Canine laparoscopic-assisted ovary-sparing hysterectomy does not increase risk of stump pyometra.

OBJECTIVE: To evaluate incidences of pyometra and orthopedic, behavioral, urinary/reproductive, neoplastic, or atopic disease processes as outcomes for dogs undergoing either a laparoscopic-assisted ovary-sparing spay/hysterectomy (LapOSS) or a laparoscopic ovariectomy (LapOVE). ANIMALS: 33 client-owned dogs. PROCEDURES: Medical records of client-owned dogs presenting between August 2013 and May 2020 for elective LapOSS or LapOVE were reviewed. A multiple-choice client questionnaire was emailed to all clients whose dogs' complete medical records were available. RESULTS: 17 of the 33 dogs were in the LapOSS group, and 16 of 33 dogs were in the LapOVE group. Of the 17 dogs undergoing LapOSS, 5 of 17 (29%) underwent an elective OVE at a later date. The mean follow-up time was 4.2 ± 1.8 years for the LapOSS group and 4.3 ± 2.0 years for the LapOVE group. No dogs developed stump pyometra. One LapOSS dog developed mammary tumor, and 2 others developed nonreproductive malignant neoplasia while 2 of the LapOVE dogs developed malignant neoplasia. One of the LapOSS dogs with malignant neoplasia had an ovariectomy prior to development of disease. CLINICAL RELEVANCE: Laparoscopic-assisted ovary-sparing spay appears to provide a safe and reliable method of sterilization, with no observable increased risk of pyometra with hysterectomy. Owners must be counseled prior to surgery regarding the consequences of gonadal hormone retention and multiple heat cycles.

Isolation of Campylobacter fetus subspecies fetus from an abdominal abscess in an adult mare.

A 12-year-old Warmblood mare was referred for evaluation of behavioral changes not explained by general physical examination or lameness evaluation. Transrectal ultrasound examination was performed to determine if the behavioral changes were related to ovarian abnormalities, and a large abscess was found near the base of the cecum. Laparoscopic-guided aspiration and lavage of the abscess cavity followed by injection of benzyl penicillin G was carried out. Culture of the lavage sample yielded Campylobacter fetus subspecies fetus, an organism not previously reported as an etiological agent in abdominal abscesses in horses. The mare was treated after surgery with an extended course of antibiotics (minocycline per os q12h for 10 days followed by enrofloxacin per os q24h for 42 days). The mare resumed work in competitive eventing 10 months after surgery, and the behavioral complaints had resolved according to the owner. Key clinical message: We describe the diagnosis and treatment of a mare with an abdominal abscess from which Campylobacter fetus subspecies fetus was cultured. This organism has not previously been reported as an etiological agent in abdominal abscesses in horses.

Isolement de Campylobacter fetus sous-espèce fetus d'un abcès abdominal chez une jument adulte. Une jument Warmblood âgée de 12 ans fut référée pour évaluation de changements de comportement non-expliqués par un examen physique général ou une évaluation de boiterie. Un examen échographique transrectal fut effectué afin de déterminer si les changements de comportement étaient reliées à des anomales ovariennes et un large abcès fut trouvé près de la base du caecum. Une aspiration guidée par laparoscopie et un lavage de la cavité de l'abcès suivis d'une injection de benzyle pénicilline G furent effectués. Une culture de l'échantillon de lavage permis d'identifier Campylobacter fetus sous-espèce fetus, un organisme n'ayant pas été rapporté antérieurement comme agent étiologique dans les abcès abdominaux chez les chevaux. La jument fut traitée après la chirurgie avec un régime prolongé d'antibiotiques (minocycline per os q12h pour 10 jours suivi d'enrofloxacine per os q24h pour 42 jours). La jument recommença à travailler dans des compétitions 10 mois après la chirurgie et les plaintes concernant le comportement étaient résolues selon le propriétaire.Message clinique clé:Nous décrivons le diagnostic et le traitement d'une jument avec un abcès abdominal à partir duquel on isola C. fetus sous-espèce fetus. Cet organisme n'a pas été rapporté antérieurement comme agent étiologique dans les abcès abdominaux chez les chevaux.(Traduit par Dr Serge Messier).

