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The recent interest in advanced biologic therapies in veterinary medicine has opened up opportunities for new treatment modalities with considerable clinical potential. Studies with mesenchymal stromal cells (MSCs) from animal species have focused on in vitro characterization (mostly following protocols developed for human application), experimental testing in controlled studies and clinical use in veterinary patients. The ability of MSCs to interact with the inflammatory environment through immunomodulatory and paracrine mechanisms makes them a good candidate for treatment of inflammatory musculoskeletal conditions in canine species. Analysis of existing data shows promising results in the treatment of canine hip dysplasia, osteoarthritis and rupture of the cranial cruciate ligament in both sport and companion animals. Despite the absence of clear regulatory frameworks for veterinary advanced therapy medicinal products, there has been an increase in the number of commercial cell-based products that are available for clinical applications, and currently the commercial use of veterinary MSC products has outpaced basic research on characterization of the cell product. In the absence of quality standards for MSCs for use in canine patients, their safety, clinical efficacy and production standards are uncertain, leading to a risk of poor product consistency. To deliver high-quality MSC products for veterinary use in the future, there are critical issues that need to be addressed. By translating standards and strategies applied in human MSC manufacturing to products for veterinary use, in a collaborative effort between stem cell scientists and veterinary researchers and surgeons, we hope to facilitate the development of quality standards. We point out critical issues that need to be addressed, including a much higher level of attention to cell characterization, manufacturing standards and release criteria. We provide a set of recommendations that will contribute to the standardization of cell manufacturing methods and better quality assurance.
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This is a case of twins who had a rarely seen diagnosis of congenital erosive and vesicular dermatosis. This report includes a description of the case and discussion around the topic. Click https://www.wileyhealthlearning.com/#/online-courses/2fd90f74-cd50-4ae4-aeef-61d902f63ec0 for the corresponding questions to this CME article.
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Atresia Esofágica , Dermatopatias Vesiculobolhosas , Cicatriz/patologia , Atresia Esofágica/complicações , Humanos , Dermatopatias Vesiculobolhosas/complicaçõesRESUMO
OBJECTIVE: To report current recommendations made by veterinarians for rehabilitation after surgical treatment of cranial cruciate ligament (CrCL) disease. STUDY DESIGN: Anonymized electronic survey. SAMPLE POPULATION: Veterinarians performing CrCL stabilization. METHODS: An electronic survey was created to collect information on general attitudes toward postoperative rehabilitation and recommendations regarding therapeutic modalities and bandaging. Quantitative data are reported by descriptive statistical analysis, percentage of responses, or mean (±SD). The recommendations for postoperative bandaging beyond 24 hours and for postoperative rehabilitation after extracapsular stabilization compared with after tibial osteotomy were tested by using Cochran-Mantel-Haenszel tests, with P < .05 considered statistically significant. RESULTS: The data analysis included 376 responses (13% response rate). Most (71%) respondents consistently recommended postoperative rehabilitation. Rehabilitation was more than twofold more likely to be recommended after extracapsular stabilization than after osteotomies (P = .0142). Most respondents did not recommend bandaging beyond 24 hours postoperatively (P = .00012). CONCLUSION: Most respondents recommended either formal or informal postoperative rehabilitation therapy. CLINICAL SIGNIFICANCE: If the survey respondents are representative of veterinarians performing CrCL surgery, the current attitude is supportive of postsurgical rehabilitation. Most respondents would welcome evidence-based guidelines for rehabilitation protocols.
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Lesões do Ligamento Cruzado Anterior/veterinária , Cães/lesões , Joelho de Quadrúpedes/lesões , Animais , Lesões do Ligamento Cruzado Anterior/reabilitação , Lesões do Ligamento Cruzado Anterior/cirurgia , Cães/cirurgia , Irlanda , Osteotomia/veterinária , Modalidades de Fisioterapia/veterinária , Guias de Prática Clínica como Assunto , Joelho de Quadrúpedes/cirurgia , Inquéritos e Questionários , Suíça , Estados Unidos , Médicos Veterinários , Medicina VeterináriaRESUMO
OBJECTIVE: To describe a dorsoproximal midline (DPM) standing technique for proximal interphalangeal joint (PIPJ) injection and to compare it to established dorsolateral flexed (DLF), palmaroproximal (PP), and dorsolateral standing (DLS) techniques. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Sixty cadaver equine thoracic limbs. METHODS: Limbs were divided into four groups (n = 15 each group), DLF, DPM, PP, and DLS. For each technique, three operators injected radiopaque contrast and methylene blue into the PIPJ in five limbs. The number of attempts required was recorded. Successful injection was confirmed by radiographic presence of contrast media within the PIPJ. Iatrogenic cartilage damage was assessed by gross examination. Statistical analysis was performed by Wilcoxon signed-rank test (P < .05). RESULTS: The overall success rates were 86.6% to 93.3%. Although there was no difference in success rate, the frequency of needle repositioning was influenced by injection technique (P = .009). Dorsolateral standing had the highest mean ± SD value of attempts required to insert the needle in the joint space (2.62 ± 1.94). Injection technique influenced cartilage damage (P = .025), with the highest frequency recorded for DLS. CONCLUSION: All four techniques for injecting the PIPJ were highly successful; DLS was associated with the highest number of needle repositionings and the highest incidence of iatrogenic injury to cartilage. CLINICAL SIGNIFICANCE: Dorsolateral flexed should be considered as an alternative to the DLS technique to reduce iatrogenic cartilage injury when injecting the PIPJ. Dorsoproximal midline and DLF techniques have success rates comparable to traditional techniques, with lower incidence of iatrogenic cartilage damage in cadaver limbs.
