Persistent urinary incontinence in female Golden Retrievers following laser ablation of intramural ectopic ureters may be associated with the presence of historical urinary tract infection.

OBJECTIVE: To identify predictive factors for postoperative continence in female Golden Retrievers following cystoscopic-guided laser ablation of intramural ectopic ureters (CLA-EU). ANIMALS: 41 client-owned female entire Golden Retrievers with uni- or bilateral intramural ectopic ureter(s) were retrospectively enrolled. METHODS: Patients were diagnosed with ectopic ureters with a combination of ultrasonography and cystoscopy. CLA-EU was performed for all dogs so that each ureteral opening was considered to be in an appropriate position by a single operator. All dogs had short-term follow-up 4 weeks and long-term follow up > 10 weeks after the procedure via telephone, which included urinary continence scoring. Clinical factors and ultrasonographic and cystoscopic findings from initial presentation were evaluated to identify predictive factors for postoperative continence. RESULTS: Short-term urinary continence was achieved in 46.3% of dogs with no additional medical therapies. Presence of historical urinary tract infections prior to CLA-EU (OR, 0.130; 95% CI, 0.020 to 0.621; P = .018) was negatively correlated and ureteral dilatation (OR, 34.260; 95% CI, 1.813 to 2,143; P = .043) was positively correlated with likelihood of urinary continence. Long-term urinary continence was achieved in 63.4% of dogs, and presence of historical urinary tract infections was negatively prognostic (OR, 0.173; 95% CI, 0.023 to 0.856; P = .048). CLINICAL RELEVANCE: Female Golden Retrievers undergoing CLA-EU have similar outcomes to those reported for other mixed-breed cohorts with > 30% of dogs failing to regain urinary continence. Historical urinary tract infections were significantly associated with both short- and long-term urinary continence in our population.

Diagnosis of a tracheal tear by use of an oxygen analyzer in a dog with cervical trauma.

CASE DESCRIPTION: A 7.75-year-old sexually intact male Welsh Terrier was examined because of cervical soft tissue wounds and an inability to maintain hemoglobin oxygen saturation without oxygen supplementation following a dog attack. CLINICAL FINDINGS: A 2-cm-long penetrating wound that extended into a large open pocket was identified on the left ventral aspect of the dog's neck. The dog was anesthetized and underwent advanced imaging, the findings of which suggested that the trachea was intact. However, when the cuff of the endotracheal tube was deflated during the dog's recovery from anesthesia, sudden oxygen desaturation occurred. Given no radiographic signs of deteriorating lung injury, a tracheal tear was suspected. For rapid confirmation of a tracheal tear, without the need for additional advanced imaging, the oxygen concentration at the skin wound was investigated by use of an oxygen analyzer. When the dog was breathing 100% oxygen, the analyzer identified a higher oxygen concentration at the edge of the penetrating wound, compared with the concentration of oxygen in room air; the leakage of oxygen-rich gases from the airway through the wound confirmed the presence of a tracheal tear, immediately indicating the need for surgical exploration and repair. TREATMENT AND OUTCOME: Surgical repair of the tracheal tear with a left sternothyroideus muscle flap was successfully performed. CLINICAL RELEVANCE: For this dog, an oxygen analyzer was used to confirm the presence of a tracheal tear, suggesting that application of an oxygen analyzer may be useful in the emergency management of neck trauma cases.

Adult Age Differences in the Effects of Chronic Mental Fatigue on Task-Related Fatigue, Appraisals, and Performance.

