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- Author or Editor: Howard B. Seim III x
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Abstract
Objective—To evaluate the long-term prognosis of cats with a congenital extrahepatic portosystemic shunt (CEPSS) attenuated through gradual occlusion with cellophane banding (CB).
Design—Retrospective case series.
Animals—9 cats with a CEPSS that was attenuated with CB.
Procedures—Medical records of cats surgically treated for CEPSS by means of CB from January 2000 through March 2007 were reviewed. Extracted data included preoperative clinical signs, medications, diagnostic results including serum bile acids concentrations, surgical technique, intraoperative and postoperative complications, and long-term follow-up information.
Results—2 cats that developed refractory seizures were euthanized within 3 days after the CB procedure. Seven of the 9 cats survived to 15 days after surgery. Four cats did not have any clinical signs of CEPSS at long-term follow up. At that time, 5 cats had a postprandial SBA concentration within reference limits and 1 cat had persistent ptyalism. One cat had biurate ammonium stones removed > 2 years after surgery. One cat was euthanized 105 days after surgery because of uncontrolled seizures. The 3-year survival rate was 66%.
Conclusions and Clinical Relevance—Uncontrolled seizure activity was the most common cause of death after CB. Long-term outcome for cats with CEPSS was fair to good after the procedure. Cats with a CEPSS surviving the immediate postoperative period had a fair to good long-term outcome. Cellophane banding without intraoperative attenuation appears to be an acceptable technique for gradual occlusion of a CEPSS in cats. Cats should be monitored closely for development of neurologic disorders in the postoperative period.
Abstract
Objective—To determine the long-term survival rate and factors that affect survival time of domestic ferrets treated surgically for hyperadrenocorticism.
Study Design—Retrospective case series.
Animals—130 ferrets with hyperadrenocorticism that were treated surgically.
Procedures—Medical records of ferrets surgically treated for hyperadrenocorticism were reviewed. Data recorded included signalment, duration of clinical signs prior to hospital admission, CBC values, serum biochemical analysis results, anesthetic time, surgical time, concurrent diseases, adrenal gland affected (right, left, or both [bilateral]), histopathologic diagnosis, surgical procedure, caudal vena caval involvement (yes or no), postoperative melena (yes or no), days in hospital after surgery, and whether clinical signs of hyperadrenocorticism developed after surgery.
Results—130 ferrets were entered in the study (11 of 130 ferrets were admitted and underwent surgery twice). The 1- and 2-year survival rates were 98% and 88%, respectively. A 50% survival rate was never reached. Combined partial adrenal gland resection with cryosurgery had a significantly negative effect on survival time. No other risk factors were identified. Survival time was not significantly affected by either histopathologic diagnosis or specific affected adrenal gland (right, left, or bilateral).
Conclusions and Clinical Relevance—Ferrets with adrenal gland masses that were treated surgically had a good prognosis. Survival time of ferrets with hyperadrenocorticism undergoing surgery was not affected by the histologic characteristic of the tumor, the adrenal glands affected (right, left, or bilateral), or complete versus partial adrenal gland resection. Debulking was a sufficient surgical technique to allow a favorable long-term outcome when complete excision was not possible.
Abstract
Objective—To evaluate risk factors associated with death and development of perioperative complications in dogs undergoing surgery for treatment of gastric dilatation-volvulus (GDV).
Design—Retrospective case series.
Animals—166 dogs.
Procedures—Records of dogs with confirmed GDV that underwent surgery were reviewed. Logistic regression was performed to identify factors associated with development of complications (ie, hypotension, arrhythmias, gastric necrosis necessitating gastrectomy, disseminated intravascular coagulation, peritonitis, sepsis, postoperative dilatation, postoperative vomiting, and incisional problems) and with short-term outcome (ie, died vs survived to the time of suture removal).
Results—Short-term mortality rate was 16.2% (27/166). Risk factors significantly associated with death prior to suture removal were clinical signs for > 6 hours prior to examination, combined splenectomy and partial gastrectomy, hypotension at any time during hospitalization, peritonitis, sepsis, and disseminated intravascular coagulation. Partial gastrectomy was not a significant risk factor for death but was for peritonitis, disseminated intravascular coagulation, sepsis, and arrhythmias. Age, gastrectomy, and disseminated intravascular coagulation were risk factors for development of hypotension. Use of a synthetic colloid or hypertonic saline solution was associated with a significantly decreased risk of hypotension.
Conclusions and Clinical Relevance—Results suggest that the prognosis for dogs undergoing surgery because of GDV is good but that certain factors are associated with an increased risk that dogs will develop perioperative complications or die.
Abstract
Objective—To determine factors associated with long-term survival after biliary surgery in dogs.
Design—Retrospective case series.
Animals—34 dogs that underwent biliary surgery.
Procedures—Data extracted from medical records included sex, breed, body weight, age at surgery, history and clinical examination findings, preoperative and postoperative CBC, serum biochemical panel and coagulation profiles results, abdominal ultrasonographic findings, results of bacteriologic culture and histologic examination, surgical findings, postoperative complications, and survival time. Follow-up information was obtained from medical records or phone conversations with owners and referring veterinarians.
Results—Primary biliary findings included gallbladder mucocele (n = 20 dogs), inflammatory diseases (4), trauma (3), and neoplasia (1). Secondary biliary diseases included pancreatitis (n = 4), pancreatic neoplasia (1), and duodenal perforation (1). One- and 2-year survival rates were both 66%. Increasing age; γ-glutamyltransferase activity; preanesthetic heart rate; BUN, phosphorus, and bilirubin concentrations; and the use of biliary diversion procedures were risk factors for death, although pancreatitis was not. However, poor long-term survival was associated with pancreatitis.
Conclusions and Clinical Relevance—Long-term prognosis was guarded after biliary surgery in dogs. However, dogs that survived the early postoperative period had good long-term prognosis. Dogs with pancreatitis had poor prognosis. Overall, the prognosis was worse for dogs that underwent a biliary diversion, compared with dogs that did not.
