Placement of a subcutaneous ureteral bypass in a Miniature Pinscher with presumed xanthine urolithiasis as a result of allopurinol treatment.

INTRODUCTION: This case report describes the long-term success of a subcutaneous ureteral bypass device in a dog for treatment of a ureteral obstruction. The suspected xanthine urolithiasis was secondary to treatment with allopurinol for leishmaniasis. The dog presented initially with lethargy, anuria and abdominal pain. Mild azotemia was found on biochemical analysis and abdominal ultrasound revealed bilateral ureteral obstruction. A subcutaneous ureteral bypass was subsequently placed using a standard surgical technique. The dog recovered uneventfully and the azotemia resolved within days. Follow-up examinations were performed every trimester for over three years and no complications like obstruction of the bypass tubes, urinary tract infection or azotemia were recognized during this follow-up period. Allopurinol was replaced with domperidone as long-term treatment against Leishmaniasis which resulted in a mild increase of the leishmania serum antibody titer. The subcutaneous ureteral bypass placement was successful and safe in this dog and is a valuable alternative in cases of ureteral obstruction also in dogs.

INTRODUCTION: Ce rapport de cas décrit le succès à long terme d'une dérivation urétérale sous-cutanée chez un chien pour le traitement d'une obstruction urétérale. L'urolithiase xanthique suspectée était secondaire à un traitement à l'allopurinol contre la leishmaniose. Le chien a d'abord présenté une léthargie, une anurie et des douleurs abdominales. L'analyse biochimique a révélé une légère azotémie et l'échographie abdominale a révélé une obstruction urétérale bilatérale. Une dérivation urétérale sous-cutanée a été mise en place selon une technique chirurgicale standard. Le chien s'est rétabli sans incident et l'azotémie a disparu en quelques jours. Des examens de suivi ont été effectués tous les trimestres pendant plus de trois ans et aucune complication telle qu'une obstruction du tube de dérivation, une infection urinaire ou une azotémie n'a été constatée au cours de cette période de suivi. L'allopurinol a été remplacé par de la dompéridone dans le cadre d'un traitement à long terme contre la leishmaniose, ce qui a entraîné une légère augmentation du titre des anticorps sériques contre la leishmaniose. La mise en place d'une dérivation urétérale sous-cutanée s'est avérée efficace et sûre chez ce chien et constitue une alternative intéressante en cas d'obstruction urétérale, y compris chez les chiens.

Addition of magnesium sulphate to ropivacaine for spinal analgesia in dogs undergoing tibial plateau levelling osteotomy.

The aim of this blinded, randomised, prospective clinical trial was to determine whether the addition of magnesium sulphate to spinally-administered ropivacaine would improve peri-operative analgesia without impairing motor function in dogs undergoing orthopaedic surgery. Twenty client-owned dogs undergoing tibial plateau levelling osteotomy were randomly assigned to one of two treatment groups: group C (control, receiving hyperbaric ropivacaine by the spinal route) or group M (magnesium, receiving a hyperbaric combination of magnesium sulphate and ropivacaine by the spinal route). During surgery, changes in physiological variables above baseline were used to evaluate nociception. Arterial blood was collected before and after spinal injection, at four time points, to monitor plasma magnesium concentrations. Post-operatively, pain was assessed with a modified Sammarco pain score, a Glasgow pain scale and a visual analogue scale, while motor function was evaluated with a modified Tarlov scale. Assessments were performed at recovery and 1, 2 and 3 h thereafter. Fentanyl and buprenorphine were administered as rescue analgesics in the intra- and post-operative periods, respectively. Plasma magnesium concentrations did not increase after spinal injection compared to baseline. Group M required less intra-operative fentanyl, had lower Glasgow pain scores and experienced analgesia of longer duration than group C (527.0 ± 341.0 min vs. 176.0 ± 109.0 min). However, in group M the motor block was significantly longer, which limits the usefulness of magnesium for spinal analgesia at the investigated dose. Further research is needed to determine a clinically effective dose with shorter duration of motor block for magnesium used as an additive to spinal analgesic agents.

Engraftment of autologous bone marrow cells into the injured cranial cruciate ligament in dogs.

