Basic Postoperative Care of the Equine Colic Patient.

The 3 time periods around colic surgery (preoperative, operative, and postoperative) are all critical to successful outcomes. Although much focus is often paid to the first 2 time periods, the importance of sound clinical judgment and rational decision-making in the postoperative period cannot be overstated. This article will outline the basic principles of monitoring, fluid therapy, antimicrobial therapy, analgesia, nutrition, and other therapeutics routinely used in patients following colic surgery. Discussions of the economics of colic surgery and expectations for normal return to function will also be included.

Systematic review of postoperative rehabilitation interventions after cranial cruciate ligament surgery in dogs.

OBJECTIVE: To critically evaluate the evidence for rehabilitation interventions following surgery for cranial cruciate ligament disease (CCLD) in dogs. STUDY DESIGN: Systematic review. METHODS: Google Scholar and Pubmed databases were searched for studies evaluating postoperative CCLD rehabilitation interventions from 1990 until March 2020 per the international Prospective Register of Systematic Reviews (PROSPERO). Each study was assigned a level of evidence score from I to IV and a risk of bias (RoB) score by 2 reviewers, and by a third reviewer, when consensus was not reached. RESULTS: Nineteen studies met the inclusion criteria. Twelve comprised randomized, controlled trials (Level II), 6 were nonrandomized or nonblinded (Level III), and one was retrospective (Level IV). Nine studies had high RoB scores. Sixteen studies yielded positive results. Therapeutic exercise had the most studies with positive results but all had high RoB. Cold compression therapy had 3 supporting studies (2 Level II, low RoB). Extracorporeal shockwave yielded 2 positive Level II studies (low-moderate and high-moderate RoB) and photobiomodulation had 1 positive study (Level II, low RoB) with objective outcomes. A negative outcome was noted in 1 photobiomodulation study. There was 1 supporting study on electrical stimulation and there was none on low-intensity pulsed ultrasound. CONCLUSION: This systematic review supports the use of rehabilitation interventions in recovery of postoperative CCLD in dogs; however, many studies had a high risk of bias. CLINICAL SIGNIFICANCE: There is a lack of class I level evidence in veterinary rehabilitation. This study supports therapeutic exercise and cold compression therapy for postoperative CCLD rehabilitation. Existing studies on other modalities are limited and demonstrate conflicting results.

The association of topical flurbiprofen with the incidence of postoperative glaucoma after phacoemulsification in dogs.

OBJECTIVE: To investigate the relationship between topical administration of flurbiprofen plus corticosteroids versus corticosteroids alone following phacoemulsification and the development of postoperative glaucoma in dogs. ANIMAL STUDIED: Thirty-eight/eighty-three (45.8%) eyes were prescribed topical flurbiprofen plus corticosteroids immediately postop while 45/83 (54.2%) eyes received topical corticosteroids alone. PROCEDURES: Logistic regression models were performed to analyze the relationship between topical flurbiprofen and development of glaucoma and to predict potential risk factors for postoperative glaucoma occurrence. RESULTS: Eighty-three eyes (65 dogs) were included. The mean age at surgery was 8.2 years, with even gender distribution. Increasing age at the time of surgery significantly increased the probability of postoperative glaucoma occurrence (odds ratio [OR] = 1.344, 95% confidence interval [CI] 1.093-1.652; p = 0.005). Glaucoma occurred in 17/83 (20.5%) eyes; of these, 15/38 (39.5%) and 2/45 (4.4%) eyes were prescribed topical flurbiprofen plus corticosteroids and topical corticosteroids alone, respectively. Immediate postoperative use of topical flurbiprofen was significantly associated with an increased probability of postoperative glaucoma occurrence (OR = 19.183 [95% CI 3.367-109.286], p = 0.001). CONCLUSIONS: Immediate postoperative use of topical flurbiprofen was a potential predisposing risk factor for the development of glaucoma following phacoemulsification. Restriction of postoperative use of topical flurbiprofen might decrease the possibility of postoperative glaucoma development in dogs.

Influence of peri-incisional epaxial muscle infiltration with bupivacaine pre- or post-surgery on opioid administration in dogs undergoing thoraco-lumbar hemilaminectomy.

