Comedones and epidermal cysts on the abdominal skin of a dog occurring after a laparotomy.

An 8-year-old neutered male shih tzu dog underwent laparotomy for cystolithectomy. Ten days later, multiple various-sized cystic nodules were observed on the suture line and surrounding abdominal skin, although the surgical incision had healed well. Microscopically, various-sized cysts lined with thin walls of stratified squamous epithelium in the dermis were dilated and filled with keratin. Adnexal differentiation from the wall was not seen. Thus, the abdominal lesions were diagnosed as comedones and epidermal cysts. Herein, we describe the case of a dog with comedones and epidermal cysts on the abdominal skin after a laparotomy. Key clinical message: Multiple various-sized cystic lesions of the follicles are described. The implantation of epidermal fragments into the dermis by surgery may induce epidermal cysts and comedones in the skin of hyperadrenocorticism-affected dogs.

Comédons et kystes épidermiques sur la peau abdominale d'un chien survenant après une laparotomie. Un chien shih tzu mâle castré de 8 ans a subi une laparotomie pour cystolithectomie. Dix jours plus tard, de multiples nodules kystiques de différentes tailles ont été observés sur la ligne de suture et sur la peau abdominale environnante, bien que l'incision chirurgicale ait bien cicatrisé. Au microscope, des kystes de différentes tailles bordés de fines parois d'épithélium pavimenteux stratifié dans le derme étaient dilatés et remplis de kératine. Aucune différenciation annexielle par rapport à la paroi n'a été observée. Ainsi, les lésions abdominales ont été diagnostiquées comme des comédons et des kystes épidermiques. Nous décrivons ici le cas d'un chien présentant des comédons et des kystes épidermiques sur la peau abdominale après une laparotomie.Message clinique clé:De multiples lésions kystiques des follicules, de différentes tailles, sont décrites. L'implantation chirurgicale de fragments d'épiderme dans le derme peut provoquer des kystes épidermiques et des comédons dans la peau des chiens atteints d'hypercorticisme.(Traduit par Dr Serge Messier).

Yersinia pseudotuberculosis in an alpaca.

A 6-year-old female huacaya alpaca was referred to the clinic for evaluation with a 1-month history of rapid weight loss, inappetence, lethargy, and severe leukocytosis refractory to medical management. Physical examination revealed a body condition score of 1 out of 5 and a large, firm structure palpable in the right caudoventral abdomen. Abdominal ultrasonographic examination revealed 3 masses with hyperechoic, swirling centers. The largest mass measured 15 cm in diameter with a 2-centimeter capsule, and extended from right of midline into the left inguinal region. Transrectal ultrasonography identified a small uterus and clear delineation between the abdominal masses. Complete blood (cell) count findings were consistent with marked systemic inflammation. Based on initial examination and laboratory findings, exploratory laparotomy was elected. Multiple mesenteric masses strongly adhered to the jejunum were observed within the abdomen. Due to the inoperable conditions and the poor long-term prognosis, the alpaca was euthanized under general anesthesia. Bacterial culture of fluid aspirated from the largest mass revealed Yersinia pseudotuberculosis. Key clinical message: Clinical progression and attempted treatment of Yersinia pseudotuberculosis in camelids have not been previously described and the bacterium should be considered as a differential diagnosis for abscessation and persistent leukocytosis. Yersinia pseudotuberculosis is also considered a zoonotic agent and proper precautions should be taken when handling cases of abdominal abscessation.

Yersinia pseudotuberculosis chez un alpaga. Une alpaga huacaya femelle de 6 ans a été référée à la clinique pour évaluation avec des antécédents d'un mois de perte de poids rapide, d'inappétence, de léthargie et de leucocytose sévère réfractaire à la prise en charge médicale. L'examen physique a révélé un score d'état corporel de 1 sur 5 et une structure large et ferme palpable au niveau de l'abdomen caudoventral droit. L'examen échographique abdominal a révélé 3 masses à centres hyperéchogènes et tourbillonnants. La plus grande masse mesurait 15 cm de diamètre avec une capsule de 2 centimètres et s'étendait de la droite de la ligne médiane jusqu'à la région inguinale gauche. L'échographie transrectale a identifié un petit utérus et une délimitation claire entre les masses abdominales. Les résultats de la numération globulaire (cellulaire) sanguine complète étaient compatibles avec une inflammation systémique marquée. Sur la base de l'examen initial et des résultats de laboratoire, une laparotomie exploratoire a été choisie. De multiples masses mésentériques fortement adhérées au jéjunum ont été observées dans l'abdomen. En raison des conditions inopérables et du mauvais pronostic à long terme, l'alpaga a été euthanasié sous anesthésie générale. La culture bactérienne du liquide aspiré de la plus grande masse a révélé Y. pseudotuberculosis.Message clinique clé :La progression clinique et les tentatives de traitement de Y. pseudotuberculosis chez les camélidés n'ont pas été décrites auparavant et la bactérie doit être considérée comme un diagnostic différentiel d'abcès et de leucocytose persistante. Yersinia pseudotuberculosis est également considérée comme un agent zoonotique et des précautions appropriées doivent être prises lors de la manipulation des cas d'abcès abdominal.(Traduit par Dr Serge Messier).

