Aorto-left atrial fistula secondary to aortic infective endocarditis in a dog with a bicuspid aortic valve.

An 11-year-old male neutered American bulldog was presented for evaluation of thrombocytopenia, acute onset of ataxia, and vomiting. A new murmur was auscultated on physical examination. Transthoracic echocardiographic examination revealed a bicuspid aortic valve, vegetative lesions on the aortic valve, and continuous shunting from the aortic root to the left atrium through an aorta to left atrial fistula. The dog was euthanized due to its guarded prognosis and critical condition. Pathological examination confirmed presence of a bicuspid aortic valve, aorto-left atrial fistula, and aortic infective endocarditis. Antemortem blood culture revealed two unusual organisms: Achromobacter xylosoxidans and Fusobacterium mortiferum.

Spontaneous rupture of the right aortic sinus resulting in a sterile aorto-atrial fistula in a pet rabbit (Oryctolagus cuniculus).

Aortocardiac fistula is a broad term used to describe defects between the aorta and other cardiac chambers that can occur in humans and animals. A 1.5-year-old, 1.7 kg, male castrated Holland lop rabbit (Oryctolagus cuniculus) was presented for a two-week history of a heart murmur with corresponding cardiomegaly on radiographs. Physical examination confirmed a grade-V/VI continuous heart murmur on the right sternal border with a regular rhythm and a gallop sound. Echocardiography revealed an aortic-to-right-atrial fistula causing severe left-sided volume overload. Based on the echocardiographic findings, rupture of the right aortic sinus was suspected. Due to the poor prognosis, euthanasia was elected. On necropsy, a fistula was found connecting the right aortic sinus with the right atrium, without evidence of an inflammatory response nor evidence of an infectious etiology. The sudden onset of a heart murmur supported acquired fistulation from a ruptured aortic sinus (also known as the sinus of Valsalva), though a congenital malformation could not be completely excluded.

Echocardiographic and pathologic identification of an aorto-left atrial fistula secondary to infective endocarditis in a canine patient.

A dog was presented for lameness, fever, and extreme lethargy. On physical exam, a new heart murmur, arrhythmia, and joint effusion were detected. These findings were not detected two months prior. A diagnostic work-up confirmed septic suppurative inflammation in multiple joints. Echocardiogram revealed aortic valvular endocarditis along with a communication, as a consequence of a fistula, that extended from just below the aortic sinotubular junction to the left atrial lumen. Due to a poor prognosis, humane euthanasia was elected. Necropsy and histopathology confirmed infective endocarditis of the aortic valve and an aorto-left atrial fistulous tract extending from the left coronary sinus of the aortic valve to the lumen of left atrium.

Ageratina adenophora damages the rumen epithelium via inducing the expression of inflammatory factors in goats.

The aim of this experiment was to investigate the effects of Ageratina adenophora on the expression of epithelium tight junction proteins and inflammatory factors in the rumen of goats. Twelve goats were randomly divided into three groups. The first group was the blank control group (n = 3, C) which was fed normal diet. The second group was fistulas control group (n = 3, RFC), which was fitted with rumen fistulas, and fed normal diet. The third group was the A. adenophora test group (n = 6, AA), which was fitted with rumen fistulas and fed a mixture of 60% of normal diet and 40% of A. adenophora grass powder. The feeding experiment lasted for 90 d, after which all goats were sacrificed and samples were collected from the rumen dorsal sac and ventral sac. The relative expression of mRNA of inflammatory factors in the rumen epithelium (tumor necrosis factor alpha [TNF-α], interferon gamma [IFN-γ], interleukin 1 beta [IL-1ß], IL-2, IL-4, IL-6, and IL-10) and tight junction protein genes (occludin, claudin-1, and ZO-1) was measured by quantitative real-time fluorescence PCR. Expression of tight junction proteins in the rumen epithelium was measured by Western blot. A correlation was established between the expression of inflammatory factors and tight junction protein genes using Graph Pad Prism. The results showed that A. adenophora caused a significant increase in the mRNA expression levels of TNF-α, IFN-γ, IL-1ß, IL-2, IL-6, and IL-10 in the rumen epithelial (P < 0.05 or P < 0.01). The expression of tight junction proteins at both gene and protein levels was significantly decreased (P < 0.05 or P < 0.01). Furthermore, the correlation analysis revealed that the changes in tight junction protein expression in the test group were closely related to the upregulation of the expression of inflammatory factors TNF-α and IFN-γ in rumen epithelial cells. In conclusion, the expression of inflammatory factors was increased and the expression of tight junction proteins was decreased in goats after feeding on A. adenophora, which caused some damage to the rumen epithelium.

