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- Author or Editor: Janet A. Grimes x
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Abstract
OBJECTIVE To determine the rate of and factors associated with survival to hospital discharge in dogs with uroabdomen.
DESIGN Retrospective case series.
ANIMALS 43 dogs with uroabdomen confirmed at 2 veterinary teaching hospitals from 2006 through 2015.
PROCEDURES Medical records were reviewed and data extracted regarding cause and location of urinary tract rupture, serum creatinine concentration and other variables at hospital admission, and outcomes. Variables were tested for associations with survival to hospital discharge.
RESULTS Urinary tract rupture occurred in the urinary bladder (n = 24 [56%]), urethra (11 [26%]), kidney (2 [5%]), ureter (1 [2%]), both the urinary bladder and kidney (1 [2%]), and undetermined sites (4 [9%]). Rupture causes included traumatic (20 [47%]), obstructive (9 [21%]), and iatrogenic (7 [16%]) or were unknown (7 [16%]). Surgery was performed for 37 (86%) dogs; the defect was identified and surgically corrected in 34 (92%) of these dogs. Hypotension was the most common intraoperative complication. Nineteen dogs had information recorded on postoperative complications, of which 10 (53%) had complications that most often included death (n = 3) and regurgitation (3). Thirty-four (79%) dogs survived to hospital discharge. Dogs with intraoperative or postoperative complications were significantly less likely to survive than dogs without complications. Serum creatinine concentration at admission was not associated with survival to discharge.
CONCLUSIONS AND CLINICAL RELEVANCE A high proportion of dogs with uroabdomen survived to hospital discharge. No preoperative risk factors for nonsurvival were identified. Treatment should be recommended to owners of dogs with uroabdomen.
Abstract
CASE DESCRIPTION
An 8-year-old 6.8-kg neutered male Dachshund was presented for evaluation of vomiting, diarrhea, anorexia, and swelling over the right perineal region. The dog had a history of a bilateral perineal herniorrhaphy and castration 14 months prior to presentation.
CLINICAL FINDINGS
Bilateral perineal hernias were confirmed by digital rectal examination. Abdominal ultrasonography confirmed the presence of intestine within the right hernia. Three days after admission to the hospital, the region of the right perineal hernia became painful, erythematous, and edematous. Computed tomography revealed jejunal incarceration within the right hernia with dilation of 1 jejunal segment that indicated intestinal obstruction.
TREATMENT AND OUTCOME
Abdominal exploratory surgery was performed, during which irreducible small intestinal incarceration was confirmed. Intra-abdominal jejunal resection and anastomosis was performed, and an approximately 13-cm-long section of the jejunum was resected. Bilateral perineal herniorrhaphies with internal obturator and superficial gluteal muscle transposition were performed. Six months after surgery, digital rectal examination of the dog revealed that the repair was intact. The dog had no perineal hernia–related clinical signs at the time of the recheck examination.
CLINICAL RELEVANCE
For the dog of the present report, surgical management of small intestinal strangulation associated with a perineal hernia was successful. Although a portion of the small intestines can frequently be found within perineal hernias in dogs, perineal hernia-related small intestinal strangulation has not been previously described, to the authors’ knowledge. Veterinarians and clients should be aware of this potential complication secondary to perineal hernia and be prepared to perform an abdominal surgical procedure to address small intestinal incarceration in affected dogs.
Abstract
OBJECTIVE
To evaluate the validity of the double two-thirds rule for a diagnosis of splenic hemangiosarcoma in dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass.
SAMPLE
Systematic literature review.
PROCEDURES
3 databases (PubMed, CAB abstracts, and World of Science) were searched in November 2020. Articles were included if data on dogs with nontraumatic hemoperitoneum due to a splenic mass were included and subsequent pathologic diagnosis could be determined.
RESULTS
In total, 2,390 unique articles were identified, with 66 articles meeting the criteria for full-text review and 14 articles included for analysis. A total of 1,150 dogs were evaluated, with 73.0% (840/1,150) of dogs being diagnosed with a malignant splenic lesion and 27.0% (310/1,150) being diagnosed with a benign splenic lesion. Of the malignancies, 87.3% (733/840) were hemangiosarcoma. Levels of evidence were low, and bias was high as most included studies were retrospective case series.
