Retrospective evaluation of serum/plasma iron, red blood cell distribution width, and nucleated red blood cells in dogs with acute trauma (2009-2015): 129 cases.

OBJECTIVE: To compare the prognostic value of admission hematologic parameters serum/plasma iron, red blood cell distribution width (RDW), and nucleated red blood cells (nRBCs) in dogs presenting with acute traumatic injury. DESIGN: Retrospective observational study (2009-2015). SETTING: University teaching hospital. ANIMALS: One hundred and twenty-nine clinical dogs presenting within 24 hours of acute traumatic injury. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: One hundred and twenty-nine dogs met the inclusion criteria and 109 (84.5%) survived, while 20 (15.5%) died or were euthanized in hospital. Patients with blunt force trauma comprised 79.8% of the patient population; dogs with penetrating trauma comprised 20.2% of cases. Hypoferremia occurred in all nonsurvivors, and the median serum/plasma iron concentration was significantly lower in nonsurvivors than survivors (P = 0.028). Normal or increased serum/plasma iron had 100% specificity and 100% positive predictive value for survival. Red blood cell distribution width was not significantly different between groups (P = 0.417). The presence of nRBCs was significantly associated with nonsurvival (P = 0.030), although the absolute nRBC concentrations were not significantly different (P = 0.070). A multiple logistic regression model found age, type of injury, presence of nRBCs, and serum/plasma iron to be independent predictors of survival with an area under the receiver operator characteristic curve of 0.813. CONCLUSIONS: The presence of nRBCs and low serum/plasma iron are associated with mortality in patients with acute trauma; however, red blood cell distribution width was not associated with survival. Absence of hypoferremia was highly associated with a favorable prognosis in this patient population. These parameters may warrant inclusion in trauma scoring systems.

Retrospective evaluation of 24 cases of gastrostomy tube usage in dogs with septic peritonitis (2009-2016).

OBJECTIVE: To describe the postoperative use of gastrostomy tubes (GT) in dogs with septic peritonitis. A secondary objective was to identify factors associated with GT placement and use that may be related to outcome. DESIGN: Retrospective study. SETTING: University teaching hospital. ANIMALS: Twenty-four dogs diagnosed with septic peritonitis with GT placement at the time of exploratory laparotomy. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eighteen dogs (75%) survived to discharge. Eighteen dogs (75%) had a gastrointestinal source of septic peritonitis. Complications were reported in 12/24 (50%) patients. Four dogs (16.6%) had non-GT-related complications such as vomiting, regurgitation, or increased gastric residual volume. GT-related complications occurred in 8/24 (33.3%) dogs, the majority of which (6/8 [75%]) were minor and did not necessitate removal of the GT. Two dogs had major complications that required removal of the GT. Significant differences between survivors and nonsurvivors were found between the length of time after placement of the GT to when they began eating and outcome (discharge versus death versus euthanasia) (P = 0.03), and GT dwell time (length of time the GT was in place) and outcome (P = 0.006). Clinically relevant correlations were found between the time after placement of the GT until feeding and time after placement until voluntarily eating (P = 0.0349), time after placement of the GT until voluntarily eating and length of hospitalization (P = 0.0391), and time after placement of the GT until feeding and length of hospitalization (P = 0.036). CONCLUSIONS: GTs can be placed during exploratory laparotomy in dogs with septic peritonitis. They facilitate early enteral nutrition and are associated with few clinically significant complications. Prospective studies are needed to determine the optimal postoperative feeding plan and the effects of early enteral nutrition on serum albumin concentration in this patient population.

Description of a novel technique for surgical placement of gastrostomy tubes in dogs.

BACKGROUND: Early enteral nutrition in dogs with critical illnesses, including septic peritonitis, has been shown to have a positive influence on patient outcome. Surgical placement of a gastrostomy tube (GT) is one option for providing early enteral nutrition. Complications, including premature tube removal or separation of the stomach from the body wall, can result in leakage of gastric contents into the abdominal cavity and subsequent peritonitis. A safe and reliable technique for the placement of a GT is desirable to minimize such complications. KEY CONCEPTS: A modified method for surgical placement of a GT is described. A thoracic trocar catheter (TTC) with an attached Pezzer tube is inserted through a gastrotomy incision and exited through the left gastric body and body wall. A left-sided tube gastropexy is performed using an interlocking box (ILB) pattern. SIGNIFICANCE: GT placement using a TTC is efficient, requiring minimal additional anesthesia time. The gastric defect created by the TTC conforms well with the Pezzer tube. As such, placement and utilization of the ILB suture pattern enables removal of the GT in the early postoperative period, if appropriate.

Traumatic atlantoaxial subluxation in dogs: 8 cases (2009-2016).

OBJECTIVE: To demonstrate the utility of advanced imaging in dogs with traumatic atlantoaxial subluxation (TAAS), and to report the presentation, treatment, and outcome for these dogs. DESIGN: Retrospective study (2009-2016). SETTING: University teaching hospital. ANIMALS: Eight dogs diagnosed with TAAS with magnetic resonance imaging (MRI), computed tomography (CT), or both. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eight dogs met criteria for inclusion. Of these, 6 were male, median age was 4 years (range, 1.5-11 years), and median body weight was 4.9 kg (range, 3.0-25.0 kg). On presentation, 6/8 (75%) dogs were nonambulatory tetraparetic and the most common injury was trauma inflicted by another animal 5/8 (62.5%). Diagnosis of TAAS was made using a combination of imaging modalities including vertebral column radiographs in 7/8 (87.5%) (of which 71.4% were suspicious for TAAS), CT in 7/8 (87.5%), and MRI in 7/8 (87.5%). In 7/8 (87.5%) dogs, CT and/or MRI offered additional information regarding the extent of injuries. Vertebral fractures were identified in 62.5% (5/8) of dogs. The majority of dogs underwent surgical repair (7/8 [87.5%]). The most common complication was aspiration pneumonia (3/8 [37.5%]). All 8 dogs survived to discharge. At the time of discharge, 4/8 (50%) were ambulatory tetraparetic. The 4 dogs that were nonambulatory tetraparetic at discharge progressed to being ambulatory within 2 months of surgery. CONCLUSIONS: Although TAAS is an uncommon occurrence it should be considered a differential for any trauma patient that is presenting with signs of a cranial cervical myelopathy. CT and MRI have been shown to be useful to identify the extent of injuries and to facilitate surgical planning. With appropriate care, these dogs can have an excellent prognosis.

Metastatic neuroendocrine carcinoma of aortic body origin in a cat.

An 8-year-old, female spayed Domestic Shorthair cat was presented to the Auburn University Emergency and Critical Care service for evaluation of pleural effusion and a suspected intrathoracic mass. Computed tomography was performed which confirmed the presence of a large intrathoracic mass, likely heart-based. Fine-needle aspirates were obtained and a cytologic diagnosis of a neuroendocrine tumor was made. Treatment with toceranib phosphate was briefly attempted at home by the owners. The cat died at home approximately 6 weeks after diagnosis. Necropsy and subsequent histopathologic examination revealed a metastatic neuroendocrine carcinoma of aortic body origin. Aortic body tumors are extremely rare in cats and to the authors' knowledge, a neuroendocrine carcinoma of aortic body origin with distant metastases has not yet been reported in a cat.