Type IV dermoid sinus, intramedullary dermoid cyst and spina bifida in a Cane Corso.

A 1-year-old male Cane Corso was presented for progressive hindlimb neurologic deficits, with a history of suspected recurrent meningitis. Physical examination and advanced diagnostic imaging findings were suggestive of a thoracic dermoid sinus extending into the dura mater, and spina bifida. After initial medical treatment, the lesion was surgically excised, and the presence of an intramedullary cyst in continuation with the dermoid sinus was confirmed, requiring partial durectomy and myelotomy for removal. Histopathological examination of the excised tissue confirmed the diagnosis of a dermoid sinus associated with an intramedullary dermoid cyst. After surgery, the dog temporarily declined neurologically but then showed progressive neurological improvement. This report describes presentation and successful surgical treatment of a type IVa dermoid sinus associated with an intramedullary dermoid cyst and spina bifida in a dog.

Comparison of the different supports used in veterinary medicine for pressure sore prevention.

OBJECTIVES: To compare the pressure-relieving capacity of different supports used in veterinary medicine and to find the more common pressure sore locations in laterally recumbent dogs, so as to recommend protocols for decubitus ulcer prevention. MATERIALS AND METHODS: We compared the support properties of: (1) blankets on the floor, (2) a standard mattress, (3) a veterinary memory foam mattress and (4) a human medicine memory foam mattress. Three cadaver dogs with different body condition scores but similar sizes were positioned on the different supports in lateral recumbency. Pressures were measured in each dog and at each support contact point over a 4-hour period using a TexiSense pressure mat. RESULTS: Regardless of the body condition score and the support used, the skin overlying the scapula-humeral articulation, the greater trochanter and the thirteenth rib were the recurrent risk zones. In these risk zones, pressure-relieving mats led to lower pressures than did the standard mats or the blanket placed on the floor. The contact pressures appeared to depend on body condition score, with maximal pressures observed in thin dogs. CLINICAL SIGNIFICANCE: It is important to use a pressure-relieving mat to reduce the risk of pressure sores, but static pressure-relieving mats are generally insufficient to maintain safe pressures in risk zones (<60 mmHg), particularly in thin patients, and so frequent changes in position are recommended.

Incidence of Abnormalities of the Second and Third Cervical Vertebral Junction in Dogs with Atlantoaxial Instability: A Multicentre Study.

Objective To evaluate the occurrence and frequency of abnormalities at the second and third cervical vertebral junction (C2/3) in dogs with and without atlantoaxial instability (AAI). Study Design Retrospective multi-institutional case-controlled case series. Animals One hundred and seventeen dogs with AAI and 117 dogs without AAI. Methods Radiographs, together with computer tomographic images or magnetic resonance images or both, of the cranial cervical spine of dogs were reviewed for the presence or absence of intervertebral disc-related anomalies, osseous fusion of the vertebrae, spondylosis, or any other anomaly of the C2/3. Results The incidence of anomalies affecting the C2/3 in dogs with AAI was 38.46% (n = 45) and in the control group it was 11.97% (n = 14). The majority of the observed anomalies involved the intervertebral disc. In conjunction with AAI, intervertebral disc-related anomalies were noted in 33.34%, spondylosis in 2.56%, osseous fusion in 1.71% and a hypoplasia of the spinous process in 0.85% of the cases. Summarized under the term intervertebral disc-related anomalies, a morphological alteration of the intervertebral disc was noted in 10 cases with AAI, characterized by a spherical outer shape and a minimally reduced size and a dorsal positioning in the intervertebral space. Conclusion There is a significantly higher incidence of anomalies affecting the C2/3 in association with AAI. In conjunction with AAI, intervertebral disc-related anomalies are the most frequent pathological finding affecting the C2/3.

Lateral orbitotomy for treatment of an orbital abscess in a dog.

A two-year-old Jack Russell terrier was diagnosed with a retrobulbar abscess and orbital cellulitis. The diagnosis was confirmed by ultrasound, magnetic resonance imaging examination and ultrasound-guided fine-needle aspiration. Transoral ventral drainage was attempted but was unsuccessful. The abscess was successfully treated by open drainage through a lateral orbitotomy. Despite the exposure of the orbital structures, the orbital soft tissues healed by second intention without further complications. The open drainage was well tolerated and resulted in immediate reduction of inflammation and pain, allowing a quick recovery. This report describes the diagnosis and, surgical management and the long-term (3 years) follow-up of an unusual case of orbital abscess associated with diffuse periorbital cellulitis successfully treated by open drainage through a lateral orbitotomy.

