The use of a novel nitric oxide wound dressing in acute traumatic wounds in dogs.

OBJECTIVE: To describe the use of a novel wound dressing that delivers nitric oxide (NO) to naturally occurring traumatic wounds in dogs. ANIMALS: 24 client-owned dogs with 30 wounds. METHODS: Dogs were presented with acute traumatic wounds requiring open wound management. Wounds were bandaged with a novel NO wound dressing and reassessed as needed for continued open wound management until wounds healed by second intention or wound closure was recommended. Dogs could be removed from the study at any point at the clinician's discretion. RESULTS: All wounds had the novel NO wound dressing used during open wound management until wound closure was recommended. Median time to wound closure was 6 days (range, 2 to 42). There were no complications directly attributed to the use of the novel wound dressing that clinically affected the dogs. Three wounds dehisced following wound closure. Wound healing was confirmed in 19 dogs with 25 wounds, with 3 dogs lost to follow-up prior to suture removal. Only 7.1% of wounds had clinical signs consistent with wound infection following wound closure. CLINICAL RELEVANCE: The novel NO wound dressing was easy to use and well tolerated in dogs with naturally occurring traumatic wounds. It can be used throughout all phases of wound healing, simplifying open wound management.

Laryngeal Disease in Dogs and Cats: An Update.

Laryngeal diseases are manifested by obstructive breathing patterns reflecting functional or mechanical upper airway obstruction. Laryngeal paralysis is the most common disease of the larynx. Diagnosis requires close attention to anesthetic plane and coordination of respiratory effort with laryngeal motion. Surgical arytenoid lateralization improves clinical signs and quality of life in dogs; however, aspiration pneumonia is a recognized complication, and generalized neuropathy can progress. Laryngeal collapse can result from any cause of chronic upper airway obstruction but is most often associated with brachycephalic obstructive airway syndrome. Although uncommon, laryngeal neoplasia has a guarded to grave prognosis regardless of treatment.

Incidence of Postoperative Neurologic Complications in Pugs Following Portosystemic Shunt Attenuation Surgery.

Postoperative seizures occur in 5-12% of dogs following surgical attenuation of congenital extrahepatic portosystemic shunts (CEPSS) and are often refractory to treatment. Because pugs are predisposed to necrotizing meningoencephalitis, they may be at higher risk of developing neurologic complications after CEPSS attenuation. We hypothesized that pugs have a higher prevalence of postoperative neurologic complications and that pugs who died due to neurologic complications would have evidence of encephalitis at necropsy. Records were searched for pugs that had undergone surgical correction of a single extrahepatic CEPSS. Fourteen pugs met the inclusion criteria and were compared with a control group of 30 dogs of varying breeds who also underwent surgical attenuation for a single CEPSS. Four of 14 pugs (28.6%) died or were euthanized within 1 mo after surgery for neurologic complications, compared with only 1 of 30 dogs in the control group (P < .029). No evidence of necrotizing meningoencephalitis was seen on necropsy. Pugs may be at an increased risk of developing fatal neurologic complications following surgical attenuation for CEPSS. Further studies are indicated to investigate reasons for this increased risk, as well as to determine any factors that may indicate which pugs are at higher risk.

Retroperitoneal abscesses in seven dogs.

Retroperitoneal abscesses, although uncommon, are clinically important. Medical records of seven dogs with naturally occurring retroperitoneal infections from 1999 to 2011 were reviewed to document historical, examination, clinicopathologic, imaging, and surgical findings; etiologic agents; and outcome. Middle-aged sporting dogs were most commonly affected. Dogs were febrile with evidence of either abdominal or lumbar pain. Although traditional radiography can aid in diagnosis, ultrasound appeared to be a more sensitive indicator of disease within the retroperitoneal space. Numerous bacteria were isolated from the abscesses, with anaerobic and facultative anaerobic bacteria being the most commonly isolated. Etiology was largely unknown, but migrating plant material was often suspected. Resolution of the infection required surgical intervention as well as prolonged antibiotic therapy. Although recurrence is possible, outcome can be favorable with no long-term sequela.

Anatomic distribution and clinical findings of intermuscular lipomas in 17 dogs (2005-2010).

