Cranioplasty Using Titanium Mesh After Skull Tumor Resection in Five Dogs.

OBJECTIVE: To describe the clinical details, surgery, postoperative imaging, and short to mid-term outcome after cranioplasty with titanium mesh in dogs with large skull tumors. STUDY DESIGN: Case series. ANIMALS: Client-owned dogs with skull tumors (n=5). METHODS: All tumors were removed via craniectomy and a sheet of titanium mesh was contoured to reconstruct the calvarial defect and sutured to surrounding musculature. RESULTS: Four dogs had multilobular tumors of bone and 1 dog had a soft tissue sarcoma invading the cranial vault. Neurologic examination was unchanged or improved postoperative, a good cosmetic appearance was achieved, and no complications were noted at 2 weeks postoperative. Late postoperative computed tomography (CT) in 2 dogs and magnetic resonance (MR) imaging in 1 dog confirmed the presence of the titanium mesh without migration. There was no interference of the mesh with image interpretation and definitive radiation therapy was pursued in 1 dog without complication. Late follow-up reported 2 dogs euthanatized; at 44 weeks postoperative due to tumor re-growth; at 12 weeks postoperative for hemoabdomen, respectively. One dog drowned at 40 weeks postoperative, 1 dog was lost to follow-up, and 1 dog is alive at 83 weeks postoperative free of clinical signs. CONCLUSIONS: Titanium mesh is suitable for cranioplasty based on its strength, biocompatibility, and excellent handling characteristics. It does not interfere with acquisition or interpretation of CT or MR images, thereby allowing postoperative imaging for ongoing assessment.

Clinicopathologic and MRI characteristics of presumptive hypertensive encephalopathy in two cats and two dogs.

Two dogs and two cats were evaluated for the acute-onset of abnormal mentation, recumbency, and blindness. All cases had systemic hypertension, ranging from 180 mm Hg to 260 mm Hg. MRI of the brain disclosed noncontrast-enhancing, ill-defined, T2-weighted (T2W) hyperintensities in the white matter of the cerebrum in the areas of the frontal, parietal, temporal, and occipital lobes. Lesions were also observed in the caudate nuclei and thalamus (n = 1 in each). Intracranial hemorrhage was observed in one animal. Diffusion-weighted imaging (DWI) was consistent with vasogenic edema in two animals. Retinal lesions were observed in three animals. Hypertension was secondary to renal disease in three animals. A primary underlying disorder was not identified in one animal. Normalization of blood pressure was achieved with amlodipine either alone or in combination with enalapril. In one cat, hypertension spontaneously resolved. In three cases, neurologic improvement occurred within 24-48 hr of normalization of blood pressure. The presumptive diagnosis of hypertensive encephalopathy was supported by the MRI findings and neurologic dysfunction coincident with systemic hypertension in which the neurologic dysfunction improved with treatment of hypertension. The prognosis appears good for the resolution of neurologic deficits with normalization of blood pressure in animals with hypertensive encephalopathy.

Insertion of the dorsal oblique muscle in the dog: an anatomic basis for ventral strabismus associated with oculomotor nerve dysfunction.

OBJECTIVE: To describe the insertion of the dorsal oblique (DO) muscle in relationship to the equator of the globe in dogs. PROCEDURE: The study was conducted on 10 fresh cadaver eyes from five dogs, which were euthanized for disease processes unrelated to ocular disease. A manual vernier caliper was used to determine the calculated measurements. RESULTS: The median anterior-to-posterior diameter of the globe was 21 mm. The median length from the vertex of the anterior pole to the anterior point of insertion of the DO tendon was 11.5 mm. The median length from the posterior pole to the posterior point of insertion of the DO tendon was 10 mm. The width of tendon of insertion of the DO tendon was 3.25 mm. CONCLUSIONS: In disorders involving the oculomotor nerve or the oculomotor nerve nucleus in the mesencephalon, the resultant strabismus is directed ventrolaterally. Based on the insertion of the superior oblique muscle in humans, we hypothesized that the DO muscle would likely explain the ventral deviation in disorders of the oculomotor nerve or its nucleus. In this study, the point of the insertion of the DO muscle tendon was posterior to the equator. Based on this anatomic location, unopposed function of the DO muscle would be expected to result in ventral deviation of the globe.