Surgical repair of thoraco-lumbar vertebral fracture-luxations in eight cats using screws and polymethylmethacrylate fixation.

OBJECTIVE: To report our clinical experience in the surgical treatment of feline thoraco-lumbar vertebral fracture-luxations using optimal safe implantation corridors as previously described in vitro. STUDY DESIGN: Retrospective clinical study. MATERIALS AND METHODS: Medical records and radiographs of cats with vertebral fracture-luxations stabilized by screws and polymethylmethacrylate (PMMA) using optimal safe implantation corridors between 2009 and 2011 were reviewed. For each patient the data included: signalment, cause of vertebral fracture-luxations, presence of concurrent injuries, pre- and postoperative neurological grade, surgical treatment, imaging findings, and clinical outcome with short-term (2 weeks) and long-term (12 months) follow-up. RESULTS: Eight cats with vertebral fracture-luxations involving the lumbar (L)(n = 5), the thoracic (T) spinal segments (n = 2), or the thoraco-lumbar junction (n = 1) were included in the study. Screws and PMMA were used bilaterally in five cats and unilaterally in three cats. No surgical intra-operative complications using the defined corridors were recorded. Implant failure followed by spontaneous recovery was recorded in one case. Two cats died in the postoperative period (≤ 4 days). The short-term and long-term clinical outcome was excellent in four out of eight cats and satisfactory in two out of eight cats. CONCLUSION AND CLINICAL RELEVANCE: This pilot study demonstrates the clinical applicability of optimal safe implantation corridors for stabilization of feline thoraco-lumbar vertebral fracture-luxations with screws and PMMA. This technique can be used with limited risks of iatrogenic injuries for stabilization of vertebral fracture-luxation localized between T11-L4.

Elasticity and breaking strength of synthetic suture materials incubated in various equine physiological and pathological solutions.

REASONS FOR PERFORMING STUDY: Selection of suture material in equine surgery is often based on costs or subjective factors, such as the surgeon's personal experience, rather than objective facts. The amount of objective data available on durability of suture materials with regard to specific equine physiological conditions is limited. OBJECTIVES: To evaluate the effect of various equine physiological and pathological fluids on the rate of degradation of a number of commonly used suture materials. STUDY DESIGN: In vitro material testing. METHODS: Suture materials were exposed in vitro to physiological fluid, followed by biomechanical analysis. Three absorbable suture materials, glycolide/lactide copolymer, polyglactin 910 and polydioxanone were incubated at 37°C for 7, 14 or 28 days in phosphate-buffered saline, equine serum, equine urine and equine peritoneal fluid from an animal with peritonitis. Five strands of each suture material type were tested to failure in a materials testing machine for each time point and each incubation medium. Yield strength, strain and Young's modulus were calculated, analysed and reported. RESULTS: For all suture types, the incubation time had a significant effect on yield strength, percentage elongation and Young's modulus in all culture media (P<0.0001). Suture type was also shown significantly to influence changes in each of yield strength, percentage elongation and Young's modulus in all culture media (P<0.0001). While the glycolide/lactide copolymer demonstrated the highest Day 0 yield strength, it showed the most rapid degradation in all culture media. For each of the 3 material characteristics tested, polydioxanone showed the least variation across the incubation period in each culture medium. CONCLUSIONS: The duration of incubation and the type of fluid have significant effects on the biomechanical properties of various suture materials. These findings are important for evidence-based selection of suture material in clinical cases.

Use of preoperative computed tomography for surgical treatment of recurrent draining tracts.

