ABSTRACT
OBJECTIVE: To describe the detailed surgical procedure for open-chest CPR (OC-CPR) through a transdiaphragmatic (TD) approach during planned laparotomy and to evaluate the procedure time and damage to organs. ANIMALS: 7 mixed-breed canine cadavers. METHODS: The procedure was divided into 3 stages. Durations for each of the 3 stages of the procedure and total time from diaphragmatic incision to the end of Rumel tourniquet application were recorded. Subjective assessment of ease of procedures and postprocedural physical evaluation of thoracoabdominal organs were also performed. RESULTS: Mean time from diaphragmatic incision to pericardiotomy was 15.1 seconds (SD, 4.0). Performing 10 cardiac compressions took 12.0 seconds (SD, 1.8). Dissection of the aorta and application of a Rumel tourniquet took 130.4 seconds (SD, 52.2). The mean total time from start of first procedure to end of last procedure was 157.6 seconds (SD, 21.5). The mean length of diaphragmatic incision was 11.5 cm (SD, 2.2). Lung laceration was identified in one dog, and liver laceration was identified in another dog. The mean ease of pericardiotomy was 10, and application of a Rumel tourniquet was 4 (SD, 1.9). There was no instance of abdominal organs moving into the thoracic cavity during the procedure in any of the dogs. CLINICAL RELEVANCE: Resuscitation techniques during TD OC-CPR can be performed with acceptable timing and effort, except for aortic Rumel tourniquet application, which was difficult and time consuming. Avoidable damage to thoracoabdominal organs can occur.
Subject(s)
Cadaver , Cardiopulmonary Resuscitation , Diaphragm , Animals , Dogs , Cardiopulmonary Resuscitation/veterinary , Cardiopulmonary Resuscitation/methods , Diaphragm/surgery , Male , Female , Laparotomy/veterinaryABSTRACT
Surgical site infection (SSI) is a common complication after celiotomy in horses, leading to increased morbidity and costs. Increased concern about antibiotic resistance justifies evaluation of alternative preventive approaches, such a Manuka honey which has displayed antimicrobial properties. Pectin-Honey Hydrogels (PHH), composed by Manuka honey and pectin provide a moist wound environment and microbial growth inhibition. The aim of the study was to evaluate the effectiveness of PHHs in preventing SSI in horses subjected to emergency laparotomy. Horses undergoing laparotomy were evaluated. Horses were randomly divided into two groups: Group 1 received PHH application onto the sutured linea alba before skin closure, while Group 2 received no treatment. Horses with postoperative antimicrobial administration or survival of less than 5 days were excluded. The incidence of SSIs was reported as percentages and compared between groups. Out of 44 horses enrolled in the study, only thirty-six were ultimately included. Exclusions occurred either due to death before 5 days postoperatively (2 horses) or the administration of postoperative antimicrobials (6 horses). The median length of hospitalization was 9 days (range 8-14 days). The overall occurrence of SSI was 19.4 %. One out of eighteen horses (5.5 %) in Group 1 and 6 out of 18 (33.3 %) horses in Group 2 developed SSI. Group 2 had an 8.5-fold increased risk of SSI (p = 0.035, OR = 8.5, 95 % CI. 0.9-80.07). No macroscopically visible adverse reactions were associated with PHH. PHH placed at the abdominal incision during surgery was safe and reduced the prevalence of SSI in horses.
Subject(s)
Honey , Horse Diseases , Hydrogels , Laparotomy , Pectins , Surgical Wound Infection , Animals , Horses , Surgical Wound Infection/prevention & control , Surgical Wound Infection/veterinary , Surgical Wound Infection/epidemiology , Pilot Projects , Laparotomy/adverse effects , Laparotomy/veterinary , Horse Diseases/prevention & control , Horse Diseases/surgery , Hydrogels/administration & dosage , Pectins/administration & dosage , Male , FemaleABSTRACT
A prospective, quasi-experimental, clinical trial was performed to assess acute postoperative pain in healthy female dogs following elective ovariectomy by either laparoscopy (n=13) or laparotomy (n=14). Pain was assessed by both a veterinarian at the hospital, and by the owner once the patient was discharged. The Spanish version of the short form of the Glasgow Composite Measuring Pain Scale (CMPS-SF) was used. Pain scores were assessed by the veterinarian preoperatively and at 1, 2, 4, and 6â¯h after extubation, whilst owner-assessed scores were performed preoperatively and at postoperative days 0, 1, 2, 3, 5 and 7. Data were compared with Mann-Whitney-U test. Veterinarian-assessed CMPS-SF scores were different between both groups at all postoperative times but not at baseline, being below 6/24 in all dogs in the laparoscopy group, but equal to or greater than 6/24 in the laparotomy group at 1â¯h (n=12), and 4â¯h (n=4) (P<0.001 and P=0.029, respectively). There were also differences in pain scores between both groups at 2â¯h (P=0.012) and 6â¯h (P=0.007), being below 6/24 in all of them. However, there were no differences in owner assessments between groups. In conclusion, ovariectomy performed by laparoscopy induced lower pain scores that were below the pain threshold set by the CMPS-SF during the first 6â¯h postoperatively. After discharge, and up to one week later, ongoing owner-assessed scores suggest no pain was induced with neither of the techniques. Owners were proactive allowing real-time pain assessment to be reported. The development and validation of instruments for acute pain assessment by owners is warranted, as these tools are currently lacking.