Current research indicates that exogenous stem cells may accelerate reparative processes in joint disease but, no previous studies have evaluated whether bone marrow cells (BMCs) target the injured cranial cruciate ligament (CCL) in dogs. The objective of this study was to investigate engraftment of BMCs following intra-articular injection in dogs with spontaneous CCL injury. Autologous PKH26-labelled BMCs were injected into the stifle joint of eight client-owned dogs with CCL rupture. The effects of PKH26 staining on cell viability and PKH26 fluorescence intensity were analysed in vitro using a MTT assay and flow cytometry. Labelled BMCs in injured CCL tissue were identified using fluorescence microscopy of biopsies harvested 3 and 13 days after intra-articular BMC injection. The intensity of PKH26 fluorescence declines with cell division but was still detectable after 16 days. Labelling with PKH26 had no detectable effect on cell viability or proliferation. Only rare PKH26-positive cells were present in biopsies of the injured CCL in 3/7 dogs and in synovial fluid in 1/7 dogs. No differences in transforming growth factor-ß1, and interleukin-6 before and after BMC treatment were found and no clinical complications were noted during a 1 year follow-up period. In conclusion, BMCs were shown to engraft to the injured CCL in dogs when injected into the articular cavity. Intra-articular application of PKH26-labelled cultured mesenchymal stem cells is likely to result in higher numbers of engrafted cells that can be tracked using this method in a clinical setting.

Use of nitinol self-expandable stents in 26 dogs with tracheal collapse.

A study was designed to describe a novel approach to the treatment of tracheal collapse (TC) in dogs using self-expandable nitinol stents. Medical records were reviewed retrospectively for 26 client owned dogs in which nitinol stents were deployed. The entire length of trachea was supported independently of the extent of TC. Two overlapping stents were used instead of one in cases where one stent was not spanning the entire trachea adequately. The diameter of the cranial radiolucent portion of trachea, just behind the cricoid cartilage, was measured as a specific landmark to select the appropriate size of the stent. Two self-expandable nitinol stents were inserted in 9 of 26 dogs; the trachea in the rest of the cases was supported with only one stent. A follow up tracheoscopy was performed in 10 of 26 cases with recurrent clinical signs. Secondary tracheal stenosis in these cases was caused by stent fracture, granuloma or excessive stent shortening. Additional stents were placed successfully to expand the stenotic lumen. A support of the entire trachea may decrease risk of nitinol fracture at the end of the implant. Long term clinical improvement (25 of 26 dogs, 96 %) is comparable with the results of other studies.

Des stents auto-expansifs en nitinol ont été utilisés pour traiter 26 chiens atteints de collapsus trachéal et les résultats ont été évalués rétrospectivement. La trachée a été renforcée sur toute sa longueur, indépendamment de la localisation du collapsus. Si aucun stent d'une longueur suffisante n'était disponible, on a utilisé deux stents se recouvrant pour dilater l'ensemble de la trachée. Le diamètre du stent a été choisi sur la base du diamètre de la trachée directement caudalement au cricoïde. Chez 9 des 26 patients, on a posé deux stents se recouvrant. Chez tous les autres patients, il a été possible de renforcer la trachée sur toute sa longueur au moyen d'un seul stent. On a procédé chez dix patients à une seconde trachéoscopie, car de nouveaux signes de collapsus trachéal étaient apparus. Une sténose trachéale secondaire a été constatée suite à une fracture du stent, à du tissus de granulation ou à un raccourcissement excessif du stent. Un stent supplémentaire a été placé avec succès, pour dilater la lumière trachéale rétrécie. Le renforcement de la trachée sur toute sa longueur peut diminuer le risque de fracture du stent à son extrémité. L'amélioration clinique à long terme obtenue chez 25 des 26 patients (96 %) est comparable aux résultats d'autres études.

In vitro biomechanical testing of a micro external skeletal fixator.

