Successful laparotomic ethanol ablation for an adrenal tumour in a dog.

Adrenalectomy is the gold standard for canine adrenal tumours, but not always recommended due to patient age, underlying conditions and perioperative mortality. Ethanol ablation is an alternative in human medicine for poor surgical candidates. A 13-year-old neutered female toy-poodle with hypercortisolism presented with severe haematuria. Ultrasonography revealed left adrenal and right kidney tumours. Due to high surgical risk, simultaneous laparotomic right nephroureterectomy and ethanol ablation of the left adrenal tumour were performed. Post-ethanol injection complications included transient hypertension and arrhythmia, which resolved spontaneously. The adrenal tumour size decreased within 2.5 months, and cortisol levels normalised within 8 days, remaining stable for 12 months. No hypercortisolism signs were observed without trilostane until death from renal insufficiency. Autopsy showed that the ablated left adrenal gland was an adrenocortical tumour and had shrunk. Ethanol ablation may be a feasible alternative to adrenalectomy for high-risk canine patients.

Postoperative pain in dogs undergoing either laparoscopic or open ovariectomy.

A prospective, quasi-experimental, clinical trial was performed to assess acute postoperative pain in healthy female dogs following elective ovariectomy by either laparoscopy (n=13) or laparotomy (n=14). Pain was assessed by both a veterinarian at the hospital, and by the owner once the patient was discharged. The Spanish version of the short form of the Glasgow Composite Measuring Pain Scale (CMPS-SF) was used. Pain scores were assessed by the veterinarian preoperatively and at 1, 2, 4, and 6 h after extubation, whilst owner-assessed scores were performed preoperatively and at postoperative days 0, 1, 2, 3, 5 and 7. Data were compared with Mann-Whitney-U test. Veterinarian-assessed CMPS-SF scores were different between both groups at all postoperative times but not at baseline, being below 6/24 in all dogs in the laparoscopy group, but equal to or greater than 6/24 in the laparotomy group at 1 h (n=12), and 4 h (n=4) (P<0.001 and P=0.029, respectively). There were also differences in pain scores between both groups at 2 h (P=0.012) and 6 h (P=0.007), being below 6/24 in all of them. However, there were no differences in owner assessments between groups. In conclusion, ovariectomy performed by laparoscopy induced lower pain scores that were below the pain threshold set by the CMPS-SF during the first 6 h postoperatively. After discharge, and up to one week later, ongoing owner-assessed scores suggest no pain was induced with neither of the techniques. Owners were proactive allowing real-time pain assessment to be reported. The development and validation of instruments for acute pain assessment by owners is warranted, as these tools are currently lacking.

Pectin-honey hydrogel to prevent laparotomy surgical site infection in horses: A pilot study.

Surgical site infection (SSI) is a common complication after celiotomy in horses, leading to increased morbidity and costs. Increased concern about antibiotic resistance justifies evaluation of alternative preventive approaches, such a Manuka honey which has displayed antimicrobial properties. Pectin-Honey Hydrogels (PHH), composed by Manuka honey and pectin provide a moist wound environment and microbial growth inhibition. The aim of the study was to evaluate the effectiveness of PHHs in preventing SSI in horses subjected to emergency laparotomy. Horses undergoing laparotomy were evaluated. Horses were randomly divided into two groups: Group 1 received PHH application onto the sutured linea alba before skin closure, while Group 2 received no treatment. Horses with postoperative antimicrobial administration or survival of less than 5 days were excluded. The incidence of SSIs was reported as percentages and compared between groups. Out of 44 horses enrolled in the study, only thirty-six were ultimately included. Exclusions occurred either due to death before 5 days postoperatively (2 horses) or the administration of postoperative antimicrobials (6 horses). The median length of hospitalization was 9 days (range 8-14 days). The overall occurrence of SSI was 19.4 %. One out of eighteen horses (5.5 %) in Group 1 and 6 out of 18 (33.3 %) horses in Group 2 developed SSI. Group 2 had an 8.5-fold increased risk of SSI (p = 0.035, OR = 8.5, 95 % CI. 0.9-80.07). No macroscopically visible adverse reactions were associated with PHH. PHH placed at the abdominal incision during surgery was safe and reduced the prevalence of SSI in horses.

Retrospective evaluation of the effects of a single intraoperative dose of dexamethasone in horses undergoing exploratory laparotomy for small intestinal lesions (2008-2019): 240 cases.