Subject(s)
Laparoscopy , Ovariectomy , Pain Measurement , Pain, Postoperative , Animals , Dogs , Ovariectomy/veterinary , Ovariectomy/adverse effects , Female , Pain, Postoperative/veterinary , Pain, Postoperative/etiology , Laparoscopy/veterinary , Pain Measurement/veterinary , Prospective Studies , Laparotomy/veterinary , Dog Diseases/surgeryABSTRACT
OBJECTIVE: To determine the effect of a single intraoperative dose of dexamethasone on the risk of postoperative reflux (POR) in horses undergoing small intestinal surgery and to investigate its association with incisional complications and short-term survival. DESIGN: Retrospective cohort study over an 11-year period (2008-2019). SETTING: UK-based private referral center. ANIMALS: Two hundred and forty client-owned horses >6 months of age undergoing exploratory laparotomy for treatment of a small intestinal lesion. INTERVENTIONS: Ninety-seven horses received a single intraoperative dose of dexamethasone (0.1 mg/kg, IV). MEASUREMENTS AND MAIN RESULTS: Of 97 horses that received dexamethasone, 52 (53.6%) required small intestinal resection. Of 143 horses that did not receive dexamethasone, small intestinal resection was performed in 78 (54.5%). A total of 70 horses (29%) developed POR. There was no difference in the risk of POR between horses that received dexamethasone (25/97; 26%) and those that did not (45/143; 31%, P = 0.34). Risk factors associated with the development of POR included small intestinal resection (odds ratio [OR]: 4.55, 95% confidence interval [CI]: 2.27-9.11, P < 0.001), a PCV >40% 24 hours postoperatively (OR: 4.11, 95% CI: 2-8.45, P < 0.001), and a WBC count >10 × 109/L on admission (OR: 3.29, 95% CI: 1.47-7.41, P = 0.004). Dexamethasone was not associated with the odds of POR. Horses undergoing repeat laparotomy had a higher risk of incisional infection (OR: 8.07, 95% CI: 1.98-32.81, P = 0.004). Dexamethasone administration was not associated with incisional infection. The development of POR was negatively associated with short-term survival (OR: 0.07, 95% CI: 0.03-0.17, P ≤ 0.001). Dexamethasone administration was not retained in the final multivariable model for survival. CONCLUSIONS: Intraoperative dexamethasone was not associated with the development of POR in this study population, nor did it have an effect on postoperative survival or incisional infection in horses undergoing surgical management of small intestinal disease.
Subject(s)
Dexamethasone , Horse Diseases , Intestine, Small , Laparotomy , Postoperative Complications , Animals , Horses , Dexamethasone/administration & dosage , Dexamethasone/therapeutic use , Retrospective Studies , Horse Diseases/surgery , Female , Male , Laparotomy/veterinary , Laparotomy/adverse effects , Intestine, Small/surgery , Postoperative Complications/veterinary , Cohort Studies , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Intestinal Diseases/veterinary , Intestinal Diseases/surgeryABSTRACT
An 8-year-old neutered male shih tzu dog underwent laparotomy for cystolithectomy. Ten days later, multiple various-sized cystic nodules were observed on the suture line and surrounding abdominal skin, although the surgical incision had healed well. Microscopically, various-sized cysts lined with thin walls of stratified squamous epithelium in the dermis were dilated and filled with keratin. Adnexal differentiation from the wall was not seen. Thus, the abdominal lesions were diagnosed as comedones and epidermal cysts. Herein, we describe the case of a dog with comedones and epidermal cysts on the abdominal skin after a laparotomy. Key clinical message: Multiple various-sized cystic lesions of the follicles are described. The implantation of epidermal fragments into the dermis by surgery may induce epidermal cysts and comedones in the skin of hyperadrenocorticism-affected dogs.
