Long-term follow-up of laryngeal Rhinosporidium seeberi diagnosed by PCR and treated with laser ablation and voriconazole nebulization in a retired thoroughbred polo horse.

A 21-year-old retired polo Argentinian thoroughbred horse from a teaching herd was presented for a routine bronchoalveolar lavage demonstration, during which an incidental finding of a granulomatous mass on the dorsal aspect of the epiglottis was made. Rhinosporidium seeberi was suspected from a histological section obtained from an initial biopsy, and the mass was removed via laser surgery for cytology and PCR. Sequencing of the PCR amplicons confirmed the diagnosis of R. seeberi. A treatment protocol of nebulized voriconazole for 10 d postoperatively was used. Long-term follow-up required 2 more laser surgeries plus oral fluconazole to resolve the remaining fungal spores. However, 2.5 y later, there was no evidence of remaining fungal spores. Key clinical message: Horses from endemic regions can potentially be exposed to R. seeberi. Based on its travel history, this horse may have contracted the infection in South America, California, or Alberta. Treatments administered, including diode laser resection, voriconazole antifungal nebulization, and oral fluconazole administration, were successful but required repeated interventions.

Suivi à long terme du Rhinosporidium seeberi laryngé diagnostiqué par PCR et traité par ablation au laser et nébulisation au voriconazole chez un cheval de polo thoroughbred pur-sang à la retraiteUn cheval thoroughbred argentin de polo retraité de 21 ans, issu d'un troupeau d'enseignement, a été présenté pour une démonstration de lavage broncho-alvéolaire de routine, au cours de laquelle une découverte fortuite d'une masse granulomateuse sur la face dorsale de l'épiglotte a été faite. Rhinosporidium seeberi a été suspecté à partir d'une coupe histologique obtenue à partir d'une biopsie initiale, et la masse a été retirée par chirurgie au laser pour cytologie et PCR. Le séquençage des amplicons PCR a confirmé le diagnostic de R. seeberi. Un protocole de traitement au voriconazole nébulisé pendant 10 jours après l'opération a été utilisé. Le suivi à long terme a nécessité 2 autres interventions chirurgicales au laser et du fluconazole oral pour éliminer les spores fongiques restantes. Cependant, 2,5 ans plus tard, il n'y avait aucune trace de spores fongiques restantes.Message clinique clé:Les chevaux des régions endémiques peuvent potentiellement être exposés à R. seeberi. D'après ses antécédents de voyage, ce cheval pourrait avoir contracté l'infection en Amérique du Sud, en Californie ou en Alberta. Les traitements administrés, notamment la résection au laser à diode, la nébulisation antifongique au voriconazole et l'administration orale de fluconazole, ont été efficaces mais ont nécessité des interventions répétées.(Traduit par Dr Serge Messier).

Morphology and volume of Meibomian glands ex vivo pre and post partial tarsal plate excision, cryotherapy and laser therapy in the dog using microCT.

OBJECTIVE: To determine the morphology and volume of Meibomian glands (MG) of dogs with microCT before and after partial tarsal plate excision (PTPE), cryotherapy, and laser therapy. PROCEDURE: MicroCT scans were made of 12 upper lids (ULs) and lower lids (LLs) of 12 dogs. After undergoing PTPE, 10 ULs and LLs were scanned again, and one UL and one LL was scanned after laser therapy and one UL and one LL after cryotherapy. RESULTS: The length of the area containing MGs did not change pre- and post-PTPE, and cryo- or laser therapy. The mean number of MGs in the ULs and LLs was 30.50 and 29.42, respectively, and did not change during the procedures. The average length of one individual MG was 2.60 mm. The mean volume of MGs in the 10 ULs and LLs pre-PTPE was 21.45 and 17.2 mm3 , respectively, and 12.84 and 11.25 mm3 in the UL and LL after PTPE, respectively. The mean volume of MGs decreased from 29.78 mm3 precryotherapy to 28.91 mm3 post-treatment and in the lower eyelid from 22.87 to 22.4 mm3 after cryotherapy. The mean volume of MGs in the UL and LL before laser therapy was 8.95 and 6.78 mm3 , respectively, and after 9.25 and 6.38 mm3 , respectively. CONCLUSION: MicroCT is a valuable tool to determine the morphology and the volume of MGs and to demonstrate changes that occur after PTPE, laser-, and cryotherapy. There is no need for additional preparation, such as staining, of the specimen prior to scanning.

