Diagnostic and surgical treatment for traumatic bile peritonitis in dogs and cats.

OBJECTIVE: To describe short-term outcomes of dogs and cats undergoing surgery for traumatic bile peritonitis. ANIMALS: 13 dogs and 4 cats. METHODS: Multi-institutional, retrospective study. Medical records from 6 institutions were reviewed for cases of traumatic bile peritonitis between 2006 and 2022. Clinical presentation, additional injuries, surgical treatment, and outcome were recorded. RESULTS: Trauma occurred a median of 2 (range, 1 to 22) and 4 (range, 1 to 22) days prior to presentation in dogs and cats, respectively. Total bilirubin was increased in 11 of 13 dogs and 2 of 4 cats. Rupture occurred at the common bile duct (CBD) in 10 dogs and 1 cat, gallbladder in 3 dogs, cystic duct in 2 cats, and hepatic duct in 1 dog and 1 cat. The most common surgeries were cholecystoduodenostomy and CBD repair in dogs and cholecystectomy in cats. Eleven of 13 dogs and all cats survived to hospital discharge (88.2% overall survival). Median follow-up in surviving dogs and cats was 35 days (range, 14 to 401) and 30 days (range, 14 to 90), respectively. One dog that underwent cholecystectomy experienced recurrent bile peritonitis 20 days postoperatively. Short-term survival following surgical treatment of traumatic bile peritonitis was excellent and recurrence appears uncommon. The most frequent site of rupture was the CBD in dogs and the cystic duct in cats. CLINICAL RELEVANCE: Measurement of peritoneal bilirubin should be considered in dogs and cats with peritoneal effusion following trauma. Surgeons should be prepared to identify and address ruptures in locations other than the gallbladder.

Improved predictability is needed for calculators used to preoperatively determine the etiology of splenic masses in dogs: an external validation study of the HeLP score and T-STAT.

OBJECTIVE: To assess the predictability of the hemangiosarcoma likelihood prediction (HeLP) score and the Tufts Splenic Tumor Assessment Tool (T-STAT) for hemangiosarcoma and malignancy, respectively. ANIMALS: 261 dogs undergoing splenectomy for a splenic mass. METHODS: Medical records were retrospectively reviewed; variables for the HeLP score and T-STAT were collected, and scores were assigned. Area under the curve (AUC) was calculated for each score. RESULTS: The HeLP score included 141 dogs; hemangiosarcoma was diagnosed in 87 (61.7%) dogs. The median cumulative HeLP score was 51 (range, 17 to 82; IQR, 39 to 58) for dogs with hemangiosarcoma and 28 (range, 0 to 70; IQR, 17 to 41) for dogs without hemangiosarcoma. The categorical HeLP score was low (28; 32.2%), medium (31; 35.6%), and high (28; 32.2%) for dogs with hemangiosarcoma and was low (41; 75.9%), medium (9; 16.7%), and high (4; 7.4%) for dogs without hemangiosarcoma. The AUC of the cumulative and categorical HeLP scores for diagnosis of hemangiosarcoma were 0.79 (95% CI, 0.71 to 0.86) and 0.73 (95% CI, 0.65 to 0.82), respectively. The T-STAT included 181 dogs. Lesions were benign in 95 (52.5%) and malignant in 86 (47.5%) dogs. The median T-STAT score was 62% (range, 5% to 98%; IQR, 36% to 77%) for dogs with malignant lesions and 38% (range, 5% to 91%; IQR, 24% to 59%) for dogs with benign lesions. The T-STAT had an AUC of 0.68 (0.60 to 0.76) for diagnosis of malignancy. CLINICAL RELEVANCE: The HeLP score had acceptable performance, and the T-STAT had poor performance for diagnosis prediction. A tool with excellent or outstanding discrimination is needed to more reliably predict the presence of hemangiosarcoma or a malignant lesion preoperatively.

Treatment of retroperitoneal sarcoma results in improved outcomes.

OBJECTIVE: To report the clinical characteristics, treatments, and outcomes in a cohort of dogs with histologically confirmed retroperitoneal sarcoma (RPS) and to identify potential variables of prognostic significance. ANIMALS: 46 client-owned dogs from 10 clinics with histopathologic diagnosis of a sarcoma originating from the retroperitoneal space. METHODS: Medical records were retrospectively reviewed to obtain information regarding clinical characteristics, treatments, and outcomes. Recorded variables were analyzed to report descriptive data for all cases and overall survival time. Multivariate analysis was utilized to evaluate prognostic factors for overall survival. RESULTS: Hemangiosarcoma was the most common histologic subtype diagnosed (76.1%). Cytoreductive and curative intent surgical excision of the RPS was attempted in 12 and 22 dogs, respectively; 12 dogs underwent no surgery or had an exploratory laparotomy with incisional biopsy only. Nineteen dogs received adjuvant chemotherapy, either injectable or metronomic, and 1 dog received adjuvant radiation therapy. Fourteen of the 34 (41.2%) surgically treated dogs developed evidence of local recurrence, but there was no difference in local recurrence when comparing dogs categorized as curative intent versus cytoreductive surgery. The median overall survival time was 238 days. On multivariable analysis, treatment approach was associated with survival with surgical excision (vs palliative treatment) and adjuvant chemotherapy following surgery being protective against death. A diagnosis of hemangiosarcoma was associated with a greater hazard of death. CLINICAL RELEVANCE: This study demonstrates a substantially greater survival time than previously published and suggests a survival benefit from surgical excision and adjuvant chemotherapy.

