RESUMEN
Septic peritonitis is a life-threatening disease that can be caused by neoplasia, among other disease processes. There is no veterinary literature directly evaluating the outcome of patients with septic peritonitis caused by neoplasia. The objective of this study was to evaluate for differences in survival to discharge and complication rates between septic peritonitis caused by neoplastic and nonneoplastic disease in canine patients. A single-institution retrospective cross-sectional cohort study was performed, identifying dogs that were treated surgically for septic peritonitis between January 1, 2010, and November 1, 2020. A total of 86 patients were included, 12 with a neoplastic cause for septic peritonitis and 74 with another cause. The most common neoplastic lesions associated with septic peritonitis were gastrointestinal lymphoma and hepatocellular adenoma. Presence of neoplasia was not a significant factor for development of intraoperative or immediate postoperative complications, nor did it decrease chances of survival to discharge (P < .09). The diagnosis of a primary, localized, neoplastic lesion alone should not deter clinicians and owners from pursuing treatment for septic peritonitis.
Asunto(s)
Enfermedades de los Perros , Neoplasias , Peritonitis , Perros , Animales , Estudios Retrospectivos , Estudios Transversales , Enfermedades de los Perros/etiología , Enfermedades de los Perros/cirugía , Neoplasias/veterinaria , Peritonitis/etiología , Peritonitis/cirugía , Peritonitis/veterinaria , Resultado del TratamientoRESUMEN
Objective: Compare veterinary student success at urethral catheterization of small female cats and dogs using traditional and novel 2-catheter techniques. Animal: Healthy anesthetized female cats (n = 23) and dogs (n = 6) weighing < 10 kg undergoing elective ovariohysterectomy. Procedure: Two junior (Year 3) veterinary students with no previous urethral catheterization experience participated. Each pet was catheterized by 1 student using both the traditional blind technique and the novel 2-catheter method (placement of a large red rubber catheter into the vaginal canal prior to insertion of the conventional catheter). Technique order was randomized and attempts for each technique was allowed for up to 3 min. Time to successful catheterization and catheterization success within the allotted time were recorded. Results: Successful urethral catheterization was performed using the traditional blind and novel 2-catheter techniques in 56.3 and 87.5% of cases, respectively. Conclusion: Students had a higher rate of successful catheterization with the 2-catheter catheterization technique in this report. Clinical relevance: Urethral catheterization in small female cats and dogs is technically challenging, which is compounded by the inability to consistently and reliably palpate loco-regional anatomic landmarks due to the small sized vestibules. Data from this report will be used to design future studies to assess the utility of this novel urethral catheterization technique for teaching inexperienced students this challenging clinical skill.
Résumé. Objectif: Comparez le succès des étudiants vétérinaires lors du cathétérisme urétral de petites chattes et chiennes en utilisant des techniques traditionnelles et nouvelles à deux cathéters. Animal: Chattes (n = 23) et chiennes (n = 6) en bonne santé et anesthésiées pesant < 10 kg subissant une ovariohystérectomie élective. Procédure: Deux étudiants vétérinaires juniors (3e année) sans expérience préalable en cathétérisme urétral ont participé. Chaque animal a été cathétérisé par un étudiant en utilisant à la fois la technique traditionnelle à l'aveugle et la nouvelle méthode à deux cathéters (placement d'un gros cathéter en caoutchouc rouge dans le canal vaginal avant l'insertion du cathéter conventionnel). L'ordre des techniques a été randomisé et les tentatives pour chaque technique ont été autorisées jusqu'à 3 minutes. Le temps de cathétérisme réussi et le succès du cathétérisme dans le temps accordé ont été enregistrés. Résultats: Un cathétérisme urétral réussi a été réalisé en utilisant les techniques traditionnelles à l'aveugle et les nouvelles techniques à deux cathéters dans 56,3 et 87,5 % des cas, respectivement. Conclusion: Les étudiants avaient un taux plus élevé de cathétérisme réussi avec la technique de cathétérisme à deux cathéters dans ce rapport. Pertinence clinique: Le cathétérisme urétral chez les petites chattes et chiennes est techniquement difficile, ce qui est aggravé par l'incapacité de palper de manière cohérente et fiable les repères anatomiques loco-régionaux en raison des vestibules de petite taille. Les données de ce rapport seront utilisées pour concevoir de futures études afin d'évaluer l'utilité de cette nouvelle technique de cathétérisme urétral pour enseigner aux étudiants inexpérimentés cette habileté clinique difficile.(Traduit par Dr Serge Messier).
