Implant removal rate after partial carpal arthrodesis in dogs: A retrospective analysis of 22 cases.

Introduction: The purpose of this study is to determine the rate of implant removal after partial carpal arthrodesis and to investigate factors associated with implant removal. Methods: Case records of 22 dogs that underwent partial carpal arthrodesis at two private veterinary referral hospitals were reviewed. Details retrieved were body weight at time of surgery, sex, neuter status, breed, age, cause of carpal hyperextension injury, joint(s) involved in carpal hyperextension injury, laterality, type of implant, administration of post-operative antibiotics, post-operative outcome and indication for implant removal. Association between these factors and implant removal was evaluated. Results: Of 22 partial carpal arthrodesis, 12 (55%) had implant removal due to persistent lameness and 9/12 (75%) returned to full and acceptable function after implant removal. Indications for implant removal were implant interference (8), infection (4), and migration (1). When comparing type of implant, there was a significant difference when observing implant removal rates (p = 0.04). All 5 dogs with pins and wires (100%) required implant removal. Of 17 dogs with a plate, 7 (41.2%) required implant removal. Implant removal was performed on average 114 days post-operative. Discussion: Implant removal after partial carpal arthrodesis was frequent and was commonly indicated due to pin and wire fixation or plate implant interference. This study may impact how we prepare clients for potential post-operative complications and implant removal when recommending partial carpal arthrodesis.

Associations of abdominal discomfort and length of clinical signs with surgical procedure in 181 cases of canine small intestinal foreign body obstruction.

BACKGROUND: Gastrointestinal foreign bodies are a common indication for abdominal exploratory surgery. OBJECTIVES: The objective of this study was to evaluate the relationship of pre-operative abdominal discomfort and duration of clinical signs with surgical resolution of canine small intestinal foreign body obstructions (SIFBO). METHODS: We performed a retrospective study of 181 canine abdominal exploratory surgeries for confirmed SIFBO at two referral hospitals. Animals were categorized into five surgical groups (gastrotomy after manipulation into the stomach, enterotomy, resection-and-anastomosis [R&A], manipulated into colon, already in colon) and further grouped by whether entry into the gastrointestinal tract (GIT) was required. RESULTS: Abdominal discomfort was noted in 107/181 cases (59.1%), but no significant differences in abdominal discomfort rates were present among the surgical groups or between GIT entry and no entry groups. Clinical sign duration was associated with surgical procedure; median durations were R&A = 3 days (range, 1-9), enterotomy = 2 days (range, 1-14), gastrotomy = 2 days (range, 1-6), already in colon = 1.5 days (range, 1-2), and manipulated into colon = 1 day (range, 1-7). In a pairwise comparison, differences in the duration of clinical signs were found for obstructions manipulated into the colon versus R&A, gastrotomy versus R&A, and in colon versus R&A. When patients were grouped according to GIT entry, cases with entry had a longer duration of clinical signs (median = 2 days [range, 1-14] versus 1 day [range, 1-7], respectively). CONCLUSIONS: Abdominal discomfort was not associated with surgical complexity; however, the duration of clinical signs was associated with surgical complexity, with longer duration being associated with entry into the GIT and R&A. Despite statistical significance, the maximum difference of 2 days between surgical groups is unlikely to be clinically relevant.

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 and Prognostic Factors in Cats Undergoing Resection of Intestinal Adenocarcinomas: 58 Cases (2008-2020).