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Membro Anterior , Cavalos , Injeções/veterinária , Articulações , Animais , CadáverRESUMO
OBJECTIVE: To determine current methods of arthroscopic skills training and proficiency assessment, identify skills considered fundamental to arthroscopy, and evaluate desire for a formal training and assessment program. STUDY DESIGN: Anonymized electronic survey. SAMPLE POPULATION: Diplomates and residents of the American College of Veterinary Surgeons (ACVS) and European College of Veterinary Surgeons (ECVS). METHODS: An electronic survey was distributed in commercial software (Qualtrics, Provo, Utah). Questions were divided into 4 categories: (1) demographics, (2) arthroscopy experience, (3) teaching, and (4) proficiency assessment. Descriptive statistical analysis was performed. Comparisons between groups were performed by using χ2 , t tests, and 1-way ANOVA (P ≤ .05). RESULTS: In total, 429 diplomates and 149 residents responded (response rate 28%). Overall, 80% of respondents trained using clinical cases. Barriers to simulator training included cadaver/simulator availability and time. Skills deemed most fundamental included anatomic knowledge, precise portal placement, triangulation, and image orientation. Overall, 90% of respondents supported a formal training program with requirement to demonstrate proficiency; 80% believed this should be part of standard ACVS/ECVS residency training. CONCLUSION: Arthroscopic skills are taught by using clinical cases, with subjective proficiency assessment. Fundamental skills are those that may be taught using simulators. There is enthusiasm for formal arthroscopic skills training and assessment. CLINICAL SIGNIFICANCE: Improved acquisition and assessment of fundamental arthroscopic skills is indicated. A validated methodology for formal training using simulators, minimizing morbidity, and facilitating objective evaluation is warranted. This is the first phase of a project to develop and validate a simulator program.
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Artroscopia/veterinária , Competência Clínica , Internato e Residência , Animais , Artroscopia/educação , Educação em Veterinária , Europa (Continente) , Humanos , Avaliação de Programas e Projetos de Saúde , Treinamento por Simulação , Sociedades Veterinárias , Cirurgiões , Inquéritos e Questionários , Estados UnidosRESUMO
Wounds are often addressed by primary or delayed primary closure. Although many skin wounds could go on to heal by second intention, this results in a less cosmetic outcome, takes longer, and in the long run, is often more expensive. As a general rule, the simplest method of wound closure that is likely to succeed should be chosen. If tension is present at the wound edges, wound dehiscence is likely to occur. Using specific techniques to relieve tension on wound edges and recruiting local flaps from neighboring regions are useful ways to achieve wound closure.
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Lesões dos Tecidos Moles/veterinária , Retalhos Cirúrgicos/veterinária , Cicatrização/fisiologia , AnimaisRESUMO
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.
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A 5-year-old female entire German Shepherd presented for otitis and lethargy. An incidental abdominal mass was identified on examination. Ultrasound examination (US) identified a heterogeneous left ovarian mass. Computed tomography (CT) was performed for surgical planning and staging. The reproductive tract was removed en bloc and submitted for histopathology. Multiple small (1-5 mm) nodules identified at coeliotomy on the surface of the liver, spleen and peritoneum were biopsied. The lesions were not visible on CT nor US on review. This is the first case report of the CT findings of ovarian papillary adenocarcinoma with carcinomatosis.
