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.