Accuracy, precision, and interobserver and intraobserver agreements related to pressure-measurement devices.

OBJECTIVE: To evaluate the accuracy, precision, and observer agreement of three pressure measurement devices. STUDY DESIGN: In vitro model study. SAMPLE POPULATION: Water manometer with built-in gauge (WMg), arterial pressure transducer (APT), and Compass CT (CCT). METHODS: The model was set to five predetermined pressures (4, 8, 13, 17, and 24 cm H2 O) using a water manometer with a ruler (WMr) as the gold standard. Each device was tested at each pressure in a randomized order by three investigators. Bland-Altman plots were used to assess agreement between devices. Intraclass correlation coefficients (ICC) were calculated for interobserver and intraobserver agreements. RESULTS: The mean differences (cm H2 O) ± SEM in comparison with the set pressure were -0.020 ± 0.010 (WMg), -0.390 ± 0.077 (APT), and -1.267 ± 0.213 (CCT). Pressures measured by WMg did not differ from those measured by WMr. Pressures measured by all devices did not differ from each other (p > .062 for all comparisons). Interobserver agreement was excellent (1.000), and intraobserver agreement was excellent (0.985, 0.990, 0.998 for each observer). CONCLUSION: Compared to the WMr, the WMg was the most accurate and precise, followed by the APT; the CCT was the least accurate and precise. Interobserver and intraobserver agreements for all three devices were excellent. CLINICAL SIGNIFICANCE: The largest mean difference of all devices was within 1.3 cm H2 O of the set pressure, indicating possible clinical utility of any of the devices. However, WMr or WMg should be considered first due to their high precision and accuracy.

Outcome in 38 dogs surgically treated for hepatic abscessation.

OBJECTIVE: To report outcomes following surgical treatment of hepatic abscessation in dogs. STUDY DESIGN: Retrospective. ANIMALS: Thirty-eight dogs. METHODS: Records from 6 institutions were evaluated for dogs undergoing surgical treatment for hepatic abscessation between 2010 and 2020. Signalment, clinical signs, medical therapy, surgical treatment, and postoperative outcome was obtained from medical records. Long-term outcome was recorded when possible. Median survival time was assessed using the Kaplan-Meier product-limit method. RESULTS: Peritoneal effusion was documented in 32/38 dogs preoperatively, with septic peritonitis confirmed in 21/23 samples. Liver lobectomy was the most common surgery (27 dogs). A single organism was cultured in 24/35 dogs, most commonly Escherichia coli. Hepatic neoplasia was identified in 11/36 dogs. Dogs were hospitalized for a median of 5 days (range, 3-17) with complications recorded in 21 dogs (regurgitation, aspiration pneumonia, and pancreatitis most commonly). Two dogs died intraoperatively, and 6 dogs died prior to discharge. Median survival time for dogs surviving to discharge was 638 days. Of these, 19 were lost to follow up a median of 301 (range, 3-1418) days postoperatively and 11 died a median of 291 (range, 7-1292) days postoperatively. No abscess recurrence was noted. CONCLUSION: Septic peritonitis was a common sequela to hepatic abscessation. Perioperative complications were recorded in approximately one-third of dogs. In dogs surviving the postoperative period, long-term prognosis was good. CLINICAL SIGNIFICANCE: Dogs treated surgically for hepatic abscessation have a high risk of perioperative complications but favorable long-term prognosis and apparent low risk of recurrence.

Outcomes and clinical features associated with surgically excised canine salivary gland carcinoma: A multi-institutional, retrospective, Veterinary Society of Surgical Oncology study.

OBJECTIVE: The objective of this study was to describe the clinical features, prognostic factors, and outcomes in dogs with surgically treated salivary gland carcinoma. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Seventy-two client-owned dogs from 16 institutions with surgically excised salivary gland carcinoma. METHODS: Medical records of dogs undergoing sialoadenectomy from January 1, 2000 to January 1, 2020 were reviewed for signalment, clinical signs, preoperative staging results, preoperative mass evaluation, complications, histopathologic diagnosis, local recurrence, metastatic disease, and survival times. Survival functions were estimated using the Kaplan-Meier estimator. Factors related to survival were individually tested using the log-rank test. RESULTS: The overall median survival time (MST) associated with salivary carcinoma was 1886 days. Local recurrence occurred in 29/69 (42%) dogs with an overall disease-free interval (DFI) of 191 days. Metastatic disease occurred in 22/69 (31.9%) dogs, with an overall DFI of 299 days. Lymph node metastasis was present at the time of surgery in 11/38 (28.9%) dogs in which lymphadenectomy was performed at the time of surgery; these dogs had a shorter DFI at 98 days (P = .03) and MST at 248 days (P < .001). CONCLUSION: The prognosis for dogs with salivary gland carcinoma treated surgically was more favorable than previously reported. Nodal metastasis was a negative prognostic factor for canine salivary gland carcinoma. CLINICAL SIGNIFICANCE: Surgical intervention should be considered for dogs with salivary carcinoma.

