Use of a semitendinosus myocutaneous flap for the coverage of hindlimb full-thickness skin defects in cats.

BACKGROUND: The management of feline hindlimb full-thickness skin defects is challenging. On the other hand, the use of a semitendinosus (ST) myocutaneous flap for their coverage has not been reported. OBJECTIVES: To describe the ST flap and compare it with second intention healing for managing hindlimb full-thickness skin defects. METHODS: In 12 purpose-bred laboratory domestic short-haired cats, two wounds were made on each tibia. The wounds in group A (n = 12) were covered with ST flaps, and those in group B (n = 12) were left to heal by second intention. In both groups, clinical assessment scoring and planimetry were performed between one-30 d postoperatively. Computed tomography-angiography (CTA) was performed on days zero, 10, and 30, and histological examinations were performed on days zero and 14 and at 6 and 12 mon postoperatively. RESULTS: Statistically significant differences in the clinical assessment scores were observed between groups A and B on days 14 (p = 0.046) and 21 (p = 0.016). On the other hand, the time for complete healing was similar in the two groups. CTA revealed significant differences in the muscle width (day 0 compared to days 10 and 30 [p = 0.001, p = 0.026, respectively], and days 10 to 30 [p = 0.022]), ST muscle density, and the caliber of the distal caudal femoral artery and vein (day 0 compared to day 10 [p < 0.001], and days 10 to 30 [p < 0.001]). Histologically significant differences in inflammation, degeneration, edema, neovascularization, and fibrosis were observed on day 14 compared to zero and 6 mon, but no differences were found between the time interval of 6 and 12 mon. CONCLUSIONS: An ST flap can be used effectively to manage hindlimb full-thickness skin defects.

Comparison of Two Surgical Techniques Based on the Semitendinosus Myocutaneous Flap in Cats.

The objective of this experimental study was to compare the semitendinosus (ST) to the split-semitendinosus (SST) myocutaneous flap in covering distal limb skin defects in cats. Twenty-eight purpose-bred laboratory DSH cats were used and allocated into two groups (ST-group (A); n = 14, SST-group (B); n = 14). ST flaps, based on the distal muscle pedicle, and SST flaps, after longitudinal division of the muscle based on both muscle pedicles, were tested over skin defects created on the medial distal tibia. Clinical assessment, planimetry, CT-angiography (CTA) and histological examination were compared between groups. Days to complete flap healing between ST and SST-flaps (30.36 ± 9.1, 32.29 ± 5.44, respectively) and final total flap areas (68.36% ± 27.18, 51.83% ± 22.48, respectively) revealed no significant differences. On CTAs, the caliber of the distal caudal femoral vein on day 10 was statistically significant higher (p < 0.001) for group A and a significantly higher caliber of the distal caudal femoral artery on day 30 for group B (p = 0.021). Histology revealed statistically higher degeneration at 6 months (p = 0.047) for group A, and statistically higher fibrosis at 12 months (p = 0.019) for group B. Both ST and SST flaps had similar healing times and provided coverage of skin tibial defects in cats.

Computed tomographic appearance of transcaval ureter in two dogs and three cats: A novel CVC congenital malformation.

Transcaval ureter is a rarely reported human congenital malformation of the prerenal segment of the inferior vena cava (IVC) not yet reported in veterinary medicine. The objective of this multicenter retrospective case series study was to describe the computed tomography (CT) features of transcaval ureters in dogs and cats. Patients referring to pre- and post-contrast CT exams of the abdomen and presenting this abnormality were retrospectively included. Multiple qualitative features were described for each ureteral abnormality detected. Three cats and two dogs with transcaval ureter were identified consisting of a segmental duplication of the CVC at the prerenal level creating a vascular ring through which the ureter extended, identified as a double-barrel gun sign. The malformation was divided into two types according to the symmetry of the caval branches and location in relation to the aorta, namely, type I symmetrical branches and right-lateral to the aorta, and type II asymmetrically branches and right-dorsal to the aorta. In one case, the malformation was associated with hydroureter and mild pyelectasis. In three cases, the anomaly was incidental and, in the remaining two cases, the clinical significance was uncertain. This is the first study describing the presence of transcaval ureter in dogs and cats. CT was a suitable method for the diagnosis of transcaval and a focal double-barrel gun sign of the CVC is proposed as the hallmark feature of this anomaly. The clinical relevance of this congenital vascular malformation is unclear and needs to be further investigated.