Bupivacaine liposomal injectable suspension does not provide improved pain control in dogs undergoing abdominal surgery.

OBJECTIVE: To evaluate the difference in postoperative pain scores of dogs undergoing abdominal surgery receiving surgical incision infiltration of saline or bupivacaine liposomal injectable suspension (BLIS). ANIMALS: 40 dogs undergoing exploratory laparotomy. METHODS: Dogs were prospectively enrolled and randomized to receive either BLIS or saline surgical incision infiltration. All dogs received 5.3 mg of BLIS/kg or an equal volume of saline infiltrated in the muscle/fascia, subcutaneous tissue, and intradermal layer during closure. All dogs received a standardized postoperative pain management protocol. Pain assessment was performed at select time points postoperatively by blinded observers with an electronic algometer, short version of the Glasgow Composite Measure Pain Scale (GCMPS), and indirect measures of pain, including systolic blood pressure, heart rate, and serum cortisol levels. RESULTS: At day 0, blood pressure was higher in the saline group (149.6 vs 125.8 mm Hg; P = .006). At day 3, GCMPS was lower in the BLIS group (BLIS = 1, saline = 2, P = .027), though both average GCMPS scores were low and only 10 dogs were available for day 3 assessments (6 BLIS and 4 saline). No other differences in algometer readings, GCMPS scores, other measured parameters, or need for rescue analgesia were present between BLIS and saline groups at any time point. There was no difference in postoperative incisional infection rate or complications. CLINICAL RELEVANCE: Use of BLIS for exploratory laparotomy did not provide improved pain control over postoperative opioid administration alone. Patients that received BLIS had no increase in short-term complications.

Accuracy, precision, and interobserver and intraobserver agreements related to pressure-measurement devices.

OBJECTIVE: To evaluate the accuracy, precision, and observer agreement of three pressure measurement devices. STUDY DESIGN: In vitro model study. SAMPLE POPULATION: Water manometer with built-in gauge (WMg), arterial pressure transducer (APT), and Compass CT (CCT). METHODS: The model was set to five predetermined pressures (4, 8, 13, 17, and 24 cm H2 O) using a water manometer with a ruler (WMr) as the gold standard. Each device was tested at each pressure in a randomized order by three investigators. Bland-Altman plots were used to assess agreement between devices. Intraclass correlation coefficients (ICC) were calculated for interobserver and intraobserver agreements. RESULTS: The mean differences (cm H2 O) ± SEM in comparison with the set pressure were -0.020 ± 0.010 (WMg), -0.390 ± 0.077 (APT), and -1.267 ± 0.213 (CCT). Pressures measured by WMg did not differ from those measured by WMr. Pressures measured by all devices did not differ from each other (p > .062 for all comparisons). Interobserver agreement was excellent (1.000), and intraobserver agreement was excellent (0.985, 0.990, 0.998 for each observer). CONCLUSION: Compared to the WMr, the WMg was the most accurate and precise, followed by the APT; the CCT was the least accurate and precise. Interobserver and intraobserver agreements for all three devices were excellent. CLINICAL SIGNIFICANCE: The largest mean difference of all devices was within 1.3 cm H2 O of the set pressure, indicating possible clinical utility of any of the devices. However, WMr or WMg should be considered first due to their high precision and accuracy.

Staphylectomy in nonbrachycephalic dogs: A retrospective study of 27 cases.

Objective: To report the outcomes and complications associated with staphylectomy in nonbrachycephalic dogs. Animal: Twenty-seven nonbrachycephalic dogs with elongated soft palates and undergoing staphylectomy. Procedure: Retrospective study. Results: Increased upper airway noise (70.4%) and dyspnea (44.4%) were the most common presenting clinical signs. Concurrent upper airway abnormalities found in the study population included laryngeal collapse (25.9%) and laryngeal paralysis (14.8%). The most common staphylectomy technique used in this study was sharp excision (66.7%) with sutured oral and nasal mucosal apposition. The dogs in this study had an overall minor postoperative complication rate of 33.3%, with regurgitation/vomiting (11.1%) and coughing (11.1%) occurring most commonly. No dog required supplemental oxygen therapy or temporary tracheostomy. Conclusion: Staphylectomy was well-tolerated in nonbrachycephalic dogs and was associated with a relatively low rate of complications. Concurrent airway abnormalities were common among nonbrachycephalic dogs with elongated soft palates, similar to brachycephalic dogs. Clinical relevance: Clinicians should be aware that elongated soft palate can occur in nonbrachycephalic dogs, and surgical correction can be achieved with rare major or catastrophic complications.

