Diagnostic findings in sinonasal aspergillosis in dogs in the United Kingdom: 475 cases (2011-2021).

OBJECTIVES: To describe the diagnostic tests used and their comparative performance in dogs diagnosed with sinonasal aspergillosis in the United Kingdom. A secondary objective was to describe the signalment, clinical findings and common clinicopathologic abnormalities in sinonasal aspergillosis. MATERIALS AND METHODS: A multi-centre retrospective survey was performed involving 23 referral centres in the United Kingdom to identify dogs diagnosed with sinonasal aspergillosis from January 2011 to December 2021. Dogs were included if fungal plaques were seen during rhinoscopy or if ancillary testing (via histopathology, culture, cytology, serology or PCR) was positive and other differential diagnoses were excluded. RESULTS: A total of 662 cases were entered into the database across the 23 referral centres. Four hundred and seventy-five cases met the study inclusion criteria. Of these, 419 dogs had fungal plaques and compatible clinical signs. Fungal plaques were not seen in 56 dogs with turbinate destruction that had compatible clinical signs and a positive ancillary test result. Ancillary diagnostics were performed in 312 of 419 (74%) dogs with observed fungal plaques permitting calculation of sensitivity of cytology as 67%, fungal culture 59%, histopathology 47% and PCR 71%. CLINICAL SIGNIFICANCE: The sensitivities of ancillary diagnostics in this study were lower than previously reported challenging the clinical utility of such tests in sinonasal aspergillosis. Treatment and management decisions should be based on a combination of diagnostics including imaging findings, visual inspection, and ancillary testing, rather than ancillary tests alone.

Classification of portosystemic shunts entering the caudal vena cava at the omental foramen in dogs.

OBJECTIVE: To re-evaluate the anatomy and classification of congenital extrahepatic portosystemic shunts entering the caudal vena cava at the level of the omental foramen. MATERIAL AND METHODS: A retrospective review of a consecutive series of dogs undergoing CT angiography as part of the diagnostic work-up for a congenital extrahepatic portosystemic shunt. RESULTS: In total, 53 dogs met the inclusion criteria revealing four anatomically distinct omental foramen shunt types; one of which (32 of 53 dogs) showed no shunting blood flow through the right gastric vein and three of which (21 of 53 dogs) involved shunting flow through this vessel. The anatomy of these four distinct shunt types, as defined by CT angiography, was found to be highly consistent. In all cases, regardless of the tributary vessels, the left gastric vein was the final vessel that communicated with the caudal vena cava. Using these findings, a more accurate naming classification for congenital portosystemic shunts entering the caudal vena cava at the level of the omental foramen was proposed. CLINICAL SIGNIFICANCE: A precise pre-treatment anatomical classification of congenital extrahepatic portosystemic shunts entering the caudal vena cava at the level of the omental foramen is important for a more complete understanding of the severity of clinical signs and prognosis, and for the better communication between clinicians and researchers in this clinical field.

Implications of shunt morphology for the surgical management of extrahepatic portosystemic shunts.

OBJECTIVE: To describe the implications of extrahepatic portosystemic shunt morphology for the chosen site of shunt closure in dogs and cats. METHODS: A retrospective review of a consecutive series of dogs and cats managed for congenital extrahepatic portosystemic shunts. RESULTS: In total, 54 dogs and 10 cats met the inclusion criteria, revealing five distinct shunt types: left gastrophrenic, right gastrocaval (types Ai, Aii and Aiii), splenocaval, colocaval and left gastro-azygos. Without exception, findings of computed tomography angiography and direct gross observations at the time of surgery confirmed four consistent sites of communication between the anomalous shunting vessel and the systemic venous system: the caudal vena cava at the level of the epiploic foramen; the left phrenic vein at the level of the oesophageal hiatus; the azygos vein at the level of the aortic hiatus; and the caudal vena cava or iliac vein at the level of the 6th or 7th lumbar vertebrae. The use of intraoperative mesenteric portography was effective for confirming that at the time of surgery all portal tributary vessels were proximal to the point of shunt attenuation. CONCLUSIONS: Findings confirmed that for the common types of extrahepatic portosystemic shunts there were only four consistent sites of communication between the shunt and the systemic venous system. This information supports the use of a systematic approach for the location and attenuation of shunts in dogs and cats.

New perspectives on the development of extrahepatic portosystemic shunts.

In this essay we use clinical evidence and knowledge of anatomy to examine the relationship between blood flow and formation of congenital extrahepatic portosystemic shunts in dogs and cats. First we report on the clinical findings in a series of 50 dogs and 10 cats and then systematically review peer-reviewed data on the detailed anatomy of shunts in dogs and cats. In dogs four types of shunt: spleno-caval, left gastro-phrenic, left gastro-azygos and those involving the right gastric vein account for 94% of extrahepatic shunts. Cats also exhibit four types of shunt: spleno-caval, left gastrophrenic, left gastro-caval and left gastro-azygos, and the first three of these account for 92% shunts in this species. Our findings lead us to propose that preferential blood flow influences the subsequent formation of one of a number of defined and consistent congenital extrahepatic portosystemic shunts in dogs and cats.