Asunto(s)
Uretra , Cateterismo Urinario , Perros , Gatos , Femenino , Animales , Humanos , Cateterismo Urinario/veterinaria , Uretra/cirugía , Competencia Clínica , EstudiantesRESUMEN
OBJECTIVE: To determine the diagnostic accuracy of optical coherence tomography (OCT) to assess surgical margins of canine soft tissue sarcoma (STS) and determine the influence of observer specialty and training. STUDY DESIGN: Blinded clinical prospective study. ANIMALS: Twenty-five dogs undergoing surgical excision of STS. METHODS: In vivo and ex vivo surgical margins were imaged with OCT after tumor resection. Representative images and videos were used to generate a training presentation and data sets. These were completed by 16 observers of four specialties (surgery, radiology, pathology, and OCT researchers). Images and videos from data sets were classified as cancerous or noncancerous. RESULTS: The overall sensitivity and specificity were 88.2% and 92.8%, respectively, for in vivo tissues and 82.5% and 93.3%, respectively, for ex vivo specimens. The overall accurate classification for all specimens was 91.4% in vivo and 89.5% ex vivo. There was no difference in accuracy of interpretation of OCT imaging by observers of different specialties or experience levels. CONCLUSION: Use of OCT to accurately assess surgical margins after STS excision was associated with a high sensitivity and specificity among various specialties. Personnel of all specialties and experience levels could effectively be trained to interpret OCT imaging. CLINICAL SIGNIFICANCE: Optical coherence tomography can be used by personnel of different specialty experience levels and from various specialties to accurately identify canine STS in vivo and ex vivo after a short training session. These encouraging results provide evidence to justify further research to assess the ability of OCT to provide real-time assessments of surgical margins and its applicability to other neoplasms.
Asunto(s)
Enfermedades de los Perros/cirugía , Márgenes de Escisión , Sarcoma/veterinaria , Tomografía de Coherencia Óptica/veterinaria , Animales , Perros , Femenino , Masculino , Sarcoma/cirugía , Sensibilidad y Especificidad , Tomografía de Coherencia Óptica/métodosRESUMEN
This case report details a previously undescribed malignancy of the tendon sheath in a golden retriever. This dog originally presented with lameness of the left forelimb, at which point radiographs revealed a monostotic, lytic lesion of the distal radius with overlying soft-tissue swelling. A fine-needle aspirate was performed, and cytology was compatible with a sarcoma, with the primary differential being an osteosarcoma. After amputation, the leg was submitted for histopathology, which revealed inconsistencies with a typical osteosarcoma lesion, including lack of osteoid deposition. Second opinion histopathology showed a fibrosarcoma that appeared to have originated in the tendon sheath of an extensor tendon and then secondarily invaded the radius. At the time of publication, â¼17 mo after amputation, the dog continues to do well without any evidence of recurrent or metastatic disease.
Asunto(s)
Neoplasias Óseas , Enfermedades de los Perros , Fibrosarcoma , Osteólisis , Animales , Neoplasias Óseas/cirugía , Neoplasias Óseas/veterinaria , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/cirugía , Perros , Fibrosarcoma/cirugía , Fibrosarcoma/veterinaria , Osteólisis/veterinaria , Radio (Anatomía) , TendonesRESUMEN
Cavitary pulmonary lesions can result from the localized breakdown of pulmonary parenchyma or be caused by the expulsion of a necrotic part of a mass. The objectives of this study were to describe the clinical and computed tomographic characteristics for cases of cavitary pulmonary adenocarcinoma and find associations between the features and those identified in human pulmonary cavitary soft tissue lesions. Five cases were identified that had a cavitary pulmonary mass on thoracic computed tomography (CT) and histopathology of the lesions. Three dogs and 2 cats had cavitary pulmonary adenocarcinoma. Common features of CT in these cases included lesions in the caudal lung lobes, lobular and spiculated lesion margins, air bronchograms within the mass, pleural tags, heterogeneous contrast enhancement, and ground glass opacity in the surrounding parenchyma. The findings of this case series suggest there are similarities in the CT characteristics of malignancy in human and animal cavitary pulmonary masses.
Caractéristiques tomodensitométriques d'adénocarcinome pulmonaire cavitaire chez trois chiens et deux chats. Les lésions pulmonaires cavitaires peuvent résulter de la dégradation localisée du parenchyme pulmonaire ou être provoquées par l'expulsion d'une partie nécrotique d'une masse. Les objectifs de cette étude étaient de décrire les caractéristiques cliniques et tomodensitométriques de cas d'adénocarcinome pulmonaire cavitaire et de trouver des associations entre les caractéristiques et celles identifiées dans les lésions des tissus mous de la cavité pulmonaire humaine. Cinq cas ont été identifiés avec une masse pulmonaire cavitaire par tomodensitométrie (TDM) thoracique et histopathologie des lésions. Trois chiens et deux chats avaient un adénocarcinome pulmonaire cavitaire. Les caractéristiques communes de la tomodensitométrie dans ces cas comprenaient des lésions dans les lobes du poumon caudal, des marges lobulaires et spiculées des lésions, des bronchogrammes aériens dans la masse, des étiquettes pleurales, l'augmentation du contraste hétérogène et une opacité d'apparence de verre dépoli dans le parenchyme environnant. Les résultats de cette série de cas suggèrent qu'il existe des similitudes dans les caractéristiques tomodensitométriques de la malignité dans les masses pulmonaires cavitaires humaines et animales.(Traduit par Dr Serge Messier).
