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1.
Comp Med ; 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38902012

RESUMO

Tubulointerstitial fibrosis is a classic histologic feature of chronic kidney disease (CKD) in cats and a final common pathway toward end-stage renal disease. Domesticated cats have been used in models of ischemia-induced renal fibrosis. The objective of this study was to evaluate the performance of 2 variations of a transient unilateral renal ischemia and delayed contralateral nephrectomy model of tubulointerstitial fibrosis in cats. Purpose-bred, young adult, domesticated cats underwent 90 min of surgically induced ischemia to the right kidney followed by delayed contralateral nephrectomy performed 21 d (RI-CN21d group; n = 10) or 90 d postischemia (RI-CN90d group; n = 12). Control cats underwent sham surgery followed by left nephrectomy 21 d after (sham-CN group; n = 3). Renal functional parameters, including glomerular filtration rate and serum creatinine concentration, were evaluated before and after surgeries. The right kidneys were harvested 120 d postischemia/sham. Renal histology with lesion scoring and histomorphometry for quantification of smooth muscle actin immunolabeling and collagen staining were performed on harvested kidneys. Severe acute kidney injury prompted euthanasia after left nephrectomy in 5/10 (50.0%), 2/12 (16.7%), and 0/3 (0%) of cats in the RI-CN21d, RI-CN90d, and sham-CN groups, respectively. A significant decrease in glomerular filtration rate by day 120, relative to baseline, occurred in cats in the RI-CN21d group (P < 0.001) and RI-CN90d group (P < 0.001) but not the sham-CN group (P = 0.76). All but one cat in the ischemia groups were azotemic at the study end. Kidneys subjected to ischemia had higher interstitial inflammation, tubular atrophy, and fibrosis scores compared with sham-operated kidneys. There were significant increases in smooth muscle actin immunolabeling and collagen staining in these kidneys, relative to the contralateral kidneys. In summary, 90 min of unilateral renal ischemia and delayed contralateral nephrectomy induced histologic and biochemical changes consistent with CKD in cats. A 90-d period between ischemia and nephrectomy resulted in improved survivability of the model.

2.
J Am Vet Med Assoc ; 262(9): 1251-1258, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38823414

RESUMO

OBJECTIVE: To retrospectively describe clinical characteristics of canine gastrointestinal foreign bodies (GIFB) that were successfully and unsuccessfully managed conservatively. ANIMALS: 68 client-owned dogs presented to the Texas A&M Small Animal Teaching Hospital between January 1, 2018, and October 1, 2023, for GIFB where medical management was attempted. CLINICAL PRESENTATION: Medical records were reviewed for signalment, history, physical examination, bloodwork, diagnostic imaging, foreign body type, location, treatments, and outcome. Success was defined as the passage of the foreign body through the colon, while failure was defined as requiring surgery, endoscopy, or euthanasia. RESULTS: Medical management was successful in 32 cases (47%; 95% CI, 0.32 to 0.66). Gastric dilation resolved in all success cases (n = 5 [100%]; 95% CI, 0.32 to 2.3) but did not resolve in any failure cases (13 [0%]). Small intestinal dilation resolved in all success cases (n = 13 [100%]; 95% CI, 0.53 to 1.7) but progressed in most failure cases (9 [75%]; 95% CI, 0.34 to 1.4). In the success group, 31 GIFB were nonlinear (96.9%; 95% CI, 0.66 to 1.4), while 1 was linear (3.1%; 95% CI, 0.001 to 0.17). In the failure group, 29 GIFB were nonlinear (80.6%; 95% CI, 0.54 to 1.16), while 7 were linear (19.4%; 95% CI, 0.08 to 0.4). Of the cases that elected surgery (n = 29 [42.7%]; 95% CI, 0.29 to 0.61), resection and anastomosis was performed in 3 cases (10.3%; 95% CI, 0.02 to 0.3). All cases that required resection and anastomosis were nonlinear GIFB. CLINICAL RELEVANCE: Conservative management of GIFB provides a feasible treatment option and may be considered based on presentation, foreign body location, hemodynamic stability of the patient, diagnostic imaging, and type of foreign body.


