RESUMO
Substantial knowledge has been gained in the pathological findings following naturally occurring spinal cord injury (SCI) in dogs and cats. The molecular mechanisms involved in failure of neural regeneration within the central nervous system, potential therapeutics including cellular transplantation therapy, neural plasticity, and prognostic indicators of recovery from SCI have been studied. This 2-part review summarizes 1) basic science perspectives regarding treating and curing spinal cord injury, 2) recent studies that shed light on prognosis and recovery from SCI, 3) current thinking regarding standards of care for dogs with SCI, 4) experimental approaches in the laboratory setting, and 5) current clinical trials being conducted in veterinary medicine. Part I presents timely information on the pathophysiology of spinal cord injury, challenges associated with promoting regeneration of neurons of the central nervous system, and experimental approaches aimed at developing treatments for spinal cord injury.
Assuntos
Gatos/lesões , Cães/lesões , Traumatismos da Medula Espinal/veterinária , Animais , Sistema Nervoso Central/fisiologia , Descompressão Cirúrgica , Regeneração Nervosa/fisiologia , Plasticidade Neuronal/fisiologia , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/cirurgia , Traumatismos da Medula Espinal/terapiaRESUMO
Laparoscopic portosystemic shunt attenuation was successfully performed in two dogs. Aberrant vessels were noted on visual examination of the abdominal vasculature. Cellophane bands were placed around the vessel laparoscopically for attenuation. The dogs had minimal postoperative morbidity, and there was biochemical evidence of adequate shunt ligation at follow-up examination.
Assuntos
Doenças do Cão/congênito , Doenças do Cão/cirurgia , Veia Porta/anormalidades , Veia Porta/cirurgia , Animais , Celofane , Cães , Feminino , Ligadura/veterinária , Masculino , Resultado do TratamentoRESUMO
OBJECTIVE: To develop and evaluate surgical approaches to the arteries and veins of the fore- and hindlimbs for use as potential recipient vessels for free tissue transfer. STUDY DESIGN: Experimental anatomic study. SAMPLE POPULATION: Canine cadavers (11): 2 preserved and 9 fresh cadavers. METHODS: Fore- and hindlimbs from 1 preserved cadaver injected with a pigmented silicone/barium mixture, through the common carotid artery and external jugular vein, were cut in 1 cm cross-sections. Tissue sections were used to identify the location of vessels >1 mm that could be used as recipient vessels for free tissue transfer. The other preserved cadaver was used to develop surgical approaches to these vessels. Three surgeons evaluated the written descriptions and illustrations for these approaches using fresh cadavers. Modifications to the surgical approaches were made based on recommendations from these surgeons. RESULTS: Six approaches were developed to isolate forelimb recipient vessels: palmar access, distal medial antebrachial, mid-antebrachial, proximal antebrachial, distal humeral, and mid-humeral vascular access. Twelve approaches were developed to isolate recipient vessels of the hindlimb: plantar access, dorsal tarsal, cranial distal tibial, craniomedial distal tibial, lateral distal tibial, medial distal tibial, medial femorotibial, lateral distal femoral, medial femoral, proximal medial femoral, groin, and proximal lateral femoral vascular access. CONCLUSIONS: Six forelimb and 12 hindlimb sites were identified for surgical access to recipient vessels (>1 mm diameter) suitable for use in free tissue transfer for wound reconstruction. CLINICAL RELEVANCE: For reconstruction of complex wounds of the extremities of dogs, surgeons should consider use of readily accessible recipient vessels that would allow for free tissue transfer to the fore- and hindlimbs.
Assuntos
Anastomose Cirúrgica/veterinária , Artérias/cirurgia , Cães/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Veias/cirurgia , Anastomose Cirúrgica/métodos , Animais , Cadáver , Cães/anatomia & histologia , Membro Anterior/irrigação sanguínea , Membro Anterior/cirurgia , Membro Posterior/irrigação sanguínea , Membro Posterior/cirurgiaRESUMO
OBJECTIVE: To describe an extended pedicle flap based on the superficial cervical artery (SCA) for closure of oral defects in dogs. STUDY DESIGN: Anatomic study; in vivo experimental study. ANIMALS: Canine cadavers (13) and 3 dogs. METHODS: The prescapular branch of the SCA was cannulated and perfused with a lead oxide gelatin mixture. The area perfused by 1 SCA was examined as was the rostral extent of the flap. Staged implantation was performed to evaluate flap performance in vivo. In stage 1, the flap was prepared for implantation into the oral cavity. In stage 2, the flap was fully developed to include the 1 degrees, 2 degrees, and partial 3 degrees angiosome of 1 SCA pedicle. The flap was transposed by a bridging incision and a parapharyngeal tunnel into the oral cavity. The flap was used to reconstruct a partial-thickness defect created in the palate. RESULTS: The territory of the contralateral SCA was captured in all cadavers. The full flap reached the level of the canine teeth in all cadavers. In live dogs, necrosis was not observed after implantation into partial-thickness defects and dehiscence was minimal. Loss of pliability secondary to de-epithelialization and staging resulted in a limitation of rostral reach of the flap. CONCLUSIONS: Whereas the flaps did not reach as far rostrally as anticipated, they survived well in the harsh oral environment. The flap may be modified to reconstruct full-thickness palatal defects. CLINICAL RELEVANCE: The extended SCA pattern flap may be adapted for closure of oral defects.
Assuntos
Doenças do Cão/cirurgia , Doenças da Boca/veterinária , Pele/irrigação sanguínea , Retalhos Cirúrgicos/veterinária , Animais , Doenças do Cão/patologia , Cães , Doenças da Boca/patologia , Doenças da Boca/cirurgia , Pescoço/cirurgia , Radiografia , Pele/diagnóstico por imagem , Resultado do TratamentoRESUMO
OBJECTIVE: To develop and evaluate surgical approaches to the arteries and veins of the head and neck for use as potential recipient vessels for free tissue transfer. STUDY DESIGN: Experimental anatomic study. SAMPLE POPULATION: Eleven canine cadavers; 2 preserved cadavers and 9 fresh cadavers. METHODS: The head and neck of one preserved cadaver injected with pigmented silicone/barium, through the common carotid artery and external jugular vein, was cut in 1 cm sagittal sections and cross-sections. These tissue sections were used to identify the location of recipient vessels >1 mm that could be used as recipient vessels for free tissue transfer. The other preserved cadaver was used to develop surgical approaches to these vessels. Three board certified surgeons evaluated the written descriptions and illustrations of the approaches using fresh cadavers. Modifications to the surgical approaches were made based on recommendations from these surgeons. RESULTS: Seven approaches were developed to isolate recipient vessels of the head and neck region. The infraorbital, temporal, and sublingual approaches were easily performed and provided excellent access to the vessels in the region. The approach to the caudal auricular vessels was found to be more difficult but modification of the approach resolved this problem. Access to the facial artery was difficult; it was consistently <1 mm in diameter and thus its use could not be recommended. The approach to the vessels in the cervical region was easily performed. Because of the large size of the external jugular vein and the common carotid artery, end-to-side anastomosis of the donor to recipient vessels is necessary. The large superficial cervical vessels were easily accessed by a lateral shoulder approach. CONCLUSIONS: Surgical approaches to potential recipient vessels of the head and neck were consistently achieved and provided relatively easy access to the vessels. Clinical Relevance- The surgical approaches described in this report can be used to isolate arteries and veins of the head and neck that are >1 mm in diameter. These vessels are suitable for use as recipient vessels for free tissue transfer for reconstruction of complex wounds of the head and neck.