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- Author or Editor: Alexander J. Daniel x
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Abstract
Objective—To describe pathological findings identified with MRI in the distal tarsal bones of horses with unilateral hind limb lameness attributable to tarsal pain and to compare the usefulness of MRI with that of radiography and nuclear scintigraphy in evaluation of this region.
Design—Retrospective case series.
Animals—20 lame horses.
Procedures—In all horses, MRI, radiography (4 standard projections), and nuclear scintigraphy of the tarsus had been performed. Horses were excluded if the results of all 3 imaging modalities were not available or if lameness was detected in more than 1 limb. Pathological changes identified with MRI were cross-referenced with the findings determined with other imaging modalities.
Results—Compared with MRI findings, the following lesions were identified with radiography: medullary and subchondral bone sclerosis in 9 of 16 horses, pathological changes related to osseous hyperintensity in 0 of 10 horses, and osteoarthritis in 5 of 8 horses. Standard radiographic projections did not aid in the identification of fracture of the distal tarsal bones (3 horses). Location of increased radiopharmaceutical uptake with nuclear scintigraphy corresponded with the location of pathological changes detected with MRI in all horses. The intensity of the radiopharmaceutical uptake on nuclear scintigraphic images did not correspond with the severity of the pathological changes identified with MRI.
Conclusions and Clinical Relevance—Radiography was unreliable for the detection of pathological changes related to osseous hyperintensity identified with MRI, fracture, and subchondral bone sclerosis in the equine tarsus. Nuclear scintigraphy was effective in localizing pathological changes, but MRI provided superior anatomic detail.
Abstract
Case Description—A 4-year-old sexually intact female French Bulldog was evaluated because of lethargy, anorexia, and chronic rhinitis-sinusitis. The dog had nasal discharge of 18 months' duration; dorsal rhinotomies were performed 3 months and 2 weeks prior to referral.
Clinical Findings—On initial evaluation, intraventricular pneumocephalus and sinusitis were diagnosed; CSF analysis revealed high total protein concentration and mononuclear pleocytosis. The dog's condition improved with treatment. Two weeks after discharge, it was treated by a local veterinarian because of upper airway obstruction; 3 days later, the dog was referred because of seizures. Computed tomography revealed a large fluid-filled, left lateral ventricle and a soft tissue mass protruding through a cribriform plate defect. The mass was histologically consistent with brain tissue. Findings of clinicopathologic analyses were unremarkable. Results of cytologic examination of a CSF sample were indicative of septic, suppurative inflammation, and bacteriologic culture of CSF yielded Escherichia coli.
Treatment and Outcome—Amputation of the herniated olfactory bulb and antimicrobial treatment resolved the septic meningoencephalitis, but neurologic deficits recurred 6 weeks later. Definitive correction of the cribriform plate defect with bone and fascial grafts was attempted. Postoperative rotation of the bone graft resulted in cerebral laceration and hemorrhage, and the dog was euthanized.
Clinical Relevance—Findings suggest that following dorsal rhinotomy and nasal polypectomy surgery, the dog developed herniation of the left olfactory bulb, intra-ventricular pneumocephalus, and septic meningo-encephalitis because of a cribriform plate defect. Care must be taken to prevent rotation of bone grafts used in cribriform defect repair.
Abstract
OBJECTIVE
To evaluate the feasibility of ultrasound-guided, temporary, percutaneous T-fastener gastropexy (TG) and gastrostomy catheter (GC) placement for providing sustained gastric decompression in dogs with acute gastric dilatation-volvulus (GDV) and to compare findings with those of trocarization.
ANIMALS
16 dogs with GDV.
PROCEDURES
Dogs were randomly assigned to undergo gastric decompression by means of percutaneous trocarization (trocar group; n = 8) or temporary TG and GC placement (TTG+GC group; 8) with ultrasound guidance. The gastric volvulus was then surgically corrected, and the decompression sites were examined. Outcomes were compared between groups.
RESULTS
The proportion of dogs with successful decompression did not differ significantly between the TTG+GC (6/8) and trocar (7/8) groups; median procedure duration was 3.3 and 3.7 minutes, respectively. After the failed attempts in the TTG+GC group, the procedure was modified to include ultrasound guidance during T-fastener placement. The decrease in intragastric pressure by 5 minutes after trocar or GC insertion was similar between groups. For dogs in the TTG+GC group, no significant difference in intragastric pressure was identified between 5 and 60 minutes after GC insertion. Complications included inadvertent splenic or jejunal placement in 2 dogs (TTG+GC group) and malpositioned and ineffective trocar placement in 1 dog (trocar group). All dogs survived for at least 2 weeks.