Abdominal computed tomography and exploratory laparotomy have high agreement in dogs with surgical disease.

OBJECTIVE: To compare the results of abdominal CT with exploratory laparotomy in the dog. ANIMALS: 100 client-owned dogs from 1 academic institution. METHODS: Medical records were searched for dogs that had undergone a preoperative abdominal CT scan read by a board-certified veterinary radiologist followed by an exploratory laparotomy. CT and surgical reports were compared. RESULTS: The overall agreement between abdominal CT scan and exploratory laparotomy in all cases was 97%. Overall, there was no evidence that proportion agreement differed on the basis of body condition score, time interval between CT and surgery, or oncologic versus nononcologic disease. CLINICAL RELEVANCE: Abdominal CT scan read by a board-certified diplomate is a sensitive presurgical diagnostic tool for surgical abdominal disease in the dog. When performing a specific abdominal surgery, it is acceptable for the surgeon to fully explore the abdomen or forego it for a smaller approach to the organ of interest if an abdominal CT was performed prior.

Laparoscopic surgical treatment for sliding hiatal hernia is associated with an owner-perceived improvement in clinical outcome in dogs.

OBJECTIVE: To report perioperative complications and client-perceived outcome following laparoscopic surgical treatment for sliding hiatal hernia (SHH) in dogs. ANIMALS: Client-owned dogs (n = 9). METHODS: Medical records were reviewed and perioperative data collected including preoperative diagnostic imaging, operative details, complications, and need for conversion to open celiotomy. A single-incision, multicannulated port was inserted in the subumbilical region followed by placement of an additional 2 or 3 instrument portals. Hiatal plication, esophagopexy, and left-sided gastropexy were performed laparoscopically. Follow-up information was collected with telephone interview with the owners and/or referring veterinarian. A standardized questionnaire was completed by dog owners postoperatively. RESULTS: Intraoperative pneumothorax occurred in 5 of 9 (55.6%) dogs and resulted in conversion to open celiotomy in 2 (22.2%) dogs. In 4 dogs, pneumothorax was suspected to be the result of progressive leakage of capnoperitoneum through the suture bite holes of the esophageal hiatal plication sutures. Hiatal plication was performed using intracorporeal simple interrupted sutures (n = 4) or a simple continuous pattern with barbed suture (4). Esophagopexy was performed using barbed suture in all dogs. Gastropexy was performed using a total laparoscopic technique (n = 4) or laparoscopic-assisted technique (3). Using a standardized questionnaire, dog owners perceived a postoperative improvement in regurgitation after eating and regurgitation after excitement/increased activity. CLINICAL RELEVANCE: Laparoscopic treatment of SHH resulted in owner-perceived improvement in clinical signs. Intraoperative pneumothorax occurred in a high proportion of dogs but did not result in long-term sequelae.

Outcomes following combined median sternotomy and ventral midline laparotomy for bicavitary penetrating wooden foreign bodies.

Combined abdominal and thoracic pathology caused by extra-gastrointestinal migration of an ingested wooden foreign body (WFB) is an uncommon but serious injury. Presenting clinical signs are typically nonspecific and, in the absence of observed WFB ingestion, diagnosis is challenging. Treatment requires concurrent abdominal and thoracic surgical exploration to remove the WFB and address injuries caused by its migration. This case series describes perioperative characteristics and outcomes in 4 dogs following combined median sternotomy and ventral midline laparotomy (CMSVML) for bicavitary penetrating WFBs. Key clinical message: Treatment of bicavitary penetrating WFBs with CMSVML provided postoperative outcomes similar to those in previous reports; however, high-grade complications and prolonged hospitalization were commonly encountered.