Clinical Utility of Cytology from Preoperative Percutaneous Fine Needle Aspirates of Solitary Liver Masses in 220 Dogs: A Retrospective Study (2009-2019).

When a solitary liver mass is identified in a dog, a fine-needle aspirate (FNA) is commonly employed to attempt to obtain a diagnosis. Little information is provided in the literature evaluating the sensitivity/specificity of FNA cytology for solitary liver masses. We hypothesized that liver lesion size nor the presence of cavitation would impact the success of cytological diagnosis. Medical records were obtained for 220 client-owned dogs. Inclusion criteria included preoperative abdominal imaging, percutaneous FNA of a solitary hepatic mass with cytologic interpretation by a board-certified pathologist, and a surgical biopsy or mass excision yielding a histopathological diagnosis. Six dogs (2.7%) experienced a complication after FNA, none considered severe. The agreement rate for correct cytologic diagnosis was 22.9% (49/220). Of the neoplastic masses 18.9% (35/185) were correctly diagnosed via cytology. The overall sensitivity was 60%, and the specificity was 68.6%. Neither institution (P = 0.16), lesion size (P = 0.88), cavitation (P = 0.34), or needle gauge (P = 0.20) had an association with correct diagnosis. This study demonstrates that, although there is a low risk of complications following FNA of a hepatic mass, overall success rate for correct cytologic diagnosis based on FNA was low compared to histopathologic diagnosis.

Scar revision for incompletely or narrowly excised soft tissue sarcomas in dogs.

Objective: Describe clinical features of dogs undergoing scar revision for incompletely or narrowly excised soft tissue sarcomas (STSs) in the absence of gross disease and to determine local recurrence rates following scar revision. Animals: Thirty-three dogs with 33 scars. Procedures: Medical records were reviewed to collect data on signalment, tumor details, pre-surgical diagnostic tests, surgical and pathologic findings for both the initial and revision surgeries, and clinical outcomes. Descriptive statistics were generated. Results: For the initial excision, cytology was performed before surgery in 45.5% (15/33) of dogs, and information on surgical margins was rarely reported [4.0% (1/25) of circumferential and 12.0% (3/25) of deep margins]. Microscopic evidence of residual STS was identified in 18.2% of scars. Recurrence occurred in 3.0% (1/33) of dogs [median follow-up of 1127 d (1 to 3192 d)]; this dog had had no evidence of residual tumor in the scar revision pathology. Conclusions: Despite the low identification rate of residual tumor, the local tumor recurrence rate was 3.0%, which is lower than what is historically reported for incompletely or narrowly excised STSs. Clinical relevance: Scar revision for incompletely or narrowly excised STSs resulted in durable tumor remission in the dogs of this study. Pre-surgical diagnostic tests were not often performed in this study; these may be considered before the first excision to plan surgical margins for potentially reducing the incidence of incomplete or narrow excision. Surgical reports should include details on circumferential and deep margins to guide pathologic interpretation and future scar revision, if required.

Révision des cicatrice pour les sarcomes des tissus mous incomplètement ou étroitement excisés chez le chien. Objectif: Décrire les caractéristiques cliniques des chiens subissant une révision de cicatrice pour des sarcomes des tissus mous (STSs) incomplètement ou étroitement excisés en l'absence de maladie macroscopique et pour déterminer les taux de récidive locale après la révision de cicatrice. Animaux: Trente-trois chiens avec 33 cicatrices. Procédures: Les dossiers médicaux ont été examinés pour recueillir des données sur le signalement, les détails de la tumeur, les tests de diagnostic pré-chirurgicaux, les résultats chirurgicaux et pathologiques pour les chirurgies initiales et de révision, et les résultats cliniques. Des statistiques descriptives ont été générées. Résultats: Pour l'excision initiale, une cytologie a été réalisée avant la chirurgie chez 45,5 % (15/33) des chiens, et les informations sur les marges chirurgicales ont été rarement rapportées [4,0 % (1/25) des marges circonférentielles et 12,0 % (3/25) des marges profondes]. Des preuves microscopiques de STS résiduel ont été identifiées dans 18,2 % des cicatrices. Une récidive est survenue chez 3,0 % (1/33) des chiens [suivi médian de 1127 jours (1 à 3192 jours)]; ce chien n'avait eu aucun signe de tumeur résiduelle dans la pathologie de révision de la cicatrice. Conclusions: Malgré le faible taux d'identification de tumeur résiduelle, le taux de récidive tumorale locale était de 3,0 %, ce qui est inférieur à ce qui est historiquement rapporté pour les STS incomplètement ou étroitement excisés. Pertinence clinique: La révision des cicatrices pour les STS incomplètement ou étroitement excisés a entraîné une rémission tumorale durable chez les chiens de cette étude. Les tests diagnostiques pré-chirurgicaux n'ont pas souvent été effectués dans cette étude; ceux-ci peuvent être envisagés avant la première excision pour planifier les marges chirurgicales afin de réduire potentiellement l'incidence de l'excision incomplète ou étroite. Les rapports chirurgicaux doivent inclure des détails sur les marges circonférentielles et profondes pour guider l'interprétation pathologique et la révision future de la cicatrice, si nécessaire.(Traduit par Dr Serge Messier).

