A Rotation Alar Fold Flap for Cosmetic Nasal Plane Reconstruction: Description of the Technique and Outcome in Three Dogs.

Nasal planum reconstruction is a surgical challenge, and several surgical techniques have been described. The objective of this study was to describe the rotation alar fold flap technique and to report clinical outcomes in a short case series. The feasibility of the technique was first assessed in a canine cadaveric model. The rotation alar fold flap was obtained by a single sharp horizontal incision of the dorsolateral nasal cartilage, preserving the caudal mucosal attachment to the ventral nasal concha. The flap was then rotated ventro-medially for the reconstruction of the ventral aspect of the nasal planum unilaterally or bilaterally. The rotation alar fold flap technique was used following a subtotal or partial planectomy for excision of a squamous cell carcinoma or mast cell tumors in three dogs. No intraoperative complications were recorded. Superficial surgical site infection was reported in two cases and minor dehiscence was reported in one case. However, survival of the flap was not affected. The cosmetic and functional outcomes were considered very satisfactory in all cases. The rotation alar fold flap technique offers a safe, valuable, feasible, functional and aesthetically satisfactory alternative surgical option for selected cases of localized tumor involving the central and ventral planum.

Use of wound infusion catheters for postoperative local anaesthetic administration in cats.

OBJECTIVES: The present study aimed to document the use of the wound infusion catheter (WIC) following a variety of surgical procedures in cats, investigating complications and risk factors associated with catheter placement or local anaesthetic (LA) administration. METHODS: A retrospective, multicentric study was performed. Medical databases of eight veterinary referral hospitals from 2010 to 2021 were searched to identify records of cats where WICs were used. Information regarding signalment, type of surgery, size and type of WIC placed, and LA protocol used, as well as postoperative complications, were retrieved. RESULTS: One hundred and sixty-six cases fulfilled the inclusion criteria. Feline injection site sarcoma resection was the most common surgery. Overall complications were identified in 22/166 cats (13.2%). Thirteen cats (7.8%) experienced wound-related complications, whereas nine cats (5.4%) experienced drug-delivery complications. The only factor associated with an increased risk of complications was the amount of a single dose of LA delivered through the catheter (P <0.001). An amount higher than 2.5 ml of LA delivered at each administration was associated with an increased risk of complications. All complications were minor and self-limiting. CONCLUSIONS AND RELEVANCE: WICs were used for a large variety of surgical procedures with different protocols of LA administration as part of a multimodal analgesic plan in cats. The risk of complications was relatively low and self-limiting, suggesting its safe use in cats. Further prospective studies are required to evaluate efficacy of postoperative analgesia and to determine the suitable protocol for WIC handling and maintenance.

Relationship between the degree of stifle flexion and the proximal patellofemoral angle in the sagittal plane: A radiographic study.

The objective of this study was to evaluate the position of the patella in relation to the proximal femoral axis in the sagittal plane and to assess its reliability as a surgical landmark for femoral component placement in canine hip replacement. The relationship between the patella and the proximal femoral axis was assessed by defining the proximal patellofemoral angle in medio-lateral radiographic projections with 3 different stifle angles (full flexion, 90°, full extension) in medium to large breed skeletally mature dogs (N = 14). Proximal patellofemoral angle measurements were compared between the 3 different groups of stifle position using ANOVA for statistical analysis. The mean proximal patellofemoral angle measurements were -7.4° (± 1.3°) in the flexion group, -1.6° (± 1.5°) in the 90° group, and 2.1° (± 1.8°) in the extension group. Statistically significant differences were seen in the proximal patellofemoral angle between groups (P ≤ 0.001). These results confirm that position of the patella related to the proximal femoral axis differs depending on the degree of stifle flexion. The degree of stifle flexion should be considered in the preoperative planning and intraoperatively when using the patella as a surgical landmark in the sagittal plane for femoral canal broaching in canine total hip replacement.

