Treatment of canine nasopharyngeal stenosis using balloon-expandable metallic stents: long-term follow-up of four cases.

Four dogs were diagnosed with nasopharyngeal stenosis using endoscopy and magnetic resonance imaging. Treatment using balloon-expandable metallic stent, placed under fluoroscopic and endoscopic guidance, resulted in immediate resolution of clinical signs. All dogs were clinically normal 40 to 62 months following stent placement.

Use of silicone tracheal stoma stents for temporary tracheostomy in dogs with upper airway obstruction.

OBJECTIVES: To report the use of silicone tracheal stoma stents for temporary tracheostomy in dogs with upper airway obstruction. METHODS: Retrospective review of medical records for dogs in which silicone tracheal stoma stents were placed. RESULTS: Eighteen dogs had a silicone tracheal stoma stent placed for maintenance of a tracheostomy stoma for periods ranging from three hours to eight months. No intra-operative or immediate postoperative complications were recorded. In 11 dogs the stent was removed by simple traction after a period ranging from 36 hours to 6 weeks, and the tracheal stoma was left to heal by second intention. Five of the 18 dogs were determined as being tracheostomy dependent and underwent conversion to permanent tracheostomy after a period ranging from five days to eight months following stent placement. One dog was euthanased after three months, with the stent still in place, because of poor respiratory function, and one dog died of unrelated reasons. In 6 of 10 dogs (60%) where the stent was in place for five days or more, granulation tissue formation caused dislodgement of the stent. CLINICAL SIGNIFICANCE: Silicone tracheal stoma stents may be used as an alternative to conventional tracheostomy tubes in selected dogs with upper airway obstruction. Long-term use of the stent beyond five days is not recommended because of granulation tissue formation. The long-term consequences of partial tracheal ring resection are unknown.

Mediastinectomy for management of chronic pyogranulomatous pleural disease in dogs.

The medical records of 12 dogs with chronic pyogranulomatous pleural disease unresponsive to medical management were reviewed retrospectively. Resection of the mediastinal pleura (mediastinectomy) was performed through a median sternotomy to remove all diseased and surgically accessible mediastinal pleural tissue. Dogs were re-examined two weeks postoperatively, and long-term outcome was evaluated by contacting owners by phone. Twelve dogs underwent mediastinectomy; additional surgeries included subtotal pericardiectomy (8), lung lobectomy (4) and partial diaphragmatic resection (2). Histology of resected tissue consistently revealed neutrophilic, pyogranulomatous cellulitis/serositis. Foreign material was evident in the mediastinal tissue of five dogs and microorganisms were recovered from three dogs. Two dogs developed pneumothorax immediately postoperatively; one dog developed haemothorax one month postoperatively and was euthanased. Median follow-up time was eight months (range: 6-43 months); eleven dogs were alive and considered to be symptom-free by their owners. Mediastinectomy resulted in complete resolution of symptoms in most dogs (92 per cent) and was associated with a low incidence of major complications. The results of this study indicated that mediastinectomy results in favourable outcome for dogs with chronic pleural pyogranulomatous pleural disease unresponsive to medical management.

Successful management of an arytenoid chondrosarcoma in a dog.

An eight-year-old Doberman pinscher was presented with a four-week history of inspiratory stridor, dysphonia, inappetence and weight loss. Inspiratory stridor was apparent and became more pronounced during gentle compression of the larynx. Previous investigations, including laryngoscopy, had revealed the presence of a left-sided arytenoid mass. Histological examination of pinch biopsies was not diagnostic. The mass was removed by resection of the arytenoid cartilage through a ventral laryngotomy allowing salvage of the cuneiform process. Histological examination of the laryngeal mass was consistent with a chondrosarcoma, grade I, infiltrating the arytenoid cartilage. Re-examination at 12 months showed complete resolution of the clinical signs and no signs of metastatic disease. To the authors' knowledge this is the first report of successful surgical intervention for laryngeal chondrosarcoma. This case demonstrates that resection via a ventral laryngotomy may be a viable and curative therapeutic option for some sarcomas of the larynx.