OBJECTIVES: To evaluate a rational decision-making approach based on preoperative computed tomography for surgical planning in dogs and cats with recurrent draining tracts. METHODS: Retrospective evaluation of case records of animals that underwent preoperative computed tomography for surgical treatment of thoracic/abdominal recurrent draining tracts. Cases were classified according to whether a source of inflammation and/or infection, in particular foreign bodies, was identified (group 1), suspected (group 2) or neither identified nor suspected (group 3) at computed tomography. Surgery consisted of removal of the source of inflammation and/or infection (group 1), debridement or abscess drainage (group 2) or en bloc resection of diseased tissues (group 3). Clinical outcome was evaluated at least 12 months after surgery. RESULTS: A source of inflammation and/or infection was found in 100% (8 of 8), 41% (7 of 17) and 25% (3 of 12) of cases in groups 1, 2 and 3, respectively. Recurrent draining tracts resolved in 100% (8 of 8), 94% (16 of 17) and 92% (11 of 12) of cases in groups 1, 2 and 3, respectively. CLINICAL SIGNIFICANCE: The proposed strategy provided a 95% (35 of 37) cure rate, after a single procedure in 81% (30 of 37) of cases. Recovery of a foreign body at surgery was not a prerequisite for the resolution of the recurrent draining tracts.

Radiography and biomechanics of sixth and seventh cervical vertebrae segments after disc fenestration and after insertion of an intervertebral body spacer. A canine cadaveric study.

OBJECTIVES: To study the radiographic characteristics and the biomechanical properties of the sixth and seventh cervical (C6-C7) vertebral motion unit (VMU) with an intact disc, after disc fenestration, and after placement of an intervertebral body spacer (IVBS). METHODS: Six cadaveric C6-C7 VMU were retrieved from six Greyhound cadavers. Each VMU was loaded at 3 Nm of torque sequentially in flexion, extension, and in right and left lateral bending. The range-of-motion (ROM) was measured with a Zebris 3D® system. The intervertebral disc cross-sectional area was measured on lateral and ventro-dorsal radiographs. Biomechanical testing and radiographic measurements were performed with an intact disc, after disc fenestration, and after IVBS placement. Data were reported as mean±SD. RESULTS: The intervertebral disc cross-sectional area was significantly decreased after disc fenestration and increased after IVBS placement, but remained significantly smaller than the area of intact disc in some of the tested conditions. The ROM with an intact disc, after disc fenestration and after IVBS placement, in flexion were 11.5°±1.0, 15.2°±2.3, and 10.9°±4.7, respectively, and in extension were 15.6°±3.7, 24.7°±6.2, 21.9°±4.0, respectively. There was a significant increase in extension ROM after disc fenestration. Intervertebral body spacer placement significantly decreased ROM in flexion but ROM in extension was not different from disc fenestration. No significant changes in lateral bending ROM were detected. CLINICAL SIGNIFICANCE: The use of an IVBS reduced disc space collapse but did not restore stability of the VMU to normal values in extension after cervical disc fenestration.

Computed tomographic study of the optimal safe implantation corridors in feline thoraco-lumbar vertebrae.

OBJECTIVE: To define the implantation corridors in feline thoraco-lumbar vertebrae (T10-L7) using computed tomography (CT) for optimal safe placement of the implants (screws/pins) in spinal column stabilization. STUDY DESIGN: Computed tomographic study. MATERIALS AND METHODS: Computed tomography images of feline spinal column (n = 10) were used to define the optimal safe implantation corridors (OSIC) in the transverse plane. The OSIC were defined as corridors allowing the greatest amount of bone purchase with safe margins for implantation of the bicortical implants. They were characterized by their insertion point, optimal angle (from the midsagital plane), maximum and minimum safe angles (from the same insertion points), length, and width. RESULTS: The OSIC are located within the vertebral bodies. Insertion points were situated at the level of the vertebro-costal joint or the base of the transverse process of the vertebral body for thoracic and lumbar vertebrae, respectively. The mean optimal angle of the OSIC was 90.2° with a maximum deviation angle from optimal angle of 10° dorsally and 8.8° ventrally in thoracic vertebrae, and 90.5° with a maximum deviation angle from the optimal angle of 8.4° dorsally and 7.6° ventrally in lumbar vertebrae. CONCLUSION AND CLINICAL RELEVANCE: Corridors drilled in the vertebral body perpendicular to the midsagital plane (90°) or with a small angle (≤10°) of deviation from the optimal angle provide an optimal safe placement of bicortical implants. However, perpendicular implant placement may not always be feasible due to surrounding soft tissue structures.