The use of rigid endoscopy in the management of acute oropharyngeal stick injuries.

OBJECTIVE: To evaluate the use of rigid endoscopy in the management of oropharyngeal stick injuries. METHODS: Retrospective analysis of case records between 2011 and 2013 from a large referral hospital. Data regarding signalment, clinical presentation, treatment options and final outcomes were recorded. RESULTS: Nine dogs were identified with acute oropharyngeal stick injuries. There were seven males and two females and the dogs were of various breeds, ages (1 · 5 to 9 years) and weights (11 · 9 to 38 · 4 kg). The time from injury to referral was between 1 and 3 days (median: 2 days). All dogs were anaesthetised and the tracts explored using a 30° forward-oblique, 2 · 7-mm-diameter, 18-cm-length rigid endoscope with corresponding 14 · 5 Fr sheath. The endoscopy was performed under saline irrigation. Foreign material (>1 mm in size) was removed using grasping forceps fed through the sheath. Subsequently, the tracts were re-inspected and flushed with further saline to confirm that all foreign material had been removed. All dogs recovered uneventfully and had excellent outcomes with no cases representing with chronic manifestations of oropharyngeal stick injuries. CLINICAL SIGNIFICANCE: Rigid endoscopy is an effective method for the diagnosis, assessment and, in certain cases, treatment of acute oropharyngeal stick injuries in dogs.

Repair of a transverse ilial fracture in a cat using an intramedullary pin.

OBJECTIVE: This case report describes the novel use of an intramedullary pin in an eight-month-old cat to repair malunion of a right transverse ilial fracture that was causing pelvic canal diameter narrowing and constipation. METHOD: A routine, right femoral head and neck ostectomy was performed due to the presence of a femoral head fracture with apparent femoral neck necrosis. Significant callus formation around the ilial fracture was removed in order to achieve satisfactory fracture reduction. A 2 mm Steinmann pin was passed in a retrograde fashion from the acetabular fracture towards the ischial tuberosity, and following removal of the trochar tip and reduction of the fracture, was driven normograde to end in the cranial ilial wing. The pin was bent at the ischium following cutting in an attempt to prevent cranial migration. RESULTS: Radiographic examination showed good fracture alignment and increased pelvic diameter by 31% The cat regained normal limb function and the constipation resolved. CLINICAL SIGNIFICANCE: A transilial pin was utilised successfully in a cat to realign and stabilise a simple transverse ilial fracture following femoral head and neck ostectomy. This technique has the potential to be useful for stabilisation of feline caudal ilial body fractures, but should not be used where there is articular surface involvement unless the coxofemoral joint is not preserved. Further studies are required to assess this technique.

Tension band stabilisation of acetabular physeal fractures in four kittens.

The surgical repair of acetabular physeal fractures in four kittens using a screw and tension band technique is reported. This was an appropriate method for restoring articular congruency and improving pelvic alignment. All cases had an excellent outcome and full limb use following fracture repair. In kittens younger than 12 weeks, there is a possibility of premature fusion of the acetabular bone resulting in development of a deformed, shallow acetabulum and hip subluxation. However, surgery is still justified when there is pelvic canal narrowing to decrease the risk of future defecatory problems. Early implant removal in such young kittens may decrease the severity of deformity caused by premature physeal closure. In kittens of 16 weeks or older, the prognosis is good for normal acetabular development and implant removal is not necessary.

Complications following full-thickness small intestinal biopsy in 66 dogs: a retrospective study.

OBJECTIVES: To retrospectively report the complications seen after full-thickness multiple small intestinal biopsies were performed in 66 dogs. METHODS: Animals that died as a result of enteric wound breakdown were compared with the surviving population to identify fatal risk factors. RESULTS: Seventeen dogs had hypoalbuminaemia and eight had albumin levels below 20 g/I at surgery. Twelve dogs had concurrent disease, of which seven had skin disease. Seven dogs suffered minor complications which resolved with treatment. Eight dogs (12 per cent) died or were euthanased between three and nine days postoperatively (mean [sd] 4.5 [2.1]) due to enteric wound breakdown. Seven of these dogs developed septic peritonitis and one died of haemorrhage. No statistically significant differences were identified in any of the parameters examined for the development of fatal enteric wound dehiscence. CLINICAL SIGNIFICANCE: Full-thickness intestinal biopsy is not a benign procedure. However, this study concludes that there are no consistent predictors for patients at increased risk of enteric wound breakdown.