Ventral stabilization of thoracic kyphosis through bilateral intercostal thoracotomies using SOP (String of Pearls) plates contoured after a 3-dimensional print of the spine.

OBJECTIVE: To describe a novel vertebral body stabilization and report its outcome in dogs with thoracic kyphosis and secondary myelopathy. STUDY DESIGN: Case series. ANIMALS: Six pugs with thoracic kyphosis and secondary myelopathy. METHODS: Medical records (2012-2017) of dogs with chronic progressive pelvic limb ataxia and ambulatory proprioceptive paraparesis due to thoracic kyphosis were reviewed. Dogs were evaluated via MRI and computed tomography. A 3-dimensional print of the kyphotic vertebral segment was used to precontour the SOP (String of Pearls) plates. Bilateral double, dorsal intercostal thoracotomies were performed to place precontoured SOP on the vertebral bodies. Long-term (6-16 months) clinical outcome was determined on the basis of neurological scoring (NS) and owner questionnaire. RESULTS: The only intraoperative complication consisted of a lung laceration due to preexisting adhesions. Postoperative complications included seroma formation (n = 2) and incidental radiographic evidence of screw breakage (n = 2). NS at presentation ranged between 2 and 4 and improved to 1 at long-term follow-up in all dogs but 1 (NS = 2). All owners felt that their dog had excellent quality of life at follow-up. CONCLUSION: In spite of the challenging local anatomy, all dogs undergoing vertebral stabilization with SOP placement experienced a good clinical outcome. CLINICAL SIGNIFICANCE: Stabilization of vertebral bodies with precontoured SOP placed through bilateral thoracotomies may be considered as a treatment option for dogs with thoracic kyphosis and secondary myelopathy.

Treatment of compensatory hyperhidrosis after sympathectomy with botulinum toxin and anticholinergics.

PURPOSE: Compensatory hyperhidrosis (CH) is the most common adverse complication of sympathectomy. It often has a major negative impact on life quality. No efficient treatment of CH is available. We report nine cases of CH after sympathectomy, which were treated with botulinum toxin A/B (BTX) and anticholinergics. METHODS: The patients responded to a dermatology life quality index (DLQI) questionnaire before injections with BTX and 3 weeks after treatment. At the follow-up visit, the participants also ranked the effect of the treatment on a five-grade scale. Three patients had residual sweating after BTX treatment, and received additional anticholinergics at the follow-up visit. Those subjects eventually had a third evaluation with the DLQI. RESULTS: The DLQI score was, on average, 16.4 before treatment and decreased to 4.8 after BTX injections. Eight out of nine patients were satisfied with the treatment. The average DLQI score decreased to 2.2 when the patients with residual sweating (n = 3) received additional anticholinergics. Adverse events from BTX were mild and temporary, but dry mouth was substantial in one patient using anticholinergics. CONCLUSIONS: A combination of BTX A/B and anticholinergics alleviated the hyperhidrosis with minor side-effects. We consider this treatment safe, effective, and well tolerated.

Evaluation of osteotomy accuracy and rotational and angular alignment for cranial closing wedge ostectomy performed with and without alignment aids.

OBJECTIVE: To (1) investigate the use of K-wires as alignment aids for cranial closing wedge ostectomy (CCWO) and (2) evaluate their effect on osteotomy accuracy and angular/rotational alignment. STUDY DESIGN: Cadaveric study. ANIMALS: Cadaveric pelvic limbs (n = 20). METHODS: CCWO was performed with and without alignment aids on 20 cadaveric pelvic limbs. CT scans were performed pre- and post-operatively to evaluate tibial torsion and valgus/varus deformity. Digital photographs of the ostectomized bone wedges were used to assess divergence of the 2 osteotomies, and the area of the medial and lateral aspects measured to assess osteotomy angulation within the dorsal plane. RESULTS: Osteotomy divergence angle, the difference between the area of the medial and lateral aspects of the ostectomized wedges, and the difference between the pre- and post-operative angles of valgus/varus deformity were all significantly smaller for the alignment aid group. The difference in pre- and post-operative tibial torsion was not significantly different between groups. CONCLUSIONS: K-wires can be used successfully as alignment aids during CCWO and help to create a significantly more orthogonal osteotomy. This allows a significant reduction in the difference between the preoperative and postoperative angles of valgus or varus, which may reduce the risk of developing a clinically important iatrogenically introduced valgus/varus deformity postoperatively.

Clinicopathological findings, treatment, and outcome in 60 cats with gastrointestinal eosinophilic sclerosing fibroplasia.

