The use of near infrared fluorescence imaging with indocyanine green for vascular visualization in caudal auricular flaps in two cats.

OBJECTIVES: To describe the use of near infrared fluorescence (NIRF) imaging with indocyanine green (ICG) for vascular visualization in two caudal auricular axial pattern flaps (APF). ANIMALS: Two client-owned cats with upper eyelid masses. STUDY DESIGN: Clinical case report. METHODS: Wide surgical excision with enucleation was performed by using a caudal auricular APF for closure. Flap margins and perforating artery location were approximated with anatomical landmarks. The caudal auricular artery origin was then visualized percutaneously by using an exoscope with NIRF camera and light source after a single 2.5-mg dose of IV ICG. Margins were adjusted as required. The flaps were routinely elevated with continued intraoperative visualization of the artery and rotated to complete closure. RESULTS: After IV ICG administration, fluorescence was initially visualized after 15 to 18 seconds and remained visible for up to 26 minutes. The achieved visualization led to flap margin adjustments in cat 1. Both cats recovered with minimal flap congestion, excellent hair regrowth, and no long-term complications (>186 days). Cat 1 experienced 100% flap survival. Cat 2 experienced 10% partial thickness flap necrosis, but revision was not required, and the flap was healed at recheck 85 days postoperatively. CONCLUSION: The use of ICG for APF vessel visualization prior to and during flap elevation resulted in transcutaneous visualization of the perforating vessel and improved awareness of vessel location intraoperatively. These two cats experienced excellent flap survival without major complications. This report highlights the potential benefits of ICG NIRF in APF for animals undergoing reconstructive surgery.

Evaluation of risk factors for mortality in dogs with lung lobe torsion: A retrospective study of 66 dogs (2000-2015).

The objectives of this retrospective case series study were to describe a group of 66 dogs with lung lobe torsion (LLT) and to investigate the incidence of complications and risk factors for mortality and overall outcome in this population. Sixty-six dogs with LLT from 3 independent academic institutions were investigated. Information on signalment, history, clinical findings, and interventions was obtained. Associations with mortality outcome were examined via logistic regression. Dogs with a depressed mentation at presentation were 21 times more likely to die than dogs with normal mentation [P = 0.008, 95% confidence interval (CI) = 1.949 to 579.904]. The overall odds of mortality were increased by 18% for each unit change in Acute Patient Physiologic and Laboratory Evaluation (APPLEfast) score (P = 0.04, 95% CI = 0.998 to 1.44). No other clinical abnormalities correlated with outcome.

Évaluation des facteurs de risque pour la mortalité chez les chiens souffrant d'une torsion du lobe pulmonaire : étude rétrospective de 66 chiens (2000­2015). Les objectifs de cette étude rétrospective d'une série de cas consistaient à décrire un groupe de 66 chiens ayant une torsion du lobe pulmonaire (TLP) et d'investiguer l'incidence de complications et les facteurs de risque pour la mortalité et les résultats généraux chez cette population. Soixante-six chiens atteints de TLP provenant de trois établissements universitaires indépendants ont été étudiés. Des données ont été obtenues sur le signalement, les résultats cliniques et les interventions. Les associations avec les résultats de mortalité ont été examinées via la régression logistique. Il était 21 fois plus probable que les chiens ayant un état mental déprimé à la présentation meurent que les chiens ayant un état mental normal (P = 0,008, intervalle de confiance [IC] de 95 % = de 1,949 à 579,904). Les probabilités globales de mortalité augmentaient de 18 % pour chaque unité de changement selon la note Acute Patient Physiologic and Laboratory Evaluation (APPLEfast) (P = 0,04, IC de 95 % = de 0,998 à 1,44). Aucune autre anomalie clinique n'offrait de corrélation avec les résultats.(Traduit par Isabelle Vallières).

Use of gentamicin sulfate-impregnated sponges as adjuvant therapy for the treatment of chronic foreign body associated sternal osteomyelitis in a dog.

