A 5-year-old 49.7-kg (109.3-lb) castrated male Boxer was referred to the surgical oncology service of the Matthew J. Ryan Veterinary Hospital at the University of Pennsylvania for further evaluation and treatment of a right-sided pulmonary mass discovered by the referring veterinarian on thoracic radiographs. The dog had a 3-month history of a nonproductive cough that had been treated with prednisone at an initial dosage of 1 mg/kg/d (0.45 mg/lb/d), PO, with the dosage having been gradually tapered over the previous month. There were no abnormal findings during a complete preanesthetic evaluation at the time of admission, including a physical
A 1-year-old spayed female domestic shorthair cat was evaluated for a sternal defect and ventral abdominal wall hernia.
The cat appeared healthy. Palpation revealed a sternal defect, and the heart could be observed beating underneath the skin at the caudoventral aspect of the thorax. A 3-cm-diameter freely movable mass, consistent with a hernia, was also palpated at the cranioventral aspect of the abdomen. Thoracic radiographic and CT images revealed a sternal cleft, cranial midline abdominal wall hernia, and peritoneopericardial diaphragmatic hernia (PPDH).
TREATMENT AND OUTCOME
Thoracotomy and celiotomy were performed. The sternal cleft was repaired with a porcine small intestinal submucosa graft, titanium contourable mesh plate, and interrupted 25-gauge cerclage wires. A diaphragmatic herniorrhaphy was used to correct the PPDH. Thoracic radiographs were obtained immediately after surgery to confirm repair of the sternal cleft, abdominal wall hernia, and PPDH and at 1 and 3 months after surgery to assess the surgical implants, which had not migrated and were intact with only mild bending at the cranial and caudal margins of the mesh plate. At both recheck examinations, the cat appeared healthy with no complications reported by the owner.
A novel surgical technique was used to successfully repair a large sternal cleft in an adult cat with no postoperative complications reported. This technique may be useful for the treatment of sternal clefts in other cats. This was the first report to describe an adult cat with congenital defects consistent with incomplete pentalogy of Cantrell.
OBJECTIVE To compare duration of surgery, recurrence rate, and survival time between cats with idiopathic chylothorax treated with thoracic duct ligation (TDL) plus subphrenic pericardiectomy (SPC) and those treated with TDL, SPC, and cisterna chyli ablation (CCA).
DESIGN Retrospective case series with nested cohort study.
ANIMALS 22 client-owned cats surgically treated for idiopathic chylothorax from 2009 through 2014.
PROCEDURES Patient and surgery data were collected from the medical records. Recurrence of chylothorax and survival time were assessed by medical record review and client interview. Comparisons were made between cats treated with TDL plus SPC (TDL-SPC group) and those treated with TDL, SPC, and CCA (TDL-SPC-CCA group).
RESULTS 15 cats were treated with TDL plus SPC, and 7 were treated with TDL, SPC, and CCA. Median duration of surgery was significantly briefer for the TDL-SPC group (80 minutes; range, 55 to 175 minutes) than for the TDL-SPC-CCA group (125 minutes; range, 105 to 205 minutes). Five cats (2 in the TDL-SPC group and 3 in the TDL-SPC-CCA group) had persistent pleural effusion 4 weeks after surgery. Chylothorax recurred in 2 cats (1/group). Median survival time in the TDL-SPC group was 774 days (range, 3 to 2,844 days) and in the TDL-SPC-CCA group was 380 days (range, 11 to 815 days); these values did not differ significantly.
CONCLUSIONS AND CLINICAL RELEVANCE Addition of CCA to the surgical treatment approach for cats with idiopathic chylothorax was associated with a significantly longer duration of surgery with no better outcome than achieved with TDL plus SPC alone.
Procedure—Forelimb feet (right, left) were randomly
assigned to laser and scalpel treatment groups. Signs
of discomfort (lameness and signs of pain) and complications
(hemorrhage, swelling, and discharge)
were assessed on days 0, 1, and 7. Surgeries were
performed by 1 experienced surgeon. Evaluations
were performed by 2 individuals without knowledge
of treatment group. Signs of discomfort and complications
were scored on scales of 0 to 8 and 0 to 9,
Results—Onychectomy did not result in high discomfort
or complication scores 1 day after surgery,
regardless of technique used, although the lasertreated
group had significantly lower scores for signs
of discomfort and complications. Seven days after
surgery, significant differences were not detected
between groups for signs of discomfort or complications.
Conclusions and Clinical Relevance—The CO2 laser
can be an excellent tool for onychectomy in cats, with
excellent hemostasis and minimal postoperative discomfort
and complications. Differences in discomfort
and complications between groups treated via scalpel
versus CO2 laser were not clinically relevant and were
only observed 1 day after surgery. (J Am Vet Med
Objective—To determine clinical outcome of permanent tracheostomy in cats with upper airway obstruction.
Design—Retrospective case series.
Procedures—Medical records were reviewed for information on history, signalment, clinical signs, results of preoperative clinicopathologic testing, cause of upper airway obstruction, surgical procedure, postoperative complications, and outcome.
Results—Causes of upper airway obstruction included neoplasia (squamous cell carcinoma [n = 6] or malignant lymphoma ), inflammatory laryngeal disease (5), laryngeal paralysis (4), trauma (3), and a laryngeal mass of unknown cause (1). Fourteen cats had dyspnea in the immediate postoperative period; dyspnea most often resulted from mucous plugs at the stoma or elsewhere in the respiratory tract. Eleven cats died, including 6 cats that died while hospitalized after surgery and 5 cats that died after discharge; 7 cats were eu-thanatized, most often because of progression of neoplasia; and 2 were still alive at the time of the study. The remaining cat was lost to follow-up after discharge from the hospital. Overall, median survival time for the 20 cats for which information was available was 20.5 days (range, 1 day to 5 years). Cats that underwent permanent tracheostomy because of inflammatory laryngeal disease were 6.61 times as likely to die as cats that underwent permanent tracheostomy for any other reason.
Conclusions and Clinical Relevance—Results indicated that permanent tracheostomy was an uncommon procedure in cats with upper airway obstruction that was associated with high complication and mortality rates.
To compare complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy (VBO) in cats.
282 client-owned cats treated by VBO at 25 veterinary referral and academic hospitals from 2005 through 2016.
Medical records of cats were reviewed to collect information on signalment, clinical signs, diagnostic test results, surgical and postoperative management details, complications (anesthetic, surgical, and postoperative), and outcome. Associations were evaluated among selected variables.
Unilateral, staged bilateral, and single-stage bilateral VBO was performed in 211, 7, and 64 cats, respectively, representing 289 separate procedures. Eighteen (9%), 2 (29%), and 30 (47%) of these cats, respectively, had postoperative respiratory complications. Cats treated with single-stage bilateral VBO were significantly more likely to have severe respiratory complications and surgery-related death than cats treated with other VBO procedures. Overall, 68.2% (n = 197) of the 289 procedures were associated with Horner syndrome (19.4% permanently), 30.1% (87) with head tilt (22.1% permanently), 13.5% (39) with facial nerve paralysis (8.0% permanently), and 6.2% (18) with local disease recurrence. Cats with (vs without) Horner syndrome, head tilt, and facial nerve paralysis before VBO had 2.6, 3.3, and 5.6 times the odds, respectively, of having these conditions permanently.
CONCLUSIONS AND CLINICAL RELEVANCE
Findings suggested that staged bilateral VBO should be recommended over single-stage bilateral VBO for cats with bilateral middle ear disease. Cats with Horner syndrome, head tilt, and facial nerve paralysis before surgery were more likely to have these conditions permanently following surgery than were cats without these conditions.