OBJECTIVE: To biomechanically test the properties of three different Universal Micro External Fixator (UMEX™) configurations with regard to their use in very small animals (<5kg) and compare the UMEX system to the widely used IMEX External Skeletal Fixation (SK™) system in terms of stiffness, space needed for pin placement and weight. METHODS: Three different UMEX configurations (type Ia, type Ib, and type II modified) and one SK configuration type Ia were used to stabilize Delrin plastic rods in a 1 cm fracture gap model. These constructs were tested in axial compression, craniocaudal bending, mediolateral bending, and torsion. Testing was conducted within the elastic range and mean stiffness in each mode was determined from the slope of the linear portion of the load-deformation curve. A Kruskal Wallis one-way analysis of variance on ranks test was utilized to assess differences between constructs (p <0.05). RESULTS: The UMEX type II modified configuration was significantly stiffer than the other UMEX configurations and the SK type Ia, except in craniocaudal bending, where the SK type Ia configuration was stiffer than all UMEX constructs. The UMEX type Ia configuration was significantly the weakest of those frames. The UMEX constructs were lighter and smaller than the SK, thus facilitating closer pin placement. CONCLUSIONS: Results supported previous reports concerning the superiority of more complex constructs regarding stiffness. The UMEX system appears to be a valid alternative for the treatment of long-bone fractures in very small animals.

Evaluation of peri-operative epidural analgesia with ropivacaine, ropivacaine and sufentanil, and ropivacaine, sufentanil and epinephrine in isoflurane anesthetized dogs undergoing tibial plateau levelling osteotomy.

The purpose of this study was to compare four epidural protocols for peri-operative analgesia in dogs undergoing tibial plateau levelling osteotomy. Forty client-owned dogs were randomly assigned to one of four treatments - groups R0.5 and R1 received 0.5mg/kg and 1mg/kg ropivacaine, respectively. Group SR0.5 received 1 µg/kg sufentanil plus 0.5mg/kg ropivacaine, and group SER0.5 received 1 µg/kg sufentanil, 0.5mg/kg ropivacaine plus 6 µg/kg epinephrine. Dilution, when required, was performed with saline, so that the injected volume was always 0.2 mL/kg. Intra-operatively, nociception assessment was based on the evaluation of changes in heart rate, respiratory rate and mean arterial pressure. Post-operative pain assessment was performed using the Glasgow visual analogue pain scale, and an ad hoc multifactorial pain score. Motor block was evaluated using a modified Bromage score. Intra-operatively, none of the animals was hypotensive. All groups except SER0.5 required rescue intra-operative fentanyl (40%, 30% and 40% of the animals in groups R0.5, R1 and SR0.5, respectively). Group SER0.5 showed lower post-operative pain scores, and group R1 significantly greater motor block, compared to the other treatment groups. None of the dogs had urinary retention. Epidural sufentanil-epinephrine-ropivacaine provided superior peri-operative analgesia compared to the other treatments, without producing clinically relevant side effects.

Ground reaction force profiles after partial and pancarpal arthrodesis in dogs.

OBJECTIVES: To evaluate and compare long-term functional outcome after partial carpal arthrodesis and pancarpal arthrodesis in dogs using kinetic gait analysis. METHODS: Fourteen dogs with 19 partial carpal or pancarpal arthrodeses were retrospectively examined and underwent force-plate gait analysis. Mean times since surgery were 29.4 and 24.4 months for pancarpal and partial carpal arthrodesis respectively. Vertical and braking-propulsive ground reaction force profiles were compared between treatment groups, and to those of normal dogs (control group) using Kruskal-Wallis one-way analysis of variance. RESULTS: With the exception of time to vertical peak that occurred earlier in dogs with pancarpal than in dogs with partial carpal arthrodesis (p <0.01), there was no difference between the two treatment groups. Several parameters differed significantly between operated and healthy dogs (p <0.01): vertical impulses were significantly lower in both treatment groups, braking forces and impulses were also reduced after both techniques. Propulsive forces and impulses were only reduced in dogs with pancarpal arthrodesis. When comparing gait parameters of sound limbs of unilateral operated dogs to those of control dogs, braking forces and impulses (p <0.01; p <0.05) were significantly higher in the sound legs of unilateral operated dogs. CLINICAL SIGNIFICANCE: Long-term outcome after partial carpal and pancarpal arthrodesis is good and comparable to each other. Propulsive action may be altered more in dogs with pancarpal arthrodesis.

Primary splenic peripheral nerve sheath tumour in a dog.