OBJECTIVE: To determine the effect of a single intraoperative dose of dexamethasone on the risk of postoperative reflux (POR) in horses undergoing small intestinal surgery and to investigate its association with incisional complications and short-term survival. DESIGN: Retrospective cohort study over an 11-year period (2008-2019). SETTING: UK-based private referral center. ANIMALS: Two hundred and forty client-owned horses >6 months of age undergoing exploratory laparotomy for treatment of a small intestinal lesion. INTERVENTIONS: Ninety-seven horses received a single intraoperative dose of dexamethasone (0.1 mg/kg, IV). MEASUREMENTS AND MAIN RESULTS: Of 97 horses that received dexamethasone, 52 (53.6%) required small intestinal resection. Of 143 horses that did not receive dexamethasone, small intestinal resection was performed in 78 (54.5%). A total of 70 horses (29%) developed POR. There was no difference in the risk of POR between horses that received dexamethasone (25/97; 26%) and those that did not (45/143; 31%, P = 0.34). Risk factors associated with the development of POR included small intestinal resection (odds ratio [OR]: 4.55, 95% confidence interval [CI]: 2.27-9.11, P < 0.001), a PCV >40% 24 hours postoperatively (OR: 4.11, 95% CI: 2-8.45, P < 0.001), and a WBC count >10 × 109/L on admission (OR: 3.29, 95% CI: 1.47-7.41, P = 0.004). Dexamethasone was not associated with the odds of POR. Horses undergoing repeat laparotomy had a higher risk of incisional infection (OR: 8.07, 95% CI: 1.98-32.81, P = 0.004). Dexamethasone administration was not associated with incisional infection. The development of POR was negatively associated with short-term survival (OR: 0.07, 95% CI: 0.03-0.17, P ≤ 0.001). Dexamethasone administration was not retained in the final multivariable model for survival. CONCLUSIONS: Intraoperative dexamethasone was not associated with the development of POR in this study population, nor did it have an effect on postoperative survival or incisional infection in horses undergoing surgical management of small intestinal disease.

Comedones and epidermal cysts on the abdominal skin of a dog occurring after a laparotomy.

An 8-year-old neutered male shih tzu dog underwent laparotomy for cystolithectomy. Ten days later, multiple various-sized cystic nodules were observed on the suture line and surrounding abdominal skin, although the surgical incision had healed well. Microscopically, various-sized cysts lined with thin walls of stratified squamous epithelium in the dermis were dilated and filled with keratin. Adnexal differentiation from the wall was not seen. Thus, the abdominal lesions were diagnosed as comedones and epidermal cysts. Herein, we describe the case of a dog with comedones and epidermal cysts on the abdominal skin after a laparotomy. Key clinical message: Multiple various-sized cystic lesions of the follicles are described. The implantation of epidermal fragments into the dermis by surgery may induce epidermal cysts and comedones in the skin of hyperadrenocorticism-affected dogs.

Comédons et kystes épidermiques sur la peau abdominale d'un chien survenant après une laparotomie. Un chien shih tzu mâle castré de 8 ans a subi une laparotomie pour cystolithectomie. Dix jours plus tard, de multiples nodules kystiques de différentes tailles ont été observés sur la ligne de suture et sur la peau abdominale environnante, bien que l'incision chirurgicale ait bien cicatrisé. Au microscope, des kystes de différentes tailles bordés de fines parois d'épithélium pavimenteux stratifié dans le derme étaient dilatés et remplis de kératine. Aucune différenciation annexielle par rapport à la paroi n'a été observée. Ainsi, les lésions abdominales ont été diagnostiquées comme des comédons et des kystes épidermiques. Nous décrivons ici le cas d'un chien présentant des comédons et des kystes épidermiques sur la peau abdominale après une laparotomie.Message clinique clé:De multiples lésions kystiques des follicules, de différentes tailles, sont décrites. L'implantation chirurgicale de fragments d'épiderme dans le derme peut provoquer des kystes épidermiques et des comédons dans la peau des chiens atteints d'hypercorticisme.(Traduit par Dr Serge Messier).

Intestinal full-thickness needle-core biopsy via laparotomy is safe, rapid, and effective and less invasive than standard incisional biopsy in dogs and cats.