Asunto(s)
Adenocarcinoma del Pulmón , Enfermedades de los Gatos , Enfermedades de los Perros , Neoplasias Pulmonares , Adenocarcinoma del Pulmón/diagnóstico por imagen , Adenocarcinoma del Pulmón/veterinaria , Animales , Enfermedades de los Gatos/diagnóstico por imagen , Gatos , Enfermedades de los Perros/diagnóstico por imagen , Perros , Pulmón , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/veterinaria , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/veterinariaRESUMEN
OBJECTIVE: To describe the clinical presentation and outcome of two greyhounds with calcaneal malunions that were treated with corrective osteotomy and partial tarsal arthrodesis. STUDY DESIGN: Short case series. ANIMALS: Two adult racing greyhounds. METHODS: Varus and recurvatum deformity of the calcaneus was ascribed to malunion of prior calcaneal fracture with concomitant central bone fracture that had been sustained during racing in both dogs. Both dogs exhibited severe, weight-bearing lameness and had radiographic evidence of moderate to severe osteoarthritis of the proximal intertarsal joint. A closing wedge corrective osteotomy and partial tarsal arthrodesis were performed with a 2.7-mm locking compression plate and cancellous autograft. RESULTS: Calcaneal morphology and alignment of the common calcaneal tendon seemed restored postoperatively. The implant was removed in one dog, while the other dog experienced no postoperative complications. Lameness improved in both dogs, although residual intermittent lameness after heavy exercise was reported by owners of both dogs 1 year after surgery. Overall, owner satisfaction and outcome were considered good-to-excellent in both dogs. CONCLUSION: Corrective osteotomy and partial tarsal arthrodesis for treatment of malunited calcaneal fractures may be considered in dogs with clinical signs related to calcaneal malunion.
Asunto(s)
Tobillo/cirugía , Artrodesis/veterinaria , Calcáneo/cirugía , Perros/cirugía , Fracturas Mal Unidas/veterinaria , Osteotomía/veterinaria , Animales , Calcáneo/lesiones , Perros/lesiones , Femenino , Fracturas Mal Unidas/cirugía , MasculinoRESUMEN
OBJECTIVE: To evaluate the feasibility and safety of microwave ablation (MWA) as a modality to induce tumor necrosis within distal radial osteosarcoma (OSA). STUDY DESIGN: Pilot study. ANIMALS: Six client-owned dogs with distal radius OSA confirmed by cytological examination. METHODS: Dogs underwent computed tomography for surgical planning before general anesthesia for fluoroscopy-guided ablation. Computed tomography was repeated 48 hours after MWA, before amputation. The ablated tumor was evaluated with histopathology. RESULTS: Six dogs underwent MWA of distal radius OSA. A lower power setting (30 W) was selected for the first two dogs to avoid collateral soft tissue damage. The power was increased to 75 W for the last four dogs. The temperature was maintained between 45°C and 55°C (113 °F-131 °F) at the bone/soft tissue interface. Tumor necrosis varied between 30% and 90% (median, 55%) according to histopathology. No intraoperative or periprocedural complications were observed. CONCLUSION: Microwave ablation induced variable tumor necrosis and did not induce immediate postablation complications in these six dogs with distal radius OSA. CLINICAL SIGNIFICANCE: These results justify further evaluation of MWA as a potential modality to treat primary bone lesions in dogs.