L'objectif de cette étude était d'évaluer la position de la rotule par rapport à l'axe fémoral proximal dans le plan sagittal et d'évaluer sa fiabilité en tant que repère chirurgical pour le placement du composant fémoral dans le remplacement de la hanche canine. La relation entre la rotule et l'axe fémoral proximal a été évaluée en définissant l'angle fémoro-patellaire proximal dans des projections radiographiques médio-latérales avec trois angles de grasset différents (flexion complète, 90°, extension complète) chez des chiens de race moyenne à grande (N = 14). Les mesures de l'angle fémoro-patellaire proximal ont été comparées entre les trois groupes différents de position de grasset en utilisant l'ANOVA pour l'analyse statistique. Les mesures moyennes de l'angle fémoro-patellaire proximal étaient de −7,4° (± 1,3°) dans le groupe flexion, −1,6° (± 1,5°) dans le groupe 90° et 2,1° (± 1,8°) dans le groupe extension. Des différences statistiquement significatives ont été observées dans l'angle fémoro-patellaire proximal entre les groupes (P ≤ 0,001). Ces résultats confirment que la position de la rotule par rapport à l'axe fémoral proximal diffère selon le degré de flexion du grasset. Le degré de flexion du grasset doit être pris en compte dans la planification préopératoire et peropératoire lors de l'utilisation de la rotule comme repère chirurgical dans le plan sagittal pour la présentation du canal fémoral dans le cadre d'une arthroplastie totale de hanche canine.(Traduit par Docteur Serge Messier).

Clinical characteristics and long-term outcome of lung lobe torsions in cats: a review of 10 cases (2000-2021).

CASE SERIES SUMMARY: Lung lobe torsion is rare in cats. The aim of this multi-institution retrospective study was to describe clinical and diagnostic findings, treatments and outcomes of lung lobe torsion (LLT) in 10 cats. Dyspnoea and tachypnoea were the most common clinical signs. Pleural effusion was present in nine cats at presentation. Fluid analysis confirmed chylothorax in three cats. Nine cats underwent CT and five cats had thoracic radiographs taken. A diagnosis was made preoperatively in six cats, while in the other four cats it was made at exploratory thoracotomy. Affected lung lobes were the right cranial (n = 4/11), left cranial (n = 4/11) and right middle (n = 3/11). One cat had a concurrent torsion of two lung lobes. Lung lobectomy was successfully performed in all cases. Based on clinical, diagnostic and lung histopathology findings, three cats had idiopathic and seven cats secondary LLT. Intraoperative complications included hypotension and hypothermia in four and five cats, respectively. Postoperative complications occurred in six cats and lead to euthanasia or death in four cats, whereas complications resolved in the other two cats. Three cats were euthanased within 5 weeks of discharge. For the three cats surviving long term, including one euthanased at 252 days postoperatively, owner-described outcomes and quality of life were considered good to excellent. RELEVANCE AND NOVEL INFORMATION: Secondary LLT associated with underlying thoracic pathology was associated with high complication rates and poor outcomes. Long-term outcomes of cats undergoing surgery for LLT and surviving the perioperative period were deemed good to excellent.

Feline sialocoele: clinical presentation, treatment and outcome in 19 cases.

OBJECTIVES: The aim of this retrospective observational study was to describe the clinical presentation, treatment and outcome of cats with sialocoele. METHODS: Clinical records from seven referral hospitals were retrospectively searched to identify cats with sialocoele between 2007 and 2021. RESULTS: Nineteen cats were identified. The most common clinical signs were ptyalism, dysphagia and anorexia. Localisation of the sialocoele was cervical (n = 6), sublingual (n = 6), cervical/sublingual (n = 3), facial (n = 2), cervical/pharyngeal (n = 1) and zygomatic (n = 1). The affected salivary glands were mandibular-sublingual (n = 15), mandibular-sublingual/parotid (n = 1), zygomatic/parotid (n = 1) and parotid (n = 2). The aetiology of the sialocoele was traumatic in two cases, neoplastic in one cat and unknown in 16 cats. Sialoadenectomy was performed in 11 cats. Other treatments included ranula marsupialisation (n = 3), needle drainage (n = 2), single stab incision (n = 2) and parotid duct ligation (n = 1). The median follow-up time was 399 days (range 15-1460). Postoperative seroma was the only complication observed in one cat. No recurrence was reported. CONCLUSIONS AND RELEVANCE: Feline salivary sialocoele are relatively rare and have a good prognosis. They can be managed successfully with sialoadenectomy; however, a more conservative approach can be used with appropriate case selection.

Complications between ventral and lateral approach for mandibular and sublingual sialoadenectomy in dogs with sialocele.

