Multiple midline defects identified in a litter of golden retrievers following gestational administration of prednisone and doxycycline: a case series.

BACKGROUND: The teratogenic effects of immunomodulatory and certain antimicrobial therapies are described in small rodents and humans. While the described teratogenic effects in small rodents have been extrapolated to make conclusions about its use in the pregnant dam, teratogenic effects of prednisone and doxycycline have not yet been reported in the dog. Here we report and describe midline defects observed in a litter of golden retriever puppies exposed to mid-gestational immunosuppressive and antimicrobial therapy. CASE PRESENTATION: Twenty-one days into gestation, the dam of a litter of eight golden retriever puppies was administered prednisone, doxycycline, and tramadol as treatment for immune-mediated polyarthritis. The individuals in the litter were subsequently diagnosed with a variety of midline defects and congenital cardiac defects. This case series describes the variety of identified defects and presents a descriptive account of complex congenital abnormalities that are likely secondary to teratogenic effects of one or more drugs administered during gestation. The available puppies, dam, and grand dam underwent thorough physical examination, complete echocardiogram, and where indicated, advanced imaging with various surgical corrections when possible. Numerous midline congenital defects and congenital heart disease were identified in the puppies evaluated. Ultimately 5 of 8 puppies born to the dam were presented for thorough evaluation. The midline defects include: gastroschisis (1), peritoneopericardial diaphragmatic hernias (4, PPDH), umbilical hernia (4), unilateral cryptorchidism (1 of 4 males), cleft palate (1), renal agenesis (1), renal abnormalities (1), sternal and vertebral abnormalities (3), remnant liver lobe (1) and malformations consistent with ductal plate malformations with congenital hepatic fibrosis (1). The congenital cardiac defects include: ventricular septal defect (4, VSD) and subaortic stenosis (4, SAS). The presence of greater than one congenital defect was noted in all 5 of the dogs evaluated. Surgical correction was necessary for PPDH in 4 puppies. Medical intervention was recommended for congenital cardiac disease in 1 puppy. CONCLUSION: This case report is the first to describe midline defects in dogs that have been exposed to immunomodulatory therapy during gestation. A causative relationship between mid-gestational immunomodulatory exposure and midline defects cannot be proven, however, this case supports a clear association and provides case-based evidence to support its avoidance when possible.

Complications and short-term outcomes associated with single-port laparoscopic splenectomy in dogs.

OBJECTIVE: To describe a technique and report complications and outcome for single-port laparoscopic splenectomy in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Twenty-two client-owned dogs. METHODS: Medical records of dogs that underwent single-port laparoscopic splenectomy at 4 veterinary teaching hospitals were evaluated. Commercially available single-port devices were used in all dogs. In all cases, a vessel-sealing device was used to perform a hilar splenectomy. After the procedure was completed, the spleen was exteriorized through the single-port device incision or placed into a specimen retrieval device; enlargement of the incision was required in some cases. RESULTS: Median weight of dogs was 9.9 kg (interquartile range [IQR], 7.0-26.0). Splenectomy was performed because of splenic mass (n = 14), diffuse splenic disease (n = 4), or as adjunctive treatment for management of immune-mediated disease (n = 4). In cases with splenic masses, median maximal diameter of the largest splenic mass was 2.0 cm (IQR, 1.3-2.5). In 6 of 22 cases, mild splenic capsular bleeding occurred during the procedure. Conversion occurred in 6 of 22 cases to either a laparoscopic-assisted approach (n = 5) or an open celiotomy (n = 1). Reasons for conversion included large splenic dimensions (n = 3), adhesion formation (n = 1) or poor visualization resulting from abundant intra-abdominal fat (n = 1) or hemorrhage (n = 1). Heavier body weight was significantly associated with conversion (odds ratio, 1.62; 95% confidence interval, 1.05-2.51), but body condition score, having a splenic mass, splenic mass size, and surgical time were not. CONCLUSION: Single-port laparoscopic splenectomy is an effective approach for elective splenectomy in dogs. The technique may be well suited to smaller dogs with modestly sized splenic masses or diffuse splenic disease.

Lung lobe torsion in seven juvenile dogs.

CASE DESCRIPTION 7 juvenile (< 12 months old) dogs with lung lobe torsion were evaluated. CLINICAL FINDINGS All patients were male; breeds included Pug (n = 5), Chinese Shar-Pei (1), and Bullmastiff (1). Dyspnea and lethargy were the most common initial complaints, with a duration of clinical signs ranging from 1 to 10 days. A CBC showed leukocytosis and neutrophilia in all dogs. Anemia was present in 6 dogs, 2 of which received packed RBC transfusions. The diagnosis was made on the basis of results of thoracic radiography, CT, ultrasonography, or a combination of modalities. The left cranial lung lobe was most commonly affected (n = 4), followed by the right middle lung lobe (2) and the right cranial lung lobe (1). TREATMENT AND OUTCOME A lateral intercostal thoracotomy with lobectomy of the affected lobe was performed in all patients. All dogs survived to be discharged between 1 and 2 days postoperatively. Six of 7 owners contacted for follow-up information 7 to 170 months after discharge reported satisfaction with the treatment and no apparent signs of recurrence of disease. CLINICAL RELEVANCE The juvenile patients of this report were successfully treated surgically with no apparent complications. Clinicians should be aware of the possibility of lung lobe torsion when evaluating young dogs with clinical signs related to the respiratory system, including those with vague signs, to avoid undue delays in treatment.