CLINICAL RELEVANCE
The double two-thirds rule should be refined when evaluating dogs with nontraumatic hemoperitoneum from a ruptured splenic mass, with more dogs being diagnosed with a malignancy and hemangiosarcoma specifically than the double two-thirds rule indicates. These findings may be useful in an emergency setting to guide owners on potential diagnoses for dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass. However, there remains a portion of these dogs with benign conditions and nonhemangiosarcoma malignancies that may have a good long-term prognosis compared to dogs with hemangiosarcoma. Studies with higher levels of evidence, lower risks of bias, and large case numbers are needed in the literature.
Abstract
OBJECTIVE
To characterize abdominal lymphatic drainage in cats after thoracic duct ligation (TDL) and cisterna chyli ablation (CCA).
ANIMALS
7 purpose-bred research cats.
PROCEDURES
Baseline CT lymphangiography was performed. A popliteal lymph node was injected with iohexol, and images were acquired at 5-minute intervals for 15 minutes. Cats underwent TDL and CCA; methylene blue was used to aid in identifying lymphatic vessels. The CT lymphangiography was repeated immediately after and 30 days after surgery. All cats were euthanized and necropsied.
RESULTS
Results of baseline CT lymphangiography were unremarkable for all 7 cats. Only 5 cats completed the study. Leakage of contrast medium at the level of the cisterna chyli was seen on CT lymphangiography images obtained from all cats immediately after surgery. Evaluation of 30-day postoperative CT lymphangiography images revealed small branches entering the caudal vena cava in 2 cats, leakage of contrast medium into the caudal vena cava with no visible branches in 1 cat, and no contrast medium in the caudal vena cava in 2 cats. Contrast medium did not flow beyond the level of the cisterna chyli in any cat. Gross examination during necropsy revealed that all cats had small lymphatic vessels that appeared to connect to local vasculature identified in the region of the cisterna chyli.
CONCLUSIONS AND CLINICAL RELEVANCE
Abdominal lymphaticovenous anastomoses formed after TDL and CCA in cats. This would support use of these procedures for treatment of cats with idiopathic chylothorax, although additional studies with clinically affected cats are warranted.
Abstract
OBJECTIVE
Ovariohysterectomy (OVH) is frequently recommended at the time of c-section in canines, yet prior literature suggests poor mothering ability and increased morbidity to the bitch with c-section with concurrent OVH (CSOVH). The study objective was to compare maternal survival, complications, and mothering ability between bitches that underwent c-section alone (CS) or CSOVH.
ANIMALS
125 bitches.
PROCEDURES
Medical records from 2014 through 2021 were retrospectively reviewed; owners were surveyed for information up to weaning.
RESULTS
80 bitches undergoing CS and 45 bitches undergoing CSOVH were identified. There was no difference in anesthesia duration, intraoperative complications, postoperative complications, mothering ability, puppy survival to weaning, or other variables compared between groups. CSOVH bitches had longer surgery times (P = .045; 54.4 ± 20.7 min vs 46.9 ± 16.6 min) and longer time from delivery to nursing (P = .028; 75.4 ± 22.3 min vs 65.2 ± 19.5 min). Ninety (72%) owners responded to the survey. All 90 bitches survived until puppy weaning. CSOVH bitches were more frequently perceived as painful postoperatively (P = .015).
CLINICAL RELEVANCE
Performing an OVH at the time of c-section does not pose a significant increase in risk of mortality, intraoperative complications, postoperative complications, or decreased mothering ability of the bitch. The increased duration of surgery and increased time from delivery to nursing in the CSOVH group were clinically insignificant. Appropriate postoperative pain management should be emphasized post-CSOVH. Based on these results, OVH should be performed concurrently with c-section if indicated.
Abstract
OBJECTIVE To identify risk factors for temporary tracheostomy tube placement (TTTP) following surgery for alleviation of signs associated with brachycephalic obstructive airway syndrome (BOAS) in dogs.
DESIGN Retrospective case-control study.
ANIMALS 122 client-owned dogs with BOAS that underwent surgery to alleviate clinical signs (BOAS surgery).
PROCEDURES The medical records database of a veterinary teaching hospital was searched to identify dogs that underwent BOAS surgery from January 2007 through March 2016. Of the 198 dogs identified, 12 required postoperative TTTP (cases); 110 of the remaining 186 dogs were randomly selected as controls. Data regarding signalment and select preoperative, intraoperative, and postoperative variables were extracted from the medical record of each dog. Variables were compared between cases and controls and evaluated for an association with the odds of postoperative TTTP.
