Ultrasonographic and computed tomographic features of a true gastro-gastric intussusception with concurrent foreign bodies in a dog.

A 2-year-old intact male Cane Corso dog was presented for acute weakness, vomiting, and diarrhea. Abdominal ultrasound revealed the stomach had severe wall edema and a target appearance. Computed tomography was consistent with a gastro-gastric intussusception and concurrent mineral-like gastric foreign bodies. After reduction of the intussusception, bilateral incisional gastropexy was performed to prevent recurrence. True gastrogastric intussusception is a rare condition and should be considered if the stomach has severe wall edema with a target sign on abdominal ultrasound. Computed tomography was useful to confirm this rare diagnosis and screen the entire abdomen for concurrent lesions. Key clinical message: This case highlights the usefulness of a CT examination to confirm this rare diagnosis, to determine the position of gastric compartments, and to detect potential concurrent lesions prior to surgery.

Caractéristiques échographiques et tomodensitométriques d'une véritable intussusception gastrogastrique avec corps étrangers concomitants chez un chien. Un chien Cane Corso mâle intact de 2 ans a été présenté pour faiblesse aiguë, vomissements et diarrhée. L'échographie abdominale a révélé que l'estomac présentait un ædème sévère de la paroi et une apparence de cible. La tomodensitométrie était compatible avec une intussusception gastro-gastrique et des corps étrangers gastriques de type minéral concomitants. Après réduction de l'intussusception, une gastropexie incisionnelle bilatérale a été réalisée pour prévenir les récidives. L'intussusception gastro-gastrique vraie est une affection rare et doit être envisagée si l'estomac présente un ædème sévère de la paroi avec un signe de cible à l'échographie abdominale. La tomodensitométrie a été utile pour confirmer ce diagnostic rare et d'examiner tout l'abdomen à la recherche de lésions concomitantes.Message clinique clé :Ce cas met en évidence l'utilité d'un examen CT pour confirmer ce diagnostic rare, pour déterminer la position des compartiments gastriques et pour détecter d'éventuelles lésions concomitantes avant la chirurgie.(Traduit par Dr Serge Messier).

Radiographically confirmed outcomes after fracture repair with a PLS polyaxial locking system in 40 dogs and cats.

OBJECTIVE: To report radiographic findings and complications after fracture repair with a new polyaxial locking plate system (PLS polyaxial locking system; Aesculap/B Braun, Tuttlingen, Germany) in dogs and cats. STUDY DESIGN: Retrospective case review from four veterinary practices. SAMPLE POPULATION: Twenty-six dogs and 14 cats (40 long bone fractures). METHODS: Medical and radiographic records of dogs and cats with long bone fractures treated with the PLS were reviewed. Cases were included when operative records were complete and included documentation of radiographic union or complications. Phone interviews of owners were performed for long-term follow-up. Ancillary methods of fracture fixation and associated complications were recorded. RESULTS: Only two complications were recorded, one of which required a revision surgery. Radiographic follow-up was performed for all fractures. Radiographic union without complications was achieved in 38 of 40 (95%) fractures. Radiographic union was documented before 60 days in 19 of 40 (47.5%) fractures, between 61 and 90 days in 15 of 40 (37.5%) fractures, and after 90 days in six of 40 (15%) fractures. A functional union was observed at a mean time ± SD of 70.8 ± 38.9 days (range, 32-182). One or more ancillary fixation methods were used in 27 of 40 (67.5%) fractures. CONCLUSION: The PLS polyaxial locking system was often used with adjunct fixation in this series, and radiographically confirmed healing without complications was documented in most cases. CLINICAL SIGNIFICANCE: Use of the PLS can result in high success rates for fracture repair in dogs and cats, but ancillary fixation should be strongly considered.

Effect of Intravenous Morphine Injection on Neurological Examination of Dogs With Thoracolumbar Intervertebral Disk Extrusion.

