Decompressive craniectomy surgery in a dog with intracranial extradural hematoma following blunt force trauma.

A young miniature poodle was presented following blunt force trauma to the head. The dog initially responded well to medical management before developing clinical signs associated with increased intracranial pressure 48 h post-injury that became refractory to hyperosmolar therapy. A computed tomography scan obtained 76 h post-injury showed a short, oblique, non-displaced, complete fissure in the right temporal bone and a second short, oblique, non-displaced, complete fissure in the ventral aspect of the temporal bone. A biconvex, moderately hyperattenuating, space-occupying temporoparietal lesion was visualized immediately adjacent to the area of the temporal fractures. These findings were consistent with a diagnosis of intracranial extradural hematoma. Decompressive craniectomy successfully evacuated the extradural hematoma to alleviate increased intracranial pressure. The dog's neurologic function recovered quickly postoperatively. At follow-up physical examinations at 14 and 437 d, excellent return to function was noted. Key clinical message: This report describes the diagnosis and surgical management of an intracranial extradural hematoma in a dog with increased intracranial pressure refractory to medical management. Furthermore, this report describes the diagnostic imaging findings used to diagnose this particular form of primary brain injury.

Chirurgie de craniectomie décompressive chez un chien présentant un hématome extradural intracrânien à la suite d'un traumatisme contondant. Un jeune caniche miniature a été présenté à la suite d'un traumatisme contondant à la tête. Le chien a initialement bien répondu à la prise en charge médicale avant de développer des signes cliniques associés à une augmentation de la pression intracrânienne 48 heures après la blessure, qui sont devenus réfractaires au traitement hyperosmolaire. Une tomodensitométrie obtenue 76 heures après la blessure a montré une fissure complète courte, oblique, non déplacée dans l'os temporal droit et une deuxième fissure complète courte, oblique, non déplacée dans la face ventrale de l'os temporal. Une lésion temporo-pariétale biconvexe, modérément hyperatténuée et occupant de l'espace a été visualisée immédiatement à côté de la zone des fractures temporales. Ces résultats concordaient avec un diagnostic d'hématome extradural intracrânien. La craniectomie décompressive a réussi à évacuer l'hématome extradural pour atténuer l'augmentation de la pression intracrânienne. La fonction neurologique du chien s'est rétablie rapidement après l'opération. Lors des examens physiques de suivi à 14 et 437 jours, un excellent retour au fonctionnement a été noté.Message clinique clé:Ce rapport décrit le diagnostic et la prise en charge chirurgicale d'un hématome extradural intracrânien chez un chien présentant une augmentation de la pression intracrânienne réfractaire à la prise en charge médicale. En outre, ce rapport décrit les résultats de l'imagerie diagnostique utilisée pour diagnostiquer cette forme particulière de lésion cérébrale primaire.(Traduit par Dr Serge Messier).

Cricopharyngeal and thyropharyngeal myectomy for management of cricopharyngeal achalasia in a 6-month-old coton de Tulear dog.

A 6-week-old intact female coton de Tulear dog presented to a veterinary teaching hospital (VTH) internal medicine service for dysphagia that was persistent since birth. The patient was diagnosed with cricopharyngeal achalasia based on a fluoroscopic swallow study. To facilitate surgical intervention, a percutaneous endoscopic gastrostomy (PEG) tube was placed to bypass the upper esophageal sphincter and provide nutritional support until the dog was larger. At 6 mo of age, the dog underwent unilateral cricopharyngeal and thyropharyngeal myectomy. Marked improvement in dysphagia was noted immediately postoperatively. Improvement in dysphagia persisted in this dog, with continued marked improvement in clinical signs noted 1 y postoperatively. Key clinical message: Cricopharyngeal achalasia can be successfully managed with surgical intervention with a good long-term prognosis. Before surgical intervention, nutritional support is of critical importance. A combined procedure of cricopharyngeal and thyropharyngeal myectomy may be associated with outcomes superior to those of alternative procedures.