Asunto(s)
Neoplasias Óseas/veterinaria , Enfermedades de los Perros/cirugía , Microondas/uso terapéutico , Osteosarcoma/veterinaria , Ablación por Radiofrecuencia/veterinaria , Radio (Anatomía)/cirugía , Animales , Neoplasias Óseas/cirugía , Perros , Femenino , Fluoroscopía/veterinaria , Masculino , Osteosarcoma/cirugía , Proyectos Piloto , Resultado del TratamientoRESUMEN
OBJECTIVE: To report outcomes after radical mandibulectomy in cats. STUDY DESIGN: Multi-institutional retrospective study. ANIMALS: Eight cats were included. METHODS: Medical records were searched for cats with confirmed oral neoplasia treated with radical mandibulectomy. Data collected included demographics, surgical procedure, histopathological diagnosis, postoperative management, and outcomes. RESULTS: Ages ranged from 8 to 17 years. All cats had 75% to 90% of the mandible removed and feeding tubes placed. Seven cats had squamous cell carcinoma, and one cat had a giant cell tumor. Six cats ate on their own postoperatively. Three cats had local recurrence and tumor-related died at 136 and 291 days. Six cats had no recurrence, with survival times of 156, 465, 608, and 1023 days, and two cats were still alive at 316 and 461 days after surgery. The three long-term survivors died of causes unrelated to oral neoplasia. One cat died at 156 days due to aspiration of food material. The overall estimated mean survival time was 712 days. CONCLUSION: After radical mandibulectomy, independent food intake was achieved in 6 of eight cats, and four cats lived longer than one year. CLINICAL SIGNIFICANCE: Radical mandibulectomy should be considered for the treatment of extensive oral neoplasia in cats. Successful long-term outcomes are possible with aggressive supportive care perioperatively.
Asunto(s)
Carcinoma de Células Escamosas/veterinaria , Enfermedades de los Gatos/cirugía , Tumores de Células Gigantes/veterinaria , Osteotomía Mandibular/veterinaria , Neoplasias de la Boca/veterinaria , Animales , Carcinoma de Células Escamosas/cirugía , Gatos , Femenino , Tumores de Células Gigantes/cirugía , Masculino , Neoplasias de la Boca/cirugía , Estudios Retrospectivos , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
OBJECTIVE: To describe percutaneous microwave ablation (MWA) of presumptive pulmonary metastases and the outcome of two dogs. ANIMALS: Two dogs with pulmonary lesions after treatment of spontaneously occurring appendicular osteosarcoma. STUDY DESIGN: Preliminary prospective clinical study. METHODS: Two large-breed dogs were referred from tertiary veterinary hospitals 146 and 217 days after limb amputation to pursue MWA as an alternative therapy to metastasectomy. Both dogs had been receiving chemotherapy protocols at their respective referral centers. RESULTS: A novel percutaneous approach for MWA with ultrasonographic or computed tomographic (CT) guidance was successfully performed. The only complications consisted of pneumothoraxes, requiring treatment in one dog. In the weeks after their procedures, both dogs were reported to do well at home. Dog 1 died and dog 2 was euthanized 82 and 19 days, respectively, after their MWA of confirmed (dog 1) or presumed (dog 2) metastatic disease. CONCLUSION: Percutaneous MWA of pulmonary nodules was technically feasible in two dogs without major complications. CLINICAL SIGNIFICANCE: Percutaneous MWA may provide a minimally invasive option for treatment of osteosarcoma pulmonary metastases. Additional studies are required to evaluate the benefits of MWA on survival and confirm histologic cell death within pulmonary neoplastic lesions.
Asunto(s)
Enfermedades de los Perros/cirugía , Neoplasias Pulmonares/veterinaria , Microondas/uso terapéutico , Osteosarcoma/veterinaria , Ablación por Radiofrecuencia/veterinaria , Amputación Quirúrgica/veterinaria , Animales , Enfermedades de los Perros/patología , Perros , Neoplasias Pulmonares/secundario , Neoplasias Pulmonares/cirugía , Masculino , Osteosarcoma/patología , Osteosarcoma/cirugía , Tomografía Computarizada por Rayos X/veterinaria , Ultrasonografía/veterinariaRESUMEN
OBJECTIVE: To report the outcomes of dogs with lesions of the genitourinary tract treated by vaginectomy or vulvovaginectomy. STUDY DESIGN: Multi-institutional retrospective study. ANIMALS: Female dogs that underwent vulvovaginectomy, complete vaginectomy, or subtotal vaginectomy from 2003 to 2018 with complete medical records and a minimum of 60 days follow-up. METHODS: Data collected from medical records included preoperative, intraoperative, and postoperative data, such as the occurrence of urinary incontinence (UIC), disease recurrence, and death/euthanasia. RESULTS: This study included 21 dogs. Four dogs had vulvovaginectomy, six had complete vaginectomy, and 11 had a subtotal vaginectomy performed. The mean age at surgery was 9.2 years (SD, 3.3). Thirteen dogs were intact at presentation. Smooth muscle tumors were diagnosed most commonly (10 leiomyomata, three leiomyosarcomas, two leiomyofibromas). The median duration of follow-up was 520 days (range, 71-1955). Major complications requiring revision surgery were recorded in two dogs. Postoperative UIC occurred in six of 21 dogs, resolving spontaneously within 60 days in three dogs. Dogs with malignant tumors (n = 6) survived at least 71 days (median, 626; 95% CI, 71-1245), and recurrence of disease occurred in two dogs. In dogs with benign tumors (n = 15), the median survival time was not reached. These dogs survived at least 104 days and had no recurrence of the disease. CONCLUSION: Vaginectomy and vulvovaginectomy resulted in prolonged survival and low rates of major complications and UIC. CLINICAL SIGNIFICANCE: This study provides evidence to recommend that the risks of this procedure and expectations should be discussed with clients.