Successful treatment of bilateral Paecilomyces pyelonephritis in a German shepherd dog.

A six-year-old female entire German shepherd dog was investigated for polyuria, polydipsia and lethargy. Investigations revealed a mild azotaemia and abdominal ultrasound revealed marked bilateral dilation of the renal pelves with echogenic material and proximal left hydroureter. Urine cytological examination and aspirates from the right renal pelvis revealed mats of fungal hyphae consistent with fungal bezoar formation. Fungal cultures revealed a profuse growth of Paecilomyces variotii. Initial treatment with oral itraconazole was unsuccessful, leading to bilateral nephrotomies to remove the fungal material. Postoperatively the Paecilomyces infection persisted despite continued itraconazole therapy. Treatment was commenced with amphotericin B, leading to resolution of the dog's clinical signs. To the authors' knowledge this is the first report of canine Paecilomyces pyelonephritis, without disseminated systemic disease, which documents its successful treatment.

Rib metastases from a non-tonsillar squamous cell carcinoma in a dog.

Metastatic spread to the ribs in a 15-year-old, male, neutered, Irish setter is reported occurring secondary to an oral squamous cell carcinoma (SCC). The dog presented with a history of a rapidly growing SCC of the right upper incisive region, which was confirmed by histopathology as a SCC. Thoracic radiographs showed bony lesions associated with the body of the right third rib, and the fifth and seventh costal cartilages. A rostral partial maxillectomy was performed as palliative treatment for the oral mass and a core biopsy of the lesion on the third rib was performed. The rib lesion was identified histopathologically as a metastatic SCC. A review of the literature of oropharyngeal SCC and the metastatic potential of non-tonsillar SCC is presented, in particular metastatic bone disease. This case report suggests possible implications of metastatic bone disease for treatment and prognosis for future cases of non-tonsillar SCC.

Treatment of idiopathic chylothorax in 14 dogs by ligation of the thoracic duct and partial pericardiectomy.

The outcome and complications associated with thoracic duct ligation combined with partial pericardiectomy in 14 dogs with idiopathic chylothorax were investigated retrospectively. Nine of the dogs were treated in the uk and five in Italy. All of them were reassessed clinically four weeks after surgery and the respiratory function and any pleural fluid accumulation were evaluated; they were followed up by telephone contact for at least six months. Eleven of the dogs were clinically normal and had no radiographic signs of pleural effusion when reassessed after four weeks. Two showed radiographic signs of a minor accumulation of pleural fluid but were clinically normal; when reassessed after three months they showed similar radiographic signs and clinical findings; but after four months there was no evidence of pleural effusion. One dog had a major complication that required a second surgical intervention.

Hypobaric intrathecal anaesthesia for partial hemipelvectomy in a dog.

OBJECTIVE: To report the intrathecal use of a hypobaric anaesthetic solution for partial hemipelvectomy in a nine-year-old, neutered female, Golden Retriever dog, weighing 34 kg. METHODS: Under inhalational anaesthesia, with the dog lying in lateral recumbency and the surgical side uppermost, 1.9 ml of a hypobaric solution containing 3.42 mg of bupivacaine and 0.66 mg of morphine were administered in the subarachnoid space at L5-6 level 30 minutes before surgery. Following the intrathecal injection the dog was maintained for five minutes in a 10 degrees head-down position, then for three minutes in a 10 degrees head-up position. RESULTS: Apart from a transient increase in heart and respiratory rates during resection of the sartorius muscle, which was treated with a plasma Target Controlled Infusion (TCI) of fentanyl, spinal anaesthesia provided cardiovascular stability and excellent relaxation of the surgical site. Neither motor blockade nor proprioceptive deficit were apparent in the contra-lateral hind limb at recovery, 200 minutes after injection. Postoperatively, rescue analgesia was not required in the 48 hours following surgery. CLINICAL SIGNIFICANCE: In dogs, the use of intrathecal hypobaric bupivacaine and morphine as a part of a balanced anaesthetic protocol should be considered during unilateral major orthopaedic surgeries of the pelvis and hind limb, as it allowed a reduction in the dose administered compared to isobaric solutions, providing selective spinal anaesthesia, excellent long-lasting analgesia, and rapid recovery of ambulation.