This study investigated the influence of bupivacaine infiltration before or after hemilaminectomy on peri-operative opioid requirement in dogs. Thirty dogs undergoing T3-L3 hemilaminectomy were randomly assigned to receive peri-incisional infiltration of bupivacaine 2 mg/kg into the epaxial muscles before surgery (Group A), at wound closure (Group B), or no infiltration (Group C). Anaesthesia comprised dexmedetomidine 4 mcg/kg and methadone 0.3 mg/kg IV (premedication), alfaxalone IV (induction), and isoflurane in oxygen (maintenance). All dogs received meloxicam SC/PO prior to induction of general anaesthesia. Response to surgery, defined as a change in autonomic physiological variables >20% above baseline, was treated with fentanyl 2.5 mcg/kg boluses, followed by a continuous rate infusion of fentanyl at 5 mcg/kg/h. The Glasgow Composite Pain Score-Short Form (GCPS-SF) was performed before premedication and at regular intervals until 24 h postoperatively. Methadone 0.2 mg/kg analgesia was given IV if GCPS-SF was ≥5/20. Number of intraoperative, postoperative and total analgesic interventions were recorded. Analgesic interventions were analysed using a chi-squared test using a Pocock approach and statistical significance was set at P < 0.029. The number of intra-operative analgesic interventions in Group A (median, 0; range, 0-2), was significantly lower than in Group B (median, 3; range, 0-5) and Group C (median, 3; range, 0-5; P = 0.019). Regarding postoperative interventions, there were significantly fewer in Group A (median, 0; range, 0-1) and Group B (median, 0; range, 0-1) than in Group C (median, 1; range, 0-2; P = 0.047). Group A (median, 0; range, 0-3), had significantly fewer total analgesic interventions than Group B (median, 3; range, 0-6) and Group C (median, 4; range, 1-7; P = 0.014). Bupivacaine reduced peri-operative opioid administration and pre-surgical peri-incisional infiltration yielded the greatest benefit.

Pyometra Management Practices in the High Quality, High Volume Spay-Neuter Environment.

Pyometra management in the high quality, high volume spay-neuter (HQHVSN) environment is not well documented. The goal of this study was to identify pyometra management practices and patient outcomes in the HQHVSN environment. An electronic survey was piloted and distributed to HQHVSN clinics using Survey Monkey via email lists and social media. A total of 118 responses were received from June to July 2020. Respondents were distributed across the United States with the majority of clinics associated with a shelter (75%). Clinics performed a median of 25 spays and neuters per day and 5000 per year. Most clinics (86%) were willing to treat nonincidental pyometras at least sometimes, and nearly all of these clinics (97%) were willing to accept pyometra referrals. Of these clinics, nearly all (95%) felt they had the necessary resources to treat most pyometras that presented and that a pyometra case was only modestly disruptive to their surgery flow. Most clinics (70%) charged a fee for treatment, charging a median of $200 for dogs and $125 for cats. This is much lower as compared to the estimated ranges for private practice ($600-$2500) and emergency hospitals ($1500-$3579). The majority of patients that HQHVSN clinics accepted for treatment were seen the same day (50%) or next day (42%). These clinics estimated that of the animals who presented, 76% were BAR or QAR, 20% were depressed or nonambulatory, and 4% were obtunded and lateral. Estimated survival for these treated groups were 98%, 80%, and 38%, respectively. HQHVSN clinics may represent a resource for treating pyometras when treatment is disruptive to the schedule of a private practice or clients present with financial limitations. There is an opportunity for HQHVSN and private practice to form a partnership to leverage the strengths of both models and improve access to care for pets.

Corneo-limbo-conjunctival transposition to treat deep and perforating corneal ulcers in dogs: A review of 418 eyes and corneal clarity scoring in 111 eyes.