In vitro radiographic characteristics and biomechanical properties of the canine lumbar vertebral motion unit after lateral corpectomy, mini-hemilaminectomy and hemilaminectomy.

OBJECTIVE: The purpose of this study was to assess the effect of three surgical procedures (left lateral corpectomy [LC], LC plus mini-hemilaminectomy [LC-MH], and LC plus hemilaminectomy [LC-H]) on the biomechanics and intervertebral collapse of a lumbar vertebral motor unit (VMU). METHODS: Six canine cadaveric first and second lumbar vertebrae (L1-L2) VMU were retrieved. Range-of-motion (ROM) was measured while a custom-built mechanical simulator applied 3 Nm torque in lateral bending, flexion and extension to the intact VMU and following the three surgical procedures (LC, LC-MH, LC-H) performed sequentially. Radiographs were taken with and without 3 kg axial compression at each step. RESULTS: Left lateral corpectomy and LC-MH significantly increased the ROM in left lateral bending and total lateral bending. A LC-H significantly increased the ventral, left, right, total lateral, and total dorsoventral ROM. Significant intervertebral collapse was observed after LC-H with and without axial compression, and after LC and LC-MH, but only with axial compression. CLINICAL SIGNIFICANCE: A LC induces significantly increased ROM in lateral bending to the side of the surgery and in total lateral ROM. Extending the LC to a LC-MH does not change the spinal column stability compared to LC alone, while it provides better access to the spinal canal. The LC-H further destabilizes the VMU. The finding of intervertebral collapse following these surgical procedures confirms the importance of the intervertebral disc and articular facet in the maintenance of spatial integrity.

Anatomical and safety considerations in establishing portals used for canine elbow arthroscopy.

OBJECTIVES: To describe the relationship of the major muscular, ligamentous and neurovascular structures in relation to standard medial elbow arthroscopic portals used in dogs, and to evaluate their potential iatrogenic lesions. DESIGN: Anatomical study using 20 canine cadaveric elbows. METHODS: Arthroscopic explorations were performed using medial portals. Three 4 mm orthopaedic pins were introduced in place of the arthroscope, egress canula and instrumental portals. Limbs were dissected. Distances between pins and neurovascular structures were measured. Muscle, ligament and cartilage lesions were recorded. RESULTS: Minimal muscular lesions were observed. No ligament injury was evidenced. Superficial iatrogenic cartilage lesions were observed in three joints. The arthroscopic portal was 23.1 mm (range: 16 to 28.5 mm) caudal to the brachial artery, 21.0 mm (13-30.5 mm) caudal to the median nerve, and 4.0 mm (1-7 mm) cranial to the ulnar nerve. The instrumental portal was 16.3 (9-24 mm) caudal to the brachial artery, 13.5 mm (7-24.5 mm) caudal to the median nerve, and 11.8 (8-18 mm) cranial to the ulnar nerve. The egress portal was 21.4 mm (12-37 mm) caudal to the ulnar nerve. CONCLUSIONS AND CLINICAL RELEVANCE: The study confirmed the safety of elbow medial arthroscopic portals. Care must be taken when placing the camera portal so as to avoid injury of the ulnar nerve. Should extensive intra-articular procedures be needed, manipulation of instruments should be done cautiously in the cranio-medial compartment of the joint due to the proximity of the median nerve to the capsule.

Retrograde placement of a novel 3.5 mm titanium interlocking nail for supracondylar and diaphyseal femoral fractures in cats.