Perioperative morbidity and outcome of esophageal surgery in dogs and cats: 72 cases (1993-2013).

OBJECTIVE To evaluate perioperative morbidity and outcome in dogs and cats undergoing esophageal surgery. DESIGN Retrospective case series. ANIMALS 63 client-owned dogs and 9 client-owned cats. PROCEDURES Medical records of dogs and cats that underwent esophageal surgery were reviewed for information on signalment, history, results of preoperative diagnostic testing, condition treated, details of surgery, intraoperative complications, and postoperative complications. Long-term follow-up data were obtained via veterinarian and client telephone conversations. The relationship between complications and survival to hospital discharge was evaluated by means of regression analysis. RESULTS The most common indication for surgical intervention was an esophageal foreign body in dogs (50/63 [79%]) and esophageal stricture in cats (3/9). Complications were documented in 54% (34/63) of dogs and 3 of 9 cats. The most common immediate postoperative complications were respiratory in nature (9 dogs, 1 cat). Partial esophagectomy and resection with anastomosis were significantly associated with the development of immediate postoperative complications in dogs. The most common delayed postoperative complications were persistent regurgitation (7 dogs) and esophageal stricture formation (3 dogs, 1 cat). For dogs, a mass lesion and increasing lesion size were significantly associated with the development of delayed postoperative complications. Six dogs (10%) and 1 cat died or were euthanized prior to discharge, and pneumomediastinum and leukopenia were negative prognostic factors for dogs being discharged from the hospital. CONCLUSIONS AND CLINICAL RELEVANCE Results of this study suggested that the short-term prognosis for dogs and cats that survive surgery for treatment of esophageal lesions is favorable, with 90% of patients discharged from the hospital (57/63 dogs; 8/9 cats). However, dogs treated for more extensive esophageal lesions as well as those undergoing esophagectomy or resection and anastomosis were more likely to develop postoperative complications.

Video-Assisted Thoracoscopic Resection of a Noninvasive Thymoma in a Cat with Myasthenia Gravis Using Low-Pressure Carbon Dioxide Insufflation.

OBJECTIVE: To report the use of low-pressure carbon dioxide insufflation during video-assisted thoracoscopic surgery for resection of a noninvasive thymoma in a cat with secondary myasthenia gravis. STUDY DESIGN: Clinical case report. ANIMAL: Client-owned cat. METHODS: An 11-year-old castrated male domestic shorthair cat was examined for generalized weakness, voice change, hypersalivation, hyporexia, vomiting, coughing, and gagging. Thoracic ultrasound revealed a cranial mediastinal mass for which cytology was consistent with a thymoma (or lymphoid tissue). Acetylcholine receptor antibody concentration was elevated at 3.16 mmol/L (reference interval < 0.3 mmol/L). Thoracic computed tomography showed two round, contrast-enhancing structures in the cranioventral mediastinum identified as the sternal lymph node and a cranial mediastinal mass (11 × 17 × 24 mm). A presumptive diagnosis of thymoma with paraneoplastic myasthenia gravis was made and surgical resection of both mediastinal masses was recommended. RESULTS: Video-assisted thoracoscopic resection of the cranial mediastinal mass and sternal lymph node were performed with low-pressure carbon dioxide insufflation maintained at an intrathoracic pressure of 2-3 mmHg. The cat recovered from surgery without serious complications. Nineteen months after surgery, the cat developed hind limb stiffness. Thoracic radiographs ruled out a cranial mediastinal mass or megaesophagus. Acetylcholine receptor antibody concentration remained elevated at 2.72 mmol/L. CONCLUSION: Low-pressure thoracic insufflation facilitated video-assisted thoracoscopic resection of cranial mediastinal masses in this cat.

Kinetic and kinematic gait analysis in the pelvic limbs of normal and post-hemilaminectomy Dachshunds.

