Long-lasting hypoaldosteronism after adrenalectomy in a cat with hyperaldosteronism.

Case summary: A 10-year-old neutered male domestic shorthair cat was presented with an abdominal mass, associated renal failure, chronic vomiting, anorexia and progressive polyuria/polydipsia lasting for 3 weeks. Clinical examination and initial blood work revealed azotaemia, hypokalaemia and hypertension. Abdominal ultrasound showed an adrenal mass with a diameter of 3 cm near the right kidney. High serum aldosterone suggested primary hyperaldosteronism. Surgery enabled identification of the mass and its excision along with the right adrenal gland. Histologically, carcinoma of the adrenal cortex was diagnosed. Postoperatively, an increase in serum creatinine and potassium, along with a low serum aldosterone, led to a diagnosis of hypoaldosteronism. Mineralocorticoid therapy for 6 months was necessary, resulting in clinical and biological improvement. Relevance and novel information: To our knowledge, this case describes the longest-lasting reported secondary hypoaldosteronism in a cat, after unilateral adrenalectomy for an adrenal carcinoma with hyperaldosteronism.

Long-term outcomes after arthroscopic treatment of dogs affected by osteochondrosis dissecans of the humeral trochlea, with or without medial coronoid disease: 23 cases (2012-2020).

The objective of this study was to report long-term clinical and radiographic outcomes following arthroscopic reparative treatment - flap removal, curettage, and osteostixis of subchondral bone - in dogs with humeral trochlea osteochondritis dissecans (OCD). Dogs were included in this retrospective multicenter case series if they had a computed tomography diagnostic of humeral trochlear OCD, with or without medial coronoid disease, that was treated by arthroscopic reparative technique, and a detailed follow-up at least 6 mo postoperatively. The latter included a clinical examination, assessment of lameness, measurement of the brachial circumference and elbow amplitude, International Elbow Working Group (IEWG) radiographic score, owner-completed canine brief pain inventory (CBPI) score, and visual analogue scale (VAS) rating. A generalized linear model and tests for symmetry and marginal homogeneity were used to compare data. Twenty-three dogs (30 affected elbows) were included. Long-term (median: 22 mo; range: 6 to 98 mo) postoperative lameness, CBPI, VAS, joint distension, and pain scores were significantly improved compared with the preoperative values. Long-term postoperative range of motion and brachial circumference did not reveal any significant difference between OCD-affected and unaffected elbows. Long-term IEWG scores were similar to preoperative values in 56% of elbows and had progressed by 1 grade in 44%. Long-term complications included persistent Grade-1 lameness and occurred in 23% of dogs. Long-term outcomes based on lameness and CBPI scores were considered excellent in 67% of dogs, good in 27%, and intermediate in 6%. Arthroscopic treatment is thus a suitable surgical procedure for OCD of the humeral trochlea in dogs and provides good long-term results.

Cette étude rapporte les résultats cliniques et radiographiques à long terme après un traitement arthroscopique chez des chiens atteints d'ostéochondrite disséquante (OCD) de la trochlée humérale. Les chiens inclus ont reçu un diagnostic d'OCD de la trochlée humérale par tomographie, un traitement réparateur par arthroscopie et un suivi post-opératoire d'au moins 6 mois. Ce dernier comprenant un examen clinique et orthopédique, la mesure de la circonférence brachiale et de l'amplitude du coude, le score radiographique de l'International Elbow Working Group (IEWG), le score Canine Brief Pain Inventory (CBPI) et l'échelle visuelle analogique (EVA). Un modèle linéaire généralisé et des tests de symétrie et d'homogénéité marginale ont permis de comparer les données. Vingt-trois chiens (30 coudes affectés) ont été inclus. Les scores postopératoires à long terme (médiane, 22 mois), de boiterie, de CBPI, d'EVA, de distension articulaire et de douleur étaient significativement améliorés. L'amplitude de mouvement et la circonférence brachiale postopératoires à long terme entre les coudes affectés et non affectés n'ont pas révélé de différence significative. Les scores IEWG à long terme étaient similaires aux valeurs préopératoires dans 56 % des coudes et avaient progressé d'un grade dans 44 %. Les résultats à long terme basés sur la boiterie et les scores CBPI ont été considérés comme excellents chez 67 % des chiens, bons chez 27 % et intermédiaires chez 6 %. Le traitement arthroscopique est donc une procédure chirurgicale appropriée pour l'OCD de la trochlée humérale chez le chien et donne de bons résultats à long terme.(Traduit par les auteurs).

