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- Author or Editor: Gary W. Ellison x
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Abstract
Objective—To evaluate signalment, clinical findings, surgical treatment, and long-term outcomes in puppies and kittens after surgical repair of various types of atresia ani (AA) with or without concomitant anogenital or rectogenital malformations.
Design—Retrospective case series.
Animals—11 puppies and 1 kitten.
Procedures—Medical records of 2 veterinary teaching hospitals were reviewed for puppies and kittens that underwent surgical treatment for AA. Information regarding signalment, diagnosis, surgical procedures, follow-up time, and outcome was recorded. A previously described classification scheme was used to classify AA as type I, II, III, or IV. Follow-up times and outcomes were evaluated.
Results—AA was classified as type I in 3 animals, type II in 6, and type III in 3. Nine of 12 patients had anogenital or rectogenital malformations; 8 of these had rectovaginal fistulas. Eleven animals underwent in situ anoplasty, and 1 underwent surgery in which the rectovaginal fistula was used for anal reconstruction. Six also underwent balloon dilation for treatment of anal stenosis, and revision anoplasty was performed in 5. All patients with type I or II AA survived ≥ 1 year. Two puppies with type III AA were euthanized 3 and 40 days after surgery. Follow-up time for the remaining 10 patients ranged from 12 to 92 months, and 3 had fecal incontinence.
Conclusions and Clinical Relevance—Surgical repair of type I or II AA resulted in long-term survival and fecal continence in most cases. Although numbers were small, patients with type III AA had poorer outcomes than did those with type I or II AA.
Abstract
OBJECTIVE
To describe clinical characteristics and surgical outcomes for kittens with phimosis and to develop a system to classify phimosis on the basis of gross pathological lesions.
ANIMALS
8 kittens with phimosis.
PROCEDURES
Medical record databases of 2 veterinary teaching hospitals were searched to identify records of cats ≤ 20 weeks old (ie, kittens) with phimosis that underwent surgical intervention between 2009 and 2017. For each kitten, information extracted from the record included signalment, history, clinical signs, physical examination findings, treatments, and details regarding the surgical procedure performed, postoperative complications, and outcome.
RESULTS
The most common clinical signs were stranguria (n = 6), marked preputial swelling (5), and a small (6) or inevident (2) preputial orifice. Six kittens had type 1 phimosis (generalized preputial swelling owing to urine pooling without penile-preputial adhesions) and underwent circumferential preputioplasty. Two kittens had type 2 phimosis (focal preputial swelling and urine pooling in the presence of penile-preputial adhesions) and underwent preputial urethrostomy. No postoperative complications were recorded for kittens that underwent preputial urethrostomy. All 6 kittens that underwent circumferential preputioplasty had some exposure of the tip of the penis immediately after surgery, which typically resolved over time. At the time of last follow-up (mean, 1.4 years after surgery), all 8 patients were able to urinate and had no signs of phimosis recurrence.
CONCLUSIONS AND CLINICAL RELEVANCE
Results suggested that circumferential preputioplasty and preputial urethrostomy could be used to successfully manage kittens with type 1 and type 2 phimosis, respectively.
Abstract
Objective—To compare required time and costs of surgery and hospitalization as well as prevalence of incomplete urinary cystolith removal associated with laparoscopic-assisted cystotomy versus open cystotomy in dogs.
Design—Retrospective case series.
Animals—20 dogs with urolithiasis treated by laparoscopic-assisted cystotomy and 23 dogs treated by open cystotomy.
Procedures—Medical records were reviewed. Surgery cost, hospitalization cost, total cost, surgery time, days in hospital, incomplete cystolith removal, and number of doses of analgesic administered IV after surgery were compared between the laparoscopic-assisted cystotomy and open cystotomy groups.
Results—Surgery cost and total cost were significantly higher in the laparoscopic-assisted cystotomy group. Hospitalization cost, days in hospital, and prevalence of incomplete cystolith removal did not differ significantly between groups. Number of doses of analgesic was significantly lower in the laparoscopic-assisted cystotomy group.
Conclusions and Clinical Relevance—Laparoscopic-assisted cystotomy was more time-consuming and expensive but associated with fewer postoperative doses of injectable analgesics, compared with open cystotomy. Laparoscopic-assisted cystotomy is an acceptable, more expensive, and minimally invasive alternative to open cystotomy for the removal of urinary cystoliths in dogs.
Abstract
OBJECTIVE To compare pursestring, Witzel (seromuscular inversion), and seromuscular incision jejunostomy tube placement techniques in vitro.
SAMPLE Jejunal specimens from 10 dogs.
PROCEDURES Jejunal segments (50 cm) were harvested immediately prior to euthanasia from 10 mixed-breed dogs Specimens were harvested with the orad and aborad ends clamped and stored in saline (0.9% NaCl) solution–soaked towels during instrumentation. Three jejunostomy tubes were placed via 3 techniques (pursestring, Witzel, and seromuscular incision), and 2 double lumen central venous catheters were placed at each intestinal end for luminal filling and leak testing. Intestinal luminal area was measured ultrasonographically with specimens suspended in a warm undyed saline solution bath with the intestinal lumen filled with dyed saline solution (intraluminal pressure, 6 mm Hg). Leak testing was performed by means of infusion of dyed saline solution (4 mL/min) until each jejunostomy site failed. Intestinal luminal area and leakage pressure were compared between the 3 tube placement techniques.