Association of intraperitoneal ceftriaxone, intravenous gentamicin and oral metronidazole in the treatment of an abdominal abscess and peritonitis in a horse: case report / Associação da ceftriaxona intraperitoneal, gentamicina intravenosa e do metronidazol oral no tratamento de abscesso abdominal e peritonite em equino: relato de um caso

Medical management of abdominal abscesses in horses requires prolonged antibiotic therapy and presents varied success rates. A 6-year-old male horse with a history of colic and multiple abdominal punctures to relieve gas was attended. At admission, tachycardia, tachypnea, hyperthermia, mucosal congestion, dehydration, and rigid gait were observed. The association of physical examination, laboratory and ultrasonographic findings allowed the diagnoses of peritonitis and abdominal abscess. Supporting treatment plus broad spectrum antibiotic therapy was performed: daily intraperitoneal ceftriaxone (25 mg/kg, 7 days); daily intravenous gentamicin (6.6 mg/kg, 7 days); per os metronidazole three times a day (15 mg/kg 12 days), followed by the same dose twice a day (15 mg/kg 33 days), totaling 45 days of treatment. Plasma fibrinogen and ultrasonographic examination were the most effective tools to evaluate abscess evolution. There was normalization of the physical examination 24 h after beginning the treatment, consecutive regression of the nucleated cell count in the peritoneal fluid, and regression of plasma fibrinogen and size of the abscess. On the 10th treatment day, the animal was discharged from the hospital, maintaining oral therapy with metronidazole every 12 h (15 mg / kg). When the animal returned on the 30th day, an abscess size regression was observed. However, there was no resolution, and therapy with metronidazole was maintained. On the 45th day of treatment, a new hospital evaluation was performed, where the abscess resolved, and metronidazole was suspended. It is highlighted that the therapeutic association used in the treatment of abdominal infection and abscess resulted in a rapid clinical response.(AU)

O tratamento conservativo dos abscessos abdominais em equinos requer antibioticoterapia prolongada e apresenta variadas taxas de sucesso. Foi atendido um cavalo de seis anos de idade, com histórico de cólica e múltiplas punções abdominais por agulha para esvaziamento de gás. Na admissão, foram observados taquicardia, taquipnéia, hipertermia, congestão mucosa, desidratação e marcha rígida. A associação do exame físico, achados laboratoriais e ultrassonográficos permitiu o diagnóstico de peritonite e abscesso abdominal. Foi realizado tratamento suporte e antibioticoterapia de amplo espectro: ceftriaxona intraperitoneal diária (25 mg/kg, 7 dias); gentamicina intravenosa diária (6,6 mg/kg, 7 dias); metronidazol oral três vezes ao dia (15 mg/kg, 12 dias), seguido de mesma dose duas vezes ao dia, por mais 33 dias, totalizando 45 dias de tratamento. O fibrinogênio plasmático e o exame ultrassonográfico foram os recursos mais eficazes para a avaliação da evolução do abscesso. Após 24 horas do início do tratamento foi constatada a normalização do exame fisico, regressão progressiva da contagem de células nucleadas no líquido peritoneal, do fibrinogênio plasmático e do tamanho do abscesso. No 10° dia de tratamento o animal recebeu alta hospitalar, mantendo-se a terapia oral com metronidazol a cada 12 horas (15 mg/Kg). Em retorno, ao 30° dia, observou-se regressão do tamanho do abscesso, entretanto, não houve resolução, tendo sido mantida a terapia com metronidazol. No 45º dia de tratamento, realizou-se nova avaliação hospitalar, onde foi observada a resolução do abscesso e a admnistração do metronidazol foi suspensa. Destaca-se, que a associação terapêutica utilizada no tratamento de infecção abdominal e abscesso resultou em rápida resposta clínica.(AU)

Intramural Abscess Causing Obstruction at a Previous Jejunal Enterotomy Site in a Dog.

This case report documents a novel late surgical complication in a 2 yr old dog following an enterotomy to remove a jejunal foreign body. Twenty-six days following the original surgery, the dog was re-presented with signs consistent with an intestinal obstruction. A mural intestinal abscess was found as the cause of the obstruction during exploratory surgery, and the site was successfully removed with a resection and anastomosis. Histopathology showed multifocal abscessation with cyst-like structures partially lined with mucosa. The dog recovered without complication and remains healthy 4 mo later. The exact cause of the lesion is not known; however, local contamination through a focal mucosal defect or complications related to the use of barbed suture in the original enterotomy repair may have contributed.

