[Diagnosis and treatment of feline persistent ductus arteriosus: a retrospective evaluation of 17 cats]. / Diagnose und Therapie eines persistierenden Ductus arteriosus: Eine retrospektive Evaluation bei 17 Katzen.

OBJECTIVE: The objective of this study was to evaluate the signalement, clinical features, and echocardiographic findings of cats diagnosed with patent ductus arteriosus (PDA) as well as short- and medium-term outcome after successful ligation of the PDA. MATERIAL AND METHODS: Over a 10-year period 17 cats were diagnosed with PDA by transthoracic echocardiography. Thirteen cats were surgically treated by thoracotomy and ligation of the PDA. RESULTS: In all cats, a heart murmur was detected. In 88.2% of the cases, this presented as grade 4 out of 6 murmur (15/17 cats). A continuous murmur was more common (10/17 cats; 58.9%) than a systolic murmur (7/17 cats; 41.1%). Echocardiography showed that left ventricular internal diameter end diastole (LVIDd) and left ventricular internal diameter end systole (LVIDs) were significantly above reference values in the majority of cats. Mean diameter of the PDA measured at the widest point of the vessel was 3.4 mm (± 1.08 mm) and mean maximum flow velocity amounted to 5,06 m/sec (2,6m/sec-6,4m/sec). Surgery was successfully performed in all cats treated by surgical ligation and all of these patients were discharged after postoperative inpatient therapy. One cat experienced perioperative bleeding from the PDA, which was stopped efficaciously. This cat exhibited a residual shunt directly postoperatively; this could no longer be visualized in a re-check echocardiography 3 months later. Six cats were followed over a longer period of time. CONCLUSIONS: The surgical prognosis in this case study is very good with a postoperative survival rate of 100%. CLINICAL RELEVANCE: Surgical treatment of PDA is curative in animals not displaying advanced cardiac lesions. The auscultation of a heart murmur can provide initial findings indicative of PDA. Therefore, cardiac auscultation is warranted at every first presentation of a kitten. It must however be taken into consideration that not every cat with PDA necessarily has a continuous murmur but may display a systolic heart murmur. Therefore, it is important give utmost attention to the patients' clinical signs.

Influence of a single locking throw on the in vitro holding security of five friction throws.

OBJECTIVE: To compare the in vitro security of four different friction throws (square, surgeon's, Miller's, and strangle), with and without a locking throw, and a slip knot, on a vascular ligation model. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Nine groups with nine samples per group. METHODS: Four throws (square, surgeon's, Miller's, and strangle), with and without a locking throw, and a square throw locked in slip knot fashion, were tested to measure leakage pressure. RESULTS: The square and surgeon's throws leaked at a lower pressure than the Miller's and strangle throws (p < .0001). The leakage pressure was below physiologic arterial pressure for the square and the surgeon's throws. After the addition of a locking throw, the five knots leaked at a similar pressure (p = .5233) above physiologic arterial pressure. CONCLUSION: Following the addition of a locking throw, all the constructs tested in this study leaked at a similar pressure. The leakage pressure for all knots exceeded physiologic arterial pressures. CLINICAL SIGNIFICANCE: Any throw tested may be appropriate for secure vascular ligation if the initial throw is applied correctly.

Evaluation of thoracic duct ligation and unilateral subphrenic pericardiectomy via a left fourth intercostal approach in normal canine cadavers.