Objectives: We aimed to determine the effect of intravenous morphine injection on the modified Frankel scores of dogs with thoracolumbar intervertebral disk extrusion (IVDE). Methods: This was a prospective, blinded, randomized, and placebo-controlled study. We included dogs with a presumptive diagnosis of thoracolumbar IVDE that did not undergo analgesic, anti-inflammatory, or sedative treatment within the last 12 h. A neurological examination was performed and the deficits were graded using the modified Frankel score (MFS). Subsequently, each dog was randomly allocated to receive an intravenous injection of either morphine or placebo. After 30 min, the dogs were re-evaluated by the same veterinary officer who was blinded to the contents of the injections. Dogs were included in the study if IVDE was ultimately confirmed by surgery within one week of initial presentation. Results: Among the 79 dogs initially enrolled, 62 dogs met the inclusion criteria. Among them, thirty-two dogs received intravenous morphine injections and there was no difference between the pre- and post-injection modified Frankel scores. Thirty dogs received an intravenous placebo injection. One dog had a worsening of the MFS by one grade in the post-injection examination. Clinical Significance: In dogs with thoracolumbar intervertebral disk extrusion, an intravenous injection of morphine does not affect the modified Frankel score after 30 min compared with the pre-injection value. These findings support the use of an analgesic morphine dose if the neurological examination can be performed 30 min or later after the injection.

Infection and extrusion of a subcutaneous access port in a cat: a long-term postoperative complication of a subcutaneous ureteral bypass device.

CASE SUMMARY: A 5-year-old domestic shorthair neutered female cat was presented for a wound in the region of the subcutaneous ureteral bypass shunting port with externalisation of the device, 2 years after its initial positioning. The cat had had positive urine bacterial cultures over the previous year and a half without any clinical signs of urinary tract infection. Bacterial cultures of urine and the wound revealed the same bacteria, suggesting a complication caused by infected urine from the implanted system. The wound was successfully treated with surgery and at the time of writing, 3 months later, the cat is healthy with no evidence of recurrence. RELEVANCE AND NOVEL INFORMATION: To our knowledge, this is the first report of a subcutaneous ureteral bypass shunting port extrusion as a long-term major complication of the bacterial infection of the device.

Reproducibility, Accuracy and Effect of Autoclave Sterilization on a Thermoplastic Three-Dimensional Model Printed by a Desktop Fused Deposition Modelling Three-Dimensional Printer.

OBJECTIVES: The main purpose of this study was to determine the reproducibility and accuracy of a three-dimensional (3D) bone model printed on a desktop 3D-printer based on fused deposition modelling (FDM) technology with polylactic acid (PLA) and the effect of autoclave sterilization on the printed models. METHODS: Computed tomographic images of the tibia were obtained from 10 feline cadavers, used to create a bone surface-rendering file and sent to the 3D printing software. Right and left tibias were each printed five times with the FDM desktop 3D printer using PLA plastic material. Plastic models and cadaveric bones were measured with a profile projector device at six predetermined landmarks. Plastic bones were then sterilized using an autoclave before being re-measured applying the same method. Analyses of printed model size reliability were conducted using intra-class correlation coefficients (ICC) and Bland-Altman plots. RESULTS: The ICC always showed an almost perfect agreement when comparing 3D-printed models issued from the same cadaveric bone. The ICC showed moderate agreement for one measurement and strong/perfect agreement for others when comparing a cadaveric bone with the corresponding 3D model. Concerning the comparison of the same 3D-printed model, before and after sterilization, ICC showed either strong or perfect agreement. CLINICAL SIGNIFICANCE: Rapid-prototyping with our FDM desktop 3D-printer using PLA was an accurate, a reproducible and a sterilization-compliant way to obtain 3D plastic models.

Ultrasonography is more accurate than percutaneous palpation for identifying targeted thoracolumbar intervertebral disc spaces in dogs.