Assuntos
Doenças do Cão , Corpos Estranhos , Animais , Cães , Corpos Estranhos/veterinária , Corpos Estranhos/terapia , Corpos Estranhos/cirurgia , Doenças do Cão/terapia , Doenças do Cão/cirurgia , Estudos Retrospectivos , Feminino , Masculino , Resultado do Tratamento , Trato Gastrointestinal/cirurgia
3.
J Am Vet Med Assoc ; 262(7): 1-6, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38569535

RESUMO

OBJECTIVE: To describe short-term outcomes of dogs and cats undergoing surgery for traumatic bile peritonitis. ANIMALS: 13 dogs and 4 cats. METHODS: Multi-institutional, retrospective study. Medical records from 6 institutions were reviewed for cases of traumatic bile peritonitis between 2006 and 2022. Clinical presentation, additional injuries, surgical treatment, and outcome were recorded. RESULTS: Trauma occurred a median of 2 (range, 1 to 22) and 4 (range, 1 to 22) days prior to presentation in dogs and cats, respectively. Total bilirubin was increased in 11 of 13 dogs and 2 of 4 cats. Rupture occurred at the common bile duct (CBD) in 10 dogs and 1 cat, gallbladder in 3 dogs, cystic duct in 2 cats, and hepatic duct in 1 dog and 1 cat. The most common surgeries were cholecystoduodenostomy and CBD repair in dogs and cholecystectomy in cats. Eleven of 13 dogs and all cats survived to hospital discharge (88.2% overall survival). Median follow-up in surviving dogs and cats was 35 days (range, 14 to 401) and 30 days (range, 14 to 90), respectively. One dog that underwent cholecystectomy experienced recurrent bile peritonitis 20 days postoperatively. Short-term survival following surgical treatment of traumatic bile peritonitis was excellent and recurrence appears uncommon. The most frequent site of rupture was the CBD in dogs and the cystic duct in cats. CLINICAL RELEVANCE: Measurement of peritoneal bilirubin should be considered in dogs and cats with peritoneal effusion following trauma. Surgeons should be prepared to identify and address ruptures in locations other than the gallbladder.


Assuntos
Doenças do Gato , Doenças do Cão , Peritonite , Animais , Cães , Gatos , Doenças do Cão/cirurgia , Doenças do Cão/diagnóstico , Doenças do Gato/cirurgia , Doenças do Gato/diagnóstico , Estudos Retrospectivos , Peritonite/veterinária , Peritonite/cirurgia , Peritonite/diagnóstico , Masculino , Feminino
4.
Am J Vet Res ; 84(12)2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38039627

RESUMO

OBJECTIVE: To evaluate skin perfusion in cats receiving dexmedetomidine compared to a placebo. ANIMALS: 9 healthy adult research cats. METHODS: A randomized, blinded, placebo-controlled study design was used. Two sites, the dorsal metatarsus (site: limb) and lateral flank (site: flank), were evaluated with laser speckle contrast imaging (LSCI) at baseline and following administration of dexmedetomidine (1, 3, or 5 mcg/kg, IV) or a placebo (0.9% saline, IV). Mean speckle contrast (MSC), a surrogate for perfusion, was obtained from LSCI and compared between treatments. Heart rate, sedation score, and body temperature were recorded. Skin perfusion to the flank and limb, reported as MSC, was assessed via LSCI at baseline and at 5, 10, and 15 minutes posttreatment. RESULTS: There was a significant decrease in heart rate (P < .001) in cats receiving 1, 3, and 5 mcg/kg dexmedetomidine compared to placebo. There was a significant increase in median sedation score at all time points postsedation compared to baseline (P < .018). Changes in MSC for the metatarsus were not significantly different between treatments at any time point (P = .12). For the flank, MSC was significantly higher for cats treated with dexmedetomidine compared to baseline (P ≤ .01). Skin perfusion to the flank decreased as early as 5 minutes posttreatment with dexmedetomidine and persisted for at least 15 minutes, regardless of dexmedetomidine dose. CLINICAL RELEVANCE: Dexmedetomidine decreased skin perfusion in cats, even at low doses. Veterinarians may elect for an alternative sedative medication when decreased skin perfusion is a concern.


Assuntos
Dexmedetomidina , Gatos , Animais , Dexmedetomidina/farmacologia , Hipnóticos e Sedativos/farmacologia , Frequência Cardíaca , Perfusão/veterinária
5.
J Am Vet Med Assoc ; 261(12): 1-9, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-37734721

