Evaluation of dogs with digit masses: 117 cases (1981-1991).

Medical records of 117 dogs with digit masses were reviewed. Of 124 digit masses, 76 (61%) were malignant neoplasms, 25 (20%) were benign neoplasms, and 23 (19%) were pyogranulomatous inflammation. Of 29 digits with radiographic evidence of bone lysis, 24 (83%) were affected by malignant masses, whereas only 5 of 29 (17%) digits with radiographic evidence of bone lysis were affected by benign or pyogranulomatous masses. Only 1 of 19 (5%) dogs with melanoma had radiographic evidence of lysis, but 20 of 25 (80%) dogs with squamous cell carcinoma had radiographic evidence of bone lysis. Thoracic radiographs of 95 dogs were available. Six of 19 (32%) dogs with melanoma had radiographic evidence of pulmonary metastasis at the time of diagnosis, whereas 3 of 24 (13%) dogs with squamous cell carcinoma had radiographic evidence of pulmonary metastasis at the time of diagnosis. Twenty-nine digit neoplasms were squamous cell carcinoma, and 19 of 29 (66%) arose from the subungual epithelium. Of 19 dogs with squamous cell carcinoma originating from the subungual epithelium, 18 (95%) survived for at least 1 year, whereas only 6 of 10 (60%) dogs with squamous cell carcinoma originating in other parts of the digit survived for at least 1 year. Furthermore, of 19 dogs with squamous cell carcinoma originating from the subungual epithelium, 14 (74%) survived at least 2 years, whereas only 4 of 9 (44%) dogs with squamous cell carcinoma originating in other parts of the digit survived for 2 years. Dogs with melanoma of the digits had a median survival time of 12 months, with 10 of 24 (42%) alive at 1 year and 3 of 23 (13%) alive at 2 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Ventricular arrhythmias in dogs undergoing splenectomy: a prospective study.

Fifty dogs undergoing splenectomy for splenic masses (n = 40), torsion of the splenic pedicle (n = 5), and immune-mediated disease (n = 5) were evaluated preoperatively and and postoperatively for ventricular arrhythmias and the relationship between ventricular arrhythmia splenic disease. The ability of 1-minute electrocardiograms recorded every 6 hours (ECGs/q6hr) to detect ventricular arrhythmia was compared with continuous 48-hour Holter monitoring. Based on continuous Holter monitoring, splenectomized dogs had a high incidence (22 of 50) of rapid ventricular tachycardia. The incidence of rapid ventricular tachycardia was significantly higher in dogs with ruptured splenic masses (16 of 23) than without rupture (1 of 17) (P < .001). When the results of ECG/q6hr were compared with the results of continuous Holter monitoring ECG/q6hr was normal in 29% (4 of 14) of dogs with rapid ventricular tachycardia at > 3,000 ventricular extrasystoles (VE)/hr; 50% (4 of 8) of dogs with rapid ventricular tachycardia at 1,000 to 3,000 VE/hr and 100% (6 of 6) of dogs with 10 to 300 VE/hr without rapid ventricular tachycardia. Although dogs undergoing splenectomy had a high incidence of ventricular arrhythmias, one-minute ECGs/q6h were unreliable for detection of ventricular arrhythmias even when high-frequency extrasystoles occurred.

Results of craniotomy for the treatment of cerebral meningioma in 42 cats.