The purpose of this multi-institutional retrospective study was to expand the available data pertaining to pre-operative clinical findings, progression-free and overall survival times, and potential prognostic factors for cats undergoing surgery for intestinal adenocarcinomas. Fifty-eight cats treated over a 12-year period were included in the study. Progression-free and overall survival times were estimated using Kaplan-Meier analyses. Potential prognostic variables were evaluated for associations with progression-free and overall survival using univariate Cox proportional hazards regression analyses. Prior to surgery, the intestinal mass was identified using ultrasonography in 89% of cats in which it was applied; however, imaging findings suggestive of intrathoracic metastases were observed in only 9% of cats. Among 22 cats undergoing ultrasound-guided fine needle aspiration cytology, the results agreed with the results of histopathology in only 10 cats. Discordant results were most commonly related to the presence of marked inflammation in cytology samples, which may have obscured the presence of neoplastic cells. Diffuse intestinal small cell lymphoma was identified as a comorbidity in 5 cats. Resection of the tumor with the objective of obtaining wide surgical margins was performed in each cat. On histopathology, 20 tumors were classified as mucinous adenocarcinoma and 28 were adenocarcinoma not otherwise specified. Intestinal transection site margins were complete in 94% of cats; however, complete mural margins were present in only 15% of cats. Local lymph node metastases were identified in 52% of cats and carcinomatosis was diagnosed in 81% of cats. Disease progression was documented in 32 of the 58 cats (55%). Of these 32 cats, 14 (43%) had local recurrence of the primary intestinal tumor. Median progression-free survival was 203 days (95% CI 130-299 days), and median overall survival time was 284 days (95% CI 200-363 days). Mitotic count was inversely associated with progression-free survival (HR 1.04; 95% CI 1.01-1.07, P = 0.005); however, none of the remaining potential prognostic factors, including administration of adjuvant chemotherapy, were significantly associated with progression-free or overall survival. Feline intestinal adenocarcinoma remains an aggressive and highly fatal disease. Large, randomized controlled clinical trials will be needed to improve the survival prospects for affected cats.

Analysis of risk factors associated with complications following mandibulectomy and maxillectomy in dogs.

OBJECTIVE: To provide information about complication rates and the risk factors for complications with mandibulectomy and maxillectomy procedures in dogs. ANIMALS: 459 client-owned dogs that underwent a mandibulectomy or maxillectomy between January 1, 2007, and January 1, 2018. PROCEDURES: Inclusion criteria included a complete medical record that contained an anesthesia record, surgical report, available histopathology results, and results of CBC and serum biochemical analysis before surgery. A minimum follow-up of 90 days after surgery was required. RESULTS: 271 complications occurred in 171 of 459 (37.3%) dogs. Eighteen complications were not given a severity description. Of the remaining 253 complications, most were considered minor (157/253 [62.1%]). Multivariable logistic regression analysis revealed that only increased surgical time had a significant (OR, 1.36; 95% CI, 1.12 to 1.54) association with the occurrence of ≥ 1 complication. For each additional hour of surgery, the odds of complications increased by 36%. Preoperative radiation therapy or chemotherapy increased the odds of incisional dehiscence or oral fistula formation (OR, 3.0; 95% CI, 1.3 to 7.2). Additionally, undergoing maxillectomy, compared with mandibulectomy, increased the odds of incisional dehiscence or oral fistula formation (OR, 1.8; 95% CI, 1.1 to 3.1). Two hundred forty-four of 271 (90.0%) complications occurred in the perioperative period (0 to 3 months after surgery). CONCLUSIONS AND CLINICAL RELEVANCE: Compared with mandibulectomy, performing maxillectomy increased the risk for incisional dehiscence or oral fistula formation. Mandibulectomy and maxillectomy had a moderate risk for a complication.

Paramedian incisional complications after prophylactic laparoscopy-assisted gastropexy in 411 dogs.

