Objective—To determine clinical findings and outcomes for cats and dogs with peritoneopericardial diaphragmatic hernia (PPDH) treated surgically or nonsurgically.
Design—Retrospective case series.
Animals—28 dogs and 30 cats.
Procedures—Medical records for cats and dogs evaluated at 1 of 2 veterinary teaching hospitals were reviewed, and data regarding clinical signs, diagnostic and surgical findings, and outcome were evaluated.
Results—Prevalence of PPDH in the 2 hospitals during the study period was 0.025% (0.062% and 0.015% for cats and dogs, respectively); PPDH was an incidental finding for 13 (46.4%) dogs and 15 (50.0%) cats. Other congenital abnormalities were identified in 16 (571%) dogs and 7 (23.3%) cats (most commonly umbilical hernias, abdominal wall hernias cranial to the umbilicus, or sternal anomalies). Thirty-four (58.6%) animals underwent surgical repair of PPDH; 27 (79.4%) of these animals had a primary diagnosis of PPDH. Detection of clinical signs of PPDH (primary diagnosis) and intestines in the pericardial sac were significantly associated with surgical treatment. Short-term mortality rate for surgically treated animals was 8.8% (3/34). Clinical signs associated with PPDH resolved in 29 (85.3%) of surgically treated animals. No significant differences were detected between dogs and cats or between surgically and nonsurgically treated animals regarding long-term survival rate.
Conclusions and Clinical Relevance—Results of this study indicated animals with clinical signs of PPDH were more likely to undergo surgery than were animals without such signs. Herniorrhaphy was typically effective for resolution of clinical signs. Long-term survival rates were similar regardless of treatment method. Surgical or nonsurgical treatment of PPDH may be appropriate for animals with or without clinical signs, respectively.
To evaluate a novel 2-catheter technique for urethral catheterization in female cats and small dogs and compare the time required for and success rates achieved by use of the novel technique versus traditional methods (blind technique in cats and digital palpation in dogs) as performed by personnel (catheter placers [CPs]) with different levels of experience in urinary catheter placement.
2 CPs were board certified in veterinary surgery, 1 of whom had experience with the novel technique, and the other did not. The third CP was a veterinary surgical intern who was unfamiliar with the novel technique. For each animal enrolled in the study, 1 CP performed catheterization with the novel technique and traditional methods. Data recorded included the time required for successful catheterization and whether a successful catheterization was achieved within a 3-minute time limit.
The overall success rates were 79.5% (31/39 animals) with the novel technique and 43.6% (17/39 animals) with traditional methods. Median times for successful catheter placement were 48 seconds for the novel technique and 41 seconds for traditional methods. Among CPs, success rates or times to successful catheter placement did not differ significantly.
CONCLUSIONS AND CLINICAL RELEVANCE
Study results suggested that the novel 2-catheter technique for urethral catheterization may be a more efficient option than traditional methods for gaining access to the urinary bladder in cats and small dogs, particularly when patient size limits use of instrumentation or digital palpation.
OBJECTIVE To determine whether brachycephalic dogs were at greater risk of anesthesia-related complications than nonbrachycephalic dogs and identify other risk factors for such complications.
DESIGN Retrospective cohort study.
ANIMALS 223 client-owned brachycephalic dogs undergoing general anesthesia for routine surgery or diagnostic imaging during 2012 and 223 nonbrachycephalic client-owned dogs matched by surgical procedure and other characteristics.
PROCEDURES Data were obtained from the medical records regarding dog signalment, clinical signs, anesthetic variables, surgery characteristics, and complications noted during or following anesthesia (prior to discharge from the hospital). Risk of complications was compared between brachycephalic and nonbrachycephalic dogs, controlling for other factors.