OBJECTIVE: To compare complications of dogs treated with mandibular and sublingual sialoadenectomy for sialocele using a lateral (LAT) or ventral paramedian (VPM) approach. STUDY DESIGN: Retrospective multicenter study. ANIMALS: Dogs (140) with mandibular and sublingual sialocele. METHODS: Medical records of dogs that underwent mandibular and sublingual sialoadenectomy through a LAT or VPM approach from 2004 to 2020 were reviewed. Clinical and histopathological findings were analyzed to compare the groups. RESULTS: Seventy dogs were included in each group. The most represented breed was crossbreed (26%), and males (99/140 [71%], intact/neutered) were overrepresented. Dogs in the VPM approach group were more likely to undergo digastricus tunnelization and placement of a drain or a bandage. Dogs in the LAT approach group were heavier and more likely to undergo excision of an inflammatory pseudocapsule. No difference was detected in complication rates between groups (LAT [20%], VPM [31%], P = .116). Recurrences were more likely after LAT approach (5/70 vs 0/70, respectively; P = .029), whereas wound-related complications were more likely after VPM approach (20/70 vs 9/70, respectively; P = .018). Prolonged duration of surgery was associated with an increased risk of recurrence, and none of the other variables affected the complication rate. CONCLUSION: Ventral paramedian approach for mandibular and sublingual sialoadenectomy was associated with a lower risk of recurrence but a higher risk of wound-related complications compared with LAT approach. CLINICAL SIGNIFICANCE: Ventral paramedian approach for mandibular and sublingual sialoadenectomy may be preferred to reduce recurrence in dogs with sialoceles, but wound-related complications are common.

Renal adenocarcinoma associated with hypertrophic osteopathy in a cat.

CASE SUMMARY: A 10-year-old neutered male domestic shorthair cat was diagnosed with renal adenocarcinoma associated with hypertrophic osteopathy. The cat was referred for chronic ambulation difficulties. The physical examination showed a painful thickening of all four limbs, a right cranial abdominal mass and a conjunctival hyperaemia. Radiographic findings were consistent with extensive periosteal new bone formation involving not only the diaphyses of the fore- and hindlimbs, but also of the pelvis, tarsus and carpus. Abdominal ultrasonography and CT revealed a mass within the right kidney and a primary neoplasm was suspected. A ureteronephrectomy of the right kidney was performed and histopathology confirmed the diagnosis of renal adenocarcinoma. Although clinical improvement of the lameness occurred after surgery, no radiographic changes of hypertrophic osteopathy lesions were observed at the 9-month follow-up. RELEVANCE AND NOVEL INFORMATION: Feline cases of hypertrophic osteopathy are rarely reported in the literature and only a few of them were associated with abdominal neoplastic diseases. To our knowledge, this is the first case of renal adenocarcinoma associated with hypertrophic osteopathy in a cat.

Transoral approach for ventral tympanic bulla osteotomy in the dog: A descriptive cadaveric study.

OBJECTIVE: To describe a transoral approach for tympanic bulla osteotomy in the dog. STUDY DESIGN: Anatomic cadaveric study. SAMPLE POPULATION: Fifteen canine cadavers (n = 29 tympanic bullae), including mesaticephalic, dolichocephalic, and brachycephalic breeds. MATERIALS AND METHODS: The oral surface of the tympanic bulla was identified during an anatomical study (3 canine cadavers) and the ventral approach to the tympanic bulla was described (3 canine cadavers). The safety of the technique was assessed (9 canine cadavers, n = 17 bullae) during further anatomical dissections, where a complete approach and drilling of the tympanic bulla were performed. RESULTS: In all cases, tympanic bulla osteotomy was performed without damaging the inner ear, the epitympanic recess contents, and the neurovascular structures. The oral approach to the tympanic bulla was easier in mesaticephalic and dolichocephalic dogs than in brachycephalic breeds. CONCLUSION: This study defines anatomical landmarks for transoral bulla osteotomy, without a high risk of damage to neurovascular and anatomical structures within and/or surrounding the tympanic cavity. This minimally invasive approach to the tympanic bulla is performed via a natural opening, and does not require simultaneous access through the ear canal. In vivo evaluation of this technique is required to verify its safety in clinical cases prior to large scale application.

Complications of appendicular fracture repair in cats and small dogs using locking compression plates.

