Evaluation of short- and long-term complications after endoscopically assisted gastropexy in dogs.

OBJECTIVE: To determine short- and long-term complications in clinically normal dogs after endoscopically assisted gastropexy. DESIGN: Prospective case series. ANIMALS: 24 dogs. PROCEDURES: Endoscopically assisted gastropexy was performed on each dog. Dogs were evaluated laparoscopically at 1 or 6 months after surgery to assess integrity of the gastropexy. Long-term outcome was determined via telephone conversations conducted with owners > or = 1 year after surgery. RESULTS: Mean +/- SD gastropexy length was 4.5 +/- 0.9 cm, and mean duration of surgery was 22 +/- 5 minutes. One dog had a partially rotated stomach at the time of insufflation, which was corrected by untwisting the stomach with Babcock forceps. Two dogs vomited within 4 weeks after surgery, but the vomiting resolved in both dogs. Four dogs had diarrhea within 4 weeks after surgery, which resolved without medical intervention. In all dogs, the gastropexy site was firmly adhered to the abdominal wall at the level of the pyloric antrum. Long-term follow-up information was available for 23 dogs, none of which had any episodes of gastric dilatation-volvulus a mean of 1.4 years after gastropexy. CONCLUSIONS AND CLINICAL RELEVANCE: Endoscopically assisted gastropexy can be a simple, fast, safe, and reliable method for performing prophylactic gastropexy in dogs. At 1 and 6 months after gastropexy, adequate placement and adhesion of the gastropexy site to the body wall was confirmed. Such a procedure could maximize the benefits of minimally invasive surgery, such as decreases in morbidity rate and anesthetic time. This technique appeared to be suitable as an alternative to laparoscopic-assisted gastropexy.

Outcome of permanent tracheostomy for treatment of upper airway obstruction in cats: 21 cases (1990-2007).

OBJECTIVE: To determine clinical outcome of permanent tracheostomy in cats with upper airway obstruction. DESIGN: Retrospective case series. ANIMALS: 21 cats. PROCEDURES: Medical records were reviewed for information on history, signalment, clinical signs, results of preoperative clinicopathologic testing, cause of upper airway obstruction, surgical procedure, postoperative complications, and outcome. RESULTS: Causes of upper airway obstruction included neoplasia (squamous cell carcinoma [n = 6] or malignant lymphoma [2]), inflammatory laryngeal disease (5), laryngeal paralysis (4), trauma (3), and a laryngeal mass of unknown cause (1). Fourteen cats had dyspnea in the immediate postoperative period; dyspnea most often resulted from mucous plugs at the stoma or elsewhere in the respiratory tract. Eleven cats died, including 6 cats that died while hospitalized after surgery and 5 cats that died after discharge; 7 cats were euthanatized, most often because of progression of neoplasia; and 2 were still alive at the time of the study. The remaining cat was lost to follow-up after discharge from the hospital. Overall, median survival time for the 20 cats for which information was available was 20.5 days (range, 1 day to 5 years). Cats that underwent permanent tracheostomy because of inflammatory laryngeal disease were 6.61 times as likely to die as cats that underwent permanent tracheostomy for any other reason. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that permanent tracheostomy was an uncommon procedure in cats with upper airway obstruction that was associated with high complication and mortality rates.

In vitro expansion patterns of ameroid ring constrictors.