Comédons et kystes épidermiques sur la peau abdominale d'un chien survenant après une laparotomie. Un chien shih tzu mâle castré de 8 ans a subi une laparotomie pour cystolithectomie. Dix jours plus tard, de multiples nodules kystiques de différentes tailles ont été observés sur la ligne de suture et sur la peau abdominale environnante, bien que l'incision chirurgicale ait bien cicatrisé. Au microscope, des kystes de différentes tailles bordés de fines parois d'épithélium pavimenteux stratifié dans le derme étaient dilatés et remplis de kératine. Aucune différenciation annexielle par rapport à la paroi n'a été observée. Ainsi, les lésions abdominales ont été diagnostiquées comme des comédons et des kystes épidermiques. Nous décrivons ici le cas d'un chien présentant des comédons et des kystes épidermiques sur la peau abdominale après une laparotomie.Message clinique clé:De multiples lésions kystiques des follicules, de différentes tailles, sont décrites. L'implantation chirurgicale de fragments d'épiderme dans le derme peut provoquer des kystes épidermiques et des comédons dans la peau des chiens atteints d'hypercorticisme.(Traduit par Dr Serge Messier).
Subject(s)
Dog Diseases , Epidermal Cyst , Dogs , Male , Animals , Epidermal Cyst/surgery , Epidermal Cyst/veterinary , Epidermal Cyst/pathology , Laparotomy/veterinary , Dog Diseases/surgery , Dog Diseases/pathologyABSTRACT
BACKGROUND: The aim of this study was to compare ultrasonographic findings of the ventral midline incision after exploratory laparotomy for colic in horses with and without surgical site infection (SSI). METHODS: Ultrasonographic examination of the surgical wound was performed on postoperative day 5 (D5) and day 10 (D10) to assess the presence of fluid accumulation, suture sinus formation, hyperechogenic spots and fistulous path. Clinical evaluation of the wound was used to classify horses with and without SSI. The accuracy, sensitivity, specificity and positive and negative predictive values of the ultrasonographic findings were then calculated. Multivariable logistic regression analyses were performed with SSI as a dependent variable and age, sex, breed and ultrasonographic findings as independent variables after univariate and collinearity analyses. RESULTS: Twenty-nine of the 84 horses examined had an SSI. Detection of fluid accumulation and hyperechogenic spots increased the odds for SSI at D5 (odds ratio [OR]: 4.99, 95% confidence interval [CI]: 1.53-16.33, p = 0.008; OR: 10.78, 95% CI: 1.75-26.59, p = 0.01, respectively) and D10 (OR: 11.51, 95% CI: 2.39-55.47, p = 0.002; OR: 12.34, 95% CI: 3.45-44.15, p < 0.001, respectively). LIMITATION: Ultrasonographic images were taken only on the longitudinal section. CONCLUSION: Ultrasonographic examination is helpful in evaluating the surgical incision after laparotomy, with the detection of fluid accumulation and hyperechogenic spots surrounding the sutures being strongly related to SSI.
Subject(s)
Colic , Horse Diseases , Laparotomy , Surgical Wound Infection , Ultrasonography , Animals , Horses , Horse Diseases/surgery , Horse Diseases/diagnostic imaging , Laparotomy/veterinary , Ultrasonography/veterinary , Surgical Wound Infection/veterinary , Surgical Wound Infection/diagnostic imaging , Colic/veterinary , Colic/surgery , Colic/diagnostic imaging , Female , Male , Sensitivity and SpecificityABSTRACT
A 6-year-old female huacaya alpaca was referred to the clinic for evaluation with a 1-month history of rapid weight loss, inappetence, lethargy, and severe leukocytosis refractory to medical management. Physical examination revealed a body condition score of 1 out of 5 and a large, firm structure palpable in the right caudoventral abdomen. Abdominal ultrasonographic examination revealed 3 masses with hyperechoic, swirling centers. The largest mass measured 15 cm in diameter with a 2-centimeter capsule, and extended from right of midline into the left inguinal region. Transrectal ultrasonography identified a small uterus and clear delineation between the abdominal masses. Complete blood (cell) count findings were consistent with marked systemic inflammation. Based on initial examination and laboratory findings, exploratory laparotomy was elected. Multiple mesenteric masses strongly adhered to the jejunum were observed within the abdomen. Due to the inoperable conditions and the poor long-term prognosis, the alpaca was euthanized under general anesthesia. Bacterial culture of fluid aspirated from the largest mass revealed Yersinia pseudotuberculosis. Key clinical message: Clinical progression and attempted treatment of Yersinia pseudotuberculosis in camelids have not been previously described and the bacterium should be considered as a differential diagnosis for abscessation and persistent leukocytosis. Yersinia pseudotuberculosis is also considered a zoonotic agent and proper precautions should be taken when handling cases of abdominal abscessation.