A retrospective case series of the postoperative outcome for 30 dogs with inflammatory interdigital nodules, surgically treated with carbon dioxide laser and a nonantimicrobial wound-healing protocol.

BACKGROUND: Inflammatory interdigital nodules (IIN) affecting the paws of dogs is a multifactorial and painful condition. Surgery using carbon dioxide (CO 2 ) laser has been shown to be helpful in the management. HYPOTHESIS/OBJECTIVES: To assess a postoperative treatment protocol without use of antibiotics following CO2 laser surgery for IIN treatment. ANIMALS: Forty-seven paws, in 30 client-owned dogs, with IINs affecting the interdigital web between the 4th and 5th digits of the forepaws, surgically treated using CO2 laser, were included. MATERIALS AND METHODS: Medical records were reviewed for demographic details, medication use and wound healing using a set wound care protocol. Time to resolution of the surgical wounds and the postoperative outcome were assessed. RESULTS: The mean healing time was 34 days. Resolution was seen in 42 of 47 paws with complications in five paws (11%), including development of new fistulae or nonhealing granulation tissue. Surgery was repeated in those five cases. Relapse occurred during the follow-up period of five-19 months in six paws (13%). CONCLUSIONS AND CLINICAL RELEVANCE: This study shows that surgical treatment with CO2 laser for interdigital nodules is successful in most cases. The postoperative outcome using a wound-healing protocol avoiding use of antimicrobials can be used without compromising patient care whilst following antimicrobial stewardship guidelines.

Extensive progressive pigmented viral plaques in a Chihuahua dog.

Extensive exophytic pigmented viral plaques developed on a Chihuahua dog causing pruritus and discomfort. Neither the medical treatments used nor a papillomavirus vaccine resulted in clinical improvement. Laser surgery removed some plaques, yet others developed. This case illustrates the difficulty in treating viral plaques and the progressive nature of this disease.

De vastes plaques virales pigmentées exophytiques se sont développées sur un Chihuahua, provoquant prurit et inconfort. Ni les traitements médicaux utilisés ni un vaccin contre le papillomavirus n'ont entraîné d'amélioration clinique. La chirurgie au laser a enlevé certaines plaques, mais d'autres se sont développées. Ce cas illustre la difficulté de traiter les plaques virales et le caractère évolutif de cette maladie.

Se desarrollaron extensas placas virales pigmentadas exofíticas en un perro Chihuahua que causaban prurito y malestar. Ni los tratamientos médicos utilizados ni la vacuna contra el virus del papiloma resultaron en una mejoría clínica. La cirugía con láser eliminó algunas placas, pero se desarrollaron otras. Este caso ilustra la dificultad para tratar las placas virales y la naturaleza progresiva de esta enfermedad.

Placas virais pigmentadas exofíticas extensas se desenvolveram em um cão Chihuahua, causando prurido e desconforto. Nem os tratamentos médicos utilizados nem a vacina contra o papilomavírus resultaram em melhora clínica. A cirurgia a laser removeu algumas placas, mas outras se desenvolveram. Este caso ilustra a dificuldade no tratamento das placas virais e a natureza progressiva da doença.

Outcomes of 25 female dogs treated for ectopic ureters by open surgery or cystoscopic-guided laser ablation.

