Single-port laparoscopic-assisted abdominal cryptorchidectomy in 14 dogs.

OBJECTIVE: To describe a modified laparoscopic-assisted cryptorchidectomy technique in dogs using a single-port endoscope and evaluate clinical outcome in abdominal cryptorchid dogs that underwent the procedure. STUDY DESIGN: Prospective case series. ANIMALS: A total of 14 client-owned dogs (19 abdominal cryptorchid testes). METHODS: Dogs scheduled for laparoscopic cryptorchidectomy between January 2019 and April 2022 were enrolled in the study. The dogs underwent single-port laparoscopic-assisted cryptorchidectomy (SP-LAC) performed by a single surgeon using a 10-mm single-port endoscope placed in the midline immediately cranial to the prepuce. The abdominal testis was endoscopically located and grasped, the cannula was retracted, the capnoperitoneum was reversed to allow exteriorization of the testis, and the spermatic cord was ligated extracorporeally. RESULTS: Median age was 13 months (range, 7-29 months) and median bodyweight was 23.0 kg (range, 2.2-55.0 kg). Nine of 14 dogs had unilateral abdominal cryptorchidism (7 right-sided and 2 left-sided) and 5/14 dogs had bilateral abdominal cryptorchidism. Median surgical time for unilateral abdominal cryptorchidectomy was 17 min (range, 14-21 min) and for bilateral abdominal cryptorchidectomy 27 min (range, 23-55 min). Ten dogs had additional surgical procedures performed concurrently with SP-LAC. One major intraoperative complication (testicular artery hemorrhage) occurred that required emergency conversion and two minor entry-related complications were observed. CONCLUSION: The SP-LAC procedure enabled removal of abdominal testes and was associated with a low morbidity. CLINICAL SIGNIFICANCE: The SP-LAC procedure can be performed by a single surgeon and represents a less invasive alternative to multi-port laparoscopic-assisted or single-port multi-access laparoscopic cryptorchidectomy techniques.

Revolutionizing non-conventional wound healing using honey by simultaneously targeting multiple molecular mechanisms.

Hospital-acquired infections and treatment-related wound complications constitute a tremendous burden for the health care system, particularly given the serious increase in multidrug resistant pathogens. Imagine that a large part of nosocomial infections can be prevented using a simple treatment. In this respect, honey is used mainly in topical cutaneous wound care because of its potent broad-spectrum antibacterial and wound healing activities. However, therapeutic use outside this scope has been limited. The current review provides an in-depth view of studies using honey outside the conventional wound care indications. Non-conventional routes of honey application include subcutaneous, intra-socket, abdominal, and oral administration in novel indications, such as post colon surgery, mucositis, and tooth extraction. Honey consistently demonstrates beneficial therapeutic activities in these novel applications, orchestrating antimicrobial and prophylactic activity, reducing inflammation and wound dehiscence, and inducing healing, epithelialization, and analgesic activity. Several molecular mechanisms are responsible for these beneficial clinical effects of honey during the course of wound healing. Pro-inflammatory effects of honey, such as induction of iNOS, IL-1ß, and COX-2, are mediated by TLR4 signaling. In contrast, honey's anti-inflammatory actions and flavonoids induce anti-inflammatory and antioxidant pathways by inducing NRF2 target genes, including HO-1 and PRDX1. The molecular and biochemical pathways activated by honey during the different phases of wound healing are also discussed in more detail in this review. Variation between different honey origins exists, and therefore standardized medical-grade honey may offer an optimized and safe treatment. Honey is a valuable alternative to conventional antimicrobial and anti-inflammatory therapies that can strongly reduce nosocomial infections.

Intraoral approach for zygomatic sialoadenectomy in dogs: An anatomical study and three clinical cases.

OBJECTIVE: To describe an intraoral approach (IOA) for zygomatic sialadenectomy in dogs and to compare this surgical approach to a modified lateral orbitotomy approach (LOA). STUDY DESIGN: Cadaveric study and short case series. SAMPLE POPULATION: Ten canine cadavers and three dogs with clinical disease. METHODS: Bilateral zygomatic sialoadenectomies were performed in six mesocephalic, two brachycephalic and two dolichocephalic cadavers, randomly assigned to IOA on one side and LOA on the contralateral side. Duration of surgery, ease of surgical stage scores (rated on 5-point Likert scale) and completeness of gland removal were recorded. Additionally, IOA was performed in three dogs with zygomatic salivary gland (ZSG) disease. RESULTS: Removal of the ZSG was complete in 8/10 and 10/10 dogs using the IOA and LOA, respectively. Surgery was faster with IOA (42.0 min; 33.5-49.6 min) than LOA (65.7 min; 54.9-76.4 min, p = .005). Ease of removal did not differ between approaches (p = .091). Diseased ZSGs were successfully removed in three dogs without intra- or short-term postoperative complications. CONCLUSIONS: The intraoral approach described here was technically equally challenging but faster than the LOA. Its clinical use led to an uneventful surgery with excellent short-term outcome in three dogs. CLINICAL RELEVANCE: The IOA provides an alternative approach for zygomatic sialoadenectomy in dogs with ZSG disease.

Immortalised canine buccal epithelial cells' CXCL8 secretion is affected by allergen extracts, Toll-like receptor ligands, IL-17A and calcitriol.