Staphylectomie chez des chiens non-brachycéphales : une étude rétrospective de 27 cas. Objectif: Rapporter les résultats et les complications associés à la staphylectomie chez des chiens non-brachycéphales. Animal: Vingt-sept chiens non-brachycéphales au palais mou allongé et subissant une staphylectomie. Procédure: Étude rétrospective. Résultats: L'augmentation du bruit des voies respiratoires supérieures (70,4 %) et la dyspnée (44,4 %) étaient les signes cliniques les plus fréquents. Les anomalies concomitantes des voies respiratoires supérieures trouvées dans la population étudiée comprenaient un collapsus laryngé (25,9 %) et une paralysie laryngée (14,8 %). La technique de staphylectomie la plus couramment utilisée dans cette étude était l'exérèse fine (66,7 %) avec apposition suturée des muqueuses buccale et nasale. Les chiens de cette étude présentaient un taux global de complications postopératoires mineures de 33,3 %, les régurgitations/vomissements (11,1 %) et la toux (11,1 %) étant les plus fréquents. Aucun chien n'a eu besoin d'une oxygénothérapie supplémentaire ou d'une trachéotomie temporaire. Conclusion: La staphylectomie a été bien tolérée chez les chiens non-brachycéphales et a été associée à un taux relativement faible de complications. Les anomalies concomitantes des voies respiratoires étaient courantes chez les chiens nonbrachycéphales avec des palais mous allongés, semblables aux chiens brachycéphales. Pertinence clinique: Les cliniciens doivent être conscients qu'un palais mou allongé peut survenir chez les chiens non-brachycéphales et qu'une correction chirurgicale peut être obtenue avec de rares complications majeures ou catastrophiques.(Traduit par Dr Serge Messier).

Acute kidney injury is common in dogs with septic peritonitis and is associated with increased mortality.

OBJECTIVE: To identify the frequency of and risk factors for acute kidney injury (AKI) in dogs undergoing abdominal surgery for septic peritonitis, and to evaluate outcome and kidney-related risk factors for survival to discharge in those dogs. ANIMALS: 77 dogs that underwent abdominal surgery for septic peritonitis. METHODS: Medical records of dogs that underwent surgery for septic peritonitis from 2012 through 2022 were reviewed. Data regarding signalment, clinical and biochemical findings at presentation, blood creatinine concentration throughout hospitalization, surgery characteristics, postoperative monitoring, and outcome were collected. Dogs were classified based on occurrence of AKI and whether they presented with or developed AKI in-hospital. Perioperative risk factors were evaluated, and outcomes were compared with univariable logistic regression. RESULTS: 31 dogs (40.3%) had AKI diagnosed; 18/77 (23.4%) dogs presented with AKI, 11 (61.1%) of which had it postoperatively, and 13/77 (16.9%) dogs developed AKI postoperatively. Significant factors for presenting with AKI included increasing baseline respiratory rate (OR 2.5 for every 10 beats per minute higher), decreasing systolic blood pressure (OR 0.8 for every 10 mm Hg higher), and increasing body condition score (OR 2.2 for every score greater). No significant factors for developing AKI postoperatively were identified after multiple comparisons adjustment. Sixteen dogs (20.8%) did not survive to discharge; 12 (75.0%) had AKI and 4 (25.0%) did not. Dogs with AKI had decreased odds of survival to discharge (OR 0.2). CLINICAL RELEVANCE: AKI was common in dogs with septic peritonitis and was a significant risk factor for survival to discharge. Clinical surveillance of AKI is critical in this population.

Perioperative ventricular arrhythmias are increased with hemoperitoneum and are associated with increased mortality in dogs undergoing splenectomy for splenic masses.

OBJECTIVE: To identify risk factors for intra- and postoperative ventricular arrhythmias (VAs) and in-hospital mortality in dogs undergoing splenectomy for splenic masses. ANIMALS: 308 dogs. METHODS: Records from 2010 through 2018 were reviewed for dogs undergoing splenectomy for a splenic mass. Clinical and laboratory findings on admission, diagnostic imaging, anesthesia, surgery and pathology reports, treatment records, and in-hospital mortality were evaluated with logistic regression. RESULTS: VAs occurred in 138 (44.8%) dogs (126/308 [40.9%] postoperative, 51/308 [16.6%] intraoperative, 26/308 [8.4%] preoperative), with 50/308 (16.2%) dogs having more than one type of VA. Increasing heart rate and body weight, decreasing PCV and platelet count, hemoperitoneum, receipt of a transfusion, and diagnosis of hemangiosarcoma were associated with the presence of intra- and postoperative VAs on univariable analysis (all P < .001). On multivariable analysis, hemoperitoneum (P < .001 , < .001), increasing body weight (P = .026, < .001), and increasing heart rate (P = .028, < .001) were significant for intra- and postoperative VAs, respectively. Twenty dogs died (20/308 [6.5%]; 14/138 [10.1%] with VAs, 6/170 [3.5%] without VAs). Intra- and postoperative VAs were associated with in-hospital mortality (P = .009, .025, respectively). CLINICAL RELEVANCE: Perioperative VAs were common and odds of VAs were increased with hemoperitoneum, increasing heart rate, and increasing body weight. Presence of VAs increased the odds of in-hospital mortality. Despite this, the overall in-hospital mortality rate was low (6.5%), indicating a good prognosis for survival of surgery in dogs with splenic masses, regardless of the presence of VAs or hemoperitoneum.