An 8-year-old crossbred dog was presented with a one-month history of progressive weakness, respiratory impairment and abdominal distension. Surgical exploration revealed the presence of a splenic mass that infiltrated the mesentery and was adherent to the stomach and pancreas. The mass was composed of highly cellular areas of spindle-shaped cells arranged in interlacing bundles, streams, whorls and storiform patterns (Antoni A pattern) and less cellular areas with more loosely arranged spindle to oval cells (Antoni B pattern). The majority of neoplastic cells expressed vimentin, S-100 and glial fibrillary acidic protein (GFAP), but did not express desmin, alpha-smooth muscle actin or factor VIII. These morphological and immunohistochemical findings characterized the lesion as a malignant peripheral nerve sheath tumour (PNST). Primary splenic PNST has not been documented previously in the dog.

Measurements of C-reactive protein in serum and lactate dehydrogenase in serum and synovial fluid of patients with osteoarthritis.

Diagnosis of osteoarthritis (OA) is based upon the clinical orthopaedic examination and the radiographic assessment, both of which can be non-specific and insensitive in early joint disease. The aim of our study was to investigate if there is an increase in serum levels of C-reactive protein (CRP) in degenerative joint disease (DJD) and if CRP could be used to help diagnose OA. We also wished to investigate whether it was possible to distinguish a joint with clinically and radiographically confirmed OA from a healthy joint by comparing lactate dehydrogenase (LDH) levels within the synovial fluid and the serum. We have shown a difference in synovial LDH levels between diseased and healthy joints (P<0.0001). There was also a significant difference between LDH in arthritic synovial fluid and serum, with no correlation between the values. Despite the fact that the values of our clinical patients tended to be higher than the values of our control group (P=0.05) all measured values were within the normal limits of previous publications. From these data, we conclude that single measurements of serum CRP do not permit detection of OA in clinical patients and that serum LDH is not a reliable marker for osteoarthritis. LDH levels in the synovial fluid could be of diagnostic value for identifying osteoarthritis.

Evaluation of different techniques for percutaneous needle biopsy of synovial membrane in the dog.

Four different needles were evaluated for percutaneous needle biopsy (PNB) of the synovial membrane (SM) in six different joints (carpus, tarsus, elbow, shoulder, stifle, hip) from eight dog cadavers. Needle biopsies were retrieved with the Parker-Pearson (PP), a novel modified Parker-Pearson (PPM), the Tru-Cut (TC), and the Franklin-Silverman (FS) needles. The success rate of PNB to produce biopsies, of adequate histological quality, was assessed for each needle type and joint. The joints were subsequently surgically opened and standard open SM biopsies were harvested from an adjacent area. The articular cartilage was inspected and graded for damage caused by PNB sampling. The length of the intact synovial lining cell layer (SLCL) and the histological quality of the needle biopsies were compared to the open surgical biopsies. Success rates for the different needles were 49.2% (PPM), 37.5% (PP), 26.7% (TC), and 1.7% (FS). The highest success rates were achieved in the carpus and stifle; the lowest success rate was found in the hip joint. The intact SLCL from the PNB samples was an average of 3.4 times shorter than that of the surgical biopsies. The proportion of the samples with adequate histological quality was 81% for open surgical biopsies and 62% for PNB samples. The FS was found to produce the highest incidence of articular cartilage damage. The application of PNB for SM sampling is a valuable alternative to the open surgical biopsy in dogs. Modifications of the Parker Pearson needle by Arassy and Schumacher and novel modifications introduced by the authors, offer encouraging results, and merit further clinical and research investigations.

Treatment of large distal extremity skin wounds with autogenous full-thickness mesh skin grafts in 5 cats.

Five cats with large, distal extremity abrasion wounds were treated with an autogenous, full-thickness, mesh skin graft. Survival of the mesh grafts in all five cats was considered between 90 and 100%. Successful grafting requires asepsis, an adequately prepared recipient bed consisting of healthy granulation tissue, proper harvesting and preparation of the graft, meticulous surgical technique and strict postoperative care. Factors that are essential for the survival of skin grafts include good contact between the graft and the recipient bed, normal tension on the sutured graft, strict immobilization after grafting and prevention of accumulation of blood or serum under the graft. Meshing the graft provides more graft flexibility over uneven surfaces and allows adequate drainage. In contrast to previous proposals, the authors recommend no bandage change before the fourth day after grafting. Full-thickness mesh skin grafting can be used to successfully treat large distal skin wounds in cats.

