Video-Assisted Ventral Bulla Osteotomy to Remove a Bullet Foreign Body in a Cat.

A 7 yr old castrated male domestic shorthair presented for assessment of a chronic left head tilt, losses of balance, and positional nystagmus. A computed tomographic scan of the head revealed several fragments of a metallic foreign body in the left tympanic cavity. The foreign material was removed under endoscopic assistance through a minimally invasive ventral bulla osteotomy. No complications were noted during the immediate postoperative period. Follow-up 5 mo after surgery revealed complete resolution of the neurological signs with no evidence of recurrence. Foreign bodies associated with middle ear infection have not been previously reported in the cat. They should now be included in the differential diagnosis of vestibular disease. Endoscopic-assisted foreign body removal in the middle ear seems to be a safe and efficient way to retrieve small foreign bodies in bullae in cats.

Use of a bone-to-tendon plate to stabilize a comminuted calcaneus fracture in a dog.

OBJECTIVE: To report the use of an ancillary plate spanning from the calcaneus to the common calcaneal tendon to stabilize a comminuted fracture in a dog. STUDY DESIGN: Case report ANIMALS: Two year old male neutered mix-breed dog. METHODS: The dog presented for a grade IIIa open highly comminuted fracture of the shaft and tuber of the left calcaneus from a suspected gunshot wound. Plantar and lateral locking plates were applied to the calcaneus, with the lateral plate extending proximally and sutured directly to the common calcaneal tendon. Autogenous cancellous and allogenic corticocancellous bone grafts were placed into the fracture site, and a human placental matrix was injected after closure. A lateral tarsal splint was applied for 17 weeks postoperatively. The lateral bone-to-tendon plate was replaced with a smaller lateral plate spanning only the calcaneus 9 weeks after the initial surgery. RESULTS: Radiographic union was documented at 17 weeks. At 25 weeks, both plates were removed due to suspected implant associated infection. At the final follow-up assessment, 36 weeks after initial surgery, the dog had returned to normal function with no observable lameness. CONCLUSION: Incorporation of the common calcaneal tendon as a proximal segment for plate fixation led to successful union of a highly comminuted calcaneal fracture.

Treatment of acute traumatic nasopharyngeal stenosis with balloon dilation in two dogs.

CASE HISTORY: Two dogs were referred to Veterinary Specialists Aotearoa for evaluation and treatment after sustaining significant head trauma. Case 1 was a 7-month-old, female Staffordshire Bull Terrier who was hit by a car at low speed. Case 2 was a 2-year old, male neutered German Shepherd who sustained a gunshot wound to the head whilst on duty for the New Zealand Police Dog Unit. CLINICAL FINDINGS: The dog in Case 1 suffered numerous facial fractures which caused collapse of the ventral nasal meatus and dorsal nasopharyngeal wall. The dog in Case 2 had extensive osseous and soft tissue damage to the nose, nasopharynx and cervical region with severe narrowing of the ventral meatuses, nasopharyngeal meatus and rostral nasopharynx due to multiple fracture fragments and shrapnel pieces. A diagnosis of traumatic nasopharyngeal stenosis was made in each case by computed tomography. Mechanical balloon dilation was used to treat the stenosis in both dogs. The balloon dilations were performed using a 12-mm balloon dilation catheter inserted in an antegrade fashion. In the first dog, the procedure was performed blind and was repeated three times with 5- and 9-day intervals between dilations. In the second dog, the procedure was performed under endoscopic guidance and again, was repeated three times with a 7-day interval between dilations. Clinical success was reported in both patients following treatment and the second dog also underwent a follow-up computed tomography scan which confirmed resolution of the stenosis. DIAGNOSIS: Traumatic nasopharyngeal stenosis that was successfully treated with balloon dilation. CLINICAL RELEVANCE: Findings suggest that balloon dilation may be an effective technique for the treatment of traumatic nasopharyngeal stenosis in dogs. Multiple dilation procedures are likely required, but the procedure can ultimately result in long term clinical resolution.Abbreviations: CT: Computed tomography; VSA: Veterinary Specialists Aotearoa.

Achieving humane outcomes in killing livestock by free bullet I: Penetrating brain injury.

