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- Author or Editor: Kyle G. Mathews x
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Objective—To compare preplanned lateral surgical margins and measured lateral histologic margins for cutaneous and subcutaneous mast cell tumor (MCT) resections in dogs.
Design—Retrospective case series.
Sample—51 biopsy specimens from dogs (n = 46) with MCTs.
Procedures—All canine patients that underwent curative-intent surgical resection of cutaneous or subcutaneous MCTs from January 1, 2010, through June 30, 2013, with complete medical records including signalment, body condition score (BCS), surgery report (with measured surgical margins), and histopathology report were included. The surgically measured tumor margins in each quadrant were grouped and compared with the corresponding histologic margins. Specimens from dogs with truncal MCTs and a BCS of 7 to 9 on a scale from 1 to 9 (ie, high) were compared with those of dogs with a BCS of 4 to 6 to evaluate effect of BCS on tissue margins.
Results—51 specimens were included. Surgically mapped lateral margins differed significantly from histologically reported margins in all 4 quadrants. The mean histologic margins were 35% to 42% smaller than the surgical margins for the combined 51 specimens. A higher BCS did not significantly influence the magnitude of the decrease in lateral margins measured histologically. No significant difference was found for the magnitude of the differences between any of the 4 lateral margins.
Conclusions and Clinical Relevance—Results of this study suggested that surgical and histologic margins may differ significantly for canine cutaneous and subcutaneous MCTs. This may be a result of tissue shrinkage following excision and fixation, extension of the MCT beyond palpable margins, or both. Histologic measurements may significantly underestimate the tumor-free margins in dogs with cutaneous and subcutaneous MCTs. (J Am Vet Med Assoc 2015;247:184–189)
Objective—To evaluate the stability and retention of viscous formulations of the antifungal drug clotrimazole in vitro and to evaluate retention times, absorption, and histologic response to these compounds when placed in the frontal sinus of dogs.
Animals—6 male Beagles.
Procedures—1% clotrimazole gels were formulated with hydroxypropyl cellulose, poloxamer, and carboxymethylcellulose sodium bases. Commercially available 1% clotrimazole creams were also evaluated. Each compound was incubated at 37°C in a funnel. Volume retained and clotrimazole stability were evaluated for 4 weeks. Six compounds were then chosen for in vivo evaluation. The frontal sinuses of 6 dogs were filled with 1 of the 6 compounds. Computed tomographic evaluation was performed weekly for up to 4 weeks to evaluate gel retention. Blood samples were collected to evaluate clotrimazole absorption. Following euthanasia, sinuses were examined histologically.
Results—Commercially available clotrimazole creams were not retained in funnels in vitro. In vivo, hydroxypropyl cellulose– and carboxymethylcellulose-based gels resulted in the most severe inflammatory response and were retained the longest. Poloxamer-based gels had a shorter retention time and were associated with less inflammation. Clotrimazole was minimally absorbed. Despite a marked inflammatory response to several of the clotrimazole-containing gels, no notable adverse clinical responses were observed.
Conclusions and Clinical Relevance—Poloxamer gels had the most promise for improving drug contact within the frontal sinus of dogs, while limiting the inflammatory response. Poloxamer gels have the additional benefit of improved handling as a result of reverse gelation (ie, they gel when warmed to 37°C).
Objective—To evaluate the effects of fascial abrasion, fasciotomy, and fascial excision on cutaneous wound healing in cats.
Animals—Eight 1- to 3-year-old domestic shorthair cats.
Procedures—8 evenly spaced 4-cm2 skin wounds were created on each cat's dorsum, and the underlying subcutaneous tissue was removed to expose the epaxial muscle fascia. Wounds were randomized to receive 1 of 4 treatments (2 wounds/treatment/cat): fascial abrasion, fasciotomy, fascial excision, or control treatment (muscle fascia not disturbed). Bandages were changed and digital photographs and acetate tracings of the wounds were obtained for planimetry daily for 1 week, every other day for 2 weeks, and then every third day for 3 weeks (ie, 40-day observation period). Digitized images were evaluated for granulation tissue formation, wound contraction (surface area measurements), and area of epithelialization.
Results—The epithelialized area and open and total wound areas did not differ among treatments at any time point. Time to the first appearance of granulation tissue was significantly shorter for all treatment groups, compared with that of the control group. Time to achieve granulation tissue coverage of wound base was significantly shorter following fasciotomy (9.6 days) and fascial excision (9.0 days), compared with that of control treatment (18.5 days) or abrasion (16.7 days). Numbers of wounds that developed exuberant granulation tissue following fascial excision (9/16) and control treatment (3/16) differed significantly.