OBJECTIVE: To compare pelvic limb kinetic and kinematic gait parameters between Dachshunds six months following hemilaminectomy for treatment of thoracolumbar disc extrusion (post-hemilaminectomy; PHL) and Dachshunds without history and clinical evidence of spinal cord disease (control; CON). METHODS: The CON (n = 8) and PHL (n = 6) Dachshunds were recruited for objective gait evaluation. Kinetic data collected included peak vertical force (PVF), stance phase duration and swing phase duration. Kinematic data collected included tarsal, stifle and hip range of motion (ROM) during stance and swing phases of the trot, tail ROM, and horizontal and vertical components of pelvis ROM. RESULTS: No significant differences were identified between tarsal, stifle, hip, and tail ROM between CON and PHL Dachshunds. Although PVF was not significantly different between CON and PHL Dachshunds, PVF varied on average by 14% between the pelvic limbs in PHL Dachshunds (p <0.01). Horizontal and vertical components of pelvic ROM were on average 51% and 36% greater in PHL Dachshunds compared to CON Dachshunds (p = 0.04 and p = 0.02 respectively). CLINICAL SIGNIFICANCE: Six months after decompressive hemilaminectomy, Dachshunds have abnormal pelvic motion and asymmetric pelvic limb weight bearing. Pelvic sway (ROM) may be a more sensitive indicator of myelopathy than pelvic limb joint ROM and may serve as a useful objective tool to characterize response to treatment in patients with spinal cord disease.

Gastric malpositioning and chronic, intermittent vomiting following prophylactic gastropexy in a 20-month-old great Dane dog.

A 20-month-old castrated male great Dane dog was presented for evaluation of chronic intermittent vomiting of 2 months' duration. A prophylactic incisional gastropexy performed at 6 mo of age resulted in gastric malpositioning and subsequent partial gastric outflow tract obstruction.

Malposition gastrique et vomissements intermittents chroniques après une gastropexie prophylactique chez un chien Grand danois âgé de 20 mois. Un chien Grand danois mâle castré âgé de 20 mois a été présenté pour une évaluation de vomissements chroniques durant depuis 2 mois. Une gastropexie incisionnelle prophylactique réalisée à l'âge de 6 mois a produit une malposition gastrique et une obstruction partielle de l'échappement du tractus gastrique.(Traduit par Isabelle Vallières).

Complications after corrective surgery for lateral patellar luxation in dogs: 36 cases (2000-2011).

OBJECTIVE: To determine the frequency and severity of complications after corrective surgery in dogs with lateral patellar luxation (LPL) and identify risk factors for reluxation. DESIGN: Retrospective case series. ANIMALS: 36 client-owned dogs with 47 affected stifle joints. PROCEDURES: Medical records of dogs that underwent surgical correction of LPL at 1 of 2 veterinary teaching hospitals between 2000 and 2011 were reviewed. Data analyzed included signalment, grade of luxation, orthopedic comorbidities, surgical procedures performed, frequency and type of complications, and whether a second surgery was performed. RESULTS: A total of 36 dogs with 47 affected stifle joints met the inclusion criteria. Complications were recorded for 24 of 47 (51.1%) stifle joints; there were major complications for 18 of 47 (38.3%) stifle joints. All complications were confirmed through examination by a veterinarian. The most frequent complication was reluxation, which was detected in 10 of 47 (21.3%) stifle joints. Dogs that underwent bilateral surgical repair during a single anesthetic episode had odds of reluxation that were 12.5 times the odds of reluxation for dogs that underwent unilateral surgical repair. CONCLUSIONS AND CLINICAL RELEVANCE: Complication rate after corrective surgery for LPL was high, with reluxation being the most common complication in this population of dogs. Performing staged bilateral surgeries may decrease the risk of reluxation.

Evaluation of the radiographic infrapatellar fat pad sign of the contralateral stifle joint as a risk factor for subsequent contralateral cranial cruciate ligament rupture in dogs with unilateral rupture: 96 cases (2006-2007).

OBJECTIVE: To determine prevalence of the contralateral radiographic infrapatellar fat pad sign and contralateral radiographic degenerative sign (degenerative changes) and evaluate both signs as risk factors for subsequent contralateral cranial cruciate ligament (CrCL) rupture in dogs with unilateral CrCL rupture. DESIGN: Retrospective cohort study. ANIMALS: 96 dogs with unilateral CrCL rupture and 22 dogs with bilateral CrCL rupture. PROCEDURES: Dogs with unilateral CrCL rupture were classified as having normal (n = 84) or abnormal (12) contralateral stifle joints on the basis of joint palpation. Associations between potential predictive variables and rates of subsequent contralateral CrCL rupture were evaluated. RESULTS: Of the 84 dogs with unilateral CrCL rupture in which the contralateral stifle joint was palpably normal, 29 (34.5%) had a contralateral fat pad sign and 31 (36.9%) had a degenerative sign. All dogs with unilateral CrCL rupture in which the contralateral stifle joint was palpably abnormal had a contralateral fat pad sign and degenerative sign. The contralateral fat pad sign was the most important risk factor for subsequent rupture of the contralateral CrCL. For dogs with unilateral CrCL rupture and palpably normal contralateral stifle joint with and without a contralateral fat pad sign, median time to subsequent rupture was 421 and 1,688 days, respectively, and the 3-year probability of subsequent rupture was 85.3% and 24.9%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Bilateral stifle joint radiography should be performed for all dogs with CrCL rupture. Bilateral stifle joint arthroscopy should be considered for dogs with a contralateral fat pad sign.