Yersinia pseudotuberculosis chez un alpaga. Une alpaga huacaya femelle de 6 ans a été référée à la clinique pour évaluation avec des antécédents d'un mois de perte de poids rapide, d'inappétence, de léthargie et de leucocytose sévère réfractaire à la prise en charge médicale. L'examen physique a révélé un score d'état corporel de 1 sur 5 et une structure large et ferme palpable au niveau de l'abdomen caudoventral droit. L'examen échographique abdominal a révélé 3 masses à centres hyperéchogènes et tourbillonnants. La plus grande masse mesurait 15 cm de diamètre avec une capsule de 2 centimètres et s'étendait de la droite de la ligne médiane jusqu'à la région inguinale gauche. L'échographie transrectale a identifié un petit utérus et une délimitation claire entre les masses abdominales. Les résultats de la numération globulaire (cellulaire) sanguine complète étaient compatibles avec une inflammation systémique marquée. Sur la base de l'examen initial et des résultats de laboratoire, une laparotomie exploratoire a été choisie. De multiples masses mésentériques fortement adhérées au jéjunum ont été observées dans l'abdomen. En raison des conditions inopérables et du mauvais pronostic à long terme, l'alpaga a été euthanasié sous anesthésie générale. La culture bactérienne du liquide aspiré de la plus grande masse a révélé Y. pseudotuberculosis.Message clinique clé :La progression clinique et les tentatives de traitement de Y. pseudotuberculosis chez les camélidés n'ont pas été décrites auparavant et la bactérie doit être considérée comme un diagnostic différentiel d'abcès et de leucocytose persistante. Yersinia pseudotuberculosis est également considérée comme un agent zoonotique et des précautions appropriées doivent être prises lors de la manipulation des cas d'abcès abdominal.(Traduit par Dr Serge Messier).
Subject(s)
Camelids, New World , Yersinia pseudotuberculosis , Female , Animals , Leukocytosis/veterinary , Laparotomy/veterinaryABSTRACT
OBJECTIVE: To compare the results of abdominal CT with exploratory laparotomy in the dog. ANIMALS: 100 client-owned dogs from 1 academic institution. METHODS: Medical records were searched for dogs that had undergone a preoperative abdominal CT scan read by a board-certified veterinary radiologist followed by an exploratory laparotomy. CT and surgical reports were compared. RESULTS: The overall agreement between abdominal CT scan and exploratory laparotomy in all cases was 97%. Overall, there was no evidence that proportion agreement differed on the basis of body condition score, time interval between CT and surgery, or oncologic versus nononcologic disease. CLINICAL RELEVANCE: Abdominal CT scan read by a board-certified diplomate is a sensitive presurgical diagnostic tool for surgical abdominal disease in the dog. When performing a specific abdominal surgery, it is acceptable for the surgeon to fully explore the abdomen or forego it for a smaller approach to the organ of interest if an abdominal CT was performed prior.
Subject(s)
Abdominal Injuries , Dog Diseases , Gastrointestinal Diseases , Humans , Dogs , Animals , Laparotomy/veterinary , Retrospective Studies , Tomography, X-Ray Computed/veterinary , Gastrointestinal Diseases/surgery , Gastrointestinal Diseases/veterinary , Abdomen/diagnostic imaging , Abdomen/surgery , Abdominal Injuries/surgery , Abdominal Injuries/veterinary , Dog Diseases/diagnostic imaging , Dog Diseases/surgeryABSTRACT
OBJECTIVE: To report perioperative complications and client-perceived outcome following laparoscopic surgical treatment for sliding hiatal hernia (SHH) in dogs. ANIMALS: Client-owned dogs (n = 9). METHODS: Medical records were reviewed and perioperative data collected including preoperative diagnostic imaging, operative details, complications, and need for conversion to open celiotomy. A single-incision, multicannulated port was inserted in the subumbilical region followed by placement of an additional 2 or 3 instrument portals. Hiatal plication, esophagopexy, and left-sided gastropexy were performed laparoscopically. Follow-up information was collected with telephone interview with the owners and/or referring veterinarian. A standardized questionnaire was completed by dog owners postoperatively. RESULTS: Intraoperative pneumothorax occurred in 5 of 9 (55.6%) dogs and resulted in conversion to open celiotomy in 2 (22.2%) dogs. In 4 dogs, pneumothorax was suspected to be the result of progressive leakage of capnoperitoneum through the suture bite holes of the esophageal hiatal plication sutures. Hiatal plication was performed using intracorporeal simple interrupted sutures (n = 4) or a simple continuous pattern with barbed suture (4). Esophagopexy was performed using barbed suture in all dogs. Gastropexy was performed using a total laparoscopic technique (n = 4) or laparoscopic-assisted technique (3). Using a standardized questionnaire, dog owners perceived a postoperative improvement in regurgitation after eating and regurgitation after excitement/increased activity. CLINICAL RELEVANCE: Laparoscopic treatment of SHH resulted in owner-perceived improvement in clinical signs. Intraoperative pneumothorax occurred in a high proportion of dogs but did not result in long-term sequelae.