Forty-two cats underwent craniotomy for removal of a meningioma between 1985 and 1991. Median duration of clinical signs before examination was 1.25 months. All cats had inappropriate demeanor: 48% were dull and 38% were lethargic. Neurological deficits included impaired vision in 93%, paresis in 83%, and seizures in 19%. Computed tomography (CT) showed solitary masses in 86% and multiple masses in 14%. Intraoperative complications included hemorrhage and difficulty excising deep or adherent masses. Anemia in 13 of 42 cats was the most common immediate postoperative complication. Ten of 42 cats had no improvement or a more severe neurological status after surgery. Eight of 42 cats died immediately after surgery; 6 of these were anemic. Of the cats that survived the immediate postoperative period, evaluation 10 to 14 days after surgery showed that 97% (33 of 34) were alert and 79% (27 of 34) had returned to normal behavior. Neurological deficits, except for vision impairment, had resolved in most cats. The duration of follow-up varied from 1.3 months to 55.1 months. Ten cats developed neurological abnormalities from 1 month to 44.2 months after surgery; of these, 6 had tumor recurrence or new growth confirmed by CT scan or necropsy. Overall survival was 71% at 6 months, 66% at 1 year, and 50% at 2 years. Age of cat and location of tumor did not significantly affect survival (P = .1034 and .1851, respectively). There were too few precise measurements of tumor size to make a valid statistical comparison of the effect of size on survival. Location or presence of multiple tumors did not affect final outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

Fibular head transposition.

Fibular head transposition provides biomolecular support to the cranial cruciate-deficient stifle similar to that of other lateral extracapsular techniques. The technique of fibular head transposition is described and illustrated. Technical and postoperative complications are described in detail.

Acquired antral pyloric hypertrophy in the dog.

Acquired antral pyloric hypertrophy is one of the most common causes of pyloric obstruction in the small (10 kg) mature or old dog. Clinical signs include chronic intermittent vomiting after meals and occasional weight loss or abdominal distension. Definitive diagnosis is made by exploratory laparotomy and histologic examination of excised tissues. Most dogs with acquired antral pyloric hypertrophy become clinically normal after surgical correction of the gastric outlet obstruction.

Leiomyosarcoma in dogs: 44 cases (1983-1988).

During a 5-year period, leiomyosarcoma was diagnosed in 57 dogs. Forty-four dogs were included in the study on the basis of completeness of medical records. All dogs underwent exploratory laparotomy, and dogs were allotted to 4 groups according to primary site of tumor: spleen (16 dogs, median age 10.3 years), stomach/small intestine (13 dogs, median age 10.3 years), cecum (10 dogs, median age 11.8 years), and liver (5 dogs, median age 9 years). All dogs with leiomyosarcoma of the liver had visible metastasis and were euthanatized at surgery. In the other 3 groups, 79% of the dogs had no gross evidence of metastasis at surgery, and 64% survived greater than 2 weeks. Median survival in these 3 groups was 10 months (range, 1 month to 7 years); 48% died of metastasis, 32% died of unrelated causes, and 16% died of unknown causes. The prognosis in dogs with leiomyosarcoma of the spleen, stomach, small intestine, and especially the cecum is good to excellent if surgery is performed. In dogs with leiomyosarcoma of the liver, the prognosis is poor.

Hemimaxillectomy for the treatment of oral tumors in 69 dogs.

Hemimaxillectomy was performed in 69 dogs for the treatment of benign or malignant maxillary tumors. Eighteen dogs with ameloblastomas had a median disease-free interval of 21.5 months (range, 1 to 76 months), with a 72% 1-year survival time. There was recurrence in three dogs, with metastasis after malignant transformation in one of them. Based on calculated survival curves, seven dogs with squamous cell carcinoma had a median survival time of 19.2 months (range, 2 to 24 months), with a 57% 1-year survival time. There was local recurrence in two dogs. Twenty-three dogs with melanoma had a median survival time of 9.1 months (range, 1 to 46 months), and a 27% 1-year survival time. Twelve dogs died or were euthanatized because of recurrence or metastases. Fifteen dogs with fibrosarcoma had a median survival time of 12.2 months. Eight dogs died or were euthanatized because of recurrence or metastases. Six dogs with osteosarcoma had a median survival time of 4.6 months (range, 1 to 12.5 months), with a 17% 1-year survival time. Five dogs died or were euthanatized for recurrence or metastases. Tumor size or location and type of partial maxillectomy performed did not affect survival.