Femoral artery thrombosis in an 11-year old boy due to a blunt trauma.

An 11-year old boy presented with a blunt trauma in the right inguinal area after a bicycle accident. Initial clinical picture was indicative of decreased arterial blood supply to the right lower extremity and the diagnostic confirmation was made with a colour flow Doppler ultrasonography. During operative investigation, a thrombosis of the common femoral artery, 3.5 cm in length, was found. The thrombotic part of the femoral artery was removed and replaced with a venous graft taken from the major saphenous vein, before the saphenofemoral junction. Postoperative course was uneventful. Traumatic thrombosis of the common femoral artery as a result of a blunt trauma is very rare, as only 4 relevant cases have been described previously.

Hydrocele in Pediatric Population.

Hydrocele is a collection of fluid within the tunica vaginalis. Based upon the etiology and the pathophysiology, it is divided into, the primary and secondary. The primary hydrocele includes the neonatal or the congenital, the communicating and the non-communicating or the closed or the adult type. The secondary hydrocele can develop in the substrate of a pre-existing disease. After systematic and thorough systematic and thorough research of the relevant literature, we aim at describing all the aspects of this entity, with specific emphasis on the issues that remain unanswered from the scientific community.

64-multidetector CT anatomical assessment of the feline bronchial and pulmonary vascular structures.

OBJECTIVES: The aim of the study was to provide a detailed anatomical study of the feline bronchial and vascular structures by using CT angiography (CTA). METHODS: Adult cats with no respiratory clinical signs were enrolled in a CTA protocol to provide an anatomical study of the thorax. The dimensions, number of branches and branching pattern (monopodial vs dichotomic) of both bronchial and pulmonary vascular structures were evaluated under positive inspiration apnoea. A linear generalised estimating equations analysis (Spearman's rho) was used to identify statistical correlation between tracheal diameter, age and body weight of the cats. RESULTS: Fourteen cats met the inclusion criteria. The pulmonary arteries had larger diameters than the pulmonary veins, and the pulmonary veins had larger diameters than the bronchial structures. A higher number of segmental bronchial and pulmonary vascular branches was observed in the left caudal lung lobe than in the other lobes. The monopodial branching pattern of both bronchial and pulmonary vascular structures was predominant in all cats of our study (100%) in cranial, caudal and right middle lung lobes, while a dichotomic branching pattern of the bronchial and pulmonary vascular structures of the accessory lung lobe was seen in 13 cats (93%). Thirteen cats (93%) had three pulmonary vein ostia, and one cat (7%) also presented with an additional left intermediate pulmonary vein ostium. Variation in the number of segmental pulmonary vein branches was noted in the right caudal lung lobe. There was no statistical correlation between tracheal diameter, age and weight. CONCLUSIONS AND RELEVANCE: Architecture of the feline bronchovascularr structures belongs to a mixed type of monopodial and dichotomic branching pattern. In cats, the pulmonary venous drainage system predominately presents three pulmonary vein ostia. Variations in the type of formation and the number of branches of the pulmonary venous drainage system were noted.

Canine and feline abdominal arterioportal communications can be classified based on branching patterns in computed tomographic angiography.

