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1.
Vet Anaesth Analg ; 50(4): 341-348, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37291042

ABSTRACT

OBJECTIVE: To investigate the statistical association of severe intraoperative hypoxemia in thoracic surgery with mortality, postoperative hospitalization times and cost of care. STUDY DESIGN: Retrospective study. ANIMALS: Dogs that underwent thoracic surgery in three veterinary hospitals between October 1, 2018 and October 1, 2020. METHODS: Anesthesia and hospitalization records from 112 dogs were reviewed and 94 cases met inclusion criteria. Recorded data included signalment, disease etiology, pulmonary or extrapulmonary nature of disease, surgical procedure performed, episodes of severe intraoperative hypoxemia defined as a pulse oximetry reading (SpO2) <90% of 5 minutes or longer duration, survival to discharge, time from extubation to hospital discharge and total invoice cost for clinical visit. Dogs were divided into two groups, those that experienced severe hypoxemia (group A) and those in which SpO2 reading <90% was not observed throughout the procedure (group B). RESULTS: Group A had a greater risk of mortality (odds ratio 10.6, 95% confidence interval 1.9-106.7; p = 0.002), prolonged hospitalization (median 62 hours versus 46 hours; p = 0.035) and more expensive cost of care (median US$10,287 versus $8506; p = 0.056) than group B. No significant difference was found for the type of surgical procedure or pulmonary versus extrapulmonary nature of disease. CONCLUSIONS AND CLINICAL RELEVANCE: Severe intraoperative hypoxemia was statistically associated with an increased risk of mortality and longer postoperative hospitalization times. Although not achieving statistical significance, there was a trend toward increased costs to the client for animals with intraoperative hypoxemia.


Subject(s)
Thoracic Surgery , Thoracic Surgical Procedures , Dogs , Animals , Retrospective Studies , Hypoxia/etiology , Hypoxia/veterinary , Thoracic Surgical Procedures/adverse effects , Thoracic Surgical Procedures/veterinary , Oximetry/veterinary
2.
Vet Surg ; 50(2): 402-409, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33331095

ABSTRACT

OBJECTIVE: To describe and report the outcomes after closure of median sternotomies with crimped monofilament nylon leader (MNL) in dogs. STUDY DESIGN: Retrospective observational study. ANIMALS: Dogs (n = 10) that underwent intrathoracic surgery through a median sternotomy approach. METHODS: The median sternotomy was closed in a peristernal figure eight pattern with crimped MNL. Medical records were reviewed for clinical and histopathological findings and complications. Owners or veterinarians were contacted to collect long-term follow-up information. RESULTS: The technique was simple, with no intraoperative complications. Postoperative infection was documented in one dog, requiring removal of a single MNL and associated crimp clamp. Delayed healing of the surgical incision in one dog was managed conservatively. No other complications were documented throughout long-term follow-up at a median of 488 days (range, 199-608). CONCLUSION: Median sternotomies were successfully closed with crimped MNL and were associated with a low complication rate. CLINICAL SIGNIFICANCE: Crimped MNL represents an alternative method to close median sternotomies in dogs.


Subject(s)
Dogs/surgery , Nylons , Postoperative Complications/veterinary , Sternotomy/veterinary , Animals , Female , Male , Postoperative Complications/etiology , Retrospective Studies , Sternotomy/instrumentation , Thoracic Surgical Procedures/veterinary , Wound Healing
3.
Vet Surg ; 49(4): 694-703, 2020 May.
Article in English | MEDLINE | ID: mdl-32077513

ABSTRACT

OBJECTIVE: To report the clinical, radiographic, and surgical findings and determine prognostic factors for outcome in dogs with thoracic dog bite wounds. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n = 123). METHODS: Medical records of dogs with thoracic dog bite wounds between October 2003 to July 2016 were reviewed for presenting findings, management, and outcomes. Standard wound management included debridement and sterile probing, extending the level of exploration to the depth of the wound. Univariable and multivariable binary logistic regression were used to assess risk factors for exploratory thoracotomy, lung lobectomy, and mortality. RESULTS: Twenty-five dogs underwent exploratory thoracotomy, including lung lobectomy in 12 of these dogs. Presence of pneumothorax (odds ratio [OR] 25.4, confidence interval (CI) 5.2-123.2, P < .001), pseudo-flail chest (OR 15.8, CI 3.2-77.3, P = .001), or rib fracture (OR 11.2, CI 2.5-51.2, P = .002) was associated with increased odds of undergoing exploratory thoracotomy. Presence of pleural effusion (OR 12.1, CI 1.2-120.2, P = .033) and obtaining a positive bacterial culture (OR 23.4, CI 1.6-337.9, P = .021) were associated with increased odds of mortality. The level of wound management correlated with the length of hospitalization (Spearman rank order correlation = 0.52, P < .001) but was not associated with mortality. CONCLUSION: Dogs that sustained pseudo-flail chest, rib fracture, or pneumothorax were more likely to undergo exploratory thoracotomy. Nonsurvival was more likely in dogs with pleural effusion or positive bacterial culture. CLINICAL SIGNIFICANCE: Presence of pseudo-flail, rib fracture, or pneumothorax should raise suspicion of intrathoracic injury. Strong consideration should be given to radiography, surgical exploration, and debridement of all thoracic dog bite wounds.