OBJECTIVE: To investigate a left-sided fourth intercostal approach to thoracic duct (TD) ligation and unilateral subphrenic pericardiectomy in dogs. STUDY DESIGN: Retrospective computed tomography (CT) review and cadaveric study. ANIMALS: Thirteen dogs with idiopathic chylothorax and 10 canine cadavers. METHODS: A retrospective study of CT lymphangiograms in client-owned dogs with idiopathic chylothorax evaluated location and branching of the TD at the left fourth intercostal space. A cadaveric study evaluated the efficacy of TD ligation at this site. Following methylene blue mesenteric lymph node injection, TDs were identified through a left fourth intercostal thoracotomy, ligated, and sealed. Unilateral subphrenic pericardiectomy was performed through the same incision. Computed tomography scans were performed to determine the success of TD ligation. RESULTS: A review of lymphangiograms revealed a single TD in 10/13 clinical cases at the fourth intercostal space. Three cases had additional branches. Thoracic duct ligation via a left fourth intercostal thoracotomy was successful in nine out of 10 cadavers. A single branch was noted intraoperatively in six out of 10, and two branches were noted in four out of 10 cadavers. All branches were observed on the left side of the esophagus. CONCLUSION: TD ligation at the left fourth intercostal space was successfully performed in 9/10 canine cadavers and appeared feasible in a retrospective review of 10/13 clinical cases. Unilateral subphrenic pericardiectomy can also be performed via this approach. CLINICAL SIGNIFICANCE: Fewer thoracic duct branches at this location in comparison with the standard caudal location may simplify TD ligation. If elected, unilateral subphrenic pericardiectomy can be performed through the same incision. Further investigation in clinical patients is warranted.

Diagnosis and treatment of a congenital portosystemic shunt in a ferret (Mustela putorius furo).

A 3-year-old female neutered ferret presented with progressive weight loss was diagnosed with portosystemic shunting based on increased fasting bile acids, rectal ammonia tolerance testing and advanced imaging. Ammonia reference values were determined in 16 healthy ferrets. A congenital extrahepatic spleno-caval shunt was visualised with ultrasonography and CT angiography of the abdomen. Complete surgical shunt closure by suture ligation was performed, without clinical improvement after surgery. Euthanasia was elected 4 months postoperatively because the clinical condition deteriorated. This is a case report of advanced diagnostics and surgical treatment of a congenital extrahepatic portosystemic shunt in a ferret, demonstrating rectal ammonia tolerance testing and imaging as feasible techniques for the diagnosis.

A preliminary investigation of the subcutaneous tissue reaction to a 3D printed polydioxanone device in horses.

BACKGROUND: A 3D printed self-locking device made of polydioxanone (PDO) was developed to facilitate a standardized ligation technique. The subcutaneous tissue reaction to the device was evaluated after implantation in ten horses of mixed age, sex and breed and compared to loops of poly(lactic-co-glycolic acid) (PLGA). In two of the horses, the implants were removed before closing the skin. The appearance of the implants and surrounding tissue was followed over time using ultrasonography. Implants were removed after 10 and 27 (± 1) days for histologic examination. RESULTS: On macroscopic inspection at day 10, the PDO-device was fragmented and the surrounding tissue was oedematous. On ultrasonographic examination, the device was seen as a hyperechoic structure with strong acoustic shadowing that could be detected 4 months post-implantation, but not at 7 months. Histology revealed a transient granulomatous inflammation, i.e., a foreign body reaction, which surrounded both PDO and PLGA implants. The type and intensity of the inflammation varied between individuals and tissue category. CONCLUSIONS: The 3D printed PDO-device caused a transient inflammatory reaction in the subcutaneous tissue and complete resorption occurred between 4 and 7 months. Considering the intended use as a ligation device the early fragmentation warrants further adjustments of both material and the 3D printing process before the device can be used in a clinical setting.

Percutaneous transvenous coil embolization (PTCE) for treatment of single extrahepatic portosystemic shunt in dogs.

