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- Author or Editor: Sherry L. Appel x
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Abstract
Objective—To compare client perception of outcome of phacoemulsification in dogs with information obtained from medical records.
Design—Retrospective cohort study.
Animals—108 dogs (203 eyes) undergoing phacoemulsification from May 1999 through April 2004.
Procedure—Data obtained from medical records included signalment, presence of diabetes mellitus, cataract stage, whether surgery was unilateral or bilateral, intraocular lens (IOL) placement, and postoperative complications. Owners completed a survey concerning outcome of phacoemulsification in their dog. Survey responses from owners classified as satisfied or dissatisfied with the outcome of phacoemulsification on the basis of their willingness, in retrospect, to have the surgery performed again were compared.
Results—Data from medical records and survey responses were available for 108 dogs (203 eyes). Median follow-up was 3 months via medical record review and 12 months via owner survey responses. Most (81%) owners were satisfied with outcome. The most common reason for dissatisfaction was loss of vision after surgery; however, most dissatisfied owners did not return their dog for examinations. Owner perception of success was not associated with patient age, sex, presence of diabetes mellitus, cataract stage, or IOL placement in at least 1 eye but was associated with perceived improvement of their pet's vision and activity level. Dissatisfied owners were significantly more likely to report that explanation of risks and complications before surgery was inadequate.
Conclusions and Clinical Relevance—Owner perception of outcome after phacoemulsification in dogs was highly favorable. However, surgical risks and the importance of postoperative examinations, particularly in dogs undergoing visual deterioration, must be conveyed to clients.
Abstract
Objective—To characterize and evaluate risk factors for suture-associated cystoliths in dogs and cats.
Design—Retrospective case-control study.
Animals—163 dogs and 13 cats with suture-associated cystoliths and 326 control dogs and 26 control cats with non–suture-associated cystoliths.
Procedures—Submissions to the Canadian Veterinary Urolith Centre received from 1999 to 2006 were reviewed. Case dogs and cats had cystoliths associated with visible suture or with hollow, cylindrical channels or suture knot impressions consistent with dissolved suture. Control dogs and cats had at least a single recurrent non–suture-associated cystolith submitted closest in time to the sample case. Associations among cystolith composition, recurrence times, sex, age, and breed were evaluated.
Results—Cases consisted of 92 dogs and 7 cats with visible suture and 71 dogs and 6 cats with dissolved suture. Suture-associated cystoliths represented 0.6% of canine cystoliths, 9.4% of recurrent canine cystoliths, 0.17% of feline cystoliths, and 4% of recurrent feline cystoliths. Sexually intact and neutered males were at increased odds of suture-associated cystoliths, relative to spayed female dogs. Shih Tzus, Lhasa Apsos, and Pomeranians were significantly predisposed to form suture-associated cystoliths. In dogs, compound suture-associated cystoliths were significantly more likely than other cystolith types (OR, 8.6). Dogs with suture-associated cystoliths had significantly shorter recurrence times than did control dogs.
Conclusions and Clinical Relevance—Suture remnants in the bladder have an important role in recurrent cystolithiasis in dogs. Identification of risk factors is important for avoiding recurrence of iatrogenic cystoliths.
Abstract
Case Description—A 1.5-year-old spayed female domestic shorthair cat was admitted for hind limb locomotor difficulties and signs of pain along the lumbar portion of the vertebral column. At the time of referral, the cat was paraparetic with deficits in the spinal reflexes of the hind limbs. Neuroanatomic localization was at the L6-S2 spinal cord segments, corresponding approximately to the region of the L4-L6 vertebral bodies.
Clinical Findings—Radiography revealed a mixed osteolytic-proliferative lesion within the body of L5 involving the cranial end plate, as well as punctate radiolucencies in the distal portion of the femur. Magnetic resonance imaging revealed an intramedullary spinal cord lesion along with extensive meningeal and nerve root lesions in the area of the L4-L6 vertebral bodies. Cytologic analysis of a bone marrow aspirate from the right trochanteric fossa revealed a substantial plasma cell infiltrate. Analysis of CSF revealed a high protein concentration and morphologically abnormal plasma cells. Urine, but not serum, protein electrophoresis revealed a sharp γ-globulin peak consistent with a monoclonal band of Bence-Jones proteins. The diagnosis was multiple myeloma.
Treatment and Outcome—The cat was treated with melphalan and prednisolone. A rapid clinical response was reported, and by week 3 after diagnosis, the cat's locomotion and behavior had normalized. However, by month 4, multifocal neurologic deficits were evident. The cat was euthanized at 9 months because of tetraparesis and substantial weight loss.
Clinical Relevance—To our knowledge, this is the first report of myeloma in a cat that had electrophoretically detectable light chain proteinuria but lacked a detectable serum monoclonal gammopathy.