Scar revision for incompletely or narrowly excised cutaneous mast cell tumors in dogs.

Objective: Describe clinical features and outcomes of dogs undergoing scar revision for incompletely or narrowly excised cutaneous mast cell tumors without gross disease. Animals: 52 dogs undergoing 54 scar revisions. Procedures: Retrospective record review with information collected on signalment, tumor type/location, pre-surgical diagnostics, surgical and pathologic findings for the first excision and scar revision surgeries, and follow-up. Descriptive statistics were generated. Results: Prior to initial excision, cytology was performed on 38.9% (21/54) of tumors and the initial surgery report rarely described surgical resection margins [14.6% (7/48) of surgeries]. Residual tumor was identified pathologically in 29.6% (16/54) of scars. Local recurrence following scar revision occurred in 3.7% (2/54) of all scars [median follow-up 881.5 d (range: 0 to 3317 d)]; both scars had either complete excision of residual mast cell tumor or no evidence of mast cell tumor on scar revision and neither dog received radiation therapy. Conclusions: Identification of residual disease was uncommon, and local recurrence was less common than previously reported for incomplete/narrow mast cell tumor excision. Clinical relevance: Scar revision of unplanned primary excisions appears to yield a high likelihood of durable tumor remission in patients. First opinion practitioners are encouraged to avoid unplanned excisions by informing the surgical plan with cytology of the primary tumor and detailing surgical margin excision which may facilitate revision, if necessary.

Révision des cicatrices pour des mastocytes cutanés incomplètement ou étroitement excisés chez le chien. Objectif: Décrire les caractéristiques cliniques et les résultats des chiens subissant une révision de cicatrice pour des tumeurs mastocytaires incomplètement ou étroitement excisées sans maladie grave. Animaux: Cinquante-deux chiens soumis à 54 révisions de cicatrice. Procédures: Examen rétrospectif des dossiers avec des informations recueillies sur le signalement, le type/l'emplacement de la tumeur, les diagnostics pré-chirurgicaux, les résultats chirurgicaux et pathologiques pour les premières chirurgies d'excision et de révision de cicatrice, et le suivi. Des statistiques descriptives ont été générées. Résultats: Avant l'excision initiale, une cytologie a été réalisée sur 38,9 % (21/54) des tumeurs et le rapport chirurgical initial décrivait rarement les marges de résection chirurgicale [14,6 % (7/48) des chirurgies]. Une tumeur résiduelle a été identifiée pathologiquement dans 29,6 % (16/54) des cicatrices. Une récidive locale après révision des cicatrices s'est produite dans 3,7 % (2/54) de toutes les cicatrices [suivi médian de 881,5 jours (intervalle : 0 à 3317 jours)] les deux cicatrices présentaient soit une excision complète du tumeur mastocytaire résiduel, soit aucun signe de tumeur mastocytaire lors de la révision de la cicatrice et aucun chien n'a reçu de radiothérapie. Conclusions: L'identification de la maladie résiduelle était rare et la récidive locale était moins fréquente que précédemment rapportée pour l'excision incomplète/étroite du tumeur mastocytaire. Pertinence clinique: La révision de la cicatrice des excisions primaires non planifiées semble donner une forte probabilité de rémission tumorale durable chez les patients. Les praticiens de première opinion sont encouragés à éviter les excisions non planifiées en informant le plan chirurgical avec la cytologie de la tumeur primaire et en détaillant les marges de l'excision chirurgicale ce qui peut faciliter la révision, si nécessaire.(Traduit par Dr Serge Messier).

Staphylectomy in nonbrachycephalic dogs: A retrospective study of 27 cases.

Objective: To report the outcomes and complications associated with staphylectomy in nonbrachycephalic dogs. Animal: Twenty-seven nonbrachycephalic dogs with elongated soft palates and undergoing staphylectomy. Procedure: Retrospective study. Results: Increased upper airway noise (70.4%) and dyspnea (44.4%) were the most common presenting clinical signs. Concurrent upper airway abnormalities found in the study population included laryngeal collapse (25.9%) and laryngeal paralysis (14.8%). The most common staphylectomy technique used in this study was sharp excision (66.7%) with sutured oral and nasal mucosal apposition. The dogs in this study had an overall minor postoperative complication rate of 33.3%, with regurgitation/vomiting (11.1%) and coughing (11.1%) occurring most commonly. No dog required supplemental oxygen therapy or temporary tracheostomy. Conclusion: Staphylectomy was well-tolerated in nonbrachycephalic dogs and was associated with a relatively low rate of complications. Concurrent airway abnormalities were common among nonbrachycephalic dogs with elongated soft palates, similar to brachycephalic dogs. Clinical relevance: Clinicians should be aware that elongated soft palate can occur in nonbrachycephalic dogs, and surgical correction can be achieved with rare major or catastrophic complications.