OBJECTIVE: To describe the intestinal full-thickness needle-core biopsy technique via abdominal laparotomy outcomes and compare the histopathological and immunohistochemical diagnosis with standard incisional intestinal biopsy technique in dogs and cats. ANIMALS: 3 dogs and 17 cats. METHODS: Client-owned dogs and cats were prospectively enrolled if intestinal full-thickness biopsies were indicated for the diagnosis of diffuse chronic intestinal diseases following ultrasonography. The study period extended from June 2021 to December 2022. All animals underwent intestinal biopsies with both techniques (needle-core biopsy and standard incisional biopsy) via abdominal laparotomy. Data collected included clinical signs, biopsy collection times, complications, and histopathologic and immunohistochemical findings. A minimum follow-up of 14 days was required. RESULTS: The main clinical sign at presentation was chronic vomiting (65%). Mean needle-core biopsy collection time (262 seconds) was significantly shorter than standard incisional biopsy collection time (599 seconds; P < .000001). The incidence of minor complications was 10% (inflammation of the skin surgical site secondary to licking). One catastrophic complication occurred on a standard incisional biopsy site in 1 cat in a context of bile peritonitis (5% of all cases). There were no complications associated with the needle-core biopsy. All but 1 cat were discharged, with a median of 2 days (range, 1 to 4 days) after surgery. The diagnoses resulting from both techniques were 100% concordant for the distinction between inflammatory bowel disease and intestinal lymphoma via histopathology and immunochemistry. CLINICAL RELEVANCE: Needle-core biopsy is safe, rapid, and effective and is less invasive than standard incisional biopsy.

Abdominal computed tomography and exploratory laparotomy have high agreement in dogs with surgical disease.

OBJECTIVE: To compare the results of abdominal CT with exploratory laparotomy in the dog. ANIMALS: 100 client-owned dogs from 1 academic institution. METHODS: Medical records were searched for dogs that had undergone a preoperative abdominal CT scan read by a board-certified veterinary radiologist followed by an exploratory laparotomy. CT and surgical reports were compared. RESULTS: The overall agreement between abdominal CT scan and exploratory laparotomy in all cases was 97%. Overall, there was no evidence that proportion agreement differed on the basis of body condition score, time interval between CT and surgery, or oncologic versus nononcologic disease. CLINICAL RELEVANCE: Abdominal CT scan read by a board-certified diplomate is a sensitive presurgical diagnostic tool for surgical abdominal disease in the dog. When performing a specific abdominal surgery, it is acceptable for the surgeon to fully explore the abdomen or forego it for a smaller approach to the organ of interest if an abdominal CT was performed prior.

Laparoscopic surgical treatment for sliding hiatal hernia is associated with an owner-perceived improvement in clinical outcome in dogs.

OBJECTIVE: To report perioperative complications and client-perceived outcome following laparoscopic surgical treatment for sliding hiatal hernia (SHH) in dogs. ANIMALS: Client-owned dogs (n = 9). METHODS: Medical records were reviewed and perioperative data collected including preoperative diagnostic imaging, operative details, complications, and need for conversion to open celiotomy. A single-incision, multicannulated port was inserted in the subumbilical region followed by placement of an additional 2 or 3 instrument portals. Hiatal plication, esophagopexy, and left-sided gastropexy were performed laparoscopically. Follow-up information was collected with telephone interview with the owners and/or referring veterinarian. A standardized questionnaire was completed by dog owners postoperatively. RESULTS: Intraoperative pneumothorax occurred in 5 of 9 (55.6%) dogs and resulted in conversion to open celiotomy in 2 (22.2%) dogs. In 4 dogs, pneumothorax was suspected to be the result of progressive leakage of capnoperitoneum through the suture bite holes of the esophageal hiatal plication sutures. Hiatal plication was performed using intracorporeal simple interrupted sutures (n = 4) or a simple continuous pattern with barbed suture (4). Esophagopexy was performed using barbed suture in all dogs. Gastropexy was performed using a total laparoscopic technique (n = 4) or laparoscopic-assisted technique (3). Using a standardized questionnaire, dog owners perceived a postoperative improvement in regurgitation after eating and regurgitation after excitement/increased activity. CLINICAL RELEVANCE: Laparoscopic treatment of SHH resulted in owner-perceived improvement in clinical signs. Intraoperative pneumothorax occurred in a high proportion of dogs but did not result in long-term sequelae.

Comparison of Systemic Extended-release Buprenorphine and Local Extended-release Bupivacaine-Meloxicam as Analgesics for Laparotomy in Mice.

