Smoke Inhalation in Veterinary Patients: Pathophysiology, Diagnosis, and Management.

Smoke contains a mixture of harmful gases, chemicals, and superheated particles. Inhalation of smoke causes generalized hypoxia and airway inflammation due to impaired oxygen transport and utilization, as well as thermal and chemical injury in the airways. Generally, treatment is supportive with oxygen therapy and airway management, including chest physiotherapy, bronchodilators, and nebulization. Immediate oxygen therapy is mandatory for all suspected smoke inhalation patients and should not be delayed pending diagnostic test results or due to "normal" oxygen saturation readings that can be falsely elevated in carbon monoxide intoxication. Smoke inhalation patients with mild clinical signs who respond well to initial stabilization generally have a favorable prognosis. However, patients with severe signs or progression despite initial stabilization may require more advanced or intensive care.

Neurological consequences after portosystemic shunt attenuation in cats: A meta-analysis study.

Neurological symptoms that occur after treatment of portosystemic shunts, in cats, known as post-attenuation neurological signs (PANS) can be quite severe. This study seeks to analyze a better understanding of the neurological outcomes that result from reducing portosystemic shunts in felines and provide insights that could guide future clinical approaches and treatment strategies for congenital portosystemic shunts (CPSS).The research utilized the MOOSE Checklist as a guide. PubMed/MEDLINE, Web of Science ScienceDirect, Embase, Scopus, ProQuest, and Google Scholar were used. The study investigated diversity using variance, Cochran Q tests with Applied fixed effects, and random effects models. A meta-regression model identified contributors. Eggers test funnel plot and Beggs test for asymmetry addressed publication bias. 12 high-quality studies were discovered from 664 research papers. This research covered years, shunt morphology, and surgery. PANS occurred 38.9 % of the time in cats, while PAS occurred 20.2 %. The overall PANS mortality rate was 17 %, while PAS was 37.2 %. The complete ligation technique was most common in subgroup analysis. PANS occurrence ranged from 26.8 % to 56.5 % in cats with congenital extrahepatic portosystemic shunts The cause of PANS in cats is still unknown, and there is only limited evidence to justify the use of preventive antiepileptic medications such as levetiracetam. The treatment primarily aims to control neurologic symptoms, and the long-term outlook varies, with the potential for the reappearance of symptoms.

A case of haemoglobinuria in a cat after near-drowning.

The aim of this study is to describe a case of haemoglobinuria in a cat after near-drowning. A 6-year-old male neutered domestic short hair cat weighing 6.5 kg with a pre-existing seizure disorder presented to an emergency hospital after near-drowning in a swimming pool during a seizure episode. On presentation, the patient was obtunded, dyspnoeic, bradycardic and hypothermic. Imaging revealed evidence of severe bilateral pulmonary infiltrates. Treatment with intravenous diazepam, amoxicillin, fluid therapy, active warming and oxygen therapy was administered. The cat developed haemoglobinuria approximately 6 h after nearly drowning. Despite improvements in mentation, pulse quality and heart rate, respiratory compromise and poor oxygen saturation persisted, prompting euthanasia approximately 10 h after admission. To the author's knowledge, this is the first reported clinical case of haemoglobinuria following near-drowning in veterinary medicine.

A large case-control study indicates a breed-specific predisposition to feline tooth resorption.

Tooth resorption (TR) is one of the most common dental diseases of cats. It is a painful condition leading to tooth loss. The etiology of TR remains unclear, but old age, breed, other oral and dental diseases, and environmental factors are suspected predisposing factors. In our study, we used part of the data from the extensive feline health online survey of 8115 Finnish cats. As TR is difficult to detect and as the feline health survey included diagnoses defined by both veterinarians and the owners, we limited our study to a subpopulation of cats diagnosed with oral or dental disease by a veterinarian and had dental examination or surgery under sedation (n=944). We utilized case-control study analysed by multivariable logistic regression to determine the risk factors and breed variation of feline TR. The 202 cats diagnosed with TR were defined as TR cases and the remaining 742 cats as controls. The frequency of veterinarian-diagnosed TR was 3.9% in the health survey data (316/8115) and 21% in the subpopulation (202/944). The risk of TR increased with age (14.7% in youngest and 25.3% in oldest age group). Our finding that TR was significantly associated with gingivitis or periodontitis in cats that had also calculus (OR: 2.49 and 3.70, respectively) suggests that inflammatory changes caused by calculus increase the risk of TR. We found that Cornish Rex, European, and Ragdoll are at higher risk for TR (OR: 2.44, 2.98 and 2.90, respectively). Exotic-Persians breed group had lower risk (OR: 0.28). TR was not observed in Turkish van or Devon Rex. The differences between breeds highlight a genetic contribution. In addition, female cats that had food available constantly had significantly less TR than female cats that had feeding times (OR: 0.44). The underlying reasons for this remain unexplained in our study.

