Standard and modified glabellar flap for medial canthus reconstruction following mass removal in three dogs and two cats.

PURPOSE: To describe the surgical technique and clinical outcomes of the glabellar flap and its modification for the reconstruction of the medial canthus following resection of tumors in three dogs and two cats. METHODS: Three dogs (7-, 7-, and 12.5-year-old mixed breeds) and two cats (10- and 14-year-old Domestic shorthair) presented with a 7-13 mm tumor affecting the eyelid and/or conjunctiva in the medial canthal region. Following en bloc mass excision, an inverted V-shaped skin incision was made in the glabellar region (i.e., the area between the eyebrows in humans). The apex of the inverted V-shaped flap was rotated in three cases, whereas a horizontal sliding movement was performed in the other two cases to better cover the surgical wound. The surgical flap was then trimmed to fit the surgical wound and sutured in place in two layers (subcutaneous and cutaneous). RESULTS: Tumors were diagnosed as mast cell tumors (n = 3), amelanotic conjunctival melanoma (n = 1), and apocrine ductal adenoma (n = 1). No recurrence was noted in a follow-up time of 146 ± 84 days. Satisfactory cosmetic outcome with normal eyelids closure was achieved in all cases. Mild trichiasis was present in all patients and mild epiphora was noted in 2/5 patients, but there were no associated clinical signs such as discomfort or keratitis. CONCLUSIONS: The glabellar flap was easy to perform and provided a good outcome in terms of cosmetic, eyelid function, and corneal health. Postoperative complications from trichiasis appear to be minimized by the presence of the third eyelid in this region.

Analgesic effects of intraorbital insertion of an absorbable gelatin hemostatic sponge soaked with 1% ropivacaine solution following enucleation in dogs.

OBJECTIVE: To evaluate analgesic effects and complications associated with intraorbital insertion of an absorbable gelatin hemostatic sponge (AGHS) soaked with 1% ropivacaine solution following enucleation in dogs. ANIMALS: 20 client-owned dogs undergoing enucleation. PROCEDURES: Dogs were randomly assigned to receive an AGHS soaked with 1% ropivacaine solution (n = 10) or saline (0.9% NaCl) solution (control group; 10) inserted intraorbitally prior to skin closure following enucleation. Carprofen (2 mg/kg [0.9 mg/lb]) was administered SC once after orotracheal extubation and then PO twice a day for 5 days. During the postoperative recovery period, apparent pain level was scored at various points with a modified short-form Glasgow Composite Pain Scale (score range, 0 to 19), and methadone was administered for rescue analgesia if any score was ≥ 5. After dogs returned home, owners recorded their behavior and apparent pain level for the first 3 days following enucleation. RESULTS: At extubation, the median (range) pain score was significantly higher in the control group (8 [2 to 14]) versus the ropivacaine group (3 [1 to 7]). A greater proportion of dogs in the control group received methadone (7/10 vs 1/10) and had crying or attention-seeking behavior on the first day following enucleation (7/10 vs 1/10). No complications were observed in either group. CONCLUSIONS AND CLINICAL RELEVANCE: Addition of intraorbital insertion of a ropivacaine-soaked AGHS to the analgesic protocol for dogs undergoing enucleation provided better analgesia than was achieved without this treatment as measured immediately and the first day after surgery, with no noted adverse effects.

A comparison of retrobulbar and two peribulbar regional anesthetic techniques in dog cadavers.

OBJECTIVE: To compare injectate distribution and likelihood of regional anesthesia to the orbit following retrobulbar (RB) or peribulbar (PB) injections in dog cadavers. STUDY DESIGN: Randomized, masked study. ANIMALS: Twenty-four dog cadavers (aged 5.5-17 years, 2.0-36.3 kg). METHODS: Orbits underwent one of three injection techniques with bupivacaine 0.5% and iohexol (1:1): ventrolateral RB injection (1-2 mL; 15 orbits), medial canthal PB injection (2-8 mL; PB-1; 16 orbits), or dorsomedial and ventrolateral PB injections (each 1-4 mL; PB-2; 16 orbits). The likelihood of successful regional anesthesia was estimated based on computed tomographic images scored for injectate volume of distribution at the base and within the extraocular muscle cone (EOMC), and injectate distribution around the optic nerve. Intraocular pressure (IOP) was measured before and after injections. Mixed-effects linear regression with post hoc Bonferroni contrast adjustments was performed. Significance was set at 0.05. RESULTS: A difference in injectate volume of distribution within or at the base of the EOMC was not detected among groups. The median optic nerve circumference of injectate distribution was significantly higher in the RB injected group than in the PB-2 group. Injectate distribution following RB, PB-1 and PB-2 injections was graded as likely to provide regional anesthesia within the EOMC in 40%, 19% and 31% of eyes, and at the EOMC base in 60%, 63% and 50% of eyes, respectively. The probability of likelihood to provide regional anesthesia was lower in dogs of higher body weights. The IOP was significantly higher than baseline following PB-1 (18 ± 14 mmHg) and in comparison with RB (2 ± 3 mmHg), but not different from PB-2 injection (10 ± 11 mmHg). CONCLUSIONS AND CLINICAL RELEVANCE: None of the techniques reliably produced 'successful' injectate distribution based on this study's definitions; however, clinical assessment of anesthetic success is required.