RESUMO

OBJECTIVE: To conduct a retrospective multi-institutional study reporting short- and long-term outcomes of adrenalectomy in patients presenting with acute hemorrhage secondary to spontaneous adrenal rupture. ANIMALS: 59 dogs and 3 cats. METHODS: Medical records of dogs and cats undergoing adrenalectomy between 2000 and 2021 for ruptured adrenal masses were reviewed. Data collected included clinical presentation, preoperative diagnostics, surgical report, anesthesia and hospitalization findings, histopathology, adjuvant treatments, and long-term outcome (recurrence, metastasis, and survival). RESULTS: Median time from hospital admission to surgery was 3 days, with 34% of surgeries being performed emergently (within 1 day of presentation). Need for intraoperative blood transfusion was significantly associated with emergent surgery and presence of active intraoperative hemorrhage. The short-term (≤ 14 days) complication and mortality rates were 42% and 21%, respectively. Negative prognostic factors for short-term survival included emergent surgery, intraoperative hypotension, and performing additional surgical procedures. Diagnoses included adrenocortical neoplasia (malignant [41%], benign [12%], and undetermined [5%]), pheochromocytoma (38%), a single case of adrenal fibrosis and hemorrhage (2%), and a single case of hemangiosarcoma (2%). Local recurrence and metastasis of adrenocortical carcinoma were confirmed in 1 and 3 cases, respectively. Overall median survival time was 574 days and 900 days when short-term mortality was censored. No significant relationship was found between histopathological diagnosis and survival. CLINICAL RELEVANCE: Adrenalectomy for ruptured adrenal gland masses was associated with similar short- and long-term outcomes as compared with previously reported nonruptured cases. If hemodynamic stability can be achieved, delaying surgery and limiting additional procedures appear indicated to optimize short-term survival.


Assuntos
Neoplasias do Córtex Suprarrenal , Neoplasias das Glândulas Suprarrenais , Doenças do Gato , Doenças do Cão , Hemorragia , Laparoscopia , Animais , Gatos , Cães , Humanos , Neoplasias do Córtex Suprarrenal/complicações , Neoplasias do Córtex Suprarrenal/cirurgia , Neoplasias do Córtex Suprarrenal/veterinária , Neoplasias das Glândulas Suprarrenais/complicações , Neoplasias das Glândulas Suprarrenais/cirurgia , Neoplasias das Glândulas Suprarrenais/veterinária , Adrenalectomia/veterinária , Adrenalectomia/efeitos adversos , Adrenalectomia/métodos , Doenças do Gato/cirurgia , Doenças do Cão/patologia , Hemorragia/veterinária , Laparoscopia/veterinária , Estudos Retrospectivos , Ruptura Espontânea/veterinária , Resultado do Tratamento
6.
Vet Surg ; 52(1): 127-133, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36413335

RESUMO

OBJECTIVE: To report outcomes following surgical treatment of hepatic abscessation in dogs. STUDY DESIGN: Retrospective. ANIMALS: Thirty-eight dogs. METHODS: Records from 6 institutions were evaluated for dogs undergoing surgical treatment for hepatic abscessation between 2010 and 2020. Signalment, clinical signs, medical therapy, surgical treatment, and postoperative outcome was obtained from medical records. Long-term outcome was recorded when possible. Median survival time was assessed using the Kaplan-Meier product-limit method. RESULTS: Peritoneal effusion was documented in 32/38 dogs preoperatively, with septic peritonitis confirmed in 21/23 samples. Liver lobectomy was the most common surgery (27 dogs). A single organism was cultured in 24/35 dogs, most commonly Escherichia coli. Hepatic neoplasia was identified in 11/36 dogs. Dogs were hospitalized for a median of 5 days (range, 3-17) with complications recorded in 21 dogs (regurgitation, aspiration pneumonia, and pancreatitis most commonly). Two dogs died intraoperatively, and 6 dogs died prior to discharge. Median survival time for dogs surviving to discharge was 638 days. Of these, 19 were lost to follow up a median of 301 (range, 3-1418) days postoperatively and 11 died a median of 291 (range, 7-1292) days postoperatively. No abscess recurrence was noted. CONCLUSION: Septic peritonitis was a common sequela to hepatic abscessation. Perioperative complications were recorded in approximately one-third of dogs. In dogs surviving the postoperative period, long-term prognosis was good. CLINICAL SIGNIFICANCE: Dogs treated surgically for hepatic abscessation have a high risk of perioperative complications but favorable long-term prognosis and apparent low risk of recurrence.


Assuntos
Doenças do Cão , Neoplasias Hepáticas , Peritonite , Cães , Animais , Estudos Retrospectivos , Prognóstico , Neoplasias Hepáticas/veterinária , Período Pós-Operatório , Peritonite/veterinária , Doenças do Cão/cirurgia , Resultado do Tratamento
7.
J Am Anim Hosp Assoc ; 58(6): 309-313, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36315863

RESUMO

A 7 mo old intact male Australian cattle dog presented for evaluation of a suspected urethrorectal fistula after being examined by the primary veterinarian for leaking of urine from the rectum at rest and when posturing to urinate. Advanced imaging identified a caudally retroflexed urinary bladder, several healing pelvic fractures, and a rectovesicular fistula. Primary surgical repair of the fistula was performed. The dog recovered well from surgery and was urinating and defecating normally as of 5 mo after the operation. This is the first report of a traumatic rectovesicular fistula in the veterinary literature.