OBJECTIVE: Our objectives were: 1) to review the complications associated with stabilization of appendicular fractures in cats and small dogs using locking compression plates (LCP), and 2) to identify factors that could influence fixation construct stability. STUDY DESIGN: Retrospective clinical study. MATERIALS AND METHODS: Medical and radiographic records of cats and small dogs with appendicular fractures treated with LCP were reviewed. Only cases with adequate follow-up to document clinical union and cases for which complications appeared before the clinical union were included. Complications were classified as implant-related complications or other complications. Cases with implant-related complications were compared to cases with non-implant-related complications for differences in signalment (species, age, body weight, multiple fractures), fracture location and type (fractured bone, fracture localization, closed or open fracture), reduction method (open reduction and internal fixation [ORIF] or minimally invasive plate osteosynthesis [MIPO]) and fixation evaluations (implant size, plate-bridging ratio, plate span ratio, working length, plate screw density, number of screws and cortices engaged per plate and per main fragment, ratio between screw and bone diameter at the narrowest aspect of the bone, and presence of ancillary fixation). RESULTS: Seventy-five fractures from 63 cats (64 fractures) and 10 dogs (11 fractures) met the inclusion criteria. Eight humeral, 13 radio-ulnar, 26 femoral, and 28 tibio-fibular fractures were treated. Primary repair of the fracture was performed using 2.0 mm and 2.4 mm LCP in 22 and 53 fractures, respectively. Overall and implant-related complications were encountered in 13 and seven of 75 fractures, respectively. Fixation failure was not significantly associated with any aforementioned factor considered in this study, and in particular, there was no significant difference in the occurrence of fixation failure between fractures stabilized with two, or more than two, bicortical locking screws per main fragment. CLINICAL SIGNIFICANCE: 2.0 mm and 2.4 mm LCP were used to manage appendicular fractures in cats and small dogs. The overall complication and fixation failure rate were comparable to those reported in previous studies in which various locking plate systems were used.

Indwelling double pigtail ureteral stent combined or not with surgery for feline ureterolithiasis: complications and outcome in 15 cases.

Ureteral obstruction secondary to ureterolithiasis in cats is a challenging situation. Ureteral stenting has recently been introduced to prevent complications that often occurred after ureterotomy or other invasive surgeries. The purpose of this study is to describe the stenting technique and perioperative difficulties, as well as long-term outcome and complications with ureteral stenting in 12 cats with ureteroliths. Fifteen 2.5 Fr soft double pigtail multi-fenestrated ureteral stents were placed in an anterograde fashion under open surgical approaches and with fluoroscopic guidance in 12 cats. Nine cats received a unilateral stent and three received bilateral stents. Ureterotomy or ureteral resection and end-to-end anastomosis were performed in three and four cases, respectively. In six cats, papillotomy was performed to facilitate dilatator and stent placement. All cats recovered well from the surgical procedure, except one cat, which died during the anaesthesia recovery period. Postoperative complications included dysuria (three cases, diagnosed at 15 days, 1 month and 3 months, respectively), urinary tract infection (one case, 1 month after surgery), stent migration requiring stent replacement (one case, 19 months after surgery) and stent obstruction requiring stent removal (three cases with previously end-to-end anastomosis between 2 and 8 months after surgery). Nine cats (75%) were alive at a mean follow-up of 453 ± 194 (123-720) days. The median survival time was >415 days. Stent placement appeared to be a valuable and safe option for treating ureteral obstruction in cats. However, periodic and long-term monitoring of stents is warranted.

Type II atresia ani associated with rectovaginal fistula in a male pseudohermaphrodite kitten.

A combination of gastrointestinal and urogenital congenital abnormalities was diagnosed and surgically treated in a kitten. Physical examination, exploratory laparotomy, castration, histological examination, and cytogenetic karyotyping were utilized to determine the true gender of the kitten. The kitten was confirmed to be a male (38 XY) pseudohermaphrodite with Type II atresia ani and rectovaginal fistula.

Atrésie anale associée à une fistule recto-vaginale chez un chaton male pseudohermaphrodite. Une combinaison d'anomalies congénitales gastro-intestinales et uro-génitales a été diagnostiquée et traitée chirurgicalement chez un chaton. L'examen clinique, une laparotomie exploratrice, la castration avec examen histologique des testicules ainsi qu'un caryotypage ont été réalisés pour déterminer le véritable sexe de l'animal. Il a été confirmé que le chaton était un male (38 XY) pseudohermaphrodite avec atrésie anale de Type II et fistule rectovaginale.(Traduit par les auteurs).

Traumatic elbow luxation in a free-ranging hedgehog (Erinaceus europaeus): surgical management using circumferential suture prostheses.

A free-ranging adult female hedgehog (Erinaceus europaeus) was presented injured, presumably from vehicular trauma. Clinical and radiographic examination under general anesthesia revealed a lateral elbow luxation. Closed reduction was unsuccessful, so a surgical approach with circumferential suture prostheses was used to stabilize the elbow. Neither perioperative nor postoperative complications were recorded. The hedgehog regained good range of motion of the elbow and was fully able to run and to roll into a ball.

A fistula flap technique for correction of type II atresia ani and rectovaginal fistula in 6 kittens.