Conclusions and Clinical Relevance—Fasciotomy and fascial excision facilitated early granulation tissue development in cutaneous wounds in cats. In clinical use, these fascial treatments may expedite secondary wound closure or skin grafting.
To determine whether muscle-sparing laryngoplasty results in fewer changes in swallowing function compared to standard surgical treatment for laryngeal paralysis.
12 clinically normal sexually intact male Beagles.
Group A dogs (n = 4) had a standard approach to the larynx, with left arytenoid cartilage lateralization. Group B dogs (n = 4) had a muscle-sparing laryngoplasty performed with the thyropharyngeus muscle fibers bluntly separated, and the cricoarytenoideus dorsalis muscle spared. Pre- and 24-hour postoperative fluoroscopic swallowing studies were performed and graded. Larynges were harvested after humane euthanasia, and glottic area was measured. Group C dogs (n = 4) acted as controls, with surgical dissection ending lateral to the thyropharyngeus muscle, arytenoid lateralization not performed, and the dogs not euthanized. The study was performed between October 15, 2011 and May 15, 2021.
Changes in pharyngeal and upper esophageal sphincter function were not detected in any group. There was no difference in glottic area between treatment groups. Aspiration of liquid was not a consistent finding. Two dogs in each treatment group developed moderate to severe cervical esophageal paresis. This did not occur in control dogs.
We found no evidence to support our hypothesis that muscle-sparing laryngoplasty results in less severe changes in swallowing function compared to a standard technique. The cervical esophageal paresis identified in both treatment groups could increase the risk of postoperative aspiration pneumonia in dogs treated for laryngeal paralysis via a lateral approach to the larynx. Further study to determine the frequency, cause, and duration of esophageal dysfunction is warranted.
Case Description—A 6-year-old Siberian Husky–mix dog was examined for episodes of collapse.
Clinical Findings—Physical examination, echocardiography, abdominal ultrasonography, ECG, and thoracic computed tomography with contrast were performed and revealed a 2.5 × 2.3 × 2.0-cm mass over the pulmonic valve leaflets, resulting in moderate pulmonic stenosis. Other abnormal findings included systemic hypertension, right bundle branch block, proteinuria, and a urinary bladder mass.
Treatment and Outcome—Pulmonary arteriotomy was performed under inflow occlusion, and the mass was resected with transesophageal echocardiographic guidance and direct visualization. Results of histologic examination of the mass revealed a vascular hamartoma. Sequential follow-up examinations and telephone contacts (at 0.5, 5, and 15 months after surgery) revealed that the patient had been free from episodes of collapse since surgery. No regrowth of the mass was noted on follow-up echocardiograms, and the pulmonic stenosis had resolved, although mild to moderate pulmonary insufficiency later developed. The bladder mass was excised 15 months after the first surgery when hematuria developed, and results of histologic examination of this mass revealed a vascular hamartoma. The dog was eventually euthanized 31 months after the initial surgery for reasons that could not be directly linked to any recurrence of the pulmonary artery mass.
Clinical Relevance—Hamartomas are benign tumors that can be located in various tissues, including large arteries. Computed tomography was helpful in predicting the resectability of the intracardiac mass in this dog. Treatment with arteriotomy under inflow occlusion and mild hypothermia resulted in a favorable outcome.
OBJECTIVE To evaluate the 3-D geometry of canine pelves and to characterize the long-term effects of juvenile pubic symphysiodesis (JPS) on pelvic geometry by comparing the pelvic configuration between littermates that did and did not undergo the procedure.
ANIMALS 24 Labrador Retriever, Golden Retriever, or Labrador Retriever–Golden Retriever crossbred service dogs from 13 litters.
PROCEDURES At 16 weeks old, puppies with a hip joint distraction index ≥ 0.5 were randomly assigned to undergo thermal JPS (n = 9), mechanical JPS (7), or a sham (control) surgical procedure (8). Ten years later, each dog underwent a CT scan of the pelvic region. Modeling software was used to create 3-D reconstructions from the CT scans, and various pelvic measurements were made and compared among the 3 treatments.
RESULTS Compared with the control treatment, thermal and mechanical JPS increased the hemipelvis acetabular angle by 4°, the acetabular angle of lateral opening by 5°, and the orientation of the medial acetabular wall in a transverse plane by 6°, which indicated that JPS increased dorsal femoral head coverage by the acetabulum. Both JPS procedures decreased the pelvic canal area by approximately 20% and acetabular inclination by 6° but did not alter acetabular retroversion.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that thermal and mechanical JPS were equally effective in altering the 3-D pelvic geometry of dogs. These findings may help guide future studies of alternatives for optimizing canine pelvic anatomy to minimize the risk of hip dysplasia and associated osteoarthritis.