Intermuscular lipomas (IML) in dogs can be associated with ominous clinical signs, especially in the thoracic limb. However, the prognosis is excellent following surgical excision. There is a paucity of information in the veterinary literature regarding IML. Our objective was to describe the anatomical location, imaging techniques, and clinical findings in a series of dogs that were diagnosed and treated for IML. The prevalence of thoracic versus pelvic limb IML was not different. Most IML of the thoracic limb were located in the axilla. Operative time for IML of the thoracic and pelvic limb averaged 60 minutes. Complications were rare after marginal surgical excision and recurrence was not seen in any of the cases in this report. Intermuscular lipomas of the axilla are as common as IML of the caudal thigh. Surgical treatment of both axillary and caudal-thigh IML is associated with an excellent prognosis in dogs.

Use of a nitinol stent to palliate a colorectal neoplastic obstruction in a dog.

CASE DESCRIPTION: A 12-year-old castrated male Labrador Retriever was evaluated for clinical signs associated with colorectal obstruction. CLINICAL FINDINGS: The dog had a 2-week history of tenesmus and hematochezia. On rectal examination, an annular colorectal mass was palpable extending orad into the pelvic canal. The original diagnosis of the colorectal mass was a mucosal adenoma. The dog was maintained on a low-residue diet and fecal softeners for a period of 13 months after initial diagnosis. At that time, medical management was no longer effective. TREATMENT AND OUTCOME: Placement of a colonic stent was chosen to palliate the clinical signs associated with colorectal obstruction. By use of fluoroscopic and colonoscopic guidance, a nitinol stent was placed intraluminally to open the obstructed region. Placement of the stent resulted in improvement of clinical signs, although tenesmus and obstipation occurred periodically after stent placement. At 212 days after stent placement, the patient had extensive improvement in clinical signs with minimal complications; however, clinical signs became severe at 238 days after stent placement, and the dog was euthanized. Histologic evaluation of the rectal tumor from samples obtained during necropsy revealed that the tumor had undergone malignant transformation to a carcinoma in situ. CLINICAL RELEVANCE: A stent was successfully placed in the colon and rectum to relieve obstruction associated with a tumor originally diagnosed as a benign neoplasm. Placement of colorectal stents may be an option for the palliation of colorectal obstruction secondary to neoplastic disease; however, clinical signs may persist, and continuation of medical management may be necessary.

Outcomes of cats undergoing surgical attenuation of congenital extrahepatic portosystemic shunts through cellophane banding: 9 cases (2000-2007).

OBJECTIVE: To evaluate the long-term prognosis of cats with a congenital extrahepatic portosystemic shunt (CEPSS) attenuated through gradual occlusion with cellophane banding (CB). DESIGN: Retrospective case series. ANIMALS: 9 cats with a CEPSS that was attenuated with CB. PROCEDURES: Medical records of cats surgically treated for CEPSS by means of CB from January 2000 through March 2007 were reviewed. Extracted data included preoperative clinical signs, medications, diagnostic results including serum bile acids concentrations, surgical technique, intraoperative and postoperative complications, and long-term follow-up information. RESULTS: 2 cats that developed refractory seizures were euthanized within 3 days after the CB procedure. Seven of the 9 cats survived to 15 days after surgery. Four cats did not have any clinical signs of CEPSS at long-term follow up. At that time, 5 cats had a postprandial SBA concentration within reference limits and 1 cat had persistent ptyalism. One cat had biurate ammonium stones removed > 2 years after surgery. One cat was euthanized 105 days after surgery because of uncontrolled seizures. The 3-year survival rate was 66%. CONCLUSIONS AND CLINICAL RELEVANCE: Uncontrolled seizure activity was the most common cause of death after CB. Long-term outcome for cats with CEPSS was fair to good after the procedure. Cats with a CEPSS surviving the immediate postoperative period had a fair to good long-term outcome. Cellophane banding without intraoperative attenuation appears to be an acceptable technique for gradual occlusion of a CEPSS in cats. Cats should be monitored closely for development of neurologic disorders in the postoperative period.

Prevalence of select infectious agents in inflammatory aural and nasopharyngeal polyps from client-owned cats.

Benign, inflammatory polyps may affect the nasopharynx and auditory canal of cats. It has been proposed that inflammation induced by infectious disease agents could trigger polyp formation. The objective of this pilot study was to determine the prevalence of feline herpesvirus-1 (FHV-1), feline calicivirus (FCV), Mycoplasma species, Bartonella species and Chlamydophila felis nucleic acids in polyp tissues collected from 30 clinically affected cats. Samples collected from the tympanic bulla from 12 clinically normal cats were also assayed. DNA or RNA of some of the target agents were amplified from samples from 25% of normal cats and 33% of affected cats; however, statistical associations were not detected for individual agent results or grouped results. The study documents that common oropharyngeal or blood borne agents can be detected in the tympanic bullae of normal cats. Failure to consistently amplify RNA or DNA of the select agents from polyp tissues suggests the agents studied were not directly associated with the pathogenesis of this syndrome in the cats tested. Alternately, the inflammatory response may have cleared microbial nucleic acids to undetectable levels by the time of sample collection.