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Neoplasias Abdominais/veterinária , Adenocarcinoma/veterinária , Doenças do Cão/diagnóstico por imagem , Neoplasias Ovarianas/veterinária , Tomografia Computadorizada por Raios X/veterinária , Neoplasias Abdominais/diagnóstico por imagem , Neoplasias Abdominais/secundário , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma/secundário , Animais , Doenças do Cão/patologia , Cães , Feminino , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/patologiaRESUMO
Perineal wounds in dogs present a challenge due to limited local availability of skin for closure and constant exposure to fecal contaminants. This report describes temporary rectal stenting in two dogs following severe perineal wounds. Dog 1 presented with a 4 × 4 cm full-thickness perineal slough secondary to multiple rectal perforations. A 12 mm internal diameter endotracheal tube was placed per-rectum as a temporary stent to minimize fecal contamination. The stent was removed 18 days after placement, and the perineal wound had healed at 32 days post-stent placement, when a minor rectal stricture associated with mild, intermittent tenesmus was detected. Long-term outcome was deemed good. Dog 2 presented with multiple necrotic wounds with myiasis, circumferentially surrounding the anus and extending along the tail. A 14 mm internal diameter endotracheal tube was placed per-rectum. The perineal and tail wounds were managed with surgical debridement and wet-to-dry and honey dressings prior to caudectomy and negative pressure wound therapy (NPWT). Delayed secondary wound closure and stent removal were performed on day six without complication. Long-term outcome was deemed excellent. Temporary rectal stenting may be a useful technique for fecal diversion to facilitate resolution of complex perineal injuries, including rectal perforation.
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Doenças do Cão/cirurgia , Períneo/lesões , Reto/lesões , Stents/veterinária , Ferimentos e Lesões/veterinária , Animais , Cães , Masculino , Cicatrização , Ferimentos e Lesões/terapiaRESUMO
This manuscript describes the extended clinical abnormalities that can occur in severe snake envenomation and the clinical signs associated with antivenom hypersensitivity in a 3 yr old dog. Treatment consisted of IV fluid therapy, analgesics, a vasopressor, cardiac antiarrhythmia drugs, and polyvalent pit viper antivenom. Following initial response to treatment, relapse of clinical signs occurred. Most interesting was the recrudescence of clinical signs on day 7 that may have been caused by the release of deposited venom during surgical debridement of necrotic skin. The resulting extensive clinical signs required multiple vials of antivenom (22 vials over a 7 day period). Both F(ab')2 antivenom and antivenin (Crotalidae) polyvalent were used in this dog because of availability logistics. It is thought that this large amount of antivenom resulted in type I (anaphylaxis) and type III hypersensitivity (serum sickness) reactions. The dog made a complete clinical recovery. This description of extended, fluctuating clinical abnormalities that were associated with envenomation together with the development of hypersensitivity reactions that were presumably secondary to antivenom administration is information that can be useful for the management of patients afflicted with severe pit viper envenomation.
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Antivenenos/uso terapêutico , Venenos de Crotalídeos/efeitos adversos , Doenças do Cão/etiologia , Mordeduras de Serpentes/veterinária , Viperidae , Animais , Antivenenos/administração & dosagem , Doenças do Cão/patologia , Doenças do Cão/terapia , Cães , Relação Dose-Resposta a Droga , Feminino , Mordeduras de Serpentes/complicações , Mordeduras de Serpentes/terapiaRESUMO
Osteochondrosis is a common developmental abnormality affecting the subchondral bone of immature, large breed dogs. The purpose of this retrospective study was to describe CT lesions detected in scapulohumeral joints of 32 immature dogs undergoing CT for thoracic limb lameness. Eight dogs (14 scapulohumeral joints) had arthroscopy following imaging. Thirteen dogs (19 scapulohumeral joints) were found to have CT lesions, including 10 dogs (16 scapulohumeral joints) with subchondral bone lesions and 3 dogs with enthesopathy of the supraspinatus tendon. In one dog, subchondral bone lesions appeared as large oval defects within the mid-aspect of the glenoid cavities, bilaterally. These lesions resembled osseous cyst-like lesions commonly identified in the horse. This is the first report of such a presentation of a subchondral bone lesion in the glenoid cavity of a dog. In all dogs, small, focal, round or linear lucent defects were visible within the cortical bone at the junction of the greater tubercle and intertubercular groove. These structures were thought to represent vascular channels. Findings from this study support the use of CT as an adjunct modality for the identification and characterization of scapulohumeral subchondral bone lesions in immature dogs with thoracic limb lameness.