OBJECTIVE: To report outcomes after the correction of ectopic ureter (EU) by open surgery or cystoscopic-guided laser ablation (CLA) in female dogs. STUDY DESIGN: Retrospective study from 2011 to 2018. ANIMALS: Twenty-five female dogs. METHODS: Data collected included signalment, clinicopathologic data, procedural data, complications, and short-term and long-term outcomes. Complications were graded as minor or major if a surgical revision was required. Continence status was scored subjectively (1 = completely incontinent to 10 = fully continent). RESULTS: Fifteen dogs had bilateral EU and 24 had intramural EU (iEU). Open surgical correction included 13 neoureterostomies, 2 neocystoureterostomies, and a combination of these in 2 dogs. Eight dogs underwent CLA. Eighteen dogs experienced minor complications (72%), and 2 experienced major complications (8%). One-month postoperative continence was achieved in 20/25 (80%) dogs (median score of 10). Incontinence recurred at a median time of 24.9 months in 5 dogs but responded to medical treatment. Overall, dogs remained continent for 66 months (median) and 22/25 (88%) dogs achieved continence with adjunction of medical/surgical treatment in incontinent ones. Fewer minor complications and postoperative recurrences of incontinence were documented after CLA than neoureterostomy (P < .01 and P < .05). CONCLUSION: Ectopic ureter correction by open surgery or CLA resulted in a subjectively good prognosis, most dogs reaching continence within a month of surgery, although incontinence occasionally recurred in the long term. CLA was associated with fewer complications and incontinence recurrences than neoureterostomy. CLINICAL SIGNIFICANCE: Cystoscopic-guided laser ablation should be preferred to correct iEU to prevent short-term complications and the recurrence of incontinence. Further studies should investigate the cause of postoperative recurrence of urinary incontinence.

Long-term outcome of female dogs treated for intramural ectopic ureters with cystoscopic-guided laser ablation.

OBJECTIVE: To report the complications and long-term outcome of female dogs with intramural ectopic ureter(s) (iEU) undergoing cystoscopic-guided laser ablation (CLA) and determine the effect of post-CLA neutering on urinary continence. STUDY DESIGN: Retrospective clinical study. ANIMALS OR SAMPLE POPULATION: Thirty-four client-owned dogs. METHODS: Medical records of female dogs that had iEU-CLA were reviewed. A 10-point continence score was assigned before, immediately after, and at a minimum of 12 months postprocedure via owner telephone contact. Neutering status prior to and postprocedure was recorded. RESULTS: Continence scores increased in all dogs after CLA (p < .0001, mean duration of follow-up: 63.9 ± 5.7 months) with an increase of the median score from 2 (preprocedure) to 10 (postprocedure). A urethral tear occurred in 2/34 dogs immediately after the procedure, successfully managed conservatively. Mild hematuria was present in 2/34, lasting less than 48 h. Postoperative urinary tract infections were documented in 6/34 dogs. Two dogs died of urinary-related issues at 1 and 5 months after CLA. Complete and near-complete urinary continence (scores 9 and 10/10) was achieved in 26/32 dogs including 3 dogs requiring medical (2) or surgical interventions (1). Post-CLA neutering did not affect continence scores (p = .44). CONCLUSION: A large proportion of dogs regained and maintained full continence after CLA alone. Subsequent medical or surgical therapy allowed further improvements when needed. Post-CLA neutering did not negatively impact urinary continence score. CLINICAL SIGNIFICANCE: The beneficial effect of iEU-CLA in female dogs is long standing and not affected by postprocedural neutering.

Successful treatment of distichiasis in a cow using a direct-contact 810-nm diode laser.

OBJECTIVES: To describe the use of direct-contact diode laser as a new treatment for distichiasis. STUDY DESIGN: Case report. ANIMALS: A 2-month-old Italian Friesian calf with bilateral excessive tearing and corneal opacification was presented to the Visionvet Eye Clinic. Abnormalities on ophthalmic examination included epiphora, seromucous discharge, bilateral distichiasis and secondary chronic keratitis affecting both eyes. METHODS: Distichiae were surgically removed after insertion of the 810-nm diode laser tip into the associated meibomian gland. RESULTS: Clinical signs gradually improved postoperatively with minimal and transient post-operative complications. Ophthalmic examination was within normal limits 6 months later beyond distichiae. CONCLUSION: Treatment of distichiasis with direct-contact 810-nm diode laser resulted in long-term resolution of signs in the case described here.