Subject(s)
Bites and Stings/veterinary , Dogs/injuries , Lung/surgery , Thoracic Injuries/veterinary , Thoracotomy/veterinary , Animals , Bites and Stings/diagnosis , Bites and Stings/etiology , Bites and Stings/mortality , Dogs/surgery , Female , Male , Prognosis , Radiography/veterinary , Retrospective Studies , Thoracic Injuries/diagnosis , Thoracic Injuries/etiology , Thoracic Injuries/mortality , Thoracic Surgical Procedures/statistics & numerical data , Thoracic Surgical Procedures/veterinary , Thoracotomy/statistics & numerical data
4.
Vet Surg ; 46(8): 1098-1109, 2017 Nov.
Article in English | MEDLINE | ID: mdl-29090865

ABSTRACT

OBJECTIVE: To evaluate response to surgical management of sliding hiatal hernia (SHH) and gastroesophageal reflux (GER) in dogs using standardized clinical scoring, videofluoroscopic swallow studies, and impedance planimetry. STUDY DESIGN: Prospective clinical trial. ANIMALS: A total of 17 client-owned dogs. METHODS: Dogs were included if they had clinical signs and videofluoroscopic evidence of SHH and/or GER. Owners were asked to complete a standardized canine dysphagia assessment tool (CDAT) preoperatively and postoperatively. Conscious videofluoroscopic swallowing studies and impedance planimetry (IP) were used to evaluate esophageal function and lower esophageal sphincter location and geometry preoperatively and in a subsection of dogs postoperatively. RESULTS: Preoperatively, 13/17 dogs included in the study had a history of regurgitation, and 4/17 had radiographic evidence of aspiration pneumonia. Postprandial regurgitation improved in 8/10 dogs with preoperative regurgitation, and for which completed preoperative and postoperative CDAT questionnaires were available (P < .01). The hiatal hernia severity score improved postoperatively (P = .046) in dogs with preoperative and postoperative videofluoroscopic swallowing studies (n = 12). However, hernia frequency score (P = .2) and IP parameters did not differ significantly between time points. CONCLUSION: Clinical signs of SHH generally improved with surgery but did not consistently resolve. Videofluoroscopic studies provide evidence that GER and SHH can persist postoperatively in some patients. Based on IP findings, clinical improvement may be attributed to a mechanism independent of lower esophageal sphincter attenuation.


Subject(s)
Dog Diseases/surgery , Esophageal Sphincter, Lower/diagnostic imaging , Gastroesophageal Reflux/veterinary , Hernia, Hiatal/veterinary , Thoracic Surgical Procedures/veterinary , Animals , Dogs , Female , Fluoroscopy/veterinary , Gastroesophageal Reflux/surgery , Hernia, Hiatal/surgery , Male , Prospective Studies , Thoracic Surgical Procedures/methods
5.
Vet Anaesth Analg ; 44(3): 567-576, 2017 May.
Article in English | MEDLINE | ID: mdl-28347629