Retrospective evaluation of traumatic pneumomediastinum in dogs and cats (2005-2022): 52 cases.

OBJECTIVE: To describe the incidence, etiology, clinical signs, diagnostics, treatments, and outcome of noniatrogenic traumatic pneumomediastinum (TPM) in dogs and cats. DESIGN: Retrospective study of cases (2005-2022). SETTING: University veterinary teaching hospital. ANIMALS: Fifty-two patients (29 dogs, 23 cats). MEASUREMENTS AND MAIN RESULTS: Data collected from the medical records included signalment, physical examination findings, animal trauma triage (ATT) score, clinicopathological data, imaging data, surgical intervention, length of hospitalization, supportive care, complications, and outcome. Most dogs presented with tachycardia and tachypnea, while cats presented with hypothermia and tachypnea. Subcutaneous emphysema, pneumothorax, and dyspnea were the most common clinical signs for both species. The median calculated ATT score was 3.5 in dogs and 4 in cats. The most common radiographic abnormalities other than pneumomediastinum were pneumothorax and lung contusions. The overall mortality rate was 18%, with a significantly higher survival rate in dogs (26/28 dogs [93%], 15/22 cats (68%); P = 0.03). Outcome was unknown in 1 dog and 1 cat. The only significant difference in treatment between survivors and nonsurvivors was the requirement in dogs for positive pressure ventilation. The median hospitalization period was 2 days for both species, with a shorter hospitalization in the nonsurvivors (0.6 vs 2 days, respectively; P = 0.006). CONCLUSIONS: TPM is an infrequent pathology in veterinary medicine and may be seen without an externally obvious injury. The most common causes for TPM in dogs were vehicular trauma and bite wounds, while high-rise syndrome was the most common cause in cats. Most of the cases have concurrent pneumothorax and require thoracocentesis; however, direct intervention to treat TPM is not usually required. The vast majority of cases did not undergo surgery to treat TPM. The prognosis for dogs with TPM was good but was guarded for cats.

Recurrent skin opening induced by chronic sternal osteomyelitis caused by a bite wound in a cat: A case report.

BACKGROUND: Chronic sternal osteomyelitis is a rare condition in felines, with limited reported cases to date. OBJECTIVES: We report the case of a 2-year-old castrated male, domestic shorthair cat, weighing 4.68 kg, that presented with skin openings every 3-4 months, despite skin debridement and reconstruction. METHODS: A subcutaneous dead space larger than the skin defect was detected. Haematological analysis revealed elevated levels of inflammatory markers. Thoracic radiography revealed sternal deformation and suspected osteomyelitis. Computed tomography revealed a fistula extending from the third to the fourth sternebrae. RESULTS: Bone and soft tissue debridement and abscess flushing were performed along with long-term antibiotic therapy. The cat remained recurrence-free throughout an 18-month post-surgery follow-up period. CONCLUSION: To the best of our knowledge, this is the first report of chronic osteomyelitis occurring in a cat's sternebrae and represents the first successful case of its treatment. This case showcases the potential for improved treatment outcomes in similar cases. Understanding and successful treatment of such cases can pave the way for better management of feline osteomyelitis.

Suspected malnutrition-induced reversible feline skin fragility syndrome in a cat with congenital axial deformities.

