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Abstract
OBJECTIVE
To compare use of a 3-level self-locking suture (3LSLS) technique with use of a previously described modified 3-loop pulley (M3LP) technique to repair rupture of the proximal aspect of patellar tendons in limbs from canine cadavers.
SAMPLE
Paired hind limbs of 6 adult mixed-breed dogs.
PROCEDURES
A limb from each pair was randomly assigned to be repaired by the 3LSLS technique or M3LP technique with size-2 ultrahigh-molecular-weight polyethylene and size-0 monofilament polypropylene suture, respectively. Limbs were prepared, and each patellar tendon was transected at a site chosen to simulate rupture at the proximal aspect. Tendons were repaired with the assigned techniques and mechanically tested with a biaxial servohydraulic test system; the clamp was distracted until the repair failed. Force at 1 -mm gap formation, 3-mm gap formation, and repair failure and gap size at failure were measured and compared between methods. Mode of failure was recorded.
RESULTS
There was no significant difference between methods for the force required to produce a 1 - or 3-mm gap in the repair. The 3LSLS technique required a significantly higher load for complete failure; gap formation immediately before failure was significantly greater for this method than for the M3LP technique. Four of 6 repairs with the M3LP technique and 0 of 6 repairs with the 3LSLS technique failed by suture breakage.
CONCLUSIONS AND CLINICAL RELEVANCE
The 3LSLS technique with size-2 ultrahigh-molecular-weight polyethylene suture was as effective at resistance to 1 - and 3-mm gap formation as the M3LP with size-0 monofilament polypropylene suture.
Abstract
Objective—To compare survival rate, duration of hospitalization, and complications in dogs with pancreatic abscesses treated with omentalization with abdominal closure versus open peritoneal drainage and evaluate a pancreatitis severity score for potential prognostic value.
Design—Retrospective case series.
Animals—15 dogs with pancreatic abscesses.
Procedure—Data regarding species, breed, age, initial clinical signs, CBC, serum biochemical abnormalities, pancreatitis severity score, anatomic location of the abscess, intraoperative bacteriologic culture results, treatment modality, postoperative complications, outcome (dismissed alive from the hospital, died in the postoperative period, or euthanized at surgery), and duration of hospitalization were evaluated.
Results—6 dogs survived, 6 dogs died or were euthanized after surgery, and 3 were euthanized during surgery. Five of 8 dogs treated with omentalization and abdominal closure survived, and 1 of 4 dogs treated with open peritoneal drainage survived. In several dogs, treatment required additional surgical procedures, which did not appear to affect outcome. Postoperative complications were similar among survivors and nonsurvivors. Mean duration of hospitalization for dogs treated with omentalization and abdominal closure was less than that of dogs treated with open peritoneal drainage. Neither pancreatitis severity score nor any individual components of the score were associated with outcome.
Conclusions and Clinical Relevance—Omentalization is a viable treatment option for pancreatic abscess in dogs. Furthermore, shorter hospitalization and better survival outcomes may make omentalization preferred over open peritoneal drainage.
Abstract
OBJECTIVE
To report the surgical technique, complications, and outcomes of 8 dogs that underwent a unilateral pantarsal arthrodesis stabilized using a circular external skeletal fixator (CESF) construct for the treatment of uni- or multilevel tarsal instability.
ANIMALS
8 dogs.
CLINICAL PRESENTATION
Medical records from 2010 to 2023 from 2 small animal hospitals were retrospectively reviewed for dogs undergoing pantarsal arthrodeses stabilized with CESF. Data collected for each dog included signalment, injury etiology, construct configuration, radiographic imaging, antimicrobial use, complications, length of time until construct removal, and outcome based on clinical evaluation by the owner and veterinary surgeon.
RESULTS
8 dogs met the requirements of inclusion for the study. Dogs had a mean age of 5.5 years (range, 0.42 to 13 years) and weight of 15.1 kg (range, 2.5 to 26.4 kg). Angulated 3- and 4-ring constructs were used in 5 and 3 dogs, respectively, with or without hybridization. Tarsi were stabilized with a mean angle of extension of 124.8° (range, 111.5° to 136.5°). Fixator removal was performed at a mean time of 11.3 weeks (range, 6 to 16 weeks). Complications developed in 4 dogs, 2 of which had poor clinical outcomes despite additional interventions, including recurrent digit trauma and poor limb use postoperatively. Six dogs had excellent outcomes.
CLINICAL RELEVANCE
A CESF may be considered as an alternative to plate stabilization when performing a pantarsal arthrodesis. This fixation requires rigorous postoperative care but obviates the need for supplemental postoperative coaptation.
