Surgical management of urethral obstruction secondary to perineal liposarcoma in a dog: a case report.

BACKGROUND: Swelling of the perineal region in male dogs is most commonly caused by a perineal hernia. Clinical signs associated with perineal hernia are constipation, tenesmus or stranguria. This case report documents a rare cause of perineal swelling created by the growth of a malignant tumour leading to urethral obstruction and subsequent stranguria. CASE PRESENTATION: An 11-year-old neutered male German Shepherd was presented for swelling in the perineal region and stranguria for three days. Complete blood count and serum biochemistry were unremarkable. Ultrasound revealed a heterogeneous mass in the perineal region. Retrograde urethrography showed a severe narrowing of the urethra caudal to the pelvis. A fine-needle aspirate of the mass was highly suspicious for liposarcoma. Staging was performed by computed tomography (CT) of the thorax and abdomen. Total penile amputation in combination with pubic-ischial pelvic osteotomy, transposition of the remaining urethra through the inguinal canal, V-Y-plasty cranial to the prepuce and preputial urethrostomy were performed to remove the tumour. Histopathology confirmed a well-differentiated liposarcoma with complete histological margins. Six months after the surgery the dog was doing well and there were no signs indicating local tumour recurrence. CONCLUSIONS: Wide surgical excision is generally recommended for soft tissue sarcomas, however this is sometimes not feasible for large tumours. In the case reported here, tumour resection was achieved by a combination of several surgical techniques with a good clinical outcome.

Effects of simulated radioulnar synostosis on supination and pronation in cats. A cadaveric study.

OBJECTIVE: To evaluate the effect of an induced synostosis with a screw on pronation and supination in cats. STUDY DESIGN: Ex vivo biomechanical study. SAMPLE POPULATION: A total of 58 feline forelimbs. METHODS: A total of 58 cadaveric feline thoracic limbs were mounted on a custom-built jig with the elbow and carpus flexed at a 90° angle. To exclude any orthopedic disease, radiographs of the forelimbs were performed prior to the mechanical tests. Radioulnar synostosis was imitated with a 2 mm cortical screw through the radius into the ulna in the proximal (Group P; n = 54), middle (Group M; n = 52), and distal (Group D; n = 53) radial diaphysis. The angles of pronation and supination were recorded after manually applying a two-finger tight rotational force to the metacarpus. Rotational tests were performed without a screw (Group N) and with a screw in each of the aforementioned positions. Pairwise comparisons between the groups were performed based on their angles of rotation with a paired t-test with the Benjamini-Hochberg procedure and a mixed model ANOVA. RESULTS: Mean angles of rotation decreased between Group N (129.5 ± 15.9°) and all groups with imitated radioulnar synostosis to a mean angle of 37.5 ± 14.5° (p < .0001). Mean angles of rotation did not differ between the groups with imitated radioulnar synostosis. CONCLUSION: Induced radioulnar synostosis decreases antebrachial rotation by more than two-thirds, regardless of location. CLINICAL SIGNIFICANCE: Implants fixating the radius to the ulna should be avoided in cats, regardless where they are located along the radial diaphysis.

Indications for the removal of implants after fracture healing: A comparison between human and veterinary medicine.

Indications for implant removal after fracture healing are still under debate in both human and veterinary medicine. Although hardware removal is a common procedure, it should not be undertaken lightly. Intra and post-operative complications are common and a thorough evaluation of the risks and benefits should be performed. This review aimed to collect and summarise published data on the indications for implant removal in small animals, compare the collected data with human and equine medicine, and investigate the existence of guidelines for this purpose. There is no international consensual agreement for implant removal after fracture healing, neither in small animals nor in human orthopaedics. Decision-making processes are still controversial in some scenarios, thus clear evidence-based protocols for implant removal are needed.

Repair of a Tibiotarsal Fracture in a Pomeranian Goose ( Anser anser) With a Locking Plate.

A 2-year-old Pomeranian goose ( Anser anser) weighing 8.1 kg was examined because of non-weight-bearing lameness of the right limb. A closed, transverse, diaphyseal fracture of the distal third of the right tibiotarsus with a craniolateral displacement of the distal fragment was diagnosed radiographically. Surgery under general anesthesia was performed to repair the fracture with a 14-hole, 2.7-mm locking plate fixed with 6 screws in a bicortical manner. Two days later, the bird was fully weight-bearing on the leg. Radiographs performed 4 and 8 weeks after surgery showed good healing of the affected bone with an appropriate callus formation bridging the fracture line. Sixteen weeks after surgery, the patient was readmitted because of lameness exhibited while staying outside exposed to subzero (°C) temperatures. On the basis of this finding, heat conduction was postulated as the possible cause of lameness because it disappeared after implant removal. To the best our knowledge, this case represents the first report of a surgical repair of a tibiotarsal fracture with a locking plate in waterfowl.

REPAIR OF A FEMORAL FRACTURE IN A CONGO AFRICAN GREY PARROT ( PSITTACUS ERITHACUS ERITHACUS) WITH A PARACORTICAL-CLAMP-CERCLAGE TECHNIQUE.