A stray cat, an intact female Japanese domestic shorthair cat of unknown age (suspected to be a young adult), was rescued. The cat was lethargic and thin and had marked skin fragility, delayed wound healing without skin hyperextensibility, and hind limb proprioceptive ataxia and paresis. Survey radiography, computed tomography, and magnetic resonance imaging revealed congenital vertebral anomalies, including thoracolumbar transitional vertebrae, scoliosis resulting from a thoracic lateral wedge-shaped vertebra, and a kinked tail, and a dilated spinal cord central canal. Through nutritional support, the cat's general condition normalized, followed by a gradual and complete improvement of skin features. Whole-genome sequencing was completed; however, no pathogenic genetic variant was identified that could have caused this phenotype, including congenital scoliosis. A skin biopsy obtained 7 y after the rescue revealed no remarkable findings on histopathology or transmission electron microscopy. Based on clinical course and microscopic findings, malnutrition-induced reversible feline skin fragility syndrome (FSFS) was suspected, and nutritional support was considered to have improved the skin condition. Key clinical message: This is the second reported case of presumed malnutrition-induced reversible FSFS and was accompanied by long-term follow-up.

Syndrome de fragilité cutanée réversible induit par la malnutrition soupçonné chez un chat avec des difformités axiales congénitales. Un chat errant, une femelle intacte de race japonaise à poil court et d'âge inconnu (suspecté être une jeune adulte), a été secourue. La chatte était léthargique et maigre, et avait une fragilité marquée de la peau, un retard dans la guérison de plaies sans hyperextensibilité de la peau, et une ataxie proprioceptive et parésie des membres postérieurs. Des radiographies, un examen par tomodensitométrie, et de l'imagerie par résonnance magnétique ont révélé des anomalies congénitales des vertèbres, incluant des vertèbres transitionnelles thoraco-lombaires, une scoliose résultant d'une vertèbre thoracique en forme de coin, une queue pliée, et un canal central de la moelle épinière dilaté. Grâce à un soutien nutritionnel, la condition générale du chat s'est stabilisée, suivi d'une amélioration graduelle et complète des caractéristiques de la peau. Le séquençage du génome complet a été effectué; toutefois, aucune variation génétique pathogénique n'a été identifiée qui aurait pu causer ce phénotype, incluant la scoliose congénitale. Une biopsie cutanée obtenue 7 j après le sauvetage n'a révélé aucune trouvaille spéciale à l'histopathologie ou par microscopie électronique à transmission. Basé sur le déroulement clinique et l'examen microscopique, le syndrome de fragilité cutanée réversible félin induit par la malnutrition (FSFS) était suspecté, et le soutien nutritionnel a été considéré comme ayant amélioré la condition cutanée.Message clinique clé :Ce cas est le deuxième cas rapporté de FSFS induit par la malnutrition soupçonné et a fait l'objet d'un suivi à long terme.(Traduit par Dr Serge Messier).

Blood pressure in hyperthyroid cats before and after radioiodine treatment.

BACKGROUND: Hyperthyroid cats commonly have systemic hypertension, with a reported prevalence of 7% to 48%. Although hypertension might be expected to resolve once treatment restores euthyroidism, it can persist or only first develop after treatment. OBJECTIVES: To determine the proportion of hyperthyroid cats with hypertension (systolic blood pressure [SBP] ≥160 mm Hg), persistence or first development of hypertension after successful radioiodine treatment, and correlation of post-treatment hypertension with azotemia or hypothyroidism. ANIMALS: Four hundred one hyperthyroid nonazotemic cats were included in the study. METHODS: Prospective, cross-sectional and before-and-after studies. All hyperthyroid cats had SBP measured by Doppler; 255 had SBP rechecked 6 months after successful radioiodine (131I) treatment. RESULTS: Of untreated hyperthyroid cats, 108/401 (27%) were hypertensive. A higher proportion of hypertensive cats were nervous/excited compared with normotensive cats (47% vs 12%; P < .001). Of the initially hypertensive cats, 87/108 cats were reexamined after 131I treatment; 43/87 (49%) cats normalized SBP, whereas 44/87 (51%) remained hypertensive. Of the initially normotensive cats, 16/168 (9.5%) first developed hypertension after successful 131I treatment. 7/60 (12%) of the 131I-treated hypertensive cats were azotemic and 9/60 (15%) were hypothyroid. A higher proportion of cats remaining hypertensive had nervous/excited demeanor than did normotensive cats (50% vs 17%; P < .001). CONCLUSIONS/CLINICAL IMPORTANCE: Hypertension, when present, resolves in many hyperthyroid cats after successful treatment. Hyperthyroid cats uncommonly develop new hypertension after treatment. Persistent or newly detected hypertension was unrelated to azotemia or iatrogenic hypothyroidism. More frequently perceived nervousness/anxiety in radioiodine-treated hypertensive cats suggests that many of these cats might have "situational" hypertension, as hyperthyroid-induced hypertension should resolve after treatment.