RESULTS Perianesthetic (intra-anesthetic and postanesthetic) complications were recorded for 49.1% (n = 219) of all 446 dogs (49.8% [111/223] of brachycephalic and 48.4% [108/223] of nonbrachycephalic dogs), and postanesthetic complications were recorded for 8.7% (39/446; 13.9% [31/223] of brachycephalic and 3.6% [8/223] of nonbrachycephalic dogs). Factors associated with a higher perianesthetic complication rate included brachycephalic status and longer (vs shorter) duration of anesthesia; the risk of perianesthetic complications decreased with increasing body weight and with orthopedic or radiologic procedures (vs soft tissue procedures). Factors associated with a higher postanesthetic complication rate included brachycephalic status, increasing American Society of Anesthesiologists status, use of ketamine plus a benzodiazepine (vs propofol with or without lidocaine) for anesthetic induction, and invasive (vs noninvasive) procedures.
CONCLUSIONS AND CLINICAL RELEVANCE Controlling for other factors, brachycephalic dogs undergoing routine surgery or imaging were at higher risk of peri- and postanesthetic complications than nonbrachycephalic dogs. Careful monitoring is recommended for brachycephalic dogs in the perianesthetic period.
Objective—To evaluate the effectiveness of episioplasty
for the treatment of perivulvar dermatitis or
chronic or recurrent urinary tract infections (UTI)
believed to be secondary to excessive perivulvar skin
folds in dogs and to document whether a causal relationship
exists between the presence of chronic or
recurrent UTI and excessive perivulvar skin folds in
Animals—31 female dogs.
Procedure—Medical records of dogs with vulvar dermatitis
(group 1; n = 15) or UTI (group 2; 16) were
reviewed for history, signalment, physical examination
findings, hematologic findings, results of urine or
vaginal bacteriologic culture, and results of additional
Results—14 of 15 dogs in group 1 had complete resolution
of perivulvar dermatitis and associated clinical
signs following episioplasty. One dog had a relapse of
clinical signs and vulvar dermatitis 2 years after
surgery in association with a 9-kg (19.8-lb) weight gain.
Sixteen of 16 dogs in group 2 had complete resolution
of clinical signs of UTI following episioplasty. Urine
samples were obtained via cystocentesis no earlier
than 1 month after surgery to confirm resolution of UTI
in 13 of 16 of dogs in group 2. Mild-to-moderate incisional
swelling was the only surgical complication
reported for either group, with the exception of 1 dog
in group 2 that had wound dehiscence. All owners
were satisfied with surgical outcomes.
Conclusions and Clinical Relevance—All owners
reported complete resolution of clinical signs for both
groups of dogs. Episioplasty is an effective low morbidity
treatment for perivulvar dermatitis and chronic
UTI associated with excessive perivulvar skin folds. (J Am Vet Med Assoc 2001;219:1577–1581)
To evaluate the role of simulation models and previous surgical experience on subjective and objective stress levels of students performing their 1st elective surgery within the veterinary curriculum.
141 third-year veterinary students
Using a pre–post experimental design, salivary alpha-amylase, and cortisol were evaluated as markers of physiologic stress response before students’ first elective surgery. Student self-reported State-Trait Anxiety Inventory (STAI) scores and quantitative measures of experience were correlated to biomarker results.
No association was found for change in salivary biomarkers of stress, alpha-amylase, and cortisol, between baseline and presurgical samples accounting for gender, age, type of elective surgery performed, previous surgical experience, or simulation model use. Salivary cortisol levels were markedly elevated falling between the 66th and 99th percentile compared to an age and gender-matched population. Salivary alpha-amylase levels were also 2 to 3 times higher than those recorded by other health professionals. Veterinary student STAI scores were high falling between the 65th and 73rd percentile compared to working adults in the general population.
Veterinary students’ salivary cortisol, alpha-amylase, and STAI scores fell into the upper 2/3rds of the general population, demonstrating a high level of stress. Simulation models and previous surgical experience were not associated with decreased stress. Further evaluation of the implementation of high-fidelity simulation models and the role of stress on performance is indicated.
Objective—To evaluate transurethral cystoscopy and
excretory urography for diagnosis of ectopic ureter in
female dogs and identify concurrent urogenital abnormalities.
Animals—25 female dogs.
Procedure—Medical records of female dogs that
underwent transurethral cystoscopy, excretory urography,
and ventral cystotomy were reviewed for signalment,
history, physical examination findings,
results of bacteriologic culture of urine, and surgical
findings. Videotapes of transurethral cystoscopy and
radiographic studies were reviewed systematically
without knowledge of surgical findings.
