RESUMO
Surgical antimicrobial prophylaxis (SAP) is widely used to reduce the risk of surgical site infections (SSI), but there is uncertainty as to what the proportion of SSI reduction is. Therefore, it is difficult for surgeons to properly weigh the costs, risks and benefits for individual patients when deciding on the use of SAP, making it challenging to promote antimicrobial stewardship in primary practice settings. The objective of this study was to map the veterinary evidence focused on assessing the effect of SAP on SSI development and in order to identify surgical procedures with some research evidence and possible knowledge gaps. In October 2021 and December 2022, Scopus, CAB Abstracts, Web of Science Core Collection, Embase and MEDLINE were systematically searched. Double blinded screening of records was performed to identify studies in companion animals that reported on the use of SAP and SSI rates. Comparative data were available from 34 out of 39123 records screened including: eight randomised controlled trials (RCT), 23 cohort studies (seven prospective and 16 retrospective) and three retrospective case series representing 12476 dogs and cats in total. Extracted data described peri- or post-operative SAP in nine, and 25 studies, respectively. In the eight RCTs evaluating SAP in companion animals, surgical procedure coverage was skewed towards orthopaedic stifle surgeries in referral settings and there was large variation in SAP protocols, SSI definitions and follow-up periods. More standardized data collection and agreement of SSI definitions is needed to build stronger evidence for optimized patient care.
Assuntos
Antibioticoprofilaxia , Infecção da Ferida Cirúrgica , Animais , Infecção da Ferida Cirúrgica/veterinária , Infecção da Ferida Cirúrgica/prevenção & controle , Gatos/cirurgia , Cães , Antibioticoprofilaxia/veterinária , Animais de Estimação , Guias de Prática Clínica como Assunto , Doenças do Gato/prevenção & controle , Doenças do Gato/tratamento farmacológico , Doenças do Gato/cirurgia , Antibacterianos/uso terapêutico , Antibacterianos/administração & dosagem , Europa (Continente) , Doenças do Cão/prevenção & controle , Doenças do Cão/cirurgia , Doenças do Cão/tratamento farmacológico , Gestão de AntimicrobianosRESUMO
Three West Highland white terriers were presented for investigation of left-sided para-aural abscessation. CT revealed chronic otitis media with extensive osseous proliferation surrounding the horizontal and vertical ear canals contiguous with the expanded temporal bone, consistent with a unilateral variant of craniomandibular osteopathy. A left total ear canal ablation with lateral bulla osteotomy was performed in all dogs. An ultrasonic bone curette (Sonopet; Stryker) proved useful when removing the osseous proliferation in two dogs. Histopathological examination of the ear canals was consistent with craniomandibular osteopathy and the treatment led to resolution of the presenting clinical signs in all dogs. To our knowledge, this is the first report of craniomandibular osteopathy engulfing the external ear canal, presumably leading to chronic otitis media and para-aural abscess formation. This is also the first reported use of an ultrasonic bone curette in canine otic surgery.
Assuntos
Doenças do Cão , Otite Externa/veterinária , Otite Média/veterinária , Abscesso/veterinária , Animais , Cães , Meato Acústico Externo , Osteotomia/veterináriaRESUMO
BACKGROUND: Gall bladder mucoceles (GBM) are a leading cause of biliary disease in dogs with several breeds, including the Shetland Sheepdog, American Cocker Spaniel, Chihuahua, Pomeranian, and Miniature Schnauzer apparently predisposed. OBJECTIVE: To determine risk factors, clinical features, and response to treatment of GBM in Border terriers (BT). ANIMALS: Medical records of 99 dogs (including 51 BT) with an ultrasonographic (±histopathologic) diagnosis of GBM from three referral centers in the United Kingdom were collected. A control group of 87 similar-aged BT with no ultrasonographic evidence of gall bladder disease was selected for comparison. METHOD: Retrospective case-control study. Odds ratios were calculated to establish breed predisposition. Signalment, presence of endocrine disease, clinicopathologic results, and outcome were compared between the BT, other breeds, and control BTs. RESULTS: The odds of identifying a GBM in a BT in this hospital population was 85 times that of all other breeds (95% confidence interval 56.9-126.8). BT had similar clinical signs and clinicopathologic changes to other breeds with GBM. There was no evidence that endocrinopathies were associated with GBM in BT. CLINICAL SIGNIFICANCE: A robust breed predisposition to GBM is established for the BT.