OBJECTIVE: To determine the frequency and types of paramedian incisional complications after prophylactic laparoscopy-assisted gastropexy (LAG) in dogs and to evaluate potential risk factors for complications. STUDY DESIGN: Multi-institutional retrospective study. ANIMALS: Client-owned dogs (N = 411). METHODS: Records for dogs that underwent single-incision-port laparoscopy-assisted gastropexy (SIPLAG) or multiple-port laparoscopy-assisted gastropexy (MPLAG) at five veterinary referral hospitals were reviewed. Information regarding signalment, surgical procedures, perioperative care, and incisional complications was collected. Follow-up information was obtained by review of medical records and/or communication with owners. Potential risk factors for complications were examined statistically. RESULTS: Paramedian incisional complications were observed in 78 of 411 (19%) dogs. The most common complication was seroma formation, which occurred in 51 (12.4%) dogs. Surgical site infections were observed in 16 (3.9%) dogs, and dehiscence or development of excessive scar tissue at the incision site were each observed in nine (2.2%) dogs. Complications resolved with conservative treatment in 75 of 78 (96.2%) dogs and with surgical treatment in three of 78 (3.8%) dogs. The odds of complications were approximately twice as high in dogs undergoing SIPLAG than in dogs undergoing MPLAG (odds ratio, 2.03; P = .006). CONCLUSION: Minor paramedian incisional complications, particularly seroma formation, were frequently observed after LAG. Most complications were successfully managed conservatively. Single-incision-port laparoscopy-assisted gastropexy was associated with a higher complication rate compared with MPLAG. CLINICAL SIGNIFICANCE: Owners should be informed that there is a relatively high rate of minor paramedian incisional complications after LAG. The risk of complications appears to be higher for SIPLAG than for MPLAG.

Prevalence of malignancy in masses from the mammary gland region of dogs with single or multiple masses.

OBJECTIVE: To determine the prevalence of malignancy in masses from the mammary gland region of dogs with single or multiple masses. ANIMALS: 95 female dogs from which mammary gland masses had been excised. PROCEDURES: Medical records of all female dogs from which mammary gland tissue was submitted to the Angell Animal Medical Center Pathology Department from 2009 through 2014 were reviewed. For each dog, data were obtained on breed, body weight, age, reproductive status, and number, location, and histologic classification of masses. The prevalence of malignancy was compared between dogs with single versus multiple masses and among the 5 pairs of mammary glands. Dogs with single versus multiple masses were also compared with respect to age and reproductive status. RESULTS: Among 161 evaluated masses, 137 (85%) were classified as benign or nonneoplastic and 24 (15%) as malignant. Five of 95 (5%) dogs had masses that were not of mammary gland origin. Age, reproductive status, and quantity of masses (single vs multiple) were not significantly associated with the prevalence of malignancy. The prevalence of malignancy in masses from the fourth (caudal abdominal) mammary gland was significantly lower than that in the other 4 mammary glands combined. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs with multiple masses in the mammary gland region were not significantly more likely than dogs with single masses to have a malignancy, suggesting that these 2 groups could be managed similarly. Further studies are needed to evaluate the clinical relevance of the lower prevalence of malignancy in masses from the fourth mammary gland.

Influence of methods of joint inspection during tibial plateau leveling osteotomy on the radiographic appearance of the patellar tendon.

OBJECTIVE: To determine the influence of methods of joint inspection during tibial plateau leveling osteotomy (TPLO) on radiographic appearance of the patellar tendon. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (191) treated with TPLO (199). METHODS: Data collected from medical records included signalment, weight, duration of anesthesia and surgery, preoperative and postoperative tibial plateau angle (TPA), cranial cruciate ligament status, meniscal status, and meniscal treatment. Method of joint inspection was recorded as (1) arthroscopy (AR), (2) craniomedial parapatellar arthrotomy (CrMA), or (3) caudomedial arthrotomy (CdMA). The radiographic thickness of the patellar tendon (PTT) was measured preoperatively and at 8-12 weeks postoperatively. Radiographic signs of patellar tendonitis were graded as 0-2 on the basis of the severity of changes. RESULTS: Thirty-nine dogs (41 stifles) underwent AR, 86 dogs (87 stifles) underwent CrMA, and 70 dogs (71 stifles) underwent CdMA. Durations of surgery (P < .001) and anesthesia (P < .001) were longer when joints were inspected by AR than by arthrotomies. PTT was greater after AR than after CrMA (P = .004) and CdMA (P < .001). The proportion of dogs with grade 1 or grade 2 PTT was greater after AR (78.04%) than after CrMA (52.87%, P = .0065) and CdMA (28.17%, P < .001). CONCLUSION: The PTT was thicker 8-12 weeks after TPLO when stifles were inspected arthroscopically rather than via arthrotomies. CLINICAL SIGNIFICANCE: The method of stifle exploration during TPLO influences the postoperative radiographic appearance of the patellar tendon and may contribute to patellar tendinopathy.

