Prospective measurement of outcomes and complications of tibial tuberosity advancement using novel mini plates in small breed dogs.

Cranial cruciate ligament (CrCL) disease is a common orthopedic disease in canine patients. Tibial osteotomy procedures for the treatment of cranial cruciate ligament disease in small breed dogs (<15 kg) have previously been limited. A total of 22 client-owned dogs, 26 stifles, with cranial cruciate ligament disease were treated with novel mini-tibial tuberosity advancement plates. The most common intraoperative complications included the need for plate-cage overlap in 7 stifles (26.92%) and screw head fracture in 1 (3.85%). Post-operative complications included tibial tuberosity fracture (3.85%), post-operative medial patella luxation (7.69%), and persistent lameness (7.69%). Of the 26 stifles evaluated in the medium term (>6-12 months) post-operatively, 92.3% had no lameness, with the remaining 7.7% having Grade 1 lameness. A good to excellent clinical outcome was noted in all 26 stifles that underwent TTA with novel mini plates.

Clinical outcomes in cats with renal carcinoma undergoing nephrectomy: A retrospective study.

Renal carcinomas (RC) are uncommonly encountered in feline medicine. Limited information regarding clinical presentation and postoperative outcomes is available. The purpose of this multi-institutional, retrospective study was to describe the presenting features and clinical outcomes of cats with RC undergoing nephrectomy. Thirty-six client-owned cats were included. Medical records from participating institutions were searched to identify cats that had a histopathologic diagnosis of RC and underwent nephrectomy from January 2001 to October 2021. The most common presenting complaints were weight loss (36.1%) and hyporexia (30.6%). Based on preoperative imaging and intraoperative findings, eight cats had suspected metastasis at the time of surgery (22.2%). Twenty-eight cats survived to discharge (77.8%). Median progression free interval (PFI) could not be determined, as only six cats developed suspected recurrence (16.7%) and seven cats developed suspected metastasis (19.4%). The all-cause median survival time (MST) was 203 days (95% confidence interval [CI]: 84, 1379 days). When cases that died prior to discharge were excluded, MST increased to 1217 days (95% CI: 127, 1641 days). One-year, two-year, and three-year survival rates were all 40.4%. Neither renal tumour histologic subtype nor the presence of preoperative azotemia, anaemia, erythrocytosis, haematuria, or suspected metastasis at diagnosis were found to influence survival. For cats surviving to discharge, prolonged survival times were possible. Further studies are necessary to elucidate other potential prognostic factors, the utility of postoperative adjuvant treatment, and to identify cats at-risk of mortality in the perioperative period.

Retrospective study of 20 cats surgically treated for insulinoma.

OBJECTIVE: To report the clinical signs, histopathology results, and prognostic factors for outcomes following excision for feline insulinoma (INS). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Twenty client-owned cats. METHODS: Medical records from 2006 to 2020 were reviewed by Veterinary Society of Surgical Oncology members for cats with hypoglycemia resulting from INS, with surgical excision and follow up. Clinical signs and histopathology results were summarized. Factors potentially related to disease-free interval (DFI), disease-related death (DRD), and overall survival time (OST) were analyzed with a Cox proportional hazards regression analysis. RESULTS: All cats were hypoglycemic on presentation with neurologic signs in 18 out of 20 and inappropriate insulin levels in 12/13. Excision of insulinomas resulted in immediate euglycemia or hyperglycemia in 18 cats. Eighteen cats survived to hospital discharge. The median time to death or last postoperative follow up was 664 days (range: 2-1205 days). Prognostic factors included age at presentation (for DFI); time to postoperative euglycemia (for DRD); preoperative and postoperative serum blood glucose concentrations; metastasis at the time of surgery (DFI and DRD), and histopathologic tumor invasion (for OST). The median OST for all cats was 863 days. The 1-, 2- and 3-year survival rates were 75%, 51%, and 10%, respectively. CONCLUSION: Excision of insulinoma resulted in euglycemia or hyperglycemia in most cats. Negative prognostic factors included young age, low serum glucose concentrations, metastasis at time of surgery, tumor invasion, and shorter time to euglycemia. CLINICAL SIGNIFICANCE: Surgical excision resulted in survival times comparable to those of canine INS.

Complications and outcomes of cats with coxofemoral luxation treated with hip toggle stabilization using ultrahigh-molecular-weight-polyethylene or nylon (2009-2018): 48 cats.