OBJECTIVE: To evaluate and quantify in vitro dimensional changes of ameroid ring constrictors (ARCs) with and without the outer stainless steel ring in place over time. SAMPLE POPULATION: 12 ARCs (5.0-mm diameter). PROCEDURES: 6 ARCs were immersed in canine plasma baths for 34 days without the stainless steel outer ring in place (group N), and 6 ARCs were immersed in canine plasma baths with the stainless steel outer ring in place (group R). The ARCs were digitally imaged at day 0, daily for the first 10 days, then on days 14, 20, 27, and 34. Inner diameter, outer diameter, luminal area, and height were measured for each time point. Volume and weight of rings were obtained at the start and completion of the study. RESULTS: The inner diameter, outer diameter, and luminal area were significantly different between the 2 groups over the course of 34 days. The inner diameter and luminal area of the R-group constructs did not change significantly, while the inner diameter, outer diameter, luminal area, and height of N-group constructs all significantly increased over the course of the study. CONCLUSIONS AND CLINICAL RELEVANCE: R-group constructs had insignificant centripetal swelling without ring closure, whereas N-group constructs had significant generalized centrifugal expansion. Results of this study indicated that the outer stainless steel ring of an ARC may not be necessary for attenuation and closure of some single extrahepatic portosystemic shunts.

Evaluation of an endoscopically assisted gastropexy technique in dogs.

OBJECTIVE: To evaluate the use of endoscopy in conjunction with a gastropexy technique in dogs as a potential means to aid prevention of gastric dilatation-volvulus. ANIMALS: 12 healthy adult medium- and large-breed dogs. PROCEDURES: 12 adult research dogs that had no abnormal physical examination findings each underwent an endoscopically assisted gastropexy procedure. On completion of the procedure, the dogs were euthanized and exploratory laparotomies were performed to evaluate the surgical site. Data recorded included anatomic location of the gastropexy, gastropexy length, and duration of procedure as well as any complications. RESULTS: Mean+/-SD gastropexy length was 3.3+/-0.25 cm, and mean duration of surgery was 18+/-7 minutes. In each dog, the stomach was located in its normal anatomic position and all gastropexies were sutured to the abdominal wall at the level of the pyloric antrum. The only complications during the procedure were needle bending and breakage at the time of stay suture placement. CONCLUSIONS AND CLINICAL RELEVANCE: On the basis of these findings, it appears that endoscopically assisted gastropexy is a simple, fast, safe, and reliable method of performing a prophylactic gastropexy in dogs when undertaken by a person who is skilled in endoscopy. Such a procedure maximizes the benefits of decreased morbidity and shorter duration of anesthesia associated with minimally invasive surgery. Further clinical studies are warranted to evaluate the long-term efficacy of this procedure in dogs at risk for development of gastric dilatation-volvulus.

Clinical outcomes of 30 cases (1997-2004) of canine gastrointestinal lymphoma.

In 30 cases of canine gastrointestinal lymphoma, each case was localized to the stomach, small intestine, large intestine, or two or more sites. Treatments consisted of surgery alone (n=4), surgery with chemotherapy (n=8), chemotherapy alone (n=15), or supportive care (n=3). Four dogs died, 24 were euthanized, and two are currently alive. Median survival time for all cases was 13 days. In both surviving dogs, the site of lymphoma was the large intestine. Canine gastrointestinal lymphoma is a severe disease that warrants a poor to grave prognosis. However, cases of colorectal origin may have longer survival times.

Evaluation of the effects of ischemic injury and ureteral obstruction on delayed graft function in cats after renal autotransplantation.

OBJECTIVE: To determine the relative importance of ischemic injury to delayed graft function (DGF) in cats. STUDY DESIGN: Experimental study. ANIMALS: Six intact female cats. METHODS: Cats had renal autograft transplantation without ureteral transection and reimplantation and a contralateral nephrectomy. Serum creatinine and blood urea nitrogen (BUN) concentrations were measured regularly and abdominal ultrasound was performed before surgery, the day after surgery and twice weekly thereafter. Ultrasound-guided renal biopsy was performed on day 7. Cats were euthanatized on day 21. Histology of the autograft, ureter, bladder, vascular anastomoses sites, and contralateral kidney were performed. Observations were compared with those from an historic group of research cats that had extravesicular ureteroneocystostomy and contralateral nephrectomy. RESULTS: Five cats completed the study. Serum creatinine and BUN concentrations increased after surgery, peaking at 3.2+/-0.8 and 77.6+/-15.9 mg/dL, respectively, 1-2 days after surgery. Serum creatinine concentration returned to the reference interval by 6 days after surgery. BUN gradually decreased in all cats but did not return to the reference interval by study end. Serum creatinine and BUN concentrations were consistently lower but not significantly so (P=.29 and .56, respectively) compared with the historic ureteroneocystostomy group. No ultrasonographic abnormalities or renal biopsy histologic abnormalities were observed. At necropsy, 1 autograft had generalized interstitial fibrosis. CONCLUSION: Harvesting the renal graft and the ischemia before revascularization causes impaired renal function after engraftment. CLINICAL RELEVANCE: The process of harvesting and reimplanting the renal graft can contribute to DGF in cats, independent of ureteral obstruction.