Résultats après sternotomie médiane et laparotomie médiane ventrale combinées pour des corps étrangers en bois pénétrant bicavitaires. La pathologie combinée abdominale et thoracique causée par la migration extra-gastro-intestinale d'un corps étranger en bois (WFB) ingéré est une blessure rare mais grave. Les signes cliniques présentés sont généralement non spécifiques et, en l'absence d'ingestion observée de WFB, le diagnostic est difficile. Le traitement nécessite une exploration chirurgicale abdominale et thoracique simultanée pour retirer le WFB et traiter les blessures causées par sa migration. Cette série de cas décrit les caractéristiques peropératoires et les résultats chez 4 chiens après une sternotomie médiane et une laparotomie médiane ventrale combinées (CMSVML) pour des WFB pénétrantes bicavitaires.Message clinique clé:Le traitement des WFB pénétrants bicavitaires avec CMSVML a fourni des résultats postopératoires similaires à ceux des rapports précédents; cependant, des complications de haut grade et une hospitalisation prolongée ont été fréquemment rencontrées.(Traduit par Dr Serge Messier).

Comparison of Systemic Extended-release Buprenorphine and Local Extended-release Bupivacaine-Meloxicam as Analgesics for Laparotomy in Mice.

Extended-release (ER) local anesthetics can be used in multi-modal analgesia or in situations in which systemic analgesics may alter animal physiology and thus introduce interpretational confounds. In this study, we compared the analgesic efficacy of an ER buprenorphine formulation with that of a synergistic combination of ER bupivacaine and meloxicam. Female and male CD1 mice were randomly assigned to receive subcutaneous buprenorphine (3.25mg/kg) preemptively, subcutaneous infiltration of bupivacaine???meloxicam (0.03mL at incision closure (bupivacaine, 35mg/kg; meloxicam, 1mg/kg), or saline (10mL/kg SC) after induction of anesthesia. After laparotomy, mice were assessed for changes in daily body weight, rearing frequency, nest consolidation scores, time-to-integrate-nest test (TINT), and response to von Frey testing at 4, 8, 24, 48, and 72h after surgery. Daily weight, nest consolidation scores and rearing frequency were not significantly different among the 3 groups. TINT had fallen significantly response at 24 and 48h after injection in the ER buprenorphine group as compared with the saline and ER bupivacaine-meloxicam groups. Nociceptive thresholds, as assessed with von Frey testing, differed between saline controls and both analgesic groups at 4, 8, 24, 48, and 72 h after surgery. None of the mice in the bupivacaine???meloxicam group developed signs of neurotoxicity, a potential side effect of high-dose local anesthetics. This study demonstrates that local ER bupivacaine???meloxicam may be a useful alternative to systemic, ER buprenorphine for the relief of pain after laparotomy in mice.

Infrared thermography is a novel tool to assess small intestinal surface temperature in dogs undergoing laparotomy for foreign body obstruction.

OBJECTIVE: To evaluate local temperature differences directly over and adjacent to small intestinal foreign body obstruction (FBO) using infrared thermography (IRT) in dogs. ANIMALS: 49 client-owned dogs were initially enrolled. METHODS: In a prospective, clinical observational study, IRT was utilized to compare median small intestinal (SI) surface temperature differences at the site of FBO and segments oral and aboral before and after surgical resolution from April 24, 2019, to July 19, 2020. These differences were evaluated for correlation with canine acute patient physiologic and laboratory evaluation fast (APPLEfast) scoring, lactate, foreign body material (hard vs soft), and blood pressure. RESULTS: There was not a significant surface temperature difference between SI segments at the site of FBO, oral or aboral. After resolution of obstruction, there was a significant decrease in median temperature directly over the FBO (2.4 °C; IQR, -2.55 to 10.6 °C; P = .0043). A decrease in surface temperature of the oral SI segment was appreciated with FBO due to hard material (-1.7 °C; IQR, -5.2 to 3.4 °C), whereas soft material had an increase in SI surface temperature oral to the FBO (+1.1 °C; IQR, 0.3 to 3.2 °C). This difference did not achieve significance (P = .08; Z = 1.75). No correlation was found between APPLEfast, lactate, or blood pressure and SI segment temperatures. CLINICAL RELEVANCE: IRT may be useful diagnostic modality to identify changes in small intestinal surface temperature relating to FBO. Further evaluation is warranted to determine if IRT may be a clinically useful to evaluate intestinal perfusion.

Epiploic foramen entrapment in a dog.