En bloc resection of primary rib tumors in 40 dogs.

Single or multiple rib resection was performed in 40 dogs for the treatment of primary osteosarcoma or chondrosarcoma. The resulting thoracic wall defect was closed with polypropylene (12 dogs), primary muscle flap (16 dogs), diaphragmatic advancement (10 dogs), or a combination (2 dogs). Few immediate (less than 2 weeks) postoperative complications were observed. Twenty dogs with osteosarcoma had a median survival time of 3.3 months (range, 0.5 to 23 months), with a 20% 6-month survival time. Metastases occurred in all the dogs. Fourteen dogs with chondrosarcoma followed up longer than 2 weeks had a median survival time of 10.7 months (range, 0.5 to 36 months) with a 64% 6-month survival time. Eight dogs developed metastases, five died from concurrent disease, and one dog is alive. Dogs with chondrosarcoma survived significantly longer than dogs with osteosarcoma. Survival time was not related to tumor size or number of ribs resected.

Fractures of the humerus.

A single or double bar, type I, unilateral external fixator can be used as primary or ancillary treatment for repair of many humeral fractures. Treatment of contaminated and comminuted fractures with external skeletal fixation provides rotational stability and axial alignment, access for wound management and bone grafting, and avoidance of vascular compromise by surgical invasion. In addition, the combination of external and internal (IM pins, cerclage wires, plates) fixation can provide greater initial fracture stability and subsequent dynamization or loading of bone (as the fixator is removed) than either of the systems used individually.

Results of partial mandibulectomy for the treatment of oral tumors in 142 dogs.

Partial mandibulectomy was performed for the treatment of benign or malignant oral tumors in 142 dogs. Forty-two dogs with a benign tumor (ameloblastoma) had a 22.5 month (range, 6 to 74 months) median disease-free interval, with a 97% 1-year survival rate; there was local recurrence in one dog. Twenty-four dogs with squamous cell carcinoma had a disease-free interval of 26 months (range, 6 to 84 months), with a 91% 1-year survival rate; recurrence and metastasis developed in two dogs and metastatic disease in one dog. Based on survival curves, 37 dogs with a melanoma had a median survival time of 9.9 months (range, 1 to 36 months), with a 21% 1-year survival rate; 20 dogs died or were euthanatized for recurrent or metastatic disease. Twenty dogs with osteosarcoma had a median survival time of 13.6 months (range, 3 to 28 months), with a 35% 1-year survival rate; nine dogs died or were euthanatized for recurrent or metastatic disease. Nineteen dogs with fibrosarcoma had median survival time of 10.6 months (range, 3 to 32 months), with a 50% 1-year survival rate; 12 dogs died or were euthanatized for recurrent or metastatic disease. Results of this and previous studies demonstrated that partial mandibulectomy was effective in prolonging survival and decreasing recurrence for squamous cell carcinoma and ameloblastoma. Progressive disease and corresponding low survival times were common in dogs with melanoma, osteosarcoma, and fibrosarcoma. There were no differences in survival times or the progression of disease among five partial hemimandibulectomy procedures. The high rates of recurrence and metastasis in dogs with these tumors suggest a need for evaluation of ancillary chemotherapy and local radiation therapy to decrease the prevalence of progressive disease.

Infiltrative urethral disease in female dogs: 41 cases (1980-1987).

Forty-one cases of infiltrative urethral disease in female dogs were reviewed. The cause was epithelial neoplasia in 29 dogs, granulomatous (chronic active) urethritis in 10 dogs, and leiomyoma in 2 dogs. Clinical signs of disease were similar in dogs with neoplastic and inflammatory disease and included strangury (36/41), hematuria (30/41), pollakiuria (20/41), vaginal discharge (16/41), and complete urinary obstruction (7/41). Results of aspiration biopsy of the urethra correlated with those of surgical biopsy in 11 of 15 dogs. In 4 of 15 dogs, results of cytologic and histologic examinations differed. Granulomatous (chronic active) urethritis is an infiltrative urethral disease in female dogs. Clinical findings are similar, but the prognosis is more favorable than that in dogs with urethral epithelial neoplasia.

