Case Description—A 7-day-old female alpaca was examined because of an acute onset of diffuse central neurologic deficits.
Clinical Findings—Diagnostic imaging with CT and MRI identified an intracranial cyst occupying approximately one-third to one-half of the dorsal portion of the cranial cavity, markedly displacing the cerebral hemispheres bilaterally.
Treatment and Outcome—Initial surgical management via trephination and needle drainage was only transiently effective at resolving the neurologic signs. Craniotomy and drainage and removal of the cyst lining resulted in a sustained improvement in neurologic status, and the cria remained clinically normal and well grown at follow-up 5 months after surgery.
Clinical Relevance—This report represented the first description of the successful treatment of an intracranial cyst in a New World camelid.
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.
To compare the rate of postoperative dehiscence on the basis of intraoperative anastomotic leak test results (ie, positive or negative for leakage or testing not performed) between dogs that underwent hand-sewn anastomosis (HSA) or functional end-to-end stapled anastomosis (FEESA) of the small intestine.
131 client-owned dogs that underwent 144 small intestinal anastomoses (94 FEESA and 50 HSA).
Medical records were searched to identify dogs that had undergone a small intestinal anastomosis (HSA or FEESA) from January 2008 through October 2019. Data were collected regarding signalment, indication for surgery, location of the anastomosis, surgical technique, the presence of preoperative septic peritonitis, performance of intraoperative leak testing, development of postoperative dehiscence, and duration of follow-up.
Intraoperative leak testing was performed during 62 of 144 (43.1%) small intestinal anastomoses, which included 26 of 94 (27.7%) FEESAs and 36 of 50 (72.0%) HSAs. Thirteen of 144 (9.0%) anastomoses underwent dehiscence after surgery (median, 4 days; range, 2 to 17 days), with subsequent septic peritonitis, including 10 of 94 (10.6%) FEESAs and 3 of 50 (6.0%) HSAs. The incidence of postoperative dehiscence was not significantly different between FEESAs and HSAs; between anastomoses that underwent intraoperative leak testing and those that did not, regardless of anastomotic technique; or between anastomoses with positive and negative leak test results. Hand-sewn anastomoses were significantly more likely to undergo leak testing than FEESAs. Preoperative septic peritonitis, use of omental or serosal reinforcement, preoperative serum albumin concentration, and surgical indication were not significantly different between anastomotic techniques.
CONCLUSIONS AND CLINICAL RELEVANCE
Performance of intraoperative anastomotic leak testing, regardless of the anastomotic technique, was not associated with a reduction in the incidence of postoperative anastomotic dehiscence.
Objective—To evaluate postmortem surgery site leakage by use of in situ isolated pulsatile perfusion after partial liver lobectomies.
Animals—10 healthy mixed-breed male dogs.
Procedures—Dogs were anesthetized, and 5 surgical techniques (pretied suture loop, energy-based sealer-divider, harmonic scalpel, suction with clip application, or suction with use of a thoracoabdominal stapler) were used to perform 5 partial liver lobectomies in each dog. Dogs were euthanatized, and the portal vein and hepatic artery were cannulated and perfused with a modified kidney perfusion machine (pulsatile flow for arterial perfusion and nonpulsatile flow for portal perfusion). Lobectomy sites were inspected for leakage of perfusate, and time until detection of leakage was recorded. The techniques in each dog were ranked on the basis of time until leakage. Time until leakage and rankings for each surgical technique were analyzed by use of an ANOVA.
Results—Leakage of perfusate was recorded in 44 lobes at supraphysiologic pressures. Of the 6 lobes without leakage, a pretied suture loop procedure was performed in 5 and a harmonic scalpel procedure was performed in 1. Time until leakage and the ranking differed significantly between the pretied suture loop and the other techniques. Time until leakage and ranking did not differ significantly among the other techniques.
Conclusions and Clinical Relevance—Time until leakage of perfusate was greater for the pretied suture loop technique than for the other techniques, and that technique did not fail in 5 of 10 lobes. However, all techniques appeared to be safe for clinical use.
Objective—To biomechanically and histologically compare single-layer continuous Cushing and simple continuous appositional cystotomy closure in rats with xylene-induced cystitis.
Animals—40 female Sprague-Dawley rats.