ABSTRACT

OBJECTIVE: To determine the frequency of provision and main providers (veterinary surgeons, nurses or trainees) of manual ventilation in UK veterinary practices. Furthermore, to determine the variation in peak inspiratory (inflation) pressure (PIP), applied to a lung model during manual ventilation, by three different groups of operators (inexperienced, experienced and specialist), before and after training. STUDY DESIGN: Questionnaire survey, lung model simulator development and prospective testing. METHODS: Postal questionnaires were sent to 100 randomly selected veterinary practices. The lung model simulator was manually ventilated in a staged process over 3 weeks, with and without real-time biometric feedback (PIP display), by three groups of volunteer operators: inexperienced, experienced and specialist. RESULTS: The questionnaires determined that veterinary nurses were responsible for providing the majority of manual ventilation in veterinary practices, mainly drawing on theoretical knowledge rather than any specific training. Thoracic surgery and apnoea were the main reasons for provision of manual ventilation. Specialists performed well when manually ventilating the lung model, regardless of feedback training. Both inexperienced and experienced operators showed significant improvement in technique when using the feedback training tool: variation in PIP decreased significantly until operators provided manual ventilation at PIPs within the defined optimum range. Preferences for different forms of feedback (graphical, numerical or scale display), revealed that the operators' choice was not always the method which gave least variation in PIP. CONCLUSIONS AND CLINICAL RELEVANCE: This study highlighted a need for training in manual ventilation at an early stage in veterinary and veterinary nursing careers and demonstrated how feedback is important in the process of experiential learning. A manometer device which can provide immediate feedback during training, or indeed in a real clinical setting, should improve patient safety.


Subject(s)
Feedback , Nurses , Respiration, Artificial/veterinary , Simulation Training , Veterinarians , Animals , Apnea/therapy , Apnea/veterinary , Biometry , Health Care Surveys , Inhalation , Lung , Models, Anatomic , Pressure , Prospective Studies , Respiration, Artificial/methods , Thoracic Surgical Procedures/veterinary
6.
Schweiz Arch Tierheilkd ; 157(2): 105-9, 2015 Feb.
Article in English | MEDLINE | ID: mdl-26753336

ABSTRACT

This case report describes a combination of negative pressure-wound-therapy (NPWT) and NPWT assisted incision management after resection of an abscess located at the right thoracic wall in a Rottweiler. The patient had a history of severe incisional complications after surgical interventions performed in the past, including repeated episodes of wound dehiscence, major skin necrosis and infection with and without a multiresistant strain of Staphylococcus aureus and several episodes of open wound management with healing rates between months and a year. Wound closure after resection of the mass was performed as a staged procedure. After two days of open NPWT the wound was primarily closed and a preventive incisional vacuum assisted therapy (CI-NPWT) was started for 7 days. The patient was discharged during therapy with the portable device in place. The Unit was removed at day 7 post wound closure, suture removal followed at day 10. Wound healing was uneventful and no major complications occurred at a follow up time of 8 months. This is the first description of closed incisional negative pressure wound therapy in the dog.


Subject(s)
Abscess/veterinary , Dog Diseases/therapy , Negative-Pressure Wound Therapy/veterinary , Surgical Wound Infection/veterinary , Thoracic Surgical Procedures/veterinary , Abscess/complications , Abscess/surgery , Animals , Dog Diseases/prevention & control , Dog Diseases/surgery , Dogs , Female , Risk Factors , Surgical Wound Dehiscence/prevention & control , Surgical Wound Dehiscence/veterinary , Surgical Wound Infection/prevention & control , Surgical Wound Infection/therapy , Thoracic Surgical Procedures/adverse effects , Treatment Outcome , Wound Healing
7.
Vet Surg ; 43(5): 623-9, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24909699

ABSTRACT

OBJECTIVE: To describe the clinical findings, diagnosis, and treatment of an incomplete cleft of the 5th-8th sternebra and a cranioventral abdominal wall hernia in a 2 month old Ragdoll kitten and to evaluate the short- and long-term outcome. STUDY DESIGN: Clinical report. ANIMALS: Ragdoll cat (n = 1), 2 months old. METHODS: Sternal cleft was confirmed by thoracic radiographs. Computed tomography (CT) was used to plan an optimal surgical approach. A ventral median incision was made, starting at the 3rd sternebra and extended into the abdomen. Ostectomy of the proximal part of the 5th left sternebra was performed. Lateral periosteal flaps were created, unfolded, and absorbable monofilament sutures preplaced to facilitate closure and the repair was reinforced by 2 peristernal sutures. A bone graft was applied, and the free margin of the omentum was sutured to the cranial aspect of the wound. RESULTS: No major complications occurred. At 3 weeks, CT scan confirmed approximation of the hemisternebrae and at 10 months, complete fusion of the hemisternebrae had not occurred, but a strong connection of the sternal bars was present. CONCLUSION: Sternal cleft is a rare congenital abnormality that can be corrected surgically with favorable outcome.