Extended-release (ER) local anesthetics can be used in multi-modal analgesia or in situations in which systemic analgesics may alter animal physiology and thus introduce interpretational confounds. In this study, we compared the analgesic efficacy of an ER buprenorphine formulation with that of a synergistic combination of ER bupivacaine and meloxicam. Female and male CD1 mice were randomly assigned to receive subcutaneous buprenorphine (3.25mg/kg) preemptively, subcutaneous infiltration of bupivacaine???meloxicam (0.03mL at incision closure (bupivacaine, 35mg/kg; meloxicam, 1mg/kg), or saline (10mL/kg SC) after induction of anesthesia. After laparotomy, mice were assessed for changes in daily body weight, rearing frequency, nest consolidation scores, time-to-integrate-nest test (TINT), and response to von Frey testing at 4, 8, 24, 48, and 72h after surgery. Daily weight, nest consolidation scores and rearing frequency were not significantly different among the 3 groups. TINT had fallen significantly response at 24 and 48h after injection in the ER buprenorphine group as compared with the saline and ER bupivacaine-meloxicam groups. Nociceptive thresholds, as assessed with von Frey testing, differed between saline controls and both analgesic groups at 4, 8, 24, 48, and 72 h after surgery. None of the mice in the bupivacaine???meloxicam group developed signs of neurotoxicity, a potential side effect of high-dose local anesthetics. This study demonstrates that local ER bupivacaine???meloxicam may be a useful alternative to systemic, ER buprenorphine for the relief of pain after laparotomy in mice.

Epiploic foramen entrapment in a dog.

OBJECTIVE: To report small intestinal herniation through the epiploic foramen in a dog. ANIMALS: Nine-year-old male castrated Shih Tzu. STUDY DESIGN: Case report. METHODS: The dog presented with an 8-year history of vomiting and regurgitation and acute onset of melena, lethargy, anorexia, anemia, and suspected gastrointestinal mass or obstruction on prereferral imaging. Abnormalities on abdominal radiographs included a large, midcaudal soft tissue structure and cranial displacement and segmental dilation of the small intestine. On abdominal ultrasound, severe gastric dilation, jejunal tortuosity and stacking, and peritoneal effusion were observed. Epiploic herniation of the small intestine and segmental jejunal devitalization was diagnosed on exploratory laparotomy, and the dog underwent hernia reduction, jejunal resection and anastomosis, and nasogastric tube placement. RESULTS: Severe gastric distention and atony persisted 24 h after surgery, despite medical management. The dog was taken to surgery for decompressive gastrotomy and placement of gastrostomy and nasojejunostomy tubes for postoperative decompression and feeding, respectively. Three days after the original surgery, the dog developed a septic abdomen from anastomotic dehiscence and underwent jejunal resection and anastomosis and peritoneal drain placement. Gastric dysmotility gradually resolved with the administration of motility stimulants, removal of gastric residual volume, and nutritional support via nasojejunostomy tube feedings. Three months after discharge, the dog was clinically normal. CONCLUSION: Epiploic foramen entrapment should be considered a type of herniation in dogs. Clinical suspicion should be raised in dogs with unresolving regurgitation and vomiting, visceral displacement, and stacking and distension of small intestine.

Bilateral, single-session, laparoscopic adrenalectomy was associated with favorable outcomes in a cohort of dogs.

OBJECTIVE: To report perioperative characteristics and outcome following bilateral, single-session, laparoscopic adrenalectomy (BSSLA) in dogs. ANIMALS: Client-owned dogs (n = 6). CLINICAL PRESENTATION AND PROCEDURES: Medical records were reviewed and perioperative data collected, including preoperative diagnostic imaging, operative details, complications, and need for conversion to open laparotomy. Bilateral, single-session, laparoscopic adrenalectomy was performed on the right or left side with a standard 3- or 4-portal transperitoneal technique. The dog was repositioned to contralateral recumbency, and laparoscopic adrenalectomy was repeated. Follow-up information was collected by telephone interviews with the owners and/or referring veterinarian. RESULTS: Median age and weight of dogs were 126 months and 14.75 kg, respectively. Contrast-enhanced CT (CECT) was performed in all dogs. Median maximal tumor diameter was 2.6 and 2.3 cm for the right and left-sided tumors, respectively. Median surgical and anesthesia times were 158 and 240 minutes, respectively. Conversion to open laparotomy was performed in 1 dog following renal vein laceration during initial adrenalectomy. Left adrenalectomy and ureteronephrectomy were performed, and the right adrenal tumor was left in situ. Cardiac arrest occurred in 1 dog following initial adrenalectomy (left); however, the dog was resuscitated successfully, and contralateral laparoscopic adrenalectomy was performed without complication. All dogs survived to hospital discharge. Follow-up ranged from 60 to 730 days (median, 264 days) for dogs that successfully underwent BSSLA. CLINICAL RELEVANCE: BSSLA was associated with favorable outcomes in this cohort of dogs. Laparoscopy may be considered in dogs with bilateral, modestly sized, noninvasive adrenal tumors.