OBJECTIVE: To report overall rate and type of complications and outcomes of cats with coxofemoral luxation managed with hip toggle stabilization (HTS), to compare rate of postoperative complications and outcomes of cats treated with ultrahigh-molecular-weight-polyethylene (UHMWPE) or nylon, and to identify risk factors for reluxation and non-excellent outcomes. STUDY DESIGN: Multi-institutional retrospective cohort study. SAMPLE POPULATION: Forty-eight client-owned cats. METHODS: Medical records of cats that underwent HTS from 2008-2018 using UHMWPE or nylon were reviewed. Univariable and multivariable logistic regression was performed to assess for factors associated with reluxation and non-excellent outcome. Final outcome was obtained from owner questionnaire. RESULTS: Intraoperative and postoperative complications were recorded in two (4.2%) and 11 (24.4%) cats, respectively. The most common postoperative complication was reluxation (n = 5 [11.1%]). Outcome was classified as excellent in 81.1% and good in 16.2% of cats after a median of 445.5 days (range, 53-3720). No difference in rate of complications or outcomes was identified between UHMWPE and nylon. Performance of additional orthopedic procedures, occurrence of intraoperative complications, and non-performance of capsulorrhaphy were associated with reluxation. Performance of additional non-hip procedures (orthopedic/nonorthopedic) was associated with non-excellent outcome. CONCLUSION: Hip toggle stabilization was associated with a low rate of intraoperative complications and reluxation and excellent long-term outcomes in most cats. No difference in rate of postoperative complications or outcomes of cats treated using UHMWPE or nylon was identified. Cats that underwent additional orthopedic procedures had greater risk of reluxation. CLINICAL SIGNIFICANCE: Hip toggle stabilization is an effective technique for management of coxofemoral luxation in cats. Comparable results are expected using UHMWPE or nylon.

Unique Differences of Minimally Invasive Fracture Repair in the Feline.

As the saying goes, "cats are not small dogs." Throughout veterinary medicine history, most of the literature focus has been on the canine. Feline patients, however, now constitute a larger proportion of the pet population and are unique in many aspects. They differ anatomically and biomechanically from canines and have specific recovery needs and different pain-related behaviors. It is important that veterinary surgeons understand these differences and improve their knowledge base in the treatment of cats. This article highlights the differences in cats relevant to minimally invasive fracture repair and how they affect a surgeon's approach to fractures in cats.

Minimally Invasive Osteosynthesis Techniques for Humerus Fractures.

A thorough knowledge of humeral anatomy is critical to performing minimally invasive techniques. Fluoroscopy, when available, is invaluable in optimizing fracture repair with minimally invasive techniques. Minimally invasive approaches decrease morbidity and allow an earlier return to function. Minimally invasive fracture repair is performed using implant systems similar to open approaches.

Comparison of complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy in cats.

OBJECTIVE: To compare complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy (VBO) in cats. ANIMALS: 282 client-owned cats treated by VBO at 25 veterinary referral and academic hospitals from 2005 through 2016. PROCEDURES: Medical records of cats were reviewed to collect information on signalment, clinical signs, diagnostic test results, surgical and postoperative management details, complications (anesthetic, surgical, and postoperative), and outcome. Associations were evaluated among selected variables. RESULTS: Unilateral, staged bilateral, and single-stage bilateral VBO was performed in 211, 7, and 64 cats, respectively, representing 289 separate procedures. Eighteen (9%), 2 (29%), and 30 (47%) of these cats, respectively, had postoperative respiratory complications. Cats treated with single-stage bilateral VBO were significantly more likely to have severe respiratory complications and surgery-related death than cats treated with other VBO procedures. Overall, 68.2% (n = 197) of the 289 procedures were associated with Horner syndrome (19.4% permanently), 30.1% (87) with head tilt (22.1% permanently), 13.5% (39) with facial nerve paralysis (8.0% permanently), and 6.2% (18) with local disease recurrence. Cats with (vs without) Horner syndrome, head tilt, and facial nerve paralysis before VBO had 2.6, 3.3, and 5.6 times the odds, respectively, of having these conditions permanently. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggested that staged bilateral VBO should be recommended over single-stage bilateral VBO for cats with bilateral middle ear disease. Cats with Horner syndrome, head tilt, and facial nerve paralysis before surgery were more likely to have these conditions permanently following surgery than were cats without these conditions.

