Objective—To evaluate fluid production and factors associated with seroma formation after placement of closed suction drains in clean surgical wounds in dogs.
Design—Retrospective case series.
Animals—77 client-owned dogs with a subcutaneous closed suction drain placed following a clean surgical procedure.
Procedures—Medical records (January 2005 to June 2012) were reviewed, and signalment, site of surgery and underlying disease process, histologic evaluation results, total drain fluid production, fluid production rate (mL/kg/h) at 12-hour intervals, cytologic evaluation of drain fluid, and development of dehiscence, infection, or seroma were recorded. Associations among variables were evaluated.
Results—The most common complication was dehiscence (n = 18), followed by seroma (14) and infection (4). Dogs that developed a seroma had significantly greater total drain fluid volume relative to body weight and greater fluid production rate at 24 and 72 hours as well as the last time point measured before drain removal. Dogs in which drains were removed when fluid production rate was > 0.2 mL/kg/h (0.09 mL/lb/h) were significantly more likely to develop a seroma.
Conclusions and Clinical Relevance—Seroma formation was more common in dogs with a higher rate of fluid production relative to body weight, but was not associated with the number of days that a closed suction drain remained in situ. Dogs may be at greater risk of seroma formation if their drains are removed while drainage is still occurring at a rate > 0.2 mL/kg/h.
A 4-year-old spayed female mixed-breed rabbit was evaluated because of a 3-year history of sneezing and nasal discharge that were refractory to medical management.
Signs of chronic left-sided rhinitis and sinusitis were observed on physical examination and confirmed by CT evaluation. Lysis of the rostral aspect of the left maxillary bone and destruction of nasal turbinates were evident on CT images.
TREATMENT AND OUTCOME
Pararhinotomy of the left maxillary sinus through the facies cribrosa was performed. Purulent material was removed from the maxillary sinus recesses, a middle meatal antrostomy was completed to allow permanent drainage into the left middle nasal meatus, and the tissues were closed routinely. Microbial culture of a sample from the maxillary sinus recesses revealed Bordetella bronchiseptica, undetermined fastidious nonenteric bacteria, and Streptococcus viridans. Medical management was continued, and nasal discharge resolved but sneezing persisted. Increased sneezing and bilateral nasal discharge developed 1.5 years later; CT examination revealed right-sided rhinitis, and culture of a nasal swab sample revealed Bordetella spp, Staphylococcus spp, and Micrococcus spp. Right-sided pararhinotomy and middle meatal antrostomy were performed, and medical management continued. A subsequent recurrence was managed without additional surgery; 4 years after the initial surgery, the rabbit was still receiving medical treatment, with mild intermittent nasal discharge and sneezing reported.
This report describes a surgical approach for treatment of chronic rhinitis in companion rabbits with maxillary sinus involvement that included creation of a permanent drainage pathway from the maxillary sinus to the middle nasal meatus.
Objective—To describe the clinicopathologic features of a cohort of dogs with adrenocortical masses that underwent laparoscopic adrenalectomy and to compare perioperative morbidity and mortality rates in these dogs with rates for dogs that underwent open adrenalectomy for resection of similarly sized (maximal diameter, ≤ 5 cm) adrenocortical masses.
Design—Retrospective case series.
Animals—48 client-owned dogs that underwent laparoscopic (n = 23) or open (25) adrenalectomy for noninvasive tumors (ie, tumors that did not invade the vena cava or other surrounding organs).
Procedures—Medical records were reviewed. History, clinical signs, physical examination findings, clinicopathologic findings, imaging results, and surgical variables were recorded. A 3- or 4-port approach was used for laparoscopic adrenalectomy. Surgical time, perioperative complications, postoperative and overall hospitalization times, and perioperative deaths were recorded and compared between groups.
Results—The surgical method for 1 dog was converted from a laparoscopic to an open approach. Perioperative death occurred in no dogs in the laparoscopic group and 2 dogs in the open adrenalectomy group. Surgical time was shorter for laparoscopic (median, 90 minutes; range, 40 to 150 minutes) than for open (median, 120 minutes; range, 75 to 195 minutes) adrenalectomy. Laparoscopic adrenalectomy was associated with shorter hospitalization time and more rapid discharge from the hospital after surgery, compared with the open procedure.
Conclusions and Clinical Relevance—With careful patient selection, laparoscopic adrenalectomy was associated with a low complication rate and low conversion rate for resection of adrenocortical masses as well as shorter surgical and hospitalization times, compared with open adrenalectomy.