Combined clotrimazole irrigation and depot therapy for canine nasal aspergillosis.

OBJECTIVES: To evaluate the effect of short duration 1 per cent clotrimazole flush when combined with 1 per cent clotrimazole cream instilled into the frontal sinuses for the treatment of nasal aspergillosis in 14 dogs. METHODS: Fourteen dogs with clinical, radiological, serological and rhinoscopic findings consistent with nasal aspergillosis were treated by frontal sinus trephination and a short, five-minute flushing of 1 per cent topical clotrimazole solution followed by a 1 per cent clotrimazole cream instilled as a depot agent. RESULTS: Twelve of the 14 dogs (86 per cent) responded well to treatment and either had no clinical signs after treatment or had signs consistent with mild rhinitis during a minimum follow-up period of six months. Only one dog required multiple treatments. Treatment was well tolerated by all patients, with minimal complications. CLINICAL SIGNIFICANCE: This treatment compares favourably to previously published data using one-hour topical clotrimazole or enilconazole flushing treatment protocols. The treatment technique significantly reduced treatment time under anaesthesia.

Complications following full-thickness small intestinal biopsy in 66 dogs: a retrospective study.

OBJECTIVES: To retrospectively report the complications seen after full-thickness multiple small intestinal biopsies were performed in 66 dogs. METHODS: Animals that died as a result of enteric wound breakdown were compared with the surviving population to identify fatal risk factors. RESULTS: Seventeen dogs had hypoalbuminaemia and eight had albumin levels below 20 g/I at surgery. Twelve dogs had concurrent disease, of which seven had skin disease. Seven dogs suffered minor complications which resolved with treatment. Eight dogs (12 per cent) died or were euthanased between three and nine days postoperatively (mean [sd] 4.5 [2.1]) due to enteric wound breakdown. Seven of these dogs developed septic peritonitis and one died of haemorrhage. No statistically significant differences were identified in any of the parameters examined for the development of fatal enteric wound dehiscence. CLINICAL SIGNIFICANCE: Full-thickness intestinal biopsy is not a benign procedure. However, this study concludes that there are no consistent predictors for patients at increased risk of enteric wound breakdown.

Left ventricular myxosarcoma in a dog.

An entire male Neopolitan mastiff, aged two years and eight months, presented with a history of chronic diarrhoea and weight loss. The diarrhoea had been present for approximately 12 months and had progressively worsened, with weight loss developing over an eight-week period prior to presentation. No primary gastrointestinal or metabolic cause for the diarrhoea could be identified. Echocardiography revealed a large, multilocular, cyst-like structure within the pericardium compressing the heart and displacing it to the right. The mass was surgically excised from the left ventricular myocardium. Histopathological examination showed it to be a low-grade malignant myxosarcoma. The dog made a full recovery and was still clinically normal nine months postoperatively, with no evidence of tumour recurrence or metastases. However, 11 months postsurgery, the clinical signs of diarrhoea and weight loss returned. Tumour recurrence with local metastasis was diagnosed and the dog was euthanased 358 days after the original surgery.

Total ear canal ablation in the cat: indications, morbidity and long-term survival.

Fifty-two total ear canal ablation (TECA) procedures in 44 cats were reviewed. The indication for surgery was neoplasia in 41 per cent of the cats, 86 per cent of which had ceruminous gland adenocarcinoma. Chronic inflammatory or polypoid disease accounted for 50 per cent of surgical procedures. Postoperative complications included Horner's syndrome (42 per cent) and facial paralysis (56 per cent) and these were permanent in 14 per cent and 28 per cent of cases, respectively, with the rest resolving in the ensuing weeks or months. The higher incidence of Horner's syndrome and facial paralysis in the cat, compared to the dog, was attributed to greater fragility of the feline tympanic plexus and facial nerve. The median survival time of cats with ceruminous gland adenocarcinoma was 50-3 months, and did not differ significantly from that for inflammatory or polypoid disease. A potential prognostic indicator for this tumour was the mitotic index (MI): cases with MI < or = 2 survived significantly longer than those with MI > or = 3.