Subject(s)
Dog Diseases , Hernia, Hiatal , Laparoscopy , Pneumothorax , Humans , Dogs , Animals , Hernia, Hiatal/surgery , Hernia, Hiatal/veterinary , Pneumothorax/surgery , Pneumothorax/veterinary , Dog Diseases/surgery , Laparoscopy/veterinary , Laparoscopy/methods , Laparotomy/veterinary , Treatment Outcome , Retrospective StudiesABSTRACT
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.
Subject(s)
Cat Diseases , Dog Diseases , Inflammatory Bowel Diseases , Humans , Cats , Dogs , Animals , Laparotomy/veterinary , Cat Diseases/diagnosis , Cat Diseases/surgery , Cat Diseases/etiology , Dog Diseases/diagnosis , Dog Diseases/surgery , Dog Diseases/etiology , Biopsy/veterinary , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/surgery , Inflammatory Bowel Diseases/veterinary , Retrospective StudiesABSTRACT
Combined abdominal and thoracic pathology caused by extra-gastrointestinal migration of an ingested wooden foreign body (WFB) is an uncommon but serious injury. Presenting clinical signs are typically nonspecific and, in the absence of observed WFB ingestion, diagnosis is challenging. Treatment requires concurrent abdominal and thoracic surgical exploration to remove the WFB and address injuries caused by its migration. This case series describes perioperative characteristics and outcomes in 4 dogs following combined median sternotomy and ventral midline laparotomy (CMSVML) for bicavitary penetrating WFBs. Key clinical message: Treatment of bicavitary penetrating WFBs with CMSVML provided postoperative outcomes similar to those in previous reports; however, high-grade complications and prolonged hospitalization were commonly encountered.
Résultats après sternotomie médiane et laparotomie médiane ventrale combinées pour des corps étrangers en bois pénétrant bicavitaires. La pathologie combinée abdominale et thoracique causée par la migration extra-gastro-intestinale d'un corps étranger en bois (WFB) ingéré est une blessure rare mais grave. Les signes cliniques présentés sont généralement non spécifiques et, en l'absence d'ingestion observée de WFB, le diagnostic est difficile. Le traitement nécessite une exploration chirurgicale abdominale et thoracique simultanée pour retirer le WFB et traiter les blessures causées par sa migration. Cette série de cas décrit les caractéristiques peropératoires et les résultats chez 4 chiens après une sternotomie médiane et une laparotomie médiane ventrale combinées (CMSVML) pour des WFB pénétrantes bicavitaires.Message clinique clé:Le traitement des WFB pénétrants bicavitaires avec CMSVML a fourni des résultats postopératoires similaires à ceux des rapports précédents; cependant, des complications de haut grade et une hospitalisation prolongée ont été fréquemment rencontrées.(Traduit par Dr Serge Messier).
Subject(s)
Dog Diseases , Foreign Bodies , Animals , Dogs , Sternotomy/veterinary , Laparotomy/veterinary , Foreign Bodies/surgery , Foreign Bodies/veterinary , Dog Diseases/surgeryABSTRACT
OBJECTIVE: To evaluate local temperature differences directly over and adjacent to small intestinal foreign body obstruction (FBO) using infrared thermography (IRT) in dogs. ANIMALS: 49 client-owned dogs were initially enrolled. METHODS: In a prospective, clinical observational study, IRT was utilized to compare median small intestinal (SI) surface temperature differences at the site of FBO and segments oral and aboral before and after surgical resolution from April 24, 2019, to July 19, 2020. These differences were evaluated for correlation with canine acute patient physiologic and laboratory evaluation fast (APPLEfast) scoring, lactate, foreign body material (hard vs soft), and blood pressure. RESULTS: There was not a significant surface temperature difference between SI segments at the site of FBO, oral or aboral. After resolution of obstruction, there was a significant decrease in median temperature directly over the FBO (2.4 °C; IQR, -2.55 to 10.6 °C; P = .0043). A decrease in surface temperature of the oral SI segment was appreciated with FBO due to hard material (-1.7 °C; IQR, -5.2 to 3.4 °C), whereas soft material had an increase in SI surface temperature oral to the FBO (+1.1 °C; IQR, 0.3 to 3.2 °C). This difference did not achieve significance (P = .08; Z = 1.75). No correlation was found between APPLEfast, lactate, or blood pressure and SI segment temperatures. CLINICAL RELEVANCE: IRT may be useful diagnostic modality to identify changes in small intestinal surface temperature relating to FBO. Further evaluation is warranted to determine if IRT may be a clinically useful to evaluate intestinal perfusion.