PURPOSE: To report surgical and corneal clarity scores (CCSs) of corneo-limbo-conjunctival transpositions (CLCTs) in a large number of canine cases. METHODS: Retrospective review of records that underwent CLCT to repair deep ulcers or perforations between 2002 and 2018. Signalment, concurrent eye disease, additional procedures, pathogenesis, medication, graft orientation, follow-up, and CCSs were recorded. RESULTS: 418 eyes of 399 dogs were included. Brachycephalics were most commonly affected, comprising 325/418 (77.75%) of the eyes. The most commonly affected breeds were Pugs, Shih Tzus, Cavalier King Charles Spaniels, and French Bulldogs, with 116/418 (27.75%), 64/418 (15.31%), 34/418 (8.13%), and 34/418 (8.13%) ulcerated eyes, respectively. Mean age at surgery was 5.5 years (range 59 days-17.7 years), and median follow-up time was 100 days (range 3 days-7.64 years). The most common etiopathogenesis was spontaneous ulceration in 205/418 eyes (49.04%) of which 191 (93.17%) occurred in brachycephalics. Primary keratoconjunctivitis sicca affected 122/418 eyes (29.19%) and injury 39/418 eyes (9.33%). Mean ulcer width was 3.5 mm (0.5-10 mm). Success rate was 97.13% (406/418 eyes). Failure end points recorded included no menace response, secondary glaucoma, and endophthalmitis. Pre-existing perforation was found in 101/418 (24.16%) of the eyes and significantly increased failure rate (P < .001). The median CCS was G3 (G0-G4), which was lower for Pugs (G2). Graft orientation affected CCS, but did not reach statistical significance. CONCLUSION: The high success rate and CCS for CLCT in dogs make it a good technique to treat deep ulcers but a less desirable outcome is anticipated when treating perforations and Pugs.

Comparison between head-tail-rope assisted and unassisted recoveries in healthy horses undergoing general anesthesia for elective surgeries.

OBJECTIVE: To compare attempts to stand, duration, quality, and occurrence of injuries between head-tail rope assistance and unassisted recoveries in healthy horses undergoing general anesthesia for elective surgeries. STUDY DESIGN: Randomized, prospective, clinical trial. METHODS: Three hundred one healthy horses undergoing elective surgeries were randomly assigned to recover with head-tail rope assistance (group A) or unassisted (group U); 305 recoveries (group A, n = 154; group U, n = 151) were analyzed. Anesthesia was maintained with isoflurane and triple drip. For each recovery, attempts to stand, duration, quality, and recovery-associated injuries were recorded. Data were analyzed by linear regression and analysis of covariance. RESULTS: Anesthesia duration was similar between groups (mean ± SD, 70 ± 29 minutes). Compared with group U, group A had fewer attempts to stand (median [range], group A = 1 [1-7] vs group U = 3 [1-34]) and shorter duration of recovery (mean ± SD, A = 36 ± 12 minutes vs U = 41 ± 15 minutes). Recovery quality in group A (28 points [15-70]) was better than that in group U (38 points [11-87]). More horses had recovery-associated injuries in group U (9 horses) compared with group A (2 horses). One horse per group was euthanized. CONCLUSION: Head-tail rope assistance reduced standing attempts, shortened recovery duration, improved recovery quality, and reduced recovery-associated minor injuries after general anesthesia for elective surgery in healthy horses. Fatalities could not be prevented. CLINICAL SIGNIFICANCE: Head-tail rope assistance may improve recovery in healthy horses after short-duration elective surgeries with isoflurane and triple drip.

Effect of hyperbaric oxygen therapy on the healing of postoperative wounds in bitches after hemimastectomy.

The use of hyperbaric oxygen therapy (HBOT) is an accepted method of supporting wound healing in human medicine. Yet, because of the risk of complications associated with HOBT, a safer modification of the therapy, known as L-HOBT (lower pressure and lower oxygen concentration), is increasingly used nowadays. Therefore, due to the lack of literature reports regarding the clinical use of L-HBOT in animals, the authors decided to present the results of L-HBOT supportive treatment of postoperative wounds after hemimastectomy compared to classic treatment. The study group included 12 bitches divided into two groups: group A (assisted L-HBOT) and group B (classic treatment). In addition to conventional treatment, the supportive therapy included 1.5 hours of hyperbaric chamber therapy for 5 consecutive days, starting 24 hours after surgery (1500hPa pressure and 26% oxygen concentration in the chamber). The patients were followed and evaluated throughout the course of the treatment by two independent doctors. The results of the treatment revealed no negative clinical impact of L-HOBT supportive therapy on the body of the animals. At the same time, postoperative wounds after L-HOBT healed faster and with fewer postoperative complications compared to the control group. This resulted in a shorter treatment period, terminating with an earlier skin suture removal.