Perilesional photobiomodulation therapy and physical rehabilitation in post-operative recovery of dogs surgically treated for thoracolumbar disk extrusion.

BACKGROUND: Recent studies have reported contrasting results of the effects of laser therapy on post-operative intervertebral disk herniation, with a lack of evidence-based advantages of this modality within a rehabilitation protocol. The aim of this study was to report the clinical effects of photobiomodulation therapy within a post-operative rehabilitation protocol in dogs submitted to surgery for thoracolumbar disk extrusion. Twenty-four dogs were included in the study (12 dogs treated with laser therapy and rehabilitation protocol and 12 dogs treated with same rehabilitation protocol but without laser therapy). RESULTS: All dogs treated with laser therapy showed improved neurological status (Modified Frankel Score more than 3 within 30 days of physiotherapy starting) if deep nociception on admission was maintained (P = 0.04). However, Kaplan-Meier analysis did not show any statistical difference in time to regain ambulatory ability, although there was a tendency for a shorter mean time of 14.2 ± 8.55 days in the laser group versus 24 ± 18.49 days in the no laser group. CONCLUSIONS: The use of laser therapy in the post-operative rehabilitation of dogs affected by intervertebral disc extrusion and submitted to surgery for spinal decompression could help improve their neurological status.

Lasers in the surgical treatment of canine prostatic neoplasia and selected tumours of the male reproductive system.

Light-based technologies are applied in various fields of medicine: for example optical diagnostics, light-activated therapy and surgery. Although light-based surgical procedures had hardly been a novelty, the revolutionizing moment for surgery came with the first use of light to cut tissue. Nowadays, surgical lasers are routinely used across numerous medical specialties, including gynaecology and urology. They are a part of the surgical treatment of benign prostatic hyperplasia, prostate carcinoma, penis carcinoma, genital skin lesions and orchidectomy. While in human urology lasers continue to establish their position as one of the standard surgical tools, veterinary patients are rarely treated with what here is still considered a technical innovation. However, through research on laser treatment of the prostate hyperplasia conducted on a canine model, veterinary medicine has gained a massive portion of data. It may prove beneficial for our clinical patients. In this review, we introduce the very principles of laser surgery as well as its current and future applications in oncologic surgery of the canine prostate gland and the male reproductive system.

A retrospective comparison of carbon dioxide surgical laser and non-laser excision for removal of cutaneous and subcutaneous soft-tissue sarcomas in dogs.

Aims: To compare the duration of anaesthesia, surgery, and postoperative hospitalisation, the proportion of tumours excised with complete histologic margins and immediate postoperative surgical site complications in dogs undergoing removal of cutaneous or subcutaneous soft tissue sarcomas (STS) by either carbon dioxide (CO2) laser or non-laser surgical excision methods. Methods: Medical records of dogs that underwent surgical excision of cutaneous and subcutaneous STS at the University of Missouri between December 2004 and May 2018 were evaluated. The study population consisted of client-owned dogs that underwent CO2 laser (n = 4) or non-laser (n = 20) excision of a single STS. Data recorded included: signalment, duration of anaesthesia, surgery and postoperative hospitalisation, tumour characteristics, completeness of histologic margins, postoperative complications, adjunctive therapy, and other procedures at the time of surgery. Results: There was no evidence of a difference in mean age, body weight or tumour size between groups. Similarly there was no evidence of a difference in the duration of anaesthesia or surgery, or in the proportion of dogs whose STS were removed with complete histologic margins between dogs whose STS was removed using laser or non-laser surgical excision methods. However, the duration of postoperative hospitalisation trended towards being longer for the laser excision group (p = 0.061). Conclusions: These data provide preliminary evidence that excision of cutaneous or subcutaneous STS with CO2 surgical laser is comparable to non-laser methods for the measured outcomes.

