing, cause of upper airway obstruction, surgical procedure, postoperative complications, and outcome.
Results—Causes of upper airway obstruction included neoplasia (squamous cell carcinoma [n = 6] or malignant lymphoma ), inflammatory laryngeal disease (5), laryngeal paralysis (4), trauma (3), and a laryngeal mass of unknown cause (1). Fourteen cats had dyspnea in the immediate postoperative period; dyspnea most often resulted from mucous plugs at the stoma or elsewhere in the respiratory tract. Eleven cats died, including 6 cats that died while hospitalized after surgery and 5 cats that died after discharge; 7 cats were eu-thanatized, most often because of progression of neoplasia; and 2 were still alive at the time of the study. The remaining cat was lost to follow-up after discharge from the hospital. Overall, median survival time for the 20 cats for which information was available was 20.5 days (range, 1 day to 5 years). Cats that underwent permanent tracheostomy because of inflammatory laryngeal disease were 6.61 times as likely to die as cats that underwent permanent tracheostomy for any other reason.
Conclusions and Clinical Relevance—Results indicated that permanent tracheostomy was an uncommon procedure in cats with upper airway obstruction that was associated with high complication and mortality rates.
To determine long-term outcomes and factors associated with those outcomes in dogs with gastroesophageal intussusception (GEI).
36 dogs with GEI evaluated at 16 veterinary hospitals from January 2000 through January 2018.
Medical records of included dogs were reviewed to collect information regarding signalment, clinical signs, physical examination findings, blood work and diagnostic imaging results, surgical findings, and outcome. Factors were evaluated for associations with various outcomes.
Median age of dogs with GEI was 13.2 months, and males (72% [26/36]) and German Shepherd Dogs (33% [12/36]) were most common. Vomiting (67% [24/36]) and regurgitation (33% [12/36]) were the most common clinical signs. Ten of 36 (28%) dogs were euthanized without treatment, and 26 (72%) underwent treatment (25 surgically and 1 endoscopically). Twenty-three of the 26 (88%) treated dogs survived to discharge; median survival time was 995 days. At last follow-up, 15 of the 23 (65%) surviving dogs remained alive and 8 (35%) had died for reasons related to persistent regurgitation (n = 6) or reasons unrelated to GEI (2). Of the 10 dogs for which owners were contacted, 7 had persistent regurgitation, the severity of which was reduced through managed feedings. Dogs with acute (≤ 7 days) clinical signs or a previous diagnosis of megaesophagus were more likely to have persistent regurgitation than were dogs without these factors.
CONCLUSIONS AND CLINICAL RELEVANCE
Treatment should be considered for dogs with GEI given the high rate of survival to discharge and median survival time. Although persistent regurgitation was common after treatment, a satisfactory outcome was possible with medical management, including managed feedings and medications.