Septic peritonitis secondary to intra-peritoneal grass awn migration: 7 cases (2014-2021).

Objectives: To describe the clinical presentation, management, and outcome of cases treated for septic peritonitis secondary to intra-peritoneal grass awn migration. Animals: Six client-owned dogs and 1 client-owned cat. Procedures: Clinical data of dogs and cats treated surgically for septic peritonitis secondary to an intra-peritoneal grass awn identified during surgery between January 2014 and December 2021 were retrospectively reviewed. Data included signalment, clinical presentation, blood test results, diagnostic imaging findings, surgical procedure, postoperative complications, and outcome. Telephone interviews were conducted for long-term follow-up. Results: Six dogs and 1 cat met the inclusion criteria. The most common reported clinical signs were lethargy (n = 7), anorexia/dysorexia (n = 4), and pyrexia (n = 4). The vegetal foreign body was not identified in any case with ultrasound (0/5) and only suspected for one case with a computed tomography scanner (1/4). A grass awn was identified within an omental abscess for each case during surgery. Abscess resection for each case resulted in partial pancreatectomy and a splenectomy for 1 case, and partial gastrectomy for another case. All cases survived to discharge. Only one minor post-operative complication was identified, and no other complication was reported at the long-term telephone interview. Conclusion and clinical significance: Septic peritonitis secondary to omental grass awn foreign body is an uncommon condition that has a good to excellent prognosis after surgical treatment. Identification of omental grass awn with ultrasound and computed tomography is rare. Therefore, particular care should be given to omental exploration during surgery for septic peritonitis with no underlying cause identified.

Péritonite septique secondaires à la migration de barbes de graminées : 7 cas (2014-2021). Objectifs: Décrire la présentation clinique, la prise en charge et pronostic des chiens et chats traité pour une péritonite septique secondaire à la migration intrapéritonéale d'un corps étranger végétal. Animaux: Six chiens et un chat traités. Protocole: Les informations des dossiers des chiens et chats pris en charge chirurgicalement pour une péritonite septique pour lesquelles un corps étranger végétal intrapéritonéal a été identifié entre janvier 2014 et décembre 2021 ont été obtenues. Les données concernant le signalement, la présentation clinique, les analyses sanguines, les examens d'imagerie, les procédures chirurgicales, les complications post-opératoires et l'évolution post-opératoire ont été collectées. Le suivi à long terme a été réalisé par téléphone. Résultats: Six chiens et un chat ont été inclus dans l'étude. Les signes cliniques les plus fréquents rapportés sont l'apathie (n = 7), l'anorexie/dysorexie (n = 4) et l'hyperthermie (n = 4). Les corps étrangers végétaux n'ont été identifiés dans aucun cas par échographie (0/5) et suspectés dans un cas à l'examen tomodensitométrique (1/4). Les corps étrangers ont tous été identifiés au sein d'un abcès dans l'omentum en chirurgie. Une résection de l'abcès a été réalisée dans chaque cas associé à une pancréatectomie partielle et une splénectomie pour un cas et une gastrectomie partielle pour un autre cas. Tous les animaux ont survécu. Seule une complication mineure a été rapportée en post-opératoire et aucune autre complication n'a été rapportée lors des entretiens téléphoniques. Conclusion et portée clinique: Les péritonites septiques secondaires à des migrations intra-péritonéale de corps étrangers végétaux sont des affections rares qui semblent être associées à un pronostic de survie bon à excellent après prise en charge chirurgicale. L'identification des corps étrangers dans l'omentum est difficile par échographie ou examen tomodensitométrique. Par conséquent, une attention particulière doit être portée à l'exploration de l'omentum lors de prise en charge chirurgicale de péritonite septique sans cause sous-jacente identifiée.(Traduit par les auteurs).