Oesophageal stricture in a cat with true pleuroperitoneal hernia.

A 2-year-old neutered male Bengal cat presented with solid food dysphagia and chronic regurgitation for >5 months. There were no clinical abnormalities on haematological or radiographic examinations. Thoracic radiography revealed a soft tissue opacity mass adjacent to the diaphragm in the caudoventral thorax. Ultrasonography revealed a protruding liver lobe surrounded by a hyperechoic lining from the diaphragm towards the thorax, and a pleuroperitoneal hernia was diagnosed. An endoscopy was performed to examine the cause of regurgitation, and an oesophageal stricture was observed. Endoscopic balloon dilation of the oesophageal stricture was performed, and the regurgitation was resolved immediately. However, regurgitation relapsed 2 months later, and computed tomography was performed to ascertain the cause. Computed tomography revealed oesophageal mural thickening and true pleuroperitoneal hernia with partial liver lobe herniation. A second endoscopy with balloon dilation was performed to treat the relapsing oesophageal stricture, and the clinical signs resolved without the need for herniorrhaphy. Nevertheless, oesophageal stricture could occur due to gastroesophageal reflux related to a pleuroperitoneal hernia; however, a definite link could not be elucidated in this case. This report describes a case of oesophageal stricture and concurrent true pleuroperitoneal hernia in a cat.

Difficult catheterization and previous urethral obstruction are associated with lower urinary tract tears in cats with urethral obstruction.

OBJECTIVE: To retrospectively assess the hospital prevalence and risk factors associated with iatrogenic lower urinary tear in cats with urethral obstruction (UO). ANIMALS: 15 client-owned cats diagnosed with concurrent UO and lower urinary tears and year-matched control population of 45 cats diagnosed with UO. METHODS: University teaching hospital records were reviewed for cats presenting with UO between January 2010 and December 2022. Signalment, anatomic location of tear, experience of the individual passing the urinary catheter, difficulty level of catheter passage, history of previous UO, blood work parameters on presentation, presence of visible grit in urine, and survival to discharge were recorded. In addition, prevalence of lower urinary tears in cats presenting with UO was calculated. RESULTS: The prevalence of lower urinary tears was 0.92% in UO cats. Cats with lower urinary tears were significantly less likely to survive to discharge and had a longer period of hospitalization than cats without tears. In addition, cats with tears were more likely to have a history of previous UO and had more difficult urinary catheter passage than cats in the control group. Cats with tears also had a higher Hct than the control UO cats. CLINICAL RELEVANCE: Cats that develop lower urinary tears are more likely to have a history of previous UO and difficult catheter passage. This group of cats is also more likely to have a longer hospitalization period and lower survival to discharge rates.

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.

Clinical signs, causes, and outcome of central cord syndrome in 22 cats.

OBJECTIVE: To describe the signalment, clinical findings, presumptive or definitive diagnosis, and outcome in cats with central cord syndrome (CCS). ANIMALS: 22 cats. CLINICAL PRESENTATION: Cats evaluated for CCS at 7 referral hospitals between 2017 and 2021 were included. Information retrieved from medical records included signalment, physical and neurological examination findings, diagnostic investigations, definitive or presumptive diagnosis, treatment, and follow-up. RESULTS: Median age at presentation was 9 years. Two neuroanatomical localizations were associated with CCS: C1-C5 spinal cord segments in 17 (77.3%) cats and C6-T2 spinal cord segments in 5 (22.7%) cats. Neuroanatomical localization did not correlate with lesion location on MRI in 8 (36.3%) cats. The most common lesion location within the vertebral column was over the C2 and C4 vertebral bodies in 6 (27.2%) and 5 (22.7%) cats, respectively. Peracute clinical signs were observed in 11 (50%) cats, acute in 1 (4.5%), subacute in 4 (18%), and chronic and progressive signs were seen in 6 (40.9%) cats. The most common peracute condition was ischemic myelopathy in 8 (36.3%) cats, whereas neoplasia was the most frequently identified chronic etiology occurring in 5 (22.7%) cats. Outcome was poor in 13 (59%) cats, consisting of 4 of 11 (36.6%) of the peracute cases, 3 of 4 (75%) of the subacute cases, and 6 of 6 of the chronic cases. CLINICAL RELEVANCE: Central cord syndrome can occur in cats with lesions in the C1-C5 and C6-T2 spinal cord segments. Multiple etiologies can cause CCS, most commonly, ischemic myelopathy and neoplasia. Prognosis depends on the etiology and onset of clinical signs.