Objective—To determine clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in cats with ureteral calculi.
Animals—163 client-owned cats.
Procedure—Medical records were reviewed, and information on signalment, history, clinical signs, and results of clinicopathologic testing and diagnostic imaging was obtained.
Results—The number of cats in which ureterolithiasis was diagnosed each year increased progressively during the study period. Clinical signs tended to be nonspecific and included inappetence, vomiting, lethargy, and weight loss. A combination of survey radiography and abdominal ultrasonography revealed ureteral calculi in 66 of 73 (90%) cats in which the diagnosis was confirmed at surgery or necropsy. Ultrasonography revealed that ureteral calculi were causing ureteral obstruction in 143 of 155 (92%) cats. One hundred thirty-four of 162 (83%) cats had azotemia, 84 of 156 (54%) had hyperphosphatemia, and 22 of 152 (14%) had hypercalcemia. Urinary tract infection was documented in 10 of 119 (8%). Fifty-eight of 76 (76%) cats with unilateral ureterolithiasis had azotemia and 33 (43%) had hyperphosphatemia, indicating impairment of renal function in the contralateral kidney or prerenal azotemia. Ultrasonographic imaging of the contralateral kidney in cats with unilateral ureteral calculi suggested that preexisting renal parenchymal disease was common in cats with ureterolithiasis. Ninety-one of 93 (98%) ureteral calculi contained calcium oxalate.
Conclusions and Clinical Relevance—Results suggest that abdominal imaging should be performed in all cats with chronic nonspecific signs or with acute or chronic renal failure to rule out ureterolithiasis. Preexisting renal disease may be common in cats with ureteral calculi. (J Am Vet Med Assoc 2005;226: 932–936)
Objective—To determine outcome of medical and surgical treatment in cats with ureteral calculi.
Procedure—Medical records were reviewed. Owners and referring veterinarians were contacted for follow-up information.
Results—All cats were initially treated medically before a decision was made to perform surgery. Medical treatment included parenteral administration of fluids and diuretics to promote urine production and passage of the ureteral calculus and supportive treatment for renal failure. Ureteral calculi in the proximal portion of the ureter were typically removed by ureterotomy, whereas ureteral calculi in the distal portion of the ureter were more likely to be removed by partial ureterectomy and ureteroneocystostomy. Ureterotomy could be performed without placement of a nephrostomy tube for postoperative urine diversion. Postoperative complication rate and perioperative mortality rate were 31% and 18%, respectively. The most common postoperative complications were urine leakage and persistent ureteral obstruction after surgery. Chronic renal failure was common at the time of diagnosis and continued after treatment, with serum creatinine concentration remaining greater than the upper reference limit in approximately half the cats. Twelve-month survival rates after medical and surgical treatment were 66% and 91%, respectively, with a number of cats dying of causes related to urinary tract disorders, including ureteral calculus recurrence and worsening of chronic renal failure.
Conclusions and Clinical Relevance—Results suggest that medical and surgical management of ureteral calculi in cats are associated with high morbidity and mortality rates. Treatment can stabilize renal function, although many surviving cats will continue to have impaired renal function. (J Am Vet Med Assoc 2005;226:937–944)
Objective—To compare pathologic findings and results of adrenalectomy for adrenal gland tumors in dogs with and without vena caval tumor thrombi.
Animals—40 dogs with adrenal gland tumors.
Procedure—Medical records were examined. An exact logistic regression analysis was used to evaluate associations between tumor type or right-sided versus left-sided tumor involvement and development of caval tumor thrombi and associations between tumor thrombi, tumor type, or right- versus left-sided location and perioperative complications and mortality rate. Survival was compared between dogs with and without tumor thrombi.
Results—Caval thrombi were detected in 25% of dogs, including 3 of 28 (11%) dogs with an adrenocortical tumor and 6 of 11 dogs with a pheochromocytoma. A caval tumor thrombus was detected in 6 of 17 right-sided and 4 of 20 left-sided tumors. Sensitivity and specificity of abdominal ultrasonography for detection of caval thrombi were 80 and 90%, respectively. Intraoperative and postoperative complications developed in 15 and 51% of dogs, respectively. The mortality rate was 22%. There were no significant differences in perioperative morbidity and mortality rates between dogs with and without tumor thrombi.
Conclusions and Clinical Relevance—Caval thrombi associated with adrenal gland tumors are amenable to adrenalectomy and thrombectomy without significantly increased perioperative morbidity and mortality rates, assuming the surgeon is experienced in appropriate techniques. (J Am Vet Med Assoc 2003;223: 654–662)