BACKGROUND: There is limited information regarding percutaneous transvenous coil embolization (PTCE) for single extrahepatic portosystemic shunt (PSS). This study aimed to describe the procedure and outcome of PTCE in dogs with a single extrahepatic PSS. Forty-two privately owned dogs were included in this study. All dogs were diagnosed with extrahepatic PSS by computed tomography (CT). Preoperative CT images were used to evaluate the diameter of the PSS for coil placement. A multipurpose balloon catheter was percutaneously inserted into the PSS via the jugular vein, and transvenous retrograde portography (TRP) and measurement of blood pressure in the PSS (pPSS) were performed during balloon inflation; one or more embolization coils were implanted via the catheter. RESULTS: In most cases, preoperative median fasting and postprandial serum total bile acid (TBA) concentrations were high (fasting, 86.5 µmol/L [ 3.7-250.0 µmol/L]; postprandial, 165.5 µmol/L [ 1.5-565.0 µmol/L]). CT revealed that 30 dogs had left gastrophrenic shunt; eight had left gastroazygos shunt; and one each had left gastrocaval, splenocaval, splenophrenic, and left colocaval shunt. TRP revealed that intrahepatic portal vascularity was clearly detectable in all dogs. The median values of pPSS before and during the balloon occlusion were 4.8 mmHg [2.0-13.0 mmHg] and 8.6 mmHg [5.0-18.0 mmHg], respectively. The median number and diameter of coils used were 2 coils [1 - 5 coils] and 8.0 mm [4.0 - 12.0 mm], respectively. The median times of irradiation and PTCE were 9 min [4-26 min] and 40 min [23-75 min], respectively. The median fasting and postprandial TBAs significantly decreased to 8.2 µmol/L [0.3-45.1 µmol/L, n = 38, p = 0.0028] and 19.8 µmol/L [0.3-106.7 µmol/L, n = 38, p = 0.0018], respectively, approximately 1 month after PTCE. The clinical success rate of PTCE without requirement for a second surgery was 95.2% (40/42 dogs). During revision surgery, one dog underwent surgical ligation and, in another dog, an ameroid constrictor was placed. CONCLUSIONS: PTCE was clinically effective in treating single extrahepatic PSS in dogs. Preoperative CT and TRP prior to PTCE might be clinically valuable for choosing the size of embolization coils, deciding the appropriate location of coil implantation, and estimating the number of coils to be implanted. PTCE is a promising alternative to conventional surgical procedures for single extrahepatic PSS in dogs.

Percutaneous shunt vessel embolisation with Amplatzer vascular plugs II and IV in the treatment of dogs with splenophrenic shunts: four cases (2019-2022).

OBJECTIVES: To describe the treatment of four dogs with splenophrenic shunts using percutaneous shunting vessel embolisation with Amplatzer vascular plugs II and IV and provide information on their clinical outcomes. MATERIALS AND METHODS: Dogs with splenophrenic shunts treated at a veterinary hospital from January 2019 to December 2022 were identified through a medical record search. RESULTS: Six dogs with splenophrenic shunts were identified. Two dogs were excluded because they were treated with laparoscopic surgery. Four underwent percutaneous shunting vessel embolization with Amplatzer vascular plugs and were included in the case series. A sheath was placed in the left external jugular vein and a balloon catheter was advanced to the shunting vessel under fluoroscopy. Portal vein pressure was confirmed to be within an acceptable range during temporary balloon occlusion. Based on preoperative CT angiography and intraoperative contrast examination, Amplatzer vascular plugs II were selected for two dogs and IV were selected for two dogs. Under fluoroscopy, the plug was deployed into the shunting vessel, and angiography confirmed occlusion. In all cases, the increase in portal pressure after temporary occlusion was within the acceptable range, and complete occlusion of blood flow was possible with a single plug. There were no major procedure-related complications. No dogs developed post-ligation seizures or signs of portal hypertension. In addition, improvements in ammonia values were observed in all cases. CLINICAL SIGNIFICANCE: Percutaneous splenophrenic shunt embolisation using Amplatzer vascular plugs II and IV is technically feasible in dogs, and assessed by intra-procedure angiography, a single plug completely obstructed blood flow in all dogs. Based on the literature search, this is the first report describing Amplatzer vascular plugs for the treatment of splenophrenic shunts.

Outcomes in dogs with congenital extrahepatic portosystemic shunts treated with surgical ligation or medical management.