Comparison of computed tomography and surgical findings and investigation of their associations with outcomes for dogs with sublumbar abscesses.

OBJECTIVE: To describe and compare the results of preoperative CT and surgical findings in dogs with sublumbar abscesses and investigate potential associations between these variables and the outcome of abscess recurrence. ANIMALS: 51 client-owned dogs. PROCEDURES: A retrospective, records-based study was performed of dogs undergoing surgery for treatment of sublumbar abscesses diagnosed by use of CT between January 2010 and December 2018. Signalment, clinical signs, clinicopathologic data, CT findings, surgical techniques and findings, duration of hospitalization, postoperative treatment, and complications were recorded. Long-term follow-up was performed through telephone interviews. Logistic regression analysis was used to investigate associations between the variables of interest and abscess recurrence. RESULTS: 51 dogs met the study inclusion criteria; 48 were included in outcome analysis. The CT findings agreed with surgical findings for identification of a migrating vegetal foreign body for 39 of 51 (77%) dogs. All dogs survived to hospital discharge; 1 dog died of hemoabdomen 3 days after surgery, and 6 had minor (surgical wound) complications reported. Abscess recurrence developed in 12 of 48 (25%) dogs with a median time to recurrence of 6 months. Identification of diskospondylitis on CT examination was the only investigated factor significantly associated with recurrence; odds of recurrence in dogs with this finding were 8.4 times those for dogs without this finding. CONCLUSIONS AND CLINICAL RELEVANCE: Our results suggested dogs with sublumbar abscesses have a good prognosis after surgery, although recurrence can develop. Preoperative identification of diskospondylitis was significantly associated with abscess recurrence in this study sample.

Treatment and outcome of spontaneous pneumothorax secondary to suspected migrating vegetal foreign body in 37 dogs.

BACKGROUND: The aim of this study is to describe surgical findings, treatment and outcome of spontaneous pneumothorax (SP) secondary to suspected migrating vegetal foreign body (MVFB). METHODS: This retrospective study included dogs with computed tomography (CT) consistent with SP suspected to be secondary to MVFB that underwent thoracic surgery. They were divided into two groups according to whether CT identified (group 1) or only suspected (group 2) an MVFB. RESULTS: Thirty-seven dogs were included (twenty-one in group 1 and 16 in group 2). An MVFB was identified during surgery in 18 of 21 of cases of group 1 and in 10 of 16 of group 2. An agreement between lobes affected on CT and surgical findings was observed in 34 of 40 lobes. In nine of 37 of cases, a lung perforation was identified without evidence of MVFB. Thirty-nine lobectomies were performed: 15 complete and 24 partial. No recurrence of pneumothorax was observed. In four dogs, a second surgery was necessary to remove an MVFB 1.5 to 3 months after the initial surgery due to secondary draining tracts. CONCLUSION: Surgical approach planed with CT resolved SP in all cases before discharge with excellent short-term outcome and no major complication. CT was reliable to assess perforated lung lobes in 85% of cases. Clinical signs of delayed draining tract developed in 33% of cases where surgery failed to find an MVFB identified on CT.

Long-lasting nosocomial persistence of chlorhexidine-resistant Serratia marcescens in a veterinary hospital.

Healthcare-associated infections (HAIs) are often overlooked in veterinary medicine. Serratia marcescens isolates were recovered over a ten-year period from companion animals in a French veterinary hospital. The pets were sampled either for diagnostic purposes or to monitor colonization. A retrospective study showed that 32 S. marcescens isolates were identified as HAI cases and a further 22 cases were associated with colonization of the surgical site. Two S. marcescens lineages were responsible for two different outbreaks during the study period. Chlorhexidine solution (1%) used to impregnate gauze was found to be the source of the second S. marcescens outbreak and all isolates had high MIC values for chlorhexidine (MIC = 128 mg/L). This study reports, for the first time to our knowledge, the nosocomial spread of chlorhexidine-resistant S. marcescens in a veterinary setting and highlights consequences of the improper use of disinfectants.