Humane killing of farm animals by free bullet is a commonly used second-best option in emergency situations and disease control operations. Theoretical justification has been weak in experimental reports of firearm system use in the field. Veterinarians require an in-depth understanding of killing with free bullet to take corrective action when systems fail under field application. This review describes the technical considerations in choosing safe, effective firearm systems to effectively kill minimally restrained livestock at close range. Frequently referenced firearm/bullet recommendations are excessively powerful and unnecessarily hazardous. Based on ballistic energetic performance and mechanical design, the rifle chambered for low energy pistol ammunition, using non-toxic controlled expanding bullets, has the technical capability to deliver immediate insensibility and death at a distance of 5 m or less. At 1 m distance, the .410 shotgun with steel or porcelain shot meets the environmental safety, ballistic, and mechanical challenges and has workplace safety advantages over rifle-based systems.

Atteinte de résultats non cruels lors de l'abattage du bétail par balle libre. I : lésion cérébrale par pénétration. L'abattage sans cruauté des animaux de ferme par balle libre est une option de deuxième choix communément utilisée dans des situations d'urgence et des opérations de maitrise des maladies. La justification théorique a été faible dans les rapports expérimentaux sur l'utilisation de systèmes d'armes à feu sur le terrain. Les vétérinaires ont besoin d'une compréhension approfondie de l'abattage par balle libre afin de prendre des mesures correctrices lors de l'échec des systèmes dans l'application sur le terrain. Ce compte rendu décrit les considérations techniques pour le choix de systèmes d'armes à feu efficaces afin de tuer efficacement à courte distance du bétail retenu de façon minimale. Les recommandations fréquemment mentionnées pour les armes et les balles sont excessivement puissantes et inutilement dangereuses. Selon la performance énergétique balistique et la conception mécanique, l'arme à feu chambrée pour des munitions de pistolet à faible énergie, en utilisant des balles à expansion contrôlée non toxiques, possède la capacité technique d'infliger une insensibilité immédiate et la mort à une distance de 5 m ou moins. À une distance de 1 m, le fusil .410 avec de la grenaille d'acier ou de porcelaine satisfait aux exigences en matière d'environnement, de balistique et de mécanique et présente des avantages pour la sécurité au travail par rapport aux systèmes à carabines.(Traduit par Isabelle Vallières).

Veterinary Forensics: Firearms and Investigation of Projectile Injury.

Projectile injury represents an estimated 14% of reported animal cruelty cases in the United States. Cases involving projectiles are complicated by gross similarities to other common types of injury, including bite wounds and motor vehicle injuries, by weapons and ammunition not commonly recognized or understood by veterinary medical professionals, and by required expertise beyond that employed in routine postmortem examination. This review describes the common types of projectile injuries encountered within the United States, as well as firearms and ammunition associated with this form of injury. The 3 stages of ballistics-internal, external, and terminal-and wounding capacity are discussed. A general understanding of firearms, ammunition, and ballistics is necessary before pursuing forensic projectile cases. The forensic necropsy is described, including gunshot wound examination, projectile trajectories, different imaging procedures, collection and storage of projectile evidence, and potential advanced techniques for gunpowder analysis. This review presents aspects of projectile injury investigation that must be considered in tandem with standard postmortem practices and procedures to ensure reliable conclusions are reached for medicolegal as well as diagnostic purposes.

Heterotopic Ossification Secondary to Gunshot and Fragment Wounds in a Golden Eagle ( Aquila chrysaetos ).

Heterotopic ossification is the process of pathologic bone formation in soft tissue structures that usually do not form bone. An immature golden eagle ( Aquila chrysaetos ) was examined 2 months after a gunshot wound in the right wing. A solid oval mass with a gun pellet at its core was found attached to the ulna by a bony pedicle and was surgically excised. Heterotopic ossification secondary to gunshot and fragment wounds in the right ulna was diagnosed based on clinical, radiographic, and histopathologic findings. This report is the first to describe heterotopic ossification occurring around a gun pellet in a bird.

CHRONICALLY EMBEDDED LEAD PROJECTILES IN WILDLIFE: A CASE SERIES INVESTIGATING THE POTENTIAL FOR LEAD TOXICOSIS.