A 2-year-old Labrador retriever dog was referred for evaluation of parasternal chronic draining sinus tracts associated with sternal osteomyelitis secondary to the presence of a residual wooden foreign body. The use of gentamicin-impregnated collagen sponges as adjunctive therapy to osteomyelitis treatment is reported herein.

Utilisation d'éponges imprégnées de sulfate de gentamicine comme thérapie adjuvante pour le traitement d'un corps étranger chronique associé à une ostéomyélite sternale chez un chien. Un chien Labrador retriever âgé de 2 ans a été recommandé pour l'évaluation de tractus sinusaux parasternaux chroniques et d'un écoulement persistant associés à une ostéomyélite sternale secondaire à la présence d'un corps étranger résiduel en bois. L'utilisation d'éponges de collagène imprégnées de gentamicine est présentée dans le présent article.(Traduit par Isabelle Vallières).

Comparison of complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy in cats.

OBJECTIVE: To compare complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy (VBO) in cats. ANIMALS: 282 client-owned cats treated by VBO at 25 veterinary referral and academic hospitals from 2005 through 2016. PROCEDURES: Medical records of cats were reviewed to collect information on signalment, clinical signs, diagnostic test results, surgical and postoperative management details, complications (anesthetic, surgical, and postoperative), and outcome. Associations were evaluated among selected variables. RESULTS: Unilateral, staged bilateral, and single-stage bilateral VBO was performed in 211, 7, and 64 cats, respectively, representing 289 separate procedures. Eighteen (9%), 2 (29%), and 30 (47%) of these cats, respectively, had postoperative respiratory complications. Cats treated with single-stage bilateral VBO were significantly more likely to have severe respiratory complications and surgery-related death than cats treated with other VBO procedures. Overall, 68.2% (n = 197) of the 289 procedures were associated with Horner syndrome (19.4% permanently), 30.1% (87) with head tilt (22.1% permanently), 13.5% (39) with facial nerve paralysis (8.0% permanently), and 6.2% (18) with local disease recurrence. Cats with (vs without) Horner syndrome, head tilt, and facial nerve paralysis before VBO had 2.6, 3.3, and 5.6 times the odds, respectively, of having these conditions permanently. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggested that staged bilateral VBO should be recommended over single-stage bilateral VBO for cats with bilateral middle ear disease. Cats with Horner syndrome, head tilt, and facial nerve paralysis before surgery were more likely to have these conditions permanently following surgery than were cats without these conditions.

Risk factors and prognostic indicators for surgical outcome of dogs with esophageal foreign body obstructions.

OBJECTIVE To determine risk factors for surgical intervention, complications, and outcome in dogs with an esophageal foreign body (EFB). DESIGN Retrospective observational study. ANIMALS 224 incidents of EFB in 223 dogs evaluated at a veterinary teaching hospital from 1995 through 2014. PROCEDURES Hospital records were reviewed to collect data regarding signalment, history, clinical signs, EFB type and location, procedures, complications, and outcomes. Breed distributions were compared between dogs with EFB and the entire canine patient population during the study period. Variables were tested for associations with each other and with outcomes. RESULTS Terrier breeds were most common (71/233 [30.5%]). Duration of EFB entrapment, body weight, anorexia, lethargy, rectal temperature, and esophageal perforation were associated with the need for surgical intervention. Older age, longer duration of EFB entrapment, and perforation were associated with a poorer prognosis. Endoscopic retrieval or advancement into the stomach was successful for 183 of 219 (83.6%) EFBs, and 16 of 143 (11.2%) entrapments resulted in postprocedural esophageal stricture. Overall median duration of hospitalization was brief (1 day), and the need for surgical intervention was associated with a longer duration. Overall mortality rate was 5.4% (12/223); 90 of 102 (88.2%) dogs with a median follow-up period of 27 months after EFB treatment had an excellent outcome. CONCLUSIONS AND CLINICAL RELEVANCE Study findings suggested that endoscopic EFB retrieval remains the initial treatment option of choice for affected dogs, provided that esophageal perforation does not necessitate surgical intervention. Although esophageal stricture formation was the most common complication, the overall rate of this outcome was low.