New Device for Noninvasive Telemetric Monitoring of Vital Signs in Healthy and Newly Operated Piglets.

Measuring vital signs is central to medical practice, but they are difficult to monitor in awake laboratory animals. We examined the feasibility of a noninvasive device for telemetric assessment of respiration rate, heart rate, temperature and movement in pigs. Awake piglets were monitored continuously for 31 h (interquartile range, 7) before (n = 4) and after (n = 3) surgery. Data quality was sufficient for determination of all parameters. We conclude that continuous, noninvasive monitor- ing of pigs is possible by using the evaluated device.

Evaluation of the effectiveness of preoperative administration of maropitant citrate and metoclopramide hydrochloride in preventing postoperative clinical gastroesophageal reflux in dogs.

OBJECTIVE: To investigate the prophylactic effectiveness of preoperative administration of maropitant citrate and metoclopramide hydrochloride in preventing postoperative clinical gastroesophageal reflux (GER) in dogs and to identify risk factors for clinical postoperative GER in dogs. ANIMALS: 93 client-owned dogs undergoing surgery at the Washington State University Veterinary Teaching Hospital between March 2016 and February 2017. PROCEDURES: Dogs were randomly assigned to either the intervention group (preoperatively received maropitant and metoclopramide) or the control group (did not preoperatively receive maropitant and metoclopramide). After surgery, all dogs were recovered and monitored, and occurrences of GER were noted. The prophylactic effectiveness of maropitant and metoclopramide was evaluated, and univariate and multivariate logistic regression analyses were performed to identify variables associated with postoperative clinical GER in dogs. RESULTS: No meaningful difference in the incidence of clinical GER during the postoperative period was detected between the control and intervention groups. Results indicated that variables associated with significantly increased odds of postoperative clinical GER included the male sex (OR, 9.2; 95% confidence interval [CI], 1.26 to 195.0), an overweight BCS (OR, 12.3; 95% CI, 2.1 to 135.1), gastrointestinal surgery (OR, 30.5; 95% CI, 3.0 to 786.9), and requirement for a dexmedetomidine constant rate infusion after surgery (OR, 9.6; 95% CI, 1.3 to 212.5). CONCLUSIONS AND CLINICAL RELEVANCE: Findings indicated that incidence of clinical GER during the postoperative period was not lower for dogs that received preoperative prophylactic administration of metoclopramide and maropitant, compared with incidence dogs that did not receive the prophylactic treatment. Further research is required into alternative measures to prevent postoperative clinical GER in dogs.

Investigation into clients' perception of postoperative physiotherapy for dogs undergoing cranial cruciate ligament disease surgery.

AIM: To evaluate clients' understanding, perception and experience of postoperative physiotherapy after undergoing an osteotomy technique for cranial cruciate ligament disease (CCLD). METHOD: A retrospective questionnaire was sent to 202 owners of dogs that underwent CCLD surgery at the Queen Mother Hospital for Animals between 1 January 2015 and 31 December 2017, with 63 responses obtained. RESULTS: Significant differences were found in choice of physiotherapy between clients recommended or not by their vets (p<0.01), and between those offered additional information and those who were not (p<0.01). Of those who chose physiotherapy, 85% had a satisfactory experience. No difference was found in choice of physiotherapy between clients aware of its availability and those who were not (p=0.069). No association was found between cost of the service and clients' perception of cost-worthiness (p=0.169) or between cost-worthiness and recovery outcome (p=0.420). A correlation was found between clients' perception of cost-worthiness and satisfaction level (p=0.03). Clients' knowledge was related to the choice of physiotherapy (p=0.01), but not to other investigated factors. A significant relationship was found between clients' age and choice of physiotherapy (p=0.01), with younger clients choosing physiotherapy more often. CONCLUSION: Veterinarians recommending physiotherapy and providing accurate information affect clients' decision to choose, and perception of, physiotherapy, in addition to clients' own knowledge.