Staphylectomie chez des chiens non-brachycéphales : une étude rétrospective de 27 cas. Objectif: Rapporter les résultats et les complications associés à la staphylectomie chez des chiens non-brachycéphales. Animal: Vingt-sept chiens non-brachycéphales au palais mou allongé et subissant une staphylectomie. Procédure: Étude rétrospective. Résultats: L'augmentation du bruit des voies respiratoires supérieures (70,4 %) et la dyspnée (44,4 %) étaient les signes cliniques les plus fréquents. Les anomalies concomitantes des voies respiratoires supérieures trouvées dans la population étudiée comprenaient un collapsus laryngé (25,9 %) et une paralysie laryngée (14,8 %). La technique de staphylectomie la plus couramment utilisée dans cette étude était l'exérèse fine (66,7 %) avec apposition suturée des muqueuses buccale et nasale. Les chiens de cette étude présentaient un taux global de complications postopératoires mineures de 33,3 %, les régurgitations/vomissements (11,1 %) et la toux (11,1 %) étant les plus fréquents. Aucun chien n'a eu besoin d'une oxygénothérapie supplémentaire ou d'une trachéotomie temporaire. Conclusion: La staphylectomie a été bien tolérée chez les chiens non-brachycéphales et a été associée à un taux relativement faible de complications. Les anomalies concomitantes des voies respiratoires étaient courantes chez les chiens nonbrachycéphales avec des palais mous allongés, semblables aux chiens brachycéphales. Pertinence clinique: Les cliniciens doivent être conscients qu'un palais mou allongé peut survenir chez les chiens non-brachycéphales et qu'une correction chirurgicale peut être obtenue avec de rares complications majeures ou catastrophiques.(Traduit par Dr Serge Messier).

Perioperative characteristics, histologic diagnosis, complications, and outcomes of dogs undergoing percutaneous drainage, sclerotherapy or surgical management of intrarenal cystic lesions: 18 dogs (2004-2021).

BACKGROUND: Canine intrarenal cystic lesions (ICLs) are infrequently reported in the veterinary literature. Several treatment options have been described including cyst fenestration (partial nephrectomy/deroofing) +/- omentalization, sclerotherapy using alcohol as a sclerosing agent, percutaneous cyst drainage (PCD), and ureteronephrectomy. Information regarding presenting clinical signs, physical examination findings, histologic diagnosis and outcomes of dogs with ICLs treated by different methods is limited. Medical records of 11 institutions were retrospectively reviewed to identify dogs that underwent PCD, sclerotherapy, surgical deroofing +/- omentalization, or ureteronephrectomy for management of ICLs from 2004 to 2021. Six weeks postoperative/post-procedural follow-up was required. Cases suspected to represent malignancy on preoperative imaging were excluded. The study objective was to provide information regarding perioperative characteristics, complications, and outcomes of dogs undergoing treatment of ICLs. RESULTS: Eighteen dogs were included, with 24 ICLs treated. Ten had bilateral. There were 15 males and 3 females, with crossbreeds predominating. PCD, sclerotherapy, deroofing and ureteronephrectomy were performed in 5 (5 ICLs treated), 7 (11 ICLs), 6 (6), and 7 (7) dogs, respectively, with 5 dogs undergoing > 1 treatment. Seven dogs experienced 8 complications, with requirement for additional intervention commonest. PCD, sclerotherapy and deroofing resulted in ICL resolution in 0/5, 3/11 and 3/6 treated ICLs, respectively. Histopathology identified renal cysts (RCs) in 7/13 dogs with histopathology available and neoplasia in 6/13 (4 malignant, 2 benign). Of 5 dogs diagnosed histopathologically with neoplasia, cytology of cystic fluid failed to identify neoplastic cells. Among 7 dogs with histologically confirmed RCs, 4 had concurrent ICLs in ipsilateral/contralateral kidney, compared with 2/6 dogs with histologically confirmed neoplasia. CONCLUSIONS: Benign and neoplastic ICLs were approximately equally common and cystic fluid cytology failed to differentiate the 2. Among renal-sparing treatments, deroofing most commonly resulted in ICL resolution. Presence of concurrent ICLs in ipsilateral/contralateral kidney does not appear reliable in differentiating benign from malignant ICLs.

Surgical ligation of patent ductus arteriosus in dogs: Incidence and risk factors for rupture.