AN OUTBREAK OF FELINE INFECTIOUS PERITONITIS IN THREE RELATED SAND CATS (FELIS MARGARITA) IN HUMAN CARE.

Feline infectious peritonitis (FIP) is a systemic disease in felid species caused by infection with mutated forms of feline coronavirus (FCoV), and outbreaks can devastate exotic felid populations in human care. Feline infectious peritonitis was diagnosed in three of four related juvenile sand cats (Felis margarita) from a single institution over a 6-wk period. Case 1 was a 7-mon-old male found deceased with no premonitory signs. Case 2, an 8-mon-old male (littermate to Case 1), and Case 3, a 6-mon-old male (from a different litter with identical parentage), were evaluated for lethargy and anorexia 1 mon after Case 1. Both exhibited transient anisocoria and progressive lethargy, anorexia, and dehydration despite antibiotic and supportive treatment. Approximately 1 wk after initial presentation, Case 2 was humanely euthanized, and Case 3 was found deceased. Necropsy findings included intrathoracic and/or intra-abdominal lymphadenopathy (3/3 cases), bicavitary effusion (2/3), multifocal tan hepatic and intestinal nodules (1/3), and multifocal yellow renal nodules (1/3). Histologically, all cats had severe pyogranulomatous vasculitis in multiple organs, and the presence of FCoV antigen was confirmed using immunohistochemical staining. Next-generation sequencing of the virus from Case 3's affected kidney demonstrated ∼93% homology to the UG-FH8 virus, a serotype 1 feline alphacoronavirus isolated from Denmark. Future research will focus on comparative viral genomic sequencing with the goals of identifying potential sources of FCoV infection and identifying features that may have contributed to the development of FIP in this species.

Etiologies of nontraumatic feline uveitis in the UK: A retrospective observational study of 72 cats.

Background: Uveitis is a common ophthalmic diagnosis in cats, that can lead to discomfort and loss of vision. Identification of nonidiopathic cases facilitates treatment and could reduce morbidity associated with this condition. Aim: To evaluate etiologies of nontraumatic uveitis in the UK, to compare diagnostic features between idiopathic cases and those with an established underlying etiology, and to investigate the association of clinical signs and abnormal diagnostic findings with a confirmed etiology. Methods: Records of cats diagnosed with uveitis at a UK referral center between August 2009 and April 2018 were retrospectively reviewed, excluding traumatic (and reflex) cases. Cases were categorized based on whether an underlying etiology had been established in cases with confirmed etiology, idiopathic, and inconclusive cases. All cases had a minimum of 12-month follow-up unless an underlying etiology had been established. Population characteristics, clinical signs, diagnostic investigation features, and results were reported. Results: 72 cases of uveitis were included, of which male cats and domestic breeds were overrepresented. An underlying etiology was determined in 23.6% of cases: 9.7% had infectious diseases, 5.6% had systemic neoplasia, 4.2% had primary ocular neoplasia, and 4.2% had metabolic disease. Idiopathic uveitis comprised 37.5% of cases, and the remaining 38.9% were inconclusive, of which 35.7% died or were euthanased within the follow-up period. Among the study population, no significant age difference was found between cats with idiopathic disease or confirmed etiology. The unilateral disease was reported in 56.9% of cases and was not different across the idiopathic cases and confirmed etiology groups. The most common ophthalmic clinical sign was an aqueous flare, followed by keratic precipitates and hypotony. Iris color change (p = 0.015) and the presence of an intraocular mass (p = 0.025) were associated with an underlying etiology. Conclusion: Idiopathic uveitis was found to be the most common diagnosis in this study population. However, a similar proportion of cases had possible underlying etiologies as a high proportion manifested systemic disease within the follow-up time. An underlying etiology could be established only in a quarter of cases. Further studies are required to standardize the investigations required when assessing cats with uveitis to minimize patient morbidity.