Arterioportal vascular anomalies are communications between the splanchnic arteries and the portal system that represent a rare cause of presinusoidal portal hypertension in small animals. There is little information concerning the imaging findings of arterioportal communications in small animals and no classification could be found for radiologists and surgeons. The aims of this retrospective descriptive multicentric study were to describe the computed tomographic characteristics of arterioportal communications in a group of cats and dogs, and to propose a classification based on computed tomography (CT) angiographic anatomy. Computed tomography databases from multiple veterinary hospitals were searched for cats and dogs with a diagnosis of arterioportal communication. A total of 36 animals (33 dogs, three cats) met the inclusion criteria. There were 32 intrahepatic arterioportal malformations and four extrahepatic fistulae. The intrahepatic arterioportal malformations were classified as right divisional (11/32) and left divisional (21/32), and the left divisional were subclassified as left medial (16/21) and left lateral (4/21). One patient showed multiple intrahepatic arterioportal communications with concomitant left medial and left lateral conformations. Two patients with intrahepatic arteriovenous malformation showed concomitant congenital intrahepatic shunts. The proposed anatomical classification based on CT angiography could allow veterinary radiologists to have a more systematic approach and help improve the radiologist-surgeon communication.

Multidetector computed tomographic pulmonary angiography in a cat with fatal heartworm disease.

A 17-month-old neutered male domestic shorthair cat was referred for a computed tomographic (CT) study of the thorax due to respiratory distress. Multidetector CT angiography showed a multifocal interstitial ground glass opacity, tortuous and blunted pulmonary arteries consistent with thromboembolism with perivascular lung infiltration and hypoventilation in multiple lung lobes. A blood antigen test was positive for Dirofilaria immitis. The cat's clinical condition rapidly declined and the owners elected euthanasia. The histopathologic examination confirmed heartworm disease with parasitic pulmonary thromboembolism.

A "spaghetti sign" in feline abdominal radiographs predicts spleno-systemic collateral circulation.

A well-defined, tortuous, and tubular soft tissue opaque structure has been observed within the left mid abdominal cavity in digital radiographs of some cats. Authors hypothesized that this radiographic "spaghetti sign" is a predictor for spleno-systemic collateral circulation. The purpose of this multicenter, retrospective, descriptive study was to further characterize radiographic "spaghetti signs" in a group of cats and compare these signs with results of ultrasonography or computed tomography (CT). A multiinstitutional database was reviewed for radiographic reports describing the presence of a tubular tortuous structure within the left abdominal cavity of feline patients. Patients were included if additional abdominal ultrasound or CT studies were available. Imaging studies and medical records were retrieved and reviewed by a board-certified veterinary radiologist, and characteristics were recorded. Eighteen cats met the inclusion criteria. The presence of a tortuous vessel consistent with spleno-systemic collateral circulation was observed by ultrasonography or CT examinations in all patients with a "spaghetti sign" on abdominal radiographs. All patients were spayed females. One cat showed ultrasonographic imaging features consistent with portal hypertension. In conclusion, findings supported the hypothesis that a radiographic "spaghetti sign" is a predictor of spleno-systemic collateral circulation in feline patients and should be distinguished from other signs such as focal loss of serosal detail or a space occupying lesion.

The role of surgery in the management of gastrointestinal stromal tumors (GISTs) in the era of imatinib mesylate effectiveness.

Surgical resection is the treatment of choice for the gastrointestinal stromal tumors (GISTs). In the literature, the 5-year patient survival after surgical resection, ranged from 48 to 80%, before the era of imatinib mesylate and the exploration of the prognostication criteria. Imatinib mesylate targets an intracellular signaling molecule of the natural history and malignant development of GISTs, and increased the 5-year survival rate, after the resection of primary low-risk GISTs, to similar values to the normal population. For high-risk GISTs, current knowledge which is still under expansion, show major improvement at the 1-year survival rate of more than 90% versus less than 50% before imatinib era. After surgical resection, for both low and high malignant potential GISTs, a closed control directed to the early identification of confined resectable recurrences, is required. This paper assesses the current knowledge of GIST management, motivated by a case of patient with intermediate risk GIST.