Abstract
OBJECTIVE To evaluate the feasibility of laparoscopy versus exploratory laparotomy for the diagnosis of specific lesions in dogs with suspected gastrointestinal obstruction.
DESIGN Controlled trial.
ANIMALS 16 client-owned dogs with physical and radiographic findings consistent with gastrointestinal obstruction.
PROCEDURES Single-incision laparoscopy with intracorporeal and extracorporeal examination of the gastrointestinal tract was performed by 1 surgeon. Immediately afterward, exploratory laparotomy was performed by a second surgeon. Accessibility and gross appearance of organs, surgical diagnoses, incision lengths, procedure duration, and complications were compared between diagnostic techniques.
RESULTS Mean (95% confidence interval) incision length was 4.9 cm (3.9 to 5.9 cm) for laparoscopy and 16.4 cm (14.0 to 18.7 cm) for exploratory laparotomy. Mean (95% confidence interval) procedure duration was 36.8 minutes (31.6 to 41.2 minutes) and 12.8 minutes (11.4 to 14.3 minutes), respectively. Diagnoses of the cause of obstruction were the same with both methods. In 13 dogs, the laparoscopic examination was successfully completed, and in the other 3, it was incomplete. In 4 dogs in which laparoscopy was successful, conversion to exploratory laparotomy or considerable extension of the laparoscopic incision would have been required to allow subsequent surgical treatment of identified lesions. No dogs developed major complications, and minor complication rates were similar between procedures.
CONCLUSIONS AND CLINICAL RELEVANCE Laparoscopy was feasible and clinically applicable in dogs with suspected gastrointestinal obstruction. Careful patient selection and liberal criteria for conversion to an open surgical approach are recommended when laparoscopy is considered for the diagnosis of gastrointestinal lesions in dogs.
Abstract
OBJECTIVE To evaluate the usefulness of noncontrast abdominal CT and abdominal ultrasonography for the detection of mechanical gastrointestinal obstruction in dogs and compare intestinal diameter ratios between dogs with and without obstruction.
DESIGN Controlled trial.
ANIMALS 16 client-owned dogs with physical and radiographic findings consistent with mechanical gastrointestinal obstruction.
PROCEDURES Abdominal ultrasonography and CT were performed for all dogs, followed by laparoscopy and exploratory laparotomy. Time required for image acquisition and presence and location of gastrointestinal obstruction were assessed with both imaging modalities. Findings were compared with those of exploratory surgery. Maximum and minimum intestinal diameters were recorded on CT scans; values were converted to a ratio and compared between dogs with and without obstruction.
RESULTS Results of abdominal CT and exploratory surgery for the diagnosis of mechanical obstruction agreed for all 16 dogs; 10 dogs had complete obstruction, 3 had partial obstruction, and 3 had no obstruction. In 1 dog with functional ileus, abdominal ultrasonography resulted in an incorrect diagnosis of mechanical obstruction. Median (interquartile range) image acquisition time for abdominal CT (2.5 minutes [2.0 to 3.8 minutes]) was markedly and significantly shorter than that for ultrasonography (26.0 minutes [22.0 to 35.8 minutes]). In both dorsal and transverse CT planes, dogs with gastrointestinal obstruction (partial or complete) had significantly larger intestinal diameter ratios than dogs without obstruction.
CONCLUSIONS AND CLINICAL RELEVANCE Abdominal CT was feasible, rapid, and accurate for the diagnosis of mechanical obstruction in dogs with clinical signs and physical examination findings consistent with partial or complete gastrointestinal obstruction.
Abstract
OBJECTIVE To determine the effect of arthrotomy alone or in combination with osteotomy of the proximal portion of the tibia on blood delivery to the patellar tendon of dogs.
SAMPLE 24 canine cadavers.
PROCEDURES One hind limb from each cadaver was assigned to 1 of 4 treatment groups: medial arthrotomy (MA; MA group), lateral arthrotomy (LA; LA group), MA and LA with tibial tuberosity transposition (MALA group), and MA with tibial plateau leveling osteotomy (TPLO; TPLO group). The contralateral hind limb served as the control sample. Contrast solution (barium [33%], India ink [17%], and saline [0.9% NaCl] solution [50%]) was injected through an 8F catheter inserted in the caudal portion of the abdominal aorta. Limbs were radiographed to allow examination of vascular filling. The patella, patellar tendon, and tibial crest were harvested, radiographed to allow examination of tissue vascular filling, and fixed in 4% paraformaldehyde. Vessels perfused with contrast solution were counted in sections obtained from the proximal, middle, and distal regions of each patellar tendon.