Intra-abdominal fungal pseudomycetoma in two cats.

BACKGROUND: Pseudomycetomas are deep cutaneous to subcutaneous lesions caused by Microsporum canis mainly described in Persian cats, with few reports of intra-abdominal location. This report describes the clinical signs and lesions of intra-abdominal pseudomycetomas caused by M. canis in two Persian cats. CASE REPORT: Two Persian cats with a history of previous laparotomy (ovariohysterectomy and nephrostomy) and fecal impaction were examined. Cat #1 was euthanized and subjected to necropsy, histopathology and mycological evaluation. Cat #2 presented with chronic dermatophytosis, and an intra-abdominal mass, that was subjected to histopathology evaluation. Cat #1 presented at necropsy a white-grayish, firm mass (6cm×3.5cm×2.8cm) in the uterine cervix. Cat #2 presented a firm whitish mass (6.5cm×1.5cm×0.5cm) located close to the left kidney. Histologically, both masses contained multifocal granules with hyphae and spores surrounded by Splendore-Hoeppli reaction, with a pyogranulomatous inflammatory infiltrate and fibrous connective tissue proliferation in the periphery. Hyphae and spores exhibited marked Grocott and periodic acid-Schiff staining. M. canis was identified by fungal isolation in cat #1. CONCLUSIONS: Pseudomycetoma should be considered as a differential diagnosis in cats, especially in Persian cats presenting with an intra-abdominal mass. Entrance of the agent into the cavity can occur during laparotomy.

Septicemia and Infection due to ESBL-producing K. pneumoniae Following Feline Renal Allograft Transplantation.

A 12 yr old castrated male domestic longhair underwent renal transplantation for treatment of chronic interstitial nephritis. Full-thickness intestinal biopsies obtained prior to transplantation revealed mild enteritis. Twelve months following transplantation, the patient underwent surgery for resection of a mesenteric mass causing septic peritonitis. The mesenteric mass was resected and an intestinal resection and anastomosis was performed. Extended-spectrum-ß-lactamase producing Klebsiella pneumoniae was cultured from the resected tissue and urinary tract. Bacterial rods were noted to be circulating in the bloodstream, causing septicemia. Despite aggressive treatment of the septic peritonitis and septicemia using surgical debridement, drain placement, aggressive antibiotic therapy with IV meropenem, and vasopressor support, the patient succumbed to persistent hypotension and suffered cardiopulmonary arrest. Extended-spectrum-ß-lactamase-producing bacteria are of growing concern in human and veterinary medicine, maintaining susceptibility often only to carbapenem and aminoglycoside antibiotics. Resistance to even those antibiotics is emerging. Veterinary patients with a history of antibiotic therapy, central venous or urinary catheterization, immunosuppression, enteric surgery, and an extended stay in the intensive care unit may be predisposed.

Heterotopic gastric mucosa associated with abdominal abscess formation, hypotension, and acute abdominal pain in a puppy.

OBJECTIVE: To describe the presence of heterotopic gastric mucosa forming an abscess associated with acute abdominal pain and shock in a puppy. CASE SUMMARY: A 7-month-old male intact Shih-Tzu was presented to the emergency service for evaluation of a 12-hour history of vomiting and lethargy progressing to weakness. On presentation, the puppy was obtunded and hypotensive. Radiographs revealed an ill-defined mid-ventral abdominal mass. Ultrasound revealed an echogenic, fluid-filled mass associated with the jejunum. The puppy had an exploratory celiotomy and a 2 × 4 cm oval fluid-filled soft tissue mass was found to be intimately associated, but not communicating with, a section of the mid-jejunum. The mass and associated jejunum were removed via enterectomy. Histopathology of the resected mass revealed heterotopic gastric mucosa; bacterial culture of the fluid contained in the mass revealed heavy growth of Escherichia coli. The puppy recovered from surgery, was discharged from the hospital, and has had no further complications from this episode. UNIQUE INFORMATION PROVIDED: Heterotopic gastric mucosa is commonly found incidentally on necropsy. When it has been associated with acute gastrointestinal signs, mechanical intestinal obstruction with or without perforation was noted. To the authors' knowledge, this is the first reported case of heterotopic gastric mucosa leading to abscess formation and acute abdominal pain in the dog.