Use of rheolytic thrombectomy in the treatment of feline distal aortic thromboembolism.

The purpose of this prospective clinical trial was to evaluate the safety and efficacy of a commercially available rheolytic thrombectomy system in the treatment of naturally occurring feline aortic thromboembolic disease. All 6 cats enrolled in the investigation were affected at the level of the distal aorta and had signs of the disease affecting both pelvic limbs. Cats were anesthetized and an arteriotomy was performed on 1 carotid artery to gain access to the arterial system. Selective arterial angiography was used to confirm the presence of thromboembolic disease. The thrombectomy system was advanced to the level of the thrombus using fluoroscopic guidance. Repeat angiography was used intermittently to assess progress of thromboembolus dissolution throughout the procedure. The use of the rheolytic thrombectomy system resulted in successful thrombus dissolution in 5 of 6 cats. Three of 6 cats survived to discharge. Both of these results compare favorably with conventional therapies used in the treatment of this disease. Feline distal aortic thromboembolism is a frustrating disease that warrants a guarded to poor prognosis. Rheolytic thrombectomy may provide veterinarians with an alternative therapy in the treatment of thromboembolic diseases, including feline distal aortic thromboembolism.

Multiple endocrine neoplasia type I in a cat.

A 13-year-old 4.6-kg (10.2-lb) neutered male domestic long hair cat was evaluated because of a history of lethargy, exercise intolerance, and ventroflexion of the cervical portion of the vertebral column. After extensive assessment at the Veterinary Teaching Hospital at Michigan State University, the clinical signs were attributed to an aldosterone-secreting tumor of the adrenal gland. Subsequently, an insulin-secreting tumor of the pancreas as well as a functional parathyroid gland adenoma were diagnosed. All 3 masses were surgically removed, and the cat made a full recovery with complete resolution of clinical signs. The syndrome of multiple endocrine neoplasia is well described in humans, and the heritability of the condition has been confirmed. In cats and other species with 1 or more endocrine neoplasms, it is important to perform thorough clinical assessments of patients to identify other endocrine organs that may also be affected concurrently with neoplastic disease.

Evaluation of the effect of routine histologic processing on the size of skin samples obtained from dogs.

OBJECTIVE: To determine the effects that routine histologic processing has on the dimensions of samples of normal skin of dogs and assess whether the inclusion of a muscle or fascial layer in such samples alters those effects. SAMPLE POPULATION: Skin samples obtained from 6 medium-sized adult dogs with grossly normal skin. PROCEDURE: From each dog, skin samples (with or without underlying fascia or muscle) were obtained from 3 sites bilaterally (6 samples/dog) and processed routinely for histologic evaluation; their dimensions were measured at intervals during the experiment. RESULTS: As a result of processing, skin samples decreased in size (combined percentage change in length and width) and increased in thickness, compared with their original dimensions. Samples without fascia or muscle decreased in size by 21.1% to 32.0% and increased in thickness by 45.1 % to 75.8%. The site of sample origin influenced processing-associated changes in sample size but did not affect the change in thickness. Decreases in dimensions did not vary with inclusion of fascia but did vary with inclusion of muscle. The change in thickness did not vary with inclusion of a layer of fascia or muscle. CONCLUSIONS AND CLINICAL RELEVANCE: Processing of skin samples obtained from dogs for histologic evaluation can cause changes in sample dimensions; samples may decrease in length and width by as much as 32% and increase in thickness by 75.8%, compared with their original dimensions. The presence of muscle in canine skin samples can restrict the amount of shrinkage in length or width associated with processing.