RESULTS Vessel counts did not differ significantly among the 3 tendon regions. Compared with results for the control group, delivery of contrast solution to the patellar tendon was significantly decreased in the MALA and TPLO groups but was not changed in the MA or LA groups.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that surgical procedures used to treat cranial cruciate injuries (ie, TPLO) and patellar luxation decreased blood delivery to the patellar tendon of canine cadavers, at least acutely.
Abstract
Objective—To compare the mechanical properties of laryngeal tie-forward (LTF) surrogate constructs prepared with steel fixtures and No. 5 braided polyester or braided polyethylene by use of a standard or a modified suture placement technique.
Sample—32 LTF surrogate constructs.
Procedures—Surrogate constructs were prepared with steel fixtures and sutures (polyester or polyethylene) by use of a standard or modified suture placement technique. Constructs underwent single-load-to-failure testing. Maximal load at failure, elongation at failure, stiffness, and suture breakage sites were compared among constructs prepared with polyester sutures by means of the standard (n = 10) or modified (10) technique and those prepared with polyethylene sutures with the standard (6) or modified (6) technique.
Results—Polyethylene suture constructs had higher stiffness, higher load at failure, and lower elongation at failure than did polyester suture constructs. Constructs prepared with the modified technique had higher load at failure than did those prepared with the standard technique for both suture materials. All sutures broke at the knot in constructs prepared with the standard technique. Sutures broke at a location away from the knot in 13 of 16 constructs prepared with the modified technique (3 such constructs with polyethylene sutures broke at the knot).
Conclusions and Clinical Relevance—Results suggested LTF surrogate constructs prepared with polyethylene sutures or the modified technique were stronger than those prepared with polyester sutures or the standard technique.
Abstract
OBJECTIVE
To compare joint stability and ultimate strength among 4 prosthetic ligament constructs for repair of tarsal medial collateral ligament (MCL) injury in dogs.
SAMPLE
13 canine cadavers (26 hind limbs).
PROCEDURES
Each limb was stripped of all soft tissues except those associated with the tarsal joint and assigned to 1 of 4 prosthetic ligament constructs. The AN construct consisted of 3 bone anchors connected with monofilament nylon suture. The AU construct consisted of low-profile suture anchors connected with multifilament ultrahigh-molecular-weight polyethylene (UHMWPE) suture. The TN and TU constructs involved the creation of 3 bone tunnels and use of nylon or UHMWPE suture, respectively. Each limb underwent biomechanical testing before and after MCL transection and before and after cyclic range-of-motion testing following completion of the assigned construct. Tarsal joint stability (extent of laxity) was assessed with the joint in each of 3 positions (75°, 135°, and 165°). After completion of biomechanical testing, each limb was tested to failure to determine the ultimate strength of the construct.
RESULTS
Relative to intact tarsal joints, joint laxity was significantly increased following completion of all 4 constructs. Construct type was not associated with the magnitude of change in joint laxity. Ultimate strength was greatest for the UHMWPE-suture constructs.
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that all 4 constructs effectively stabilized MCL-deficient tarsal joints. Implants used for the TU, TN, and AU constructs had a lower profile than those used for the AN construct, which may be clinically advantageous. In vivo studies are warranted.
Abstract
OBJECTIVE
To assess the feasibility and accuracy of using 2 methods for reduction and alignment of simulated comminuted diaphyseal tibial fractures in conjunction with 3-D–printed patient-specific pin guides.
SAMPLE
Paired pelvic limbs from 8 skeletally mature dogs weighing 20 to 35 kg.
METHODS
CT images of both tibiae were obtained, and 3-D reconstructions of the tibiae were used to create proximal and distal patient-specific pin guides. These guides were printed and used to facilitate fracture reduction and alignment in conjunction with either a 3-D–printed reduction guide or a linear type 1A external fixator. Postreduction CT images were used to assess the accuracy of pin guide placement and the accuracy of fracture reduction and alignment.
RESULTS
The 3-D–printed guides were applied with acceptable ease. Guides for both groups were placed with minor but detectable deviations from the planned location (P = .01), but deviations were not significantly different between groups. Fracture reduction resulted in similar minor but detectable morphological differences from the intact tibiae (P = .01). In both groups, fracture reduction and alignment were within clinically acceptable parameters for fracture stabilization by means of minimally invasive plate osteosynthesis.
CLINICAL RELEVANCE
Virtual surgical planning and fabrication of patient-specific 3-D–printed pin guides have the potential to facilitate fracture reduction and alignment during use of minimally invasive plate osteosynthesis for fracture stabilization.