Evaluation of Nodular Splenic Lesions in 370 Small-Breed Dogs (<15 kg).

Three hundred seventy small-breed dogs (<15 kg) undergoing splenectomy for the presence of nodular splenic lesions were evaluated in a retrospective study to assess associations with breeds, malignancy, hemoperitoneum, and median survival time compared with previous studies. Data analyzed included signalment, histopathologic diagnosis, presence or absence of hemoperitoneum, breed associations, and survival times. In the current study, 44% (163/370) of dogs had nonneoplastic splenic lesions and 56% (207/370) had neoplastic lesions. Hemangiosarcoma was present in 27% (100/370) of splenic lesions. Hemoperitoneum was present in 31% (115/370) of dogs, and of this population, 66% (76/115) had malignant splenic lesions. The most common breeds were miniature schnauzers, dachshunds, and beagles, with beagles exhibiting a positive association with malignancy. The presence of hemoperitoneum was associated with malignancy. Distribution for nodular splenic lesions, correlation of hemoperitoneum to malignancy, and median survival time were similar to previous reports in large-breed dogs. Small-breed dogs who present with hemoperitoneum are 2.6 times more likely to have a diagnosis of a malignant splenic lesion. The most common small-breed dogs with nodular splenic lesions were miniature schnauzers, dachshunds, and beagles. Beagles and small-breed terriers were more likely to have malignant splenic lesions, and small-breed terriers were more likely to present with hemoperitoneum.

Primary appendicular hemangiosarcoma and telangiectatic osteosarcoma in 70 dogs: A Veterinary Society of Surgical Oncology retrospective study.

OBJECTIVE: To define and compare clinical characteristics of canine primary appendicular hemangiosarcoma (HSA) and telangiectatic osteosarcoma (tOSA), including signalment, presentation, response to treatment, and prognosis. STUDY DESIGN: Multi-institutional retrospective study. ANIMALS: Seventy dogs with primary appendicular HSA or tOSA. METHODS: Patient data were obtained from institutions' medical records. Immunohistochemistry was applied to archived tissues to establish tumor type. Patient characteristics, treatment responses, and outcomes were described and compared by tumor type. RESULTS: Forty-one HSA and 29 tOSA were identified. Dogs with HSA were more likely than dogs with tOSA to be male and have hind limb tumors; 78% of HSA occurred in hind limbs, particularly the tibia. Dogs with tOSA weighed a median of 9.9 kg (95% CI 4.6-15.3) more than dogs with HSA. Most dogs received antineoplastic treatment, predominantly amputation with or without adjuvant chemotherapy. Overall survival with local treatment and chemotherapy was 299 days (95% CI 123-750) for HSA and 213 days (95% CI 77-310) for tOSA. Younger age and more aggressive treatment were associated with longer survival in dogs with HSA but not tOSA. One-year survival rates did not differ between dogs with HSA (28%) and those with tOSA (7%). CONCLUSION: Distinct clinical features were identified between HSA and tOSA in this population. Both tumors were aggressive, with a high incidence of pulmonary metastases. However, local treatment combined with chemotherapy led to an average survival 7 months for tOSA and 10 months for HSA. CLINICAL SIGNIFICANCE: HSA should be considered as a differential in dogs with aggressive lytic bone lesions, particularly medium-sized dogs with tibial lesions. HSA has a unique clinical presentation but similar therapeutic response and outcome to OSA. Amputation and chemotherapy appear to prolong survival in some dogs with HSA and tOSA.

Complications and outcomes following rectal pull-through surgery in dogs with rectal masses: 74 cases (2000-2013).

OBJECTIVE: To evaluate the incidence of and factors associated with complications following rectal pull-through (RPT) surgery and the outcome for dogs with rectal tumors. DESIGN: Retrospective case series. ANIMALS: 74 dogs with rectal masses. PROCEDURES: Information regarding signalment, history, diagnostic testing, type of rectal disease, surgical details, and postoperative complications, treatments, and outcomes was obtained from medical records and follow-up communications. Survival times were calculated. Descriptive statistics were generated. Regression analyses were used to evaluate the effect of various variables on the development of postsurgical complications and survival time. RESULTS: 58 (78.4%) dogs developed postsurgical complications, the most common of which was fecal incontinence with 42 (56.8%) dogs affected, of which 23 (54.8%) developed permanent incontinence. Other complications included diarrhea (n = 32), tenesmus (23), stricture formation (16), rectal bleeding (8), constipation (7), dehiscence (6), and infection (4). The rectal tumor recurred in 10 dogs. The median survival time was 1,150 days for all dogs and 726 days for dogs with malignant tumors. The 2 most common rectal masses were rectal carcinoma and rectal carcinoma in situ, and the dogs with these tumors had median survival times of 696 and 1,006 days, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs with rectal diseases that underwent RPT surgery had a high incidence of complications; however, those dogs had good local tumor control and survival times. The risk and impact of postsurgical complications on the quality of life and oncological outcomes should be discussed with owners before RPT surgery is performed in dogs with rectal masses.