CT is helpful for the detection and presurgical planning of lung perforation in dogs with spontaneous pneumothorax induced by grass awn migration: 22 cases.

Spontaneous pneumothorax induced by grass awns accounts for 5% of spontaneous pneumothorax and 22.5% of thoracic grass awn cases. Previous studies report limited interest of CT for spontaneous pneumothorax. Aims of this retrospective case series were to describe CT features of this condition and determine if CT features can efficiently localize the perforation site. Dogs that had a spontaneous pneumothorax, CT examination, thoracic surgery, and confirmed lung perforation due to a grass awn were included. Computed tomography studies were reviewed and compared to the surgical findings.  In 19 of 22 (86.4%) dogs, the pneumothorax or its recurrence were ipsilateral to the perforation site. The perforation site was identified in 21 of 22 (95.5%) dogs and involved the caudal lobes in 20 of 22 (90.9%) cases. The lateralization and the involved lung lobe corresponded to surgical findings in 21 of 22(95.5%) dogs. The perforation site was characterized as a soft tissue attenuating focus lying against an extensive pleural thickening in 21 of 22(95.5%) dogs. An adjacent defect in the visceral pleura was seen in 13 of 22(59.1%) dogs. A grass awn was seen in 11 of 22(50%) dogs.  The pneumothorax distribution and grass awn position consistently indicated the perforation side in this sample of dogs. The comparison with surgical findings suggests CT might be helpful for future presurgical planning of this etiology for pneumothorax.

Comparison of complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy in cats.

OBJECTIVE: To compare complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy (VBO) in cats. ANIMALS: 282 client-owned cats treated by VBO at 25 veterinary referral and academic hospitals from 2005 through 2016. PROCEDURES: Medical records of cats were reviewed to collect information on signalment, clinical signs, diagnostic test results, surgical and postoperative management details, complications (anesthetic, surgical, and postoperative), and outcome. Associations were evaluated among selected variables. RESULTS: Unilateral, staged bilateral, and single-stage bilateral VBO was performed in 211, 7, and 64 cats, respectively, representing 289 separate procedures. Eighteen (9%), 2 (29%), and 30 (47%) of these cats, respectively, had postoperative respiratory complications. Cats treated with single-stage bilateral VBO were significantly more likely to have severe respiratory complications and surgery-related death than cats treated with other VBO procedures. Overall, 68.2% (n = 197) of the 289 procedures were associated with Horner syndrome (19.4% permanently), 30.1% (87) with head tilt (22.1% permanently), 13.5% (39) with facial nerve paralysis (8.0% permanently), and 6.2% (18) with local disease recurrence. Cats with (vs without) Horner syndrome, head tilt, and facial nerve paralysis before VBO had 2.6, 3.3, and 5.6 times the odds, respectively, of having these conditions permanently. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggested that staged bilateral VBO should be recommended over single-stage bilateral VBO for cats with bilateral middle ear disease. Cats with Horner syndrome, head tilt, and facial nerve paralysis before surgery were more likely to have these conditions permanently following surgery than were cats without these conditions.

[Fibrocartilaginous embolic myelopathy in dogs: a retrospective study]. / L'embolie fibrocartilagineuse chez le chien : une etude rétrospective.

The clinical aspects of 26 dogs suspected of fibrocartilaginous embolic myelopathy (FEM) were documented and compared to results from 2 studies published in the literature. The short-term recovery capacity of 15 of these patients was also evaluated during a 30 day period by giving a neurological score. We have observed, compared to other studies, a larger proportion of cervical localization (15.4%) as well as a larger variety of race sizes for FEM. We have established that, after 30 days, 67% of patients had improved and that 88% of non-ambulatory patients had regained their ambulatory capacity. Also, patients showing signs of grey matter lesions (inferior motor neuron--IMN) as well as those having white matter lesions (superior motor neuron--SMN) had shown signs of neurological progress. Therefore, we have observed that the recovery capacity of an animal suffering from FEM does not seem to be impacted by its initial ambulatory state, nor by its lesions to IMN or SMN, although the low number of cases does not allow us to positively confirm this situation.