Assuntos
Doenças do Cão/patologia , Doenças da Vesícula Biliar/veterinária , Mucocele/veterinária , Animais , Estudos de Casos e Controles , Doenças do Cão/genética , Cães , Doenças da Vesícula Biliar/genética , Predisposição Genética para Doença , Mucocele/genética , Mucocele/patologia , Estudos Retrospectivos , Fatores de RiscoRESUMO
OBJECTIVES: The objectives of this study were to: (1) document the incidence of surgical site dehiscence after full-thickness gastrointestinal biopsy in dogs and cats and (2) identify potential risk factors. METHODS: Data relating to dogs and cats undergoing full-thickness gastrointestinal biopsy were reviewed retrospectively following submission of a completed questionnaire by 12 referral institutions. Outcome measures were definite dehiscence, possible dehiscence (clinical records suggestive of dehiscence but not confirmed), suspected dehiscence (definite and possible combined) and death within 14 days. Logistic regression was planned for analysis of association of dehiscence with low preoperative serum albumin, biopsy through neoplastic tissue, biopsy alongside another major abdominal surgical procedure and biopsy of the colon. RESULTS: Of 172 cats, two (1·2%) had definite dehiscence, and four (2·3%) had possible dehiscence. Low preoperative serum albumin was significantly associated with definite dehiscence in univariable analysis and with suspected dehiscence and death within 14 days in univariable analysis, but all odds ratios had wide 95% confidence intervals. A histopathological diagnosis of neoplasia was significantly associated with death within 14 days in univariable analysis. Of 195 dogs, two (1·0%) had definite dehiscence, and three (1·5%) had possible dehiscence. In dogs, there was no association between any outcome measure and the putative risk factors. CLINICAL SIGNIFICANCE: Incidence of dehiscence following full-thickness gastrointestinal biopsy was low in this study. When determining the appropriateness of biopsy in individual cases, this information should be balanced against the potentially life-threatening consequences of dehiscence.
Assuntos
Gatos/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/veterinária , Cães/cirurgia , Deiscência da Ferida Operatória/veterinária , Abdome , Animais , Biópsia/métodos , Biópsia/veterinária , Incidência , Estudos Retrospectivos , Fatores de Risco , Deiscência da Ferida Operatória/epidemiologiaRESUMO
A ten-year-old, female-entire English springer spaniel presented with a large intra-abdominal mass but no other clinical signs. Gastrointestinal stromal tumour of the caecum with widespread abdominal metastasis was confirmed. Treatment with toceranib phosphate resulted in complete response, despite the absence of exon-8 or exon-11 c-kit mutation. There was no clinical evidence of tumour recurrence nine months after diagnosis.
Assuntos
Antineoplásicos/uso terapêutico , Doenças do Cão/tratamento farmacológico , Tumores do Estroma Gastrointestinal/veterinária , Indóis/uso terapêutico , Pirróis/uso terapêutico , Animais , Cães , Feminino , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Mutação , Recidiva Local de Neoplasia , Proteínas Proto-Oncogênicas c-kitRESUMO
A 4·5-year-old, female neutered Leonberger was presented with a 2-month history of sneezing, nasal discharge and epistaxis. A presumptive diagnosis of nasal aspergillosis was made based on a suspected (fungal) granuloma on rhinoscopic examination and fungal hyphae on cytological examination. A poor response to targeted therapy was observed and computed tomography 16 months after initial presentation revealed a progressive, locally invasive mass lesion. Histopathological and immunohistochemical analysis of deep surgical biopsies revealed a spindle cell population and a plasma cell rich inflammatory infiltrate, with diffuse expression of vimentin, supporting a diagnosis of inflammatory myofibroblastic tumour. Complete resolution of the nasal discharge and reduced sneezing frequency was reported 9 months post-surgical debridement via rhinotomy. To the authors' knowledge, this is the first report of IMT in the nasal cavity of a dog. IMT should be considered when presented with a nasal mass lesion, particularly if histopathological features and clinical course are inconsistent.