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Doenças do Cão/diagnóstico por imagem , Coxeadura Animal/diagnóstico por imagem , Osteocondrose/veterinária , Articulação do Ombro/diagnóstico por imagem , Animais , Artroscopia/veterinária , Doenças do Cão/epidemiologia , Cães , Feminino , Florida/epidemiologia , Membro Anterior/diagnóstico por imagem , Coxeadura Animal/epidemiologia , Masculino , Osteocondrose/diagnóstico por imagem , Prevalência , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/veterináriaRESUMO
BACKGROUND: Unilateral cricoarytenoid laryngoplasty is commonly performed for treatment of idiopathic laryngeal paralysis in dogs. Determination of the appropriate tension applied to the suture can be difficult, particularly for the novice surgeon. OBJECTIVE: To describe a technique for video-assisted unilateral cricoarytenoid laryngoplasty (VAUCAL) and to report short-term outcome in dogs undergoing VAUCAL. ANIMALS AND METHODS: Dogs (n = 14) with bilateral idiopathic laryngeal paralysis undergoing VAUCAL between August 2011 and May 2013 were evaluated. A cricoarytenoid suture was tensioned under video observation of the rima glottidis using a 5-mm rigid endoscope. Real-time visualization of arytenoid abduction during suture tensioning, and final arytenoid position were assessed. Requirement for additional intravenous anesthestic, intra- and post-operative complications and short-term outcomes were documented. RESULTS: Adequate, real-time visualization of the larynx during tensioning of the cricoarytenoid suture was accomplished in 13/14 dogs. Additional intravenous anesthesia was required in 5/14 dogs to facilitate reintubation. Final arytenoid position was considered inadequate in two dogs on post-operative trans-oral laryngeal examination. Recurrence of clinical signs occurred in one dog three months following initial surgery. Owner outcome was deemed good (n = 8) or excellent (n = 6). CONCLUSIONS: VAUCAL is a feasible technique to permit direct real-time visualization of the larynx during tensioning of the cricoarytenoid suture, and enables assessment of final arytenoid position intra-operatively by the operating surgeon. CLINICAL IMPORTANCE: VAUCAL allows the operating surgeon to assess arytenoid abduction intra-operatively, at the time of knot placement. This technique may be particularly useful for the novice surgeon or surgeon in training.
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Doenças do Cão/cirurgia , Glote/cirurgia , Laringoplastia/veterinária , Suturas/veterinária , Cirurgia Vídeoassistida/veterinária , Paralisia das Pregas Vocais/veterinária , Animais , Cães , Feminino , Laringoplastia/métodos , Masculino , Estatísticas não Paramétricas , Suturas/normas , Paralisia das Pregas Vocais/cirurgiaRESUMO
Coarctation of the aorta has been described previously as either a post-mortem or angiographic finding in three dogs with clinical signs related to the aortic coarctation. A 10-year-old dog was presented for evaluation of suspected laryngeal paralysis. On physical examination, femoral pulses were absent bilaterally, with an indirect systolic blood pressure difference of 60 mmHg between the ipsilateral thoracic and pelvic limbs. Coarctation of the aorta was detected on a thoracic computed tomographic angiography study. The coarctation was pre-ductal in position, with extensive dilation of the descending thoracic aorta. Characteristic rib changes that are seen in humans with coarctation were not apparent in this dog. 3D reconstructions of the thorax provided high vascular definition with exact localization of the aortic narrowing.
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Coartação Aórtica/veterinária , Doenças do Cão/diagnóstico , Tomografia Computadorizada por Raios X/veterinária , Animais , Coartação Aórtica/diagnóstico , Coartação Aórtica/patologia , Doenças do Cão/patologia , Cães , MasculinoRESUMO
Treatment options for dogs with nasopharyngeal stenosis include fluoroscopic placement of metallic stents. Reported complications include entrapment of hair and food, obstruction and persistent nasal discharge. Two toy breed dogs were examined for persistent nasal discharge and halitosis at 4 and 20 months after placement of permanent metallic stents for acquired nasopharyngeal stenosis. Full thickness defects were found in the palate of both dogs, with extensive communication between the mouth and the nasal passages. Portions of the metal stent were observed within the lesion in both patients. Additional treatment was declined by the owner of one dog; the stent was removed through the fistula in the other dog. Palatal erosion with secondary oronasal fistulation is a potential complication of nasopharyngeal stent placement in dogs.