BACKGROUND: Gastrointestinal eosinophilic sclerosing fibroplasia (GESF) in cats presents as mass(es) associated with the gastrointestinal tract, mesentery, and abdominal lymph nodes. HYPOTHESIS/OBJECTIVES: To report the clinicopathological findings, treatment, and outcome of cats with GESF. ANIMALS: Sixty client-owned cats diagnosed with GESF. METHODS: Retrospective review of medical records of cats with histopathologically confirmed GESF. RESULTS: The median age was 5.4 years (interquartile range [IQR], 3.3-8.9.); 30% were Domestic Shorthairs and 12% were Domestic Longhair cats, with the most prevalent pedigree breeds being Ragdolls (25%), Exotic Shorthair (10%) and Persian (8%) cats. The median duration of clinical signs was 90 days (IQR, 17.5-247.0); the most common clinical signs were weight loss (60%), hyporexia/anorexia (55%), chronic vomiting (37%), lethargy (35%) and chronic diarrhea (27%). Masses were located in the small intestine (32%), stomach (27%), ileocolic junction (15%), colon (10%), lymph node (8%) and mesentery (8%) and 15% of cats had >1 mass. Eosinophilia was present in 50% and hypoalbuminemia in 28% of cats. The mass was removed surgically in 37% of cases. Most cats (98%) were treated with corticosteroids. Survival was not statistically different between cats treated with surgical resection and cats treated with medical therapy alone, 88% of the cats were still alive at the time of writing. CONCLUSIONS AND CLINICAL IMPORTANCE: GESF is an important differential diagnosis for abdominal masses in cats, and has a much better prognosis than previously reported.

Safety of percutaneous ultrasound-guided fine-needle aspiration of adrenal lesions in dogs: Perception of the procedure by radiologists and presentation of 50 cases.

BACKGROUND: Percutaneous ultrasound (US)-guided fine-needle aspiration (FNA) of adrenal gland lesions is controversial in veterinary medicine. OBJECTIVE: To evaluate the frequency and radiologists' perception of the risk of the procedure as well as determining the incidence of complications. METHODS: Retrospective study. A first survey was submitted by e-mail to all board-certified radiologists of the American College of Veterinary Radiology (ACVR) and European College of Veterinary Diagnostic Imaging (ECVDI). A second survey was sent to radiologists who declared having performed the procedure at least once in their career (observational cross-sectional case study). RESULTS: The first survey was sent to 977 diplomates and answered by 138. Of 138 diplomates, 40 currently performed the procedure and 98 did not; 44 of the 98 gave the hypertensive crisis risk in pheochromocytoma as a reason. To the second survey, 12 of 65 responded positively; 50 dogs with 58 lesions were recruited, including 23 pheochromocytomas. Complications were reported in 4 of 50 dogs; 3 hemorrhages (1 mild and 1 moderate) and 1 death from acute respiratory distress syndrome (possibly related to laryngeal paralysis). No hypertensive crisis was reported. There was no relationship between the method of FNA/type of needle used and occurrence of complications. Based on the recollection of these 65 radiologists, who performed approximately 200 FNA of adrenal lesions, a death rate of approximately 1% was estimated. CONCLUSIONS AND CLINICAL IMPORTANCE: Percutaneous US-guided FNA of adrenal lesions can be considered a minimally risky procedure, despite the negative perception by radiologists.

[Implementation of the unified model of presenting cancer diagnosis in Polish pediatric onco-hematology centers]. / Wdrazanie jednolitego modelu informowania dzieci o rozpoznaniu choroby nowotworowej w polskich osrodkach onko/hematologii dzieciecej.

Presentation of full information related to diagnosis of children with cancer should be one of principles in pediatric oncology. Multidisciplinary approach to each newly diagnosed child and its parents contributes to improving this standard. The Polish Pediatric Leukemia and Lymphoma Group is engaged in these activities since 1998 and it resulted in implementation of several SIOP recommendations in most of Polish pediatric oncohematology centers. The unified model of presentation of diagnosis for a child, parents and family was of an importance and the efforts to introduce it in all cooperating centers was undertaken. Proposed model of informing consists of several steps. Procedure should be individually tailored according to natural history of the disease and characteristics of the family. The purpose of the study was to evaluate the informing procedure in 60 children with newly diagnosed neoplasmatic disease.

Vitamin D intoxication caused by ingestion of commercial cat food in three kittens.

Two siblings, a 6-month-old sexually intact male weighing 2.5 kg (cat 1) and a sexually intact female (cat 2) British Shorthair cat weighing 2.3 kg, were examined because of a 3-week history of polyuria, lethargy and laboured breathing. One year previously, another sibling (cat 3) had been presented because of similar, yet more severe, clinical signs at the age of 5 months. Physical examination revealed lethargy, dehydration and polypnoea with slightly increased inspiratory effort. Diagnostic investigation revealed severe hypercalcaemia (cats 1-3), renal azotaemia (cats 1 and 3) and a radiologically generalised miliary interstitial pattern of the lungs (cats 1-3) attributable to hypervitaminosis D caused by ingestion of commercial cat food. Cat 3 was euthanased. Cats 1 and 2 were treated with isotonic saline solution (180 ml/kg IV daily), sucralfate (30 mg/kg PO q12h), terbutaline (only cat 1: 0.1 mg/kg SC q4h), furosemide (1.5 mg/kg IV q8h) and tapering doses of prednisolone. Cat 2 was normal on day 14. Cat 1 had stable renal disease and was followed up to day 672. The radiological generalised military interstitial pattern of the lungs had improved markedly. Excessive cholecalciferol-containing commercially available cat food poses a great hazard to cats. Supportive treatment may result in long-term survival and improvement of radiological pulmonary abnormalities.

Expansile, inflammatory middle ear disease causing nasopharyngeal obstruction in a cat.

A 7-year-old, entire female, domestic shorthair cat presented with recurrent upper respiratory tract problems. Infectious otitis media caused expansion of the middle ear which ultimately resulted in complete obstruction of the nasopharynx. A ventral bulla osteotomy was successful in relieving the clinical signs.