Large intra-abdominal abscess treatment by marsupialization in 2 alpacas.

OBJECTIVES: To report the clinical signs, diagnostic findings, surgical treatment, postoperative complications, and long-term outcome in 2 adult alpacas with large intra-abdominal abscesses treated by marsupialization of the abscess to the ventral body wall. STUDY DESIGN: Clinical report. ANIMALS: Alpacas (n = 2). METHODS: Two alpacas each presented with decreased appetite, lethargy, poor body condition, and marked abdominal distension. A complete physical examination, abdominal radiography, and ultrasonography confirmed the presence of large intra-abdominal abscesses. Streptococcus equi ssp. zooepidemicus was cultured from the abscess fluid of alpaca 1, and a Gram-negative bacillus from alpaca 2. RESULTS: Both alpacas had exploratory celiotomy with marsupialization of the abdominal abscess to the ventral body wall. Postoperatively, alpacas were administered systemic antibiotics and non-steroidal anti-inflammatory drugs, and the abscesses were lavaged for several days. Alpaca 2 required a second surgical procedure. The abscesses ultimately resolved in both alpacas, with body wall hernia formation as the only major complication. Both alpacas had good long-term outcomes. CONCLUSION: Marsupialization to the ventral abdominal wall with concurrent antibiotic treatment should be considered as a treatment option for alpacas with large intra-abdominal abscesses in which complete surgical resection of the abscess is not possible. An abdominal wall hernia can result from this procedure, and clients should be informed of this potential complication before surgery.

[Omphalourachitis with abscess of the urachus and rectal prolapse in a llama cria (Lama glama)]. / Omphalourachitis mit Urachusabszess und Rektumprolaps bei einem Lamafohlen (Lama glama).

This case report describes the diagnosis and therapy of an omphalo-urachitis in a llama cria. Additionally, the cria developed a rectal prolapse, which was successfully treated with a temporary pararectal tobacco pouch suture following umbilical surgery.

Pressão intra-abdominal em cães / Intra-abdominal pressure in dogs

Sob consenso recente em pacientes humanos, os valores basais da pressão intra-abdominal (PIA) e seus prováveis limiares em casos mórbidos, foram estipulados com intuito de favorecer a homogeneidade de estudos científicos, além de fornecer diretrizes para conduta diagnóstica e terapêutica destes pacientes. Valores basais e alterações na pressão intra-abdominal em animais não são ainda suficientemente conhecidos e cientificamente determinados. Médicos veterinários necessitam conhecer melhor os estados mórbidos que cursam com Hipertensão Intra-Abdominal (HIA) ou Síndrome de Compartimento Abdominal (SCA). O presente estudo objetivou testar em cães a técnica já descrita sob consenso na medicina como modelo de mensuração da pressão intra-abdominal, assim como determinar os valores normais para a espécie. Foram utilizados 15 cães hígidos, machos e fêmeas, homogêneos e todos sem raça definida. A mensuração da pressão intra-abdominal foi realizada por meio da técnica indireta de sondagem vesical e utilização de coluna de água com régua graduada em cm de H2O, sendo seu valor final convertido para a unidade de mm de Hg. Foi observado valor mínimo subatmosférico (abaixo de zero mm de Hg) até o valor máximo de 3,75 mmHg. Houve importante variação entre os valores encontrados individualmente em determinados cães, colocando sob discussão questões como massa corporal, freqüência/volume total de solução fisiológica a ser infundida e agitação destes pacientes no momento do exame. Os valores limítrofes encontrados são considerados fisiológicos, indicando confiabilidade da técnica e possibilidade do seu emprego clínico. A ausência de sedação e utilização de sonda uretral não inviabilizou a realização da mensuração, porém podendo culminar numa sub ou superestimativa dos valores encontrados.