Assuntos
Doenças dos Bovinos , Doenças do Cão , Fraturas Ósseas , Fístula Retal , Doenças Uretrais , Fístula Urinária , Bovinos , Cães , Masculino , Animais , Doenças do Cão/diagnóstico , Doenças do Cão/cirurgia , Austrália , Fístula Urinária/cirurgia , Fístula Urinária/veterinária , Doenças Uretrais/diagnóstico , Doenças Uretrais/cirurgia , Doenças Uretrais/veterinária , Fístula Retal/diagnóstico , Fístula Retal/cirurgia , Fístula Retal/veterinária , Fraturas Ósseas/veterinária
8.
JFMS Open Rep ; 8(2): 20551169221118554, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36046120

RESUMO

Case summary: A 3-month-old intact male domestic shorthair kitten's cervical region was inadvertently punctured during routine subcutaneous fluid administration. A swelling rapidly developed on the left lateral neck and continued to grow, despite compression. An emergency facility evaluated the kitten 48 h later and the swelling was determined to be blood. Fine-needle aspiration of the swelling resulted in further swelling of the mass on the neck. The kitten began showing signs of systemic shock, necessitating a blood transfusion. The kitten was referred to a tertiary facility 24 h later for further diagnostics and treatment. CT of the head and neck revealed a large fluid-filled mass with progressive contrast enhancement noted during the filling phase, consistent with active hemorrhage. A carotid pseudoaneurysm was suspected and surgery was recommended. The left carotid artery was ligated proximal to the pseudoaneurysm; hemorrhage continued and the swelling was further explored. A small connection to the carotid artery within the medial aspect of the swelling was identified and ligated. The kitten required autotransfusion and massive allotransfusion during surgery due to blood loss. Recovery was uneventful. A head tilt and Horner's syndrome were noted postoperatively and improved over the following months. Histopathology was consistent with pseudoaneurysm. Relevance and novel information: This is the first reported case of pseudoaneurysm in a kitten that was treated surgically, with massive blood transfusion and minimal complications. Early surgical intervention can result in excellent prognosis. The need for blood product administration should be anticipated.

10.
J Am Vet Med Assoc ; 260(7): 758-764, 2022 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-35201999

RESUMO

OBJECTIVE: To determine the outcome in dogs diagnosed with congenital extrahepatic portosystemic shunts (EHPSS) at ≥ 5 years of age treated with medical management only (M) or with surgical attenuation (S). The hypothesis was that dogs undergoing surgical attenuation would have a longer survival time than dogs undergoing medical management only. ANIMALS: 351 dogs definitively diagnosed with EHPSS at ≥ 5 years of age. PROCEDURES: Medical records from 2009 to 2019 at 16 veterinary teaching hospitals were evaluated. Data collected included signalment, clinical signs at diagnosis, clinicopathologic data, surgical and medical treatments, shunt morphology, clinical signs and medical treatments at 6 to 12 months after diagnosis, and survival time. RESULTS: 351 dogs (M, 119 [33.9%]; S, 232 [66.1%]) were included in the study. Survival time was longer with surgery than medical management (hazard ratio, 4.2; M, 3.4 years; S, 10.9 years). Continued clinical signs at 6 to 12 months after diagnosis were more common with medical management (M, 40% [33/88]; S, 14% [21/155]). Continued medical treatments at 6 to 12 months after diagnosis were more common in the medical management group (M, 78% [69/88]; S, 34% [53/155]). Perioperative mortality rate was 7.3%. CLINICAL RELEVANCE: Dogs diagnosed at ≥ 5 years of age with EHPSS have significantly better survival times and fewer clinical signs with surgical attenuation, compared with medical management. Older dogs have similar surgical mortality rates to dogs of all ages after surgical EHPSS attenuation.


Assuntos
Doenças do Cão , Derivação Portossistêmica Transjugular Intra-Hepática , Animais , Doenças do Cão/diagnóstico , Doenças do Cão/tratamento farmacológico , Doenças do Cão/cirurgia , Cães , Sistema Porta/anormalidades , Sistema Porta/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática/veterinária , Estudos Retrospectivos
11.
Vet Surg ; 51(3): 438-446, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35141905