Objective—To describe clinicopathologic features of dogs that underwent lung lobectomy for resection of primary lung tumors via video-assisted thoracoscopic surgery (VATS) or open thoracotomy (OT) and to compare short-term outcomes for dogs following these procedures.
Design—Retrospective cohort study.
Animals—46 medium- to large-breed dogs with primary lung tumors.
Procedures—Medical records of dogs that underwent a lung lobectomy via VATS (n = 22) or OT (24) for resection of primary lung tumors between 2004 and 2012 were reviewed. Dogs were included if they weighed > 10 kg (22 lb) and resection of a primary lung tumor was confirmed histologically. Tumor volumes were calculated from preoperative CT scans where available. Surgical time, completeness of excision, time in the ICU, indwelling thoracic drain time, postoperative and total hospitalization time, incidence of major complications, and short-term survival rate were evaluated.
Results—VATS was performed with a 3-port (n = 12) or 4-port (10) technique and 1-lung ventilation (22). In 2 of 22 (9%) dogs, VATS was converted to OT. All dogs survived to discharge from the hospital. There were no significant differences between the VATS and OT groups with regard to most variables. Surgery time was significantly longer for VATS than for OT (median, 120 vs 95 minutes, respectively).
Conclusions and Clinical Relevance—In medium- to large-breed dogs, short-term outcomes for dogs that underwent VATS for lung lobectomy were comparable to those of dogs that underwent OT. Further studies are required to evaluate the effects of surgical approach on indices of postoperative pain and long-term outcomes.
OBJECTIVE To evaluate the outcome for cats with benign ureteral obstructions treated by means of ureteral stenting and to compare the outcome for these cats with outcome for a historical cohort of cats treated by means of ureterotomy only.
DESIGN Prospective study with historical cohort.
ANIMALS 62 client-owned cats with benign ureteral obstructions, including 26 cats treated with ureteral stenting and 36 cats previously treated with ureterotomy.
PROCEDURES Data were recorded prospectively (ureteral stent cases) or collected retrospectively from the medical records (ureterotomy cases), and results were compared.
RESULTS Cats treated with ureteral stents had significantly greater decreases in BUN and serum creatinine concentrations 1 day after surgery and at hospital discharge, compared with values for cats that underwent ureterotomy. Six cats in the ureteral stent group developed abdominal effusion after surgery, and cats in this group were significantly more likely to develop abdominal effusion when a ureterotomy was performed than when it was not. Cats that developed abdominal effusion after surgery were significantly less likely to survive to hospital discharge. Cats that underwent ureteral stenting were significantly more likely to have resolution of azotemia prior to hospital discharge than were cats that underwent ureterotomy alone.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that cats with benign ureteral obstructions treated with ureteral stenting were more likely to have resolution of azotemia prior to hospital discharge, compared with cats undergoing ureterotomy alone. Results of ureteral stenting were encouraging, but further investigation is warranted.
OBJECTIVE To characterize clinical findings, surgical procedures, complications, and outcomes in dogs undergoing extirpation of masses from the cranial mediastinum via video-assisted thoracic surgery (VATS) and establish preliminary guidelines for case selection when considering VATS for thymectomy in dogs.
DESIGN Retrospective case series.
ANIMALS 18 client-owned dogs that underwent extirpation of a cranial mediastinal mass by means of VATS at 5 academic referral hospitals from 2009 through 2014.
PROCEDURES Medical records were reviewed and data extracted regarding signalment, clinical signs, physical examination findings, diagnostic imaging results, surgical approach and duration, cytologic and histologic examination results, complications, outcome, and cause of death, when applicable.
RESULTS 16 dogs had a thymoma, 1 had thymic anaplastic carcinoma, and 1 had hemangiosarcoma. Seven had both megaesophagus and myasthenia gravis. Median approximate tumor volume was 113.1 cm3 (interquartile range, 33.5 to 313.3 cm3). Median duration of VATS was 117.5 minutes (interquartile range, 91.5 to 136.3 minutes). Conversion to an open thoracic surgical procedure was required for 2 dogs, 1 of which died during surgery. Median survival time following VATS for dogs with thymoma and concurrent myasthenia gravis and megaesophagus was 20 days. Dogs with thymoma without paraneoplastic syndrome survived for ≥ 60 days, and none of these dogs died of disease-related causes.
CONCLUSIONS AND CLINICAL RELEVANCE VATS appeared to be an acceptable approach for extirpation of masses from the cranial mediastinum in dogs under certain conditions. Dogs with myasthenia gravis and megaesophagus had a poor postoperative outcome.