In order to favor the homogeneity of scientific studies and to provide guidelines on the diagnosis and therapy, human basal values of the intra-abdominal pressure (IAP) and their probable thresholds in morbid cases were recently established. However, basal values and changes in the intra-abdominal pressure in animals are still partly unknown and not scientifically confirmed. Veterinarians have the need to expand their knowledge on morbid conditions that develop with Intra-Abdominal Hypertension (IAH) or Abdominal Compartment Syndrome (ACS). The present study aims to test in dogs the technique adopted in human medicine as a model for measurement of intra-abdominal pressure (1) and determine normal values for the species (2). Fifteen known mongrel healthy dogs, males and females and homogenous were tested. The measurement of IAP was done through an indirect technique which involves catheterizing the bladder and using a water column with a graduate ruler in cm of H(2)0 - its final value converted to mm of Hg. The values observed ranged from a minimum sub atmospheric value (below of zero mm of Hg) to 3,75 mmHg. There was a considerable variation within the individual values observed in some animals, bringing up considerations related to body mass, frequency/total volume of the physiologic solution to be administered and inquietude of these dogs during the treatment. The thresholds values found are considered physiologic, indicating reliability of the technique and possibility of its clinical use. The absence of sedation and the use of urethral catheter did not compromised the measurement, however could have resulted in under- or overestimation of the values found.

Surgical drainage and post operative lavage of large abdominal abscesses in six mature horses.

Six mature horses with large abdominal abscesses (defined as an abscess >15-20 cm in at least one dimension) were treated by surgical drainage and post operative lavage. The abscess was associated with previous intestinal surgery in one horse, and with Streptococcus equi spp. equi infection in the other 5. A Foley catheter was used to drain and lavage the abscess in all cases. The abscess was accessed by a ventral midline laparotomy in 5 cases and by standing flank laparoscopy in one. Two horses were subjected to euthanasia within 7 days due to persistent or recurrent colic. The other 4 horses survived. Lavage of the abscess was continued for a median time of 19 days. Antibacterial therapy was continued until the plasma fibrinogen concentration was normal (median 47 days). Follow-up information was obtained at a median of 1.8 years. All 4 horses were alive at the time of follow-up; 2 horses had suffered one or more bouts of colic that had responded to medical treatment.

Treatment of a retroperitoneal abscess by omentalization in an orangutan (Pongo pygmaeus pygmaeus).

A 38-yr-old orangutan (Pongo pygmaeus pygmaeus) presented with chronic lethargy and difficulty in locomotion that progressed to weakness, anorexia, and permanent dorsal and/or lateral recumbency. The orangutan was immobilized with ketamine. Abdominal ultrasonography revealed a mass in the caudal portion of the abdomen. Exploratory surgery was performed, but the mass could not be resected. Instead, the mass was drained and omentalized in an attempt to establish continuous drainage after surgery. The only complication was a wound infection that was treated locally with a disinfectant and installation of a drain that was changed every 2 days under anesthesia. Omentalization was successful in providing continuous fluid drainage for this retroperitoneal abscess and required minimal postoperative handling of the animal.

Use of a rectus abdominis muscle flap to repair urinary bladder and urethral defects in a dog.

CASE DESCRIPTION: An 11-month-old female dog was evaluated because of a 3- to 4-day history of stranguria and hematuria. CLINICAL FINDINGS: Rectal and vaginal examination and abdominal radiography revealed a large (4 x 2 cm), firm, ovoid object in the area of the pelvic inlet, between the vagina and colon. TREATMENT AND OUTCOME: Surgical exploration revealed an abscess and moderate amount of seropurulent fluid in the left caudal abdominal quadrant. A large urethrolith (3.7 x 2.0 x 1.5 cm) was evident in the proximal portion of the urethra. The urethrolith was associated with a 3 x 1-cm area of necrosis in the ventral aspect of the proximal portion of the urethra and a 3 x 3-cm area of necrosis in the area of the bladder trigone. The necrotic areas were débrided, and the defect was repaired with an axial pattern flap constructed from the rectus abdominis muscle. During a follow-up examination 2.5 years after surgery, the dog was clinically normal with no history of urinary incontinence. During rigid cystoscopy, the ure-thral mucosa appeared grossly normal, and there was no evidence of stricture. CLINICAL RELEVANCE: Findings suggested that axial pattern flaps constructed from the rectus abdominis muscle flap may be useful in reconstructing large urinary bladder and urethral defects.

Omentalization of a nonresectable uterine stump abscess in a dog.