A comparative study evaluating the esophageal transit time of eight healthy cats when pilled with the FlavoRx pill glide versus pill delivery treats.

Retention of tablets or capsules in the feline esophagus can be associated with esophagitis and esophageal stricture formation. The objective of this study was to evaluate the esophageal passage of tablets and capsules when administered with either a one-step pill gun with flavored liquid (FlavoRx pill glide) or a pill delivery treat (Pill Pockets). Four different medication administrations were evaluated on different days in eight normal cats: tablets with FlavoRx pill glide (T-FG), tablets with pill delivery treats (T-PP), capsules with FlavoRx pill glide (C-FG) and capsules with pill delivery treats (C-PP). The estimated average transit time was 36s for T-FG, 60s for T-PP, 16s for C-FG, and 24s for C-PP. The results of this study suggest that either pill delivery method is acceptable for successful passage of tablets or capsules into the stomach of cats using a single replicate.

A novel technique for orchiectomy and scrotal ablation in the sugar glider (Petaurus breviceps).

In this report, we describe a simple, safe, and efficacious technique for orchiectomy and scrotal ablation with the use of a carbon dioxide light amplification by stimulated emission of radiation (laser) in sugar gliders (Petaurus breviceps). The study population included nine sugar gliders, ages 2-24 mo, presented for orchiectomy. After induction of general anesthesia, orchiectomy and scrotal ablation were performed by severing the scrotal stalk with the laser. All sugar gliders were discharged the same day. Mean anesthesia time was 6.09 +/- 0.94 min. Mean surgery time was 15.11 +/- 8.39 sec, and mean recovery time was 4.11 +/- 3.60 min. With an outlier removed, mean recovery time was 2.95 +/- 1.03 min. No serious postoperative surgical complications were observed. The technique described is a simple procedure with rapid surgical and recovery times that has the potential to become the standard procedure for orchiectomy and scrotal ablation in sugar gliders.

Long-term outcome of domestic ferrets treated surgically for hyperadrenocorticism: 130 cases (1995-2004).

OBJECTIVE: To determine the long-term survival rate and factors that affect survival time of domestic ferrets treated surgically for hyperadrenocorticism. STUDY DESIGN: Retrospective case series. ANIMALS: 130 ferrets with hyperadrenocorticism that were treated surgically. PROCEDURES: Medical records of ferrets surgically treated for hyperadrenocorticism were reviewed. Data recorded included signalment, duration of clinical signs prior to hospital admission, CBC values, serum biochemical analysis results, anesthetic time, surgical time, concurrent diseases, adrenal gland affected (right, left, or both [bilateral]), histopathologic diagnosis, surgical procedure, caudal vena caval involvement (yes or no), postoperative melena (yes or no), days in hospital after surgery, and whether clinical signs of hyperadrenocorticism developed after surgery. RESULTS: 130 ferrets were entered in the study (11 of 130 ferrets were admitted and underwent surgery twice). The 1- and 2-year survival rates were 98% and 88%, respectively. A 50% survival rate was never reached. Combined partial adrenal gland resection with cryosurgery had a significantly negative effect on survival time. No other risk factors were identified. Survival time was not significantly affected by either histopathologic diagnosis or specific affected adrenal gland (right, left, or bilateral). CONCLUSIONS AND CLINICAL RELEVANCE: Ferrets with adrenal gland masses that were treated surgically had a good prognosis. Survival time of ferrets with hyperadrenocorticism undergoing surgery was not affected by the histologic characteristic of the tumor, the adrenal glands affected (right, left, or bilateral), or complete versus partial adrenal gland resection. Debulking was a sufficient surgical technique to allow a favorable long-term outcome when complete excision was not possible.

A lifesaving model: teaching advanced procedures on shelter animals in a tertiary care facility.