Perfil de tutores de cadelas portadoras de tumor de mama / Profile of tutors of dogs with mammary tumor / Perfil de tutores de perras portadoras de tumor mama

É importante que se obtenha informações sobre tutores de cadelas portadoras de tumor de mama, pois o tutor precisa cuidar do animal principalmente no pós-operatório já que o tratamento é mastectomia. Foram entrevistados 11 tutores de cadelas submetidas à mastectomia. A maioria dos entrevistados tem ensino médio e superior, morando em casa própria com renda de um a cinco salários mínimos. Apenas uma pessoa disse que não sabia que cadelas podem ter câncer de mama. Entretanto, a maioria não sabe como prevenir o câncer de mama em cadelas, demonstrando que são necessárias campanhas educacionais sobre a doença para tutores de cadelas. A maneira mais frequente de aquisição do animal foi a adoção, o que demonstra o crescimento da posse responsável entre os tutores brasileiros. Três tutores afirmaram que aplicaram anticoncepcional nas suas cadelas várias vezes. Este fato é bastante preocupante porque tais fármacos possuem diversos efeitos colaterais adversos, inclusive tumor de mama. Oito tutores informaram que nunca haviam consultado um médico veterinário antes sobre o tumor, embora o mesmo fosse evidente. A maioria dos tutores só procurou ajuda para a cadela porque a participação no projeto era gratuita. Dificuldades financeiras é um dos principais motivos para que os tutores retardem as consultas. Entretanto, quando questionados por qual motivo as cadelas não tinham sido tratadas antes, nenhum tutor citou dificuldades financeiras. Concluiu-se que alguns tumores de mama foram causados por aplicação de anticoncepcional e que o desconhecimento sobre a doença ainda é grande entre os tutores entrevistados.(AU)

It is important to collect information about owners of dogs with mammary tumor, since the owner must take care of the animal after surgery, given that the treatment of choice is a mastectomy. This study interviewed eleven owners of female dogs submitted to mastectomy. Most respondents have high school and/or college education, live in their own homes with incomes between one to five minimum salaries. Only one person said they did not know that dogs could have mammary cancer. However, most do not know how to prevent mammary cancer in dogs, demonstrating the need for educational campaigns on the disease. The most frequent way of acquiring the animal was adoption, which demonstrates the growth of responsible ownership among Brazilian owners. Three owners stated that they used contraceptive drugs on their dogs several times. This fact is quite worrisome since such drugs have several adverse effects, including mammary tumor. Eight owners reported that they had never been to a veterinarian before about the tumor, although the tumor was evident. Most owners only sought help for the dog because participation in the project was free of charge. Financial difficulties are one of the main reasons for owners to delay consultations. However, when asked why the dogs had not been treated before, no owner mentioned financial difficulties. It can be concluded that some breast tumors were caused by the use of contraceptive drugs and that ignorance regarding the disease is still high among the interviewed tutorsd.(AU)

Es importante que se obtenga informaciones sobre los tutores de perras portadoras de tumor de mama, pues el tutor necesita cuidar del animal principalmente en el postoperatorio, ya que el tratamiento es la mastectomía. Se han entrevistado a once tutores de perras sometidas a la mastectomía. La mayoría de los encuestados tienen educación secundaria y universitaria, y viven en sus propios hogares con ingresos de uno a cinco sueldos mínimos. Solo una persona dijo que no sabía que las perras pueden tener cáncer de mama. Sin embargo, la mayoría no sabe cómo prevenir el cáncer de mama en perras, demostrando que son necesarias campañas educativas sobre la enfermedad para dueños de perras. La forma más frecuente de adquirir el animal es la adopción, lo que demuestra el crecimiento de la posesión responsable entre los tutores brasileños. Tres tutores declararon que aplicaron anticonceptivos a sus perras varias veces. Este hecho es bastante preocupante porque estos medicamentos tienen varios efectos secundarios adversos, incluso el tumor de mama. Ocho tutores informaron que nunca antes habían consultado a un médico veterinario sobre el tumor, aunque el mismo era evidente. La mayoría de los tutores solo buscaron ayuda para la perra porque la participación en el proyecto era gratuita. Las dificultades financieras es una de las principales razones por las cuales los tutores retrasan las consultas. Sin embargo, cuando cuestionados por cuál motivo las perras no habían sido tratadas antes, ningún tutor mencionó dificultades financieras. Se concluyó que algunos tumores de mama fueron causados por la aplicación de anticonceptivos y que el desconocimiento sobre la enfermedad aún es alta entre los tutores encuestados.(AU)

A controlled randomized clinical trial to assess postoperative analgesia after thiopental-isoflurane anaesthesia or total intravenous anaesthesia with alfaxalone in dogs.