One-step laparoscopy-guided abomasopexy versus omentopexy via right flank laparotomy to treat left displaced abomasum in dairy cows, in relation to return of milk yield.

This study compared two surgical techniques for treating left displaced abomasum (LDA) in dairy cows. The two techniques were compared in terms of milk production at different time intervals: before surgery; on the day of the surgery; and at 8, 15 and 30 days after surgery. The surgical techniques used in this study were laparoscopy-guided abomasopexy and right flank laparotomy omentopexy. A total of 126 lactating Holstein-Friesian cows with LDA were included, 63 of which were treated with laparoscopy, and 63 with right flank laparotomy. Cows with retained foetal membranes, metritis or natural delivery (dystocia) were included and registered on field sheets for subsequent statistical analysis. Cows with clinical mastitis were excluded. A blood sample (5 mL) was obtained from the medial coccygeal vein and analyzed for total proteins, total bilirubin, total calcium, glucose, b-hydroxybutyrate, sodium, potassium, and chloride. No differences were found between the two groups of operated cows with respect to the number of lactation days, body condition score (BCS), rectal temperature, heart rate, and respiratory rate before surgery. No differences were observed between groups regarding the biochemical parameters (P > 0.05) analyzed, except for chloride, which presented lower average values in the omentopexy group (P <0.05). Return of milk yield within the study period did not differ significantly between the laparoscopy and laparotomy groups (P > 0.05), although a significant change in post-surgery time was observed. .

Colic Surgery: Recent Updates.

The following article provides an overview of the last 5 years of research and innovation within the field of equine colic surgery, focusing on new techniques, new or recently described lesions, prevention of lesion recurrence or postoperative complications, and updates in prognoses. Early surgical intervention is an important factor in horse survival.

Development of a classification system for equine postoperative complications and its application in a cohort of 190 horses undergoing emergency laparotomy.

BACKGROUND: Accurate reporting of postoperative complications is paramount to understanding procedural outcomes, comparing procedures and assuring quality improvement. Standardising definitions of complications in equine surgeries will improve the evidence of their outcomes. To this end, we proposed a classification for postoperative complications and applied it to a cohort of 190 horses undergoing emergency laparotomy. METHODS: A classification system for postoperative complications in equine surgery was developed. Medical records of horses that underwent equine emergency laparotomy and recovered from anaesthesia were analysed. Reported complications pre-discharge were classified as per the new classification system, and the cost and days of hospitalisation were correlated with the equine postoperative complication score (EPOCS). RESULTS: Of the 190 horses that underwent emergency laparotomy, 14 (7.4%) did not survive to discharge (class 6 complications), and 47 (24.7%) did not develop complications. The remaining horses were classified as follows: 43 (22.6%) had class 1 complications, 30 (15.8%) had class 2, 42 (22%) had class 3, 11 (5.8%) had class 4; and three (1.5%) had class 5. The proposed classification system and EPOCS correlated with the cost and length of hospitalisation. LIMITATIONS: This was a single-centre study and the definition of scores was arbitrary. CONCLUSIONS: Reporting and grading all complications will help surgeons better understand the patients' postoperative course, thereby reducing subjective interpretation.

Benefits of cyanoacrylate mesh closure following exploratory laparotomy in horses.

