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Abstract

CASE DESCRIPTION A 9-year-old spayed female Dalmatian was examined because of progressive pelvic limb paraparesis.

CLINICAL FINDINGS The dog had a history of chronic urinary incontinence and had been treated with phenylpropanolamine (PPA) for almost 8.5 years. Intervertebral disk disease at T12–13 was diagnosed, and a hemilaminectomy was performed. Three days after surgery, the dog developed a ventricular tachyarrhythmia. Severe left and mild right ventricular hypertrophy were detected by echocardiography.

TREATMENT AND OUTCOME The arrhythmia was controlled with sotalol. Phenylpropanolamine administration was discontinued immediately before surgery and was not resumed. Heart rate and rhythm and blood pressure were within reference limits, and the ventricular hypertrophy had almost completely resolved 5 months later. Sotalol administration was discontinued. Shortly after the 5-month recheck evaluation, PPA administration was resumed, albeit at a lower dosage than that before surgery, for control of urinary incontinence. At the 10-month recheck evaluation, the dog was hypertensive and ventricular hypertrophy had recurred. Discontinuation of PPA administration was recommended but not heeded. The dog developed marked azotemia 1.5 years after surgery, which was managed by the referring veterinarian, and was subsequently lost to follow-up.

CLINICAL RELEVANCE The fact that the ventricular hypertrophy almost completely resolved when PPA administration was discontinued and then recurred after it was resumed strongly suggested the drug was an important contributing factor to the cardiac disease of this patient. Patients receiving PPA on a long-term basis should be frequently monitored for cardiac disease, and use of other adrenergic receptor agonists should be avoided in such patients.

Full access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Objective—

To describe the short-and long-term survival rates in horses undergoing ovariectomy for granulosa cell tumors by use of the diagonal paramedian approach.

Design—

Retrospective case study.

Animals—

12 horses with granulosa cell tumors.

Procedure—

A diagonal paramedian approach for unilateral ovariectomy was used for removal of each mare’s granulosa cell tumor. Information about complications and outcomes was analyzed.

Results—

Only minimal complications were detected postoperatively when the diagonal paramedian approach was used, regardless of the preferred technique for ovarian pedicle ligation or incisional closure and the use of pre- and postoperative medications. Clinical signs of moderate or severe postoperative abdominal pain were not evident in any of the 12 horses. Short- and long-term survival rates were 100%.

Clinical Implications—

The diagonal paramedian approach was advantageous for ovarian tumor removal, because the ovary was immediately adjacent to the body wall at a portion of the incision site. Size of the ovary was not a limitation, because muscle tissues at the edges of the incision were flexible and easily retractable. All of these factors improved exposure, decreased traction on the ovary, increased our ability to observe the vasculature, and decreased postoperative morbidity, aiding in the removal of granulosa cell tumors in mares. (J Am Vet Med Assoc 1997;211:204–206)

Free access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Summary

Postoperative abdominal fluid changes were compared in 2 groups of horses; those undergoing double small-colon resection and anastomosis (n = 10) and those undergoing exploratory celiotomy alone (n = 5). Peritoneal fluid was collected before surgery and on postoperative days 1, 3, 5, and 7. Total and differential nucleated cell counts, rbc numbers, and total protein and fibrinogen concentrations were evaluated. In both groups, all values were significantly higher than normal on the first postoperative day (after small-colon resection and anastomoses, wbc = 130,350 ± 23,310 cells/µl, rbc = 7,389,000 ± 6,234,000 cells/µl, total protein = 3.63 ± 0.16 g/dl; after exploratory celiotomy alone, wbc = 166,620 ± 34,340 cells/µl, rbc = 295,000 ± 86,070 cells/µl, total protein 4.38 ± 0.54 g/dl). The number of total peritoneal nucleated cells and rbc significantly decreased after the first postoperative day, whereas total protein and fibrinogen concentrations, percent neutrophils, and percent mononuclear cells remained unchanged. None of the values had returned to normal by postoperative day 7 (after small-colon resection and anastomoses, wbc = 45,600 ± 8,765 cells/µl, rbc= 95,390 ± 53,380 cells/µl, total protein = 4.39 ± 0.23 g/dl; after exploratory celiotomy alone, wbc= 43,340 ± 7,746 cells/µl, rbc = 12,860 ± 11,790 cells/µl, total protein = 3.92 ± 2.20 g/dl.) The resection and anastomosis group had a significantly lower total protein concentration on the first postoperative day and a significantly higher mean total rbc count over the entire 7-day postoperative evaluation than did horses that underwent celiotomy alone. Other values in the 2 groups of horses did not differ significantly. As a result, there was insufficient evidence to conclude that resection and anastomosis of the small colon in healthy horses causes a different inflammatory response than does manipulation of the intestine alone.

Free access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To report the outcomes of horses with suspected nephrosplenic entrapment (NSE) of the large colon treated by IV phenylephrine administration and exercise with and without trocarization (ie, medical management).

DESIGN Retrospective, observational study.

ANIMALS 134 horses.

PROCEDURES Electronic medical records were searched to identify horses that underwent medical management for suspected NSE at a veterinary teaching hospital between 1995 and 2014. Demographic information, physical and ultrasonographic examination findings, treatment information (including the number of times the treatment was performed and patient response), surgical findings if applicable, complications, and patient outcome were recorded. Descriptive statistics were reported.

RESULTS 72 horses had suspected NSE that resolved with medical treatment; 59 of 62 horses underwent laparotomy when medical management failed, and 3 were euthanized without surgery. Twenty-five of the 59 horses had confirmed NSE that was surgically corrected, and 34 had lesions other than or in addition to NSE. All horses that had surgically corrected NSE and 18 of 34 horses that had other lesions survived to hospital discharge. The odds of resolution of NSE with medical management were greater for horses that underwent ≤ 2 (vs > 2) treatments. The treatment success rate for horses that underwent trocarization was not greater than that for horses that did not have the procedure.

CONCLUSIONS AND CLINICAL RELEVANCE Suspected NSE resolved with the described medical management for most horses. However, results indicated the potential for misdiagnosis was high. Timely surgical intervention is recommended for horses that fail to respond to medical treatment.

Full access
in Journal of the American Veterinary Medical Association