Alfaxalone, a synthetic neuroactive steroid, has been attributed with properties including sedation, anaesthesia and analgesia. The clinical relevance of any analgesic properties of alfaxalone has not been demonstrated. This study was a prospective, blinded, randomized, negative control clinical trial in 65 healthy dogs presented for ovariohysterectomy. Anaesthesia was induced and maintained, for Group 1 (TIVA) dogs (n = 30) with intravenous alfaxalone alone and for Group 2 dogs (n = 35) with thiopental followed by isoflurane in 100% oxygen inhalation. After ovariohysterectomy, quantitative measures of pain or nociception were recorded at 15 min intervals for 4 hr using three independent scoring systems, a composite measure pain scale (CMPS), von Frey threshold testing and measures of fentanyl rescue analgesia. The mean CMPS scores of Group 2 (THIO/ISO) dogs remained higher than Group 1 (TIVA) dogs from 15 to 135 min post-surgery but this difference was not statistically significant. There were no significant differences between groups in the proportions of dogs requiring rescue fentanyl analgesia, the total fentanyl dose used or the time to first fentanyl dose. The Von Frey threshold testing was found to be unsuitable for measurement of pain in this experimental model. When administered as total intravenous anaesthesia, alfaxalone did not provide analgesia in the postoperative period.

MicroPulse™ transscleral cyclophotocoagulation in the treatment of canine glaucoma: Preliminary results (12 dogs).

OBJECTIVE: To describe the clinical application and effect of MicroPulse™ transscleral cyclophotocoagulation (MP-TSCPC) in dogs with glaucoma. ANIMALS STUDIED: Twelve dogs with primary (n = 8) or secondary (n = 4) glaucoma, aged 2-13 years (mean ± SD, 7.2 ± 3.8 years). PROCEDURES: MP-TSCPC was performed under sedation or general anesthesia. Laser duty cycle was 31.3%, laser power varied from 2000-2800 mW, and each hemisphere was treated for 90-180 seconds. The probe was applied to each quadrant in a "sweeping motion," sparing the 3 and 9 o'clock positions. RESULTS: The number of MP-TSCPC procedures per eye varied from 1 to 3 (1.4 ± 0.7). Intraocular pressure (IOP) was controlled (<25 mm Hg) in 11/12 dogs (92%) within 1-15 days post-operatively. The IOP control at 1 month and the duration between repeated procedures were significantly greater in eyes treated with high energy laser (2800 mW) compared to 2000-2500 mW. Long-term follow-up (315.3 ± 100.7 days) showed controlled IOP in 5/12 (42%) and vision retention in 4/8 (50%) dogs. In unsuccessful cases, loss of IOP control or vision loss occurred within 3-245 days (109.1 ± 93.7 days) and 28-261 days (114 ± 101.6 days), respectively, resulting in a salvage procedure in 6 dogs. Complications were as follows: corneal hypoesthesia (92%), anterior uveitis (67%), post-operative ocular hypertension (50%), neurotrophic corneal ulcer (25%), keratoconjunctivitis sicca (8%), and rubeosis iridis (8%). CONCLUSIONS: MP-TSCPC is a viable tool for managing canine glaucoma, although further studies are required to improve the long-term effect and reduce the complication rate.

Paranasal sinus cysts in the horse: Complications related to their presence and surgical treatment in 37 cases.