RESUMO

OBJECTIVE: To report data related to the short- and long-term survival of dogs undergoing adrenalectomy for pheochromocytoma, and to determine the influence of preoperative alpha-blocker therapy. STUDY DESIGN: Retrospective. ANIMALS: Fifty-three dogs. METHODS: Medical records were reviewed for dogs diagnosed with pheochromocytoma and treated with adrenalectomy between 2010 and 2020. Preoperative management, imaging studies, intraoperative cardiovascular instability, complications, and procedural information were recorded. When applicable, duration of survival and cause of death, time to recurrence or metastasis, and postoperative complications were recorded. RESULTS: During anesthesia, a hypertensive episode was documented in 46/53 dogs and arrhythmias were recorded in 16/53 dogs. Of these, 37/46 hypertensive dogs and 11/16 dogs with arrhythmias were treated with an alpha-blocker before surgery. Intraoperative systolic blood pressures reached higher levels by a magnitude of nearly 20% in dogs that were treated preoperatively with an alpha-blocker (P = .01). All dogs survived surgery and 44 survived to discharge. Follow up ranged from 6 to 1653 days (median 450 days). Median survival time for dogs discharged from the hospital was 1169 days (3.2 years). Recurrence and metastasis were suspected in 3 and 8 dogs, respectively. CONCLUSION: Most dogs survived the immediate postoperative period and achieved long-term survival with a low reported incidence of tumor recurrence or metastasis. Preoperative alpha-blocker therapy was not associated with increased survival. CLINICAL SIGNIFICANCE: The favorable outcomes reported in this study should be taken into consideration when discussing treatment options for dogs with pheochromocytomas. This study provides no evidence to support preoperative alpha-blocker therapy.


Assuntos
Neoplasias das Glândulas Suprarrenais , Doenças do Cão , Feocromocitoma , Neoplasias das Glândulas Suprarrenais/tratamento farmacológico , Neoplasias das Glândulas Suprarrenais/cirurgia , Neoplasias das Glândulas Suprarrenais/veterinária , Adrenalectomia/métodos , Adrenalectomia/veterinária , Animais , Doenças do Cão/tratamento farmacológico , Doenças do Cão/cirurgia , Cães , Feocromocitoma/tratamento farmacológico , Feocromocitoma/cirurgia , Feocromocitoma/veterinária , Complicações Pós-Operatórias/veterinária , Estudos Retrospectivos , Resultado do Tratamento
12.
Vet Surg ; 51(3): 418-425, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35006627

RESUMO

OBJECTIVE: To determine the incidence of and risk factors for surgical site infection (SSI) following canine thoracic and pelvic limb amputations. STUDY DESIGN: Retrospective, multicenter study. ANIMALS: Dogs (n = 248). METHODS: Medical records were reviewed for preoperative, intraoperative, and postoperative variables including indication for amputation, amputation type, method of muscle transection, duration of surgery and anesthesia, and wound classification. Follow up was ≥30 days or until SSI development. Logistic regression and Fisher's exact tests were used to compare SSI incidence to variables of interest. RESULTS: The incidence of SSI was 12.5% for all procedures and 10.9% for clean procedures. Factors increasing odds of SSI were muscle transection with a bipolar vessel sealing device (P = .023 for all procedures, P = .025 for clean procedures), procedure classified as other than clean (P = .003), and indication for amputation of bacterial infection (P = .041) or traumatic injury (P = .003) compared to neoplasia. CONCLUSION: Use of bipolar vessel sealing devices for muscle transection increased the odds of developing an SSI whereas use of electrosurgery and/or sharp transection did not. Dogs with surgical sites that were other than clean, or with bacterial infection and/or traumatic injury were also at increased odds of SSI. CLINICAL SIGNIFICANCE: Use of electrosurgery or sharp transection for muscle transection should be considered rather than use of bipolar vessel sealing devices to decrease odds of SSI in dogs undergoing limb amputation. Further studies across a variety of procedures are needed to validate these findings given the increasing popularity of these devices in veterinary medicine.


Assuntos
Doenças do Cão , Infecção da Ferida Cirúrgica , Amputação Cirúrgica/efeitos adversos , Amputação Cirúrgica/veterinária , Animais , Doenças do Cão/epidemiologia , Doenças do Cão/etiologia , Doenças do Cão/cirurgia , Cães , Incidência , Estudos Retrospectivos , Fatores de Risco , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/veterinária
13.
J Am Vet Med Assoc ; 259(12): 1416-1421, 2021 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-34757939

RESUMO

OBJECTIVE: To compare bacteriologic culture results for superficial swab and tissue biopsy specimens obtained from dogs with open skin wounds. ANIMALS: 52 client-owned dogs. PROCEDURES: For each dog, 1 wound underwent routine preparation prior to collection of 2 specimens, 1 by superficial swab (Levine) technique and 1 by tissue biopsy. Specimens were processed for bacteriologic culture. Two observers determined whether any detected difference in culture results for the 2 types of specimen would have resulted in differing treatment plans. RESULTS: Culture results of swab and tissue biopsy specimens were identical in 11/52 (21.2%) cases. Tissue biopsy specimen and swab cultures yielded positive results for 44 (84.6%) and 40 (76.9%) wounds, respectively. With regard to mean recovery rates of bacteria from wounds with positive culture results, both the biopsy specimens and swabs yielded 3.4 bacterial species/wound. All wounds for which swab cultures yielded no growth also had negative culture results for biopsy specimens. Biopsy specimen and swab culture results were in agreement with regard to the most common bacteria cultured. In 7/52 (13%) wounds, the observers would have treated the patient differently on the basis of the results of the 2 cultures. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that culture of a swab collected by the Levine technique is an appropriate noninvasive alternative to culture of a tissue biopsy specimen. A negative result obtained from culture of a swab is likely to be reliable. Disagreement between the results of swab and tissue biopsy specimen cultures is likely of low clinical importance.