A 1-yr-old female Congo African grey parrot ( Psittacus erithacus erithacus) was admitted with a lameness of the right pelvic limb. On the radiographs a closed, caudolaterally displaced, comminuted, diaphyseal fracture of the femur was diagnosed. Surgery under general anesthesia was performed in order to repair the fracture with a paracortical-clamp-cerclage technique. This straightforward and effective technique has been developed as a low-cost treatment for simple and comminuted diaphyseal fractures in dogs and cats. Fixation is obtained with clamps, shaped during surgery, and attached to the bone shaft with cerclage wire. This technique led to immediate weight-bearing, appropriate bone healing, and permanent fixation of the implants in the patient. To the best of the authors' knowledge, this case represents the first report of a surgical repair of a femoral fracture with a paracortical-clamp-cerclage technique in a bird.

Microbial Colonization of Explants after Osteosynthesis in Small Animals: Incidence and Influencing Factors.

Despite recent advancements in antibiotics, hygienic measures, and peri-operative systemic antibiotics, post-operative infections in osteosynthesis remain prevalent and continue to be among the most common surgical complications, leading to delayed fracture healing, osteomyelitis, implant loosening, and loss of function. Osteosynthesis implants are routinely utilized in veterinary medicine and the current study investigates the microbial colonization of implants following osteosynthesis in small animals, along with its incidence and influencing factors. The results are analyzed in regard to correlations between infection, patient, disease progression, and radiographic images, as well as other factors that may promote infection. Seventy-one explants from sixty-five patients were examined and evaluated for microbial colonization. Factors like body weight and age, location and type of plate and additional injuries like lung lesions, the surgeon's experience, or the number of people present during the surgical procedure seem to influence the development of an infection. Of the animals, 60% showed osteolytic changes and 73.3% of those with dysfunctional mobility had an implant infection. Microorganisms were detected in almost 50% of the explants, but a clinically relevant infection was only present in five patients (7.3%), suggesting that the presence of microorganisms on an implant does not necessarily lead to treatment complications.

Treatment of acquired pyloric stenosis via Y-U pyloroplasty in a Burmese cat.

Case summary: An 11-year-old female spayed Burmese cat was presented for chronic intermittent vomiting. Previous medical and dietary treatments were unsuccessful. Endoscopically, a narrow pyloric outlet was found and Y-U pyloroplasty was performed. The clinical signs disappeared postoperatively after treatment with a proton pump inhibitor and dietary management. Relevance and novel information: This is the first case report of feline-acquired pyloric stenosis with documented histopathological findings from a full-thickness biopsy of the pyloric sphincter. In addition, this is the first case of Y-U pyloroplasty being conducted in a cat. The histopathological findings might help explain the pathogenesis of this disorder in cats.

Intra-articular osteoma in the stifle joint of a cat.

Case summary: A 13-year-old male castrated cat was referred to our clinic for a 2-month history of right hindlimb lameness. Radiographs and CT showed a solid bony mass within the stifle joint. The mass was resected by arthrotomy and osteotomy of the tibial tuberosity. Histopathological examination revealed the diagnosis of osteoma. Recovery from surgery was uneventful. At the 8-week follow-up examination, the cat was free of clinical signs. Relevance and novel information: Feline osteomas are rare; only few cases have been reported. To the best of our knowledge, this is the first report of an intra-articular osteoma in the stifle joint of a cat and description of its surgical resection.

Ultrasonography of the spinal cord and the collection of cerebrospinal fluid from the Atlanto-occipital space in goat.

Ultrasonography, a non-invasive and useful technique, is used for the examination of Atlanto-occipital space structural visualization. The collection of cerebrospinal fluid is more accurate and easier under ultrasound-guided procedure. In this study, longitudinal and transverse views of the Atlanto-occipital space were scanned and their different structural dimensions were measured in sixty healthy Beetal goats. In longitudinal plane, gap between skin and arachnoidea ranged from 8.71 to 10.21 mm (mean ± SD, 9.76 ± 0.44 mm). Depth of the subarachnoid gap dorsal and ventral to the spinal cord ranged from 2.14 to 3.23 mm (mean ± SD, 2.81 ± 0.33mm) and from 6.09 to 7.68 (mean ± SD, 7.02 ± 0.45 mm) respectively. Spinal cord diameter varied from 3.76 to 5.26 mm (mean ± SD, 4.57 ± 0.44 mm) and entire dural sac diameter varied from 12.59 to 15.69 mm (mean ± SD, 14.37 ± 0.74 mm). The spinal cord can be seen only in longitudinal plane over a distance of 1.81 to 2.93 mm (mean ± SD, 2.46 ± 0.35 mm). While in the transverse plane, gap between the skin and arachnoidea ranged from 11.01 to 13.11 mm (mean ± SD, 12.39 ± 0.54 mm). Depth of the subarachnoid space dorsal and ventral to spinal cord varied from 5.05 to 6.13 mm (mean ± SD, 5.59 ± 0.34 mm) and 4.12 to 5.25 (mean ± SD, 4.65 ± 0.29 mm) respectively. Spinal cord diameter ranged from 4.45 to 5.90 mm (mean ± SD, 5.24 ± 0.44 mm) and entire dural sac diameter varied from 14.68 to 16.96 mm (mean ± SD, 15.58 ± 0.57 mm). These standard measurements will be the reference values in healthy Beetal goats. Cerebrospinal fluid was colourless with the quantity of 2-4 ml (mean ± SD, 3 ± 0.89 ml). It was neither turbid nor coagulate. The white blood cell count was 10/µl and red blood cells were not present. Furthermore, total protein and glucose were also measured, which ranged from 23.5 to 28 mg/dl (mean ± SD, 25.78 ± 2.32 mg/dl) and 38-50 mg/dl (mean ± SD, 43.33 ± 4.60 mg/dl) respectively. Ziehl-Neelsen Staining and gram staining were negative.