It is estimated that there are over 5 million homeless animals in the United States. While the veterinary profession continues to evolve in advanced specialty disciplines, animal shelters in every community lack resources for basic care. Concurrently, veterinary students, interns, and residents have less opportunity for practical primary and secondary veterinary care experiences in tertiary-care institutions that focus on specialty training. The two main goals of this project were (1) to provide practical medical and animal-welfare experiences to veterinary students, interns, and residents, under faculty supervision, and (2) to care for animals with medical problems beyond a typical shelter's technical capabilities and budget. Over a two-year period, 22 animals from one humane society were treated at Colorado State University Veterinary Medical Center. Initial funding for medical expenses was provided by PetSmart Charities. All 22 animals were successfully treated and subsequently adopted. The results suggest that collaboration between a tertiary-care facility and a humane shelter can be used successfully to teach advanced procedures and to save homeless animals. The project demonstrated that linking a veterinary teaching hospital's resources to a humane shelter's needs did not financially affect either institution. It is hoped that such a program might be used as a model and be perpetuated in other communities.

Medical and surgical management of pyothorax.

Pyothorax is the accumulation of septic suppurative inflammation within the pleural cavity. The cause and source of infection in dogs and cats often are unknown. Management of these cases can be challenging, because controversy exists over the best method for treatment. Reported outcomes and recurrence rates vary widely.

Atypical manifestations of feline inflammatory polyps in three cats.

Inflammatory polyps of the feline middle ear and nasopharynx are non-neoplastic masses that are presumed to originate from the epithelial lining of the tympanic bulla or Eustachian tube. The exact origin and cause are unknown, however, it is thought that inflammatory polyps arise as a result of a prolonged inflammatory process. It is unclear whether this inflammation initiates or potentiates the development and growth of inflammatory polyps. Cats with inflammatory polyps typically present with either signs of otitis externa and otitis media or with signs consistent with upper airway obstruction. Traditional diagnostics involve imaging of the tympanic bulla either with skull radiographs or computed topography (CT). Treatment consists of traction and avulsion of the polyp with or without ventral bulla osteotomy (VBO) to remove the epithelial lining of the tympanic bulla. The three cases described here are unusual manifestations or presentations of feline inflammatory polyps that address the following issues: (1) concurrent otic and nasopharyngeal polyps, (2) potential association with chronic viral infection, (3) polyp development in the contralateral middle ear, (4) CT appearance of the skull following VBO, and (5) development of secondary pulmonary hypertension.

Risk factors associated with short-term outcome and development of perioperative complications in dogs undergoing surgery because of gastric dilatation-volvulus: 166 cases (1992-2003).

OBJECTIVE: To evaluate risk factors associated with death and development of perioperative complications in dogs undergoing surgery for treatment of gastric dilatation-volvulus (GDV). DESIGN: Retrospective case series. ANIMALS: 166 dogs. PROCEDURES: Records of dogs with confirmed GDV that underwent surgery were reviewed. Logistic regression was performed to identify factors associated with development of complications (ie, hypotension, arrhythmias, gastric necrosis necessitating gastrectomy, disseminated intravascular coagulation, peritonitis, sepsis, postoperative dilatation, postoperative vomiting, and incisional problems) and with short-term outcome (ie, died vs survived to the time of suture removal). RESULTS: Short-term mortality rate was 16.2% (27/166). Risk factors significantly associated with death prior to suture removal were clinical signs for > 6 hours prior to examination, combined splenectomy and partial gastrectomy, hypotension at any time during hospitalization, peritonitis, sepsis, and disseminated intravascular coagulation. Partial gastrectomy was not a significant risk factor for death but was for peritonitis, disseminated intravascular coagulation, sepsis, and arrhythmias. Age, gastrectomy, and disseminated intravascular coagulation were risk factors for development of hypotension. Use of a synthetic colloid or hypertonic saline solution was associated with a significantly decreased risk of hypotension. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the prognosis for dogs undergoing surgery because of GDV is good but that certain factors are associated with an increased risk that dogs will develop perioperative complications or die.

Long-term survival and risk factors associated with biliary surgery in dogs: 34 cases (1994-2004).

OBJECTIVE: To determine factors associated with long-term survival after biliary surgery in dogs. DESIGN: Retrospective case series. ANIMALS: 34 dogs that underwent biliary surgery. PROCEDURES: Data extracted from medical records included sex, breed, body weight, age at surgery, history and clinical examination findings, preoperative and postoperative CBC, serum biochemical panel and coagulation profiles results, abdominal ultrasonographic findings, results of bacteriologic culture and histologic examination, surgical findings, postoperative complications, and survival time. Follow-up information was obtained from medical records or phone conversations with owners and referring veterinarians. RESULTS: Primary biliary findings included gallbladder mucocele (n = 20 dogs), inflammatory diseases (4), trauma (3), and neoplasia (1). Secondary biliary diseases included pancreatitis (n = 4), pancreatic neoplasia (1), and duodenal perforation (1). One- and 2-year survival rates were both 66%. Increasing age; gamma-glutamyltransferase activity; preanesthetic heart rate; BUN, phosphorus, and bilirubin concentrations; and the use of biliary diversion procedures were risk factors for death, although pancreatitis was not. However, poor long-term survival was associated with pancreatitis. CONCLUSIONS AND CLINICAL RELEVANCE: Long-term prognosis was guarded after biliary surgery in dogs. However, dogs that survived the early postoperative period had good long-term prognosis. Dogs with pancreatitis had poor prognosis. Overall, the prognosis was worse for dogs that underwent a biliary diversion, compared with dogs that did not.