OBJECTIVE: To report small intestinal herniation through the epiploic foramen in a dog. ANIMALS: Nine-year-old male castrated Shih Tzu. STUDY DESIGN: Case report. METHODS: The dog presented with an 8-year history of vomiting and regurgitation and acute onset of melena, lethargy, anorexia, anemia, and suspected gastrointestinal mass or obstruction on prereferral imaging. Abnormalities on abdominal radiographs included a large, midcaudal soft tissue structure and cranial displacement and segmental dilation of the small intestine. On abdominal ultrasound, severe gastric dilation, jejunal tortuosity and stacking, and peritoneal effusion were observed. Epiploic herniation of the small intestine and segmental jejunal devitalization was diagnosed on exploratory laparotomy, and the dog underwent hernia reduction, jejunal resection and anastomosis, and nasogastric tube placement. RESULTS: Severe gastric distention and atony persisted 24 h after surgery, despite medical management. The dog was taken to surgery for decompressive gastrotomy and placement of gastrostomy and nasojejunostomy tubes for postoperative decompression and feeding, respectively. Three days after the original surgery, the dog developed a septic abdomen from anastomotic dehiscence and underwent jejunal resection and anastomosis and peritoneal drain placement. Gastric dysmotility gradually resolved with the administration of motility stimulants, removal of gastric residual volume, and nutritional support via nasojejunostomy tube feedings. Three months after discharge, the dog was clinically normal. CONCLUSION: Epiploic foramen entrapment should be considered a type of herniation in dogs. Clinical suspicion should be raised in dogs with unresolving regurgitation and vomiting, visceral displacement, and stacking and distension of small intestine.

Bilateral, single-session, laparoscopic adrenalectomy was associated with favorable outcomes in a cohort of dogs.

OBJECTIVE: To report perioperative characteristics and outcome following bilateral, single-session, laparoscopic adrenalectomy (BSSLA) in dogs. ANIMALS: Client-owned dogs (n = 6). CLINICAL PRESENTATION AND PROCEDURES: Medical records were reviewed and perioperative data collected, including preoperative diagnostic imaging, operative details, complications, and need for conversion to open laparotomy. Bilateral, single-session, laparoscopic adrenalectomy was performed on the right or left side with a standard 3- or 4-portal transperitoneal technique. The dog was repositioned to contralateral recumbency, and laparoscopic adrenalectomy was repeated. Follow-up information was collected by telephone interviews with the owners and/or referring veterinarian. RESULTS: Median age and weight of dogs were 126 months and 14.75 kg, respectively. Contrast-enhanced CT (CECT) was performed in all dogs. Median maximal tumor diameter was 2.6 and 2.3 cm for the right and left-sided tumors, respectively. Median surgical and anesthesia times were 158 and 240 minutes, respectively. Conversion to open laparotomy was performed in 1 dog following renal vein laceration during initial adrenalectomy. Left adrenalectomy and ureteronephrectomy were performed, and the right adrenal tumor was left in situ. Cardiac arrest occurred in 1 dog following initial adrenalectomy (left); however, the dog was resuscitated successfully, and contralateral laparoscopic adrenalectomy was performed without complication. All dogs survived to hospital discharge. Follow-up ranged from 60 to 730 days (median, 264 days) for dogs that successfully underwent BSSLA. CLINICAL RELEVANCE: BSSLA was associated with favorable outcomes in this cohort of dogs. Laparoscopy may be considered in dogs with bilateral, modestly sized, noninvasive adrenal tumors.

Colic Surgery: Recent Updates.

The following article provides an overview of the last 5 years of research and innovation within the field of equine colic surgery, focusing on new techniques, new or recently described lesions, prevention of lesion recurrence or postoperative complications, and updates in prognoses. Early surgical intervention is an important factor in horse survival.

One-step laparoscopy-guided abomasopexy versus omentopexy via right flank laparotomy to treat left displaced abomasum in dairy cows, in relation to return of milk yield.

This study compared two surgical techniques for treating left displaced abomasum (LDA) in dairy cows. The two techniques were compared in terms of milk production at different time intervals: before surgery; on the day of the surgery; and at 8, 15 and 30 days after surgery. The surgical techniques used in this study were laparoscopy-guided abomasopexy and right flank laparotomy omentopexy. A total of 126 lactating Holstein-Friesian cows with LDA were included, 63 of which were treated with laparoscopy, and 63 with right flank laparotomy. Cows with retained foetal membranes, metritis or natural delivery (dystocia) were included and registered on field sheets for subsequent statistical analysis. Cows with clinical mastitis were excluded. A blood sample (5 mL) was obtained from the medial coccygeal vein and analyzed for total proteins, total bilirubin, total calcium, glucose, b-hydroxybutyrate, sodium, potassium, and chloride. No differences were found between the two groups of operated cows with respect to the number of lactation days, body condition score (BCS), rectal temperature, heart rate, and respiratory rate before surgery. No differences were observed between groups regarding the biochemical parameters (P > 0.05) analyzed, except for chloride, which presented lower average values in the omentopexy group (P <0.05). Return of milk yield within the study period did not differ significantly between the laparoscopy and laparotomy groups (P > 0.05), although a significant change in post-surgery time was observed. .