Extrahepatic biliary tract surgery in the cat: a case series and review.

Four cases of extrahepatic biliary tract surgery in the cat are described. The causes of the disease were inflammation of the gallbladder, distal common bile duct (CBD) or major duodenal papilla, and traumatic avulsion of the CBD. Bile peritonitis was present in two of the cats. Biliary enterostomy was performed in three cats, two of which were euthanased at five weeks and three months postsurgery; the third was alive at the time of writing, four months postsurgery. Cholecystectomy was curative in one cat. A literature review reveals high early mortality following biliary diversion, with only 50 per cent of cases surviving more than two weeks, and 23 per cent surviving more than six months. Surviving cats had repeated intermittent vomiting and anorexia that responded to antibiotics. No postoperative mortality was seen when biliary diversion was avoided. Whenever biliary enterostomy or temporary diversion methods are performed, a poorer prognosis should be offered due to the increased likelihood of postoperative complications and mortality.

Rupture of the cranial pubic tendon in the cat.

Seven cats with rupture of the cranial pubic tendon (CPT) were presented to the authors between 1992 and 2001. The causal aetiology was unclear in each case. Diagnosis was made on physical examination (five animals) or surgical exploration (two animals). Concurrent injuries were present in four cats, including injury to the urinary tract and musculoskeletal system. All ruptures were surgically explored and primary repair of the CPT rupture was performed in five cats. Repair was not possible in two cats, and follow-up examination showed that scar tissue had apparently formed to support the deficit. All cats were asymptomatic at follow-up examination. The prognosis for CPT rupture in the cat is favourable.

Treatment of urethral sphincter mechanism incompetence in 11 bitches with a sustained-release formulation of phenylpropanolamine hydrochloride.

Between 1995 and 1999, urethral sphincter mechanism incompetence was diagnosed in 11 bitches. They had been treated with phenylpropanolamine hydrochloride at the recommended dose rate, but had shown no response or had become refractory to treatment. They were treated with phenylpropanolamine hydrochloride in a sustained-release formulation combined with diphenylpyraline hydrochloride. The urinary incontinence resolved fully in six of the bitches, two of which remained continent after the treatment was withdrawn; two showed a marked improvement on daily treatment, but the other three bitches failed to respond and underwent colposuspension.

Long-term outcome of 56 dogs with nasal tumours treated with four doses of radiation at intervals of seven days.

A retrospective study was undertaken on 56 dogs treated for nasal tumours by megavoltage radiotherapy with a hypofractionated schedule consisting of four doses of 9 Gy given at intervals of seven days. The dogs were followed until they died or were euthanased. The clinical signs had improved in 53 of the 56 dogs by the end of the treatment schedule. Mild acute radiation side effects were observed in the majority of the dogs but late radiation side effects were rare. Kaplan-Meier survival analysis revealed a median survival time after the final dose of radiation of 212 days. The one- and two-year survival rates were 45 per cent and 15 per cent. Fifty of the dogs were euthanased because the initial clinical signs recurred.

Primary thoracic wall tumours of mesenchymal origin in dogs: a retrospective study of 46 cases.

Forty-three of the chest wall tumours in 46 dogs were malignant; five had metastases apparent at the time of presentation, five more had metastases discovered intraoperatively. Surgical resection of the tumours was associated with a significantly better outcome than conservative management. The median survival times after surgery for dogs with osteosarcoma was 17 weeks, for dogs with fibrosarcoma it was 26 weeks and for dogs with chondrosarcoma it was 250 weeks. En bloc excision of primary tumours affecting the chest wall was associated with minimal morbidity, but long-term survival was limited by distant metastases, primarily to the lungs. The tumours recurred in only three dogs. Early, radical surgical excision is recommended in the management of tumours of the chest wall. The prognosis depends on the histologic type of tumour and a histological diagnosis is mandatory before excision.