Paraneoplastic leukocytosis with mature neutrophilia in a cat with pulmonary squamous cell carcinoma.

A 13-year old cat had 3-day duration of vomiting, lethargy, and anorexia. A complete blood count revealed a severe neutrophilia (126.9 x 10(3) cells/microl). Thoracic radiographs demonstrated a large solitary lung mass. A bone marrow aspirate documented myeloid hyperplasia. A left intercostal thoracotomy was performed and left cranial and caudal lung lobectomies were performed in order to remove the mass in its entirety. Histological diagnosis was squamous cell carcinoma of the lung. Following surgery, the severe neutrophilia began to decrease. It was in the normal range approximately 6 weeks postoperatively. The presence of a primary lung tumor combined with a mature neutrophilia with resolution following surgical resection suggests a paraneoplastic syndrome.

Effect of sevoflurane on hemodynamic and cardiac energetic parameters in ferrets.

OBJECTIVE: To determine the effect of sevoflurane on cardiac energetic and hemodynamic parameters in ferrets. ANIMALS: 7 healthy domesticated ferrets. PROCEDURE: Sevoflurane was used as the sole anesthetic agent for general anesthesia in ferrets. Standard midline laparotomy and median sternotomy were performed to permit instrumentation. Myocardial blood flow was determined by use of colored microsphere technology. Measurements and blood samples were obtained at 1.25%, 2.5%, and 3.75% expired concentration of sevoflurane. RESULTS: A dose-dependent decrease in arterial blood pressure, left ventricular pressure, systemic vascular resistance, aortic flow, and dp/dt (an index of contractility) was detected as expired concentration of sevoflurane increased. Heart rate, central venous pressure, coronary vascular resistance, myocardial oxygen extraction ratio, and tau (the time constant of relaxation) were unchanged. Cardiac external work decreased, as did myocardial oxygen consumption, causing increased cardiac efficiency at higher concentrations of sevoflurane. CONCLUSIONS AND CLINICAL RELEVANCE: Sevoflurane caused minimal and predictable cardiovascular effects in ferrets without increasing myocardial metabolic demands. Data obtained from this study have not been previously reported for a species that is being commonly used in cardiovascular research. These findings also support use of sevoflurane as a safe inhalant anesthetic in ferrets for clinical and research settings.

Evaluation of splanchnic oxygen extraction ratio as an index of portal vein pressure in dogs.

OBJECTIVE: To determine changes in splanchnic oxygen extraction ratio during experimentally induced portal hypertension in dogs. ANIMALS: 6 clinically normal dogs. PROCEDURE: Standard midline laparotomy and median sternotomy were performed in anesthetized dogs. Baseline measurements of arterial blood pressure, aortic blood flow, portal vein blood flow, and portal vein pressure were acquired, and arterial, venous, and portal vein blood samples were obtained to determine systemic and splanchnic oxygen extraction ratios. The portal vein was gradually occluded until a pressure of 18 cm of H2O was reached; this pressure was maintained for 30 minutes, and measurements and collection of blood samples were repeated. RESULTS: Portal vein blood flow decreased significantly from 457 +/- 136 ml/min before to 266 +/- 83 ml/min after induction of portal hypertension. Oxygen content in the portal vein significantly decreased from 12.3 +/- 1.85 to 8.2 +/- 2.31%, and splanchnic oxygen extraction ratio significantly increased from 15.8 +/- 6.2 to 37.4 +/- 10.9% during portal hypertension. There was a significant inverse correlation between portal vein blood flow and splanchnic oxygen extraction ratio at baseline and during portal hypertension. CONCLUSIONS AND CLINICAL RELEVANCE: An increase in splanchnic oxygen extraction ratio is evident with partial attenuation of the portal vein and the concurrent decrease in portal vein blood flow. Correlation of oxygen extraction ratio with portal vein blood flow may be a more important indicator for determination of an endpoint to prevent congestion and ischemia of the gastrointestinal tract and pancreas during ligation of portosystemic shunts.