Subject(s)
Cats/surgery , Hernia, Ventral/veterinary , Sternum/abnormalities , Surgical Flaps/veterinary , Abnormalities, Multiple/surgery , Abnormalities, Multiple/veterinary , Animals , Hernia, Ventral/surgery , Male , Musculoskeletal Abnormalities , Thoracic Surgical Procedures/veterinary
8.
Vet Anaesth Analg ; 41(3): 259-68, 2014 May.
Article in English | MEDLINE | ID: mdl-24330233

ABSTRACT

OBJECTIVE: To evaluate mortality in a canine population undergoing thoracic surgery and identify factors which may be associated with outcome. STUDY DESIGN: Retrospective cohort study. ANIMALS: 286 dogs anaesthetized for thoracic surgery at the Royal Veterinary College between June 2002 - June 2011. METHODS: Variables examined included: signalment; ASA status; nature of disease; presence of co-morbidities; pre-anaesthetic oxygen requirement; surgical approach; anaesthesia management [anaesthetic agents; requirement for thoracocentesis; central venous pressure measurement; duration of surgery and anaesthesia; use of colloids, blood products, inotropes or neuromuscular blocking agents (NMBA)]. Outcome was defined as either non-survival to 24 hours after surgery or (having survived to 24 hours) to discharge. Univariate and multivariable logistic regressions were performed to identify risk factors associated with non-survival. RESULTS: Overall non-survival (excluding those euthanased) to discharge was 5.9%. Non-survival was 2.2% at 24 hours and 3.6% at time of discharge. Non-survival to 24 hours was associated with pre-anaesthetic oxygen requirement (odds ratio (OR) 12.2 [95% CI 1.8-84.5]) and NMBA use (OR 9.6 [95% CI 1.6-57.9]). Non-survival to discharge was associated with surgical duration, with surgeries >180 minutes having OR 16.9 [95% CI 2.0-144.0] compared to surgeries ≤90 minutes and blood product use (OR 4.6 [95% CI 1.3-14.6]). No association was found between ASA category and non-survival at 24 hours (OR 1.4 [95% CI 0.2-11.7]) or discharge (OR 4.4 [95% CI 0.6-34.3]). Significant associations were found between NMBA use and ASA category (p = 0.046), surgical duration (p = 0.002), use of colloids (p = 0.011), blood products (p = 0.001) and inotropes and/or vasopressors (p < 0.001). CONCLUSIONS AND CLINICAL RELEVANCE: Variables significantly associated with non-survival from canine thoracic surgery at 24 hours include NMBA use and pre-anaesthetic oxygen requirement. Blood product use and increasing surgical duration were associated with non-survival to hospital discharge. The associations may relate to the need for such products in the most complicated cases.


Subject(s)
Dog Diseases/surgery , Thoracic Surgical Procedures/veterinary , Algorithms , Animals , Cohort Studies , Dogs , Odds Ratio , Retrospective Studies , Risk Factors , Thoracic Surgical Procedures/mortality
9.
J Am Vet Med Assoc ; 262(7): 1-7, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38608662

ABSTRACT

OBJECTIVE: To assess factors associated with increased pleural fluid and air evacuation, longer duration of thoracostomy tube usage, and longer hospitalization in dogs and cats following surgery for thoracic neoplasms. ANIMALS: 62 dogs and 10 cats. METHODS: Medical records were reviewed for dogs and cats undergoing thoracic surgeries between August 1, 2019, and June 30, 2023, for resection of suspected neoplasia in which a thoracostomy tube was placed. Data collected included patient signalment, type of procedure performed, histologic diagnosis of the primary mass removed, volume of fluid and air evacuated from the thoracostomy tube, and time in hospital. RESULTS: Median sternotomy was associated with increased total fluid evacuation (median, 12.1 mL/kg; IQR, 15.4 mL/kg; P = .012), whereas rib resection was associated with increased total air evacuation (median, 2.1 mL/kg; IQR, 13.6 mL/kg; P = .06). The presence of preoperative pleural effusion was associated with higher total fluid evacuation (20.6 mL/kg; IQR, 32.1 mL/kg; P = .009), longer duration with a thoracostomy tube in place (42.5 hours; IQR, 41.9 hours; P = .027), and longer hospitalization period (61 hours; IQR, 52.8 hours; P = .025). Cats had a thoracostomy tube in place for a longer time compared to dogs (median, 42.6 hours; IQR, 23.5 hours; P = .043). CLINICAL RELEVANCE: Animals undergoing median sternotomy and rib resection may be expected to have higher fluid and air volumes, respectively, evacuated postoperatively. This often leads to an increased duration of thoracostomy tube usage and a longer period of hospitalization.