Twenty-four simple or comminuted supracondylar and diaphyseal femoral fractures in cats, which had been treated by retrograde insertion of a new 3.5 mm titanium interlocking nail (IN) from the intercondylar notch, were evaluated between June 2000 and October 2004 at the Ecole Nationale Vétérinaire d'Alfort. Patient data (species, breed, weight, and age), fracture characteristics, details of the surgery, post-operative complications and radiographic follow-up were recorded. The mean body weight was 3.75 kg and the cats ranged in age between four and 66 months (mean 29 months). The IN had a diameter of 3.5 mm and a length of 100, 109 or 119 mm, and were all fixed in a static position (two screws in seven cats, three screws in 10 cats and four screws in seven cats). Cerclage wires were used in seven cats and an autogenous bone graft was used in two cats. Screw or nail breakage were not recorded. Nineteen fractures healed without any complications, three cats died during the post-operative period from unknown causes, and two cats showed delayed bone healing. Twenty cats were considered to have an excellent limb function at one month. One cat with a sciatic injury was non-weight bearing for several months. Radiographic signs of degenerative joint disease of the stifle joint were not observed except in the cat with the sciatic nerve injury. The results of this study suggest that this new 3.5 mm titanium IN can be introduced from the intercondylar notch and be used in static fixation mode to stabilize supracondylar and diaphyseal femoral fractures in cats.

Surgical treatment of a vertebral fracture associated with a haematogenous osteomyelitis in a dog.

A seven-month-old Rottweiler was referred for a diagnosed femoral neck fracture and a suspected vertebral fracture. The simplified neurological examination revealed an acute paraplegia. A discospondyilitis associated with a pathologic fracture of Th11 and a spinal compression, and a haematogenous epiphysitis of the femoral neck were diagnosed based on radiographic and computed tomographic examinations. The vertebral fracture was stabilised using screws and polymethylmetacrylate with gentamycin by a lateral intercostal approach. The dog was able to walk seven days later. A femoral head and neck ostectomy was performed two weeks later. Staphylococcus intermedius was isolated from both sites, which confirmed the diagnosis. The dog was treated with cephalexin (30 mg/kg/d) for six weeks. A telephone interview with owners indicated that no more clinical signs were present four months after the second surgery. Discospondylitis associated with haematogenous osteomyelitis has only been reported in two cases. Paraplegia is an unusual clinical presentation for discospondylitis. The lateral approach (which allowed a direct access to the infected site) and the technique (screws associated with antibiotic-impregnated cement) are unique for surgical treatment of discospondylitis. Although applying cement to an infected area may pose a risk, antibiotic-loaded cement is successfully used in the treatment of chronic osteomyelitis in humans.

A new surgical method for the control of the epiphora in dogs: modified parotid duct transposition.

A five-year-old, female, spayed beagle with a history of unilateral epiphora of several months' duration as a result of inadequacy of the lacrimal drainage system was treated successfully with a new surgical method of parotid duct transposition. Data from complete preoperative ophthalmological examination, surgical technique, postoperative treatment, contrast radiography and histological examination were recorded. Absence of complications and complete patency of the stoma at 30 days after surgery confirmed the validity of this new technique. The use of an anatomic duct may be advantageous compared with the current techniques of conjunctivorhinostomy, conjuntivobuccostomy and conjunctival maxillary sinusostomy for the treatment of epiphora in the dogs caused by inadequacy of the lacrimal drainage system.

Inclusion of marbofloxacin in PMMA orthopaedic cement: an in vitro experimental study.

This in vitro experimental study investigated the feasibility for marbofloxacin, a veterinary fluoroquinolone antibiotic, to retain its antibacterial activity after its inclusion in polymethylmethacrylate (PMMA) cement. The assays were conducted on gelose cultures of various types of bacteria isolated from canine spontaneous osteomyelitis. The efficiency of the antibiotics was assessed by using an antibiogram method. Resistance of marbofloxacin to the temperature observed during PMMA polymerization, antimicrobial effect of galenic, useful concentrations and comparison with gentamicin (reference antibiotic for this use) were evaluated. Marbofloxacin retained its antimicrobial activity after being heated to high temperatures reached during polymerization. The more effective galenic form to incorporate into the PMMA monomer was the marbofloxacin powder and the appropriate concentration was 1/40 degrees . In this experiment, marbofloxacin included in PMMA showed a good antimicrobial activity; however this activity was lower than gentamicin added to PMMA on Gram + and Pseudomonas bacteria.Therefore, it seems useful to incorporate marbofloxacin to PMMA cement to treat, or to prevent, osteomyelitis associated with marbofloxacin sensitive bacteria. Nevertheless, the development of a marbofloxacin-PMMA cement requires further evaluation, especially pharmacological, biomechanical and clinical.

Rectovaginal fistula following colectomy with an end-to-end anastomosis stapler for a colorectal adenocarcinoma.