OBJECTIVE: To determine the rates of rupture and mortality associated with surgical ligation of patent ductus arteriosus (PDA) in dogs and to identify risk factors for rupture. STUDY DESIGN: Retrospective cohort. ANIMALS: Two-hundred and eighty-five dogs with PDA undergoing surgical ligation. METHODS: Information regarding signalment, weight, surgical findings, complications, presence of residual flow, and survival was recorded. Age, weight, and presence of residual flow were compared between cases with and without rupture. RESULTS: The initial surgical approach was extrapericardial (144), intrapericardial (46), not reported (94), or Jackson-Henderson (1). Rupture of the PDA occurred in 7.0% of dogs (20/285, 13 extrapericardial, 3 intrapericardial, 4 not reported). No difference in age or weight was found between dogs with and without rupture. Overall mortality was 0.4% (1/285). Additional major complications occurred in 1.4% of dogs, all in the nonrupture group. The overall rate of residual flow after ligation was 9.4%. Dogs with rupture were more likely to have residual flow than those without rupture (P = .012). If ligation was performed after rupture (rather than hemostasis only), no difference in residual flow rates (P = .398) was noted between dogs with rupture and those without. CONCLUSION: The rate of rupture with surgical ligation of PDAs was low. No specific risk factors for rupture were identified. CLINICAL SIGNIFICANCE: Successful treatment of PDA rupture is possible, evidenced by the low mortality rate in this population of dogs. Ligation of the PDA after rupture, either in the concurrent or a subsequent procedure, reduces the odds of residual flow.

Short- and long-term survival after adrenalectomy in 53 dogs with pheochromocytomas with or without alpha-blocker therapy.

OBJECTIVE: To report data related to the short- and long-term survival of dogs undergoing adrenalectomy for pheochromocytoma, and to determine the influence of preoperative alpha-blocker therapy. STUDY DESIGN: Retrospective. ANIMALS: Fifty-three dogs. METHODS: Medical records were reviewed for dogs diagnosed with pheochromocytoma and treated with adrenalectomy between 2010 and 2020. Preoperative management, imaging studies, intraoperative cardiovascular instability, complications, and procedural information were recorded. When applicable, duration of survival and cause of death, time to recurrence or metastasis, and postoperative complications were recorded. RESULTS: During anesthesia, a hypertensive episode was documented in 46/53 dogs and arrhythmias were recorded in 16/53 dogs. Of these, 37/46 hypertensive dogs and 11/16 dogs with arrhythmias were treated with an alpha-blocker before surgery. Intraoperative systolic blood pressures reached higher levels by a magnitude of nearly 20% in dogs that were treated preoperatively with an alpha-blocker (P = .01). All dogs survived surgery and 44 survived to discharge. Follow up ranged from 6 to 1653 days (median 450 days). Median survival time for dogs discharged from the hospital was 1169 days (3.2 years). Recurrence and metastasis were suspected in 3 and 8 dogs, respectively. CONCLUSION: Most dogs survived the immediate postoperative period and achieved long-term survival with a low reported incidence of tumor recurrence or metastasis. Preoperative alpha-blocker therapy was not associated with increased survival. CLINICAL SIGNIFICANCE: The favorable outcomes reported in this study should be taken into consideration when discussing treatment options for dogs with pheochromocytomas. This study provides no evidence to support preoperative alpha-blocker therapy.

Incidence of and risk factors for surgical site infection following canine limb amputation.

OBJECTIVE: To determine the incidence of and risk factors for surgical site infection (SSI) following canine thoracic and pelvic limb amputations. STUDY DESIGN: Retrospective, multicenter study. ANIMALS: Dogs (n = 248). METHODS: Medical records were reviewed for preoperative, intraoperative, and postoperative variables including indication for amputation, amputation type, method of muscle transection, duration of surgery and anesthesia, and wound classification. Follow up was ≥30 days or until SSI development. Logistic regression and Fisher's exact tests were used to compare SSI incidence to variables of interest. RESULTS: The incidence of SSI was 12.5% for all procedures and 10.9% for clean procedures. Factors increasing odds of SSI were muscle transection with a bipolar vessel sealing device (P = .023 for all procedures, P = .025 for clean procedures), procedure classified as other than clean (P = .003), and indication for amputation of bacterial infection (P = .041) or traumatic injury (P = .003) compared to neoplasia. CONCLUSION: Use of bipolar vessel sealing devices for muscle transection increased the odds of developing an SSI whereas use of electrosurgery and/or sharp transection did not. Dogs with surgical sites that were other than clean, or with bacterial infection and/or traumatic injury were also at increased odds of SSI. CLINICAL SIGNIFICANCE: Use of electrosurgery or sharp transection for muscle transection should be considered rather than use of bipolar vessel sealing devices to decrease odds of SSI in dogs undergoing limb amputation. Further studies across a variety of procedures are needed to validate these findings given the increasing popularity of these devices in veterinary medicine.

Risk factors for neonatal mortality prior to hospital discharge in brachycephalic and nonbrachycephalic dogs undergoing cesarean section.