Objective effectiveness of and indications for laser-assisted turbinectomy in brachycephalic obstructive airway syndrome.

OBJECTIVE: To evaluate the effectiveness of laser-assisted turbinectomy (LATE) in treating brachycephalic obstructive airway syndrome (BOAS) and to investigate the potential indications. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Client-owned pugs, French bulldogs, and English bulldogs (n = 57). METHODS: A BOAS index was obtained from whole-body barometric plethysmography before BOAS conventional multilevel surgery (CMS) and 2-6 months post-CMS. Dogs with BOAS index >50% and BOAS functional grades II-III after CMS were considered candidates for LATE. A BOAS index was repeated 2-6 months after LATE. Intranasal lesions and a measurement of soft tissue proportion at the rostral entrance of choanae (STC) were recorded on the basis of computed tomography images. Logistic regressions were used to assess the intranasal predictors for being LATE candidates. RESULTS: Twenty-nine of 57 dogs were candidates for LATE, all of which were pugs or French bulldogs. The median BOAS index of dogs that were operated on (20/29 candidates) decreased from 67% post-CMS to 42% after LATE (P < .001). Soft tissue proportion at the rostral entrance of choanae was the only predictor for candidacy for LATE. Pugs (P = .021; cutoff = 64%) and French bulldogs (P = .008; cutoff = 55%) with higher STC were more likely to be candidates for LATE. After LATE, 12 of 20 dogs had temporary episodes of reverse sneezing, and nasal noise was noted in 8 of 20 dogs when sniffing and excited. CONCLUSION: Laser-assisted turbinectomy was an effective treatment for dogs with intranasal abnormalities and a poor response to CMS. Soft tissue proportion at the rostral entrance of choanae was a predictor of candidacy for LATE in pugs and French bulldogs. CLINICAL SIGNIFICANCE: Computed tomography-based measurement of STC can be used to predict whether LATE is required in addition to CMS in pugs and French bulldogs with BOAS.

Using quarterly earnings to assess racing performance in 66 thoroughbreds after transendoscopic laser surgery for treatment of epiglottic entrapment.

OBJECTIVE: To assess the outcome of transendoscopic laser surgery for the treatment of epiglottic entrapment (EE) and determine the influence of preoperative morphological characteristics on outcomes. STUDY DESIGN: Retrospective cohort study. ANIMALS: Thoroughbred racehorses treated with transendoscopic laser surgery (n = 66) and untreated cohorts (n = 132). METHODS: Medical, surgical, and race records of 66 horses treated with transendoscopic laser surgery were compared with untreated cohorts randomly selected from their last race presurgery. Postsurgery data were collated as number of starts and race winnings for each quarter after the date of surgery. RESULTS: Treated horses performed worse (P = .002) than their untreated cohorts in their last race presurgery. Although treated horses raced fewer times (P < .001) and earned less money (P < .001) in the first quarter after surgery compared with untreated horses, quarterly earnings or starts did not differ between groups after the first quarter. Among variables tested, subepiglottic membrane resection was the only prognostic factor; horses requiring this resection raced fewer times (P = .001) but without a significant difference in earnings. CONCLUSION: Horses treated for EE via transendoscopic laser surgery returned to a performance standard comparable to their untreated cohorts by the second quarter postsurgery. Horses with entrapments requiring resection raced fewer times postoperatively than the untreated cohorts. CLINICAL SIGNIFICANCE: Treated horses can be expected to perform equivocally to that of untreated cohorts in all but the first quarter following surgery except in those cases where resection of the entrapping membranes is required.

Nasopharyngeal sialoceles in 11 brachycephalic dogs.