An 11-year-old, female neutered Labrador retriever was presented with a micro-invasive differentiated papillar adenocarcinoma at the colorectal junction. A colorectal end-to-end anastomosis stapler device was used to perform resection and anastomosis using a transanal technique. A rectovaginal fistula was diagnosed two days later. An exploratory laparotomy was conducted and the fistula was identified and closed. Early dehiscence of the colon was also suspected and another colorectal anastomosis was performed using a manual technique. Comparison to a conventional manual technique of intestinal surgery showed that the use of an automatic staple device was quicker and easier. To the authors' knowledge, this is the first report of a rectovaginal fistula occurring after end-to-end anastomosis stapler colorectal resection-anastomosis in the dog. To minimise the risk of this potential complication associated with the limited surgical visibility, adequate tissue retraction and inspection of the anastomosis site are essential.

Cross-neurotization of the caudal brachial plexus with the contralateral C-8 ventral nerve branch in the cat. Potential surgical applications, effects of graft collection on the healthy donor limb and results.

Contralateral transfer of the right, eighth ventral nerve branch (C8) (C8 cross-transfer - C8CT) was performed in 6 adult cats, in which the caudal part of the left brachial plexus (C8 and T1) had been severed, in order to mimic nerve root avulsion. Clinical and electrophysiological parameters, muscle contraction force measurements and histology were used to evaluate the effects of the surgery in a 14- to 36-month follow-up. The right forelimb (donor side) was clinically normal (no lameness) in all the cats at the end of the study. Electromyography performed 14 days after surgery revealed denervation fibrillation potentials in both forelimbs. Fibrillation potentials disappeared in all the cats at the end of the study. Direct stimulation of the right C8 ventral branch induced motor and sensory evoked potentials in the left limb muscles in all the cats. The left to right contraction ratio of the extensor carpi radialis muscle was approximately 1. This experimental study demonstrates that C8CT enables re-innervation of the contralateral brachial plexus and allows the establishment of new functional neuromuscular units. This can in turn enable the restoration of function, and could potentially lead to partial recovery after caudal brachial plexus avulsion in the cat.

Pectus excavatum surgically repaired using sternum realignment and splint techniques in a young cat.

Successful surgical repair of pectus excavatum deformities has so far only been reported in very young animals. This case report describes an alternative technique for repairing pectus excavatum in a young cat. The cat had shown moderate deformity with slight respiratory impairment when young and had experienced clinical problems with age. A sternum realignment technique involving a pin associated with an external splint was used. This alternative technique was a safe and efficient procedure in the five-month-old cat.

Macro- and microanatomical characterization of the cat brachial plexus.

The anatomy of the cat brachial plexus is poorly documented despite its importance for reparative surgery. The present work aims to study the anatomy of the brachial plexus of 20 European cats and to analyze the radicular constituents of 10 of them using histological techniques. The plexus radicular constitution is very homogeneous and is mainly composed of the ventral rami (also called ventral branches) arising from C6, C7, C8 and T1 spinal nerves. The fascicular and axonal structure is more variable. C8 is the ventral ramus that contains the largest number of axons (16,673 +/- 3,307), and is composed of 6.7 +/- 3.5 fascicles. The radial nerve is the peripheral nerve that contains the largest number of axons (11,245 +/- 2,217), and is composed of 7.3 +/- 3.8 fascicles. The number of nervous fibers does not differ proportionally to the weight of the cat, or between the right or the left side. Our data could help neurotization and entubulation repair after brachial plexus injury.

Stereotactic CT-guided brain biopsy in the dog.

This study evaluated the accuracy of a new stereotactic CT-guided brain biopsy (SCTGBB) device on 23 client-owned dogs which presented with a brain lesion. Biopsy of the lesion was achieved in 95 per cent of cases. The target tissue was not sampled in one dog. Complications were observed in six dogs. Two dogs with highly vascularised brainstem tumours died after SCTGBB. Minor complications (slight variation in the neurological status) were observed in a further four cases. A diagnosis was reached in 16 dogs after cytological examination and in 21 dogs after histological evaluation. SCTGBB is an accurate diagnostic method for the diagnosis of brain lesions.