Sonographic Evaluation of Liver Hemodynamic Indices in Overweight and Obese Dogs.

BACKGROUND: Hepatic circulatory disturbances have been associated with obesity and fatty liver in humans. In the veterinary literature, however, there is limited information regarding the effects of different body condition scores (BCS) on liver hemodynamic indices in dogs. OBJECTIVES: To investigate the influence of BCS on liver hemodynamic indices. ANIMALS: Fifty-three client-owned dogs of various breeds were included. METHODS: Prospective observational study. Dogs were divided into 3 BCS groups using a 5-point scale: G1 - 12 ideal dogs, G2 - 21 overweight dogs, G3 - 20 obese dogs. Mean portal velocity (MPV), portal blood flow volume (PBFV), portal congestion index (PCI), hepatic artery resistivity index (HARI), and hepatic vein (HV) spectral wave were obtained by pulsed Doppler sonography. Alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and alanine aminotransferase (ALT) activities were determined. Liver enzymes activities and liver hemodynamic indices were compared among groups. RESULTS: Obese dogs had lower MPV, higher percentage of abnormal hepatic vein spectral wave and higher median ALP activity than did ideal dogs (P < 0.05). Overweight and obese dogs had lower PBFV than ideal dogs (P < 0.01). Overweight dogs had higher median GGT activity than ideal dogs (P < 0.05). No difference was observed for PCI, HARI and median ALT activity among the groups. CONCLUSIONS AND CLINICAL IMPORTANCE: Obesity was associated with changes in portal vein indices and in HV spectral wave. These changes were accompanied by significant differences in some liver enzymes activities and could be a sign of early liver disease.

Measurement of post-operative pain and narcotic administration in infants using a new clinical scoring system.

We developed a clinical neurologic and behavioral scoring system composed of 10 items to measure the post-operative pain levels in infants: (1) sleep during preceeding hour, (2) facial expression of pain, (3) quality of cry, (4) spontaneous motor activity, (5) Spontaneous excitability, (6) flexion of fingers and toes, (7) sucking, (8) global evaluation of tone, (9) consolability and (10) sociability. Using this system, a group of infants ranging from one to seven months in age and undergoing minor surgical procedures was studied. The infants were randomly assigned to two groups: Group I received Fentanyl intravenously (3 micrograms/kg) prior to surgery, and Group II received a placebo. The infants then were studied post-operatively in the recovery room at 30, 60, 90 and 120 min intervals. Over the entire post-operative observation period, 54% of the infants in Group I had satisfactory analgesia compared to 18% in Group II. There were no significant differences in Group I and Group II in oxygenation, carbon dioxide elimination, blood pressure, heart rate or temperature.

[Induction anesthesia in the child]. / Induction anesthésique chez l'enfant.

The anesthesic induction in children must be technically carefully performed, but also in the child's mind. Inhalation has the advantage to be painless and easy to perform. It seems more advisable to allow the child to choice his own kind of induction. The experience of our institution is reported.

Radiographic lymphangiography in the dog using iodized oil.

The objective of this study was to develop a clinically applicable technique to visualize the medial retropharyngeal, superficial cervical, axillary, superficial inguinal and medial iliac lymph nodes on radiographs. Direct and indirect lymphangiographic methods using iodized oil were repeated for a minimum of five times at eight different locations to enhance the various lymph nodes, using 16 healthy research dogs. Direct lymphangiography, although more invasive than indirect lymphangiography, resulted in uniform contrast uptake by an increased number of nodes and increased enhancement of the lymphatic vasculature, and is recommended for imaging the medial iliac and superficial cervical lymph nodes. Side effects were more frequent after indirect lymphangiography (10/20 injection sites) than after direct lymphangiography (3/16 injection sites). The small size of afferent lymphatic vessels did not allow use of direct lymphangiography for the medial retropharyngeal, axillary and superficial inguinal lymph nodes; however, indirect techniques allowed adequate visualization of these nodes.

Diagnoses and clinical outcomes associated with surgically amputated canine digits submitted to multiple veterinary diagnostic laboratories.

Amputation is commonly performed to both treat and diagnose conditions affecting the digits of dogs. Although histopathologic evaluation of these digits is routinely done, data on the prevalence and prognosis of neoplasms of the digit are scarce. The records of multiple veterinary diagnostic laboratories were searched to identify submissions of amputated digits from dogs. Four hundred twenty-eight separate submissions were reviewed for diagnosis, age, sex, limb of origin, and digits affected, and the original submitting clinics were surveyed to determine clinical outcome of the animal. No diagnosis could be agreed upon in 24 animals, and these were excluded from the study. Kaplan-Meier product-limit method was used to determine the disease-free interval and survival time. Neoplastic disease was identified in 296 of 404 submissions, with exclusively inflammatory lesions composing 108 cases. A total of 30 different neoplastic processes were identified. In 233 (77.7%) of the neoplastic cases, a malignant tumor was identified. Squamous cell carcinoma was the most commonly identified tumor (n = 109, 36.3%), and 11 of 42 dogs for which clinical follow-up information was available developed metastatic disease. Squamous cell carcinoma of the digit appears to have a greater metastatic potential than that occurring elsewhere in the body. Other common diagnoses included melanoma (n = 52, 17.3%), soft-tissue sarcoma (n = 29, 9.7%), and mast cell tumor (n = 20, 6.7%). Melanomas were associated with poor prognoses, with a median survival time of 365 days.