Asunto(s)
Colpotomía/veterinaria , Enfermedades de los Perros/cirugía , Leiomioma/veterinaria , Vulvectomía/veterinaria , Animales , Perros , Femenino , Leiomioma/cirugía , Periodo Posoperatorio , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: To describe a novel surgical technique for ventral orbital reconstruction after ventral orbitectomy by using a temporalis fascia transposition flap. STUDY DESIGN: Case report. METHODS: A 7-year-old, spayed female Boston terrier was treated for multilobular osteochondrosarcoma arising from the cranial aspect of the left zygomatic arch, causing asymmetry of the face and mild exophthalmos of the left eye. A ventral orbitectomy with a wide surgical excision (including the cranial aspect of the zygomatic bone, the medial aspect of the lacrimal bone, and the dorsal aspect of the maxilla) was performed with preservation of the left eye. To support and maintain the left eye in a normal position, a temporalis fascia transposition flap was elevated and used. No complications occurred during the procedure. RESULTS: Thirteen days after surgery, the referring veterinarian reported no complications. Complete excision was confirmed on histopathology. Eighty-three days after surgery, the dog remained asymptomatic with only mild epiphora of the left eye. Follow-up information from the owner 11 months after surgery indicated that the dog was asymptomatic with minimal ventral globe deviation. CONCLUSION: Additional ventral support of the globe after ventral orbitectomy via a temporalis fascia transposition flap resulted in an excellent functional and cosmetic outcome. CLINICAL SIGNIFICANCE: A temporalis fascia transposition flap can be used to reconstruct the ventral aspect of the orbit in dogs.
Asunto(s)
Neoplasias Óseas/veterinaria , Enfermedades de los Perros/cirugía , Procedimientos de Cirugía Plástica/veterinaria , Sarcoma/veterinaria , Colgajos Quirúrgicos/veterinaria , Animales , Neoplasias Óseas/cirugía , Perros , Fascia/trasplante , Femenino , Neoplasias Orbitales/cirugía , Neoplasias Orbitales/veterinaria , Estudios Retrospectivos , Sarcoma/cirugía , Resultado del TratamientoRESUMEN
OBJECTIVE: To describe the clinical characteristics, perioperative complications, and outcomes in dogs surgically treated for gastric carcinoma. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Forty client-owned dogs with histologically confirmed gastric carcinoma. METHODS: Medical records were reviewed for preoperative diagnostics, surgery, histopathology, postoperative complications, adjuvant chemotherapy, disease progression, and survival. Variables were assessed for associations with outcome by using Cox proportional hazards regression analysis. RESULTS: Surgical treatment included partial gastrectomy (28 dogs), Billroth I (9 dogs), subtotal gastrectomy (2 dogs), and submucosal resection (1 dog). Major postoperative complications occurred in 8 of 40 dogs, including septic peritonitis secondary to dehiscence in 4 dogs. The median progression free interval was 54 days, and the median survival time (MST) was 178 days (range, 1-1902). According to multivariable analysis results, experiencing an intraoperative complication was associated with an increased risk of death (hazard ratio [HR] 3.5, 95% CI 1.1-9.8, P = .005), and administration of adjuvant chemotherapy correlated with an improved survival (HR 0.4, 95% CI 0.2-0.9, P = .03). CONCLUSION: In this population of dogs, MST exceeded historically reported data, major postoperative complication rates were comparable to established literature, and administration of adjuvant chemotherapy was associated with improved survival. CLINICAL SIGNIFICANCE: Results from this study may be used to counsel owners more accurately regarding prognosis for dogs undergoing surgical excision for gastric carcinoma.
Asunto(s)
Carcinoma/veterinaria , Enfermedades de los Perros/cirugía , Complicaciones Intraoperatorias/veterinaria , Complicaciones Posoperatorias/veterinaria , Sociedades Veterinarias , Neoplasias Gástricas/veterinaria , Animales , Carcinoma/cirugía , Quimioterapia Adyuvante , Perros , Femenino , Masculino , Estudios Retrospectivos , Neoplasias Gástricas/cirugía , Resultado del TratamientoRESUMEN
A 6-year-old spayed female Labrador retriever dog was evaluated for trismus and peripheral vestibular syndrome. Computed tomography (CT) revealed a mass arising from the tympanic bulla consistent with a cholesteatoma. A total ear canal ablation, bulla osteotomy, and adjunct segmental mandibulectomy were performed. Re-evaluation 2 weeks after surgery revealed no neurologic abnormalities, normal jaw range of motion, and no discomfort. Despite concern for recurrence of cholesteatoma based on CT imaging performed 33 months after surgery, repeat surgical intervention was not pursued as the owner considered the dog's comfort level to be satisfactory. The patient continued to do well for the 42-month follow-up period.