Incidence of malignancy and outcomes for dogs undergoing splenectomy for incidentally detected nonruptured splenic nodules or masses: 105 cases (2009-2013).

OBJECTIVE To determine the frequency of malignancy and survival rates of dogs that underwent splenectomy for incidentally detected nonruptured splenic masses or nodules. DESIGN Retrospective case series. ANIMALS 105 client-owned dogs. PROCEDURES Medical records of dogs that underwent splenectomy at a veterinary teaching hospital between 2009 and 2013 were examined to identify patients with incidentally detected nonruptured splenic masses or nodules without associated hemoperitoneum. Only dogs with histologically confirmed diagnoses were included. Information regarding signalment, preoperative diagnostic tests, perioperative blood product transfusions, splenic mass diameter, histologic findings, adjunctive treatments, and survival time was collected and analyzed. RESULTS 74 of 105 (70.5%) patients had benign splenic lesions and 31 (29.5%) had malignant neoplasia, most commonly hemangiosarcoma (18/31 [58%]). The hazard of death decreased as preoperative PCV increased; histopathologic diagnosis of malignant neoplasia was significantly associated with an increased hazard of death. Median life expectancy of dogs with benign and malignant lesions was 436 and 110 days, respectively; 41 of 74 patients with benign lesions and 3 of 31 patients with malignant neoplasia were still alive at study conclusion. Median life expectancy of dogs with hemangiosarcoma was 132 days; only 7 of these 18 dogs received any adjunctive chemotherapeutic treatments. CONCLUSIONS AND CLINICAL RELEVANCE Incidentally found, nonruptured splenic masses or nodules without associated hemoperitoneum were most commonly benign. Results suggested that life expectancy for these dogs with incidentally detected benign or malignant splenic lesions that received prompt intervention was better than has previously been reported for other studied populations.

Short-term outcome following partial or complete liver lobectomy with a commercially prepared self-ligating loop in companion animals: 29 cases (2009-2012).

OBJECTIVE: To evaluate the clinical use of a self-ligating loop (SLL) for partial or complete liver lobectomy in a variety of companion animal species. DESIGN: Retrospective case series. ANIMALS: 22 dogs, 2 cats, 4 rabbits, and 1 ferret with partial or complete liver lobectomy performed with an SLL. PROCEDURES: Medical records of companion animal patients that underwent partial or complete liver lobectomy with an SLL between 2009 and 2012 at the Angell Animal Medical Center were reviewed, and signalment, intraoperative and postoperative complications, histologic diagnosis, hospital discharge (yes or no), time to hospital discharge, and short-term survival rate were recorded. Follow-up information was obtained through evaluation of medical records. RESULTS: 28 of 29 (97%) patients were discharged from the hospital and survived at least 5 days after discharge. Of the 29 patients, 3 underwent 2 liver lobectomies. During 4 of 32 (12.5%) lobectomies, mild intraoperative bleeding occurred on the cut surface of the liver after transection. No transection performed with ≥ 2 SLLs resulted in notable intraoperative bleeding. One of 29 (3.4%) patients had evidence of postoperative hemoabdomen, which was successfully treated with a single packed RBC transfusion. Expansion of the SLL diameter from 8 to 15 cm was accomplished to allow for resection of larger masses. CONCLUSIONS AND CLINICAL RELEVANCE: Use of an SLL for partial or complete liver lobectomy in a variety of companion animal species was a safe technique and was associated with low morbidity and mortality rates. Expansion of the ligature loop diameter and use of multiple SLLs may be necessary for larger lobectomies.

