CASE DESCRIPTION A 17-month-old neutered female Labrador Retriever with a 3- to 4-month history of abdominal distention was referred for evaluation and treatment.
CLINICAL FINDINGS Evaluation of a peritoneal fluid specimen collected by the referring veterinarian indicated a pure transudate. At admission, transabdominal ultrasonography revealed microhepatica, dilation of the intrahepatic and mesenteric vasculature, peritoneal effusion, and multiple aberrant blood vessels. A large, high-flow hepatic arteriovenous malformation (HAVM) with secondary portal hypertension, peritoneal effusion, multiple acquired portosystemic shunts, and microhepatica was evident on CT angiography.
TREATMENT AND OUTCOME Transfemoral hepatic arteriography and staged coil and glue (n-butyl cyanoacrylate) embolization of the complex arteriovenous malformation nidus and central main left hepatic artery resulted in ablation of the lesion, restoration of arterial blood flow to the contralateral hepatic lobes, and resolution of the peritoneal effusion. The dog remained without clinical signs of hepatic disease until it was euthanized 5 months after treatment for an unrelated condition.
CLINICAL RELEVANCE Successful endovascular management of a HAVM was accomplished by means of coil and glue embolization in the patient of this report. Dogs with comparable HAVMs may benefit from similar minimally invasive treatment.
OBJECTIVE To evaluate a percutaneous, continuous gastric decompression technique for dogs involving a temporary T-fastener gastropexy and self-retaining decompression catheter.
ANIMALS 6 healthy male large-breed dogs.
PROCEDURES Dogs were anesthetized and positioned in dorsal recumbency with slight left-lateral obliquity. The gastric lumen was insufflated endoscopically until tympany was evident. Three T-fasteners were placed percutaneously into the gastric lumen via the right lateral aspect of the abdomen, caudal to the 13th rib and lateral to the rectus abdominis muscle. Through the center of the T-fasteners, a 5F locking pigtail catheter was inserted into the gastric lumen and attached to a device measuring gas outflow and intragastric pressure. The stomach was insufflated to 23 mm Hg, air was allowed to passively drain from the catheter until intraluminal pressure reached 5 mm Hg for 3 cycles, and the catheter was removed. Dogs were hospitalized and monitored for 72 hours.
RESULTS Mean ± SD catheter placement time was 3.3 ± 0.5 minutes. Mean intervals from catheter placement to a ≥ 50% decrease in intragastric pressure and to ≤ 6 mm Hg were 2.1 ± 1.3 minutes and 8.4 ± 5.1 minutes, respectively. After catheter removal, no gas or fluid leakage at the catheter site was visible laparoscopically or endoscopically. All dogs were clinically normal 72 hours after surgery.
CONCLUSIONS AND CLINICAL RELEVANCE The described technique was performed rapidly and provided continuous gastric decompression with no evidence of postoperative leakage in healthy dogs. Investigation is warranted to evaluate its effectiveness in dogs with gastric dilatation-volvulus.
To determine the optimal energy profile for and to assess the feasibility and efficacy of ultrasonographic and laparoscopic guidance for microwave ablation (MWA) of clinically normal canine ovaries.
44 extirpated ovaries from 22 healthy dogs.
In the first of 2 trials, 13 dogs underwent oophorectomy by routine laparotomy. Extirpated ovaries underwent MWA at 45 W for 60 (n = 11) or 90 (12) seconds; 3 ovaries did not undergo MWA and served as histologic controls. Ovaries were histologically evaluated for cell viability. Ovaries without viable cells were categorized as completely ablated. Histologic results were used to identify the optimal MWA protocol for use in the subsequent trial. In the second trial, the ovaries of 9 dogs underwent MWA at 45 W for 90 seconds in situ. Ultrasonographic guidance for MWA was deemed unfeasible after evaluation of 1 ovary. The remaining 17 ovaries underwent MWA with laparoscopic guidance, after which routine laparoscopic oophorectomy was performed. Completeness of ablation was histologically assessed for all ovaries.
2 ovaries were excluded from the trial 1 analysis because of equivocal cell viability. Six of 11 ovaries and 10 of 10 ovaries that underwent MWA for 60 and 90 seconds, respectively, were completely ablated. In trial 2, laparoscopic-guided MWA resulted in complete ablation for 12 of 17 ovaries. Dissection of the ovarian bursa for MWA probe placement facilitated complete ablation.
CONCLUSIONS AND CLINICAL RELEVANCE
Laparoscopic-guided MWA at 45 W for 90 seconds was feasible, safe, and effective for complete ablation of clinically normal ovaries in dogs.