Subject(s)
Cat Diseases , Dog Diseases , Pleural Effusion , Thoracostomy , Animals , Cats , Dogs , Cat Diseases/surgery , Dog Diseases/surgery , Thoracostomy/veterinary , Female , Pleural Effusion/veterinary , Male , Retrospective Studies , Chest Tubes/veterinary , Thoracic Surgical Procedures/veterinary , Thoracic Surgical Procedures/adverse effects , Postoperative Complications/veterinary , Postoperative Complications/etiology , Thoracic Neoplasms/veterinary , Thoracic Neoplasms/surgery
10.
Vet Clin North Am Small Anim Pract ; 54(4): 697-706, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38575454

ABSTRACT

Significant advances in veterinary minimally invasive surgeries and procedures have occurred in the past 10 years. These advances have been allowed due to continual research into optimizing working space through one-lung ventilation techniques and carbon dioxide insufflation. Additionally, minimally invasive surgery enthusiasts have joined forces with interventionalists and, in many cases, physicians to push the boundaries, minimize pain, suffering, and time away from owners with advances in a variety of procedures. Several larger multi-institutional retrospective studies on various disease processes allow veterinarians and owners to understand that minimally invasive approaches allow for outcomes comparable to traditional open surgery and, in some cases, may now be considered the standard of care in canine and feline patients.


Subject(s)
Cat Diseases , Dog Diseases , Minimally Invasive Surgical Procedures , Animals , Cats , Dogs , Minimally Invasive Surgical Procedures/veterinary , Minimally Invasive Surgical Procedures/methods , Cat Diseases/surgery , Dog Diseases/surgery , Thoracic Cavity/surgery , Thoracic Surgical Procedures/veterinary , Thoracic Surgical Procedures/methods
11.
Exp Physiol ; 97(7): 822-32, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22447975

ABSTRACT

Left ventricular pressure overload in response to aortic banding is an invaluable model for studying progression of cardiac hypertrophy and transition to heart failure. Traditional aortic banding has recently been superceded by minimally invasive transverse aortic banding (MTAB), which does not require ventilation so is less technically challenging. Although the MTAB approach is superior, few laboratories have documented success, and minimal information on the model is available. The aim of this study was to optimize conditions for MTAB and to characterize the development and progression of cardiac hypertrophy. Isofluorane proved the most suitable anaesthetic for MTAB surgery in mice, and 1 week after surgery the MTAB animals showed significant increases in systolic blood pressure (MTAB 110 ± 6 mmHg versus sham 78 ± 3 mmHg, n = 7, P < 0.0001) and heart weight to body weight ratio (MTAB 6.2 ± 0.2 versus sham 5.1 ± 0.1, n = 12, P < 0.001), together with systolic (e.g. fractional shortening, MTAB 31.7 ± 1% versus sham 36.6 ± 1.4%, P = 0.01) and diastolic dysfunction (e.g. left ventricular end-diastolic pressure, MTAB 12.7 ± 1.0 mmHg versus sham 6.7 ± 0.8 mmHg, P < 0.001). Leucocyte infiltration to the heart was evident after 1 week in MTAB hearts, signifying an inflammatory response. More pronounced remodelling was observed 4 weeks postsurgery (heart weight to body weight ratio, MTAB 9.1 ± 0.6 versus sham 4.6 ± 0.04, n = 10, P < 0.0001) and fractional shortening was further decreased (MTAB 24.3 ± 2.5% versus sham 43.6 ± 1.7%, n = 10, P = 0.003), together with a significant increase in cardiac fibrosis and further cardiac inflammation. Our findings demonstrate that MTAB is a relevant experimental model for studying development and progression of cardiac hypertrophy, which will be highly valuable for future studies examining potential novel therapeutic interventions in this setting.


Subject(s)
Cardiomegaly/pathology , Disease Models, Animal , Thoracic Surgical Procedures/veterinary , Anesthesia, Inhalation/instrumentation , Anesthesia, Inhalation/veterinary , Animals , Aorta, Thoracic/surgery , Blood Pressure , Cardiomegaly/physiopathology , Female , Heart Failure/etiology , Isoflurane , Ligation , Male , Mice , Thoracic Surgical Procedures/methods
12.
Vet Surg ; 40(7): 786-94, 2011 Oct.
Article in English | MEDLINE | ID: mdl-22380664