OBJECTIVE: The objective of this study was to evaluate differences in outcomes in dogs treated for extrahepatic portosystemic shunts (EHPSS) by either complete suture ligation, partial suture ligation or medical management. STUDY DESIGN: This wasa retrospective, single institutional study. SAMPLE POPULATION: Dogs (n = 152) with EHPSS treated with suture ligation (n = 62), surgery with no ligation (n = 2), or medical management (n = 88). METHODS: Medical records were reviewed for data on signalment, treatment variables, complications, and outcome. Kaplan-Meier plots were generated to assess survival across groups. Cox's proportional hazard models were used to assess the relationship between survival times and multiple predictor variables. For outcomes of interest, backwards, stepwise regression was performed (p < 0.05). RESULTS: Complete suture ligation was possible in 46/64 (71.9%) of dogs where surgical attenuation was attempted. One dog was euthanized following partial suture ligation due to suspected portal hypertension. Dogs with complete suture ligation of the EHPSS had a significantly longer median survival time (MST) compared to the medical management group (MST not reached vs. 1730 days [p < 0.001]). Complete resolution of clinical signs (without the need for further medical treatment or dietary changes) was achieved in 16/20 (80.0%) dogs with complete suture ligation and 4/10 (40.0%) dogs with partial suture ligation of their EHPSS. CONCLUSION: Suture ligation (complete or partial) for the treatment of EHPSS, where clinically possible, yielded the best clinical outcome and increased longevity compared to medical management in this study. CLINICAL SIGNIFICANCE: While medical management for the treatment of EHPSS in dogs is a valid treatment option, better clinical outcomes are achieved with surgical intervention.

Risk factors for intraoperative hemorrhage and perioperative complications and short- and long-term outcomes during surgical patent ductus arteriosus ligation in 417 dogs.

OBJECTIVE: To evaluate the short- and long-term outcomes of dogs undergoing surgical ligation for a left-to-right shunting patent ductus arteriosus (PDA), identify risk factors for intraoperative hemorrhage and intra- and postoperative complications, and report overall mortality rates. ANIMALS: 417 client-owned dogs undergoing surgical ligation for a left-to-right shunting PDA between January 2010 and January 2020. PROCEDURES: Data recorded included patient signalment, echocardiogram findings, intraoperative complications and mortality, postoperative complications, and short- and long-term outcomes. RESULTS: There was no association between age and risk of intraoperative hemorrhage (P = .7), weight and intraoperative hemorrhage (P = .96), or increasing left atrium-to-aortic (LA:Ao) ratio and intraoperative hemorrhage (P = .08). Intraoperative hemorrhage occurred in 10.8% of patients. Intraoperative mortality was 2%. Ninety-five percent of dogs experiencing intraoperative hemorrhage survived to discharge. Survival to discharge was 97%. One- and 5-year survival rates were 96.4% and 87%, respectively. CLINICAL RELEVANCE: Surgical ligation for a left-to-right shunting PDA is recommended due to the good long-term prognosis. Certain preoperative factors such as age, weight, and the presence and degree of mitral valve regurgitation had no detectable association with risks of intraoperative hemorrhage and, therefore, should not preclude surgical treatment for a left-to-right shunting PDA. Future studies are needed to further assess the association between increasing LA:Ao ratio and risk of intraoperative hemorrhage.

Prediction of outcome after ligation or thin film banding of extrahepatic shunts, based on plasma albumin concentration and hematologic expression of 8 target genes in 85 dogs.