OBJECTIVE: To report clinical features, diagnosis, surgical treatment, and outcomes of brachycephalic dogs with nasopharyngeal sialoceles (NPS). STUDY DESIGN: Retrospective case series. ANIMALS: Eleven brachycephalic dogs with NPS. METHODS: Diagnosis of NPS was based on identification of cystic nasopharyngeal masses containing saliva-like mucoid material on retroflexed endoscopy. Biopsies were obtained to support the diagnosis. Surgical deroofing was performed under endoscopic guidance, and endoscopic examination was repeated at least 3 months after surgery. The owners rated the outcome of surgery via a follow-up telephone inquiry. RESULTS: Pugs (n = 8), French bulldogs (n = 2), and English bulldogs (n = 1) were included in this study. Eight of the NPS were ventral, 6 were obstructive, and 2 were multiple; both the obstructive and the multiple sialoceles were ventral. Surgical deroofing of the sialoceles was performed under endoscopic guidance with biopsy forceps in 5 cases and by diode laser in 6 cases. No recurrence was diagnosed. Ten of 11 owners reported that they were satisfied with the outcome. CONCLUSIONS AND CLINICAL SIGNIFICANCE: NPS may be an uncommon consequence of chronic nonphysiologic mechanical stress causing changes in minor nasopharyngeal salivary glands. Direct visualization by nasopharyngoscopy is the best technique for detection of NPS, and we advise routine examination of the nasopharynx by endoscope in all brachycephalic dogs before performing surgery. Either endoscopic guided biopsy forceps or diode laser surgery can be used for noninvasive, rapid, and effective resolution of NPS in all of the dogs.

Sinonasal cysts causing dyspnoea in two cattle - case report.

Two cattle were referred to the University Clinic for Ruminants of the University of Veterinary Medicine in Vienna. The main clinical sign in both cattle was dyspnoea with nasal stridor. Clinical examination of the upper respiratory tract was conducted, supplemented by ultrasonography, endoscopy and radiography. In addition, histological, bacteriological, and cytological examinations of different specimen materials were performed. The cow of Case 1 suffered from cystic nasal conchae, which was treated successfully by a laser technique. The cow of Case 2 also suffered from cystic nasal conchae. No surgery was performed in this case because the cyst opened spontaneously the day after diagnostic endoscopic procedures had been performed and the animal did not show any respiratory signs anymore. Pathological changes in the upper respiratory tract, such as nasal obstructions, should be included in the list of differential diagnoses in cattle showing respiratory distress.

A novel approach to brachycephalic syndrome. 3. Isolated laser-assisted turbinectomy of caudal aberrant turbinates (CAT LATE).

OBJECTIVE: To describe isolated laser-assisted turbinectomy of caudal aberrant turbinates (CAT LATE) as a new minimally invasive surgical procedure for the treatment of brachycephalic dogs with obstructing caudal aberrant turbinates (CAT). STUDY DESIGN: Prospective clinical study. ANIMALS: Brachycephalic dogs (24 Pugs, 1 English Bulldog) with CAT but adequate air spaces between the lamellae of the nonobstructing ventral nasal concha. METHODS: A rhinoscopically guided diode laser fiber introduced from anterior was used to dissect CAT within the nasopharyngeal meatus, while leaving the intranasal turbinates intact. Small grasping forceps were used to extract the dissected CAT from anterior or to push it through the nasopharyngeal meatus for extraction from posterior. RESULTS: Isolated CAT LATE was successfully performed on 32 CAT in 25 dogs. Intranasally applied xylometazoline helped shrink the ventral concha, making the approach and extraction easier. Minor bleeding was the only complication observed. CONCLUSION: It is possible to remove CAT with endoscopically applied diode-laser energy while leaving the nonobstructing ventral nasal concha intact.

Development of a minimally invasive approach to equine cervical articular facet joints for placement of an ND:YAG LASER.

The purpose of this study was to develop a minimally invasive approach to equine cervical articular facet joints for application of an ND:YAG LASER and to evaluate the effects of the laser fiber on the surrounding tissue. Under general anesthesia, an ND:YAG LASER was used to apply 2000 J of energy to 5 cervical articular facet joints in 3 horses (15 joints total). Horses were euthanized and the cervical facets and spinal cords were examined grossly and histologically. Gross pathology of the articular facets revealed evidence of articular cartilage charring and diffuse roughening of the surface. Histopathology confirmed coagulative necrosis. This novel technique allowed access to the cervical articular facet joints with the ND:YAG LASER and has the potential to allow performance of a minimally invasive facilitated ankylosis procedure. Further validation in sedated, standing horses is required to establish safety and efficacy of this technique.