Mandibulectomie segmentaire comme nouvelle stratégie de gestion complémentaire pour le traitement d'un cholestéatome avancé chez un chien. Une femelle Labrador retriever de 6 ans stérilisée a été évaluée pour du trismus et un syndrome vestibulaire périphérique. La tomodensitométrie a révélé une masse issue de la bulle tympanique, compatible avec un cholestéatome. Une ablation totale du conduit auditif, une ostéotomie de la bulle et une mandibulectomie segmentaire complémentaire ont été réalisées. La réévaluation deux semaines après l'opération n'a révélé aucune anomalie neurologique, une amplitude de mouvement normale de la mâchoire et aucun inconfort. Malgré l'inquiétude suscitée par la récurrence du cholestéatome sur la base d'une tomodensitométrie réalisée 33 mois après la chirurgie, aucune nouvelle intervention chirurgicale n'a été envisagée, le propriétaire ayant estimé que le niveau de confort du chien était satisfaisant. La patiente a continué à bien se porter pendant la période de suivi de 42 mois.(Traduit par les auteurs).
Asunto(s)
Colesteatoma/veterinaria , Enfermedades de los Perros , Animales , Perros , Conducto Auditivo Externo , Femenino , Osteotomía Mandibular/veterinaria , Osteotomía/veterinariaRESUMEN
OBJECTIVE: To describe a suture-free ureterovesical anastomosis using a microvascular anastomotic system (MAS) and compare the surgical time and bursting pressure to a sutured ureterovesical anastomosis (SA) with and without an extravesical seromuscular tunnel (EVSMT). STUDY DESIGN: Randomized, unblocked design, ex vivo study. ANIMALS: Three canine cadavers. METHODS: For each cadaver, the ureters were sectioned into 3 equal lengths. The 6 sections were randomly assigned to receive either the MAS or end-side SA. The first cadaver (3 MAS, 3 SA) was used to refine the technique, and the remaining 2 cadavers were used for evaluation. Surgical time and bursting pressure of the anastomosis were compared between MAS and SA (n = 6 per technique). After bursting pressure testing of each anastomosis, an SMT was created over the anastomoses. Bursting pressures were again recorded and compared across techniques. RESULTS: The surgery time was significantly shorter for MAS (median 5.4 minutes) than SA (median 15.8 minutes; P = .002). The bursting pressure was significantly higher for MAS (median 189.5 cmH2 O) than SA (median 64 cmH2 O; P = .002). The bursting pressure for MAS-EVSMT (median 398.5 cmH2 O) was not significantly different from the SA-EVSMT (median 321 cmH2 O, P = .567); however, the creation of an SMT significantly increased the bursting pressure for both techniques (P = .028, respectively). CONCLUSION: This study demonstrated the feasibility of a suture-free ureterovesical anastomosis in the canine cadaver using a commercially available MAS. The MAS anastomosis was faster and resulted in higher bursting pressures than SA. The creation of an SMT improved the bursting resistance of both techniques but there was no difference between the techniques covered by an EVSMT.
Asunto(s)
Anastomosis Quirúrgica/veterinaria , Perros/cirugía , Análisis de Falla de Equipo/normas , Presión , Uréter/cirugía , Anastomosis Quirúrgica/métodos , Animales , CadáverRESUMEN
BACKGROUND: The most common haemostatic abnormality in dogs with cancer is hypercoagulability. A transient hypercoagulability has been documented in people with hepatocellular carcinoma (HCC) that resolves within weeks following hepatic tumour resection. OBJECTIVE: The objective was to compare the haemostatic status of dogs with liver tumours and healthy control dogs, by comparing coagulation and thromboelastography (TEG) measurements at three time points. METHODS: Liver tumour and healthy control dogs receiving surgery for liver lobectomy and ovariohysterectomy, respectively, were prospectively enrolled. All dogs had blood collected at three time points: pre-operative, 24 h post-operative and ~2 weeks post-operative. Haematological and haemostatic values were compared across time points in each group using repeated measures ANOVA tests. RESULTS: Ten and eight dogs were enrolled for the liver and control groups, respectively. Platelet count was significantly higher in the liver group than the control group at all time points, but within the normal range (pre-operative: 438.7 vs. 300.9 × 109 /L, p = .0078; 24 h post-operative: 416.2 vs. 283.9 × 109 /L, p = .0123; 10-14 days post-operative: 524.6 vs. 317.3 × 109 /L, p = .0072). The measure of the overall coagulant state (G-value) was significantly increased for the liver group compared to the control group at all time points (pre-operative: 15.6 vs. 8.6 d/sc, p = .0003; 24 h post-operative: 18.3 vs. 11.2 d/sc, p = .039; 10-14 days post-operative: 15.1 vs. 9.6 d/sc, p = .015). CONCLUSION: The liver group was hypercoagulable based on elevated G-values at all time points compared to the control group. This hypercoagulability was attributed to the effect of hepatic tumours alone, and not secondary to surgery and anaesthesia.