The article aims to investigate the toxic effects of Ageratina adenophora, an invasive plant on the integrity of the rumen epithelium by measuring the changes in the expression of inflammatory factors and tight junction proteins after the consumption of A. adenophora in goats. The results showed that A. adenophora causes damage to the rumen epithelium by increasing the expression of pro-inflammatory markers like TNF-α and IFN-γ and reducing the expression of tight junction proteins such as occludin and claudin-1 in goats.

Diagnosis and Surgical correction of salivary affections in buffaloes (Bubalus bubalis); a retrospective study.

AIM: This study aimed to describe the diagnosis and treatment of various surgical salivary affections in buffaloes. MATERIALS AND METHODS: This study included 135 buffaloes examined at Dakahlia Governorate between 2011 and 2022 suffering from various surgical salivary affections. The recorded surgical affections had salivary fistula (n = 44), ectasia of Stenson's duct (n = 11), ranula/mucocele (n = 46), and cervical sialocele (n = 34). The buffaloes were sedated using an intramuscular injection of xylazine (0.05 mg/kg) and local infiltration analgesia of lidocaine for specific surgical interventions. RESULTS: The salivary duct fistula cases were surgically corrected using a retrograde infusion of povidone-iodine into the duct and its double ligation with Prolene following fistulectomy. Intraoral marsupialization was done in buffaloes suffering from ectasia of the parotid duct. The mucocele /ranula was surgically incised with daily flushing with povidone-iodine. The cervical sialocele was treated by giving an elliptical excision on the sialocele, and sialoadenectomy of the mandibular salivary gland was performed to facilitate dynamic fluid/saliva drainage. A 92.5% of diseased buffaloes showed an uneventful recovery without any postoperative complications after the first treatment, whereas 7.5% of animals tended to recur. The most common and almost equally distributed salivary affections recorded in adult buffaloes were parotid duct fistula, mucocele, and cervical sialocele. The Stenson's duct ectasia was commonly registered in calves, being congenital. CONCLUSION: Ranula was the most common salivary affection encountered in adult buffaloes, closely followed by parotid duct fistulae and cervical sialoceles. Stenson's duct ectasia was the least encountered salivary affection in calves and was congenital. All salivary affections were corrected easily and safely, with satisfactory outcomes.

Surgical treatment for cleft palate in dogs yields excellent outcomes despite high rates of oronasal fistula formation: a narrative review.

Cleft palate is the most common congenital orofacial defect in dogs. Although this topic has been extensively studied in experimental dogs, current literature on clinical patients is limited to case reports and small case series studies with many individual opinions based on experience. This narrative review summarizes the literature of the last 10 years with application to clinical practice, focusing on the preparation of the patient until surgery, options for surgical management, and perioperative complications. Surgical treatment must be performed to obtain separation between the nasal/nasopharyngeal and oral/oropharyngeal passages. This will allow the dog to have independent function and reduce clinical signs associated with food, water, and other foreign material entering the respiratory tract. Surgical treatment has good to excellent outcomes when the procedure is carefully planned and appropriately executed despite the high rates of postoperative oronasal fistula reported.

Reverse sneezing as a clinical manifestation of nasopharyngeal-oropharyngeal fistula in a dog.

A 6-year-old spayed female Labrador retriever was evaluated for a 3-month history of intermittent reverse sneezing and gagging episodes. Pertinent findings at evaluation included frequent reverse sneezing and non-productive retching. No pathology was visible on sedated oral examination. Contrast-enhanced computed tomography of the skull revealed a gas-filled defect within the left ventral aspect of the soft palate. A non-eroded defect was present in the left caudoventral nasopharyngeal wall on nasopharyngoscopy. Surgical exploration revealed a nasopharyngeal-oropharyngeal fistula within the left palatine tonsillar fossa. The dog had a witnessed oropharyngeal stick injury (OSI) 3 months previous in the location of the fistula. The OSI had been allowed to heal by secondary intention and was treated with an oral antibiotic and NSAID. However, the dog lacked characteristic signs of a chronic OSI such as nasal discharge or abscess formation. The defect in the soft palate was surgically debrided and closed, and the left palatine tonsil was excised. The dog recovered completely with cessation of reverse sneezing and retching episodes.

