Owner-assisted recovery and early discharge after surgical treatment in dogs with brachycephalic obstructive airway syndrome.

OBJECTIVES: This study aims to describe a perioperative protocol for dogs recovered from anaesthesia with the owners and discharged from the hospital on the same day after surgical management of brachycephalic obstructive airway syndrome and to determine whether implementation of this protocol was associated with reduced incidence of complications compared with standard anaesthesia recovery and 24 hours hospitalisation. MATERIALS AND METHODS: Medical records of dogs that underwent brachycephalic obstructive airway surgery over two consecutive years (June 2017 to May 2019) were reviewed retrospectively. Signalment, clinical signs, diagnostic findings, surgical procedures and postoperative respiratory complications were recorded. Data were compared using the chi-squared or Fisher's exact tests. RESULTS: Sixty-three dogs met the inclusion criteria for the study. Forty-two dogs underwent owner-assisted recovery and 21 dogs standard recovery. No statistical difference was found between groups in age, breed, gender, severity of respiratory or gastrointestinal clinical signs and surgical techniques employed. The incidence of postoperative complications was higher in dogs that received standard recovery (28%) compared to dogs recovered with the owners (2%). None of the dogs recovered with the owners and discharged the same day required veterinary assistance after discharge from the hospital. CLINICAL SIGNIFICANCE: Corrective surgery for brachycephalic obstructive airway syndrome was associated with lower postoperative respiratory complications when dogs were discharged on the same day after recovery with the owners. Owner-assisted recovery and early discharge are possible and safe and may decrease the incidence of postoperative complications. However, other unmeasured factors may have contributed to the lower complication rate in dogs recovered with the owners during the course of this study.

The use of methylene blue to assist with parotid sialadenectomy in dogs.

INTRODUCTION: There is an important morbidity associated with parotidectomy. The most commonly reported permanent complication is facial nerve injury. Methylene blue staining has been used as an intra-operative tool to improve tissue visualisation and preserve facial nerve integrity. OBJECTIVES: To describe the functionality and feasibility of the use of methylene blue for parotidectomy in dogs. MATERIALS AND METHODS: Retrospective study included seven client-owned dogs that underwent parotidectomy after injection of methylene blue from 2016 to 2019 in a referral centre. Cross-sectional imaging was used to confirm parotid gland surgical disease and for staging purposes. All dogs underwent parotid resection and removal of the parotid duct after injection of methylene blue. Methylene blue was either administered via cannulation of the parotid duct or directly injected into the abnormal gland. RESULTS: In all cases, the gland stained dark blue within seconds without any evident leakage. Complete parotid gland resection and removal of the parotid duct was achieved successfully in all dogs with a mean surgical time of 97 minutes. Subjectively, the staining was useful to identify innervation outside the coloured gland and facilitated dissection. No complications, including facial nerve injury, were recorded. CLINICAL SIGNIFICANCE: Methylene blue staining for complete parotidectomy was feasible, rapid and easy in these dogs. It can be used as an indirect facial nerve identification technique, and can therefore facilitate dissection and possibly reduce the incidence of post-operative facial nerve paralysis.

Feasibility of the single-incision subxiphoid approach for video-assisted thoracoscopic surgery in dogs.

OBJECTIVES: To report early results of uniportal video-assisted thoracoscopic surgery in dogs using a single-incision subxiphoid approach. MATERIALS AND METHODS: Retrospective study of 10 client-owned dogs with: pyothorax (n=5), pericardial effusion (n=2), bilateral pneumothorax (n=1), retained surgical swab (n=1), cranial mediastinal mass (n=1). With the dog in dorsal recumbency a 3-4 cm incision was made over the xiphoid process. After resection of the xiphoid process, a tunnel was created towards the pleura and open access maintained with an Alexis™ wound retractor. The pleural cavity was explored with a 10 mm 30° or 5 mm 0° telescope and straight laparoscopic instruments. RESULTS: Median surgical time was 75 minutes. The SISA technique was performed successfully in five of 10 cases and allowed easy and adequate inspection of the intra-thoracic structures. One case was converted to lateral thoracotomy after laceration of the vena cava and one converted to median sternotomy because of adhesions. An additional port was placed in three cases to facilitate triangulation and surgical manipulation. No other intra-operative complications were encountered. CLINICAL SIGNIFICANCE: In this initial report of uniportal thoracic approach in dogs, this technique allowed excellent access and treatment of mediastinal structures. Further cases are required to assess its suitability for pulmonary surgery.

A modified temporary tracheostomy in dogs: outcome and complications in 21 dogs (2012 to 2017).

OBJECTIVES: To describe a modified temporary tracheostomy that included placing a Penrose drain sling dorsal to the trachea. To report outcomes and complications in brachycephalic versus non-brachycephalic breeds. MATERIALS AND METHODS: Retrospective review of signalment, diagnosis, outcome, complications and management of dogs that underwent modified temporary tracheostomy. RESULTS: Twenty-one dogs were included. Tracheostomy tubes were maintained for periods ranging from 1 to 21 days (median 4 days). There were no intraoperative complications or complications related to the placement of the Penrose drain. Postoperative complications occurred in eight dogs, including dislodgement of the tracheostomy tube (n=6), obstruction of the tracheostomy tube (n=1), subcutaneous emphysema and pneumomediastinum (n=1). Twenty dogs survived until discharge; one was euthanised due to persistence of primary disease. The complication rate in brachycephalic breeds and non-brachycephalic was 37∙5 and 40%, respectively. Tube dwell duration of 4 days or longer was associated with a higher complication rate. CLINICAL SIGNIFICANCE: The modified temporary tracheostomy appears to simplify tracheostomy care, improve tracheostomy outcome and reduce tube-associated mortality compared with standard tracheostomy. In this study, brachycephalic dogs did not have a higher complication rate than non-brachycephalic dogs.