Efficacy of adhesive incise drapes in preventing bacterial contamination of clean canine surgical wounds.

OBJECTIVE: To investigate the efficacy of adhesive incise drapes in reducing bacterial contamination of clean canine surgical wounds. STUDY DESIGN: Randomized clinical trial. ANIMALS: Dogs (n=100) having elective ovariohysterectomy or stifle surgery. METHODS: Dogs were randomly assigned to 1 of 2 groups: drape or no drape. Swabs obtained from the inner edge of the surgical wound at the beginning (swab 1) and end (swab 2) of surgery were submitted for microbial culture. Number of colony forming units was counted for all positive cultures and change in bacterial counts between swabs 1 and 2 was calculated. Percentage adhesive drape adherence at the end of surgery was calculated from a digital photograph of the surgical site. duration of surgery/anesthesia and the anesthetic induction agent used were recorded. RESULTS: There was a significant increase in bacterial counts between swabs 1 and 2 (P=.001). Wound contamination was 14% (6 drape; 8 no drape; P=0.78) with Staphylococcus spp. most commonly isolated. Median percentage drape adherence at the end of surgery was 89.3% (0-100%). Duration of anesthesia was significantly related to wound contamination (P=.013), but duration of surgery and anesthesia induction agent were not. CONCLUSIONS: Adhesive incise drapes did not reduce wound contamination of clean canine surgical wounds. CLINICAL RELEVANCE: Use of adhesive incise drapes in clean surgical procedures is of questionable benefit in dogs.

Liver size, bodyweight, and tolerance to acute complete occlusion of congenital extrahepatic portosystemic shunts in dogs.

OBJECTIVE: To investigate the relationship between preoperative liver size, bodyweight, and tolerance to shunt occlusion in dogs with congenital extrahepatic portosystemic shunt(s) (CPSS). STUDY DESIGN: Longitudinal cohort study. ANIMALS: Dogs with CPSS (n=35). METHODS: Ultrasonography was used to measure preoperative maximum transverse dimension of the liver (TS) of each dog. Intraoperative portal pressures were measured, before and after CPSS occlusion, via a jejunal vein catheter. Tolerance to shunt occlusion was judged on gross visceral observations, and on changes in portal pressure, central venous and mean arterial pressures. RESULTS: TS was significantly related to bodyweight (P<.05). Mean ratios for TS/bodyweight were calculated for dogs tolerant and intolerant of acute complete shunt occlusion. Dogs tolerant to occlusion had significantly higher TS/bodyweight ratios than dogs intolerant to occlusion (P=.025). Dogs with a TS/bodyweight ratio of >7 were more likely to tolerate CPSS occlusion than dogs with a TS/bodyweight ratio of <5 (P=.036). A model was generated to predict portal pressure rise after shunt occlusion, based on liver dimensions and bodyweight (R=0.668). Intestinal oxygenation did not correlate significantly with tolerance to CPSS occlusion (P=.29). CONCLUSION: In dogs with CPSS, liver size (relative to bodyweight) is significantly greater (P=.025) in dogs that are tolerant of full ligation than intolerant of occlusion. CLINICAL RELEVANCE: Preoperative measurement of bodyweight and liver size help indicate the likelihood of tolerance to acute complete occlusion of CPSS in dogs.

Treatment and long-term follow-up of extrahepatic biliary obstruction with bilirubin cholelithiasis in a Somali cat with pyruvate kinase deficiency.

A 2-year-old female neutered Somali cat was presented with vomiting and acute onset jaundice 1 year after diagnosis of pyruvate kinase (PK) deficiency. Diagnostic investigations revealed a moderate regenerative haemolytic anaemia, severe hyperbilirubinaemia and elevated liver enzymes. Ultrasonography revealed marked distension of the gall bladder and common bile duct (CBD), consistent with extrahepatic biliary obstruction (EHBO). At cholecystotomy, the gall bladder contained purulent material, and two obstructive choleliths were removed from the CBD by choledochotomy. The cat recovered from surgery uneventfully, and serum liver enzymes and bilirubin normalised within 10 days. Postoperative treatment consisted of cephalexin, metronidazole and ursodeoxycholic acid (UDCA). Bacterial culture of the gall bladder contents yielded a pure growth of an Actinomyces species. Cholelith analysis revealed that they consisted of 100% bilirubin. Antibiotic treatment was stopped 4 weeks after surgery but UDCA was continued indefinitely. The cat remains clinically well with no recurrence of cholelithiasis 20 months after initial presentation. This is the first report of successful treatment and long-term follow-up of a cat with EHBO due to bilirubin cholelithiasis in association with PK deficiency-induced chronic haemolysis.

Evaluation of a bladder tumor antigen test for the diagnosis of lower urinary tract malignancies in dogs.

OBJECTIVE: To evaluate the use of a human bladder tumor antigen test for diagnosis of lower urinary tract malignancies in dogs. SAMPLE POPULATION: Urine samples from dogs without urinary tract abnormalities (n = 18) and from dogs with lower urinary tract neoplasia (20) or nonmalignant urinary tract disease (16). PROCEDURE: Test results were compared among groups and among 3 observers. The effects of urine pH and specific gravity, degree of hematuria, and storage temperature and time of urine samples on test results were also assessed. RESULTS: Test sensitivity and specificity were 90 and 94.4%, respectively, for differentiating dogs with lower urinary tract neoplasia from dogs without abnormalities. However, specificity decreased to 35% for differentiating dogs with neoplasia from dogs with nonmalignant urinary tract disease. In dogs with neoplasia, results were significantly affected by degree of hematuria. However, addition of blood to urine from dogs without hematuria had no significant effect on test results. Although intraobserver variation was significant, urine pH, specific gravity, or storage time or temperature had no significant effect on results. CONCLUSIONS AND CLINICAL RELEVANCE: Although this bladder tumor antigen test was sensitive for differentiating dogs with malignancies of the lower urinary tract from dogs without urinary tract disease, it was not specific for differentiating dogs with neoplasia from dogs with other lower urinary tract abnormalities. It cannot, therefore, be recommended as a definitive diagnostic aid for the detection of lower urinary tract malignancies in dogs.