Éternuements inversés comme manifestation clinique d'une fistule oropharyngée-nasopharyngée chez un chien. Une femelle Labrador stérilisée âgée de 6 ans a été évaluée pour une histoire de 3 mois d'épisodes intermittents d'éternuements inversés et d'étouffements. Les résultats pertinents lors de l'évaluation comprenaient des éternuements inversés fréquents et des haut-le-coeur non productifs. Aucune pathologie n'était visible à l'examen oral sous sédation. La tomodensitométrie à contraste amélioré du crâne a révélé une imperfection remplie de gaz dans la face ventrale gauche du palais mou. Une imperfection non érodée était présente dans la paroi nasopharyngée caudo-ventrale gauche à la nasopharyngoscopie. L'exploration chirurgicale a révélé une fistule nasopharyngée-oropharyngée au sein de la fosse amygdalienne palatine gauche. Le chien a eu une blessure oropharyngée par une branche (OSI) il y a 3 mois à l'emplacement de la fistule. L'OSI avait été laissée à guérir par seconde intention et a été traitée avec un antibiotique oral et un AINS. Cependant, le chien ne présentait pas de signes caractéristiques d'une OSI chronique comme un écoulement nasal ou la formation d'abcès. Le défaut du palais mou a été chirurgicalement débridé et fermé, et l'amygdale palatine gauche a été excisée. Le chien s'est complètement rétabli avec l'arrêt des épisodes d'éternuements inversés et de haut-le-coeur.(Traduit par Dr Serge Messier).

Right coronary artery to left ventricle coronary cameral fistula in a cat.

A six-month-old female intact domestic shorthair cat was presented for evaluation of a loud heart murmur. Transthoracic echocardiography revealed dilation of the left ventricle secondary to an abnormal vessel shunting blood into the left ventricular outflow tract at a high velocity during diastole. Multidetector computed tomography angiography revealed a coronary cameral fistula that originated at the right coronary artery, encircled the heart, and then terminated into the left ventricular outflow tract. This case report documents the first known case of a coronary cameral fistula in a cat. Multimodal imaging was an essential aspect to diagnosing the congenital lesion in this case.

Surgical Repair of Acquired Oronasal Fistulas Secondary to Periodontal Disease in Dogs Using a Flexible Bone Membrane: A Case Series.

Oronasal fistulas are sequelae to periodontal disease in dogs. Previous case series have described the use of auricular cartilage as a type of membrane to help with surgical repair of oronasal fistulas. This case series explores the use of a commercially available flexible bone membrane in the surgical repair of ten acquired oronasal fistulas in dogs. The use of the flexible bone membrane did not necessarily improve the surgical outcomes in these cases; however, larger controlled trials are necessary to further evaluate its use.

Visual and histological evaluation of the effects of trafermin in a dog oronasal fistula model.

The standard procedure to treat oronasal fistula in dogs requires tooth extraction to close the fistula; hence, the subject would lose its tooth. In this study, trafermin was applied to four dog models with oronasal fistula to investigate the periodontal tissue regenerative effects of trafermin in the treatment without tooth extraction. A fistula was created along the palatal side of each upper canine tooth. One of the fistulae was filled with trafermin, whereas that on the contralateral side was left unfilled as a control. The results showed a significant decrease in the non-calcified periodontal tissue volume on the trafermin side after the fourth week. In addition, oronasal fistula closure was visually and histologically confirmed at the eighth week on the trafermin side of all four models.

A bronchopulmonary artery fistula in a horse.

A 24-year-old, Thoroughbred gelding presented with difficulty breathing for a few days and intermittent nose bleeding before dying. At necropsy, the bronchoesophageal artery and the bronchial artery that flowed into the left anterior lobe were tortuous and dilated, and it was found that dilated tortuous branches of the bronchial artery ran over the dorsal and ventral surfaces of the left anterior lobe. Histopathologically, an anastomosis between a muscular artery and an elastic artery were demonstrated, which were identified as bronchial and pulmonary arteries, respectively. Based on the gross and histopathological findings, a bronchopulmonary artery fistula was diagnosed. To the best of our knowledge, this is the first case report of a pulmonary vascular anastomosis in a horse.

Aorto-left atrial fistula secondary to infective aortic endocarditis and endarteritis in a cat with valvular aortic stenosis.

A cat previously diagnosed with valvular aortic stenosis developed acute respiratory distress. A new continuous heart murmur was noted on physical exam. Echocardiographic examination revealed vegetative lesions on the aortic valve and continuously shunting blood flow from the aorta into the left atrium. Despite initial treatment for left-sided congestive heart failure, the cat died suddenly. In addition to confirming aortic valve endocarditis and an acquired aorto-left atrial shunt, pathological examination identified vegetative lesions on the luminal surface of the ascending aorta. Although antemortem aerobic blood culture, 16s bacterial ribosomal DNA PCR, and Bartonella PCR failed to identify causative organisms, Escherichia coli was identified on postmortem tissue culture of the aortic lesion. This represented a unique case of primary valvular aortic stenosis with secondary infective aortic endocarditis, infective aortic endarteritis, and aorto-left atrial fistula in a cat. It highlighted potential adverse outcomes of aortic stenosis that are more commonly recognized in humans and dogs.