RESULTS The Witzel and seromuscular incision techniques decreased the intestinal luminal area measured at the tube insertion site, albeit nonsignificantly. For the seromuscular incision technique, a significant decrease in intestinal luminal area at the intraluminal site of measurement was found. For 2/30 specimens (1/10 pursestring and 1/10 seromuscular incision), failure occurred at pressures within the range of previously reported peak peristaltic pressure for dogs. Failure occurred at supraphysiologic peristaltic pressures for the remaining 28 specimens, including all 10 specimens for the Witzel technique.
CONCLUSIONS AND CLINICAL RELEVANCE In this in vitro study, all specimens for the Witzel technique withstood physiologic peristaltic pressures during leak testing. Both tunneling techniques (Witzel and seromuscular incision) created a decrease in intestinal luminal area. Further investigation, including in vivo testing, is indicated to evaluate the clinical relevance of these findings.
Abstract
Objective—To compare short-term complication rates in dogs and cats undergoing cystotomy closure by use of an inverting double-layer pattern (group I) versus cystotomy closure by use of an appositional single-layer pattern (group A).
Design—Retrospective case series.
Animals—144 client-owned dogs and cats that underwent cystotomy between 1993 and 2010.
Procedures—Information on signalment, reason for cystotomy, method of cystotomy closure, complications that developed during hospitalization, and duration of hospitalization were obtained from the medical record. The effect of closure technique on short-term complication rate and duration of hospitalization was examined.
Results—2 of the 144 animals developed dehiscence and uroabdomen following cystotomy closure: 1 from group A and 1 from group I. Of group A animals, 29 of 79 (37%) developed minor complications such as hematuria and dysuria. Of group I animals, 33 of 65 (50%) developed the same complications. Group A and group I animals did not differ significantly with regard to prevalence of minor or major complications. The mean duration of hospitalization was 4.1 days and did not differ significantly between groups.
Conclusions and Clinical Relevance—An appositional single-layer suture pattern for cystotomy closure was a safe and effective procedure with minimal risk of urine leakage and a short-term complication rate of 37%. The appositional single-layer suture pattern for cystotomy closure may be recommended for clinical use because the inverting double-layer suture pattern offered no clear advantage.
Abstract
Objective—To determine the efficacy of decontamination and sterilization of a disposable port intended for use during single-incision laparoscopy.
Sample—5 material samples obtained from each of 3 laparoscopic surgery ports.
Procedures—Ports were assigned to undergo decontamination and ethylene oxide sterilization without bacterial inoculation (negative control port), with bacterial inoculation (Staphylococcus aureus, Escherichia coli, and Mycobacterium fortuitum) and without decontamination and sterilization (positive control port), or with bacterial inoculation followed by decontamination and ethylene oxide sterilization (treated port). Each port underwent testing 5 times; during each time, a sample of the foam portion of each port was obtained and bacteriologic culture testing was performed. Bacteriologic culture scores were determined for each port sample.
Results—None of the treated port samples had positive bacteriologic culture results. All 5 positive control port samples had positive bacteriologic culture results. One negative control port sample had positive bacteriologic culture results; a spore-forming Bacillus sp organism was cultured from that port sample, which was thought to be an environmental contaminant. Bacteriologic culture scores for the treated port samples were significantly lower than those for the positive control port samples. Bacteriologic culture scores for the treated port samples were not significantly different from those for negative control port samples.
Conclusions and Clinical Relevance—Results of this study indicated standard procedures for decontamination and sterilization of a single-use port intended for use during singleincision laparoscopic surgery were effective for elimination of inoculated bacteria. Reuse of this port may be safe for laparoscopic surgery of animals.
Abstract
OBJECTIVE To develop a device intended for gradual venous occlusion over 4 to 6 weeks.
SAMPLE Silicone tubing filled with various inorganic salt and polyacrylic acid (PAA) formulations and mounted within a polypropylene or polyether ether ketone (PEEK) outer ring.
PROCEDURES 15 polypropylene prototype rings were initially filled with 1 of 5 formulations and placed in PBSS. In a second test, 10 polypropylene and 7 PEEK prototype rings were filled with 1 formulation and placed in PBSS. In a third test, 2 formulations were loaded into 6 PEEK rings each, placed in physiologic solution, and incubated. In all tests, ring luminal diameter, outer diameter, and luminal area were measured over 6 weeks.
RESULTS In the first test, 2 formulations had the greatest changes in luminal area and diameter, and 1 of those had a greater linear swell rate than the other had. In the second test, 6 of 7 PEEK rings and 6 of 10 polypropylene rings closed to a luminal diamater < 1 mm within 6 weeks. Polypropylene rings had a greater increase in outer diameter than did PEEK rings between 4.5 and 6 weeks. In the third test, 11 of 12 PEEK rings gradually closed to a luminal diameter < 1 mm within 6 weeks.
CONCLUSIONS AND CLINICAL RELEVANCE A PAA and inorganic salt formulation in a prototype silicone and polymer ring resulted in gradual occlusion over 4 to 6 weeks in vitro. Prototype PEEK rings provided more reliable closure than did polypropylene rings.