Preoperative protocol for right flank laparotomy affects postoperative serum cortisol concentrations in dairy cows.

OBJECTIVE: To evaluate analgesic efficacy of 3 different preoperative protocols in cows undergoing right flank laparotomy for displaced abomasum. ANIMALS: 40 cows diagnosed with displaced abomasum. PROCEDURES: The cows were assigned by block randomization to 1 of 3 preoperative protocols: inverted L-block using 50 mL of 2% lidocaine (ILB; n = 13), ILB plus preoperative flunixin meglumine (2 mg/kg, IV; ILB-F; 13), and dorsolumbar epidural anesthesia using 2% xylazine (0.8 mL) and 2% lidocaine (4 mL; EPI; 14). Venous blood samples were collected for CBC, serum biochemistry, and cortisol preoperatively and at 0 (immediately after), 3, 17, and 48 hours postoperatively. RESULTS: The mean (95% CI) of the serum cortisol in ILB, ILB-F, and EPI were 108.7 (66.7 to 150.7), 150.7 (116.4 to 185.0), and 139.8 (93.4 to 186.3), respectively. The serum cortisol concentrations decreased over time in all groups (ILB, P = .001; ILB-F and EPI, P < .001). In the ILB group, the cortisol concentration at 17 and 48 hours postoperatively decreased (P = .026 and P = .009, respectively), compared with that preoperatively. In the ILB-F and EPI groups, the preoperative cortisol concentration was the highest and then decreased at 0, 3, 17, and 48 hours postoperatively (ILB-F, 0 hours [P = .001] and 3, 17, and 48 hours [P < .001]; EPI, all [P < .001]). CLINICAL RELEVANCE: ILB-F and EPI improved intraoperative and immediate postoperative indicators of pain-related stress when compared to standard ILB. EPI requires less anesthetic, which may be beneficial when in short supply.

Development of a classification system for equine postoperative complications and its application in a cohort of 190 horses undergoing emergency laparotomy.

BACKGROUND: Accurate reporting of postoperative complications is paramount to understanding procedural outcomes, comparing procedures and assuring quality improvement. Standardising definitions of complications in equine surgeries will improve the evidence of their outcomes. To this end, we proposed a classification for postoperative complications and applied it to a cohort of 190 horses undergoing emergency laparotomy. METHODS: A classification system for postoperative complications in equine surgery was developed. Medical records of horses that underwent equine emergency laparotomy and recovered from anaesthesia were analysed. Reported complications pre-discharge were classified as per the new classification system, and the cost and days of hospitalisation were correlated with the equine postoperative complication score (EPOCS). RESULTS: Of the 190 horses that underwent emergency laparotomy, 14 (7.4%) did not survive to discharge (class 6 complications), and 47 (24.7%) did not develop complications. The remaining horses were classified as follows: 43 (22.6%) had class 1 complications, 30 (15.8%) had class 2, 42 (22%) had class 3, 11 (5.8%) had class 4; and three (1.5%) had class 5. The proposed classification system and EPOCS correlated with the cost and length of hospitalisation. LIMITATIONS: This was a single-centre study and the definition of scores was arbitrary. CONCLUSIONS: Reporting and grading all complications will help surgeons better understand the patients' postoperative course, thereby reducing subjective interpretation.

Laparoscopic or laparoscopic-assisted cystopexy for pelvic bladder in 3 dogs.

The techniques and clinical outcomes of laparoscopic or laparoscopic-assisted cystopexy in 3 dogs diagnosed with pelvic bladder are reported herein. The medical records of 2 dogs with pelvic bladder which underwent laparoscopic cystopexy, and 1 dog which underwent laparoscopic-assisted cystopexy were reviewed. Data retrieved included signalment, clinical signs, diagnostic imaging, surgical technique, and clinical outcome. Long-term follow-up was obtained by verbal interviews with owners. Laparoscopic or laparoscopic-assisted cystopexy was successfully performed to reposition the urinary bladder within the abdominal cavity in all dogs. An intracorporeal suture technique was used in 2 dogs, whereas an extracorpreal technique was used in 1 dog. Two dogs with stranguria experienced complete resolution immediately following surgery and remained disease-free at 18 mo after cystopexy. A third dog with urinary incontinence subjectively improved (according to the owner) but had not resolved completely 2 d following surgery. Key clinical message: Laparoscopic or laparoscopic-assisted cystopexy may be an effective treatment for pelvic bladder in dogs and may offer a minimally invasive alternative to laparotomy. Male dogs with stranguria as the primary clinical sign may experience complete resolution following cystopexy.