Results—Ectopic ureters were diagnosed in 24 of 25
(96%) of the dogs, bilaterally in 22 of 24 (91.6%) dogs.
Cystoscopic evaluation yielded a correct diagnosis in all
dogs when results of ventral cystotomy were used as
the diagnostic standard. Cystoscopic evaluation identified
a terminal ureteral opening for all ureters. Urethral
fenestrations, troughs, striping, and tenting were identified.
Abnormalities of the vestibule were identified in all
examinations available for review (24/25). The paramesonephric
septal remnant and its association with
ectopic ureters were identified and characterized by cystoscopy.
Radiographic findings were discordant with
surgical findings and correctly identified 36 of 46 (78.2%)
ectopic ureters and 2 of 4 normal ureters. Hydroureter
and renal abnormalities were associated with distal urethral
ectopic ureters on radiographic evaluations.
Conclusions and Clinical Relevance—Transurethral
cystoscopy was accurate and minimally invasive for identification
and classification of ectopic ureters in dogs.
Contrast radiography had limitations in diagnosis of
ectopic ureters. Cystoscopic findings and associated
vaginal and vestibular abnormalities support abnormal
embryologic development in the pathogenesis of ectopic
ureters. (J Am Vet Med Assoc 2003;223:475–481)
To determine whether previous corrective upper airway surgery in brachycephalic dogs would decrease perianesthetic complications in subsequent anesthetic events.
45 client-owned dogs.
Brachycephalic dogs undergoing any combination of staphylectomy, nasal alaplasty, or laryngeal sacculectomy that were anesthetized at a later date for additional surgical procedures or imaging from August 2, 2007, to February 8, 2019, had their medical records reviewed during both anesthetic events for signalment, American Society of Anesthesiologists status, perianesthetic drug administration, anesthetic duration, presence and total time of positive-pressure ventilation, procedure invasiveness, and perianesthetic complications such as bradycardia, hypothermia, hypotension, cardiac arrhythmias, hypertension, vomiting or regurgitation, dysphoria, respiratory distress, hypoxemia, reintubation, and prolonged periods of recovery.
The odds of having complications during the postanesthetic period following subsequent anesthetic events were decreased by 79% in dogs having previous surgical intervention to correct clinical signs of brachycephalic airway syndrome. Intra-anesthetic bradycardia increased the odds of developing a postanesthetic complication by 4.56 times. Every 15-minute increase in anesthetic duration increased the odds of having a postanesthetic complication by 12% and having an intra-anesthetic complication by 11%.
CONCLUSIONS AND CLINICAL RELEVANCE
Previous corrective upper airway surgery decreased odds of postanesthetic complications in brachycephalic dogs that underwent subsequent anesthetic events. Findings in this study indicated that corrective upper airway surgery for brachycephalic dogs may reduce postanesthetic complications following subsequent anesthetic events, which may reduce perianesthetic morbidity in patients undergoing multiple surgical or diagnostic imaging procedures.
To determine the effect of oral administration of gabapentin (20 mg/kg) on the minimum alveolar concentration (MAC) of isoflurane in dogs.
6 healthy adult dogs (3 males and 3 females with a mean ± SD body weight of 24.8 ± 1.3 kg).
Each dog was anesthetized twice. Dogs were initially assigned to 1 of 2 treatments (gabapentin [20 mg/kg, PO] followed 2 hours later by anesthesia maintained with isoflurane or anesthesia maintained with isoflurane alone). A minimum of 7 days later, dogs received the other treatment. The MAC of isoflurane was determined by use of an iterative bracketing technique with stimulating electrodes placed in the maxillary buccal mucosa. Hemodynamic variables and vital parameters were recorded at the lowest end-tidal isoflurane concentration at which dogs did not respond to the stimulus. Effect of treatment on outcome variables was analyzed by use of a paired t test.