OBJECTIVE: To report a surgical technique and long-term outcomes of type II atresia ani (AA) and rectovaginal fistula (RvF) correction, using a fistula flap technique in kittens. STUDY DESIGN: Clinical study. ANIMALS: Domestic shorthaired female kittens (n = 6) with type II AA-RvF. METHODS: Diagnosis of type II AA-RvF was made by clinical examination and vaginography. The anomaly was surgically corrected by a fistula flap technique for reconstruction of the anal canal and anus, and by vaginoplasty. Kittens were monitored for short and long-term complications. RESULTS: All 6 kittens were fecal and urinary continent in the immediate postoperative period. Postoperative complications occurred in 2 kittens: partial dehiscence between the anal and vaginal opening and a stenosis at the level of the rectal mucocutaneous anastomosis. Dehiscence healed by second intention and stenosis was treated by anoplasty. No long-term complications (median follow-up, 12 months; range, 12-17 months) were observed. CONCLUSIONS: Reconstruction of the anal canal and anus using the fistula as a local flap in combination with a vaginoplasty can be effective to treat feline type II AA and RvFs.

A novel murine femoral segmental critical-sized defect model stabilized by plate osteosynthesis for bone tissue engineering purposes.

Mouse models are invaluable tools for mechanistic and efficacy studies of the healing process of large bone defects resulting in atrophic nonunions, a severe medical problem and a financial health-care-related burden. Models of atrophic nonunions are usually achieved by providing a highly stable biomechanical environment. For this purpose, external fixators have been investigated, but plate osteosynthesis, despite its high clinical relevance, has not yet been considered in mice. We hereby proposed and investigated the use of an internal osteosynthesis for stabilizing large bone defects. To this aim, a 3.5-mm-long segmental bone defect was induced in the mid-shaft of the femur using a Gigli saw and a jig. Bone fixation was performed using a titanium microlocking plate with four locking screws. The bone defect was either left empty or filled with a syngenic bone graft or filled with a coralline scaffold. Healing was monitored using radiographs. The healing process was further assessed using microcomputed tomography and histology 10 weeks after surgery. With the exception of one mouse that died during the surgical procedure, no complications were observed. A stable and reproducible bone fixation as well as a reproducible fixation of the implanted materials with full weight bearing was obtained in all animals tested. Nonunion was consistently observed in the group in which the defects were left empty. Bone union was obtained with the syngenic bone grafts, providing evidence that, although such defects were of critical size, bone healing was possible when the gold-standard material was used to fill the defect. Although new bone formation was greater in the coralline scaffold group than in the left-empty animal group, it remained limited and localized close to the bony edges, a consequence of the critical size of such bone defect. Our study established a reproducible, clinically relevant, femoral, atrophic nonunion, critical-sized defect, low morbidity mouse model. The present study was successful in designing and testing in a small animal model, a novel surgical method for the assessment of bone repair; this model has the potential to facilitate investigations of the molecular and cellular events involved in bone regeneration in load-bearing, segmental-bone defects.

Parotid salivary duct sialocele associated with glandular duct stenosis in a cat.

Feline parotid salivary duct sialocele is an uncommon disorder that has been previously reported in association with traumatic rupture of the duct in only two cats. Both cases were successfully treated by proximal duct ligation. We describe the successful surgical treatment of a parotid duct sialocele, secondary to spontaneous salivary duct stenosis, in an adult domestic shorthair cat. The cat was referred for assessment of a recurrent fluid-filled swelling on the left side of the face. Cytology of the aspirated fluid was consistent with serous saliva. The anatomical localisation of the lesion and the nature of the fluid were indicative of parotid gland/duct involvement. Retrograde sialography by parotid duct cannulation was unsuccessful because the left parotid duct opening was stenosed and obstructed by scar tissue. Surgical exploration revealed a parotid salivary duct sialocele, which was completely removed along with the parotid gland without complications.

Fungal rhinosinusitis caused by Scedosporium apiospermum in a cat.

A 3-year-old neutered male Bengal cat with a history of chronic mucopurulent bilateral nasal discharge and sneezing was diagnosed with severe fungal rhinosinusitis. A diagnosis was obtained after computer tomography imaging, histopathological examination and fungal culture. The mold Scedosporium apiospermum was identified as the aetiological agent. To our knowledge, this case is the first description of a rhinitis or sinusitis caused by this agent in a cat. Aggressive surgical debridement combined with topical and systemic antifungal therapy was performed. Unfortunately, the treatment resulted only in a partial remission of signs.