Research has demonstrated that intramuscularly embedded lead in humans and rats may cause direct plumbism, albeit rarely, and has identified risk factors to this end. To the authors' knowledge, this has not been investigated in wildlife, despite a high incidence of embedded lead in these animals secondary to cynegetic activities. Fourteen wildlife cases submitted to the National Fish and Wildlife Forensics Laboratory for cause-of-death determination had chronically embedded lead projectiles that were unrelated to the cause of death. Tissue lead levels were measured in all cases and revealed clinically significant hepatic lead levels in two cases. The results corroborate comparative literature and suggest that embedded lead fragments carry a low risk for direct plumbism, even in the face of risk factors such as fractures, inflammation, and projectile fragmentation. Wildlife morbidity and mortality from embedded lead is more commonly realized secondary to incidental ingestion and ballistic trauma rather than by direct toxicity.

An optimized computed tomography protocol for metallic gunshot head trauma in a seal model.

Computed tomography (CT) is commonly used to assess animals with head trauma. However, strongly attenuating objects such as metallic gunshot cause artifacts that may make accurate localization of shrapnel pieces difficult. The purpose of this study was to develop an optimized CT protocol for minimizing metal artifacts in an animal model of gunshot head trauma. A cadaver head of a stranded Gray seal (Halichoerus grypus) was shot post-mortem with a 0.223-inch caliber rifle. The head was frozen, thawed, and scanned using a multislice CT scanner and protocols with varying acquisition and reconstruction parameters. Scans were acquired with and without use of the scanner's proprietary Extended CT Scale (ECTS) mode and beam hardening reduction (Posterior Fossa Optimization [PFO]) filter. Window/level display settings were also varied. For each protocol and each of five selected metallic shrapnel pieces, a single observer measured combined metal halo artifact and shrapnel area using a hand-traced region of interest. The number of hypo- and hyper-attenuating streak artifacts was also recorded. Measurements were repeated for three different reading sessions. Metal CT artifacts were minimized with a high-frequency image reconstruction algorithm and a wide window setting. Further artifact reduction was achieved with a proprietary ECTS raw data reconstruction technique and a very wide window. This enabled a more confident evaluation of surrounding bone. On the other hand, these techniques are unfortunately not effective under conditions of soft tissue evaluation. Increasing tube voltage and use of a proprietary PFO filter did not yield a significant reduction in metal artifacts.

Trauma and wound management: gunshot wounds in horses.

Bullet wounds in horses can cause a wide array of injuries, determined by the type of projectile, the energy of the bullet on entry, and the type of tissue the bullet encounters. Treatment includes identification of all structures involved, debridement of the permanent cavity, and establishing adequate drainage. Bullet wounds should be treated as contaminated, and broad-spectrum antibiotics, including those with an anaerobic spectrum, are indicated. Although musculoskeletal injuries resulting from gunshots are most common in horses, they carry a good prognosis for survival and return to function.

Dural tear and myelomalacia caused by an airgun pellet in a cat.

An 8-year-old cat was presented with severe neurological deficits secondary to a traumatic cervical spinal cord injury caused by an airgun pellet. This report describes, for the first time, the myelographic findings of a dural rupture in a cat and also describes a bilateral Horner's syndrome in a cat.

Déchirure durale et myélomalacie causées par le plomb d'un pistolet pneumatique chez un chat. Un chat âgé de 8 ans a été présenté avec des déficits neurologiques graves secondaires à une blessure traumatique de la moelle épinière cervicale causée par le plomb d'un pistolet pneumatique. Ce rapport décrit, pour la première fois, les résultats myélographiques d'une rupture durale chez un chat et aussi un syndrome de Horner chez un chat.(Traduit par Isabelle Vallières).

A novel case of tracheal injury secondary to gunshot trauma in a white rhinoceros (Ceratotherium simum).