Retrospective evaluation of surgical treatment of linear and discrete gastrointestinal foreign bodies in cats: 2009-2021.

OBJECTIVES: Gastrointestinal foreign bodies (FBs) are an important cause of emergency surgical intervention in cats, but little information exists in the literature evaluating the risks and outcomes in this species. The study purpose was to describe cases of feline FBs and compare perioperative factors and outcomes between linear foreign body (LFB) and discrete foreign body (DFB) surgery in cats. METHODS: The medical records from the University of Georgia Veterinary Teaching Hospital were searched for cats that had undergone surgery for FB removal between August 2009 and August 2021. Perioperative data were collected and described. Data were compared between cats with an LFB and cats with a DFB. A binomial probability series was used to estimate the likelihood of postoperative septic peritonitis or mortality in an additional cat in the series. RESULTS: A total of 56 cats were included in this study; 38 cats had a DFB and 18 had an LFB. No cats developed postoperative septic peritonitis, and all cats survived. The likelihood of postoperative septic peritonitis or mortality in an additional cat was estimated to be <5.2%. Cats with an LFB were found to have a significantly higher body condition score (P = 0.047), albumin (P = 0.025), American Society of Anesthesiologists status (P = 0.027), surgery length (P <0.001) and total cost of visit (P = 0.006) when compared with cats with a DFB. Cats with LFBs were more likely to develop a surgical site infection (SSI; P = 0.007) and be administered postoperative antibiotics (P = 0.017). CONCLUSIONS AND RELEVANCE: Cats undergoing surgery for gastrointestinal FBs had a low incidence of postoperative complications. Cats with LFBs had longer surgeries and were more likely to develop postoperative SSIs.

Performing an ovariohysterectomy at the time of c-section does not pose an increase in risk of mortality, intra- or postoperative complications, or decreased mothering ability of the bitch.

OBJECTIVE: Ovariohysterectomy (OVH) is frequently recommended at the time of c-section in canines, yet prior literature suggests poor mothering ability and increased morbidity to the bitch with c-section with concurrent OVH (CSOVH). The study objective was to compare maternal survival, complications, and mothering ability between bitches that underwent c-section alone (CS) or CSOVH. ANIMALS: 125 bitches. PROCEDURES: Medical records from 2014 through 2021 were retrospectively reviewed; owners were surveyed for information up to weaning. RESULTS: 80 bitches undergoing CS and 45 bitches undergoing CSOVH were identified. There was no difference in anesthesia duration, intraoperative complications, postoperative complications, mothering ability, puppy survival to weaning, or other variables compared between groups. CSOVH bitches had longer surgery times (P = .045; 54.4 ± 20.7 min vs 46.9 ± 16.6 min) and longer time from delivery to nursing (P = .028; 75.4 ± 22.3 min vs 65.2 ± 19.5 min). Ninety (72%) owners responded to the survey. All 90 bitches survived until puppy weaning. CSOVH bitches were more frequently perceived as painful postoperatively (P = .015). CLINICAL RELEVANCE: Performing an OVH at the time of c-section does not pose a significant increase in risk of mortality, intraoperative complications, postoperative complications, or decreased mothering ability of the bitch. The increased duration of surgery and increased time from delivery to nursing in the CSOVH group were clinically insignificant. Appropriate postoperative pain management should be emphasized post-CSOVH. Based on these results, OVH should be performed concurrently with c-section if indicated.

Outcomes and clinical features associated with surgically excised canine salivary gland carcinoma: A multi-institutional, retrospective, Veterinary Society of Surgical Oncology study.

OBJECTIVE: The objective of this study was to describe the clinical features, prognostic factors, and outcomes in dogs with surgically treated salivary gland carcinoma. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Seventy-two client-owned dogs from 16 institutions with surgically excised salivary gland carcinoma. METHODS: Medical records of dogs undergoing sialoadenectomy from January 1, 2000 to January 1, 2020 were reviewed for signalment, clinical signs, preoperative staging results, preoperative mass evaluation, complications, histopathologic diagnosis, local recurrence, metastatic disease, and survival times. Survival functions were estimated using the Kaplan-Meier estimator. Factors related to survival were individually tested using the log-rank test. RESULTS: The overall median survival time (MST) associated with salivary carcinoma was 1886 days. Local recurrence occurred in 29/69 (42%) dogs with an overall disease-free interval (DFI) of 191 days. Metastatic disease occurred in 22/69 (31.9%) dogs, with an overall DFI of 299 days. Lymph node metastasis was present at the time of surgery in 11/38 (28.9%) dogs in which lymphadenectomy was performed at the time of surgery; these dogs had a shorter DFI at 98 days (P = .03) and MST at 248 days (P < .001). CONCLUSION: The prognosis for dogs with salivary gland carcinoma treated surgically was more favorable than previously reported. Nodal metastasis was a negative prognostic factor for canine salivary gland carcinoma. CLINICAL SIGNIFICANCE: Surgical intervention should be considered for dogs with salivary carcinoma.

