Surgical treatment of feline intracranial meningiomas: a retrospective study of 26 cases.

BACKGROUND: Surgical excision is the treatment of choice for feline intracranial meningioma. OBJECTIVES: To report clinical findings, complications, and outcomes following surgery for feline intracranial meningioma. METHODS: Medical records (01/2000-01/2017) of cats that underwent surgical excision of an intracranial meningioma at our institution were reviewed. Patient data included signalment, clinical signs, surgical technique, complications, histopathologic diagnosis, survival time, and owners' answers to a satisfaction questionnaire. Survival was assessed using the Kaplan-Meier method and log-rank test. RESULTS: Twenty-six cats were included in this study. The exact cause of death was known in 17 cases and was not related to meningioma in 9/17 cases. Overall median survival time was 881 days (95% confidence interval 518; 1248). The age of the cat did not influence survival (p = 0.94) or the occurrence of complications (p = 0.051). Complications occurred in 13/24 cats, including dramatic complications in 4/24 cats. Most complications appeared in the first 24 hours post-surgery (12/13). Males had more postoperative complications (p = 0.042), including more seizures (p = 0.016). Cats with cranioplasty had fewer complications (p = 0.021). Clinical recurrence was confirmed in 3 out of 17 cats. Recurrence-free survival time was 826 days. Most owners (12/14) were satisfied with the outcome. CONCLUSIONS: Surgical treatment of intracranial meningioma in cats was associated with a long median survival time but also with a high rate of minor and major postoperative complications, including early postoperative seizures. Cranioplasty may reduce complications. Age at the time of surgery had no effect on outcomes.

Transoral ventral tympanic bulla osteotomy in cats: 13 cases (2016-2019).

OBJECTIVE: To analyze the results of transoral ventral bulla osteotomy (TOVBO) in cats. ANIMALS: 13 client-owned cats treated by TOVBO between February 2016 and February 2019. PROCEDURES: Medical records of cats with a diagnosis of middle ear disease (MED) that underwent TOVBO were reviewed. The procedure was similar to the one described for dogs. Short-term follow-up was obtained via clinical examination before discharge and at day 15 postoperatively. Long-term follow-up was performed via telephone interview. RESULTS: 13 cats (age range, 8 months to 12 years) underwent unilateral (n = 10) or bilateral (3) TOVBO (16) for the treatment of tympanic bulla (TB) infection (10), nasopharyngeal inflammatory polyps (5), or bullet retrieval from the TB (1). There were no intraoperative complications. One cat with a poor preoperative status died at postoperative day 3 from pneumonia. Eight cats experienced postoperative complications including head tilt (n = 2), Horner syndrome (3), loss of appetite (2), and temporary blindness (1). Collected samples confirmed the presence of nasopharyngeal inflammatory polyps (5), or otitis media (8). Six months after surgical intervention, 9 cats were free of MED signs. CLINICAL RELEVANCE: This oral approach provided a good access to the TB in all cases. The complications observed after TOVBO were similar to those for VBO. In cats, TOVBO seems to be an acceptable and safe minimally invasive alternative to the other approaches of the TB to address MED.

Esophageal leiomyoma in a dog causing esophageal distension and treated by transcardial placement of a self-expanding, covered, nitinol esophageal stent.

CASE DESCRIPTION A 10-year-old spayed female Rottweiler was referred for evaluation because of a 2-month history of regurgitation and weight loss, despite no apparent change in appetite. The dog had received antiemetic and antacid treatment, without improvement. CLINICAL FINDINGS Physical examination revealed a low body condition score (2/5), but other findings were unremarkable. Diffuse, global esophageal dilatation was noted on plain thoracic radiographs, and normal motility was confirmed through videofluoroscopic evaluation of swallowing. Transhepatic ultrasonographic and CT examination revealed a circumferential, intraparietal lesion in the distal portion of the esophagus causing distal esophageal or cardial subobstruction and no metastases. Incisional biopsy of the lesion was performed, and findings of histologic examination supported a diagnosis of esophageal leiomyoma. TREATMENT AND OUTCOME In view of numerous possible complications associated with esophageal surgery, the decision was made to palliatively treat the dog by transcardial placement of a self-expanding, covered, nitinol esophageal stent under endoscopic guidance. Two weeks after stent placement, radiography revealed complete migration of the stent into the gastric lumen. Gastrotomy was performed, and the stent was replaced and fixed in place. Twenty-four months after initial stent placement, the dog had a healthy body condition and remained free of previous clinical signs. CLINICAL RELEVANCE Diffuse benign muscular neoplasia should be considered as a differential diagnosis for acquired esophageal dilatation in adult and elderly dogs. In the dog of this report, transcardial stent placement resulted in resolution of the clinical signs, with no apparent adverse effect on digestive function. The described procedure could be beneficial for nonsurgical treatment of benign esophageal tumors in dogs.

Transoral approach for ventral tympanic bulla osteotomy in the dog: A descriptive cadaveric study.

OBJECTIVE: To describe a transoral approach for tympanic bulla osteotomy in the dog. STUDY DESIGN: Anatomic cadaveric study. SAMPLE POPULATION: Fifteen canine cadavers (n = 29 tympanic bullae), including mesaticephalic, dolichocephalic, and brachycephalic breeds. MATERIALS AND METHODS: The oral surface of the tympanic bulla was identified during an anatomical study (3 canine cadavers) and the ventral approach to the tympanic bulla was described (3 canine cadavers). The safety of the technique was assessed (9 canine cadavers, n = 17 bullae) during further anatomical dissections, where a complete approach and drilling of the tympanic bulla were performed. RESULTS: In all cases, tympanic bulla osteotomy was performed without damaging the inner ear, the epitympanic recess contents, and the neurovascular structures. The oral approach to the tympanic bulla was easier in mesaticephalic and dolichocephalic dogs than in brachycephalic breeds. CONCLUSION: This study defines anatomical landmarks for transoral bulla osteotomy, without a high risk of damage to neurovascular and anatomical structures within and/or surrounding the tympanic cavity. This minimally invasive approach to the tympanic bulla is performed via a natural opening, and does not require simultaneous access through the ear canal. In vivo evaluation of this technique is required to verify its safety in clinical cases prior to large scale application.

Ventral surgical approach to the lumbosacral joint in the dog.

OBJECTIVE: To describe a ventral surgical approach to the lumbosacral (LS) junction, access to L7 and S1, and access to the LS disc. STUDY DESIGN: Cadaveric descriptive study. ANIMALS: Canine cadavers (n = 6). METHODS: A ventral surgical approach to the LS junction was made and local anatomic structures documented. Accessible ventral L7 and S1 vertebral bodies and LS disc were marked with India ink. Total and marked surface areas were calculated. The potential for bicortical and unicortical implant placement was determined in transverse slices of L7 and S1. Exposed ventral disc annulus relative to vertebral canal diameters were measured. RESULTS: Portions of L7 and S1 were accessible in all dogs, but shape and dimensions varied. Ventral access for implant placement was available in both L7 and S1 in every dog. The median sacral artery and vein were in contact with the ventral LS disc annulus in every dog. Accessible ventral annulus were greater than vertebral canal in all dogs. CONCLUSIONS: Ventral approach to the LS junction is possible, with LS discectomy, and implant placement in L7 and S1 vertebral bodies possible from this approach. Injury to, or sacrifice of, the median sacral artery and/or vein may occur in this approach.