ABSTRACT

OBJECTIVE: To-determine the feasibility of a single paracostal abdominal approach for thoracic duct ligation (TDL) and cisterna chyli ablation (CCA) in dogs with chylothorax. STUDY DESIGN: Observational study and prospective case series. ANIMALS: Normal dogs (n = 5) and dogs with chylothorax (n = 8). METHODS: A single paracostal approach with transdiaphragmatic extension for TDL and CCA was developed experimentally (n = 5) and used in 8 clinical cases with subtotal pericardectomy (SPE) performed in 4 dogs. Surgery time, complications, hospitalization time, outcome, and follow-up of clinical cases were recorded. RESULTS: Exposure of relevant anatomy was excellent; vital lymphatic staining facilitated identification of lymphatic structures. In clinical cases, mean surgery time for TDL + CCA was 136 minutes. Mean hospitalization time was 3.1 days. Seven of 8 cases survived, with 1 dog dying of heart failure shortly after discharge. One dog required a second (left) paracostal approach to ligate 2 more lymphatic vessels. On follow-up (median, 7 months; range, 2-20 months), there was complete resolution of chylothorax in 6 dogs. CONCLUSIONS: A single paracostal approach provides excellent exposure of cisterna chyli, caudal thoracic duct, and intestinal lymphatics. This approach eliminates the need for repositioning during combined TDL + CCA procedures and avoids an intercostal thoracotomy.


Subject(s)
Chylothorax/veterinary , Dog Diseases/surgery , Thoracic Duct/surgery , Thoracic Surgical Procedures/veterinary , Animals , Chylothorax/surgery , Dogs , Female , Thoracic Duct/anatomy & histology , Thoracic Surgical Procedures/methods
13.
J Am Anim Hosp Assoc ; 46(5): 341-5, 2010.
Article in English | MEDLINE | ID: mdl-20810555

ABSTRACT

A large, caudal thoracic mass was removed along with ribs 11 and 12, resulting in an approximate 16 x 14-cm, caudal thoracic wall defect in a dog. The diaphragmatic musculature was mobilized and used to support the thoracic wall defect. To our knowledge, this method of thoracic wall repair has not been previously reported. This procedure allowed for airtight closure of the thoracic cavity, provided physical support, eliminated the need for muscle flaps or commercially available meshes, and provided a good cosmetic appearance without negatively affecting the dog's athletic performance.


Subject(s)
Dogs/abnormalities , Dogs/surgery , Muscle, Skeletal/transplantation , Thoracic Wall/abnormalities , Thoracic Wall/surgery , Animals , Male , Plastic Surgery Procedures/veterinary , Surgical Flaps , Surgical Mesh , Thoracic Surgical Procedures/veterinary , Treatment Outcome
14.
J Vet Med Sci ; 71(4): 489-91, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19420854

ABSTRACT

Heartworm infection with caval syndrome was detected in a thirteen-year-old male cat. However, removal of the heartworms via a jugular venotomy was infeasible because the size of the jugular vein limited our ability to use flexible alligator forceps. Therefore, a right atriotomy using total venous inflow occlusion was performed to remove the heartworms. The procedure was accomplished successfully, and the cat recovered from its symptoms. The present case suggests that right atriotomy using venous inflow occlusion is practical for removal and prevention of rupture of heartworms.


Subject(s)
Cat Diseases/parasitology , Cat Diseases/surgery , Dirofilaria/growth & development , Dirofilariasis/surgery , Thoracic Surgical Procedures/veterinary , Animals , Cats , Dirofilariasis/parasitology , Male , Thoracic Surgical Procedures/methods
15.
Aust Vet J ; 87(4): 148-51, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19335470

ABSTRACT

OBJECTIVE AND DESIGN: Retrospective study of the outcomes of Heimlich valve drainage in dogs. PROCEDURE: Medical records of the past 3 years were retrospectively reviewed. Heimlich valve drainage was used in 34 dogs (median body weight 30 +/- 5 kg): lobectomy (n = 15), pneumonectomy (n = 9), intrathoracic oesophageal surgery (n = 2), diaphragmatic hernia repair (n = 1), traumatic open pneumothorax (n = 2), bilobectomy (n = 2), ligation of the thoracic duct (n = 1), and chylothorax and pneumothorax (n = 1 each). Evacuation of air and/or fluid from the pleural cavity was performed with the Heimlich valve following thoracostomy tube insertion. During drainage, the dogs were closely monitored for possible respiratory failure. Termination of Heimlich valve drainage was controlled with underwater seal drainage and assessed with thoracic radiography. RESULTS: Negative intrathoracic pressure was provided in 29 dogs without any complications. Post pneumonectomy respiratory syncope and post lobectomy massive hemothorax, which did not originate from the Heimlich valve, were the only postoperative complications. Dysfunction of the valve diaphragm, open pneumothorax and intrathoracic localisation of an acute gastric dilatation-volvulus syndrome caused by a left-sided diaphragmatic hernia following pneumonectomy were the Heimlich valve drainage complications. CONCLUSIONS: The Heimlich valve can be used as a continuous drainage device in dogs, but the complications reported here should be considered by veterinary practitioners.