Scar revision for incompletely or narrowly excised soft tissue sarcomas in dogs.

Objective: Describe clinical features of dogs undergoing scar revision for incompletely or narrowly excised soft tissue sarcomas (STSs) in the absence of gross disease and to determine local recurrence rates following scar revision. Animals: Thirty-three dogs with 33 scars. Procedures: Medical records were reviewed to collect data on signalment, tumor details, pre-surgical diagnostic tests, surgical and pathologic findings for both the initial and revision surgeries, and clinical outcomes. Descriptive statistics were generated. Results: For the initial excision, cytology was performed before surgery in 45.5% (15/33) of dogs, and information on surgical margins was rarely reported [4.0% (1/25) of circumferential and 12.0% (3/25) of deep margins]. Microscopic evidence of residual STS was identified in 18.2% of scars. Recurrence occurred in 3.0% (1/33) of dogs [median follow-up of 1127 d (1 to 3192 d)]; this dog had had no evidence of residual tumor in the scar revision pathology. Conclusions: Despite the low identification rate of residual tumor, the local tumor recurrence rate was 3.0%, which is lower than what is historically reported for incompletely or narrowly excised STSs. Clinical relevance: Scar revision for incompletely or narrowly excised STSs resulted in durable tumor remission in the dogs of this study. Pre-surgical diagnostic tests were not often performed in this study; these may be considered before the first excision to plan surgical margins for potentially reducing the incidence of incomplete or narrow excision. Surgical reports should include details on circumferential and deep margins to guide pathologic interpretation and future scar revision, if required.

Révision des cicatrice pour les sarcomes des tissus mous incomplètement ou étroitement excisés chez le chien. Objectif: Décrire les caractéristiques cliniques des chiens subissant une révision de cicatrice pour des sarcomes des tissus mous (STSs) incomplètement ou étroitement excisés en l'absence de maladie macroscopique et pour déterminer les taux de récidive locale après la révision de cicatrice. Animaux: Trente-trois chiens avec 33 cicatrices. Procédures: Les dossiers médicaux ont été examinés pour recueillir des données sur le signalement, les détails de la tumeur, les tests de diagnostic pré-chirurgicaux, les résultats chirurgicaux et pathologiques pour les chirurgies initiales et de révision, et les résultats cliniques. Des statistiques descriptives ont été générées. Résultats: Pour l'excision initiale, une cytologie a été réalisée avant la chirurgie chez 45,5 % (15/33) des chiens, et les informations sur les marges chirurgicales ont été rarement rapportées [4,0 % (1/25) des marges circonférentielles et 12,0 % (3/25) des marges profondes]. Des preuves microscopiques de STS résiduel ont été identifiées dans 18,2 % des cicatrices. Une récidive est survenue chez 3,0 % (1/33) des chiens [suivi médian de 1127 jours (1 à 3192 jours)]; ce chien n'avait eu aucun signe de tumeur résiduelle dans la pathologie de révision de la cicatrice. Conclusions: Malgré le faible taux d'identification de tumeur résiduelle, le taux de récidive tumorale locale était de 3,0 %, ce qui est inférieur à ce qui est historiquement rapporté pour les STS incomplètement ou étroitement excisés. Pertinence clinique: La révision des cicatrices pour les STS incomplètement ou étroitement excisés a entraîné une rémission tumorale durable chez les chiens de cette étude. Les tests diagnostiques pré-chirurgicaux n'ont pas souvent été effectués dans cette étude; ceux-ci peuvent être envisagés avant la première excision pour planifier les marges chirurgicales afin de réduire potentiellement l'incidence de l'excision incomplète ou étroite. Les rapports chirurgicaux doivent inclure des détails sur les marges circonférentielles et profondes pour guider l'interprétation pathologique et la révision future de la cicatrice, si nécessaire.(Traduit par Dr Serge Messier).

Scar revision for incompletely or narrowly excised cutaneous mast cell tumors in dogs.

Objective: Describe clinical features and outcomes of dogs undergoing scar revision for incompletely or narrowly excised cutaneous mast cell tumors without gross disease. Animals: 52 dogs undergoing 54 scar revisions. Procedures: Retrospective record review with information collected on signalment, tumor type/location, pre-surgical diagnostics, surgical and pathologic findings for the first excision and scar revision surgeries, and follow-up. Descriptive statistics were generated. Results: Prior to initial excision, cytology was performed on 38.9% (21/54) of tumors and the initial surgery report rarely described surgical resection margins [14.6% (7/48) of surgeries]. Residual tumor was identified pathologically in 29.6% (16/54) of scars. Local recurrence following scar revision occurred in 3.7% (2/54) of all scars [median follow-up 881.5 d (range: 0 to 3317 d)]; both scars had either complete excision of residual mast cell tumor or no evidence of mast cell tumor on scar revision and neither dog received radiation therapy. Conclusions: Identification of residual disease was uncommon, and local recurrence was less common than previously reported for incomplete/narrow mast cell tumor excision. Clinical relevance: Scar revision of unplanned primary excisions appears to yield a high likelihood of durable tumor remission in patients. First opinion practitioners are encouraged to avoid unplanned excisions by informing the surgical plan with cytology of the primary tumor and detailing surgical margin excision which may facilitate revision, if necessary.