Procedure—Rats were anesthetized, their urinary bladders catheterized and evacuated, and xylene instilled in each bladder for 5 minutes and then aspirated. Forty-eight hours later, ventral midline celiotomy and cystotomy (8 mm) were performed. Cystotomies were closed with 6-0 poliglecaprone 25 by use of a single-layer continuous Cushing or simple continuous appositional pattern (20 rats/group), and cystotomy times were recorded. Rats were allocated to healing durations (5 rats/group) of 0, 3, 7, and 14 days. Celiotomies were closed in a routine manner. After the allotted healing interval, another celiotomy was performed, the urethra cannulated, and ureters ligated. The cannula was secured to the urethra, and the bladder infused at 0.1 mL/min. Leak pressure volume, leak pressure, peak pressure volume, and peak pressure were recorded via a pressure transducer. Bladders were harvested and histologically assessed.
Results—Cystotomy time, biomechanical testing values, and overall inflammation scores did not differ between closure methods for any healing duration. Both methods had significantly greater leak pressures, with the appositional method also having significantly greater peak pressures on day 7, compared to day 0. Biomechanical testing values decreased from day 7 to 14 as a result of juxtaincisional weakening of the bladder and xylene-induced changes in collagen.
Conclusions and Clinical Relevance—Simple continuous appositional was equal biomechanically and histologically to continuous Cushing for all comparison variables. Poliglecaprone 25 was acceptable for cystotomy closure.
Objective—To characterize the clinical and morphologic
aspects of aqueous humor misdirection syndrome
(AHMS) in cats and provide a hypothesis
regarding its pathogenesis on the basis of detailed
analysis of affected cats.
Animals—32 cats (40 eyes).
Procedure—Medical records of cats in which AHMS
was diagnosed from July 1997 to August 2003 were
reviewed. In certain cats, results of additional diagnostic
testing were also obtained, including A-scan,
B-scan, and high-resolution ultrasonography; streak
retinoscopy; video keratometry; and infrared neutralizing
videoretinoscopy as well as results of analysis of
flash-frozen sections and histologic examination of
Results—Cats had a uniformly shallow anterior
chamber, intact lens zonules, and a narrowed
approach to an open iridocorneal angle. Mean age of
affected cats was 11.7 years (range, 4 to 16 years),
and female cats were significantly more often affected
than male cats. Clinical signs included mydriasis,
decreased pupillary light reflex, decreased menace
response, and blindness. Glaucomatous changes to
the optic nerve, incipient cataracts, and eventual
blindness were seen. Intraocular pressure was ≥ 20
mm Hg (range, 12 to 58 mm Hg) in 32 of 40 eyes.
Ultrasonography and histologic examination revealed
a thickened anterior vitreal face interposed between
the lens and ciliary body, partial ciliary cleft collapse,
and cavitated vitreal regions. Various treatment
modalities were used.
Conclusions and Clinical Relevance—AHMS affects
older cats, especially females, and may result in glaucoma,
vision loss, and signs of ocular pain. Topical
administration of carbonic anhydrase inhibitors
decreased intraocular pressure. (J Am Vet Med Assoc
Objective—To compare ultrasonographic and histologic examination findings for eyes of animals with ocular diseases.
Design—Retrospective case series.
Animals—116 eyes of 113 animals examined at 2 facilities.
Procedures—Diseased eyes of animals were examined by means of ultrasonography, removed via enucleation or exenteration, then histologically examined. Ultrasonographic images and histopathologic slides were evaluated, and diseases of eyes were identified with each of those methods and allocated to various categories. For each disease category, agreement between results of ultrasonography and those of histologic examination was assessed via determination of κ statistic values.
Results—Tests had good agreement for identification of iris or ciliary body neoplasia. Overall, intraocular neoplasia was not detected via ultrasonography for only 2 of 31 eyes with histologically detected neoplasia. Hemorrhagic or inflammatory changes were misinterpreted as neoplasia for 8 of 37 (22%) eyes. Tests had moderate to acceptable agreement for identification of retinal detachment. Retinal detachment was not detected by means of ultrasonography for 14 of 38 (37%) eyes with that diagnosis determined via histologic examination at one of the facilities (primarily in eyes with intraocular hemorrhage); however, retinal detachment was not identified via histologic examination for 6 of 38 (16%) eyes with that diagnosis determined via ultrasonography at the other facility.
Conclusions and Clinical Relevance—Agreement between tests evaluated in this study was clinically satisfactory for identification of intraocular neoplasia. Typically, diseases were misdiagnosed via ultrasonography for eyes with poor image contrast. Because determination of ultrasonographic diagnoses of retinal detachment and intraocular neoplasm may be of prognostic importance, performance of additional ultrasonographic techniques may be indicated.