BACKGROUND: In dogs with a congenital extrahepatic portosystemic shunt (EHPSS), outcome after surgical attenuation is difficult to predict. OBJECTIVES: Develop a minimally invasive test to predict outcome after surgical EHPSS attenuation and establish risk factors for postattenuation seizures (PAS). ANIMALS: Eighty-five client-owned dogs referred for surgical attenuation of a single EHPSS. METHODS: mRNA expression of 8 genes was measured in preoperatively collected venous blood samples. Outcome was determined at a median of 92 days (range, 26-208) postoperatively by evaluating clinical performance, blood test results and abdominal ultrasonography. Multivariable logistic regression was used to construct models predicting clinical and complete recovery. The associations between putative predictors and PAS were studied using univariable analyses. RESULTS: Five of 85 dogs developed PAS. Risk factors were age, white blood cell (WBC) count and expression of hepatocyte growth factor activator and LysM and putative peptidoglycan-binding domain-containing protein 2. Clinical recovery was observed in 72 of 85 dogs and complete recovery in 51 of 80 dogs (median follow-up, 92 days). The model predicting clinical recovery included albumin, WBC count, and methionine adenosyltransferase 2 alpha (MAT2α) expression, whereas the model predicting complete recovery included albumin, and connective tissue growth factor precursor and MAT2α expression. The areas under the receiver operating characteristic curves were 0.886 (95% confidence interval [CI]: 0.783, 0.990) and 0.794 (95% CI: 0.686, 0.902), respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Two models were constructed for predicting outcome after EHPSS attenuation using venous blood samples. The model predicting clinical recovery showed the best diagnostic properties. Clinical application requires further validation.

Evaluation of LigaTie device for total lung lobectomy in small breed dogs - An ex vivo study.

This study aimed to evaluate an effectiveness of airway-sealing techniques used in total lung lobectomies in small dog breeds. Total lung lobectomies were performed on five canine cadavers weighing 2.5-8 kg. Airway-sealing techniques were performed on two randomly selected lobes per cadaver. The airway-sealing techniques consisted of traditional suture ligation, Endoloop, and LigaTie. After applying all surgical methods, bronchial stump was collected from the tongue and prepared. The effectiveness of each airway-sealing technique was evaluated by submerging the bronchial stumps in saline, followed by intubation to gradually increase the airway pressure to 80 cmH2O to identify the presence of air leakage in each lobe. Seven of the ten lobes in the traditional suture ligation group had a leakage; the leakages were fatal in three lobes. A single fatal leak occurred in the Endoloop group, while no leakage was noted in the LigaTie group. Therefore, the LigaTie technique had a higher statistical efficacy than the traditional suture ligation (p = 0.007). In conclusion, the LigaTie application reduced the incidence of air leakage following total lung lobectomies in small dog breeds.

Resolution, recurrence, and chyle redistribution after thoracic duct ligation with or without pericardiectomy in dogs with naturally occurring idiopathic chylothorax.

OBJECTIVE: To document outcomes of thoracoscopic treatment of idiopathic chylothorax (IC) in dogs with and without constrictive pericardial physiology (CPP) and evaluate patterns of chyle flow redistribution after thoracic duct ligation (TDL). ANIMALS: 26 client-owned dogs. PROCEDURES: In this prospective cohort study, echocardiography and cardiac catheterization were performed to document CPP in dogs with IC. Thoracoscopic TDL with pericardiectomy was performed if CPP was present (TDL/P group). Dogs without evidence of CPP underwent thoracoscopic TDL alone (TDL group). Dogs underwent preoperative, immediate postoperative, and 3-month postoperative CT lymphangiography studies when possible. Perioperative morbidity, resolution and late recurrence rates, and long-term outcome were recorded. RESULTS: 17 dogs underwent TDL, and 9 underwent TDL/P. Twenty-five of 26 (96%) survived the perioperative period. One dog died from ventricular fibrillation during pericardiectomy. Resolution rates for TDL and TDL/P were 94% and 88%, respectively (P = .55), with 1 late recurrence occurring in the TDL group in a median follow-up of 25 months (range, 4 to 60 months). On 3-month postoperative CT lymphangiography studies, ongoing chyle flow past the ligation site was demonstrated in 5 of 17 dogs, of which 1 dog developed recurrence at 13 months postoperatively. In 15 of 17 dogs, chylous redistribution after TDL was principally by retrograde flow to the lumbar lymphatic plexus. CLINICAL RELEVANCE: In dogs without evidence of CPP, TDL alone was associated with a very good prognosis for treatment of IC. In the absence of CPP, the additional benefit of pericardiectomy in the treatment of IC is questionable.