Révision des cicatrices pour des mastocytes cutanés incomplètement ou étroitement excisés chez le chien. Objectif: Décrire les caractéristiques cliniques et les résultats des chiens subissant une révision de cicatrice pour des tumeurs mastocytaires incomplètement ou étroitement excisées sans maladie grave. Animaux: Cinquante-deux chiens soumis à 54 révisions de cicatrice. Procédures: Examen rétrospectif des dossiers avec des informations recueillies sur le signalement, le type/l'emplacement de la tumeur, les diagnostics pré-chirurgicaux, les résultats chirurgicaux et pathologiques pour les premières chirurgies d'excision et de révision de cicatrice, et le suivi. Des statistiques descriptives ont été générées. Résultats: Avant l'excision initiale, une cytologie a été réalisée sur 38,9 % (21/54) des tumeurs et le rapport chirurgical initial décrivait rarement les marges de résection chirurgicale [14,6 % (7/48) des chirurgies]. Une tumeur résiduelle a été identifiée pathologiquement dans 29,6 % (16/54) des cicatrices. Une récidive locale après révision des cicatrices s'est produite dans 3,7 % (2/54) de toutes les cicatrices [suivi médian de 881,5 jours (intervalle : 0 à 3317 jours)] les deux cicatrices présentaient soit une excision complète du tumeur mastocytaire résiduel, soit aucun signe de tumeur mastocytaire lors de la révision de la cicatrice et aucun chien n'a reçu de radiothérapie. Conclusions: L'identification de la maladie résiduelle était rare et la récidive locale était moins fréquente que précédemment rapportée pour l'excision incomplète/étroite du tumeur mastocytaire. Pertinence clinique: La révision de la cicatrice des excisions primaires non planifiées semble donner une forte probabilité de rémission tumorale durable chez les patients. Les praticiens de première opinion sont encouragés à éviter les excisions non planifiées en informant le plan chirurgical avec la cytologie de la tumeur primaire et en détaillant les marges de l'excision chirurgicale ce qui peut faciliter la révision, si nécessaire.(Traduit par Dr Serge Messier).

Clinical Utility of Cytology from Preoperative Percutaneous Fine Needle Aspirates of Solitary Liver Masses in 220 Dogs: A Retrospective Study (2009-2019).

When a solitary liver mass is identified in a dog, a fine-needle aspirate (FNA) is commonly employed to attempt to obtain a diagnosis. Little information is provided in the literature evaluating the sensitivity/specificity of FNA cytology for solitary liver masses. We hypothesized that liver lesion size nor the presence of cavitation would impact the success of cytological diagnosis. Medical records were obtained for 220 client-owned dogs. Inclusion criteria included preoperative abdominal imaging, percutaneous FNA of a solitary hepatic mass with cytologic interpretation by a board-certified pathologist, and a surgical biopsy or mass excision yielding a histopathological diagnosis. Six dogs (2.7%) experienced a complication after FNA, none considered severe. The agreement rate for correct cytologic diagnosis was 22.9% (49/220). Of the neoplastic masses 18.9% (35/185) were correctly diagnosed via cytology. The overall sensitivity was 60%, and the specificity was 68.6%. Neither institution (P = 0.16), lesion size (P = 0.88), cavitation (P = 0.34), or needle gauge (P = 0.20) had an association with correct diagnosis. This study demonstrates that, although there is a low risk of complications following FNA of a hepatic mass, overall success rate for correct cytologic diagnosis based on FNA was low compared to histopathologic diagnosis.

Outcome in 38 dogs surgically treated for hepatic abscessation.