Complications and long-term results after partial laryngectomy for the treatment of idiopathic laryngeal paralysis in 45 dogs.

Forty-five dogs with severe respiratory signs caused by idiopathic, acquired laryngeal paralysis were treated by partial laryngectomy. The predominant postoperative complications were coughing in 28 dogs and pneumonia in 15 dogs. Eight dogs required a second operation to alleviate persistent or recurrent upper airway obstruction. Results of surgery were considered excellent in 11 dogs (25%), good in 18 dogs (40%), fair in 6 dogs (13%), and poor in 10 dogs (22%). Poorer results were obtained by surgical residents than by more experienced surgeons. Death in the immediate postoperative period was related to pneumonia (8 dogs) and laryngeal collapse (1 dog). Nine dogs died later of respiratory disease. Although partial laryngectomy is effective for the treatment of laryngeal paralysis, it is not recommended because of the high incidence of postoperative complications.

Subtotal colectomy for the treatment of obstipation secondary to pelvic fracture malunion in cats.

Eleven cats in which subtotal colectomy with end-to-end jejunocolostomy was performed for the treatment of chronic obstipation secondary to pelvic fracture malunion were followed for at least 18 months. Seven cats had no recurrence of clinical signs and no longterm complications. In two cats, constipation was less severe and occurred less frequently; however, medical treatment was still required. In one cat, watery diarrhea gradually changed to semiformed feces of normal consistency by month 6; the cat was clinically normal at month 18. One cat had recurrence of constipation and was euthanatized after 2 years of medical treatment.

Problems and complications associated with endocrine surgery in the dog and cat.

Complications associated with endocrine surgery involving the pancreas, adrenal, parathyroid, thyroid, or pituitary glands are relatively common and relate to technical difficulties associated with the surgical procedure and pathophysiologic alterations associated with the specific endocrine disease. Appropriate preoperative assessment, proper surgical technique, and recognition and management of postoperative complications are necessary for successful surgical results.

Partial rupture of the cranial cruciate ligament of the stifle in dogs: 25 cases (1982-1988).

Partial rupture of the cranial cruciate ligament was diagnosed in 25 dogs. In all dogs, the primary problem at the time of physical examination was hind limb lameness. The mean time from initial onset of lameness to diagnosis at exploratory surgery was 17 weeks. A cranial drawer sign was detected in 13 of the 25 dogs; in 9, the cranial drawer sign was evident only when the stifle was positioned in flexion. Of the 25 dogs, 12 had no detectable cranial drawer sign in response to manipulation of the involved stifle. In all dogs, lateral stifle arthrotomy was performed in routine manner, and the cranial cruciate ligament was found to be incompletely torn. Lesions identified during arthrotomy were rupture of the craniomedial band (n = 20 dogs), interstitial tear (n = 4 dogs), and rupture of the caudolateral band (n = 1 dog).

Problems associated with the management and treatment of jaw fractures.

Fractures of the mandible and maxilla occur frequently in the dog and cat. Appropriate preoperative, intraoperative, and postoperative management of jaw fractures is imperative for successful results. Various techniques of jaw fracture management, including tape muzzles, circumferential wiring, interarcade wiring, interosseous wiring, interdental wiring, acrylic splints, percutaneous skeletal fixation, intramedullary pinning, bone plating, and partial mandibulectomy, have unique advantages and disadvantages. Selection of the appropriate method of fixation depends on the signalment of the animal, type of fracture, and the veterinarian's experience and expertise with the various types of fixation. Careful postoperative evaluation will result in the early detection of problems and ensure proper postoperative care.