Asunto(s)
Adenoma de Células Hepáticas , Carcinoma Hepatocelular , Enfermedades de los Perros , Hemostáticos , Neoplasias Hepáticas , Oncología Quirúrgica , Trombofilia , Humanos , Perros , Animales , Tromboelastografía/veterinaria , Carcinoma Hepatocelular/cirugía , Carcinoma Hepatocelular/veterinaria , Estudios Prospectivos , Adenoma de Células Hepáticas/veterinaria , Sociedades Veterinarias , Neoplasias Hepáticas/cirugía , Neoplasias Hepáticas/veterinaria , Enfermedades de los Perros/cirugía , Trombofilia/veterinariaRESUMEN
OBJECTIVE: To determine the pharmacokinetics and pharmacodynamics of dexmedetomidine after IM administration in dogs. ANIMALS: 6 healthy adult purpose-bred dogs (3 males, 3 females) with a mean ± SD body weight of 25.2 ± 1.8 kg. PROCEDURES: Each dog received 10 µg/kg dexmedetomidine, IM. Heart rate and respiratory rate were counted via cardiac auscultation and visual assessment of chest excursions. Sedation was assessed utilizing 2 sedation scoring systems. Plasma concentrations were determined using ultra performance liquid chromatography-mass spectrometry. Plasma concentrations versus time data after IM dexmedetomidine were analyzed using noncompartmental analysis for extravascular administration. RESULTS: Over the first 2 hours following IM injection of dexmedetomidine, plasma concentrations fluctuated in each dog. The geometric mean (range) maximum plasma concentration was 109.2 (22.4 to 211.5) ng/mL occurring at 20.5 (5 to 75) minutes, and the mean half-life was 25.5 (11.5 to 41.5) minutes. Heart rate was significantly lower than baseline from 30 minutes to 2 hours postdexmedetomidine administration, and respiratory rate was significantly lower than baseline from 45 minutes to 1.75 hours. Dogs were significantly more sedated from 30 minutes to 1.5 hours postdexmedetomidine administration. Median time to onset of sedation was 7.5 minutes (range, 2 to 10 minutes), and median time to peak sedation was 30 minutes (range, 15 to 60 minutes). CLINICAL RELEVANCE: Variations in plasma concentrations occurred in all dogs for the 2 hours postinjection of dexmedetomidine at 10 µg/kg, IM. This was likely due to alterations in absorption due to dexmedetomidine-induced local vasoconstriction. Despite variable plasma concentrations, all dogs were sedated following IM dexmedetomidine administration.
Asunto(s)
Dexmedetomidina , Masculino , Femenino , Perros , Animales , Hipnóticos y Sedantes/farmacología , Inyecciones Intramusculares/veterinaria , Frecuencia Cardíaca , Frecuencia RespiratoriaRESUMEN
This case report describes a rare form of malignant bone tumor in an 8-year-old Labrador retriever. This dog initially presented for evaluation of a right distal humeral mass. Radiographs of the right elbow and thorax were performed, revealing a smooth mineralized mass adjacent to the lateral aspect of the distal humerus and a 5mm pulmonary nodule. Computed tomography (CT) of the humerus and thorax showed a smooth mineralized lesion adjacent to the lateral humeral epicondyle, and a right cranial lung lobe nodule with a thin mineral rim. Surgical biopsies of both lesions were diagnostic for parosteal osteosarcoma (POSA). The dog was then treated with stereotactic body radiation therapy (SBRT) which controlled the dog's discomfort for 14 months until he became progressively painful and subsequently had his right forelimb amputated. This case report is the first to document the CT imaging characteristics of a metastatic appendicular POSA in a dog and the first dog described with POSA treated with SBRT. The dog lived for 623 days after histopathologic diagnosis and 849 days after initial presentation with pulmonary metastatic disease.