Myectomie cricopharyngée et thyropharyngée pour prise en charge de l'achalasie cricopharyngée chez un chien coton de Tuléar âgé de 6 mois. Une chienne coton de Tuléar femelle intacte âgée de 6 semaines a été présentée au service de médecine interne d'un CHU vétérinaire pour une dysphagie persistante depuis la naissance. Le patient a reçu un diagnostic d'achalasie cricopharyngée sur la base d'une étude fluoroscopique de la déglutition. Pour faciliter l'intervention chirurgicale, un tube de gastrostomie endoscopique percutanée (PEG) a été placé pour contourner le sphincter supérieur de l'oesophage et fournir un soutien nutritionnel jusqu'à ce que le chien soit plus gros. À l'âge de 6 mois, le chien a subi une myectomie cricopharyngée et thyropharyngée unilatérale. Une nette amélioration de la dysphagie a été notée immédiatement après l'opération. L'amélioration de la dysphagie a persisté chez ce chien, avec une amélioration continue et marquée des signes cliniques notée 1 an après l'opération.Message clinique clé :L'achalasie cricopharyngée peut être gérée avec succès par une intervention chirurgicale avec un bon pronostic à long terme. Avant l'intervention chirurgicale, le soutien nutritionnel est d'une importance cruciale. Une procédure combinée de myectomie cricopharyngée et thyropharyngée peut être associée à des résultats supérieurs à ceux des procédures alternatives.(Traduit par Dr Serge Messier).

Laparoscopic ovariectomy in 2 queens with uterine unicornis.

Two unrelated queens were presented for persistent signs of estrus despite a history of ovariohysterectomy. Uterine unicornis was suspected based on historical surgical findings. Anti-Müllerian hormone testing was consistent with the presence of ovarian tissue in both queens. Based on the ultrasonographic confirmation of unilateral abnormal structures in the ovarian region and ipsilateral absence of the kidney, a laparoscopic surgical approach was performed on each queen to remove remnant ovarian tissue. Laparoscopy confirmed the absence of a kidney ipsilateral to the remnant ovarian tissue. Both cats recovered from surgery and displayed no further signs of estrus. Key clinical message: To our knowledge, these are the first reported cases of feline uterine unicornis treated with a laparoscopic surgical approach. This minimally invasive approach, preceded by a thorough diagnostic work-up, may be of benefit to future queens with uterine unicornis. In addition, anti-Müllerian hormone testing has not been well-described in the literature when used in cats with remnant ovarian tissue. These cases may be of value to clinicians discovering the absence of a uterine horn when performing an ovariohysterectomy on queens.

Résumé ­ Ovariectomie laparoscopique chez deux chattes avec un utérus unicorne. Deux chattes non apparentées ont été présentées pour des signes persistants d'oestrus malgré des antécédents d'ovariohystérectomie. Un utérus unicorne a été suspecté sur la base des résultats chirurgicaux antérieurs. Un test d'hormone anti-müllérienne était compatible avec la présence de tissu ovarien chez les deux chattes. Sur la base de la confirmation échographique des structures anormales unilatérales dans la région ovarienne et de l'absence ipsilatérale du rein, une approche chirurgicale laparoscopique a été réalisée sur chaque chatte pour retirer le tissu ovarien restant. La laparoscopie a confirmé l'absence d'un rein ipsilatéral au tissu ovarien résiduel. Les deux chattes se sont remises de la chirurgie et n'ont montré aucun autre signe d'oestrus.Message clinique clé:À notre connaissance, ce sont les premiers cas rapportés d'utérus unicorne félin traités par une approche chirurgicale laparoscopique. Cette approche peu invasive, précédée d'un bilan diagnostique approfondi, peut être bénéfique pour les futures chattes atteintes d'utérus unicorne. De plus, le test d'hormone anti-müllérienne n'a pas été bien décrit dans la littérature lorsqu'il est utilisé chez des chats avec du tissu ovarien résiduel. Ces cas peuvent être utiles aux cliniciens qui découvrent l'absence de corne utérine lors de la réalisation d'une ovariohystérectomie sur des chattes.(Traduit par Dr Serge Messier).

Treatment and outcomes of five dogs with intrathoracic migration of porcupine quills.