BACKGROUND: Paranasal sinus cysts (PSC) are a common cause of equine secondary sinusitis. The outcome and associated complications have not been frequently reported. OBJECTIVES: To review the associated clinical signs, associated morbidities and outcomes of horses treated for PSC. STUDY DESIGN: Retrospective multicentre case series. METHODS: Retrospective analysis of case records and telephone follow up survey. RESULTS: Subjects were 37 horses 1-24 years old that were presented with nasal discharge (n = 31), facial swelling (n = 25) and epiphora (n = 19). Radiography and computed tomography allowed identification of the cyst-induced changes including concomitant tissue destruction (n = 31), leading among other things to local nerve damage causing headshaking (n = 6) and unilateral blindness (n = 1). Radiographic changes to adjacent dental apices were present in 10 horses. Horses over 10 years old showed more of the named associated problems. Post-operative complications included surgical site infection (SSI) (n = 11), nasofrontal suture periostitis (n = 6) and sequestration (n = 1) following removal of the PSC via osteotomy. The long-term response to treatment was available for 28 cases with 22 horses (78.6%) fully cured, 4 (14.3%) partially cured and 2 (7.1%) not responding to treatment. In 7 horses (18.9%) there was recurrence of the cyst post-operatively. MAIN LIMITATIONS: Due to the study being a multicentre retrospective case series with collection of data over an extended period, there may be inconsistency in data recording and absence of reporting of some findings. CONCLUSIONS: Overall, the diagnosis and treatment of sinus cysts is relatively straightforward and carries a good prognosis. In long-standing cases complications secondary to the expansive growth of cysts will dramatically affect the prognosis for full recovery due to pressure-induced changes to facial bones, cheek teeth and nerves. These secondary complications mainly occurring in older horses may be due to a combination of a relatively longer period of affection and the inflexibility of older horses' bones. Cyst recurrence following treatment can occur in up to 19% of cases.

A prospective, randomized, double-blinded, placebo-controlled clinical study on postoperative antibiotherapy in 150 arthroscopy-assisted tibial plateau leveling osteotomies in dogs.

OBJECTIVE: To determine the influence of a 7-day course of postoperative antibiotherapy (cefpodoxime) on surgical site infections (SSI) after tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: Prospective, randomized, double-blinded, placebo-controlled clinical study. SAMPLE POPULATION: One hundred fifty client-owned dogs, with consent. METHODS: Dogs undergoing arthroscopy-assisted TPLO were randomly assigned to 1 of 2 groups, the placebo group receiving perioperative cefazolin and 7 days of placebo medication after surgery or the treatment group receiving perioperative cefazolin and 7 days of postoperative cefpodoxime. Twenty-seven factors were analyzed for association with SSI by using univariate analysis, Fisher's exact test, or Wilcoxon rank-sum test. RESULTS: SSI rates did not differ (P = .34) between the placebo group (17%; 95% confidence level [CL] 7.94%-26.43%) and the treatment group (11% SSI; 95% CL 3.98%-18.88%). The probability that > 23% of dogs would benefit from postoperative antibiotherapy was less than 5%. The only association between the factors tested in this study and SSI involved the body weight (kg), with each 1 unit increase in kilogram weight increasing the odds of developing an SSI by 4.7%. CONCLUSION: Although the wide CL may be consistent with a type II error, a 7-day course of cefpodoxime after arthroscopy-assisted TPLO did not influence postoperative SSI in the population tested here. In addition, only a small proportion of dogs would benefit from postoperative antibiotherapy under the conditions of our study. CLINICAL SIGNIFICANCE: These results should prompt surgeons to reconsider systematic antibiotherapy after TPLO and justify additional studies to determine whether dogs predisposed to infection could benefit from such an approach.

Treatment of Long Bone Fractures in Calves with Ilizarov External Fixator.