OBJECTIVES: To compare neonatal survival to discharge rates between brachycephalic and nonbrachycephalic dogs undergoing cesarean section (c-section) and identify risk factors for neonatal mortality. STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: A total of 480 puppies from 90 bitches undergoing 106 c-sections. METHODS: Medical records of c-sections performed between January 2012 and September 2021 were reviewed. Data collected included brachycephalic versus nonbrachycephalic breed, elective versus emergency c-section, litter size (c-section and total [including those born prior to and via c-section]), and neonatal survival to discharge. A generalized linear mixed model (univariable and multivariable) was performed to evaluate variables versus neonatal survival. RESULTS: Overall neonatal survival to discharge was 93.1% (447/480); survival was similar between brachycephalic and nonbrachycephalic breeds (p = .221, 202/213 [94.8%] brachycephalic survival, 245/267 [91.8%] nonbrachycephalic survival). Puppies delivered via elective c-section were more likely to survive compared to emergency c-section (p < .001, 238/240 [99.2%] elective survival, 209/240 [87.1%] emergency survival). Puppies delivered in larger c-section litters were more likely to survive (p < .004) compared to smaller litters. Total litter size had no effect on survival. CONCLUSION: Brachycephalism had no effect on neonatal survival. Puppies delivered via elective c-section were more likely to survive compared to puppies delivered via emergency c-section. CLINICAL SIGNIFICANCE: Outcomes following c-section are similar between brachycephalic and nonbrachycephalic breeds. While it is preferable to encourage selective breeding for bitches that are able to whelp naturally, elective c-section should be considered in bitches at high risk for dystocia to maximize neonatal survival.

Influence of doxapram and intermittent 10% carbon dioxide inspiration on cardiovascular and laryngeal functions in anesthetized dogs.

OBJECTIVE: To compare the effects of two doses of doxapram intravenous injection and carbon dioxide inhalation on the cardiovascular and laryngeal functions of anesthetized hounds. STUDY DESIGN: Experimental study. ANIMALS: Six healthy adult dogs. METHODS: In a Latin-square design, the mean arterial blood pressure (MABP) and heart rate (HR) were recorded continuously. The inspiratory normalized glottic gap areas (iNGGA) were measured before and after each stimulation with 0.55 mg/kg of doxapram (L-DOX), 2.2 mg/kg of doxapram (H-DOX), or 90 s of inhalation of 10% carbon dioxide in oxygen (I-CO2 ). The stimulations were tested in duplicate or triplicate. Video clips of the laryngeal movement were scored by board-certified surgeons masked to the treatment. RESULTS: The MABP increased with L-DOX and H-DOX up to 81% (both p < .001 compared to I-CO2 ), and persisted during the other stimulations (both p < .001). An intermittent tachycardic effect of up to 79% increase in HR was observed with doxapram. The HR following H-DOX was higher than L-DOX and I-CO2 (both p < .016). Neither hypertension nor tachycardia was observed with I-CO2 . The iNGGA increased with all treatments (p < .001). The iNGGA was greater with H-DOX than L-DOX and I-CO2 (both p < .007). All treatments received higher scores (all p < .001) with acceptable inter- and intra-observers Krippendorff's alphas. CONCLUSION: All treatments were effective respiratory stimulants in anesthetized dogs; however, doxapram caused hypertension and tachycardia. CLINICAL SIGNIFICANCE: Carbon dioxide inhalation might improve arytenoid motion without cardiovascular effects in dogs during clinical airway examinations.

Evaluation of concurrent perineal hernia in adult male dogs presenting with nontraumatic, acquired inguinal hernias.

A possible association between the development of nontraumatic, acquired inguinal hernias (NAIH) and perineal hernias (PH) has been postulated in adult dogs. The objective of this study was to evaluate the frequency of concurrent diagnosis of PH in dogs presented with NAIH and determine potential risk factors for concurrent PH and NAIH. Medical records of adult male dogs presented for NAIH to 4 hospitals between 2007 and 2017 were retrospectively reviewed. Twenty-one dogs with NAIH were included, 8 of which had concurrent PH. There were no significant differences between dogs with and without PH; however, among dogs with both conditions, intact dogs (8.1 ± 1.4 years) were younger than neutered dogs (11.7 ± 1.0 years; P = 0.007). Thirty-eight percent of male dogs presenting for NAIH had concurrent PH, indicating that these conditions commonly occur together. Dogs presenting for NAIH should be carefully evaluated for concurrent PH before surgical intervention.

Évaluation d'hernie périnéale concomitante chez des chiens mâles adultes présentant des hernies inguinales acquises non traumatiques. Une association possible entre le développement d'hernies inguinales acquises non traumatiques (NAIH) et les hernies périnéales (PH) a été postulée chez les chiens adultes. L'objectif de cette étude était d'évaluer la fréquence des diagnostics simultanés d'HP chez les chiens présentés avec NAIH et de déterminer les facteurs de risque potentiels de PH et NAIH concomitantes. Les dossiers médicaux de chiens mâles adultes présentés pour NAIH à quatre hôpitaux entre 2007 et 2017 ont été revus rétrospectivement. Vingt et un chiens atteints de NAIH ont été inclus, dont huit avaient une PH concomitante. Il n'y avait aucune différence significative entre les chiens avec et sans PH; cependant, parmi les chiens atteints des deux conditions, les chiens intacts (8,1 ± 1,4 ans) étaient plus jeunes que les chiens castrés (11,7 ± 1,0 ans; P = 0,007). Trente-huit pour cent des chiens mâles se présentant pour NAIH avaient une PH concomitante, ce qui indique que ces conditions se produisent généralement ensemble. Les chiens présentant un NAIH doivent être soigneusement évalués pour une PH concomitante avant une intervention chirurgicale.(Traduit par Dr Serge Messier).