Inclusão da ligadura da artéria e veia córnea com abraçadeira de naylon para descorna em bovinos / Inclusion of ligadura artery and vein cornea naylon with the clamp to dehorning in cattle / Inclusión de ligadura arteria y la vena cornea naylon con la pinza para descorne de los bovinos

A descorna cirúrgica a campo ainda e uma prática comum em animais de produção, apesar deste procedimento na maioria ainda se realizado por leigos, ou realizada em animais com menos de um ano de idade com ferro candente (avermelhado), esta conduta geralmente é efetuada na propriedade, sendo executada pelo próprio proprietário ou funcionário. O presente experimento usando anestesia geral e bloqueio local do nervo córneo e circularmente na base do corno com abraçadeira de naylon para sutura de pele, associada a ligadura da artéria e veia cornual mostrou ser eficiente reduzindo o tempo cirúrgico a campo e promovendo uma prevenção antecipada de hemorragia que é frequente para este procedimento.(AU)

The surgical dehorning the field and still a common practice in farm animals, although this procedure in most still held by lay people, or performed on animals less than one year old with red-hot iron (red), this conduct is usually done on the property, being executed by the owner himself or employee. This experiment using general anesthesia and local lock of corneal nerve and round the horn base with clamp naylon for skin suture, associated with ligature of the artery and vein cornual is efficient by reducing surgical time field and promoting an early prevention of bleeding is frequent for this procedure.(AU)

El quirúrgica descorne el campo quieto y una práctica común en los animales de granja, aunque este procedimiento en la mayoría todavía en manos de los laicos, o lleva a cabo en animales de menos de un año de edad con hierro al rojo vivo (rojo), este comportamiento se realiza generalmente en la propiedad, los trabajos realizados por el propietario o el propio empleado. Este experimento usando anestesia bloques general y local de los nervios de la córnea y alrededor de la base del cuerno con naylon pinza de sutura de la piel, asociados con la ligadura de la vena y la arteria cornual fue eficiente que reduce el tiempo quirúrgico el campo y la promoción de una prevención temprana sangrado que es común para este procedimiento.(AU)

Triple-combination surgery with thoracic duct ligation, partial pericardiectomy, and cisterna chyli ablation for treatment of canine idiopathic chylothorax.

This study aimed to evaluate the outcomes and complications of triple-combination surgery consisting of thoracic duct ligation (TDL), partial pericardiectomy (PPC), and cisterna chyli ablation (CCA) for the treatment of idiopathic chylothorax in dogs. Eleven privately owned dogs with idiopathic chylothorax underwent the triple-combination surgery: TDL and PPC were performed in left recumbency, followed by CCA in dorsal recumbency. Of the 11 dogs, seven were Shiba, two were Afghan hounds, and one each was Borzoi and mixed-breed. TDL and PPC required two intercostal thoracotomies in five dogs, whereas they were performed through a single intercostal incision in the other dogs. None of the dogs showed major intraoperative complications. The median operation time was 190 min (range, 151-234 min). Nine dogs showed no pleural effusion after surgery without medical management. Another dog showed the disappearance of chylous effusion, followed by the pleural accumulation of modified transudate. However, the residual one dog in whom chylothorax did not improve postoperatively died 4 months after the combination surgery. The mortality rate at the conclusion of this study was 9.1%. Although the triple-combination surgery with TDL, PPC, and CCA was complex and required a prolonged operation time, the success rate of resolving chylothorax in our study was comparable to that of open surgery as previously reported. Therefore, this study suggests that such triple-combination surgery can become one of the therapeutic options for the management of canine idiopathic chylothorax.

Quantitative analysis of contrast-enhanced ultrasound estimates intrahepatic portal vascularity in dogs with single extrahepatic portosystemic shunt.