OBJECTIVE: To report outcomes following surgical treatment of hepatic abscessation in dogs. STUDY DESIGN: Retrospective. ANIMALS: Thirty-eight dogs. METHODS: Records from 6 institutions were evaluated for dogs undergoing surgical treatment for hepatic abscessation between 2010 and 2020. Signalment, clinical signs, medical therapy, surgical treatment, and postoperative outcome was obtained from medical records. Long-term outcome was recorded when possible. Median survival time was assessed using the Kaplan-Meier product-limit method. RESULTS: Peritoneal effusion was documented in 32/38 dogs preoperatively, with septic peritonitis confirmed in 21/23 samples. Liver lobectomy was the most common surgery (27 dogs). A single organism was cultured in 24/35 dogs, most commonly Escherichia coli. Hepatic neoplasia was identified in 11/36 dogs. Dogs were hospitalized for a median of 5 days (range, 3-17) with complications recorded in 21 dogs (regurgitation, aspiration pneumonia, and pancreatitis most commonly). Two dogs died intraoperatively, and 6 dogs died prior to discharge. Median survival time for dogs surviving to discharge was 638 days. Of these, 19 were lost to follow up a median of 301 (range, 3-1418) days postoperatively and 11 died a median of 291 (range, 7-1292) days postoperatively. No abscess recurrence was noted. CONCLUSION: Septic peritonitis was a common sequela to hepatic abscessation. Perioperative complications were recorded in approximately one-third of dogs. In dogs surviving the postoperative period, long-term prognosis was good. CLINICAL SIGNIFICANCE: Dogs treated surgically for hepatic abscessation have a high risk of perioperative complications but favorable long-term prognosis and apparent low risk of recurrence.

Evaluation of the validity of the double two-thirds rule for diagnosing hemangiosarcoma in dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass: a systematic review.

OBJECTIVE: To evaluate the validity of the double two-thirds rule for a diagnosis of splenic hemangiosarcoma in dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass. SAMPLE: Systematic literature review. PROCEDURES: 3 databases (PubMed, CAB abstracts, and World of Science) were searched in November 2020. Articles were included if data on dogs with nontraumatic hemoperitoneum due to a splenic mass were included and subsequent pathologic diagnosis could be determined. RESULTS: In total, 2,390 unique articles were identified, with 66 articles meeting the criteria for full-text review and 14 articles included for analysis. A total of 1,150 dogs were evaluated, with 73.0% (840/1,150) of dogs being diagnosed with a malignant splenic lesion and 27.0% (310/1,150) being diagnosed with a benign splenic lesion. Of the malignancies, 87.3% (733/840) were hemangiosarcoma. Levels of evidence were low, and bias was high as most included studies were retrospective case series. CLINICAL RELEVANCE: The double two-thirds rule should be refined when evaluating dogs with nontraumatic hemoperitoneum from a ruptured splenic mass, with more dogs being diagnosed with a malignancy and hemangiosarcoma specifically than the double two-thirds rule indicates. These findings may be useful in an emergency setting to guide owners on potential diagnoses for dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass. However, there remains a portion of these dogs with benign conditions and nonhemangiosarcoma malignancies that may have a good long-term prognosis compared to dogs with hemangiosarcoma. Studies with higher levels of evidence, lower risks of bias, and large case numbers are needed in the literature.

Clinical presentation and outcome in cats with aural squamous cell carcinoma: a review of 25 cases (2010-2021).

CASE SERIES SUMMARY: Ear canal neoplasia is uncommon in cats. Ceruminous gland adenocarcinoma is the most frequently reported malignant neoplasm of the feline ear canal, and squamous cell carcinoma (SCC) is the most common malignant neoplasm diagnosed in the feline middle ear. However, limited information exists on the outcome of cats diagnosed with SCC of the ear canal, middle or inner ear. Therefore, the objective of this study was to describe the outcome of cats diagnosed with SCC affecting these locations. Medical records were reviewed at multiple institutions to identify cats with a definitive diagnosis of SCC. Twenty-five cats were identified. Eleven cats were treated with surgery, eight with medical management, two with coarse fractionated radiation therapy, two with a combination of coarse fractionated radiation therapy and chemotherapy, one with a combination of surgery and coarse fractionated radiation therapy, one cat with systemic chemotherapy and one cat received no treatment following diagnosis. The median survival time of cats treated with surgery was 168 days vs 85 days (P = 0.28) for those treated palliatively with either medical management, radiation therapy, chemotherapy, or a combination of radiation therapy and chemotherapy. RELEVANCE AND NOVEL INFORMATION: This case series documented that SCC of the ear canal, middle and/or internal ear is a locally aggressive tumor that carries an overall poor prognosis. The median survival time for cats treated with surgery was longer than that with any other modality, but this difference was not statistically significant.

Surgical treatment of deep neck infections in 19 dogs.

OBJECTIVE: Describe clinical features, treatment, and outcomes in dogs with deep neck infections. ANIMALS: 19 dogs undergoing surgical treatment of deep neck infections from January 1, 2015, through December 31, 2020. PROCEDURES: Retrospective record review was conducted, with data collected including clinical signs; neutrophil-to-lymphocyte ratio (NLR); diagnostic imaging, surgical, and histopathologic findings; and follow-up. Spearman correlation and Wilcoxon rank sum were used to compare variables to NLR. RESULTS: All dogs had cervical swelling, and 9 were febrile. On CT, a distinct mass or abscess (7/13) or abscessed lymph node (4/13) was common, with contrast enhancement (10/13), fluid tracking (8/13), and displacement of the trachea, pharynx, or larynx (6/13) also frequently seen. Foreign material was suspected on CT for 4 dogs and was identified at surgery or histopathology for 4 dogs, only 1 of which was suspected on CT. Histopathology most commonly revealed pyogranulomatous inflammation (14/15). Increasing NLR was moderately correlated to a decreased duration of clinical signs before presentation (ρ = -0.548; P = .035) and an increased length of hospitalization (ρ = 0.645; P = .009). Bacterial culture was submitted for all dogs, and polymicrobial infections were common (8/19). Broad-spectrum empirical antimicrobials were commonly prescribed. Change in antimicrobial treatment based on culture was uncommon (3/19). All dogs survived to hospital discharge; 18 dogs with long-term follow-up had complete resolution of clinical signs. CLINICAL RELEVANCE: CT was useful to plan for surgery, and surgical treatment resulted in resolution of clinical signs in all dogs with long-term follow-up available. Empirical antimicrobial treatment, such as amoxicillin-clavulanic acid or ampicillin-sulbactam, should be considered.