A Simulated Tumor for Teaching Principles of Surgical Oncology for Biopsy and Excision of Skin and Subcutaneous Masses to Veterinary Students.

Tumors of the skin and subcutaneous tissues are commonly encountered in primary care practice. The most common of these tumors are mast cell tumors and soft tissue sarcomas, for which the primary treatment is most often surgical excision. Understanding surgical margins, particularly the deep fascial plane, can be difficult for veterinary students. Current techniques to teach these concepts typically rely on cadaver-based laboratories, which require simulated tumors to improve the realism of the laboratory. Tumors can be difficult to replicate in cadaver laboratories; thus a new technique for a simulated tumor was developed. A gelatin-based simulated tumor was injected into the subcutaneous space in two different sites in canine cadavers. Students then practiced incisional biopsy and wide excision of a subcutaneous mass. Students were able to appropriately perform both techniques using the simulated tumors. When the deep margin was not clean on the wide excision, students were able to understand the error by identifying the simulated tumor, reinforcing the concept of obtaining an appropriate deep fascial plane. In summary, this gelatin-based simulated tumor technique was cost-effective, easy to perform, and effective for the teaching laboratory.

Influence of use of a bipolar vessel sealing device on short-term postoperative mortality after splenectomy: 203 dogs (2005-2018).

OBJECTIVE: To compare short-term postoperative mortality in dogs after splenectomy performed with or without a bipolar vessel sealing device (BVSD) and to identify variables associated with mortality. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Client-owned dogs (n = 203). METHODS: Medical records of dogs that underwent splenectomy from 2005-2018 were reviewed. Mortality rates were compared between dogs that underwent splenectomy with or without BVSD. Causes of death and variables associated with short-term mortality were assessed. RESULTS: Fifteen of 203 (7.4%) dogs died prior to discharge, and seven (3.4%) dogs died prior to suture removal for a total short-term mortality rate of 22 of 203 (10.8%). The estimated difference in proportion of deaths prior to discharge between the BVSD and non-BVSD groups was -0.01 (95% confidence interval = -0.08 to 0.06). Duration of anesthesia was longer when splenectomy was performed without BVSD (median 168 vs 152 minutes; P = .03). Multivariate analysis identified intraoperative (odds ratio [OR] 5.7) or postoperative (OR 13.6) administration of blood products, increasing duration of anesthesia (OR 1.15 per additional 16 minutes), and intraoperative ventricular arrhythmias (OR 6.8) as significantly associated with death prior to discharge. Intraoperative (OR 3.2) or postoperative (OR 7.7) administration of blood products was associated with death prior to suture removal. CONCLUSION: Use of a BVSD did not appear to increase short-term mortality after splenectomy. CLINICAL SIGNIFICANCE: Dogs undergoing splenectomy that require intraoperative or postoperative transfusions, experience intraoperative ventricular arrhythmias, or have prolonged anesthesia may be at risk for death in the short-term postoperative period.

Dorsal offset rhinoplasty for treatment of stenotic nares in 34 brachycephalic dogs.

OBJECTIVE: To describe the technique, outcome, and owner satisfaction associated with dorsal offset rhinoplasty (DOR) to treat stenotic nares in brachycephalic dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Thirty-four client-owned dogs. METHODS: Medical records of dogs treated with DOR at a veterinary teaching hospital over a 6-year period were identified. Dorsal offset rhinoplasty was defined as removal of a dorsal wedge of nasal planum from each naris with apposition of the rostral abaxial tissue to the caudal axial tissue, resulting in translocation of the alar cartilage in both median and dorsal planes. Immediate and postoperative complications were recorded. Owners were asked to report any complications with healing of the nares and to score their satisfaction with the appearance of the nares. RESULTS: Thirty-four dogs met the inclusion criteria. Twenty-nine (85%) dogs were examined a median of 402.5 days (range, 23-2042) postoperatively, with no major complications related to the rhinoplasty recorded. Eighteen owners responded a median of 701 days (range, 37-1622) postoperatively. One owner reported that self-trauma led to collapse of one naris. One owner reported collapse of both nares within 4 years; timing and cause were unknown. Sixteen of 17 responding owners reported that they were very satisfied with the outcome of the rhinoplasty. The owner of the dog with the collapsed naris was very unsatisfied. One owner did not provide a satisfaction score. CONCLUSION: Owners were generally highly satisfied with DOR, and complications were uncommon. CLINICAL SIGNIFICANCE: This report describes an alternate technique to treat stenotic nares.

Clinical findings and outcomes of 153 dogs surgically treated for intestinal intussusceptions.