Diagnoses and clinical outcomes associated with surgically amputated feline digits submitted to multiple veterinary diagnostic laboratories.

Amputation is commonly performed in an attempt to both treat and diagnose conditions affecting the digits of cats. The records of multiple veterinary diagnostic laboratories were searched to identify submissions of amputated digits from cats. Eighty-five separate submissions were reviewed for diagnosis, age, sex, limb of origin, and digits affected; and the original submitting clinics were surveyed to determine clinical outcome. The Kaplan-Meier product-limit method was used to determine the disease-free interval and survival time. Neoplastic disease was identified in 63 of 85 submissions, with exclusively inflammatory lesions composing the other 22 cases. In 60 (95.2%) of the neoplastic cases, a malignant tumor was identified. Squamous cell carcinoma was the most commonly identified malignant tumor (n = 15; 23.8%) and was associated with a median survival time of 73 days. Other diagnoses included fibrosarcoma (n = 14; 22.2%); adenocarcinoma, likely metastases of a primary pulmonary neoplasm (n = 13; 20.6%); osteosarcoma (n = 5; 7.9%); mast cell tumor (n = 4; 6.3%); hemangiosarcoma (n = 5; 7.9%); malignant fibrous histiocytoma (n = 2; 3.2%); giant cell tumor of bone (n = 2; 3.2%); and hemangioma (n = 2; 3.2%). Giant cell tumor of bone has not been previously described in the digits of cats. Various neoplasms can occur in the digits of cats, and submission of the amputated digit for histopathologic diagnosis is essential to determine the histogenesis and predict the clinical outcome.

[Continuous spectrum analysis during anesthesia and the recovery period in infants under 1 year of age]. / Analyse spectrale continue de l'EEG lors de l'anesthésie et du réveil chez l'enfant de moins de 1 an.

Continuous spectral EEG activity monitoring has been used in adults as a monitor of brain activity during anesthesia. It has not been used in infants. We studied 22 infants less than 7 months old undergoing minor surgery. Halothane alone or minimal Halothane anesthesia associated with caudal epidural anesthesia were used. Life-Scan analysis, in spite of wide individual variations, allowed us to detect infraclinical hypoxia episodes, it provided informations about operative confort, depth of anesthesia and added in the post-operative period an objective criteria to clinical evaluation of pain. A wide use of such a monitoring is warranted in infants.

[Infra-orbital nerve block in early primary cheiloplasty]. / Bloc des nerfs sous-orbitaires dans les cheiloplasties primaires précoces.

A prospective study have studied the effect of infraorbital block during anesthesia in infants with a cleft lip. The study was conducted during the year 1994, in the hospital Necker Enfants-malades. During this period 51 cleft lip surgery were performed. Anesthesia for infants with cleft lip using bilateral infraorbital block is a safe, simple and quick technique, and result in a good longlasting analgesia, seems to decrease the risk of respiratory depression, and allows an immediate and comfortable awakening.

A preliminary assessment of whole-body radiotherapy interposed within a chemotherapy protocol for canine lymphoma.

Six dogs with spontaneously occurring, previously untreated lymphoma were treated with half-body radiation therapy (RT) doses interposed in a CHOP-based 25-week chemotherapy regimen. Chemotherapy-related toxicities were as expected and were mildly increased in severity post-RT compared with pre-RT. Treatment was delayed by 1-2 weeks per delay in four dogs due to chemotherapy-related neutropenia. Radiation therapy was administered in two consecutive day fractions of 4 Gray to the cranial and caudal halves of the body 4 weeks apart. Radiation-related toxicities consisted of lethargy, alopecia, diarrhoea of less than 2-day duration and average decreases in neutrophil counts of 50%. Late effects from RT were not evident. Median remission and survival times for the six dogs were 455 and 560 days, respectively. The protocol was well tolerated and should be studied further to evaluate the potential therapeutic gain of the addition of RT to chemotherapy for the treatment of canine lymphoma.

Autologous blood donation for elective surgery in children weighing 8-25 kg.

To determine whether autologous blood donation can be used safely and efficiently in children weighing 8-25 kg, we studied children whose perioperative blood losses were expected to exceed 25% of total blood volume. Blood donations were performed in pediatric units, under the direction of an anesthesiologist and a blood bank physician experienced in paediatric care. Twenty-four children, median age 6 years (1-13), were included. They underwent surgery mainly for digestive or urological disorders, and for orthopedic defects. Forty blood collections were performed of the 46 prescribed. Phlebotomies could not be performed in 1 child because of the mother's apprehension, and in 5 cases because of venous access problems. All phlebotomies were hemodynamically well tolerated. Hemodilution was also performed in 17 children, and cell saver used in 2. Allogeneic blood transfusion was avoided in 21/24 children.