Développement d'une approche minimalement invasive pour les facettes vertébrales lombaires équines pour le placement d'un LASER ND:YAG. Le but de cette étude était de développer une approche minimalement invasive pour l'application d'un LASER ND:YAG sur les facettes vertébrales lombaires équines et l'évaluation des effets de la fibre laser sur les tissus environnants. Sous anesthésie générale, un LASER ND:YAG a été utilisé pour appliquer 2000 J d'énergie à 5 facettes vertébrales lombaires chez 3 chevaux (total de 15 articulations). Les chevaux ont été euthanasiés et les facettes vertébrales et les colonnes vertébrales ont été examinées macroscopiquement et histologiquement. La pathologie macroscopique des facettes vertébrales lombaires a révélé des preuves de carbonisation du cartilage dens articulaires et un durcissement diffus de la surface. L'histopathologie a confirmé la nécrose decoagulatio. Cette technique nouvelle a permis l'accès aux facettes vertébrales lombaires avec le LASER ND:YAG et a le potentiel de permettre la réalisation d'interventions d'ankylose minimalement invasives. De nouvelles études de validation chez des chevaux debout sous sédation sont requises pour établir l'innocuité et l'efficacité de cette technique.(Traduit par Isabelle Vallières).

Carbon dioxide laser treatment of extensive pigmented viral plaque lesions in a golden retriever dog.

BACKGROUND: Canine pigmented viral plaque (PVP) is an uncommon skin disease, associated with papillomavirus infection. Lesions are usually small (<1 cm diameter), pigmented macules to plaques on the ventral abdomen and medial thigh. ANIMALS: An 8-year-old male, neutered golden retriever dog presented with numerous dark plaques forming cohesive plaques on the ventrum extending down the medial aspect of both hind legs. The plaques were associated with significant pruritus. RESULTS: Histology confirmed a diagnosis of PVP and PCR amplified Canis familiaris papillomavirus 4 from a formalin fixed plaque sample. The PVPs were completely resolved by two courses of CO2 laser treatment. There was very minimal postoperative discomfort and no relapse or new lesion development within a 12 months follow-up period. CONCLUSIONS AND CLINICAL IMPORTANCE: Extensive PVPs have not previously been described in a golden retriever dog or previously reported to cause pruritus in dogs. Due to the large skin area involved, surgical excision was not feasible in this case. However, two rounds of treatment using laser were completely curative for both focal pedunculated and plaque-like PVP lesions. Additionally, compared to surgical excision, laser treatment is expected to result in less postoperative discomfort, reduced surgery time and fewer postoperative infections. This is the first report of successful treatment of canine PVPs using a CO2 laser. The success of this treatment in this case suggests that laser provides an excellent treatment option for extensive PVPs in dogs.

Canine eosinophilic granuloma of the digits treated with prednisolone and chlorambucil.

BACKGROUND: Canine eosinophilic granuloma (CEG) is an uncommon disease. Lesions are typically located in the oral cavity and other cutaneous sites, but are rarely reported to affect the digits. The majority of cases are treated with prednisolone as a monotherapy; alternative treatment options include corticosteroids administered in combination with azathioprine, antihistamines, electrochemotherapy with bleomycin, and surgical resection. Neither chlorambucil nor laser previously have been reported as treatments. OBJECTIVES: To describe an alternative therapy for treatment of CEG; using chlorambucil in combination with prednisolone for those cases that fail to respond to prednisolone alone. The new treatment was chosen according to good clinical practice and after owner consent. ANIMALS: Two client owned dogs. METHODS: One case was initially treated with carbon dioxide laser to debulk the lesions. Both cases were treated with a combination of oral prednisolone and chlorambucil. RESULTS: Both dogs experienced rapid resolution of lesions with prednisolone and chlorambucil therapy. Case 1 remained in remission three months after withdrawing medication. Case 2 experienced relapse 10 weeks after discontinuing therapy but was well controlled on maintenance prednisolone with chlorambucil at low, well tolerated doses. CONCLUSIONS AND CLINICAL IMPORTANCE: Although CEG appears to be an uncommon disease, it should be included as a differential diagnosis for dermal, nodular lesions affecting the digits. Chlorambucil appears to be an effective and well tolerated prednisolone sparing agent for treatment of CEG. Carbon dioxide laser ablation appears to be an effective method of debulking CEGs.