Subject(s)
Dog Diseases , Foreign Bodies , Humans , Animals , Dogs , Temperature , Thermography/veterinary , Laparotomy/veterinary , Prospective Studies , Body Temperature , Foreign Bodies/diagnosis , Foreign Bodies/surgery , Foreign Bodies/veterinary , Lactates , Infrared Rays , Dog Diseases/diagnosis , Dog Diseases/surgeryABSTRACT
Extended-release (ER) local anesthetics can be used in multi-modal analgesia or in situations in which systemic analgesics may alter animal physiology and thus introduce interpretational confounds. In this study, we compared the analgesic efficacy of an ER buprenorphine formulation with that of a synergistic combination of ER bupivacaine and meloxicam. Female and male CD1 mice were randomly assigned to receive subcutaneous buprenorphine (3.25mg/kg) preemptively, subcutaneous infiltration of bupivacaine???meloxicam (0.03mL at incision closure (bupivacaine, 35mg/kg; meloxicam, 1mg/kg), or saline (10mL/kg SC) after induction of anesthesia. After laparotomy, mice were assessed for changes in daily body weight, rearing frequency, nest consolidation scores, time-to-integrate-nest test (TINT), and response to von Frey testing at 4, 8, 24, 48, and 72h after surgery. Daily weight, nest consolidation scores and rearing frequency were not significantly different among the 3 groups. TINT had fallen significantly response at 24 and 48h after injection in the ER buprenorphine group as compared with the saline and ER bupivacaine-meloxicam groups. Nociceptive thresholds, as assessed with von Frey testing, differed between saline controls and both analgesic groups at 4, 8, 24, 48, and 72 h after surgery. None of the mice in the bupivacaine???meloxicam group developed signs of neurotoxicity, a potential side effect of high-dose local anesthetics. This study demonstrates that local ER bupivacaine???meloxicam may be a useful alternative to systemic, ER buprenorphine for the relief of pain after laparotomy in mice.
Subject(s)
Buprenorphine , Male , Female , Mice , Animals , Meloxicam/therapeutic use , Anesthetics, Local , Laparotomy/veterinary , Analgesics, Opioid , Analgesics/therapeutic use , Pain/drug therapy , Bupivacaine , Pain, Postoperative/drug therapy , Pain, Postoperative/veterinaryABSTRACT
OBJECTIVE: To report small intestinal herniation through the epiploic foramen in a dog. ANIMALS: Nine-year-old male castrated Shih Tzu. STUDY DESIGN: Case report. METHODS: The dog presented with an 8-year history of vomiting and regurgitation and acute onset of melena, lethargy, anorexia, anemia, and suspected gastrointestinal mass or obstruction on prereferral imaging. Abnormalities on abdominal radiographs included a large, midcaudal soft tissue structure and cranial displacement and segmental dilation of the small intestine. On abdominal ultrasound, severe gastric dilation, jejunal tortuosity and stacking, and peritoneal effusion were observed. Epiploic herniation of the small intestine and segmental jejunal devitalization was diagnosed on exploratory laparotomy, and the dog underwent hernia reduction, jejunal resection and anastomosis, and nasogastric tube placement. RESULTS: Severe gastric distention and atony persisted 24 h after surgery, despite medical management. The dog was taken to surgery for decompressive gastrotomy and placement of gastrostomy and nasojejunostomy tubes for postoperative decompression and feeding, respectively. Three days after the original surgery, the dog developed a septic abdomen from anastomotic dehiscence and underwent jejunal resection and anastomosis and peritoneal drain placement. Gastric dysmotility gradually resolved with the administration of motility stimulants, removal of gastric residual volume, and nutritional support via nasojejunostomy tube feedings. Three months after discharge, the dog was clinically normal. CONCLUSION: Epiploic foramen entrapment should be considered a type of herniation in dogs. Clinical suspicion should be raised in dogs with unresolving regurgitation and vomiting, visceral displacement, and stacking and distension of small intestine.