RESULTS Body condition score, tracheal diameter-to-thoracic inlet ratio, staphylectomy technique, and mortality rate did not differ significantly between cases and controls. The odds of postoperative TTTP increased approximately 30% (OR, 1.3) for each 1-year increase in patient age. Postoperative administration of corticosteroids and presence of pneumonia were also positively associated with the odds of postoperative TTTP. Median duration of hospitalization was significantly longer for cases than controls.
CONCLUSIONS AND CLINICAL RELEVANCE Age was positively associated with the odds of TTTP in dogs after BOAS surgery, and TTTP led to prolonged hospitalization. Thus, early identification and intervention may be beneficial for dogs with BOAS. The associations between TTTP and postoperative corticosteroid use or pneumonia were likely not causal, but reflective of patient disease severity.
Abstract
OBJECTIVE
To identify differentially expressed microRNA in the serum and renal tissues of cats with experimentally induced chronic kidney disease (CKD).
SAMPLE
Banked renal tissues and serum from 4 cats.
PROCEDURES
Cats previously underwent 90-minute unilateral ischemia with delayed contralateral nephrectomy 3 months after ischemia. Tissues were collected from the contralateral kidney at the time of nephrectomy and from the ischemic kidney 6 months after nephrectomy (study end). Serum was collected prior to ischemia (baseline serum) and at study end (end point serum). Total RNA was isolated from tissues and serum, and microRNA sequencing was performed with differential expression analysis between the contralateral and ischemic kidney and baseline and end point serum.
RESULTS
20 microRNAs were differentially expressed between ischemic and contralateral kidneys, and 52 microRNAs were differentially expressed between end point and baseline serum. Five microRNAs were mutually differentially expressed between ischemic and contralateral kidneys and baseline and end point serum, with 4 (mir-21, mir-146, mir-199, and mir-235) having increased expression in both the ischemic kidney and end point serum and 1 (mir-382) having increased expression in the ischemic kidney and decreased expression in end point serum. Predicted target search for these microRNA revealed multiple genes previously shown to be involved in the pathogenesis of feline CKD, including hypoxia-inducible factor-1α, transforming growth factor-β, hepatocyte growth factor, fibronectin, and vascular endothelial growth factor A.
CLINICAL RELEVANCE
MicroRNAs were differentially expressed after CKD induction in this preliminary study. Regulation of renal fibrosis in feline CKD may occur through microRNA regulation of mRNAs of pro- and anti-fibrotic genes.
Abstract
OBJECTIVE
To characterize the anatomic location of the esophageal ostium relative to the rima glottidis in adult Labrador Retrievers with the use of CT.
ANIMALS
98 CT scans of 75 adult Labrador Retrievers.
PROCEDURES
A search of the medical records database identified records of Labrador Retrievers that underwent CT of the head and neck between January 1, 2015, and December 31, 2018. Evaluators, blinded to each other's results, reviewed CT images and measured esophageal area at the level of the rima glottidis. For each dog, the left esophageal percentage (LEP) was calculated as the esophageal area left of the rima glottidis midline divided by the overall esophageal area at that level. Variables (age, sex, patient position, intubation status, and maxillary support during CT) were evaluated for association with LEP. The CT images of dogs that had multiple scans were assessed for within-patient variance.
RESULTS
Mean LEP was 56.2 ± 18.1% for all dogs. Only right lateral recumbency was significantly associated with LEP, with a lower LEP for dogs positioned in right lateral recumbency (42.4 ± 12.7%), compared with left lateral (63.0 ± 7.4%) or sternal (57.3 ± 18.8%) recumbency. No association was detected between LEP and other variables assessed. Eleven dogs had multiple CT scans; within-patient variance for LEP was ± 26.6%.
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that, although most dogs had an LEP > 50%, the esophageal ostium was fairly centrally located in most dogs and may be more mobile than previously thought. Additional research is warranted to assess this mobility and whether the esophageal ostium location, relative to the larynx, affects the incidence of aspiration pneumonia in dogs undergoing surgical treatment for geriatric-onset laryngeal paralysis and polyneuropathy.