OBJECTIVE: To describe a case of tracheal injury secondary to gunshot trauma in a rhinoceros. ANIMALS: 5-year-old female white rhinoceros (Ceratotherium simum). CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: The rhinoceros was found alive with an apparent bullet entry wound cranial to the left shoulder. The rhinoceros was agitated and had bilateral epistaxis and increased respiratory noise. Immobilization of the animal facilitated closer examination and initiation of medical therapy. Radiographs obtained of the neck region at this first examination were nondiagnostic. Subsequent immobilization events allowed for further diagnostics and treatment. TREATMENT AND OUTCOME: Initial treatment included a broad-spectrum antibiotic and a corticosteroid. Five days following the injury, the rhinoceros was considered stable, and the animal was immobilized to investigate the cause of the epistaxis and respiratory signs. Tracheoscopy revealed a full-thickness penetrating wound in the mid to caudal region of the trachea, and the surface of a metallic projectile was viewed within the wound. Medical treatment was continued and the rhinoceros was managed conservatively. At 14 days, radiographs of the neck made with a more powerful unit revealed tissue emphysema dorsal to the trachea. A subsequent tracheoscopy 54 days after injury revealed a granulated wound. Follow-up at 4 years after injury determined that the rhinoceros was reported to be behaving normally and had successfully calved. CLINICAL RELEVANCE: Gunshot wounds associated with poaching are a prevalent problem in rhinoceros in Africa. Although more aggressive therapy including surgery may likely be considered in zoo or domestic animals, limited conservative treatment was successful in this wild-managed rhinoceros.

Budd-Chiari-like syndrome in a dog secondary to a gunshot wound treated with balloon angioplasty and endovascular stent placement.

A 6-year-old female spayed Chihuahua mix presented with chronic recurrent ascites. Computed tomographic angiography revealed an isolated stenosis of the caudal vena cava secondary to a metallic foreign body, resulting in Budd-Chiari-like syndrome. Balloon angioplasty and endovascular stent placement successfully resolved the obstruction with long-term resolution of ascites.

Increased incidence and shift in the location of gunshot wound injuries in dogs and cats during the COVID-19 pandemic.

OBJECTIVE: To investigate the incidence and patterns of gunshot wound trauma in patients that were presented to an urban level 1 veterinary trauma center before and after the start of the coronavirus disease of 2019 (COVID-19) pandemic. ANIMALS: 24 dogs and 1 cat. METHODS: Medical records were retrospectively reviewed for patients presenting with gunshot wound injuries between March 2018 and February 2020 (prepandemic) and March 2020 and February 2022 (pandemic). The total number of patients presented to the hospital during those same time periods was also obtained. Patient data were collected including species, breed, age, sex, location of injury, trauma score (if available), surgical procedures performed, length of hospitalization, and case outcome. RESULTS: In the prepandemic period, 9 patients were presented for gunshot wound injuries, whereas there were 16 patients evaluated for gunshot wound injuries during the pandemic period. The total number of gunshot wound cases increased by 77.8% in the pandemic period. The total number of hospital patient visits, however, decreased by 12.2% in the pandemic period as compared to the prepandemic period: 65,168 versus 74,262 patients, respectively. Injuries were predominantly localized to the extremities (55%) in the prepandemic period versus maxillofacial (56%) in the pandemic period. CLINICAL RELEVANCE: There was an increased number of gunshot wound injuries in companion animals presenting to an urban level 1 veterinary trauma center during the COVID-19 pandemic. A shift in the predominant location of injury was also identified during the pandemic period. This study highlights the ramifications that societal dynamics can have on animal health and welfare.

Penetrating ocular gunshot injury in a Labrador Retriever.

A 3½-year-old, female (spayed) working black Labrador Retriever was referred to the Unit of Comparative Ophthalmology at the Animal Health Trust after a penetrating lead gunshot injury to the right eye. Clinical examination revealed penetrating injuries to the right cornea, left lateral canthus, and left forelimb. Radiography revealed the presence of multiple metallic foreign bodies in the head and one in the left forelimb. B-mode ocular ultrasonography confirmed the presence of an intraocular metallic foreign body within the posterior tunics of the right eye. Medical treatment of the right eye over a period of 1 month resulted in a comfortable, visual eye. Long-term follow-up over 4½ years revealed a slow deterioration in vision because of progressive lens opacification and the presence of a localized area of chorioretinopathy.

Injuries and Interventions on Transported Military Working Dogs Within the US Central Command.