A Novel Approach to Brachycephalic Syndrome. 2. Laser-Assisted Turbinectomy (LATE).

OBJECTIVE: To introduce a new surgical procedure based on interventional, laser-assisted removal of obstructing turbinate tissue to improve endonasal airway patency in brachycephalic dogs and to confirm the short and long term results using computed tomography (CT) and rhinoscopy. STUDY DESIGN: Prospective clinical study. ANIMALS: Brachycephalic dogs (n = 158; 70 Pugs, 77 French Bulldogs, 11 English Bulldogs) referred for treatment of severe respiratory distress because of brachycephalic syndrome. METHODS: Computed tomography and anterior and posterior rhinoscopy were performed to evaluate endonasal obstruction. Laser-assisted turbinectomy (LATE) using a diode laser was performed as part of a multilevel surgery. Nasal conchae that were causing airway obstruction were removed. RESULTS: The obstructing parts of the conchae were safely and efficiently removed by LATE, shaping a patent nasal airway in all dogs. The newly developed surgical procedure involved 3 steps: turbinectomy of the (1) concha nasalis ventralis; (2) rostral aberrantly growing turbinates (RAT); and (3) caudal aberrantly growing turbinates (CAT). Complications of the procedure included transient intraoperative hemorrhage in 51 of 158 dogs (32.3%); however, a temporary tamponade was necessary in only 2/158 dogs (1.3%). After 6 months, regrowth of turbinates required resection of possibly re-obstructing tissue in 25/158 dogs (15.8%; 1 Pug and 24 French Bulldogs). CONCLUSION: LATE is an effective method for creating a patent nasal airway in brachycephalic dogs with intranasal obstruction.

Preoperative findings and visual outcome associated with retinal reattachment surgery in dogs: 217 cases (275 eyes).

OBJECTIVE: Report the correlation of pre-operative findings with visual outcome in dogs undergoing retinal reattachment surgery for giant retinal tears. PROCEDURES: Retrospective analysis of dogs that underwent pars plana vitrectomy (PPV) with silicone oil (SiO) tamponade and endolaser retinopexy at one institution. Recorded parameters included signalment, etiology, and duration of retinal detachment, observable retinal tissue architecture, visual reflexes, lens status, presurgical aqueous flare, visual status postoperatively, and complications. RESULTS: Two hundred and seventeen patients (275 eyes) were included. Common etiologies of detachment were primary vitreoretinal disease (50.5%), lens surgery (35.3%), and hypermature cataracts (6.2%). Immediate postoperative anatomic success was noted in 98% of operated eyes. Maintenance or return of vision was noted in 74.2% of patients (72% of eyes) through the last known follow-up, with return of vision on average 18.5 days postoperatively. In those eyes that regained vision, 71.7% had retained vision at the last known recheck examination, with an average follow-up time of 550 days. Pre-operative findings correlated with postoperative vision included presence of a dazzle reflex, presence of a menace response, and retinal tissue architecture. The most common complications included migration of SiO into the anterior chamber (49.4%), corneal ulceration (25.7%), glaucoma (25.7%), and cataract formation (24.5%). CONCLUSION: Giant retinal tears in dogs can be successfully managed via PPV with SiO tamponade and endolaser retinopexy. Vision was maintained in the majority of cases with long-term follow-up. Patient history and thorough ophthalmic examination with attention to retinal tissue architecture are important in assessing surgical candidacy.