OBJECTIVE: To describe the perioperative findings and outcomes in dogs that underwent exploratory thoracotomy following porcupine quill migration and report (1) the use of traction alone for the removal of superficial quills in the pulmonary parenchyma, and (2) the use of exploratory pericardiotomy for the incidental identification of cardiac quills. ANIMALS: Five client-owned dogs. STUDY DESIGN: Short case series. METHODS: Medical records of dogs with pneumothorax or pericardial effusion secondary to porcupine quill migration from January 2019 to January 2022 were reviewed. Advanced imaging and a median sternotomy were performed in each dog. Demographics, preoperative findings, surgical treatment, and outcome were recorded. RESULTS: Pulmonary quills were treated with gentle traction or lung lobectomy. The intraoperative palpation or appearance of the pericardium prompted pericardiotomy in three dogs, exposing epicardial and intravascular quills. No evidence of these quills was detected on preoperative advanced imaging or on gross appearance of the pericardium. Quills were removed with a combination of gentle traction, purse-string sutures, and mattress sutures. Pneumothorax and pericardial effusion resolved postoperatively in all dogs. All dogs survived to discharge. CONCLUSION: Traction allowed removal of quills that were superficially attached to the pulmonary parenchyma without the need for subsequent lobectomy. Epicardial and myocardial quills were detected following pericardiotomy in three dogs despite the absence of quills grossly penetrating the pericardium. Preoperative imaging did not allow consistent detection of quills.

Modified balloon-catheter-assisted closed anal sacculectomy in the dog: Description of surgical technique.

The aim of this report is to describe a modified Foley catheter technique for anal sacculectomy. A standard approach used for a closed anal sacculectomy was performed. The duct of the anal sac was then freed from the surrounding tissues and ligated. The duct was transected lateral to the ligature and a purse string suture placed. The anal sac balloon catheter was inserted through the duct into the anal sac and the purse string was tightened. Once inflated, the catheter was then used as a handle to facilitate manipulation and dissection of the anal sac from surrounding tissues. This technique permits circumferential dissection of the anal sac with good visualization, accuracy, and control, especially at the medial portion of the anal sac adjacent to the rectum. This technique can be considered for application to cases of chronic anal sacculitis and small anal gland adenocarcinomas.

Sacculectomie anale fermée assistée par ballon cathéter modifié chez le chien : description de la technique chirurgicale. Le but de ce rapport consistait à décrire une technique de cathéter de Foley modifiée pour la sacculectomie anale. Une approche standard utilisée pour une sacculectomie anale fermée a été réalisée. Le canal du sac anal a ensuite été libéré des tissus environnants et ligaturé. Une dissection transversale du canal a été effectuée latéralement à la ligature et une suture en cordon de bourse a ensuite été réalisée. Le ballon cathéter du sac anal a été inséré par le canal du sac anal et le cordon de bourse a été resserré. Une fois gonflé, le cathéter a ensuite été utilisé comme une poignée pour faciliter la manipulation et la dissection du sac anal des tissus environnants. Cette technique permet la dissection circonférentielle du sac anal avec une bonne visualisation, de l'exactitude et du contrôle, particulièrement à la portion médiale du sac anal adjacent au rectum. Cette technique peut être considérée pour application à des cas de sacculite anale chronique et à de petits adénocarcinomes des glandes anales.(Traduit par Isabelle Vallières).

Effects of the use of silver-coated urinary catheters on the incidence of catheter-associated bacteriuria and urinary tract infection in dogs.

OBJECTIVE To determine the effects of silver-coated versus standard silicone urinary catheters on the incidence of catheter-associated bacteriuria (CAB) and catheter-associated urinary tract infection (CAUTI) in dogs. DESIGN Randomized controlled clinical trial. ANIMALS 36 dogs requiring urinary bladder catheterization for ≥ 24 hours. PROCEDURES Dogs were randomly assigned to receive a silver-coated or non-silver-coated (control) silicone Foley catheter. Urine samples for cytologic examination and bacterial culture were collected at the time of catheter insertion and daily until catheters were removed (≥ 24 hours to 7 days later). Results were compared between groups. RESULTS No significant differences were identified between catheter groups in the incidence of CAB or CAUTI. Although the median time to development of cytologically detected bacteriuria, culture-detected bacteriuria, and CAUTI did not differ significantly between groups, median time to CAB development (either method) was significantly longer for dogs that received a control catheter rather than a silver-coated catheter. For both types of catheters combined, older age was a significant predictor of culture-detected bacteriuria, and longer duration of catheterization was a significant predictor of culture-detected bacteriuria and overall CAB. CONCLUSIONS AND CLINICAL RELEVANCE Silver-coated urinary catheters provided no clinical benefit over standard urinary catheters for the dogs of this study and were associated with earlier development of CAB but not CAUTI. A larger prospective study is required to definitively determine whether the use of silver-coated urinary catheters should or should not be considered to reduce the risk of CAB or CAUTI in dogs.