RESUMEN
Optical coherence tomography (OCT) is an optical imaging modality that has been investigated for real-time surgical margin evaluation in human breast cancer patients. Previous veterinary OCT studies have been limited to surgical margin imaging for soft tissue sarcoma (STS) tumours. To the authors knowledge, OCT has never been used to characterize or evaluate other types of neoplasia in dogs. The goal of this study was to characterize the OCT imaging appearance of apocrine gland anal sac adenocarcinoma (AGASACA) in excised ex vivo specimens from five client-owned dogs. All excised tissue surgical margins were imaged using a clinical spectral domain OCT system and two to four areas suspicious for incomplete surgical margins were selected. These areas were inked and sections were trimmed for histopathology. This enabled OCT imaging from each area of interest to be compared with corresponding H&E stained histology imaging from the same location. OCT was able to identify the presence of AGASACA at or within 1 mm of the surgical margin in all areas of interest. AGASACA, similar to the previously described canine STS, generated a dense, highly scattering image without any specific textural architecture. This study was able to validate the ability of OCT to accurately identify another type of tumour presence at or close to the surgical margin in the dog. Further study is needed to assess OCT accuracy at identifying other tumour types in dogs to understand its potential clinical applications.
Asunto(s)
Adenocarcinoma , Sacos Anales , Enfermedades de los Perros , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/cirugía , Adenocarcinoma/veterinaria , Sacos Anales/diagnóstico por imagen , Sacos Anales/cirugía , Animales , Glándulas Apocrinas/diagnóstico por imagen , Glándulas Apocrinas/cirugía , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/cirugía , Perros , Márgenes de Escisión , Tomografía de Coherencia Óptica/veterinariaRESUMEN
Histopathologic surgical margin assessment in veterinary patients is an imprecise science with assessment limited to a small proportion of the surgical margin due to time and finances. Incomplete excision of canine mast cell tumours (MCTs) alters treatment recommendations and prognosis. Optical coherence tomography (OCT) is a novel imaging modality that has been reported in a single veterinary study for surgical margin assessment. Twenty-five dogs with 34 MCTs were enrolled in a prospective pilot-study to assess the imaging characteristics of canine MCTs with OCT and to evaluate the feasibility and utility of OCT-guided histopathology. All dogs underwent routine surgical excision of MCTs. OCT imaging was used to assess the entire surgical margin prior to placement in formalin. Either normal areas or areas suspected of incomplete MCT excision were inked. Standard histopathologic sectioning and tangential sectioning of inked areas were performed and compared to OCT results. OCT identified MCT near the surgical margin in 10 of 26 specimens (38.4%). Four specimens suspicious for incomplete margins on OCT had incomplete MCT excision that was missed on standard histopathologic sectioning. Six specimens had OCT-guided sections taken as suspicious, which did not show MCT on histopathology. OCT-guided pathology sections were able to detect incompletely excised MCT near the surgical margin with a sensitivity of 90% and specificity of 56.2% in this preliminary study. OCT imaging shows promise for guiding pathologists to areas of interest to improve the diagnostic accuracy of surgical margin assessment in excised canine MCTs.
Asunto(s)
Enfermedades de los Perros , Márgenes de Escisión , Mastocitoma/veterinaria , Tomografía de Coherencia Óptica , Animales , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/cirugía , Perros , Estudios de Factibilidad , Mastocitoma/diagnóstico por imagen , Mastocitoma/cirugía , Proyectos Piloto , Estudios Prospectivos , Tomografía de Coherencia Óptica/veterinariaRESUMEN
OBJECTIVE: To provide information about complication rates and the risk factors for complications with mandibulectomy and maxillectomy procedures in dogs. ANIMALS: 459 client-owned dogs that underwent a mandibulectomy or maxillectomy between January 1, 2007, and January 1, 2018. PROCEDURES: Inclusion criteria included a complete medical record that contained an anesthesia record, surgical report, available histopathology results, and results of CBC and serum biochemical analysis before surgery. A minimum follow-up of 90 days after surgery was required. RESULTS: 271 complications occurred in 171 of 459 (37.3%) dogs. Eighteen complications were not given a severity description. Of the remaining 253 complications, most were considered minor (157/253 [62.1%]). Multivariable logistic regression analysis revealed that only increased surgical time had a significant (OR, 1.36; 95% CI, 1.12 to 1.54) association with the occurrence of ≥ 1 complication. For each additional hour of surgery, the odds of complications increased by 36%. Preoperative radiation therapy or chemotherapy increased the odds of incisional dehiscence or oral fistula formation (OR, 3.0; 95% CI, 1.3 to 7.2). Additionally, undergoing maxillectomy, compared with mandibulectomy, increased the odds of incisional dehiscence or oral fistula formation (OR, 1.8; 95% CI, 1.1 to 3.1). Two hundred forty-four of 271 (90.0%) complications occurred in the perioperative period (0 to 3 months after surgery). CONCLUSIONS AND CLINICAL RELEVANCE: Compared with mandibulectomy, performing maxillectomy increased the risk for incisional dehiscence or oral fistula formation. Mandibulectomy and maxillectomy had a moderate risk for a complication.