Results and complications associated with partial mandibulectomy and maxillectomy techniques.

Various types of partial mandibulectomy and maxillectomy techniques can be performed to control local tumor growth, but various intraoperative and postoperative problems and complications are associated with these techniques. Intraoperative complications relate mainly to technical problems. Postoperative complications include incisional dehiscence, infection, injury to salivary ducts, subcutaneous emphysema, mandibular instability, abnormal salivation with secondary cheilitis or dermatitis, anemia, pain and discomfort, lingual dysfunction and prehension difficulties, anorexia, ocular problems, cosmetic defects, local tumor recurrence, and distant metastatic disease. The surgeon should be aware of these potential complications and have a clear understanding of their prevention and treatment.

Complications of transposition of the fibular head for stabilization of the cranial cruciate-deficient stifle in dogs: 80 cases (1982-1986).

Over a 5-year period, fibular head transposition was performed in 85 stifles in 80 dogs with rupture of a cranial cruciate ligament. The most common complication during surgery was iatrogenic fracture of the fibular head or neck (10 dogs; 12.5%), and the most common postoperative complication was seroma formation at the lateral aspect of the proximal portion of the tibia overlying the pin (6 dogs; 7.5%). Sixty-nine of 80 owners were contacted for follow-up evaluation of lameness 6 months to 5 years after surgery; 51% reported excellent results, 39% good results, and 10% fair results. Fifty-six dogs were available for long-term follow-up examination; all dogs had some degree of medical thickening of the stifle, 27 (48%) had crepitus, 4 (7%) had signs of pain, and 2 (3.5%) had moderate cranial drawer instability on manipulation of the joint. Results were good or excellent in 90% of the dogs.

Occurrence of problems after three techniques of bilateral thyroidectomy in cats.

Bilateral thyroidectomy was performed in 106 cats with hyperthyroidism by one of three techniques: original intracapsular, modified intracapsular, or modified extracapsular. Hypocalcemia was detected in the first 3 days after surgery in 11 (22%) of 50 cats treated by the intracapsular technique, 10 (33%) of 30 cats treated by the modified intracapsular technique, and 6 (23%) of 26 cats treated by the modified extracapsular technique. Hypocalcemia was classified as mild or severe. No signs of hypoparathyroidism developed in any of the 13 cats with mild hypocalcemia. Of the 14 cats with severe hypocalcemia, 8 had clinical signs of hypoparathyroidism before and during treatment with calcium and vitamin D, 3 were treated and no clinical signs developed, 2 were not treated but no clinical signs developed, and 1 was lost to follow-up. No cat required permanent calcium or vitamin D supplementation after surgery. Severe hypocalcemia and clinical signs of hypoparathyroidism occurred in 3 (6%) of the 50 cats treated by the intracapsular technique, 4 (13.3%) of the 30 cats treated by the modified intracapsular technique, and 1 (3.8%) of the 26 cats treated by the modified extracapsular technique. Twelve cats had recurrence of hyperthyroidism at a median time of 23 months. The intracapsular technique was used in 11 of these cats, and the modified extracapsular technique was used in 1. No clinical signs of hypothyroidism were detected in any of the cats. The modified intracapsular and modified extracapsular techniques of bilateral thyroidectomy are effective procedures for the treatment of feline hyperthyroidism.

Gastric outflow surgical problems.

Gastric outlet disease in the dog and cat can be successfully managed by various surgical techniques. Diagnosis is based upon clinical history, radiographic, fluoroscopic and endoscopic studies, and histological examination of excised tissue. Procedures that can improve gastric outflow include pyloromyotomy, various pyloroplasties, and antrectomy with gastroduodenostomy or gastrojejunostomy. Complications are both perioperative and long-term. A successful outcome is dependent upon proper diagnosis, complete assessment of both related and concurrent disease states, proper selection of surgical procedure, careful surgical technique, and attention to postoperative and long-term complications.