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OBJECTIVE: To evaluate the effect of proximal ulnar rotational osteotomy (PURO) on the contact mechanics and 3-dimensional (3D) alignment of cadaveric normal dog elbows. STUDY DESIGN: Ex vivo biomechanical study. ANIMALS: Unpaired thoracic limbs from 12 dogs (mean ± SD weight, 26 ± 4 kg). METHODS: PURO consisted of a transverse osteotomy with 30° external rotation of the proximal segment. With the limb under 200 N axial load, contact area (CA), mean contact pressure (CP) and peak contact pressure (PCP) were measured using digital pressure sensors in the medial and lateral compartments and 3D static elbow poses were obtained, before and after PURO. Each specimen was tested at 115°, 135°, and 155° elbow flexion, with the antebrachium in neutral rotation, in 28° supination, and in 16° pronation. Repeated measures ANOVAs with post-hoc Bonferroni (P ≤ .05) were performed. RESULTS: PURO caused significant changes, mostly at 135° elbow flexion and neutral antebrachial rotation, characterized by decreased CP (10%) and PCP (10%) in the medial compartment, and increased CP (27%) and PCP (23%) in the lateral compartment. The apex of the medial coronoid process translated 3.4 mm caudally, 1.7 mm abaxially, and rotated 1.8° externally relative to the radial head. Humeroradial varus angulation reduced by 6.7°. CONCLUSIONS: In limited poses, PURO displaces the medial coronoid process caudally and abaxially and shifts contact pressures towards the lateral elbow compartment by decreasing varus angulation.
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Cães/anatomia & histologia , Cães/cirurgia , Membro Anterior/anatomia & histologia , Membro Anterior/fisiologia , Articulações/anatomia & histologia , Osteotomia/veterinária , Animais , Fenômenos Biomecânicos , Cadáver , Membro Anterior/cirurgia , Articulações/fisiologia , Articulações/cirurgia , Osteotomia/métodosRESUMO
OBJECTIVE: To evaluate the effects of antebrachial rotation at 3 elbow flexion angles on contact mechanics and 3-dimensional (3D) alignment of normal dog elbows. STUDY DESIGN: Ex vivo biomechanical study. ANIMALS: Unpaired thoracic limbs from 18 dogs (mean ± SD weight, 27 ± 4 kg). METHODS: With the limb under 200 N axial load, digital pressure sensors measured contact area (CA), mean contact pressure (MCP), peak contact pressure (PCP), and PCP location in the medial and lateral elbow compartments, and 3D static poses of the elbow were obtained. Each specimen was tested at 115°, 135°, and 155° elbow flexion, with the antebrachium in a neutral position, in 28° supination, and in 16° pronation. Repeated measure ANOVAs with post-hoc Bonferroni (P ≤ .0167) were performed. RESULTS: Both pronation and supination decreased CA by 16% and 8% and increased PCP by 5% and 10% in the medial and lateral compartments, respectively. PCP location moved 2.3 mm (1.8-3.2 mm) closer to the apex of the medial coronoid process in pronation and 2.0 mm (1.8-2.2 mm) farther away in supination. The radial head and medial coronoid process rotated 5.4° and 1.9° internally during pronation and 7.2° and 1.2° externally during supination. CONCLUSIONS: Contact mechanics and 3D alignment of normal dog elbows varied significantly at different elbow poses.
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Cães/anatomia & histologia , Cães/fisiologia , Membro Anterior/anatomia & histologia , Membro Anterior/fisiologia , Articulações/anatomia & histologia , Articulações/fisiologia , Animais , Fenômenos Biomecânicos , CadáverRESUMO
CASE DESCRIPTION: A 5-month-old neutered male Golden Retriever was evaluated because of moderate stridor, exercise intolerance, and dyspnea. The dog had been neutered 3 weeks previously, and the referring veterinarian identified a large fluid-filled swelling on the left lateral aspect of the larynx during anesthetic intubation for that surgery. The referring veterinarian drained fluid from the mass by use of needle centesis via the oral cavity, which resulted in temporary improvement in clinical signs; however, the clinical signs returned soon thereafter. CLINICAL FINDINGS: A large, soft, spherical mass was located between the left arytenoid and thyroid cartilages and axial to the left ceratohyoid bone, thus causing partial obstruction of the rima glottidis. Laryngoscopic examination, computed tomography (CT), and cytologic evaluation of aspirates performed before surgery; examination during surgery; and histologic evaluation of tissues following surgical excision confirmed the diagnosis of a laryngeal cyst. TREATMENT AND OUTCOME: Complete surgical excision was successfully performed via a lateral extraluminal approach to the larynx. One week after surgery, the dog coughed only occasionally. Twelve months after surgery, the owner reported that the dog was clinically normal with no recurrence of clinical signs, and laryngoscopic examination revealed no recurrence of the cyst or other pathological changes in the laryngeal region. CLINICAL RELEVANCE: Congenital laryngeal cysts are rarely reported in domestic animals. The information provided here described the CT appearance of a laryngeal cyst and the use of CT in diagnosis and surgical planning. Congenital laryngeal cysts can be resected via a lateral submucosal approach.