BACKGROUND: Limited veterinary care is available in the far forward environment, leading to human medical personnel being responsible, in part, for treatment of military working dogs (MWD). Though guidelines for MWD care exist, there is little research on the care and treatment of MWDs by human medical personnel. There is a lot of research on the care and treatment of MWDs. METHODS: This is a secondary analysis of a dataset from the Transportation Command (TRANSCOM) Regulating Command & Control and Evacuation System (TRAC2ES) database within the US Central Command (CENTCOM) from 2008 to 2018. Within this dataset specific to regulated transport from locations within CENTCOM, we abstracted all entries involving MWDs and analyzed causes of injury, type of injury, and interventions performed on traumatically and non-traumatically injured MWDs. RESULTS: Within our dataset, there were 84 MWD cases for analysis. Of those, 36 (43%) were transported for traumatic injuries, and the remaining 48 (57%) were transported for other medical ailments. The most common cause of trauma was gunshot wound (31%), followed by explosion (22%). The majority of trauma MWDs had injuries to the extremities (67%), and hemorrhage requiring intervention occurred in 25%. The most common interventions performed on traumas were analgesia (67%), antibiotics (31%), IV fluids (28%), and surgery (31%). The most common indications that occurred in MWDs treated for nontraumatic medical indications were gastrointestinal diseases (33%), followed by nontraumatic orthopedic injuries (21%). CONCLUSIONS: Of the MWDs in our dataset, most were transported for nontraumatic medical events. The most frequent intervention performed was medication administration for both traumatic and medical ailments. Our dataset adds to the limited body of MWD data from theater.

Outcomes and Complications Associated with Acute Gunshot Fractures in Cats and Dogs.

OBJECTIVE: The aim of this study was to summarize outcomes and complications of gunshot fracture management in small animals. STUDY DESIGN: Review of cats and dogs with radiographically confirmed acute gunshot fractures, presenting data on signalment, fracture location, fracture management (surgical vs. non-surgical, type of surgical repair), fracture comminution, extent of soft tissue trauma, postoperative complication and overall outcome. A poor outcome was defined as patient death, major postoperative complication or limb amputation (both as primary treatment or secondary to postoperative complications). RESULTS: Ninety-seven animals with 137 acute gunshot-induced fractures were identified. There were 21 (15.3%) maxillofacial, 16 (11.7%) vertebral column, 8 (5.8%) rib, 56 (40.9%) distal long bone (below stifle/cubital joint) and 36 (26.3%) proximal long bone (at or above stifle/cubital joint) fractures. Overall, 20/37 cases with sufficient follow-up details incurred a poor fracture outcome. Extensive soft tissue trauma at the fracture site was associated with an increased likelihood of poor outcome. The most common poor outcomes were primary limb amputations (7 cases) and postoperative complications (3 osteomyelitis/surgical site infections, 4 delayed/non-unions). CONCLUSION: Gunshot fractures overall have high likelihood of poor outcome. Severe soft tissue injury is associated with complications. Mitigating poor outcome likely requires early aggressive wound management.

Radical maxillectomy as a successful treatment for gunshot-induced maxillary and nasal cavity trauma in a dog.

OBJECTIVE: To report the successful treatment of gunshot-induced maxillary and nasal cavity damage with total maxillectomy in a two-year-old Labrador retriever dog. METHODS: Radical maxillectomy was performed on highly comminuted maxillary and nasal cavity fractures resulting from gunshot trauma. The procedure was performed to remove the damaged region and reconstruct the remaining tissue. RESULTS: Treatment of the fractures by total maxillectomy was successful in reconstruction of the remaining structures following debridement and in re-establishing return to normal activities and high owner satisfaction. CLINICAL SIGNIFICANCE: The outcome in this case suggests that severe maxillary and nasal cavity trauma in other dogs may be treated with radical maxillectomy given appropriate patient and owner selection.

Treatment of a nonunion, secondary to gunshot fracture, of the distal radius with circular external fixation and rhBMP-2 in a cat.