In this study, the advantages and disadvantages of Ilizarov external fixator in the treatment of long bone fractures in calves were investigated. For this purpose, 26 calves of different breeds, ages and genders, having metacarpal (n = 12), metatarsal (n = 5) and antebrachial (n = 9) fractures underwent surgery under general anaesthesia. Frames, which were prepared before surgery in accordance with the radiographic findings, were applied under open reduction in 18 cases, and under closed reduction in eight cases. In the postoperative period, all calves except one started to bear some weigh on the injured limb on the first day, while the remaining calf did the same on the second day. The consolidation started in the first 2 weeks for 24 of the calves and was completed by the day 55. In the two remaining cases, it started in the third week and was completed on day 71 and day 90, respectively.The soft tissue wounds were completely healed in all calves and no complications occurred. In five calves that were not kept in our clinic pin tract infections formed. They were controlled rapidly, and there was no change in the fracture reduction or healing duration.In conclusion, in our study, the Ilizarov external fixator system was applied to long bone fractures in cattle calves, in cases where the fragments were not large enough to apply pins and plates, and which became open and infected after defective bandage practices or unsuitable treatment. Fractures completely healed in all cases, without any complications. These results show that many of the long bone fractures experienced by calves, that were considered for amputation due to the anticipated inability to treat them successfully, could be treated with the use of the Ilizarov system.

Description and post-operative evaluation of tie-in technique in tibial osteosynthesis in dogs / Descrição e avaliação pós-operatória de técnica de osteossíntese com tie-in em tíbia

The aim of this study was to describe and analyse the adaptability and functionality of tie-in configuration in tibial osteosynthesis in dogs. Twenty dogs with tibial fracture were included in this study. An orifice was made on the proximal tibial fragment, on the medial side, close to the tibial crest. The drill piece was angled at 45º and projected into the same orifice on the distal sense of the bone. Others orifices made with the aid of a low rotation drill and drill piece with diameter smaller than the chosen implant. After 10 days post-operative, the animals were evaluated. X-ray analysis was performed at the time of clinical examination; immediate post-operative period; and at 30, 60, 90, and 120 days post-surgery. A questionnaire was given to the owners to provide details on the post-operative period. There were no trans-operative complications or suture dehiscence up to the day of suture removal. Partial development of bone callus was observed in 20 dogs within a mean period of 76 days. Three animals showed bone consolidation within 35 days, nine by 60 days, three by 90 days, and 5 by 120 days post-operative. Dynamization was carried out in 9 animals. The surgical access to the tibial medullary canal through the orifice at the proximal medial face, by the tibial tuberosity, enables the insertion of IMP without risks to articular and peri-articular lesions in the knee in dogs.(AU)

O objetivo deste trabalho foi descrever e analisar a funcionalidade da configuração tie-in na ostessíntese de tíbia em cães. Foram usados 21 cães com fratura de tíbia da rotina clinica do hospital veterinário. Somente a primeira cortical (Sis) foi perfurada, em seguida a broca foi inclinada a 45o e projetada no mesmo orifício no sentido distal do osso. foram confeccionados outros orifícios com auxílio de furadeira de baixa rotação e broca cujo diâmetro era menor que o implante escolhido. Os procedimentos radiográficos foram realizados no momento do atendimento clínico, no período pós-operatório imediato e aos 30, 60, 90 e 120 dias pós-cirúrgico. Não houve nenhuma complicação transoperatória, tão pouco deiscência de sutura até o momento da retirada dos pontos de cútis. A formação parcial de calo ósseo foi evidenciada em 20 cães com tempo médio de 76 dias. Três cães obtiveram consolidação óssea em 35 dias, nove aos 60 dias, três aos 90 dias e cinco aos 120 dias de pós-operatório. Dinamizações foram realizadas em nove animais. Após a confirmação radiográfica de consolidação óssea, os implantes dos 20 animais foram totalmente removidos. Concluiu-se que o acesso cirúrgico ao canal medular da tíbia canina por meio de orifício na face medial proximal, junto à tuberosidade da tíbia, permite a inserção do PIM sem risco de lesões articulares e periarticulares no joelho.(AU)

Reverse Saphenous Conduit Flap in 19 Dogs and 1 Cat.

The purpose of this retrospective study was to report the outcomes of 19 dogs and 1 cat undergoing reverse saphenous conduit flap between 1999 and 2016. Reverse saphenous conduit flap was used to treat traumatic wounds and wounds resulting from tumor excision in the hind limb; the majority of cases had medial shearing injuries. All animals had complete flap survival. In five animals (20%), minor donor site dehiscence occurred, which did not require surgery. Other postoperative complications included signs of severe venous congestion in one dog. Reverse saphenous conduit flap is a useful technique to repair skin defects of the distal hind limb.