Midbody penile urethrocutaneous fistula repaired by fistulectomy and urethral anastomosis in a stallion.

CASE DESCRIPTION: A 12-year-old Friesian stallion was examined because of a 1-year history of preputial injury and urination through a urethrocutaneous fistula located at the midbody of the ventral aspect of the penis. CLINICAL FINDINGS: Physical examination revealed an opening with a clearly apparent mucocutaneous junction 12 cm from the distal opening of the urethra on the ventral left side of the penis. Endoscopic examination of the distal portion of the urethra confirmed a blind pouch with no communication with the fistula or proximal portion of the urethra. TREATMENT AND OUTCOME: A temporary perineal urethrostomy was performed with sedation and local anesthesia, with the stallion standing, to divert urine from the urethral reconstruction site. Fistulectomy and urethral resection and anastomosis were performed under general anesthesia with the stallion in dorsal recumbency. At 15 days after surgery, endoscopic examination of the urethra revealed distortion of the urethral lumen at the fistulectomy site. Under sedation, the urethra was dilated for 5 minutes every 12 hours for 3 days. At 22 days after surgery, endoscopic examination of the urethra revealed a healed anastomosis site and a large urethral luminal diameter. At 36 months after surgery, the owner reported that the stallion had normal micturition and had sired multiple foals by live cover matings. CLINICAL RELEVANCE: Severe preputial or penile trauma in horses is most commonly treated with amputation because of concerns of postoperative urethral stricture and occlusion. To the authors' knowledge, this case represented the first time that a successful end-to-end anastomosis of the distal portion of the urethra has been performed in a stallion.

Repair of an oronasal fistula with a two-layer closure method involving an autogenous fascia lata graft and oral mucosal flap in a pony.

CASE DESCRIPTION: A 9-year-old pony gelding was evaluated because it was suspected that a persistent oronasal fistula had developed after a fractured right maxillary second premolar tooth had been extracted via repulsion 6 months earlier. CLINICAL FINDINGS: Unilateral mucopurulent nasal discharge and malodorous breath were noted on clinical examination. Examination of the oral cavity revealed a 1 × 0.5-cm defect at the oral aspect of the right maxillary second premolar alveolus, from which feed material was extracted. Endoscopic examination revealed feed material in the rostral aspect of the right nasal cavity, confirming the diagnosis of oronasal fistula. TREATMENT AND OUTCOME: The pony initially underwent a reconstructive surgical procedure that combined an alveolar bone flap with a sliding mucoperiosteal hard palate flap to repair the oronasal fistula. The fistula reoccurred 5 months later and was ultimately repaired by means of a novel 2-layer flap closure method involving an autogenous fascia lata graft and oral mucosa flap. CLINICAL RELEVANCE: Fascia lata was effective as a scaffolding graft for repair of the oronasal fistula in this pony and may be useful for repair of oronasal fistulas in other equids as well.

Diagnosis and Management of an Oronasal Fistula Secondary to Nasal Transmissible Venereal Tumor in a Dog.

Canine transmissible venereal tumor (CTVT) is a contagious tumor commonly seen in populations of sexually intact dogs that have close contact with each other. CTVT is one of only 3 known naturally transmissible, contagious tumors in which the mutated tumor cell is thought to have originated in an individual canid about 11000 years ago. Clinical history, signalment, cytological and histologic evaluation are typically sufficient for reaching a diagnosis, although immunohistochemistry(IHC) may be necessary for unique presentations of this neoplasm. This case report describes the diagnosis of an oronasal CTVT using histopathology and IHC, followed by treatment of the tumor with chemotherapy and surgical correction of a defect caused by the tumor.

Sinocutaneous fistula repair with a masseter muscle transposition flap combined with wound matrix and cancellous bone graft in a horse: A new technique.