Mean ± SD MAC of isoflurane was significantly lower when dogs received gabapentin and isoflurane (0.71 ± 0.12%) than when dogs received isoflurane alone (0.91 ± 0.26%). Mean reduction in MAC of isoflurane was 20 ± 14%. Hemodynamic variables did not differ significantly between treatments. Mean time to extubation was significantly less when dogs received gabapentin and isoflurane (6 ± 4 minutes) than when dogs received isoflurane alone (23 ± 15 minutes).
CONCLUSIONS AND CLINICAL RELEVANCE
Oral administration of gabapentin 2 hours before anesthesia maintained with isoflurane had a MAC-sparing effect with no effect on hemodynamic variables or vital parameters of dogs.
Objective—To determine maximum extrarenal plasma
clearance of technetium-99m-mercaptoacetyltriglycine
(99mTc–MAG3) and maximum extrarenal
hepatic uptake of 99mTc–MAG3 in cats.
Animals—6 clinically normal adult cats.
Procedure—Simultaneously, baseline plasma clearance
and camera-based uptake of 99mTc–MAG3 were
determined in anesthetized cats. Double exponential
curves were fitted to plasma clearance data. Injected
dose was divided by area under the curve and body
weight to determine 99mTc–MAG3 clearance. Regions
of interest were drawn around kidneys and liver, and
percentage dose uptake was determined 1 to 3 minutes
after injection. After bilateral nephrectomy,
simultaneous extrarenal plasma clearance and camera-
based hepatic uptake of 99mTc–MAG3 were evaluated
in each cat.
Results—Mean ± SD baseline plasma clearance and
extrarenal clearance were 5.29 ± 0.77 and 0.84 ± 0.47
mL/min/kg, respectively. Mean extrarenal clearance
(as a percentage of baseline plasma clearance) was
16.06 ± 7.64%. For right, left, and both kidneys, mean
percentage dose uptake was 9.42 ± 2.58, 9.37 ± 0.86,
and 18.79 ± 2.47%, respectively. Mean hepatic percentage
dose uptake before and after nephrectomy
was 12.95 ± 0.93 and 21.47 ± 2.00%, respectively.
Mean percentage change of hepatic uptake after
nephrectomy was 166.89 ± 23.19%.
Conclusions and Clinical Relevance—In cats,
extrarenal clearance of 99mTc–MAG3 is higher than that
of other species; therefore, 99mTc–MAG3 is not useful
for estimation of renal function in felids. Evaluation of
renal function in cats may be more accurate via camera-
based versus plasma clearance-based methods
because camera-based studies can discriminate specific
organs. (Am J Vet Res 2003;64:1076–1080)
Objective—To describe complications and outcome
associated with chronic nonseptic pleural effusion
treated with pleuroperitoneal shunts in dogs.
Procedure—Medical records at 4 veterinary schools
were examined to identify dogs with chronic nonseptic
pleural effusion that were treated by use of a pleuroperitoneal
shunt between 1985 and 1999.
Signalment, history, physical examination and laboratory
findings, cause and type of pleural effusion, medical
and surgical treatments, complications, and outcome
Results—10 of 14 dogs had idiopathic chylothorax,
and 4 had an identified disease. All but 1 dog with
idiopathic chylothorax and 1 dog with chylothorax
from a heart base tumor had unsuccessful thoracic
duct ligation prior to pump placement. No intraoperative
complications developed during shunt placement.
Short-term complications developed in 7 of 13
dogs, necessitating shunt removal in 2 dogs and
euthanasia in 1. Eight of 11 dogs with long-term follow-
up developed complications; the overall mean
survival time and the interval in which dogs remained
free of clinical signs of pleural effusion were 27
months (range, 1 to 108 months) and 20 months
(range, 0.5 to 108 months), respectively.
Conclusions and Clinical Relevance—Pleuroperitoneal
shunts can effectively palliate clinical signs
associated with intractable pleural effusion in dogs.
Numerous short- and long-term complications related
to the shunt should be expected. Most complications
can be successfully managed, but even when shunts
are functional some treatments fail because of severe
abdominal distension or massive pleural fluid production
that overwhelms the functional capacity of the
shunt. (J Am Vet Med Assoc 2001;219:1590–1597)