Cystopexie laparoscopique ou assistée par laparoscopie pour une vessie pelvienne chez trois c hiens. Les techniques et les résultats cliniques de la cystopexie laparoscopique ou assistée par laparoscopie chez trois chiens diagnostiqués avec une vessie pelvienne sont rapportés ici.Les dossiers médicaux de deux chiens ayant une vessie pelvienne ayant subi une cystopexie laparoscopique et d'un chien ayant subi une cystopexie assistée par laparoscopie ont été examinés. Les données récupérées comprenaient le signalement, les signes cliniques, l'imagerie diagnostique, la technique chirurgicale et les résultats cliniques. Le suivi à long terme a été obtenu par des entrevues verbales avec les propriétaires.La cystopexie laparoscopique ou assistée par laparoscopie a été réalisée avec succès pour repositionner la vessie dans la cavité abdominale chez tous les chiens. Une technique de suture intracorporelle a été utilisée chez deux chiens, tandis qu'une technique extracorporelle a été utilisée chez un chien. Deux chiens atteints de strangurie ont connu une résolution complète immédiatement après la chirurgie et sont restés sans maladie à 18 mois après la cystopexie. Un troisième chien souffrant d'incontinence urinaire s'est amélioré subjectivement (selon le propriétaire) mais celle-ci n'a pas complètement disparu 2 jours après la chirurgie.Message clinique clé :La cystopexie laparoscopique ou assistée par laparoscopie peut être un traitement efficace pour une vessie pelvienne chez le chien et peut offrir une alternative peu invasive à la laparotomie. Les chiens mâles atteints de strangurie comme signe clinique principal peuvent connaître une résolution complète après la cystopexie.(Traduit par Dr Serge Messier).

Benefits of cyanoacrylate mesh closure following exploratory laparotomy in horses.

BACKGROUND: Skin closure of laparotomy incisions using topical 2-octyl cyanoacrylate (2-OCA) mesh provides a secure bactericidal barrier in humans, which may reduce the risk of postoperative incisional complications. However, the benefits of using this mesh have not been objectively assessed in horses. METHODS: From 2009 to 2020, three methods of skin closure were used following laparotomy for acute colic, including metallic staples (MS), suture (ST) and cyanoacrylate mesh (DP). The closure method was not randomised. Owners were contacted 3 months or more after the surgery to record any postoperative complications that occurred. For each method of closure, the rates of surgical site infection (SSI) and herniation were recorded, as well as surgical time and treatment costs, including those for incisional complications. Chi-square testing and logistic regression modelling were used to assess differences between the groups. RESULTS: A total of 110 horses were recruited (45 in the DP group, 49 in the MS group and 16 in the ST group) The overall rate of SSI was 15.5%, with rates of 8.9%, 18.4% and 25% for the DP, MS and ST groups, respectively (p = 0.23). In addition, incisional hernias developed in 21.8% of cases, with 8.9%, 34.7% and 18.8% of horses in the DP, MS and ST groups, respectively, being affected (p = 0.009). The median total treatment cost did not differ significantly between groups (p = 0.47). LIMITATION: This was a retrospective study with non-randomised choice of closure method. CONCLUSIONS: No significant differences in the rate of SSI or overall cost wwere demonstrated between treatment groups. However, MS was associated with a higher rate of hernia formation than DP or ST. Despite increased capital cost, 2-OCA proved to be a safe skin closure method in horses and was no more expensive than DP or ST by the time visits to remove sutures/staples and treat infections were factored in.

Persistent mullerian duct syndrome in a dog.

INTRODUCTION: This case report describes a 14-year-old, male castrated York Shire Terrier, which was presented due to stranguria and tenesmus. An abdominal computed tomography (CT) scan raised a high suspicion of a persistent mullerian duct. During laparotomy structures were found that were suspected to be a persistent ovary and uterus. The abnormal uterus was filled with fluid and had a blind end on both sides. The abnormal structures were surgically removed and pathologically examined. Pathology confirmed a persistent mullerian duct. The patient recovered well from the surgery and was able to urinate spontaneously the same day and was discharged the next day.

INTRODUCTION: Ce rapport de cas décrit un York Shire Terrier mâle castré de 14 ans, qui a été présenté en raison d'une strangurie et d'un ténesme. Une tomodensitométrie (TDM) abdominale a soulevé une forte suspicion d'un canal de Müller persistant. Une laparotomie a été pratiquée, au cours de laquelle on a découvert des structures suspectées d'être un ovaire et un utérus persistants. L'utérus anormal était rempli de liquide et avait une extrémité aveugle des deux côtés. Les structures anormales ont été retirées chirurgicalement et ont fait l'objet d'un examen pathologique. La pathologie a confirmé la présence d'un canal de Müller persistant. Le patient s'est bien remis de l'opération et a pu uriner spontanément le jour même. Il a été autorisée à sortir le lendemain.

