Effect of Prophylactic Calcitriol Administration on Serum Ionized Calcium Concentrations after Parathyroidectomy: 78 Cases (2005-2015).

BACKGROUND: Prophylactic administration of calcitriol has been suggested to mitigate the risk of hypocalcemia after parathyroidectomy. The effect of calcitriol on postoperative serum ionized calcium concentrations has not been evaluated in dogs after parathyroidectomy. HYPOTHESIS/OBJECTIVES: To determine the effect of prophylactic calcitriol administration on postoperative serum ionized calcium (iCa) concentrations in dogs with primary hyperthyroidism (PHPTH) treated by parathyroidectomy. ANIMALS: Seventy-eight dogs with primary hyperparathyroidism treated surgically. METHODS: Multi-institutional retrospective case study. Medical records from 2005 to 2015 were evaluated. Dogs were included if they had a diagnosis of PHPTH and had surgery to remove parathyroid tissue. Serum iCa concentrations were monitored for a minimum of 2 days postoperatively. Two study groups were evaluated: calcitriol administration and no calcitriol administration. RESULTS: Serial postoperative iCa concentrations measured at 12-hour time intervals for 2 days postoperatively were positively associated with preoperative iCa concentrations. This association was evident at each time interval, and the effect of preoperative iCa concentrations on postoperative iCa concentrations decreased as time elapsed (12 hours, P < 0.0001; 24 hours, P < 0.0001; 36 hours, P < 0.04; and 48 hours, P = 0.01). Prophylactic calcitriol administration was not found to be significantly associated with postoperative iCa concentrations or its rate of decrease after parathyroidectomy. CONCLUSION AND CLINICAL IMPORTANCE: We found no protective value in administering calcitriol prophylactically to prevent hypocalcemia in the immediate postoperative period (48 hours) after parathyroidectomy. Preoperative iCa concentrations had a significant positive association with postoperative iCa concentrations throughout the monitoring period.

Signalment, clinical presentation, concurrent diseases, and diagnostic findings in 28 dogs with dynamic pharyngeal collapse (2008-2013).

BACKGROUND: Most information about pharyngeal collapse in dogs is anecdotal and extrapolated from human medicine. A single case report describing dynamic pharyngeal collapse in a cat has been published, but there is no literature describing this disease process in dogs. OBJECTIVE: To describe the signalment, clinical presentation, concurrent disease processes, and imaging findings of a population of client-owned dogs with pharyngeal collapse. ANIMALS: Twenty-eight client-owned dogs with pharyngeal collapse. METHODS: Radiology reports of dogs for which fluoroscopy of the respiratory system was performed were reviewed retrospectively. Patients with a fluoroscopic diagnosis of pharyngeal collapse were included in the study population. Data regarding clinical signs, diagnostic, and pathologic findings were evaluated. RESULTS: Twenty-eight dogs met the inclusion criteria. The median age of affected patients was 6.6 years, whereas median body condition score was 7/9. The most common clinical signs were coughing (n = 20) and stertor (n = 5). In 27 of 28 cases, a concurrent or previously diagnosed cardiopulmonary disorder was detected. The most common concurrent disease processes were mainstem bronchi collapse (n = 18), tracheal collapse (n = 17), and brachycephalic airway syndrome (n = 8). Fluoroscopy identified complete pharyngeal collapse in 20 of 28 dogs. CONCLUSIONS: Pharyngeal collapse is a complex disease process that likely is secondary to long-term negative pressure gradients and anatomic and functional abnormalities. Based on the findings of this study, pharyngeal fluoroscopy may be useful diagnostic test in patients with suspected tracheal and mainstem bronchial collapse to identify concurrent pharyngeal collapse.

Traumatic tympanic bulla fracture.

A Pekingese dog was presented for evaluation of head trauma with ventral head and neck swelling, puncture wounds, palpable mandibular fractures, and loss of menace, severe miosis, and loss of palpebral reflex of the right eye. Computed tomography confirmed multiple mandibular and zygomatic fractures, a right ear canal avulsion, and a complete right tympanic bulla fracture with ventral displacement. The tympanic bulla fracture was managed conservatively. Topical lubrication and antibiotic ointment was prescribed for the right eye. A subtotal hemimandibulectomy was performed to address the mandibular fractures. A temporary oesophagostomy feeding tube was placed. No short-term complications developed as a result of the fractured bulla and avulsed ear canal being left in situ, and no complications were reported 18 months after the injury. To the authors' knowledge this is the first report of a traumatic tympanic bulla fracture in the dog.

The posterior thigh fasciocutaneous flap: vascular anatomy and clinical application.

Ten adult cadavers were used to accurately detail the vascular anatomy of posterior thigh skin. Fourteen posterior thigh specimens were dissected after blue latex injection of the internal and external iliac arteries. Six posterior thigh specimens underwent selective dye injection of individual profunda perforating arteries and the inferior gluteal artery. The findings reveal an extensive fascial plexus nourished primarily by fasciocutaneous branches of the first and second profunda perforating arteries and secondarily by a terminal fasciocutaneous branch of the inferior gluteal artery. From 1989 to 1992, 24 posterior thigh fasciocutaneous flaps were performed in 24 patients. There were 5 early postoperative complications (21 percent). All but one patient went on to satisfactory healing and stable wound coverage. Three posterior thigh fasciocutaneous flaps were used successfully despite ligation of their inferior gluteal artery blood supply in a previous surgical procedure. These anatomic and clinical findings confirm the reliability of a posterior thigh fasciocutaneous flap based primarily on the first and second profunda perforating arteries. The posterior thigh fasciocutaneous flap can survive in the absence of a patent inferior gluteal artery. Knowledge of the vascular anatomy extends the clinical applicability of the posterior thigh fasciocutaneous flap to patients who might otherwise be excluded because of prior injury or operative procedure.

Growth and refuge location in continuous, modular organisms: experimental and computer simulation studies.

Guilds of crustose bryozoans exhibited a range of growth outlines, varying from circular to elongate, and the stones on which they grew contained a range of refuge types, varying in size from a few mm2 to a few hundred cm2. These refuges, if encountered by the growing colonies of competitively subordinate species such as Electra pilosa L., enabled the latter to avoid competitive exclusion due to overgrowth mortality. Computer simulations suggested that, although modular organisms which are elongate are, in general, more likely to encounter spatial refuges than those with a different shape through vegetative growth, shape is less important than the size of the organisms themselves or the size and density of the spatial refuges. Moreover significant interactions between these 4 variables showed that they should be considered together and not in isolation from one another. Examples are given of variable growth forms in continuous, modular organisms from different taxa, including plants, and the importance of these predictive studies to refuge location by modular organisms is discussed.

Intraindividual variability in human figure drawings: a developmental study.

An investigation was conducted with a normal population, in which 180 children drew "a person" four times under identical conditions. Three types of variability were assessed: score, content, and visual. A cyclical pattern was found in all three areas, with significant correlations between visual variability and score and content variabilities.

Art and drama: partners in therapy.

An art-drama therapy group for latency-age boys made possible the exploration of personal symbols and intense fantasies which resulted in a therapeutically powerful and productive experience. This paper describes the background, rationale, and dynamic process of this group. Multimodal expressive arts therapy is supported.