Effect of intraoperative positioning on postoperative neurological status in cats after perineal urethrostomy.

OBJECTIVES: The aim of this study was to evaluate and quantify the changes in neurological status in cats after perineal urethrostomy performed in dorsal and ventral recumbency. METHODS: This was a prospective, randomised study. Twenty male castrated cats with feline lower urinary tract disease presented for perineal urethrostomy were enrolled in this study. Surgery was performed in either dorsal recumbency (group A) or ventral recumbency (group B). Motor response of patellar tendon, gastrocnemius muscle, pelvic limb withdrawal and perineal reflexes, as well as the presence of spinal pain in the lumbosacral region, motor function of the tail and faecal continence, were examined before surgery, and 24 h and 14 days after surgery. RESULTS: The animals had a mean weight of 5.07 ± 1.08 kg, with a mean age of 6.12 ± 1.85 years. Weight and age were not significantly different between groups A and B (both P = 0.897). All tested parameters of the neurological examination performed prior to surgery were considered normal in both groups (P = 1). The comparison between neurological examinations (perineal reflex and spinal pain) before and 24 h after surgery revealed a significantly decreased briskness of the perineal reflex and an increased occurrence of spinal pain 24 h after surgery (P = 0.043 and P = 0.031, respectively). However, the changes of aforementioned parameters were statistically insignificant (P = 0.249 and P = 0.141) between groups A and B. The other parameters (patellar tendon, pelvic limb withdrawal and gastrocnemius muscle reflexes, motor function of the tail and faecal continence) were statistically insignificant (P = 1) before surgery and 24 h after surgery, as well as between groups A and B 24 h after surgery. Results of all tested parameters were statistically insignificant (P = 1) before surgery and 14 days after surgery, as well as between groups A and B 14 days after surgery. CONCLUSIONS AND RELEVANCE: The briskness of the perineal reflex was significantly decreased and the occurrence of spinal pain significantly increased 24 h after surgery. A parallel with a low-grade positioning-dependent nerve injury as described in human medicine may be drawn. However, no positioning method was proven to be superior to the other.

Effect of intraoperative positioning on the diameter of the vertebral canal in cats during perineal urethrostomy (cadaveric study).

Objectives The objective of this study was to quantify the changes in the diameter of the vertebral canal in the lumbosacral and sacrococcygeal column (L6-Co2) in cats in dorsal and ventral recumbency, simulating real body positioning during a perineal urethrostomy. Methods Twenty-one male feline cadavers were enrolled in the study. All feline cadavers were evaluated by CT. Examinations were performed with the cadaver in a neutral position and dorsal and ventral recumbency. Sagittal vertebral canal diameters (VCDs) were obtained by measuring the distance between the ventral and dorsal aspects of the vertebral canal in the middle of the intervertebral space. Results A comparison of the VCDs between L6 and L7, L7 and S1, S3 and Co1 and Co1 and Co2 in neutral position vs dorsal recumbency revealed a reduction of 0.27 mm (14.6%; P <0.001) between S3 and Co1 and 0.26 mm (18.1%; P <0.001) between Co1 and Co2. No differences were seen when comparing L6-L7 and L7-S1. The VCDs were decreased in all segments when comparing neutral with ventral recumbency. This study revealed a reduction of 0.13 mm between L6 and L7 (3.3%; P = 0.003), 0.14 mm between L7 and S1 (4.1%; P = 0.003), 0.61 mm between S3 and Co1 (32.5%; P <0.001) and 0.63 mm between Co1 and Co2 (44.1%; P <0.001). Comparison of the VCD between dorsal and ventral recumbency in L6-L7, L7-S1, S3-Co1 and Co1-Co2 revealed a decrease in the VCDs in ventral recumbency of 0.13 mm (3.3%; P <0.001), 0.12 mm (3.6%; P <0.001), 0.34 mm (21.0%; P <0.001) and 0.37 mm (31.7%; P <0.001), respectively. Conclusions and relevance The results provide evidence that, from an anatomical point of view, perineal urethrostomy performed in dorsal recumbency is superior to ventral recumbency, but further clinical studies to verify these findings are necessary.