Postoperative sinusitis and pneumonia following exploratory celiotomy for treatment of colic in horses.

Sinusitis and pneumonia following exploratory celiotomy in horses were studied, evaluating associations between these 2 respiratory complications and selected pre-, peri-, and post-operative variables. The incidence of sinusitis was 2.5% (8/318) and pneumonia 3.5% (11/318). These respiratory complications were associated with peri-operative reflux, longer antimicrobial treatment, and longer hospitalization.

Sinusite et pneumonie postopératoires suite á une coeliotomie exploratoire pour le traitement des coliques chez le cheval. La sinusite et la pneumonie consécutives á une coeliotomie exploratoire chez le cheval ont été étudiées, afin d'évaluer les associations entre ces deux complications respiratoires et certaines variables pré-, péri- et postopératoires. L'incidence des sinusites était de 2,5 % (8/318) et des pneumonies de 3,5 % (11/318). Ces complications respiratoires étaient associées á un reflux périopératoire, á un traitement antimicrobien plus long et á une hospitalisation plus longue.(Traduit par Dr Serge Messier).

Outcome following emergency laparotomy in 33 UK donkeys: A retrospective multicentre study.

BACKGROUND: Emergency laparotomies in donkeys are infrequently performed and there is limited literature on the subject. OBJECTIVES: To determine findings and associated outcomes of exploratory laparotomies in donkeys. STUDY DESIGN: Descriptive retrospective study. METHODS: Donkeys undergoing emergency exploratory laparotomy for investigation and treatment of colic at seven UK referral hospitals between 2005-2017 were included. Data were retrieved from available hospital records. Descriptive statistics and inferential statistical analysis of outcomes of interest was performed in three steps. RESULTS: Thirty-three cases fulfilled the inclusion criteria. Clinical signs on presentation were available for 32 donkeys, of which 53.1% (17/32) presented for investigation of colic while in 46.9% (15/32) the presenting complaint was non-specific. Primary lesion location included small intestine (42.4%, 14/33), large colon (39.3%, 13/33), caecum (6.1%, 2/33), stomach (6.1%, 2/33) and 6.1% (2/33) had multiple abnormal findings without a clear primary lesion. Overall survival to discharge was 54.5% (18/33). Five donkeys (15.2%, 5/33) were euthanased at surgery and of those recovering from general anaesthesia a further 35.7% (10/28) were euthanased or died prior to discharge. Six donkeys (21.4%, 6/28) required a second laparotomy of which 4 (66.7%, 4/6) survived. Post-operative complications occurred in 82.1% (23/28) of cases and included hyperlipaemia (42.9%, 12/28), incisional complications (21.4%, 6/28), ileus (21.4%, 6/28) and persistent colic (17.9%, 5/28). When adjusted for other complications, donkeys with primary gastric lesions were less likely to have presented with severe colic compared with those with primary small intestinal lesions (OR: 0.07, 95% CI 0.01-0.95, p = 0.05). Only age was positively associated with death prior to discharge (OR: 1.18, 95% CI 1.03-1.36, p = 0.02). MAIN LIMITATIONS: Small sample size and retrospective design. CONCLUSION: Donkeys with abdominal lesions may present with a range of signs often not including colic. Surgical findings were diverse and survival to discharge appears to be lower than in horses.

Surgical removal of intestinal foreign bodies using a laparotomy-assisted endoscopic approach in dogs and cats and comparison with enterotomy.

OBJECTIVES: To describe a novel surgical technique for intestinal foreign body removal without enterotomy using a laparotomy-assisted endoscopic approach and compare short-term outcomes to enterotomy. MATERIALS AND METHODS: Medical records of dogs and cats with intestinal foreign bodies that underwent attempted treatment with a laparotomy-assisted endoscopic approach between June 2019 and July 2021 were extracted. The approach consisted in manoeuvring the intestinal foreign body into the stomach during laparotomy and then removing it via a gastroscopy. If the foreign body was unmovable, an enterotomy was performed. RESULTS: Fifty-eight cases were enrolled and foreign bodies were successfully removed in 25 cases using a laparotomy-assisted endoscopic approach. The median distance between the pylorus and the proximal part of the foreign body was 55 cm (range: 0 to 300). The mean surgical time and median endoscopic time were 49 minutes (±sd 12.8) and 5 minutes (range: 2 to 28), respectively. All but two cases were discharged 1 day postoperatively. In 20 cases, the foreign body was not easily movable, and an enterotomy was performed. In three of these cases, conversion to enterotomy was required due to serosal tears that occurred as a consequence of the attempted retrograde manipulation of the foreign body. Foreign body width, length and distance to pylorus were not significantly different between the two techniques. Mean surgical time was significantly shorter for laparotomy-assisted endoscopic approach compared to enterotomy: 49 minutes (±SD 12.8) versus 61.7 minutes (±SD 14.6). CLINICAL SIGNIFICANCE: Surgical removal of intestinal foreign bodies through a laparotomy-assisted endoscopic approach is a feasible technique that offers satisfactory outcomes and shorter surgical time than enterotomy. Retrograde manipulation of the intestinal foreign body may result in serosal tears.