Subject(s)
Dog Diseases/surgery , Drainage/veterinary , Surgery, Veterinary/instrumentation , Surgery, Veterinary/methods , Thoracic Surgical Procedures/veterinary , Animals , Dog Diseases/diagnostic imaging , Dogs , Drainage/instrumentation , Drainage/methods , Pleural Cavity/surgery , Postoperative Complications/veterinary , Radiography , Retrospective Studies , Thoracic Surgical Procedures/instrumentation , Thoracic Surgical Procedures/methods , Treatment Outcome
16.
J Feline Med Surg ; 10(1): 88-94, 2008 Feb.
Article in English | MEDLINE | ID: mdl-17913532

ABSTRACT

A 4-year-old, male castrated European shorthair cat was presented with a firm mass palpable on the right caudal rib cage. Lateral and ventrodorsal radiographs of the thorax revealed a 4x3x2cm large, expansile and radiodense mass originating from the distal part of the 13th rib. After removal of the tumour, which was histopathologically confirmed as feline osteochondromatosis, the diaphragm, omentum, external abdominal oblique and latissimus dorsi muscles were used to reconstruct the defect. Feline osteochondromatosis is induced by retroviruses, eg, feline leukaemia virus, for which the cat tested positive. The tumour was removed for palliative reasons, because such tumours have the tendency to transform into osteosarcomas. Six months after the surgical excision the cat showed no clinical signs of reoccurrence.


Subject(s)
Abdominal Muscles/surgery , Bone Neoplasms/veterinary , Cat Diseases/surgery , Osteochondromatosis/veterinary , Surgical Flaps/veterinary , Thoracic Surgical Procedures/veterinary , Abdominal Muscles/transplantation , Animals , Bone Neoplasms/surgery , Cats , Male , Osteochondromatosis/surgery , Treatment Outcome
17.
J Vet Sci ; 9(2): 197-202, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18487942

ABSTRACT

Canine heart worm disease is often life-threatening due to its various complications, including right side heart failure, caval syndrome and pulmonary eosinophilic granulomatosis. Several preventive medications and melarsomine have been developed and they are very effective to control heartworm infestation. However, in a case of severe infestation, melarsomine therapy often results in an unfavorable outcome because of the severe immune reaction caused by rapid killing of the adult worm. Surgical removal and an interventional method using flexible alligator forceps have been well described in the literature. Despite the usefulness of mechanical removal using flexible alligator forceps, the methodology still needs to be upgraded for increasing the applicability for treating dogs with severe infestation. We describe herein a newly developed percutaneous removal method for heartworms and this was successfully applied to 4 dogs with severe heartworm infestation. The follow-up studies also showed favorable outcomes with no complications.


Subject(s)
Dirofilaria immitis , Dirofilariasis/surgery , Dog Diseases/surgery , Thoracic Surgical Procedures/veterinary , Animals , Catheterization/veterinary , Dogs , Echocardiography , Electrocardiography , Fluoroscopy/methods , Fluoroscopy/veterinary , Surgical Instruments/veterinary , Thoracic Surgical Procedures/methods
18.
Vet Clin North Am Food Anim Pract ; 24(3): 501-10, vi, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18929956

ABSTRACT

Thoracic disease is common in cattle and is a significant cause for economic losses in the stocker and feedlot industries. In most cases, economic constraints limit diagnostic investigation and affect treatment options. Although medical management is, by far, the most appropriate therapeutic intervention in such cases, surgical management of some respiratory diseases can allow for profitable return to productivity. Surgical procedures of the thorax most often involve thoracotomy or pericardiotomy. Tracheal reconstruction and invasion of the mediastinum are rarely indicated in cattle.


