Objective—To determine whether number of instrument cannulas is associated with surgical time or severity of postoperative pain in dogs undergoing laparoscopic ovariectomy.
Design—Randomized clinical trial.
Animals—18 healthy dogs.
Procedures—Dogs were randomly assigned to undergo laparoscopic ovariectomy with 1, 2, or 3 instrument cannulas. Surgical time and intraoperative and postoperative complications were recorded. Severity of pain was monitored 2, 4, 8, 12, and 24 hours after surgery by means of pain scoring with a modified Melbourne Pain Scale and palpation of surgical sites with variably sized von Frey filaments. Owner-assessed postoperative comfort was also evaluated.
Results—Surgical time was significantly longer with 1 cannula (mean ± SD, 29.7 ± 5.6 minutes) than with 2 cannulas (18.2 ± 4.4 minutes) or 3 cannulas (19.3 ± 3.4 minutes). Intraoperative complications included splenic puncture (2 dogs), pedicle hemorrhage (1 dog), and SC emphysema (1 dog); complication rates were not significantly different among groups. Total pain score was significantly lower for dogs with 2 cannulas than for dogs with 3 cannulas; total pain score for dogs with 1 cannula did not differ significantly from scores for dogs with 2 cannulas or 3 cannulas. Owner assessments of postoperative comfort and number of days pain medications were administered did not differ among groups.
Conclusions and Clinical Relevance—Results suggested that laparoscopic ovariectomy with 2 instrument cannulas, rather than with 1, resulted in shorter surgical times without increasing severity of postoperative pain.
A 1-year-old sexually intact female domestic shorthair cat from a local shelter was admitted to the University of Wisconsin School of Veterinary Medicine for ovariohysterectomy. Physical examination findings were unremarkable; heart and lungs sounded normal on auscultation. Following routine ovariohysterectomy, the cat developed diarrhea and a fecal flotation test was performed. On the basis of findings on fecal flotation testing, thoracic radiographs were obtained (Figure 1).
Left lateral (A) and ventrodorsal (B) radiographic views of the thorax of a female domestic shorthair cat from a local shelter that developed diarrhea following ovariohysterectomy.
To evaluate outcomes of dogs with parathyroid carcinoma (PTC) treated by surgical excision and to describe the incidence of postoperative hypocalcemia, degree of hypocalcemia, duration of hospitalization, duration of calcium supplementation, and survival time
100 client-owned dogs with PTC admitted to academic, referral veterinary institutions.
In a retrospective multi-institutional study, medical records of dogs undergoing surgical excision of PTC between 2010 to 2019 were reviewed. Signalment, relevant medical history, clinical signs, clinicopathologic testing, imaging, surgical findings, intraoperative complications, histologic examination, and survival time were recorded.
100 dogs with PTC were included, and 96 dogs had clinical or incidental hypercalcemia. Common clinical signs included polyuria (44%), polydipsia (43%), hind limb paresis (22%), lethargy (21%), and hyporexia (20%). Cervical ultrasonography detected a parathyroid nodule in 91 of 91 dogs, with a single nodule in 70.3% (64/91), 2 nodules in 25.3% (23/91), and ≥ 3 nodules in 4 (4/91)% of dogs. Hypercalcemia resolved in 89 of 96 dogs within 7 days after surgery. Thirty-four percent of dogs developed hypocalcemia, on the basis of individual analyzer ranges, within 1 week after surgery. One dog had metastatic PTC to the prescapular lymph node, and 3 dogs were euthanized for refractory postoperative hypocalcemia. Estimated 1-, 2-, and 3-year survival rates were 84%, 65%, and 51% respectively, with a median survival time of 2 years.
CONCLUSIONS AND CLINICAL RELEVANCE
Excision of PTC results in resolution of hypercalcemia and excellent long-term tumor control. Surgical excision of PTC is recommended because of resolution of hypercalcemia and a good long-term prognosis. Future prospective studies and long-term follow-up are needed to further assess primary tumor recurrence, metastasis, and incidence of postoperative hypocalcemia.
To evaluate outcomes in cats undergoing subtotal colectomy for the treatment of idiopathic megacolon and to determine whether removal versus nonremoval of the ileocecocolic junction (ICJ) was associated with differences in outcome.
166 client-owned cats.
For this retrospective cohort study, medical records databases of 18 participating veterinary hospitals were searched to identify records of cats with idiopathic megacolon treated by subtotal colectomy from January 2000 to December 2018. Data collection included perioperative and surgical variables, complications, outcome, and owner perception of the procedure. Data were analyzed for associations with outcomes of interest, and Kaplan-Meier survival time analysis was performed.
Major perioperative complications occurred in 9.9% (15/151) of cats, and 14% (12/87) of cats died as a direct result of treatment or complications of megacolon. The median survival time was not reached. Cats with (vs without) a body condition score < 4/9 (hazard ratio [HR], 5.97), preexisting heart disease (HR, 3.21), major perioperative complications (HR, 27.8), or long-term postoperative liquid feces (HR, 10.4) had greater hazard of shorter survival time. Constipation recurrence occurred in 32% (24/74) of cats at a median time of 344 days and was not associated with retention versus removal of the ICJ; however, ICJ removal was associated with long-term liquid feces (OR, 3.45), and a fair or poor outcome on owner assessment (OR, 3.6).
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that subtotal colectomy was associated with long survival times and a high rate of owner satisfaction. Removal of the ICJ was associated with less favorable outcomes in cats of the present study.