Factors that influence owner consent for exploratory laparotomy in horses with colic in Australia and New Zealand.

BACKGROUND: Horse owners' motivators and barriers for consent to exploratory laparotomy are poorly understood. OBJECTIVES: To (1) determine the proportion of Australian and New Zealand horse owners who would consent to exploratory laparotomy and (2) identify motivators and barriers for consent. STUDY DESIGN: Cross-sectional survey. METHODS: A questionnaire was developed and distributed online. Descriptive statistics were calculated by tabulating respondents by their answers to whether they would consent to exploratory laparotomy. Univariate and multivariate analyses were used to identify variables associated with consenting to exploratory laparotomy. RESULTS: Two thousand two hundred horse owners participated with a 68.3% survey completion rate. Most were female (95.6%), and 18.7% stated they would consent to exploratory laparotomy, 55.2% would consider exploratory laparotomy and 26.1% would not consent to exploratory laparotomy being performed on their horse. Geographical location, intended use of the horse and perceptions regarding the cost and prognosis of exploratory laparotomy, as well as the previous experience of respondents significantly impacted the decision. Self-reported level of financial comfort, gender of respondents, number of horses owned and pre-existing relationship with nearest equine referral clinic did not impact the decision. Top motivators for exploratory laparotomy were high probability of survival, trust in hospital, emotional value of horse and the alternative being euthanasia. Top barriers for exploratory laparotomy were financial cost, uncertain outcome, welfare concern and age of the horse. MAIN LIMITATIONS: Self-selection bias and acquiescence in responses. CONCLUSIONS: Most respondents indicated that they would consider or consent to exploratory laparotomy. Several factors for owners to decide for exploratory laparotomy could be identified. Improved owner education regarding the positively reported survival rates for exploratory laparotomy would be beneficial.

INTRODUCTION/CONTEXTE: Les motivateurs et les obstacles derrières la décision des propriétaires d'autoriser ou pas une laparotomie exploratrice (LE) sur leurs chevaux demeurent mal compris. OBJECTIFS: (1) Déterminer la proportion des propriétaires de chevaux en Australie et Nouvelle-Zélande qui consentiraient à une LE et (2) identifier les motivateurs et obstacles contribuant à leur consentement. TYPE D'ÉTUDE: Étude transversale. MÉTHODES: Un questionnaire a été développé et distribué en ligne. Des statistiques descriptives ont été calculées en classifiant les répondants selon s'ils consentiraient ou non à une LE. Des analyses uni et multivariées ont été utilisées pour identifier les variables associées au consentement à la LE. RÉSULTATS: Deux milles deux cents propriétaires de chevaux ont participé et le taux de remplissage du sondage était de 68.3%. La majorité étaient des femmes (95.6%) et 18.7% donneraient leur consentement pour une LE, 55.2% considéraient une LE et 26.1% ne consentiraient pas à une LE pour leur cheval. La localisation géographique, la discipline du cheval et les perceptions relativement aux coûts et au pronostic pour une LE, de même que leurs expériences précédentes influenceraient la décision des participants de façon significative. La situation monétaire des participants (rapportés de leur plein gré), leur genre, le nombre de chevaux dont ils sont propriétaires et une relation pré-existante avec une clinique de référence à proximité n'influenceraient pas leur décision. Les motivateurs les plus importants pour le consentement à la LE étaient une chance de survie élevée, leur confiance envers le centre de référence, la valeur émotionnelle du cheval et les alternatives possibles à l'euthanasie. Les obstacles les plus flagrants étaient les coûts, une chance de survie incertaine, des préoccupations par rapport au bien-être du cheval et son âge. LIMITES PRINCIPALES: Biais de sélection et degré d'accord des réponses. CONCLUSIONS: La plupart des répondants consentiraient ou au moins considéraient une LE. Plusieurs facteurs influençant la décision des propriétaires ont pu être identifiés. Il est impératif pour les vétérinariares traitants d'éduquer les clients en ce qui concerne les taux de survie plus positifs suivant les laparotomies exploratrices.