Risk factors for neonatal mortality prior to hospital discharge in brachycephalic and nonbrachycephalic dogs undergoing cesarean section.

OBJECTIVES: To compare neonatal survival to discharge rates between brachycephalic and nonbrachycephalic dogs undergoing cesarean section (c-section) and identify risk factors for neonatal mortality. STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: A total of 480 puppies from 90 bitches undergoing 106 c-sections. METHODS: Medical records of c-sections performed between January 2012 and September 2021 were reviewed. Data collected included brachycephalic versus nonbrachycephalic breed, elective versus emergency c-section, litter size (c-section and total [including those born prior to and via c-section]), and neonatal survival to discharge. A generalized linear mixed model (univariable and multivariable) was performed to evaluate variables versus neonatal survival. RESULTS: Overall neonatal survival to discharge was 93.1% (447/480); survival was similar between brachycephalic and nonbrachycephalic breeds (p = .221, 202/213 [94.8%] brachycephalic survival, 245/267 [91.8%] nonbrachycephalic survival). Puppies delivered via elective c-section were more likely to survive compared to emergency c-section (p < .001, 238/240 [99.2%] elective survival, 209/240 [87.1%] emergency survival). Puppies delivered in larger c-section litters were more likely to survive (p < .004) compared to smaller litters. Total litter size had no effect on survival. CONCLUSION: Brachycephalism had no effect on neonatal survival. Puppies delivered via elective c-section were more likely to survive compared to puppies delivered via emergency c-section. CLINICAL SIGNIFICANCE: Outcomes following c-section are similar between brachycephalic and nonbrachycephalic breeds. While it is preferable to encourage selective breeding for bitches that are able to whelp naturally, elective c-section should be considered in bitches at high risk for dystocia to maximize neonatal survival.

Perioperative characteristics, histologic diagnosis, complications, and outcomes of dogs undergoing percutaneous drainage, sclerotherapy or surgical management of intrarenal cystic lesions: 18 dogs (2004-2021).

BACKGROUND: Canine intrarenal cystic lesions (ICLs) are infrequently reported in the veterinary literature. Several treatment options have been described including cyst fenestration (partial nephrectomy/deroofing) +/- omentalization, sclerotherapy using alcohol as a sclerosing agent, percutaneous cyst drainage (PCD), and ureteronephrectomy. Information regarding presenting clinical signs, physical examination findings, histologic diagnosis and outcomes of dogs with ICLs treated by different methods is limited. Medical records of 11 institutions were retrospectively reviewed to identify dogs that underwent PCD, sclerotherapy, surgical deroofing +/- omentalization, or ureteronephrectomy for management of ICLs from 2004 to 2021. Six weeks postoperative/post-procedural follow-up was required. Cases suspected to represent malignancy on preoperative imaging were excluded. The study objective was to provide information regarding perioperative characteristics, complications, and outcomes of dogs undergoing treatment of ICLs. RESULTS: Eighteen dogs were included, with 24 ICLs treated. Ten had bilateral. There were 15 males and 3 females, with crossbreeds predominating. PCD, sclerotherapy, deroofing and ureteronephrectomy were performed in 5 (5 ICLs treated), 7 (11 ICLs), 6 (6), and 7 (7) dogs, respectively, with 5 dogs undergoing > 1 treatment. Seven dogs experienced 8 complications, with requirement for additional intervention commonest. PCD, sclerotherapy and deroofing resulted in ICL resolution in 0/5, 3/11 and 3/6 treated ICLs, respectively. Histopathology identified renal cysts (RCs) in 7/13 dogs with histopathology available and neoplasia in 6/13 (4 malignant, 2 benign). Of 5 dogs diagnosed histopathologically with neoplasia, cytology of cystic fluid failed to identify neoplastic cells. Among 7 dogs with histologically confirmed RCs, 4 had concurrent ICLs in ipsilateral/contralateral kidney, compared with 2/6 dogs with histologically confirmed neoplasia. CONCLUSIONS: Benign and neoplastic ICLs were approximately equally common and cystic fluid cytology failed to differentiate the 2. Among renal-sparing treatments, deroofing most commonly resulted in ICL resolution. Presence of concurrent ICLs in ipsilateral/contralateral kidney does not appear reliable in differentiating benign from malignant ICLs.