Paracostal versus ventral midline approach for caudate liver lobectomy in the rabbit.

OBJECTIVE: To describe the paracostal approach to caudate liver lobectomy in rabbits and compare the outcome of paracostal versus ventral midline approach for caudate liver lobectomy in rabbits with caudate liver lobe torsion (LLT). STUDY DESIGN: Cadaveric and retrospective study. ANIMALS: Normal rabbit cadavers (n = 5) and rabbits with caudate LLT (n = 22). METHODS: Cadavers - a right paracostal or ventral midline approach was made. Accessibility of the caudate liver lobe and relationship to the gastrointestinal (GI) tract were assessed. Clinical LLT cases - 9 cases were treated via the paracostal approach and 13 were treated via the ventral midline approach. Medical records (January, 2018 to October, 2021) were reviewed. Anesthesia and surgical times, mortality rate, and relevant clinical data were compared between groups. RESULTS: In cadavers, caudate liver lobectomy was feasible through a paracostal approach without retraction of the GI tract. In clinical cases, there was no difference in anesthesia time (P = 0.1397) or surgical time (P = 0.9462) between groups. All rabbits that underwent paracostal approach survived to discharge. Mortality was lower (P = .053) and postoperative time until eating was shorter (P = .0238) for patients undergoing paracostal approach. CONCLUSION: Rabbits experienced lower mortality and shorter time until eating when treated through a right paracostal approach compared to the ventral midline approach. The paracostal approach resulted in minimal to no manipulation of the GI tract. CLINICAL SIGNIFICANCE: A right paracostal approach for caudate liver lobectomy in rabbits provides good exposure while avoiding GI tract manipulation. This approach may result in improved survival and earlier eating in rabbits with caudate LLT.

Combined tibial plateau levelling osteotomy and tibial tuberosity transposition for treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation.

OBJECTIVES: To describe the surgical technique and report short-term outcome for combined tibial plateau levelling osteotomy and tibial tuberosity transposition (TPLO-TTT) as an option in the treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation. METHODS: Medical records were reviewed (2011-2013) of dogs that underwent a standard tibial plateau levelling osteotomy followed by a tibial tuberosity transposition in the frontal plane and stabilized with pin and tension-band wire fixation as a component of surgical treatment for combined cranial cruciate ligament insufficiency and medial patellar luxation. Signalment, fixation method together with any ancillary procedures, function at the in-hospital follow-up examinations, and any complications were recorded. Healing was assessed retrospectively based on the grading criteria of the International Society Of Limb Salvage. RESULTS: Fifteen stifle joints in 11 dogs were identified; 13 stifles were available for in-hospital follow-up. All 13 achieved union (3 with grade III/IV and 10 with grade IV/IV radiographic healing scores); mean time to healing was 10.6 (± 2.9) weeks. Patellar ligament thickening was also identified radiographically in seven of the 13 of stifle joints. All dogs were reported to have mild or no lameness at their last follow-up examination. No catastrophic or major postoperative complications occurred that required additional surgery. Patellar re-luxation did not occur in any of the 13 stifles available for in-hospital follow-up. CLINICAL SIGNIFICANCE: The TPLO-TTT was found to be a reliable and effective technique when used as a part of the treatment of combined cranial cruciate ligament insufficiency with concomitant medial patellar luxation in this series of dogs.