Retrospective computed tomography analysis of endotracheal tube constriction and mispositioning in cats and dogs.

OBJECTIVE: To discover the prevalence of endotracheal tube (ETT) constriction and rostral and caudal mispositioning in anaesthetized cats and dogs, and to identify associated risk factors. STUDY DESIGN: Retrospective analysis. ANIMALS: A total of 146 cats and 670 dogs. METHODS: Computed tomography images of the head/neck/thorax from orotracheally intubated cats and dogs were visually assessed for constriction or mispositioning of the ETT. If constriction was present, measurements of the cross-sectional area (CSA) of the ETT lumen at constricted and un-constricted locations were compared. Location and cause of constriction were noted and the expected increase in resistance to gas flow was calculated. Animal information was collected from clinical records. Normality of continuous variables was assessed via the Shapiro-Wilk test. Chi-square tests examined associations between variables. Kendall's tau-b test was performed between measured ETT size and degree of constriction. RESULTS: The ETT extended rostrally beyond incisors in 52% of cases; the connector was within the oral cavity in 19% of cases. The ETT extended beyond the first rib in 25.5% of cases. The prevalence of ETT constriction was 22.7%. Median reduction in CSA was 7.68% (0.14-64.19%). Median increase in resistance assuming laminar and turbulent flow was 16.5% (0.3-680%) and 21% (0.3-1200%), respectively. The most common cause of constriction was the presence of a radiotherapy mouth gag. Significant associations existed between presence of constriction and rostral mispositioning, and caudal mispositioning and extreme brachycephaly. Increased severity of constriction was more likely in smaller ETT. CONCLUSIONS AND CLINICAL RELEVANCE: Constriction and mispositioning of ETT occurred very commonly in this population. Checking the ETT within the oral cavity for constriction and mispositioning is recommended. Radiotherapy mouth gags increase the risk of ETT compression. Smaller ETT are at greater risk of severe constriction. Brachycephalic dogs are at particular risk of caudal mispositioning.

Histopathologic diagnosis and patient characteristics in cats with small intestinal obstructions secondary to trichobezoars.

OBJECTIVES: The aim of the present study was to describe the distribution of gastrointestinal histopathology findings associated with gastrointestinal obstructions secondary to trichobezoar formation in cats. METHODS: A total of 100 surgical gastrointestinal biopsies were obtained from 44 cats with gastrointestinal obstructions secondary to a trichobezoar. Medical records, including signalment, type and duration of clinical signs, surgical reports and histopathologic analysis, were reviewed for each cat. RESULTS: Biopsies taken near the site of the trichobezoar were more likely to show neutrophilic inflammation and mucosal erosion/ulceration compared with biopsies taken elsewhere in the small intestine. Lymphoplasmacytic and mixed lymphocytic and eosinophilic populations were the most common histopathologic findings from all biopsies followed by alimentary small cell lymphoma. Biopsy samples were more likely to represent a diagnosis of alimentary lymphoma in cats older than 10 years. CONCLUSIONS AND RELEVANCE: Gastrointestinal biopsies taken at the time of surgery in cats with trichobezoar obstructions may represent an important diagnostic tool for further evaluation of potential feline chronic enteropathy. Biopsies taken at the site of the obstruction should be interpreted cautiously as the presence of a trichobezoar may induce an acute inflammatory reaction. The resultant histologic interpretation at this site may not represent the chronic state of the intestinal mucosa, supporting the utility of obtaining multiple biopsies orad and aborad to the obstruction.

Risk factors, treatment, and outcome in dogs and cats with subdural hematoma and hemispheric collapse after ventriculoperitoneal shunting of congenital internal hydrocephalus.