Treatment of temporary upward fixation of the patella in an alpaca by abrasion trochleoplasty and imbrication of the medial retinacular fascia.

A two-year-old female alpaca suddenly became lame on its right hindlimb. Eight days later clinical and radiographic examinations showed that the patella had become temporarily fixed within the supratrochlear notch of the femur. Under general anaesthesia an abrasion trochleoplasty followed by fascial imbrication was carried out. After two weeks in supporting slings, the animal put full weight on the leg, and six months after the surgery it showed no signs of lameness or recurrence of the upward fixation.

Urethral entrapment following pelvic fracture fixation in a dog.

An 18-month-old female crossbred dog was presented with a unilateral sacroiliac luxation and separation of the pelvic symphysis. Surgical correction of the luxation with screw fixation led to entrapment of the urethra between the symphyseal parts of the two hemipelves.

Spontaneous lumbar intervertebral disc protrusion in cats: literature review and case presentations.

Reports on intervertebral disc disease in cats are rare in the veterinary literature. It has been postulated that intervertebral disc protrusion is a frequent finding during necropsy in cats, without having any clinical relevance (King and Smith 1958, King & Smith 1960a, King & Smith 1960b). However, a total of six cases with disc protrusions and clinically significant neurological deficits have been reported over the past decade. (Heavner 1971, Seim & Nafe 1981, Gilmore 1983, Littlewood et al 1984, Sparkes & Skerry 1990, Bagley et al 1995). As in dogs, there are also two types of intervertebral disc disease in cats: Hansen's type I (extrusion), and type II (herniation). Cervical spinal cord involvement was more commonly recognised in cats than the lumbar or the thoraco lumbar area. Cats over 15 years were mainly affected (King & Smith 1958, King & Smith 1960a, King & Smith 1960b). We describe two cats with lumbar intervertebral disc protrusions. Emphasis is placed on differential diagnoses, treatment and follow-up.

[Bilateral idiopathic femur head epiphyseolysis ("slipped epiphysis") in cats: literature review and case description]. / Bilaterale idiopathische Femurkopfepiphyseolyse ("slipped epiphysis") bei der Katze: Literaturübersicht und Fallbeschreibung.

One case of a bilateral idiopathic slipped capital femoral epiphysis--"slipped epiphysis"--in a cat is described. The similarities and the differences between the cases in human and small animal medicine concerning the incidence, the hypotheses of the pathogenesis and the treatment options are discussed.

[Spinocellular epithelioma of the skin: etiology of the eczema syndrome in budgerigars (Melopsittacus undulatus) and lovebirds (Agapornis sp.)]. / Epithelioma spinozellulare der Haut: Aetiologie des Ekzem-Syndroms ("EMA-Syndrom") beim Wellensittich (Melopsittacus undulatus) und Unzertrennlichen (Agapornis sp.).

Squamous cell carcinoma in the axilla, unilaterally as well as bilaterally, is described pathologically in three love-birds and two budgerigars. The deep, hemorrhagic ulceration with secondary bacterial and/or mycotic infection corresponds to the "EMA-Syndrome".

[Celiotomy in tortoises: remedy of choice for dystocia (laying distress) and gastrointestinal foreign bodies]. / Cöliotomie bei der Landschildkröte: Mittel der Wahl bei Dystokie (Legenot) und gastrointestinalem Fremdkörper.

The radiological findings regarding eggs (variation in form, size, shell thickness, degree of calcification) combined with the clinical symptoms (Ca-Gluconate and Oxytocin application as well as unsuccessful labour contractions and constipation) set up the diagnosis of dystocia in the tortoise. Celiotomy is the remedy for cesarean section, ovariosalpingotomy and gastrointestinal foreign body. A large, topographically well-placed Plastron incision, separation and reposition of the m. pectoralis and m. obliquus internus abdominis using cross-stitch sutures, as well as the careful manipulation of tissues, are of great importance. Gastrotomy is even feasible on terrapins through a partial detachment of the stomach from the liver, enabling a sufficient presentation of the stomach.