The effects of topical parasympatholytic drugs on pupil diameter and intraocular pressure in healthy dogs treated with 0.005% latanoprost.

PURPOSE: Prostaglandin analogs induce miosis and lower intraocular pressure (IOP). As pupils of latanoprost-treated eyes may have to be dilated for ophthalmoscopy or intraocular surgery, we studied whether 0.5% tropicamide or 1% atropine alter the effects of 0.005% latanoprost on pupil diameter (PD) and IOP in healthy dogs. METHODS: IOP and PD were measured hourly, 8 AM-4 PM, with the right and left eyes serving as control (CE) and treated (TE) eyes, respectively. Measurements were conducted in ten Labrador retrievers with one-week washout: (i) baseline values, (ii) latanoprost at 8 AM, (iii) tropicamide at 8 AM, (iv) latanoprost at 8 AM and tropicamide at 11 AM, and (v) latanoprost at 8 AM and atropine at 11 AM (n = 4). RESULTS: At 4 PM, TE PD was 5.88 ± 0.59, 3.62 ± 0.66, 6.33 ± 1.00, 5.42 ± 0.57, and 8.12 ± 1.24 mm in sessions 1-5, respectively. TE PD was significantly different between treatment sessions 2, 4, and 5 (P = 0.018, Friedman), being most mydriatic in session 5. At 4 PM, TE IOP was 11.27 ± 2.07, 7.10 ± 1.07, 11.1 ± 2.21, 7.70 ± 1.85, and 8.87 ± 1.42 mm Hg in sessions 1-5, respectively, with no differences between treatment sessions 2, 4, and 5 (P = 0.105, Friedman). CONCLUSIONS: Tropicamide and atropine counteracted latanoprost's miotic effect, with atropine causing significantly larger mydriasis, sufficient for indirect ophthalmoscopy. Neither drug counteracted the hypotensive effect of latanoprost during this study period. Further studies are necessary to evaluate the potential risks in glaucomatous dogs.

The effects of 1% prednisolone acetate on pupil diameter and intraocular pressure in healthy dogs treated with 0.005% latanoprost.

PURPOSE: Prostaglandin analogs contribute to blood-aqueous barrier breakdown and may exacerbate uveitis. As these analogs induce de novo synthesis of endogenous prostaglandins, their therapeutic, hypotensive effect could potentially be inhibited by anti-inflammatory treatment. We therefore evaluated whether topical 1% prednisolone acetate alters the effects of 0.005% latanoprost on pupil diameter (PD) and intraocular pressure (IOP). ANIMALS STUDIED: Ten healthy Labrador retriever dogs from the Israel Guide Dog Center for the Blind. METHODS: Pupil diameter and IOP were measured hourly, 8 AM-4 PM, with the right and left eyes serving as control (CE) and treated (TE) eyes, respectively. Measurements were conducted during four sessions: (1) without treatment (n = 10), (2) following latanoprost treatment (n = 10) at 8 AM, (3) following prednisolone treatment (n = 7) at 8 AM, and (4) bilateral latanoprost treatment at 8 AM, prednisolone treatment in TE at 11 AM (n = 8). The different number of dogs in sessions 3 and 4 is because some dogs were matched with their new owners earlier than expected. RESULTS: Pupil diameters were not affected by the addition of prednisolone and, at 4 PM, were 3.82 ± 0.47 and 3.97 ± 0.36 mm in TE and CE, respectively (P = 0.175, Wilcoxon). IOPs were not affected by the addition of prednisolone and, at 4 PM, were 9.0 ± 0.8 and 9.3 ± 0.8 mm Hg in TE and CE, respectively (P = 0.339, Wilcoxon). CONCLUSION: Prednisolone did not alter latanoprost's miotic and hypotensive effects in normal dogs during this study period.

Long-term outcome of conventional endotracheal tube balloon dilation of tracheal stenosis in a dog.

This report describes a successful dilation of tracheal stenosis in a 16-year-old dog using a conventional endotracheal tube balloon. This technique should be considered as palliative treatment when owners decline other therapeutic options.

Résultat à long terme de la dilatation du ballonnet-tube trachéal d'une sténose trachéale chez un chien. Ce rapport décrit une dilatation réussie d'une sténose trachéale chez un chien âgé de 16 ans à l'aide d'un ballonnet-tube trachéal conventionnel. Cette technique devrait être considérée comme un traitement palliatif lorsque les propriétaires refusent les autres options thérapeutiques.(Traduit par Isabelle Vallières).