Assuntos
Doenças do Cão , Infecção dos Ferimentos , Animais , Biópsia/veterinária , Doenças do Cão/diagnóstico , Cães , Manejo de Espécimes/veterinária , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia , Infecção dos Ferimentos/patologia , Infecção dos Ferimentos/veterinária
14.
Vet Surg ; 50(3): 494-506, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33565116

RESUMO

OBJECTIVE: The goal of this study was to evaluate and report details of a remotely taught surgical laboratory. STUDY DESIGN: Observational. SAMPLE POPULATION: Second-year veterinary students (n = 143) enrolled in a surgical laboratory; 9 weeks were taught traditionally, and 6 weeks were taught remotely. METHODS: Because of the global pandemic, remote laboratories were developed and delivered. Students performed surgical procedures in model organs remotely while being observed by and receiving feedback from instructors on an internet-based video platform. Methods for remote surgical teaching were explored, and successes and challenges were detailed. Surveys were administered to the students and faculty to gather perspectives on their experience and subsequent confidence. RESULTS: Surveys were completed by 81 of 143 (57%) students and seven of seven (100%) instructors. The mean overall student satisfaction score (1 not at all satisfied, 10 very satisfied) for in-person instruction was 8.2, and the mean score for remote instruction was 6.2 (P < .001). Overall, the instructors had a mean satisfaction score of 8 for in-person laboratories and a mean satisfaction score of 6 for remotely taught laboratories. Most students had a perception of greater one-on-one instructor attention in remote laboratories. Students reported similar confidence levels for three surgical procedures. CONCLUSION: The described remote teaching method resulted in the perception of greater instructor attention given to students. Student and instructor satisfaction was lower with remote teaching than with in-person teaching. IMPACT: The described method of remote teaching may be applied to teaching surgical students in settings when face-to-face instruction cannot be achieved and may be developed further to create an experience equivalent to face-to-face instruction.


Assuntos
Estudantes/estatística & dados numéricos , Cirurgia Veterinária/educação , Teletrabalho/estatística & dados numéricos , COVID-19/epidemiologia , Pandemias
15.
J Am Vet Med Assoc ; 258(2): 186-191, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33405984

RESUMO

CASE DESCRIPTION: As a result of vehicular trauma, a 3-year-old neutered male domestic shorthair cat sustained luxation of the sacrocaudal joint and a urethral tear. CLINICAL FINDINGS: Retrograde contrast urethrocystography revealed a urethral tear at the level of the ischiatic tuberosity. Conservative treatment for 7 days with a urethral catheter was unsuccessful. TREATMENT AND OUTCOME: An approach for a perineal urethrostomy was performed and revealed a large urethral tear (4 mm in length in a craniocaudal orientation and encompassing approx 50% of the urethral circumference) proximal to the bulbourethral glands. Urethroplasty was performed with a graft of a rectangular section of single-layer porcine small intestinal submucosa. Perineal urethrostomy was then completed routinely, and a urethral catheter was left in place for 5 days. Two days after removal of the urethral catheter, stranguria was noted. Retrograde contrast urethrocystography revealed a urethral stricture. Balloon dilation of the urethral stricture was performed, and the cat's stranguria improved. Ten weeks following balloon dilation, the cat developed hematuria, and a urinary tract infection and urethral stricture were diagnosed. Balloon dilation was repeated with instillation of triamcinolone solution at the stricture site. Eighteen months later (approx 21 months after the initial surgery), the cat was urinating normally. CLINICAL RELEVANCE: The outcome for the cat of this report indicated that porcine small intestinal submucosa may be used to successfully augment urethroplasty for treatment of traumatic urethral tears in cats. Urethral balloon dilation with triamcinolone instillation may be used to treat postoperative urethral strictures.


