First robot-assisted radical prostatectomy in a client-owned Bernese mountain dog with prostatic adenocarcinoma.

OBJECTIVE: To describe robot-assisted radical prostatectomy (RARP) and report the short-term outcome of a dog with prostatic cancer treated with RARP. STUDY DESIGN: Case report ANIMALS: Client-owned 6-year-old male-neutered Bernese mountain dog. METHODS: Robot-assisted radical prostatectomy was performed with a daVinci Si Surgical System through a transperitoneal approach. An interfascial nerve-sparing approach was used to preserve the neurovascular bundles and increase the likelihood of postoperative urinary continence. Urinary continence was assessed by placing white cloth bedding in the kennel during hospitalization and by owners' observation at home. RESULTS: The console time was 120 minutes, and the estimated intraoperative blood loss was 30 mL. No intraoperative complications were observed. The urinary catheter was removed after 7 days, at which point the dog urinated normally. Peritoneal carcinomatosis was diagnosed 43 days after surgery, and the dog was euthanized. CONCLUSION: Robot-assisted radical prostatectomy was successfully completed in a dog with prostatic neoplasia and led to postoperative urinary continence. CLINICAL SIGNIFICANCE: This single-case report provides evidence to justify further evaluation of RARP in dogs with prostatic neoplasms.

Cardiorespiratory effects of a 7° reverse Trendelenburg position in anaesthetized horses: a randomized clinical trial.

OBJECTIVE: To evaluate the cardiorespiratory effects of a 7° reverse Trendelenburg position (RTP) in anaesthetized horses. STUDY DESIGN: Randomized, non-blinded clinical trial. ANIMALS: A total of 125 horses undergoing elective surgery in dorsal recumbency. METHODS: Horses were allocated to one of three weight classes and assigned to be positioned either on a horizontal table or on a table in 7° RTP, according to a randomized block design. In all horses, anaesthesia was maintained with isoflurane in oxygen and a constant rate infusion of romifidine. All horses were mechanically ventilated throughout anaesthesia, and routine cardiovascular monitoring and arterial blood gas analysis were performed at 15-minute intervals and relevant variables calculated. Data from the first 60 minutes of anaesthesia were compared between both positions using a mixed model analysis of variance. RESULTS: A significant interaction was found between position and weight class for the alveolar to arterial oxygen tension gradient and F-shunt: these variables were lower in RTP than in horizontal position in the two lowest weight classes and vice versa in the highest weight class. Arterial oxygen tension and oxygenation indices were significantly worse in the horses in the higher weight classes. CONCLUSIONS AND CLINICAL RELEVANCE: A 7° RTP did not result in clinically relevant changes in gas exchange or cardiovascular function. Horses with a higher body weight are at increased risk for hypoxaemia during anaesthesia in dorsal recumbency.

Impact of Trendelenburg (head down) and reverse Trendelenburg (head up) position on respiratory and cardiovascular function in anaesthetized horses.

OBJECTIVE: To describe the cardiorespiratory effects of a change in table position in anaesthetized horses. STUDY DESIGN: Prospective, crossover, randomized, experimental study. ANIMALS: Six adult horses (mean body weight 621 ± 59 kg, aged 13 ± 4 years). METHODS: The horses were anaesthetized twice in dorsal recumbency. They were either placed in the Trendelenburg position (head down; HD) followed by reverse Trendelenburg position (head up; HU) or in reverse order. Every position was maintained for 90 minutes. The order of positions was randomly assigned at initial anaesthesia. Extensive cardiorespiratory monitoring was performed. Statistical analysis consisted of a mixed model with horses as random effect and time, position, section of anaesthesia and interaction between those as fixed effects (p < 0.05). RESULTS: When HU was applied during the first section of anaesthesia, PaO2, (p = 0.012), oxygen saturation (SaO2, p < 0.01) and oxygen content (CaO2, p < 0.01) were significantly higher, while venous admixture (Q˙s/Q˙t, p < 0.01), mean arterial (p = 0.039), right atrial (p < 0.01) and mean pulmonary arterial pressure (p < 0.01) were lower than in HD. After changing from HU to HD, PaO2 and SaO2 remained higher and Q˙s/Q˙t lower compared to the inverse order. Independent of the order, in the HD position Q˙s/Q˙t (p = 0.019) increased while PaO2 (p < 0.01), SaO2 (p = 0.011), CaO2 (p < 0.01), venous PO2 (Pv¯O2; p = 0.019), venous saturation (p = 0.004) and venous oxygen content (p = 0.010) decreased over time. No significant differences were found for cardiac output, oxygen delivery, oxygen consumption and dobutamine requirement between the two positions. CONCLUSIONS AND CLINICAL RELEVANCE: Gas exchange is better preserved in HU compared to HD, especially if applied from the start of the anaesthesia.