OBJECTIVE: To evaluate the clinical impact on quantitative analysis of contrast-enhanced ultrasound (CEUS) on single extrahepatic portosystemic shunt (PSS) in dogs. ANIMALS: 21 client-owned dogs with single extrahepatic PSS and 5 healthy Beagles. PROCEDURES: In all dogs, CEUS was performed to calculate the rising time (RT), rising rate (RR), and portal vein-to-hepatic parenchyma transit time (ΔHP-PV) from the time-intensity curve obtained in the hepatic parenchyma and portal vein. All dogs in the PSS group underwent preoperative CT angiography (CTA) and surgery. The CEUS variables in the PSS group were compared with those in the healthy dogs (control group) and were analyzed for shunt types and grades of intrahepatic portal venous branches based on CTA findings, intraoperative portal pressure, and surgical procedures. RESULTS: All 3 CEUS variables showed no significant differences between the PSS and control groups. The RT and ΔHP-PV in the left gastrophrenic shunt group were significantly longer than in the other shunt types. In the intrahepatic portal vascularity, the RT in grade 1 was significantly shorter than in grades 3 and 4, and the RR in grade 1 was significantly higher than in grade 4. The RT and ΔHP-PV were significantly correlated with portal pressure variables. The RT in dogs with partial ligation was significantly shorter than in dogs with complete ligation and percutaneous transvenous coil embolization. CLINICAL RELEVANCE: Quantitative assessments of CEUS may be useful for estimating intrahepatic portal vascularity in dogs with single extrahepatic PSS.

Comparison of conventional ligatures and a vessel sealing device for haemostasis during open ovariohysterectomy in rabbits.

AIMS: To compare surgical times and rates of intra-operative and post-operative complications for open ovariohysterectomy (OVH) in female rabbits using conventional ligatures or a vessel sealing device (VSD) for haemostasis. METHODS: Female pet rabbits (n = 23) presented for OVH for either desexing or treatment of reproductive disorders were randomly assigned to a conventional ligatures (CL) group (n = 12) or a LigaSure 5-mm (LS5) group (n = 11). In the CL group, the ovarian pedicles were ligated with a single surgeon's knot. After transection of the ovarian pedicles, the broad ligament was manually broken down along the uterine horns to their respective cervices. In the LS5 group, both ovarian pedicles and the broad ligaments were sealed with a LigaSure Dolphin Tip VSD with 5-mm forceps. All the rabbits were hospitalised for 24 hours after surgery. Two weeks after discharge, a clinical recheck examination was performed. Incision length, overall surgical time (from initial incision to completion of intradermal suturing), OVH time (from identification of the first ovary to transection of the vaginal vault), and intra- and post-operative complications were recorded and compared between groups, using the Student's t-test for normally distributed continuous data, the Wilcoxon-Mann-Whitney test for non-normally distributed continuous data and Pearson's χ2 test for categorical data. RESULTS: The mean overall surgical time was 14.1 (SD 4.4) minutes. The surgery took 15.0 (SD 4.9) minutes in the CL group and 13.1 (SD 3.8) minutes in the LS5 group (p=0.10). The OVH time was shorter in the LS5 group (mean 4.2 (SD 0.9) minutes) than in the CL group (mean 6.3 (SD 1.7) minutes; p = 0.005). No intra-operative complications were encountered in the LS5 group. Haemorrhage occurred in three rabbits in the CL group. One rabbit in the LS5 group developed steatonecrosis post-operatively. There was no evidence of a difference in the proportion of rabbits that experienced intra- and post-operative complications (p = 0.25 and p = 0.94 respectively) between groups. CONCLUSIONS: The use of a LigaSure 5-mm VSD and conventional ligatures during open OVH were both associated with similar overall surgical times and complication rates. The OVH times were shorter in the LS5 group compared to the CL group. CLINICAL RELEVANCE: Use of the LigaSure 5-mm VSD allows efficient haemostasis while performing open OVH in female pet rabbits.

Clip ligation for treatment of patent ductus arteriosus occlusion in three cats.