Subject(s)
Cattle Diseases/surgery , Thoracic Diseases/veterinary , Thoracic Surgical Procedures/veterinary , Animals , Cattle , Mediastinum , Pericardiectomy/instrumentation , Pericardiectomy/methods , Pericardiectomy/veterinary , Thoracic Diseases/surgery , Thoracic Surgical Procedures/instrumentation , Thoracic Surgical Procedures/methods , Thoracostomy/instrumentation , Thoracostomy/methods , Thoracostomy/veterinary , Thoracotomy/instrumentation , Thoracotomy/methods , Thoracotomy/veterinary
19.
Vet Surg ; 37(3): 222-5, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18394067

ABSTRACT

OBJECTIVE: To describe anesthetic management of endoscopic electrosurgical removal of a bronchial carcinoma, partially blocking the right main stem bronchus in a Cocker Spaniel. STUDY DESIGN: Clinical case report. ANIMALS: Dog with a bronchial carcinoma. METHODS: To allow sufficient space for the endoscope and to avoid an oxygen-rich gas mixture in the trachea, which carries the risk of an airway fire when electrocautery is used, a 1 lumen endobronchial tube (EBT) was inserted into the left main stem bronchus. One-lung ventilation (OLV) started with a volume-controlled ventilator was switched to pressure-controlled ventilation in combination with positive end-expiratory pressure (PEEP). RESULTS: Resection of the bronchial carcinoma was successful. The dog was hypercapnic throughout the procedure and a high alveolar-arterial oxygen gradient was measured. CONCLUSION: An EBT may be a feasible and safe option to provide OLV for bronchoscopic electrocautery with a closed thoracic cavity in dogs. CLINICAL RELEVANCE: EBT intubation for OLV should be considered as part of the anesthetic management of airway diseases treated with bronchoscopic electrocautery.


Subject(s)
Anesthesia, General/veterinary , Carcinoma, Bronchogenic/veterinary , Dog Diseases/surgery , Lung Neoplasms/veterinary , Respiration, Artificial/veterinary , Anesthesia, General/instrumentation , Anesthesia, General/methods , Animals , Carcinoma, Bronchogenic/surgery , Dogs , Electrocoagulation/methods , Electrocoagulation/veterinary , Intubation, Intratracheal/instrumentation , Intubation, Intratracheal/methods , Intubation, Intratracheal/veterinary , Lung Neoplasms/surgery , Male , Thoracic Surgical Procedures/methods , Thoracic Surgical Procedures/veterinary , Treatment Outcome
20.
Vet Surg ; 36(6): 587-92, 2007 Aug.
Article in English | MEDLINE | ID: mdl-17686133

ABSTRACT

OBJECTIVE: To describe a thoracic wall reconstructive technique using a latissimus dorsi myocutaneous flap after en bloc resection of primary rib chondrosarcoma and report outcome in 5 dogs. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=5) with primary rib chondrosarcoma. METHODS: Medical records (2003-2005) were reviewed for signalment, staging investigations, surgical findings, complications, and outcomes. Owners and veterinary surgeons were contacted for outcome information. RESULTS: A latissimus dorsi myocutaneous flap provided an air-tight thoracic wall closure after chondrosarcoma resection. Paradoxical respiratory movement of the flap occurred; however, from physical examination and blood gas analysis (2 dogs), ventilation was adequate. All flaps survived, 1 had superficial skin necrosis distally and 2 had minor wound dehiscence. One dog without tumor-free margins died of tumor-related disease 56 days after surgery. Tumor recurrence did not occur in 4 dogs with tumor-free margins. One dog was euthanatized 10 months after surgery for unrelated disease; 3 dogs were alive at writing (median follow-up: 20 months; range, 18-27 months) and all had a satisfactory functional and cosmetic outcome. CONCLUSIONS: Reconstruction of ventral thoracic wall defects using a latissimus dorsi myocutaneous flap yields a functional, cosmetic outcome. CLINICAL RELEVANCE: A latissimus dorsi myocutaneous flap can be used as a successful 1-stage reconstructive technique for ventral thoracic wall defects.


Subject(s)
Abdominal Muscles/surgery , Bone Neoplasms/veterinary , Chondrosarcoma/veterinary , Dog Diseases/surgery , Plastic Surgery Procedures/veterinary , Surgical Flaps/veterinary , Abdominal Muscles/injuries , Animals , Bone Neoplasms/surgery , Chondrosarcoma/surgery , Dogs , Female , Male , Plastic Surgery Procedures/methods , Retrospective Studies , Skin Transplantation/methods , Skin Transplantation/veterinary , Thoracic Surgical Procedures/methods , Thoracic Surgical Procedures/veterinary , Treatment Outcome
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