Treatment of aldosterone-secreting adrenocortical tumors in cats by unilateral adrenalectomy: 10 cases (2002-2012).

BACKGROUND: Primary hyperaldosteronism (PHA) in cats occurs as a consequence of excessive hormone production by an adrenocortical tumor. Median survival time, association between tumor type and prognosis, and the likelihood that cats require continued medical therapy after surgery have not been systematically evaluated. OBJECTIVES: To determine the median survival time of cats with PHA treated by unilateral adrenalectomy. To examine if tumor type, anesthesia time, or tumor location (left or right side) affect survival and if affected cats require continued postoperative treatment for persistent hypertension or hypokalemia. ANIMALS: Ten client-owned cats. METHODS: Retrospective study. Cats were diagnosed with PHA based on clinical signs, increased plasma aldosterone concentration, and advanced imaging. Cats underwent unilateral adrenalectomy. Survival time (days alive after surgery) was determined for each cat. Factors affecting median survival time were investigated, including histopathology, anesthesia time, and location (side) of the tumor. RESULTS: Eight of 10 cats survived to discharge from the hospital post adrenalectomy. Overall median survival was 1,297 days (range 2-1,582 days). The only significant factor affecting median survival time was anesthesia time >4 hours. Tumor type and location (side) did not significantly affect median survival time. No cats required continued medical treatment for PHA. CONCLUSIONS AND CLINICAL IMPORTANCE: Although PHA in cats is still considered an uncommon condition, it should be considered in middle to older aged cats with hypokalemic polymyopathy and systemic hypertension. Surgical correction by unilateral adrenalectomy is a viable approach to definitive treatment of PHA with no need for continued medical management.

Correlation of ultrasonographic findings with surgical, portographic, and necropsy findings in dogs and cats with portosystemic shunts: 63 cases (1987-1993).

Results of abdominal ultrasonography in 63 dogs and cats with suspected congenital portosystemic shunts (PSS) were compared with surgical, portographic, and necropsy findings. True-positive ultrasonographic results were found in 33 animals, and 2 animals had false-positive results for detection of single extrahepatic PSS. In 4 animals, results were true negative and in 8 animals, were false-negative for detection of extrahepatic PSS. The false-negative rate decreased substantially with operator experience. The sensitivity of ultrasonography for detection of extrahepatic PSS in these animals was 80.5%, and the specificity was 66.7%. In 5 other animals, ultrasonographic examination was strongly suggestive of the existence of a shunt, but the vessel could not be definitively imaged. All 5 animals had single extrahepatic shunts. Eleven animals had true-positive results for detection of intrahepatic PSS. One animal had false-positive ultrasonographic results for intrahepatic PSS, but an extrahepatic shunt was diagnosed at surgery. The sensitivity of ultrasonography for detection of intrahepatic PSS was 100%.

En bloc resection of primary rib tumors in 40 dogs.

Single or multiple rib resection was performed in 40 dogs for the treatment of primary osteosarcoma or chondrosarcoma. The resulting thoracic wall defect was closed with polypropylene (12 dogs), primary muscle flap (16 dogs), diaphragmatic advancement (10 dogs), or a combination (2 dogs). Few immediate (less than 2 weeks) postoperative complications were observed. Twenty dogs with osteosarcoma had a median survival time of 3.3 months (range, 0.5 to 23 months), with a 20% 6-month survival time. Metastases occurred in all the dogs. Fourteen dogs with chondrosarcoma followed up longer than 2 weeks had a median survival time of 10.7 months (range, 0.5 to 36 months) with a 64% 6-month survival time. Eight dogs developed metastases, five died from concurrent disease, and one dog is alive. Dogs with chondrosarcoma survived significantly longer than dogs with osteosarcoma. Survival time was not related to tumor size or number of ribs resected.

Problems and complications associated with colorectal surgery.

Successful colorectal surgery requires a combination of thorough patient evaluation and surgical judgment to determine the correct surgical approach and to properly apply the general principles of colorectal surgery. These principles include gentle tissue handling, preservation of blood and nerve supply, proper suture selection and suture techniques, postoperative monitoring, and early recognition and treatment of complications.

Total ear canal ablation combined with lateral bulla osteotomy for end-stage otitis in dogs. Results in thirty dogs.

Thirty dogs with end-stage otitis were treated by either unilateral or bilateral total ear canal ablation and lateral bulla osteotomy. Otitis was considered end stage when the horizontal ear canal was collapsed, stenotic, or occluded in conjunction with chronic infection of the external and middle ear. The dogs were evaluated clinically and radiographically for 4 to 63 months. The frequency of scratching, head shaking, aural drainage, and para-aural fistulation was significantly decreased. Abnormal ear carriage and head tilt were not changed. The results in 23 dogs were graded as excellent or improved. One dog died of intraoperative hemorrhage. Complications during the period from suture removal to follow-up included para-aural fistulation (3 dogs), facial nerve paralysis (5 dogs), and head tilt (3 dogs).