OBJECTIVE: To report the successful use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the treatment of an antebrachial non-union, secondary to gunshot fracture, stabilized with circular external fixation in a cat. PROCEDURE: Following a diagnosis of a highly comminuted gunshot fracture of the distal right radius and ulna, the fracture was stabilized with a circular external fixation. A two-ring frame was placed in closed fashion. RESULTS: The skin wound healed uneventfully by second intention in 21 days. Twenty-eight weeks after external fixation, bone healing was absent. 0.8mL of 0.2mg/mL of rhBMP-2 in two collagen sponges was placed in the bone defect. Eight weeks after rhBMP-2 implantation, an early bone healing response was noted on radiographic evaluation. Sixteen weeks after rhBMP-2 implantation, fracture union was achieved. DISCUSSION: To the authors' knowledge, 160 µg is the lowest reported dose of rhBMP-2 that leads to bony union in a cat. However as an individual case study, this report can not be used as evidence that rhBMP-2 at this lower dose is appropriate for use in all cats. Further studies are needed to establish the minimum efficient dose of rhBMP-2 in cats.

Computed tomographic assessment of brain tissue disruption and skull damage in equine cadaveric heads caused by various firearm-ammunition combinations applied as potential gunshot methods for euthanasia of horses.

OBJECTIVE: To evaluate with CT the characteristics of brain tissue disruption and skull damage in cadaveric heads of adult horses caused by each of 6 firearm-ammunition combinations applied at a novel anatomic aiming point. SAMPLE: 53 equine cadaveric heads. PROCEDURES: Heads placed to simulate that of a standing horse were shot with 1 of 6 firearm-ammunition combinations applied at an aiming point along the external sagittal crest of the head where the 2 temporalis muscles form an inverted V. Firearm-ammunition combinations investigated included a .22-caliber long rifle pistol firing a 40-grain, plated lead, solid-core or hollow-point bullet (HPB); a semiautomatic 9-mm pistol firing a 115-grain, jacketed HPB; a semiautomatic .223-caliber carbine firing a 55-grain, jacketed HPB; a semiautomatic .45-caliber automatic Colt pistol firing a 230-grain, jacketed HPB; and a 12-gauge shotgun firing a 1-oz rifled slug. Additional heads placed in a simulated laterally recumbent position were shot with the semiautomatic 9-mm pistol-HPB combination. All heads underwent CT before and after being shot, and images were evaluated for projectile fragmentation, skull fracture, and cerebrum, cerebellum, and brainstem disruption. RESULTS: Computed tomography revealed that all firearm-ammunition combinations caused disruption of the cerebrum, cerebellum, and brainstem that appeared sufficient to result in instantaneous death of a live horse. Hollow-point ammunition was as effective as solid-core ammunition with regard to brain tissue disruption. Brain tissue disruption was not affected by head positioning. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the examined firearm-ammunition combinations, when applied at a novel aiming point, appear to be reasonable options for euthanasia of horses.

Comparison of trauma sustained by civilian dogs and deployed military working dogs.

OBJECTIVE: To compare the prevalence of types of trauma, mechanisms of injury, and outcomes among military working dogs (MWDs), operational canines (OpK9s), and civilian dogs (CDs) that sustained traumatic injury. DESIGN: Retrospective descriptive analysis. ANIMALS: One hundred and ninety-three cases of MWD trauma, 26,099 cases of CD trauma, 35 cases of OpK9 trauma. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records of MWDs that incurred trauma while deployed to the Middle East were identified, and information was extracted from these records. The resultant database was compared to CD and OpK9s in the American College of Veterinary Emergency and Critical Care (ACVECC) Veterinary Committee on Trauma registry. All 3 groups showed similar trends with regard to type of trauma: penetrating injuries occurred most frequently, followed by blunt injuries for CDs and OpK9s. An equal proportion of blunt and blunt and penetrating traumas were observed in MWDs. Only MWDs sustained trauma from explosions, which accounted for 22.3% of injuries in this group. Animal bite/scratch/quilling and motor vehicle accidents (MVAs) were significantly more prevalent among CDs than MWDs (P < 0.01), whereas injuries from gunshot wounds (GSW) or a knife/sharp object were more common among MWDs compared to CDs (P < 0.01). No statistical differences in survival were observed between CDs and MWDs after excluding civilian dogs euthanized due to financial limitations. CONCLUSIONS: MWDs, OpK9s, and CDs experience differences in injury type, mechanism, and outcome. Regardless, MWDs and CDs have good prognosis for survival to discharge after trauma.