Subject(s)
Dog Diseases , Intestinal Obstruction , Male , Dogs , Animals , Intestine, Small/surgery , Jejunum/surgery , Gastrostomy/veterinary , Laparotomy/veterinary , Vomiting/surgery , Vomiting/veterinary , Intestinal Obstruction/diagnosis , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Intestinal Obstruction/veterinary , Dog Diseases/diagnostic imaging , Dog Diseases/surgeryABSTRACT
OBJECTIVE: To report perioperative characteristics and outcome following bilateral, single-session, laparoscopic adrenalectomy (BSSLA) in dogs. ANIMALS: Client-owned dogs (n = 6). CLINICAL PRESENTATION AND PROCEDURES: Medical records were reviewed and perioperative data collected, including preoperative diagnostic imaging, operative details, complications, and need for conversion to open laparotomy. Bilateral, single-session, laparoscopic adrenalectomy was performed on the right or left side with a standard 3- or 4-portal transperitoneal technique. The dog was repositioned to contralateral recumbency, and laparoscopic adrenalectomy was repeated. Follow-up information was collected by telephone interviews with the owners and/or referring veterinarian. RESULTS: Median age and weight of dogs were 126 months and 14.75 kg, respectively. Contrast-enhanced CT (CECT) was performed in all dogs. Median maximal tumor diameter was 2.6 and 2.3 cm for the right and left-sided tumors, respectively. Median surgical and anesthesia times were 158 and 240 minutes, respectively. Conversion to open laparotomy was performed in 1 dog following renal vein laceration during initial adrenalectomy. Left adrenalectomy and ureteronephrectomy were performed, and the right adrenal tumor was left in situ. Cardiac arrest occurred in 1 dog following initial adrenalectomy (left); however, the dog was resuscitated successfully, and contralateral laparoscopic adrenalectomy was performed without complication. All dogs survived to hospital discharge. Follow-up ranged from 60 to 730 days (median, 264 days) for dogs that successfully underwent BSSLA. CLINICAL RELEVANCE: BSSLA was associated with favorable outcomes in this cohort of dogs. Laparoscopy may be considered in dogs with bilateral, modestly sized, noninvasive adrenal tumors.
Subject(s)
Adrenal Gland Neoplasms , Dog Diseases , Laparoscopy , Dogs , Animals , Adrenalectomy/veterinary , Adrenalectomy/methods , Retrospective Studies , Laparoscopy/veterinary , Laparoscopy/methods , Adrenal Gland Neoplasms/surgery , Adrenal Gland Neoplasms/veterinary , Laparotomy/veterinary , Dog Diseases/surgeryABSTRACT
The following article provides an overview of the last 5 years of research and innovation within the field of equine colic surgery, focusing on new techniques, new or recently described lesions, prevention of lesion recurrence or postoperative complications, and updates in prognoses. Early surgical intervention is an important factor in horse survival.
Subject(s)
Colic , Horse Diseases , Animals , Horses , Colic/surgery , Colic/veterinary , Laparotomy/methods , Laparotomy/veterinary , Horse Diseases/surgery , Postoperative Complications/prevention & control , Postoperative Complications/veterinary , PrognosisABSTRACT
OBJECTIVE: To evaluate analgesic efficacy of 3 different preoperative protocols in cows undergoing right flank laparotomy for displaced abomasum. ANIMALS: 40 cows diagnosed with displaced abomasum. PROCEDURES: The cows were assigned by block randomization to 1 of 3 preoperative protocols: inverted L-block using 50 mL of 2% lidocaine (ILB; n = 13), ILB plus preoperative flunixin meglumine (2 mg/kg, IV; ILB-F; 13), and dorsolumbar epidural anesthesia using 2% xylazine (0.8 mL) and 2% lidocaine (4 mL; EPI; 14). Venous blood samples were collected for CBC, serum biochemistry, and cortisol preoperatively and at 0 (immediately after), 3, 17, and 48 hours postoperatively. RESULTS: The mean (95% CI) of the serum cortisol in ILB, ILB-F, and EPI were 108.7 (66.7 to 150.7), 150.7 (116.4 to 185.0), and 139.8 (93.4 to 186.3), respectively. The serum cortisol concentrations decreased over time in all groups (ILB, P = .001; ILB-F and EPI, P < .001). In the ILB group, the cortisol concentration at 17 and 48 hours postoperatively decreased (P = .026 and P = .009, respectively), compared with that preoperatively. In the ILB-F and EPI groups, the preoperative cortisol concentration was the highest and then decreased at 0, 3, 17, and 48 hours postoperatively (ILB-F, 0 hours [P = .001] and 3, 17, and 48 hours [P < .001]; EPI, all [P < .001]). CLINICAL RELEVANCE: ILB-F and EPI improved intraoperative and immediate postoperative indicators of pain-related stress when compared to standard ILB. EPI requires less anesthetic, which may be beneficial when in short supply.