BACKGROUND: Skin closure of laparotomy incisions using topical 2-octyl cyanoacrylate (2-OCA) mesh provides a secure bactericidal barrier in humans, which may reduce the risk of postoperative incisional complications. However, the benefits of using this mesh have not been objectively assessed in horses. METHODS: From 2009 to 2020, three methods of skin closure were used following laparotomy for acute colic, including metallic staples (MS), suture (ST) and cyanoacrylate mesh (DP). The closure method was not randomised. Owners were contacted 3 months or more after the surgery to record any postoperative complications that occurred. For each method of closure, the rates of surgical site infection (SSI) and herniation were recorded, as well as surgical time and treatment costs, including those for incisional complications. Chi-square testing and logistic regression modelling were used to assess differences between the groups. RESULTS: A total of 110 horses were recruited (45 in the DP group, 49 in the MS group and 16 in the ST group) The overall rate of SSI was 15.5%, with rates of 8.9%, 18.4% and 25% for the DP, MS and ST groups, respectively (p = 0.23). In addition, incisional hernias developed in 21.8% of cases, with 8.9%, 34.7% and 18.8% of horses in the DP, MS and ST groups, respectively, being affected (p = 0.009). The median total treatment cost did not differ significantly between groups (p = 0.47). LIMITATION: This was a retrospective study with non-randomised choice of closure method. CONCLUSIONS: No significant differences in the rate of SSI or overall cost wwere demonstrated between treatment groups. However, MS was associated with a higher rate of hernia formation than DP or ST. Despite increased capital cost, 2-OCA proved to be a safe skin closure method in horses and was no more expensive than DP or ST by the time visits to remove sutures/staples and treat infections were factored in.

Laparoscopic or laparoscopic-assisted cystopexy for pelvic bladder in 3 dogs.

The techniques and clinical outcomes of laparoscopic or laparoscopic-assisted cystopexy in 3 dogs diagnosed with pelvic bladder are reported herein. The medical records of 2 dogs with pelvic bladder which underwent laparoscopic cystopexy, and 1 dog which underwent laparoscopic-assisted cystopexy were reviewed. Data retrieved included signalment, clinical signs, diagnostic imaging, surgical technique, and clinical outcome. Long-term follow-up was obtained by verbal interviews with owners. Laparoscopic or laparoscopic-assisted cystopexy was successfully performed to reposition the urinary bladder within the abdominal cavity in all dogs. An intracorporeal suture technique was used in 2 dogs, whereas an extracorpreal technique was used in 1 dog. Two dogs with stranguria experienced complete resolution immediately following surgery and remained disease-free at 18 mo after cystopexy. A third dog with urinary incontinence subjectively improved (according to the owner) but had not resolved completely 2 d following surgery. Key clinical message: Laparoscopic or laparoscopic-assisted cystopexy may be an effective treatment for pelvic bladder in dogs and may offer a minimally invasive alternative to laparotomy. Male dogs with stranguria as the primary clinical sign may experience complete resolution following cystopexy.

Cystopexie laparoscopique ou assistée par laparoscopie pour une vessie pelvienne chez trois c hiens. Les techniques et les résultats cliniques de la cystopexie laparoscopique ou assistée par laparoscopie chez trois chiens diagnostiqués avec une vessie pelvienne sont rapportés ici.Les dossiers médicaux de deux chiens ayant une vessie pelvienne ayant subi une cystopexie laparoscopique et d'un chien ayant subi une cystopexie assistée par laparoscopie ont été examinés. Les données récupérées comprenaient le signalement, les signes cliniques, l'imagerie diagnostique, la technique chirurgicale et les résultats cliniques. Le suivi à long terme a été obtenu par des entrevues verbales avec les propriétaires.La cystopexie laparoscopique ou assistée par laparoscopie a été réalisée avec succès pour repositionner la vessie dans la cavité abdominale chez tous les chiens. Une technique de suture intracorporelle a été utilisée chez deux chiens, tandis qu'une technique extracorporelle a été utilisée chez un chien. Deux chiens atteints de strangurie ont connu une résolution complète immédiatement après la chirurgie et sont restés sans maladie à 18 mois après la cystopexie. Un troisième chien souffrant d'incontinence urinaire s'est amélioré subjectivement (selon le propriétaire) mais celle-ci n'a pas complètement disparu 2 jours après la chirurgie.Message clinique clé :La cystopexie laparoscopique ou assistée par laparoscopie peut être un traitement efficace pour une vessie pelvienne chez le chien et peut offrir une alternative peu invasive à la laparotomie. Les chiens mâles atteints de strangurie comme signe clinique principal peuvent connaître une résolution complète après la cystopexie.(Traduit par Dr Serge Messier).

Persistent mullerian duct syndrome in a dog.