Assuntos
Doenças do Gato , Doenças dos Suínos , Estreitamento Uretral , Animais , Doenças do Gato/cirurgia , Cateterismo/veterinária , Gatos , Dilatação/veterinária , Masculino , Suínos , Resultado do Tratamento , Uretra/cirurgia , Estreitamento Uretral/cirurgia , Estreitamento Uretral/veterinária , Procedimentos Cirúrgicos Urológicos/veterinária
16.
Vet Surg ; 49(8): 1497-1502, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32853422

RESUMO

OBJECTIVE: To describe the technique, outcome, and owner satisfaction associated with dorsal offset rhinoplasty (DOR) to treat stenotic nares in brachycephalic dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Thirty-four client-owned dogs. METHODS: Medical records of dogs treated with DOR at a veterinary teaching hospital over a 6-year period were identified. Dorsal offset rhinoplasty was defined as removal of a dorsal wedge of nasal planum from each naris with apposition of the rostral abaxial tissue to the caudal axial tissue, resulting in translocation of the alar cartilage in both median and dorsal planes. Immediate and postoperative complications were recorded. Owners were asked to report any complications with healing of the nares and to score their satisfaction with the appearance of the nares. RESULTS: Thirty-four dogs met the inclusion criteria. Twenty-nine (85%) dogs were examined a median of 402.5 days (range, 23-2042) postoperatively, with no major complications related to the rhinoplasty recorded. Eighteen owners responded a median of 701 days (range, 37-1622) postoperatively. One owner reported that self-trauma led to collapse of one naris. One owner reported collapse of both nares within 4 years; timing and cause were unknown. Sixteen of 17 responding owners reported that they were very satisfied with the outcome of the rhinoplasty. The owner of the dog with the collapsed naris was very unsatisfied. One owner did not provide a satisfaction score. CONCLUSION: Owners were generally highly satisfied with DOR, and complications were uncommon. CLINICAL SIGNIFICANCE: This report describes an alternate technique to treat stenotic nares.


Assuntos
Constrição Patológica/veterinária , Doenças do Cão/cirurgia , Cavidade Nasal/cirurgia , Rinoplastia/veterinária , Animais , Constrição Patológica/cirurgia , Craniossinostoses/patologia , Cães , Feminino , Masculino
17.
J Am Vet Med Assoc ; 256(11): 1257-1261, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32412871

RESUMO

CASE DESCRIPTION: A 4-year-old spayed female French Bulldog was referred for treatment of a suspected right-sided nasal angiofibroma associated with a 4-month history of unilateral nasal discharge and stertor. CLINICAL FINDINGS: The dog appeared healthy other than right-sided mucoid debris and decreased airflow through the right naris. The dog was anesthetized, and a large intranasal mass was observed obstructing the right nasal passage and abutting the nasal septum. TREATMENT AND OUTCOME: A lateral rhinotomy was performed, and rigid endoscopes (0° and 30°) were used to examine the right nasal cavity. The mass filled the anterior aspect of the nasal cavity and involved a portion of the nasal turbinates with some erosion. A coblation unit was used to ablate tumor tissue laterally to remove the tumor in piecemeal fashion. Recovery was routine with only minor epistaxis after surgery, and the dog was discharged the next day. Eight months after surgery, follow-up CT revealed right-sided nasal turbinate and conchal atrophy consistent with prior mass ablation. No macroscopic recurrence was detected, and the owners reported only rare, clear rhinorrhea. CLINICAL RELEVANCE: Findings suggested that coblation may be an alternative to radiation therapy for vascular tumors with minimal invasion and low metastatic potential.


Assuntos
Doenças do Cão , Hamartoma , Neoplasias Nasais , Animais , Doenças do Cão/cirurgia , Cães , Epistaxe/veterinária , Feminino , Hamartoma/cirurgia , Hamartoma/veterinária , Recidiva Local de Neoplasia/veterinária , Neoplasias Nasais/cirurgia , Neoplasias Nasais/veterinária , Conchas Nasais/cirurgia
18.
J Feline Med Surg ; 22(12): 1238-1242, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32175790

RESUMO

OBJECTIVES: Brachycephalic obstructive airway syndrome (BOAS) is a common cause of upper airway obstruction in dogs, but is appreciated less commonly in cats. Of the components of BOAS, stenotic nares appear to play a major role in cats. However, the axial deviation of the alar wing, a common cause of nasal obstruction in dogs, is typically not present. We report a series of brachycephalic cats with a ventral nasal obstruction resulting from redundant skin along the floor of the nares. In these cats, surgical techniques developed for dogs were felt to be suboptimal. Our aim is to describe a novel surgical procedure designed specifically to surgically correct stenotic nares in cats with an obstructive fold of skin ventral to the nostril. METHODS: Five brachycephalic cats presenting for clinical signs of stenotic nares underwent surgical repair. In each case, a resection of the skin fold followed by a bilateral single pedicle advancement flap technique was performed. Postoperative outcomes were obtained by contacting owners by telephone. RESULTS: All cats had positive outcomes, resulting in immediate reduction of the nasal fold and opening of the nares. Owners noted resolution of stertor and no episodes of respiratory distress. No surgical complications were reported. CONCLUSIONS AND RELEVANCE: In brachycephalic cats, the ventral skin fold may be a significant contributor to stenotic nares, unlike dogs. Resection of the skin fold, followed by bilateral single pedicle advancement flaps is a novel technique and appeared to be successful for treating stenotic nares in this series of brachycephalic cats.


