Corneal sequestra in cats: 175 eyes from 172 cases (2000-2016).

OBJECTIVES: To report the clinical outcomes of different surgical treatments used to manage feline corneal sequestra in a large number of cases. MATERIALS AND METHODS: Medical records of 172 cats affected by feline corneal sequestra and surgically managed by different techniques were retrospectively evaluated. Signalment, surgical technique, visual outcomes, postoperative corneal clarity and recurrence were evaluated. RESULTS: One hundred and seventy-two cats (175 eyes) of different breeds, ages and sex were included in the retrospective case series. The Persian was the most represented breed (123/172; 71.5%), followed by Exotic Shorthair breed (21/172; 12.2%), Domestic shorthair breed (21/172; 12.2%) and a smaller group of other different breeds (7/172). Surgical management included a superficial (84/175 eyes) or deep (91/175 eyes) lamellar keratectomy in association with the following covering techniques (tectonic support and/or protective support): nictitans membrane flap (n=84), conjunctival pedicle graft (n=52), BioSISt graft (n=9), corneoconjunctival transposition (n=7), corneoconjunctival transposition+nictitans membrane flap (n=6), conjunctival free island graft (n=6), BioSISt+conjunctival pedicle graft (n=6), BioSISt+nictitans membrane flap (n=4) and bridge conjunctival graft (n=1). At the end of the retrospective case series, visus was present in all patients and no or mild corneal opacity was detected in 86% (151/175 eyes) of the patients. Sequestra recurred in 20 eyes (20/175; 11.4%) within 2 years. CLINICAL SIGNIFICANCE: This paper describes the clinical outcomes of a large number of cases of feline corneal sequestra treated with varying surgical techniques and provides useful insight regarding the prognosis and outcomes of these techniques within feline ophthalmology.

Treatment of idiopathic chylothorax in 14 dogs by ligation of the thoracic duct and partial pericardiectomy.

The outcome and complications associated with thoracic duct ligation combined with partial pericardiectomy in 14 dogs with idiopathic chylothorax were investigated retrospectively. Nine of the dogs were treated in the uk and five in Italy. All of them were reassessed clinically four weeks after surgery and the respiratory function and any pleural fluid accumulation were evaluated; they were followed up by telephone contact for at least six months. Eleven of the dogs were clinically normal and had no radiographic signs of pleural effusion when reassessed after four weeks. Two showed radiographic signs of a minor accumulation of pleural fluid but were clinically normal; when reassessed after three months they showed similar radiographic signs and clinical findings; but after four months there was no evidence of pleural effusion. One dog had a major complication that required a second surgical intervention.

Hypobaric intrathecal anaesthesia for partial hemipelvectomy in a dog.

OBJECTIVE: To report the intrathecal use of a hypobaric anaesthetic solution for partial hemipelvectomy in a nine-year-old, neutered female, Golden Retriever dog, weighing 34 kg. METHODS: Under inhalational anaesthesia, with the dog lying in lateral recumbency and the surgical side uppermost, 1.9 ml of a hypobaric solution containing 3.42 mg of bupivacaine and 0.66 mg of morphine were administered in the subarachnoid space at L5-6 level 30 minutes before surgery. Following the intrathecal injection the dog was maintained for five minutes in a 10 degrees head-down position, then for three minutes in a 10 degrees head-up position. RESULTS: Apart from a transient increase in heart and respiratory rates during resection of the sartorius muscle, which was treated with a plasma Target Controlled Infusion (TCI) of fentanyl, spinal anaesthesia provided cardiovascular stability and excellent relaxation of the surgical site. Neither motor blockade nor proprioceptive deficit were apparent in the contra-lateral hind limb at recovery, 200 minutes after injection. Postoperatively, rescue analgesia was not required in the 48 hours following surgery. CLINICAL SIGNIFICANCE: In dogs, the use of intrathecal hypobaric bupivacaine and morphine as a part of a balanced anaesthetic protocol should be considered during unilateral major orthopaedic surgeries of the pelvis and hind limb, as it allowed a reduction in the dose administered compared to isobaric solutions, providing selective spinal anaesthesia, excellent long-lasting analgesia, and rapid recovery of ambulation.

Survey of the current use of pharmacokinetic model-driven drug delivery in small animal anaesthesia and analgesia in Italy.

Veterinary surgeons in Italy were surveyed about their current practice with regard to the use of propofol and intravenous opioids during anaesthesia and for treatment of acute pain in small animals. Questionnaires were e-mailed to all 171 members of the Italian Society of Veterinary Regional Anaesthesia and Pain Medicine. Information was requested on the type of practice the veterinarians worked in, the administration techniques used and the perceived benefit of pumps with target-controlled infusion (TCI) capability implementing small animal pharmacokinetic models. A total of 168 responses were received (response rate 98.2 per cent). Of the respondents, 121 (72.0 per cent) worked in a first-opinion private practice, 25 (14.9 per cent) worked in a 24/7 private practice, 11 (6.5 per cent) worked in a referral private practice, eight (4.8 per cent) worked in a university hospital, two (1.2 per cent) were not currently practising with small animals and one (0.6 per cent) had retired. Of the 130 (78.8 per cent) practising respondents who reported using a syringe pump, eight (4.8 per cent) used a TCI system, 31 (18.8 per cent) used manual TCI, 40 (24.2 per cent) used a bolus-elimination-transfer scheme and 51 (31 per cent) used a constant-rate infusion. As a result, 79 of 165 (47.9 per cent) practising respondents used a pharmacokinetic model-driven method of drug delivery. The majority of respondents (81.2 per cent) believed that the use of pumps with TCI capability would improve practice and patient care.

Preliminary study evaluating tests used to diagnose canine cranial cruciate ligament failure.

OBJECTIVE: To estimate specificity, sensitivity, positive predictive value and negative predictive value of tests and signs used for the diagnosis of cranial cruciate ligament failure in dogs. METHODS: One stifle in each of 42 dogs was examined: 25 "affected" and 17 "control" dogs. All dogs were subjected to the following tests when conscious: cranial drawer, tibial compression, patellar tendon palpation and palpation of the medial aspect of the joint. Under general anaesthesia, cranial drawer and tibial compression tests were repeated and a lateral stifle radiograph was taken to evaluate changes of the infrapatellar fat pad. The results were analysed using a 2 x 2 table method. Sensitivity, specificity, positive predictive value and negative predictive value were estimated. RESULTS: The sensitivity of the cranial drawer and tibial compression tests was surprisingly low when performed on conscious patients but significantly better when performed under anaesthesia. Similarly, palpation of the medial aspect of the stifle joint cannot be considered a reliable indicator of cranial cruciate ligament injury. Patellar palpation and radiographic assessment showed excellent sensitivity, specificity, positive predictive value and negative predictive value. CLINICAL SIGNIFICANCE: In the diagnosis of cranial cruciate ligament, it is essential that the clinician is aware of each test's features and limitations to reduce the risk of misdiagnosis.