Outcome and prognostic indicators in 20 cats with surgically treated primary lung tumors.

The purpose of this retrospective study of 20 client-owned cats was to describe the clinical signs, surgical interventions, histological features, stage and treatments of primary lung tumors removed by surgical excision, and to determine which factors significantly influence survival. Any cat that underwent surgical resection of a primary lung tumor between 2000 and 2007 was included in the study. Patient records were reviewed and signalment, clinical signs, preoperative diagnostics, surgical findings and histopathological results recorded. Histological reports were reviewed and scored using World Health Organization criteria. The Kaplan-Meier test was used to evaluate each potential prognostic factor with survival. Twenty cats met the inclusion criteria. The presence of clinical signs (such as dyspnea) at the time of diagnosis (P = 0.032), pleural effusion (P = 0.046), stage M1 (P = 0.015), and moderately and poorly differentiated tumors on histopathology (P = 0.011) were factors that were significantly correlated with reduced survival times. The median survival time of the 20 cats was 11 days. Cats presenting with no clinical signs had a median survival time of 578 days post-surgery vs 4 days post-surgery when presented with clinical signs. Cats staged T1N0M0 lived longer than cats at other stages (P = 0.044). Of the cats that survived to the time of suture removal, median survival time was 64 days. The results indicate that the presence of clinical signs, pleural effusion, moderately and poorly differentiated tumors on histopathology, evidence of metastasis and any stage beyond T1N0M0 are negative prognostic indicators for cats with primary lung tumors. The findings demonstrate that cats that presented with clinical signs, pleural effusion, any stage other than T1N0M0, or moderately and poorly differentiated tumors on histopathology had a poor prognosis. Therefore, extensive preoperative diagnostics, including computed tomography scans, should be performed before considering surgical intervention in these cats. These findings may be used to guide therapeutic decision-making in cats diagnosed with primary lung tumors.

Pneumothorax.

Pneumothorax may be classified as open or closed and as traumatic, spontaneous, or iatrogenic. The most common cause of pneumothorax is thoracic trauma. Spontaneous pneumothorax is often a result of bullous emphysema, and iatrogenic pneumothorax is an important complication of procedures involving the thoracic cavity. Most animals present with tachypnea, tachycardia, respiratory distress, and anxiety. Radiography and thoracocentesis are useful diagnostic aids. Traumatic and iatrogenic pneumothorax are commonly treated with thoracocentesis or thoracostomy tube placement. Spontaneous pneumothorax usually requires surgical resection of the affected lobe(s). The prognosis for traumatic pneumothorax is excellent if there are no other life-threatening injuries; for spontaneous pneumothorax, the prognosis depends on the underlying cause and method of treatment. The prognosis for iatrogenic pneumothorax is considered good.Pneumothorax is classified as open or closed and according to the causative mechanism. Open pneumothorax results from a penetrating thoracic injury that permits entry of air into the chest, while closed pneumothorax is the accumulation of air originating from the respiratory system within the pleural space. In some cases, the air may come from both sources (e.g., severe thoracic bite wounds with lung punctures).

Acute non-ambulatory tetraparesis attributable to cranial cervical intervertebral disc disease in a cat.

A 10-year-old domestic longhair cat was presented for acute non-ambulatory tetraparesis. Clinicopathologic diagnostics revealed no abnormalities. Cervical myelogram revealed an extradural compressive lesion consistent with intervertebral disc disease of the C2-C3 intervertebral disc space. Ventral slot decompression confirmed the presence of extruded intervertebral disc material into the vertebral canal of the C2-C3 intervertebral space. The patient succumbed to cardiorespiratory arrest 3 days postoperatively.