Patent ductus arteriosus (PDA) is a rare congenital cardiovascular anomaly in cats. Due to their small body, intercostal thoracotomy is the most common option to close the PDA. However, few reports detail the surgical technique for ligating PDA in kittens. In this case report, three cats weighing 1.4 kg, 1.2 kg, and 2.9 kg were diagnosed PDA. Clip ligation via left fourth intercostal thoracotomy was performed and the cats were successfully treated. Postoperative echocardiography showed no residual flow in any of the cases. This case report highlights clip occlusion for small cats with PDA could be safe and effective.

Medial insertion of the patent ductus arteriosus characterized by computed tomography angiography in a cat and dog.

Surgical ligation of a left-to-right shunting patent ductus arteriosus was attempted in two animals. In both cases, a young cat and dog, ligation was complicated by poor visualization of the ductus resulting in unsuccessful ligation. Post-operatively, both the cat and dog underwent computed tomography angiography to characterize the location and morphology of the patent ductus arteriosus. In both cases, computed tomography angiography revealed a left-to-right shunting patent ductus arteriosus with an insertion location medial to the left pulmonary artery branch compared to the typical location. We hypothesize that this atypical location resulted in a difficult surgical visualization from the left thoracotomy approach. Transvenous coil embolization of the duct from the external jugular vein was performed in both cases and resulted in successful occlusion. Variations in the medial-lateral insertion of the ductus arteriosus may have consequences for surgical intervention. If an atypical location of a patent ductus arteriosus is suspected on transthoracic echocardiography, computed tomography angiography prior to ligation may be useful to further define ductal location and help guide the surgical approach.

Surgical ligation of patent ductus arteriosus in dogs: Incidence and risk factors for rupture.

OBJECTIVE: To determine the rates of rupture and mortality associated with surgical ligation of patent ductus arteriosus (PDA) in dogs and to identify risk factors for rupture. STUDY DESIGN: Retrospective cohort. ANIMALS: Two-hundred and eighty-five dogs with PDA undergoing surgical ligation. METHODS: Information regarding signalment, weight, surgical findings, complications, presence of residual flow, and survival was recorded. Age, weight, and presence of residual flow were compared between cases with and without rupture. RESULTS: The initial surgical approach was extrapericardial (144), intrapericardial (46), not reported (94), or Jackson-Henderson (1). Rupture of the PDA occurred in 7.0% of dogs (20/285, 13 extrapericardial, 3 intrapericardial, 4 not reported). No difference in age or weight was found between dogs with and without rupture. Overall mortality was 0.4% (1/285). Additional major complications occurred in 1.4% of dogs, all in the nonrupture group. The overall rate of residual flow after ligation was 9.4%. Dogs with rupture were more likely to have residual flow than those without rupture (P = .012). If ligation was performed after rupture (rather than hemostasis only), no difference in residual flow rates (P = .398) was noted between dogs with rupture and those without. CONCLUSION: The rate of rupture with surgical ligation of PDAs was low. No specific risk factors for rupture were identified. CLINICAL SIGNIFICANCE: Successful treatment of PDA rupture is possible, evidenced by the low mortality rate in this population of dogs. Ligation of the PDA after rupture, either in the concurrent or a subsequent procedure, reduces the odds of residual flow.

Dominant outflow vein occlusion in the management of naturally occurring peripheral arteriovenous anomalies in cats and dogs.

Two dogs and 1 cat were referred to a tertiary veterinary center for the consultation and treatment of limb edema, variable dermal sanguineous crusting lesions, and intermittent lameness. A peripheral arteriovenous anomaly (PAA) was diagnosed via computed tomographic angiography (CTA) in each case. Arteriography enabled further evaluation of the PAA with confirmation of a dominant outflow vein. Dominant outflow vein occlusion was achieved by direct ligation in 1 dog and retrograde transvenous glue embolization in the cat and other dog. Repeat arteriography demonstrated resolution of arteriovenous shunting. Presenting clinical signs resolved in all animals. The previously identified aberrant vessels in 1 dog were not identified after CTA 40 days postoperatively. No postoperative complications or recurrence was identified in any case during the 6- to 55-month follow-up period.