Engagement in potentially beneficial activities is assumed to be based partially on perceived costs and benefits. Mental fatigue may be one factor that affects perceived costs. We examined age differences in both chronic and situational mental fatigue, and their relation to task perceptions and engagement levels. Younger (M age = 32.6) and older (M age = 73.1) adults completed questionnaires measuring subjective mental fatigue, physical and mental health, and motivational states, along with several assessments of cognitive ability. In addition, assessments of effort expenditure (systolic blood pressure) and task difficulty were collected during performance of a cognitively demanding memory-scan task. Two components of chronic mental fatigue (CMF) relating to affect and motivation were identified. Although the structure of CMF did not vary with age, CMF was differentially predictive of engagement and appraisal levels across groups. As CMF-Affect levels increased, older adults' task-difficulty appraisals increased more than those of younger adults. In addition, CMF-Affect was positively associated with levels of engagement in the young, but negatively associated in the old as memory load increased. Older adults also exhibited higher levels of situational fatigue than did the young, as evidenced by increased levels of effort expenditure as both time on task and objective demands increased. However, little relationship existed between chronic and situational mental fatigue in either age group. These findings suggest that the affective aspect of CMF is particularly consequential in older adults, with both task appraisals and engagement levels being negatively affected when fatigue is high.

Variations in surgical technique for adrenalectomy with caudal vena cava venotomy in 19 dogs.

OBJECTIVE: To describe surgical techniques, caval occlusion times, and short-term outcomes in dogs undergoing adrenalectomy with caval venotomy. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs undergoing adrenalectomy with caval venotomy between October 1, 2010 and May 31, 2018. METHODS: Medical records of dogs undergoing adrenalectomy with caval venotomy were reviewed for signalment, perioperative management, surgical details, perioperative complications, mortality, and histopathology. Computed tomography images were reviewed to describe tumor morphology and signs of thrombus extension. RESULTS: Nineteen dogs had adrenal tumor thrombi extending into the prehepatic (14 dogs, 74%), hepatic (3 dogs, 16%), and posthepatic (2 dogs, 11%) caudal vena cava. Tumors occurred in left (11) and right (8) adrenal glands. Median caval occlusion was 6.5 minutes (range, 2-25). Two to six vascular tourniquets were used. Venotomy closure was performed under full caval occlusion in 11 dogs and by using a partial occlusion clamp in 8 dogs. Left ureteronephrectomy was performed in 5 dogs. Perioperative mortality rate was 21% (4 dogs). CONCLUSION: Extension of caval tumor thrombus beyond the hepatic hilus did not preclude a good outcome. Longer caval occlusion than has been previously reported was tolerated in some cases. Number of vascular tourniquets used reflected the location of phrenicoabdominal vein insertion on the cava and length of the caval tumor thrombus. Venotomy closure under full occlusion was often required for right adrenal tumors. When required, ureteronephrectomy was left sided. CLINICAL SIGNIFICANCE: Dogs with adrenal tumors extending beyond the hepatic hilus and those requiring a long caval occlusion time can survive adrenalectomy.

Surgical management of pivot-shift phenomenon in a dog.

CASE DESCRIPTION A 6.8-year-old neutered male Labrador Retriever-Poodle mix was evaluated because of continued left pelvic limb lameness unresponsive to conservative management 1 year after undergoing tibial plateau leveling osteotomy (TPLO). CLINICAL FINDINGS A jerking lateral movement of the left stifle joint was detected during walking. Orthopedic examination revealed a pivot-shift phenomenon (PSP). Palpation elicited no signs of discomfort over the TPLO plate or caudomedial aspect of the stifle joint. Radiography revealed complete bone fusion at the osteotomy site and only mild joint effusion. TREATMENT AND OUTCOME Arthrotomy was performed at the medial aspect of the stifle joint, revealing no meniscal tears. The previously applied plate was removed, and an extracapsular, synthetic, ligament-like biomaterial was placed to counteract internal tibial rotation, thereby eliminating the PSP. Six weeks later, lameness had improved considerably with no evidence of PSP; 8 weeks after surgery, the dog was assessed for sudden-onset lameness in the right pelvic limb. Cranial cruciate ligament rupture was suspected, and TPLO was performed. The PSP was identified intraoperatively, so an extracapsular implant was placed. Six weeks later, the dog had only mild lameness and no evidence of PSP in either pelvic limb. In a follow-up telephone conversation 1 year later, the owner reported no obvious lameness or gait abnormalities. CLINICAL RELEVANCE Use of an extracapsular implant effectively eliminated the PSP following TPLO in the dog of this report and can be considered as an intra- or postoperative option for dogs with PSP that responds poorly to conservative management.