OBJECTIVE: To describe perioperative characteristics and outcomes of dogs surgically treated for intestinal intussusception. STUDY DESIGN: Multi-institutional, retrospective study. ANIMALS: One hundred fifty-three client-owned dogs with intestinal intussusception. METHODS: Dogs were included when they had undergone surgical treatment of a confirmed intestinal intussusception. Medical records were reviewed for demographics and clinical data, including surgical complications (graded 1-4). Follow-up was obtained via telephone interview with owners and referring veterinarians. RESULTS: Dogs had a median age of 10 months (range, 2-156), and the most common location for intussusception was ileocolic (66/153 [43%]). Most cases had no identifiable cause (104/155 [67%]). Intestinal resection and anastomosis (IRA) was performed in 129 of 153 (84%) dogs; enteroplication was performed in 28 of 153 (18%) dogs, including 13 with and 15 without IRA. Intraoperative complications occurred in 10 of 153 (7%) dogs, all involving intestinal damage during attempted manual reduction. The median duration of follow-up after discharge was 334 days (interquartile range, 15-990; range, 1-3302). Postoperative complications occurred in 53 of 153 (35%) dogs, including 22 of 153 (14%) with severe (grade 3 or 4) events. Diarrhea, regurgitation, and septic peritonitis were the most common postoperative complications; intussusception recurred in four of 153 (3%) dogs, all within 72 hours postoperatively. Fourteen-day postoperative mortality rate was 6%. CONCLUSION: Surgical treatment of intestinal intussusception was curative in most dogs, even when an underlying cause was not identified. Surgical complications were common, including a 14% risk of life-threatening short-term complications. CLINICAL SIGNIFICANCE: Surgical treatment of intestinal intussusception offers an excellent prognosis, but the potential life-threatening complications should be considered.

Outcomes associated with vaginectomy and vulvovaginectomy in 21 dogs.

OBJECTIVE: To report the outcomes of dogs with lesions of the genitourinary tract treated by vaginectomy or vulvovaginectomy. STUDY DESIGN: Multi-institutional retrospective study. ANIMALS: Female dogs that underwent vulvovaginectomy, complete vaginectomy, or subtotal vaginectomy from 2003 to 2018 with complete medical records and a minimum of 60 days follow-up. METHODS: Data collected from medical records included preoperative, intraoperative, and postoperative data, such as the occurrence of urinary incontinence (UIC), disease recurrence, and death/euthanasia. RESULTS: This study included 21 dogs. Four dogs had vulvovaginectomy, six had complete vaginectomy, and 11 had a subtotal vaginectomy performed. The mean age at surgery was 9.2 years (SD, 3.3). Thirteen dogs were intact at presentation. Smooth muscle tumors were diagnosed most commonly (10 leiomyomata, three leiomyosarcomas, two leiomyofibromas). The median duration of follow-up was 520 days (range, 71-1955). Major complications requiring revision surgery were recorded in two dogs. Postoperative UIC occurred in six of 21 dogs, resolving spontaneously within 60 days in three dogs. Dogs with malignant tumors (n = 6) survived at least 71 days (median, 626; 95% CI, 71-1245), and recurrence of disease occurred in two dogs. In dogs with benign tumors (n = 15), the median survival time was not reached. These dogs survived at least 104 days and had no recurrence of the disease. CONCLUSION: Vaginectomy and vulvovaginectomy resulted in prolonged survival and low rates of major complications and UIC. CLINICAL SIGNIFICANCE: This study provides evidence to recommend that the risks of this procedure and expectations should be discussed with clients.

Outcome after surgical and conservative treatments of canine peritoneopericardial diaphragmatic hernia: A multi-institutional study of 128 dogs.

OBJECTIVE: To compare demographics and disease characteristics in dogs in which peritoneopericardial diaphragmatic hernia (PPDH) had been diagnosed and report outcomes after surgical treatment (ST) or conservative treatment (CT). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: One hundred twenty-eight dogs (91 ST, 37 CT) in which PPDH had been diagnosed. METHODS: Medical records were reviewed for demographics, perioperative findings, and outcomes. Follow-up was obtained via telephone interview and email correspondence with owners and referring veterinarians. Baseline variables were compared between treatment groups. RESULTS: Dogs treated surgically were younger (P < .001), more likely to be sexually intact (P = .002), more likely to have clinical signs from PPDH vs an incidental diagnosis (P < .001), and more likely to have other congenital abnormalities (P = .003) compared with dogs treated conservatively. Ninety-seven percent of ST dogs were discharged from hospitals. Intraoperative and postoperative complications were reported in 22% and 41% of dogs, respectively, although most complications were classified as low grade (75% and 83%, respectively). Follow-up was available in 87 dogs, at a median of 1062 days. Hernia recurrence was not reported in any surgically treated dog. The deaths of nine dogs (five ST, four CT) could be attributed to PPDH, and long median survival times were observed in both the ST and CT groups (8.2 and 5 years, respectively). CONCLUSION: Preoperative characteristics differed between dogs treated conservatively vs surgically. Surgical treatment was associated with low operative mortality, and both ST and CT dogs had good long-term survival. CLINICAL SIGNIFICANCE: A diagnosis of PPDH can confer a good long-term prognosis for both ST and CT dogs.