BACKGROUND: Overshunting and hemispheric collapse are well-known complications after ventriculoperitoneal shunt (VPS) implantation. Risk factors that predispose to overshunting, treatment options, and prognosis after therapeutic intervention have not been described. HYPOTHESIS/OBJECTIVES: To identify preoperative risk factors for overshunting, the effect of surgical decompression, and their outcomes. ANIMALS: Seventy-five dogs and 7 cats. METHODS: Retrospective case cohort study. Age, breed, sex, body weight, number of dilated ventricles, ventricle brain ratio, intraventricular pressure, and implanted pressure valve systems were evaluated as possible risk factors. RESULTS: Overshunting had a prevalence of 18% (Cl 95% 9.9-26.66). An increase of 0.05 in VBR increased the risk of overshunting by OR 2.23 (Cl 95% 1.4-3.5; P = .001). Biventricular hydrocephalus had the highest risk for overshunting compared to a tri- (OR 2.48 with Cl 95% 0.5-11.1) or tetraventricular hydrocephalus (OR 11.6 with Cl 95% 1.7-81.1; P = .05). There was no influence regarding the use of gravitational vs differential pressure valves (P > .78). Overshunting resulted in hemispheric collapse, subdural hemorrhage, and peracute deterioration of neurological status in 15 animals. Subdural hematoma was removed in 8 dogs and 2 cats with prompt postoperative improvement of clinical signs. CONCLUSIONS AND CLINICAL IMPORTANCE: Biventricular hydrocephalus and increased VBR indicate a higher risk for overshunting. The use of differential valves with gravitational units has no influence on occurrence of overshunting related complications and outcomes. Decompressive surgery provides a favorable treatment option for hemispheric collapse and has a good outcome.

Subcutaneous emphysema and pneumomediastinum following orbital blowout pathological fracture in a cat with nasal lymphoma: a case report.

BACKGROUND: Subcutaneous emphysema and pneumomediastinum are rare complications associated with orbital blowout pathological fracture. CASE PRESENTATION: A 7-year old, castrated male Abbysinian cat presented with anorexia, lethargy, nausea, eyelid swelling, nasal discharge, and sneezing. Based on the clinical and diagnostic work-up, the cat was diagnosed with T cell high-grade nasal lymphoma associated with orbital pathological fracture due to the tumour invasion. After chemotherapy, the cat showed massive subcutaneous emphysema from frontal region to abdomen and pneumomediastinum due to orbital blowout pathological fracture. As the nasal mass decreased in volume; the air had moved from the maxillary sinus to the subcutaneous region and the mediastinum through fascial planes in the head and neck region. CONCLUSIONS: This is a first case report of a massive subcutaneous emphysema and pneumomediastinum due to an orbital blowout pathological fracture following chemotherapy in feline nasal lymphoma in veterinary medicine.

Single institution retrospective study evaluating the frequency of implant removal and associated risk factors following open fracture fixation in 80 cases (2010-2020).

BACKGROUND: Open fractures occur commonly in small animals and are characterised by contamination of the fracture site. While never quantified, it is believed that open fractures stabilised with internal implants are at a higher risk for requiring explantation. This retrospective study determines the frequency and risk factors for explantation following use of internal fixation. Medical records of client-owned dogs and cats with an open fracture, between 2010 and 2020 stabilised using internal implants, were included. Data retrieved included signalment, cause and characterisation of the fracture, comorbidities, preexisting infections, and all details related to anesthesia and surgery. Pre-, Peri- and post-operative antibiotic use were detailed. All cases were followed to clinical union. Postoperative complications, including requirement for implant removal were recorded and classified as major or minor. Associations between potential risk factors and need for explantation were assessed. RESULTS: Of 80 cases, 72 (90%) were dogs and eight (10%) cats. Major complications were encountered in 23 (28.75%) cases and minor complications in 16 (20%) cases. Explantation was performed in 17 cases (21.25%). Out of 72 dogs, 13 required explantation (18%) whereas four of the eight cats needed implants removed (50%). Only diagnosis of postoperative infection was associated with an increased risk of explantation (RR 2.77; 95% CI 1.25; 6.15; p = 0.045). CONCLUSION: Approximately 1 in 5 open fractures stabilised using internal fixation can be anticipated to require explantation, with cats potentially being at a higher risk than dogs. Cases diagnosed with postoperative infection are at a higher risk for requiring implant removal.