Evaluation of splenectomy as a risk factor for gastric dilatation-volvulus.

OBJECTIVE: To evaluate whether dogs undergoing splenectomy had an increased risk of gastric dilatation-volvulus (GDV), compared with a control group of dogs undergoing enterotomy. DESIGN: Retrospective case-control study. ANIMALS: 219 dogs that underwent splenectomy for reasons other than splenic torsion (splenectomy group; n = 172) or enterotomy (control group; 47) without concurrent gastropexy. PROCEDURES: Medical records were reviewed for information on signalment, date of surgery, durations of surgery and anesthesia, reason for splenectomy, histopathologic findings (if applicable), whether gastropexy was performed, duration of follow-up, and date of death (if applicable). Follow-up information, including occurrence of GDV, was obtained via medical records review and a written client questionnaire. RESULTS: Reasons for splenectomy included splenic neoplasia, nonneoplastic masses, infarction, traumatic injury, and adhesions to a gossypiboma. Incidence of GDV following surgery was not significantly different between dogs of the splenectomy (14/172 [8.1 %]) and control (3/47 [6.4%]) groups. Median time to GDV for the 17 affected dogs was 352 days (range, 12 to 2,368 days) after surgery. Among dogs that underwent splenectomy, sexually intact males had a significantly higher incidence of GDV (4/16) than did castrated males and sexually intact or spayed females (10/156). Incidence of GDV among sexually intact male dogs did not differ between groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results did not support a recommendation for routine use of prophylactic gastropexy in dogs at the time of splenectomy. Other patient-specific risk factors should be assessed prior to recommending this procedure.

Complications associated with lateral fabellotibial suture surgery for cranial cruciate ligament injury in dogs: 363 cases (1997-2005).

OBJECTIVE: To report the complication rate for a commonly performed procedure (lateral fabellotibial suture [LFS]) used in the treatment of dogs with cranial cruciate ligament (CCL) injury. DESIGN: Retrospective case series. ANIMALS: 305 dogs evaluated for 363 incidents of CCL injury from January 1997 through December 2005 and treated with LFS. PROCEDURES: Medical records were reviewed for information on breed, sex, age, body weight, clinical history, duration of surgery and anesthesia, primary surgeon, percentage of ligament tear, condition of medial meniscus, unilateral versus bilateral disease, implant material, duration of follow-up, and perioperative and postoperative complications. RESULTS: 363 LFS procedures met the criteria for inclusion in the study. Complications (n=65) were recorded for 63 of the 363 (17.4%) surgical procedures. Multiple complications developed in 2 dogs. In 26 (7.2%) dogs, a second surgery was required to manage the complications. Breed, side on which surgery was performed, implant material, percentage ligament tear, meniscal condition and treatment, bandage use, perioperative antimicrobial use, and experience of surgeon did not influence the complication rate. Factors significantly associated with a higher rate of complications were high body weight and young age of dog at the time of surgery. CONCLUSIONS AND CLINICAL RELEVANCE: LFS is associated with a lower perioperative and postoperative complication rate than has been reported for other surgical procedures to repair CCL injury. Heavier and younger dogs had more complications. Complication rate must be considered when choosing a surgical treatment for dogs with CCL injury.

Volvulus of the colon in four dogs.

Four dogs were examined because of vomiting of 7 to 48 hours' duration. Gas-distended segments of intestine were identified radiographically in all dogs, but the affected portion of the intestinal tract could not always be identified as the colon. Volvulus of the colon was diagnosed during surgery in all 4 dogs. Gastrocolopexy was performed following derotation of the colon in 3 of the dogs. In 1 dog, a colectomy and an ileorectal anastomosis were performed. All 4 dogs survived. Volvulus of the colon should be considered as a cause of vomiting of short duration in dogs for which there is radiographic evidence of intestinal dilatation.