Subject(s)
Hydrocortisone , Laparotomy , Female , Cattle , Animals , Laparotomy/veterinary , Pain/veterinary , Xylazine , LidocaineABSTRACT
This study compared two surgical techniques for treating left displaced abomasum (LDA) in dairy cows. The two techniques were compared in terms of milk production at different time intervals: before surgery; on the day of the surgery; and at 8, 15 and 30 days after surgery. The surgical techniques used in this study were laparoscopy-guided abomasopexy and right flank laparotomy omentopexy. A total of 126 lactating Holstein-Friesian cows with LDA were included, 63 of which were treated with laparoscopy, and 63 with right flank laparotomy. Cows with retained foetal membranes, metritis or natural delivery (dystocia) were included and registered on field sheets for subsequent statistical analysis. Cows with clinical mastitis were excluded. A blood sample (5 mL) was obtained from the medial coccygeal vein and analyzed for total proteins, total bilirubin, total calcium, glucose, b-hydroxybutyrate, sodium, potassium, and chloride. No differences were found between the two groups of operated cows with respect to the number of lactation days, body condition score (BCS), rectal temperature, heart rate, and respiratory rate before surgery. No differences were observed between groups regarding the biochemical parameters (P > 0.05) analyzed, except for chloride, which presented lower average values in the omentopexy group (P <0.05). Return of milk yield within the study period did not differ significantly between the laparoscopy and laparotomy groups (P > 0.05), although a significant change in post-surgery time was observed. .
Subject(s)
Cattle Diseases , Laparoscopy , Stomach Diseases , Pregnancy , Female , Cattle/surgery , Animals , Milk , Lactation/physiology , Laparotomy/veterinary , Abomasum/surgery , Chlorides , Cattle Diseases/surgery , Stomach Diseases/surgery , Stomach Diseases/veterinary , Laparoscopy/veterinary , Laparoscopy/methodsABSTRACT
BACKGROUND: Accurate reporting of postoperative complications is paramount to understanding procedural outcomes, comparing procedures and assuring quality improvement. Standardising definitions of complications in equine surgeries will improve the evidence of their outcomes. To this end, we proposed a classification for postoperative complications and applied it to a cohort of 190 horses undergoing emergency laparotomy. METHODS: A classification system for postoperative complications in equine surgery was developed. Medical records of horses that underwent equine emergency laparotomy and recovered from anaesthesia were analysed. Reported complications pre-discharge were classified as per the new classification system, and the cost and days of hospitalisation were correlated with the equine postoperative complication score (EPOCS). RESULTS: Of the 190 horses that underwent emergency laparotomy, 14 (7.4%) did not survive to discharge (class 6 complications), and 47 (24.7%) did not develop complications. The remaining horses were classified as follows: 43 (22.6%) had class 1 complications, 30 (15.8%) had class 2, 42 (22%) had class 3, 11 (5.8%) had class 4; and three (1.5%) had class 5. The proposed classification system and EPOCS correlated with the cost and length of hospitalisation. LIMITATIONS: This was a single-centre study and the definition of scores was arbitrary. CONCLUSIONS: Reporting and grading all complications will help surgeons better understand the patients' postoperative course, thereby reducing subjective interpretation.
Subject(s)
Colic , Horse Diseases , Horses , Animals , Laparotomy/adverse effects , Laparotomy/veterinary , Colic/veterinary , Retrospective Studies , Horse Diseases/surgery , Horse Diseases/etiology , Postoperative Complications/epidemiology , Postoperative Complications/veterinaryABSTRACT
BACKGROUND: Skin closure of laparotomy incisions using topical 2-octyl cyanoacrylate (2-OCA) mesh provides a secure bactericidal barrier in humans, which may reduce the risk of postoperative incisional complications. However, the benefits of using this mesh have not been objectively assessed in horses. METHODS: From 2009 to 2020, three methods of skin closure were used following laparotomy for acute colic, including metallic staples (MS), suture (ST) and cyanoacrylate mesh (DP). The closure method was not randomised. Owners were contacted 3 months or more after the surgery to record any postoperative complications that occurred. For each method of closure, the rates of surgical site infection (SSI) and herniation were recorded, as well as surgical time and treatment costs, including those for incisional complications. Chi-square testing and logistic regression modelling were used to assess differences between the groups. RESULTS: A total of 110 horses were recruited (45 in the DP group, 49 in the MS group and 16 in the ST group) The overall rate of SSI was 15.5%, with rates of 8.9%, 18.4% and 25% for the DP, MS and ST groups, respectively (p = 0.23). In addition, incisional hernias developed in 21.8% of cases, with 8.9%, 34.7% and 18.8% of horses in the DP, MS and ST groups, respectively, being affected (p = 0.009). The median total treatment cost did not differ significantly between groups (p = 0.47). LIMITATION: This was a retrospective study with non-randomised choice of closure method. CONCLUSIONS: No significant differences in the rate of SSI or overall cost wwere demonstrated between treatment groups. However, MS was associated with a higher rate of hernia formation than DP or ST. Despite increased capital cost, 2-OCA proved to be a safe skin closure method in horses and was no more expensive than DP or ST by the time visits to remove sutures/staples and treat infections were factored in.