OBJECTIVE: To describe a new technique to repair a sinocutaneous fistula with a masseter muscle transposition flap. STUDY DESIGN: Case report. ANIMAL: One 13-year-old thoroughbred stallion. METHODS: One 13-year-old stallion with a 3.5 × 6-cm sinocutaneous fistula over the right caudal maxillary sinus was treated with a transpositional masseter muscle flap. This repair consisted of a commercial wound matrix dressing placed directly over the hole in the maxilla and secured with suture material; a cancellous bone graft collected from the right tuber coxa placed on the dressing; and a portion of the superficial layer of the masseter muscle, with its pedicle at the facial crest, transposed dorsally over the bone graft, followed by a rotational skin flap with skin rostral to the fistula to close the defect. RESULTS: Seroma formation and dehiscence of the skin flap occurred, but the transposed muscle flap survived, and the technique resulted in successful closure of the sinocutaneous fistula with excellent cosmetic and functional outcome. CONCLUSION: A chronic maxillary sinocutaneous fistula was successfully treated by using a transposition flap of the masseter muscle and a rotational skin flap with minor complications. CLINICAL IMPACT: Transposition of the superficial layer of the masseter muscle should be considered for a repair of large maxillary sinocutaneous fistulas in horses.

Urethral fistula after resection of a penile fibropapilloma in a Holstein Friesian bull.

INTRODUCTION: A 2-year-old Holstein Friesian bull with a penile tumour was referred to the University of Veterinary Medicine Hannover, Foundation, Germany, where the tumour was resected and diagnosed as a fibropapilloma. A urethral fistula was diagnosed eight days postoperatively and was present nine months later, although the bull had normal copulation behaviour and satisfactory fertility. Surgical removal of fibropapillomas in close proximity to the urethra is an effective treatment. A urethral fistula, which may occur as a postsurgical complication, did not have an adverse effect on copulation capacity and fertility of the bull.

INTRODUCTION: Un taureau Holstein Frisian de 2 ans atteint d'une tumeur du pénis a été référé à l'Université de médecine vétérinaire de Hanovre, Fondation, en Allemagne, où la tumeur a été réséquée et diagnostiquée comme un fibropapillome. Une fistule urétrale a été diagnostiquée huit jours après l'opération et était présente neuf mois plus tard, bien que le taureau ait eu un comportement de copulation normal et une fertilité satisfaisante. L'ablation chirurgicale des fibropapillomes à proximité immédiate de l'urètre constitue un traitement efficace. Une fistule urétrale, qui peut survenir comme complication post-chirurgicale, n'a pas eu d'effet négatif sur la capacité de copulation et la fertilité du taureau.

Congenital lacrimal fistula in two prim'Holstein calves.

Two 4- and 8-month-old prim'Holstein calves were presented for chronic epiphora. Examination of the affected eyes revealed an abnormal duct opening inferonasal to the medial canthus. A diagnosis of congenital lacrimal fistula was made based on conventional and computed tomographic-dacryocystography findings. These revealed an ectopic channel connecting the nasolacrimal duct to the skin opening near the medial canthus. Both of the calves were surgically treated with resection and closure of the ectopic duct and placement of a nasolacrimal stent.

Canine Perianal Fistulas: Clinical Presentation, Pathogenesis, and Management.

Canine perianal fistulas are painful sinus tracts and ulcers that spontaneously develop in the skin around the anus. Middle-aged German shepherd dogs are most commonly affected and may have a genetic susceptibility. Although the disease was once believed related to conformational factors and primarily managed surgically, an immune-mediated pathogenesis is now recognized. Long-term medical management with immunomodulatory agents has become standard of care for canine perianal fistulas. Perianal fistulas can be debilitating and have a negative impact on quality of life of dogs and owners. Accurate diagnosis and aggressive medical therapy are key to successful management of canine perianal fistulas.

Bioengineered surgical repair of a chronic oronasal fistula in a cat using autologous platelet-rich fibrin and bone marrow with a tailored 3D printed implant.

Clinical summary: A tissue engineering approach was used to aid the surgical repair of a chronic oronasal fistula (ONF) in a 13-year-old cat. A three-dimensional (3D) printed mesh, tailored to the size and shape of the ONF, was created to support a soft tissue flap used to close the defect; and also to provide a matrix for mesenchymal stromal cells present in bone marrow aspirate and bioactive cytokines and growth factors present in platelet-rich fibrin harvested from the patient. A CT scan at day 75 after surgery revealed the formation of new tissue in the defect and the healing process was complete at follow-up 6 months after surgery. Relevance and novel information: Complications are frequently reported following surgical repair of ONFs and include dehiscence of the palatal suture line, flap necrosis due to damage to the greater palatine artery and maxillary osteomyelitis, mainly due to chronic infection and bone lysis. The case described here demonstrates how input from a multidisciplinary team and the use of a biomaterial, processed by sophisticated technologies, can create a precision regenerative medicine strategy adapted to the patient's clinical needs; this provided a novel therapeutic solution for an otherwise hard to treat clinical problem.