Assuntos
Doenças do Cão/diagnóstico , Granuloma de Células Plasmáticas/veterinária , Doenças Nasais/veterinária , Animais , Diagnóstico Diferencial , Doenças do Cão/patologia , Doenças do Cão/cirurgia , Cães , Feminino , Granuloma de Células Plasmáticas/diagnóstico , Granuloma de Células Plasmáticas/patologia , Granuloma de Células Plasmáticas/cirurgia , Cavidade Nasal/patologia , Doenças Nasais/diagnóstico , Doenças Nasais/patologia , Doenças Nasais/cirurgia , Tomografia Computadorizada por Raios X/veterináriaRESUMO
Histopathological changes are reported in the livers of cats with congenital portosystemic shunts (CPSS) before and after surgical attenuation. Medical records, portovenograms and liver biopsies from cats treated surgically for CPSS were reviewed. Biopsies were graded for histopathological features characteristic of CPSS. Of 40 cats with CPSS included in the study, all had portal vein hypoplasia and arteriolar hyperplasia at initial surgery, 20 (50 per cent) had hepatocyte swelling with microvesicular vacuolar change, 17 (42.5 per cent) had fibrosis, 12 (30 per cent) had hepatocyte swelling with macrovesicular vacuolar change, 8 (20 per cent) had biliary hyperplasia and 2 (5 per cent) had haemosiderin within Küpffer cells. Cats with macrovesicular vacuolar change were significantly older than cats without (P = 0.001), with median ages of 18.5 months and 8.5 months, respectively. Twenty-five cats had partial attenuation of the CPSS at initial surgery, and 16 of these had follow-up biopsy samples. There were no significant differences in the histopathological features of biopsies before and after partial attenuation. From first to second surgery, there was a significant improvement in intrahepatic vasculature on portovenography both before (P = 0.001) and after (P = 0.039) temporary complete attenuation. Following partial CPSS attenuation, there was no significant change in histopathological features despite an improvement in intrahepatic vasculature on portovenography.
Assuntos
Doenças do Gato/patologia , Hepatopatias/veterinária , Fígado/patologia , Sistema Porta/anormalidades , Veia Porta/anormalidades , Animais , Estudos de Casos e Controles , Doenças do Gato/epidemiologia , Doenças do Gato/etiologia , Gatos , Feminino , Hepatopatias/epidemiologia , Hepatopatias/etiologia , Hepatopatias/patologia , Masculino , Sistema Porta/diagnóstico por imagem , Sistema Porta/cirurgia , Veia Porta/diagnóstico por imagem , Veia Porta/cirurgia , Portografia/veterináriaRESUMO
OBJECTIVES: To describe computed tomographic (CT) findings in canine spontaneous pyothorax and compare them to surgical findings and to assess the utility of CT in guiding case management. METHODS: Records from 2003 to 2010 were reviewed to identify dogs, with spontaneous pyothorax, which had undergone CT. Cases were managed medically or surgically. CT images and surgery reports were reviewed and compared for surgical cases. RESULTS: Twelve dogs were included. Eight were managed surgically, three were managed medically and one died before management. Pleural fluid was present in all dogs on CT (n=12) and at surgery (n=8). Pleural gas was identified in five dogs on CT. Pleural thickening was detected in eight dogs on CT (seven visceral, one parietal and six mediastinal) and eight dogs at surgery (seven visceral, eight parietal and six mediastinal), six of which were identified by CT. Abnormal pulmonary parenchyma was detected in 10 dogs on CT and 5 dogs at surgery, all of which were identified by CT. Mediastinal involvement was detected in 10 dogs on CT and 6 dogs at surgery, 5 of which were identified by CT. CONCLUSIONS: CT and surgical findings are similar in most cases of canine spontaneous pyothorax. CT may be a useful diagnostic tool for guiding case management.