Unusual urethral calculi in two male dogs.

The clinical presentation and advanced size of the two calculi described in this report are both atypical and noteworthy. Both dogs were presented initially with signs of hematuria, stranguria, and perineal discomfort. Each calculus was visible on survey abdominal radiographs and was present in the region of the ischial arch. Both dogs underwent a perineal urethrotomy to retrieve the calculus. Resolution of clinical signs was obtained in one case, which was referred within 2 months of the onset of clinical signs. The second dog was medically managed for approximately 2.5 years before referral. Surgical intervention failed to restore urinary continence in this second dog. Early detection of similar cases may be important in optimizing clinical outcome following appropriate treatment.

Long-term outcome of cats treated conservatively or surgically for peritoneopericardial diaphragmatic hernia: 66 cases (1987-2002).

OBJECTIVE: To determine long-term outcome of cats treated conservatively or surgically for peritoneopericardial diaphragmatic hernia (PPDH). DESIGN: Retrospective study. ANIMALS: 67 cats with PPDH. PROCEDURE: Medical records of cats with a diagnosis of PPDH made from 1987 through 2002 were reviewed. Information regarding long-term outcome was obtained from owners. RESULTS: Prevalences of PPDH in domestic longhair and Himalayan cats were significantly greater and prevalence of PPDH in domestic shorthair cats was significantly lower than prevalence of PPDH in the hospital cat population over the 15-year study period. Historical problems most commonly related to the respiratory and gastrointestinal tracts. Peritoneopericardial diaphragmatic hernia was the primary diagnosis in 40 cats and an incidental finding in 27 cats. One cat died prior to arrival at the Veterinary Medical Teaching Hospital. Thirty-seven of 66 cats were treated surgically, and 29 were treated conservatively. The postoperative mortality rate was 14%. Postoperative complications developed in 29 of 37 cats, the most common of which was hyperthermia. Two of 22 conservatively treated cats had progression of clinical signs necessitating surgical intervention or resulting in death. Owner satisfaction with treatment choice and long-term outcome was rated as very satisfied by 88% of owners of surgically treated cats and 68% of owners of conservatively treated cats. CONCLUSIONS AND CLINICAL RELEVANCE: Cats with overt clinical signs attributable to PPDH are good candidates for surgical herniorrhaphy. Postoperative complications may develop but are generally minor and self-limiting. Long-term outcome of cats treated conservatively or surgically was rated as very good by most owners.

Effects of a whole-body spandex garment on rectal temperature and oxygen consumption in healthy dogs.

OBJECTIVE: To determine whether a full-body spandex garment would alter rectal temperatures of healthy dogs at rest in cool and warm environments. DESIGN: Prospective study. ANIMALS: 10 healthy dogs. PROCEDURES: Each dog was evaluated at a low (20 degrees to 25 degrees C [68 degrees to 77 degrees F]) or high (30 degrees to 35 degrees C [86 degrees to 95 degrees F]) ambient temperature while wearing or not wearing a commercially available whole-body spandex garment designed for dogs. Oxygen consumption was measured by placing dogs in a flow-through indirect calorimeter for 90 to 120 minutes. Rectal temperature was measured before dogs were placed in the calorimeter and after they were removed. RESULTS: Rectal temperature increased significantly more at the higher ambient temperature than at the lower temperature and when dogs were not wearing the garment than when they were wearing it. The specific rate of oxygen consumption was significantly higher at the lower ambient temperature than at the higher temperature. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that wearing a snug spandex body garment does not increase the possibility that dogs will overheat while in moderate ambient temperatures. Instead, wearing such a garment may enable dogs to better maintain body temperature during moderate heat loading. These results suggest that such garments might be used for purposes such as wound or suture protection without causing dogs to overheat.