Influence of orthopedic reinforced gloves versus double standard gloves on contamination events during small animal orthopedic surgery.

OBJECTIVE: To determine the influence of orthopedic reinforced gloves on contamination events during small animal orthopedic surgery. STUDY DESIGN: Prospective randomized controlled trial SAMPLE POPULATION: Two hundred and thirty-seven pairs of orthopedic gloves (474 gloves) and 203 pairs of double standard gloves (812 gloves) worn during 193 orthopedic procedures. METHODS: Primary and assistant surgeons were randomized to wear either orthopedic reinforced gloves or double gloves. Gloves were leak tested to identify perforations at the end of procedures. Perforations detected intraoperatively or postoperatively were recorded. A contamination event was defined as at least one perforation on either hand for orthopedic reinforced gloves, or a perforation of both the inner and outer glove on the same hand for double gloves. RESULTS: Baseline characteristics between the 2 intervention groups were similar. There was no difference in contamination events between the double-gloved and orthopedic gloved groups (OR = 0.95, 95% CI = 0.49-1.87, P = .89). The same percentage of contamination events (8% glove pairs used) occurred in the double gloved group (17 contamination events) and in the orthopedic gloved group (19 contamination events). The odds of a contamination event increased by 1.02 (95% CI 1.01-1.03, P < .001) with each additional minute of surgery. CONCLUSION: Orthopedic reinforced gloves and double standard gloving were equally effective at preventing contamination events in small animal orthopedic procedures. CLINICAL RELEVANCE: Surgeons reluctant to double glove due to perceptions of decreased dexterity and discomfort may safely opt for wearing orthopedic gloves, which may improve their compliance.

Perioperative characteristics of dogs undergoing open versus laparoscopic-assisted cystotomy for treatment of cystic calculi: 89 cases (2011-2015).

OBJECTIVE To compare perioperative characteristics of dogs with cystic calculi treated via open versus laparoscopic-assisted cystotomy (LAC). DESIGN Retrospective case series. ANIMALS 89 client-owned dogs that underwent open cystotomy (n = 39) or LAC (50). PROCEDURES Medical records of dogs that underwent cystotomy between 2011 and 2015 were reviewed. History, signalment, surgery date, results of physical examination, results of preoperative diagnostic testing, details of surgical treatment, duration of surgery, perioperative complications, treatment costs, and duration of hospitalization were recorded. RESULTS 5 of 50 (10%) dogs required conversion from LAC to open cystotomy (OC). There was no significant difference between the LAC (1/50) and OC (2/39) groups with regard to percentage of patients with incomplete removal of calculi. Duration of surgery was not significantly different between the LAC (median, 80 min; range, 35 to 145 min) and OC (median, 70 min; range, 45 to 120 min) groups. Postoperative duration of hospitalization was significantly shorter for dogs that underwent LAC (median, 24 hours; range, 12 to 48 hours) versus OC (median, 26 hours; range, 12 to 63 hours). Surgical and total procedural costs were significantly higher for patients undergoing LAC. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that LAC may be an acceptable minimally invasive technique for treatment of cystic calculi in dogs. Surgery times were similar to those for dogs undergoing OC; however, surgical and total procedural costs were higher. Further investigation is suggested to determine which patients may benefit from LAC versus traditional OC.

Long-Term Outcome and Complications Following Prophylactic Laparoscopic-Assisted Gastropexy in Dogs.