INTRODUCTION: This case report describes a 14-year-old, male castrated York Shire Terrier, which was presented due to stranguria and tenesmus. An abdominal computed tomography (CT) scan raised a high suspicion of a persistent mullerian duct. During laparotomy structures were found that were suspected to be a persistent ovary and uterus. The abnormal uterus was filled with fluid and had a blind end on both sides. The abnormal structures were surgically removed and pathologically examined. Pathology confirmed a persistent mullerian duct. The patient recovered well from the surgery and was able to urinate spontaneously the same day and was discharged the next day.

INTRODUCTION: Ce rapport de cas décrit un York Shire Terrier mâle castré de 14 ans, qui a été présenté en raison d'une strangurie et d'un ténesme. Une tomodensitométrie (TDM) abdominale a soulevé une forte suspicion d'un canal de Müller persistant. Une laparotomie a été pratiquée, au cours de laquelle on a découvert des structures suspectées d'être un ovaire et un utérus persistants. L'utérus anormal était rempli de liquide et avait une extrémité aveugle des deux côtés. Les structures anormales ont été retirées chirurgicalement et ont fait l'objet d'un examen pathologique. La pathologie a confirmé la présence d'un canal de Müller persistant. Le patient s'est bien remis de l'opération et a pu uriner spontanément le jour même. Il a été autorisée à sortir le lendemain.

Factors that influence owner consent for exploratory laparotomy in horses with colic in Australia and New Zealand.

BACKGROUND: Horse owners' motivators and barriers for consent to exploratory laparotomy are poorly understood. OBJECTIVES: To (1) determine the proportion of Australian and New Zealand horse owners who would consent to exploratory laparotomy and (2) identify motivators and barriers for consent. STUDY DESIGN: Cross-sectional survey. METHODS: A questionnaire was developed and distributed online. Descriptive statistics were calculated by tabulating respondents by their answers to whether they would consent to exploratory laparotomy. Univariate and multivariate analyses were used to identify variables associated with consenting to exploratory laparotomy. RESULTS: Two thousand two hundred horse owners participated with a 68.3% survey completion rate. Most were female (95.6%), and 18.7% stated they would consent to exploratory laparotomy, 55.2% would consider exploratory laparotomy and 26.1% would not consent to exploratory laparotomy being performed on their horse. Geographical location, intended use of the horse and perceptions regarding the cost and prognosis of exploratory laparotomy, as well as the previous experience of respondents significantly impacted the decision. Self-reported level of financial comfort, gender of respondents, number of horses owned and pre-existing relationship with nearest equine referral clinic did not impact the decision. Top motivators for exploratory laparotomy were high probability of survival, trust in hospital, emotional value of horse and the alternative being euthanasia. Top barriers for exploratory laparotomy were financial cost, uncertain outcome, welfare concern and age of the horse. MAIN LIMITATIONS: Self-selection bias and acquiescence in responses. CONCLUSIONS: Most respondents indicated that they would consider or consent to exploratory laparotomy. Several factors for owners to decide for exploratory laparotomy could be identified. Improved owner education regarding the positively reported survival rates for exploratory laparotomy would be beneficial.

INTRODUCTION/CONTEXTE: Les motivateurs et les obstacles derrières la décision des propriétaires d'autoriser ou pas une laparotomie exploratrice (LE) sur leurs chevaux demeurent mal compris. OBJECTIFS: (1) Déterminer la proportion des propriétaires de chevaux en Australie et Nouvelle-Zélande qui consentiraient à une LE et (2) identifier les motivateurs et obstacles contribuant à leur consentement. TYPE D'ÉTUDE: Étude transversale. MÉTHODES: Un questionnaire a été développé et distribué en ligne. Des statistiques descriptives ont été calculées en classifiant les répondants selon s'ils consentiraient ou non à une LE. Des analyses uni et multivariées ont été utilisées pour identifier les variables associées au consentement à la LE. RÉSULTATS: Deux milles deux cents propriétaires de chevaux ont participé et le taux de remplissage du sondage était de 68.3%. La majorité étaient des femmes (95.6%) et 18.7% donneraient leur consentement pour une LE, 55.2% considéraient une LE et 26.1% ne consentiraient pas à une LE pour leur cheval. La localisation géographique, la discipline du cheval et les perceptions relativement aux coûts et au pronostic pour une LE, de même que leurs expériences précédentes influenceraient la décision des participants de façon significative. La situation monétaire des participants (rapportés de leur plein gré), leur genre, le nombre de chevaux dont ils sont propriétaires et une relation pré-existante avec une clinique de référence à proximité n'influenceraient pas leur décision. Les motivateurs les plus importants pour le consentement à la LE étaient une chance de survie élevée, leur confiance envers le centre de référence, la valeur émotionnelle du cheval et les alternatives possibles à l'euthanasie. Les obstacles les plus flagrants étaient les coûts, une chance de survie incertaine, des préoccupations par rapport au bien-être du cheval et son âge. LIMITES PRINCIPALES: Biais de sélection et degré d'accord des réponses. CONCLUSIONS: La plupart des répondants consentiraient ou au moins considéraient une LE. Plusieurs facteurs influençant la décision des propriétaires ont pu être identifiés. Il est impératif pour les vétérinariares traitants d'éduquer les clients en ce qui concerne les taux de survie plus positifs suivant les laparotomies exploratrices.