One month after ovariohysterectomy, a 2-year-old spayed female Golden Retriever was evaluated because of an extensive uterine stump abscess. Clinical signs included intermittent vomiting, signs of depression, lethargy, and pollakiuria. The dog underwent abdominal surgery; the greatly enlarged uterine stump was tightly adhered to the dorsal surface of the bladder, encompassing the distal portions of the ureters and the bladder's neurovascular supply. En bloc resection of the uterine stump was not considered an acceptable treatment option because of the risk of surgical damage to and subsequent devitalization of the bladder or ureters, urinary incontinence, or urinary tract obstruction. Therefore, the diseased uterine tissue that extended cranial to the bladder was resected, and the remaining abscess cavity was lavaged and packed with omentum. The dog recovered fully from the procedure. The omentum is an effective physiologic drain; its extensive vascular and lymphatic networks absorb fluid and actively promote elimination of infection. Omentalization appears to be an option for surgical management of nonresectable uterine stump abscesses in dogs.

Abscess-forming inflammatory granulation tissue with Gram-positive cocci and prominent eosinophil infiltration in cats: possible infection of methicillin-resistant Staphylococcus.

We occasionally encounter feline cervical or mesenteric lesions diagnosed histopathologically as abscess or inflammatory granulation tissue with eosinophil infiltration. Gram-positive cocci accompany the lesions. In the present study, such lesions obtained from 27 cats were examined to evaluate the histopathologic features and the nature of the causative bacteria. The average age was 7.3 +/- 3.5 years. No sex predilection was observed. Most frequent locations of the lesions included the abdominal cavity with/without mesenteric lymph nodes (11/27, 41%) and subcutaneous tissue or lymph nodes of the neck (9/27, 33%). Common clinical presentation was a localized mass. Grossly, the lesions contained abscesses in the center and were surrounded by fibrous tissue. Microscopically, the necrotic zone contained bacterial colonies. Large numbers of eosinophils and macrophages infiltrated the area surrounding the necrotic tissue. The surrounding connective fiber-rich granulation tissue demarcated the eosinophilic abscess. The bacteria were Gram-positive cocci in 23 of the 27 cats and were positive for anti-staphylococcus antiserum in 19 of the 23 cats. In 15 out of 17 lesions, the colonies expressed immunoreactivity to penicillin-binding protein 2', which is a drug-resistance gene product of methicillin-resistant Staphylococcus (MRS) species. These findings suggest strongly that MRS causes this type of infectious lesion.

Ultrasonographic detection of abdominal abscess in two guinea pigs.

Two guinea pigs (Cavia porcellus) with clinical signs of anorexia, weight loss, depression and abdominal enlargement were examined. During ultrasound examination, a fluid-filled anechogenic structure 3-4 cm in diameter, with echogenic spots and a highly echogenic thick wall, was found in the pelvic region in one case and connected to the liver in the other case. An abscess or a cyst was suspected and surgical treatment including laparotomy was performed. By histopathological examination performed after surgery, a liver abscess was diagnosed in one guinea pig and an abscess in the pelvic region in the other animal.

Surgical management of an abdominal abscess in a Malayan tapir.

A captive Malayan tapir was observed to have inappetence, weight loss, signs of depression, mild dehydration and diarrhoea. Haematological and serum biochemical tests showed anaemia, hypoproteinaemia, hyperfibrinogenaemia and neutrophilia with a left shift. Ultrasonic examination of the abdomen under anaesthesia revealed a well-encapsulated abscess. The abscess was marsupialised to the ventral body wall. Culture of the pus produced a mixed bacterial growth. Antimicrobial therapy was based on bacterial sensitivity results. Follow-up ultrasonic examinations showed resolution of the abscess. Ninety-one days after surgery the tapir began regurgitating food and water. An abscess originating from the stomach and occluding the lumen of the duodenum was identified at surgery. The abscess ruptured during surgical manipulations and the tapir was euthanased.

Ultrasonography of abdominal cavitary parenchymal lesions.

Cavitary parenchymal lesions are composed of varying amounts of soft tissue, fluid, and/or gas. These cavitary lesions are focal or multifocal and therefore readily detected ultrasonographically. The ultrasonographic appearance of cystic and noncystic cavitary lesions are described. Differential diagnoses for these cavitary lesions in abdominal organs are listed.