OBJECTIVE: To characterize the short- and long-term outcome (>12 months), complications, and owner satisfaction following prophylactic laparoscopic-assisted gastropexy (LAG) in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n = 49). METHODS: Dogs that underwent prophylactic LAG at 2 veterinary academic hospitals were studied. Surgical time, anesthesia time, concurrent intra- and extra-abdominal procedures, and intraoperative and postoperative complications were recorded following review of medical records. Veterinarian and/or owner follow-up was obtained to determine outcome and satisfaction with LAG. RESULTS: Five of 49 dogs (10%) experienced complications related to abdominal access during LAG. Four percent (2/49) of dogs experienced an intraoperative complication. Follow-up information was available for 89% of dogs (44/49). Four dogs died of causes unrelated to LAG or gastric dilatation volvulus (GDV) in the follow-up period. Two dogs experienced major postoperative complications requiring additional veterinary intervention. Thirty percent (13 dogs) experienced a minor postoperative self-limiting wound-related complication. Median follow-up time was 698 days (range, 411-1825). No dogs experienced GDV. One hundred percent of dog owners were satisfied with LAG, would repeat the procedure in a future pet, and would recommend the procedure to a friend or family member. CONCLUSION: LAG was an effective procedure for prevention of GDV and was associated with high client satisfaction in this cohort of dogs. A moderate rate of postoperative wound complications occurred that were minor and self-limiting in nature.

In vitro evaluation of the impact of silver coating on Escherichia coli adherence to urinary catheters.

A silver-coated urinary catheter was compared to a non-silver-coated urinary catheter for the ability to reduce adherence of 6 isolates of Escherichia coli. Catheters were incubated with E. coli strains for 0, 24, 48, and 72 h. Broth was sampled at all time points to determine CFU/mL. Catheters were subjected to sonication to determine adhered bacteria at all time points, and scanning electron microscopy (SEM) to semi-quantitatively assess biofilm formation. Silver-coated catheters had significantly less adhered bacteria than non-silver-coated catheters at times 24, 48, and 72 h. Subjectively, silver-coated urinary catheters had less biofilm formation than non-silver-coated urinary catheters as assessed by SEM. Silver coating of catheters was associated with reduced adherence of E. coli in an in vitro evaluation. Testing of catheters in dogs in vivo is required to determine if there is a reduction in catheter-associated urinary tract infections.

Évaluationin vitrode l'impact de l'argenture sur l'adhérence d'Escherichia coliaux cathéters urinaires. Un cathéter urinaire revêtu d'argent a été comparé à un cathéter urinaire non revêtu d'argent pour la capacité de réduire l'adhérence de 6 isolats d'Escherichia coli. Les cathéters ont été incubés avec des souches d'E. coli pendant 0, 24, 48 et 72 heures. Le liquide a été échantillonné à toutes les heures déterminées afin de déterminer le nombre d'unités formatrices de colonies par mL (UFC/mL). Les cathéters ont été soumis à une sonication, pour confirmer la présence des bactéries adhérées à toutes les heures déterminées, et à une microscopie par balayage afin d'évaluer semi-quantitativement la formation de biofilm. Les cathéters revêtus d'argent présentaient un nombre significativement réduit de bactéries adhérées par rapport aux cathéters non revêtus d'argent aux heures 24, 48 et 72. Subjectivement, les cathéters urinaires revêtus d'argent présentaient une formation inférieure de biofilm par rapport aux cathéters urinaires non revêtus d'argent tels qu'évalués lors d'une microscopie par balayage. L'argenture des cathéters a été associée à une adhérence réduite d'E. coli dans une évaluation in vitro. Des essais des cathéters dans des chiens in vivo sont requis afin de déterminer s'il y a une réduction des infections des voies urinaires associées aux cathéters.(Traduit par Isabelle Vallières).

Protothecosis in a dog.

A case of a disseminated algal infection is reported in a young rough-coated collie dog with progressive neurologic deficits, blindness, and hemorrhagic diarrhea. Prototheca zopfii organisms were cultured from feces, urine, and blood. At necropsy, granulomas containing typical organisms were identified within the proximal colon, heart, kidneys, and eyes.

Protothécose chez un chien. Un cas d'infection algoïde est signalé chez un jeune chien Collie à poil court avec des troubles neurologiques progressifs, de la cécité et de la diarrhée hémorragique. Des organismes de type Prototheca zopfii ont été cultivés à partir des fèces, de l'urine et du sang. À la nécropsie, des granulomes contenant des organismes typiques ont été identifiés dans le côlon proximal, le cœur, les reins et les yeux.(Traduit par Isabelle Vallières).