Outcome following emergency laparotomy in 33 UK donkeys: A retrospective multicentre study.

BACKGROUND: Emergency laparotomies in donkeys are infrequently performed and there is limited literature on the subject. OBJECTIVES: To determine findings and associated outcomes of exploratory laparotomies in donkeys. STUDY DESIGN: Descriptive retrospective study. METHODS: Donkeys undergoing emergency exploratory laparotomy for investigation and treatment of colic at seven UK referral hospitals between 2005-2017 were included. Data were retrieved from available hospital records. Descriptive statistics and inferential statistical analysis of outcomes of interest was performed in three steps. RESULTS: Thirty-three cases fulfilled the inclusion criteria. Clinical signs on presentation were available for 32 donkeys, of which 53.1% (17/32) presented for investigation of colic while in 46.9% (15/32) the presenting complaint was non-specific. Primary lesion location included small intestine (42.4%, 14/33), large colon (39.3%, 13/33), caecum (6.1%, 2/33), stomach (6.1%, 2/33) and 6.1% (2/33) had multiple abnormal findings without a clear primary lesion. Overall survival to discharge was 54.5% (18/33). Five donkeys (15.2%, 5/33) were euthanased at surgery and of those recovering from general anaesthesia a further 35.7% (10/28) were euthanased or died prior to discharge. Six donkeys (21.4%, 6/28) required a second laparotomy of which 4 (66.7%, 4/6) survived. Post-operative complications occurred in 82.1% (23/28) of cases and included hyperlipaemia (42.9%, 12/28), incisional complications (21.4%, 6/28), ileus (21.4%, 6/28) and persistent colic (17.9%, 5/28). When adjusted for other complications, donkeys with primary gastric lesions were less likely to have presented with severe colic compared with those with primary small intestinal lesions (OR: 0.07, 95% CI 0.01-0.95, p = 0.05). Only age was positively associated with death prior to discharge (OR: 1.18, 95% CI 1.03-1.36, p = 0.02). MAIN LIMITATIONS: Small sample size and retrospective design. CONCLUSION: Donkeys with abdominal lesions may present with a range of signs often not including colic. Surgical findings were diverse and survival to discharge appears to be lower than in horses.

Surgical enlargement of the epiploic foramen in horses.

OBJECTIVE: To assess the safety and efficacy of a method for digitally enlarging the caudal aspect of the epiploic foramen (EF). STUDY DESIGN: Healthy horses and clinical cases of EF entrapment (EFE). ANIMALS: Fourteen healthy horses and three clinical cases. METHODS: Through a ventral midline celiotomy under general anesthesia, the EF was enlarged by digital separation of the caudal attachments of the caudate lobe of the liver from right dorsal colon, right kidney, gastropancreatic fold, and pancreas. Healthy horses were euthanized under anesthesia, and the enlarged EF was measured at necropsy. RESULTS: The method used for enlarging the EF did not cause clinically relevant hemorrhage, as determined by visual inspection of the EF in 14 horses at necropsy and by vital parameters under anesthesia in all horses. In clinical cases, EFE was reduced following enlargement of the EF, and no intraoperative complications were encountered. In one clinical case, necropsy at 30 days confirmed partial closure of the enlarged EF. CONCLUSION: The method proposed enlarged the EF safely and effectively. Limitations of the study include the small number of clinical cases and the lack of postoperative follow-up on the healthy horses. CLINICAL SIGNIFICANCE: Enlargement of the EF at its caudal extent should be considered in selected cases of EFE in which manual reduction is difficult or protracted. Although the procedure was safe in this study, knowledge of the anatomy, practice on cadavers, and careful selection of cases with greatest need are recommended before clinical use.