Assuntos
Obstrução das Vias Respiratórias/veterinária , Doenças do Gato/cirurgia , Constrição Patológica/veterinária , Craniossinostoses/veterinária , Retalhos Cirúrgicos/veterinária , Obstrução das Vias Respiratórias/cirurgia , Animais , Gatos , Constrição Patológica/cirurgia , Craniossinostoses/cirurgia , Feminino , Masculino , Cavidade Nasal/patologia , Cavidade Nasal/cirurgia , Retalhos Cirúrgicos/cirurgia
19.
Am J Vet Res ; 80(9): 885-890, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31449451

RESUMO

OBJECTIVE: To characterize abdominal lymphatic drainage in cats after thoracic duct ligation (TDL) and cisterna chyli ablation (CCA). ANIMALS: 7 purpose-bred research cats. PROCEDURES: Baseline CT lymphangiography was performed. A popliteal lymph node was injected with iohexol, and images were acquired at 5-minute intervals for 15 minutes. Cats underwent TDL and CCA; methylene blue was used to aid in identifying lymphatic vessels. The CT lymphangiography was repeated immediately after and 30 days after surgery. All cats were euthanized and necropsied. RESULTS: Results of baseline CT lymphangiography were unremarkable for all 7 cats. Only 5 cats completed the study. Leakage of contrast medium at the level of the cisterna chyli was seen on CT lymphangiography images obtained from all cats immediately after surgery. Evaluation of 30-day postoperative CT lymphangiography images revealed small branches entering the caudal vena cava in 2 cats, leakage of contrast medium into the caudal vena cava with no visible branches in 1 cat, and no contrast medium in the caudal vena cava in 2 cats. Contrast medium did not flow beyond the level of the cisterna chyli in any cat. Gross examination during necropsy revealed that all cats had small lymphatic vessels that appeared to connect to local vasculature identified in the region of the cisterna chyli. CONCLUSIONS AND CLINICAL RELEVANCE: Abdominal lymphaticovenous anastomoses formed after TDL and CCA in cats. This would support use of these procedures for treatment of cats with idiopathic chylothorax, although additional studies with clinically affected cats are warranted.


Assuntos
Gatos/cirurgia , Drenagem , Linfografia/veterinária , Ducto Torácico/cirurgia , Abdome , Animais , Quilotórax , Meios de Contraste , Iohexol/administração & dosagem , Ligadura , Linfonodos , Masculino
20.
Vet Pathol ; 56(4): 536-543, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30895907

RESUMO

Previous work demonstrated renal fibrosis 70 days after a single unilateral in vivo renal ischemic event, but changes associated with a single episode of renal ischemia past this time are unknown. In this study, we evaluated renal function and structural changes 6 months after a 90-minute in vivo unilateral renal ischemic event. Six adult female cats underwent unilateral renal ischemia and renal function was followed for 6 months, at which time the kidneys were evaluated by histology and histomorphometry. Over time, there was a significant reduction in the glomerular filtration rate and an elevation of serum creatinine of 31% and 42%, respectively. All cats had tubulointerstitial lesions characterized by segmental interstitial inflammation, tubular atrophy, and interstitial fibrosis. Unlike short-term studies, ischemic kidneys had variable numbers of obsolescent glomeruli, consistent with the development of atubular glomeruli and subsequent ischemic glomerulosclerosis. Chronic changes associated with acute renal ischemia may include loss of function and glomerulosclerosis.


Assuntos
Doenças do Gato/patologia , Fibrose/veterinária , Glomerulosclerose Segmentar e Focal/veterinária , Isquemia/veterinária , Insuficiência Renal Crônica/veterinária , Animais , Gatos , Creatinina/sangue , Feminino , Fibrose/etiologia , Fibrose/patologia , Taxa de Filtração Glomerular/veterinária , Glomerulosclerose Segmentar e Focal/etiologia , Glomerulosclerose Segmentar e Focal/patologia , Inflamação/veterinária , Isquemia/complicações , Isquemia/patologia , Rim/irrigação sanguínea , Rim/patologia , Glomérulos Renais/irrigação sanguínea , Glomérulos Renais/patologia , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/patologia
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