Billroth II procedure for the treatment of spontaneous gastrointestinal perforation in two cats.

CASE DESCRIPTION: A 9-year-old castrated male domestic shorthair cat (cat 1) and a 10-year-old castrated male Maine Coon cat (cat 2) were presented for recurrent feline lower urinary tract disease after receiving outpatient care from their primary veterinarians. CLINICAL FINDINGS: Physical examination findings for both cats were initially within reference limits. After a short period of hospitalization, both cats developed peritoneal effusion; results of cytologic analysis of a sample of the fluid were consistent with septic peritonitis. During exploratory laparotomy, perforation of the pylorus or proximal portion of the duodenum secondary to ulceration was identified. TREATMENT AND OUTCOME: Both cats underwent partial duodenectomy, partial gastrectomy (pylorectomy), and gastrojejunostomy (Billroth II procedure). The cats recovered from surgery and returned to a normal quality of life; however, each had mild episodes of anorexia but maintained a stable body weight. Cat 2 required additional surgery for trichobezoar removal 7 weeks later but recovered quickly. At 7 months after trichobezoar removal, cat 2 developed intermittent vomiting, but clinicopathologic, abdominal ultrasonographic, and upper gastrointestinal tract endoscopic findings were within reference limits. At 9 (cat 2) and 13 (cat 1) months after the Billroth II procedure, both cats were reported to be in good general health and without gastrointestinal signs. CLINICAL RELEVANCE: In both cats, the Billroth II procedure was technically straightforward and associated with a full recovery and good medium- to long-term quality of life. A Billroth II procedure could be considered for treatment of cats with large mural lesions in the pyloroduodenal region.

Colder Ambient Temperatures Influence Acute Onset Canine Intervertebral Disc Extrusion.

Canine intervertebral disc disease is one of the most common neurologic conditions in veterinary medicine but the influence of environmental factors thereon has not been fully investigated. Subjectively, there has been the impression of increased admissions of acute spinal cord injuries due to intervertebral disc extrusion during periods of colder temperatures. In the present retrospective study, the different weather conditions (temperature, precipitation, sunshine, humidity, and atmospheric pressure) during the acute onset of clinical signs and a lag period of 3 days prior to the occurrence of symptoms were analyzed. One-hundred-and-one client owned dogs from the meteorological region of the Lake Geneva were presented to two referral centers during the 6-year (2007-2012) study period. Chondrodystrophic dogs represented 65.3% of our population, with the French Bulldog (19.8%) and Dachshund (17.8%) being the most common breeds. Multivariable logistic regression analysis identified an increased occurrence of intervertebral disc disease during colder temperatures. Our results are congruent with those of human studies which have shown that lower ambient temperatures are associated with more pain and increased risk for muscle injuries. The interplay of endogenous (breed, anatomical characteristics) and exogenous (environmental) factors should be addressed in a larger cohort study.

Non-iatrogenic traumatic isolated bilothorax in a cat.

CASE SUMMARY: A 6-month-old spayed female domestic shorthair cat presented for evaluation of suspected bite wounds over the right caudal thorax and left cranial flank. Thoracic radiographs identified a mild right-sided pneumothorax, a small volume of right-sided pleural effusion, with increased soft tissue opacity in the right cranial and middle lung lobes. Abdominal ultrasound identified a very small gall bladder and several small pockets of free peritoneal fluid. Cytological analysis of peritoneal fluid was consistent with a modified transudate. Following initial diagnostic investigations, yellow-orange fluid began to emanate from the right-sided thoracic wound. Biochemical analysis of this fluid was consistent with bile. Exploratory coeliotomy revealed a right-sided radial diaphragmatic tear, with herniation of the quadrate liver lobe and a portion of the gall bladder into the right pleural space. The gall bladder was bi-lobed and avulsion of a single herniated lobe resulted in leakage of bile into the right pleural cavity, without concurrent bile peritonitis (biloabdomen). The cat underwent total cholecystectomy and diaphragmatic defect repair and recovered uneventfully. RELEVANCE AND NOVEL INFORMATION: To our knowledge, at the time of writing non-iatrogenic isolated bilothorax without concurrent biloabdomen has not been previously reported in the cat. This case highlights the importance of thorough assessment of cats with seemingly innocuous thoracic bite wounds. Despite the rarity of its occurrence, bilothorax should be considered a differential in cats with pleural effusion, even in the absence of bile peritonitis. We believe that the optimal treatment of cases of bilothorax is multifactorial and should be determined on a case-by-case basis.