CONCLUSIONS AND CLINICAL RELEVANCE
Ultrasound-guided, temporary, percutaneous TG and GC placement was safe and effective at providing sustained gastric decompression in dogs with GDV, suggesting that this technique would be ideal for dogs in which surgical delays are anticipated or unavoidable.
Abstract
Case Description—A 4-month-old Hampshire ram underwent open right inguinal herniorrhaphy and unilateral castration following herniation that developed after a kick injury. Seven months later, the ram was reevaluated because of scrotal swelling of 1 month's duration as well as suspected left inguinal hernia.
Clinical Findings—The ram had marked scrotal swelling. Palpation of the left testicle revealed no abnormalities. Ultrasonographic examination revealed heterogenous tissue within the cranial and medial portions of the scrotum with pronounced accumulation of hypoechoic fluid at the scrotal apex. Examination findings indicated left-sided indirect inguinal herniation of omentum.
Treatment and Outcome—To preserve fertility, left inguinal hernioplasty without castration was performed. The ram was anesthetized and placed in dorsal recumbency, and laparoscopic abdominal evaluation revealed omental entrapment within the left inguinal ring. The omentum was removed, and a polypropylene mesh was secured over the internal inguinal ring with an articulating hernia stapler. Following mesh placement, a dorsally based peritoneal flap was elevated and secured over the mesh repair. The ram recovered well from surgery; there was no repeated herniation following the surgical correction, and the ram was able to breed successfully without complication.
Clinical Relevance—Laparoscopic mesh hernioplasty can be successful in rams with inguinal hernias when preservation of fertility is preferred.
Abstract
OBJECTIVE To describe a minimally invasive 3-portal laparoscopic approach for elective ovariohysterectomy and the outcome of that procedure in a population of goats.
DESIGN Descriptive clinical study.
ANIMALS 16 healthy client-owned goats.
PROCEDURES Food but not water was withheld from all goats for 24 hours before the procedure. Goats were anesthetized and positioned in dorsal recumbency. Three laparoscopic portals were created in the caudoventral portion of the abdomen, and the abdomen was insufflated to a maximum pressure of 10 mm Hg. A blunt-tip vessel sealer and divider device was used to transect the left and right mesovarium and mesometrium and uterus, and the resected tissue was removed from the abdomen. After hemostasis was verified, the portals were closed in a routine manner and anesthesia was discontinued. Goats were discharged from the hospital 24 hours after the procedure, and owners were contacted by telephone or email to obtain short- and long-term follow-up information by use of standardized questions.
RESULTS All procedures were performed by a surgeon and assistant surgeon. The procedure was not complex and was easily learned. No intraoperative complications were reported, and only 1 goat required rescue analgesia post-operatively. No other postoperative complications were recorded. Median surgery time was 43 minutes (range, 20 to 65 minutes). All owners were satisfied with the outcome of the procedure, and several perceived that the procedure improved goat behavior.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that laparoscopic ovariohysterectomy was a viable alternative for elective sterilization of female goats.
Abstract
Case Description—4 racehorses were examined because of markedly abnormal behavior following administration of fluphenazine decanoate.
Clinical Findings—Clinical signs included restlessness, agitation, profuse sweating, hypermetria, aimless circling, intense pawing and striking with the thoracic limbs, and rhythmic swinging of the head and neck alternating with episodes of severe stupor. Fluphenazine was detected in serum or plasma from all 4 horses. The dose of fluphenazine decanoate administered to 3 of the 4 horses was within the range (25 to 50 mg) routinely administered to adult humans.
Treatment and Outcome—In 2 horses, there was no response to IV administration of diphenhydramine hydrochloride, but the abnormal behavior in these 2 horses appeared to resolve following administration of benztropine mesylate, and both horses returned to racing. The other 2 horses responded to diphenhydramine administration. One returned to racing. The other was euthanized because of severe neurologic signs, respiratory failure, and acute renal failure.
Clinical Relevance—Findings indicate that adverse extrapyramidal effects may occur in horses given fluphenazine decanoate. These effects appear to be unpredictable and may be severe and life threatening. Use of fluphenazine decanoate as an anxiolytic in performance horses is not permitted in many racing and horse show jurisdictions, and analytic procedures are now available to detect the presence of fluphenazine in serum or plasma.