During minimally invasive spinal surgery, correct identification of the affected intervertebral disc space is critical. Percutaneous palpation is commonly used, but results may be unreliable. Fluoroscopy is the gold standard but can be cumbersome and exposes operators to ionizing radiation. Spinal ultrasound has been described in veterinary medicine and could be a feasible alternative. This prospective, methods comparison study mimicked a minimally invasive spinal surgery in 10 canine cadavers and compared the accuracy of ultrasound and percutaneous palpation for thoracolumbar intervertebral disc space identification, using fluoroscopy as the reference standard. For each experiment, a disc space was randomly chosen. Identification was then attempted using both percutaneous palpation and ultrasound. For ultrasound, a linear probe was used to guide the operator to the correct location. The time necessary to perform each method was recorded. Accuracies for each method were calculated and statistically compared. Effects of body condition score, location of the targeted thoracolumbar intervertebral disc space and learning curve for each method were also evaluated. Ultrasonographic identification was more accurate (96.7% vs. 76.7%; P < 0.03) but took longer (147 s vs. 29 s; P < 0.0001) than percutaneous palpation. Findings from this cadaver study indicated that percutaneous palpation alone had low accuracy for correctly identifying a targeted thoracolumbar intervertebral disc space and supported the use of ultrasound as a method for improving the accuracy. Future studies are needed to assess the method in clinical cases, especially in obese dogs and/or those in which the targeted site is distant from palpable anatomical landmarks.

Stabilization of Olecranon Fractures by Tension Band Wiring or Plate Osteosynthesis: A Retrospective Study of 41 Cases.

OBJECTIVES: This article aimed to describe olecranon fracture in dogs and cats and their stabilization with tension band wiring or plate osteosynthesis, and to evaluate complications associated with each technique. METHODS: Medical records of cats and dogs that had been surgically treated for olecranon fractures with either tension band wiring or plate osteosynthesis were retrospectively reviewed. The surgical technique, complications and long-term outcomes were assessed. RESULTS: Forty-one olecranon fractures were included. Fractures were articular, comminuted and open in 90, 31 and 27% of cases, respectively. Tension band wiring and plate osteosynthesis were performed in 22 and 19 fractures, respectively. Complications occurred more commonly after tension band wiring (74%) compared with plate osteosynthesis (27%) (p = 0.002) and these were probably related to it being used in comminuted fractures (p = 0.01) or to errors in technique. Minor complications included Kirschner wires migration (n = 5), pain (n = 3), osteomyelitis (n = 3), skin breakdown (n = 3) and seroma (n = 1). Implant failure requiring further fixation (n = 4) was observed only in the tension band wiring group. Other major complications included skin wound debridement and closure (n = 1) and chronic lameness requiring implant removal (n = 7). Long-term functional outcomes were excellent regardless of the technique used. CLINICAL SIGNIFICANCE: Plate osteosynthesis should be performed for olecranon fracture repair if technically feasible.

Effectiveness of a bipolar vessel sealant device for ovariohysterectomy in cats with pyometra.

OBJECTIVES: The objective was to describe the use of a bipolar vessel sealant device for complete ovariohysterectomy in cats (ie, removal of both the ovarian pedicle and the uterine body and vessels) and to report on the feasibility of ovariohysterectomy in cats with pyometra. METHODS: Cats with confirmed pyometra and whose owners agreed to the surgical procedure were prospectively included in the study. Ovaries were visualised and the vessel sealant device was used to coagulate and cut the suspensory ligament, the ovarian pedicle and the broad ligament up to the level of the uterine body. Once the uterine body was measured, it was grasped, coagulated and transected just proximal to the cervix using the vessel sealant device when its diameter was <0.9 cm. Immediate postoperative and short-term follow-up were evaluated by clinical examination. RESULTS: Thirteen cases were initially included between November 2015 and February 2017. Three cases were subsequently excluded because of a uterine body diameter >0.9 cm. Of the 10 cats finally included, all were intact females, with a median age of 2.7 years (range 0.9-9 years). Median weight was 3.7 kg (range 2.6-6.7 kg). The median surgery time was 10.9 mins (range 9.8-15.2 mins). Median uterus diameter was 0.51 cm (range 0.45-0.64 cm) and median skin incision was 4.1 cm (range 3.6-5.1 cm). No complications during the procedures occurred in any patient. All cases were discharged from the hospital 1 day after surgery, without any abnormality. No complications were noted during the postoperative period. CONCLUSIONS AND RELEVANCE: The findings suggest that the bipolar vessel sealant device used in this study is safe in performing ovariohysterectomy for pyometra in cats, when the uterine body is <0.9 cm in diameter, without short-term complications.