Epithelial cells are known to produce mediators which can influence the behaviour of neighbouring immune cells. Although the oral mucosa has gained increased interest as a route to induce allergy desensitisation and mucosal pathogen immunisation in dogs, there is only limited knowledge on the factors which impact mediator secretion by canine oral epithelial cells. The study's objective was to enlarge the knowledge on the stimuli that can influence the secretion of some pro- and anti-inflammatory cytokines and the chemokine CXCL8 by canine buccal epithelial cells. To investigate this, buccal epithelial cells were isolated from a biopsy of a dog and immortalised by lentiviral transduction of the SV40 large T antigen. The cells were stained with a CD49f and cytokeratin 3 antibody to confirm their epithelial origin. Cells were incubated with allergen extracts, Toll-like receptor ligands (TLRL), recombinant cytokines and vitamin A and D metabolites. Subsequently, the secretion of the cytokines interleukin (IL)-4, IL-6, IL-10, IL-17A, IFN-γ, TGF-ß1 and the chemokine CXCL8 was assayed by ELISA. Immortalised canine buccal epithelial cells stained positive for CD49f but not for cytokeratin 3. The cells produced detectable amounts of CXCL8 and TGF-ß1. A Dermatophagoides farinae extract, an Alternaria alternata extract, Pam3CSK4, heat-killed Listeria monocytogenes, FSL-1, flagellin and canine recombinant IL-17A significantly increased CXCL8 secretion, while the vitamin D metabolite calcitriol significantly suppressed the production of this chemokine. This study showed that certain allergens, TLRL, IL-17A and calcitriol modulate CXCL8 secretion in a cell line of canine buccal epithelial cells.

Persistent hypercobalaminemia three months after successful gradual attenuation of extrahepatic shunts in dogs: a prospective cohort study.

BACKGROUND: Deficiencies in vitamin A and D and disorders in the vitamin B complex are often present in people with chronic liver diseases. So far, the serum concentrations of these vitamins have not yet been studied in dogs with congenital extrahepatic portosystemic shunts (EHPSS), who also have some degree of liver dysfunction. The objective was to assess serum vitamin concentrations in dogs with EHPSS from diagnosis to complete closure. A prospective cohort study was performed using ten client-owned dogs with EHPSS, closed after gradual surgical attenuation. Serum concentrations of vitamin A, 25-hydroxyvitamin D, folic acid, cobalamin and methylmalonic acid (MMA) were measured at diagnosis prior to institution of medical therapy, prior to surgery, and three months after gradual attenuation and complete closure of the EHPSS. RESULTS: At diagnosis, median serum concentrations of vitamin A, 25-hydroxyvitamin D and folic acid were 18.2 µg/dL (8.8 - 79.5 µg/dL), 51.8 ng/mL (19.4 - 109.0 ng/mL), and 8.1 µg/L (5.2 - 14.5 µg/L), respectively, which increased significantly postoperatively (88.3 µg/dL (51.6 - 182.2 µg/dL, P=0.005), 89.6 ng/mL (49.3 - >150.0 ng/mL, P =0.005), and 14.8 µg/L (11.5 - 17.7 µg/L, P <0.001), respectively). Median serum cobalamin concentrations were 735.5 ng/L (470 - 1388 ng/L) at diagnosis and did not significantly decrease postoperatively (P =0.122). Both at diagnosis and three months postoperatively 7/10 dogs had hypercobalaminemia. CONCLUSIONS: Serum concentrations of vitamin A, 25-hydroxyvitamin D and folic acid significantly increase after surgical attenuation. Nevertheless, persistent hypercobalaminemia is suggestive of ongoing liver dysfunction, despite successful surgery.

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.

Impact of adaptive gastric electrical stimulation on weight, food intake, and food intake rate in dogs.

BACKGROUND: Gastric electrical stimulation (GES) has been studied for decades as a promising treatment for obesity. Stimulation pulses with fixed amplitude and pulse width are usually applied, but these have limitations with regard to overcoming habituation to GES and inter-subject variation. This study aims to analyze the efficacy of an adaptive GES protocol for reducing food intake and maintaining lean weight in dogs. METHODS: Six beagle dogs were implanted with a remotely programmable gastric stimulator. An adaptive protocol was designed to increase the stimulation energy proportionally to the excess of food consumption, with respect to the dogs' maintenance energy requirements. After surgery and habituation to experimental conditions, the dogs went through both a control and a stimulation period of 4 weeks each, in a randomized order. The stimulation parameters were adapted daily. Body weight, food intake, food intake rate, and postprandial cutaneous electrogastrograms (EGG) were recorded to assess the effect of adaptive GES. RESULTS: Adaptive GES decreased food intake and food intake rate (p < 0.05) resulting in weight maintenance. In the absence of GES, the dogs gained weight (p < 0.05). Postprandial EGG dominant frequency was accelerated by GES (p < 0.05). The strategy of adapting the stimulation energy was effective in causing significant mid-term changes. CONCLUSION: Adaptive GES is effective for reducing food intake and maintaining lean weight. The proposed adaptive strategy may offer benefits to counter habituation and adapt to inter-subject variation in clinical use of GES for obesity.

Influence of age, sex, body condition score, rectal temperature, anatomical location and hair on skin pH in dogs.

BACKGROUND: Physiological skin pH levels are well-documented in human medicine, and assessment of variations may be important in assessing the efficacy of wound healing. By contrast, physiological skin pH levels in dogs are sparsely described. HYPOTHESIS/OBJECTIVES: To determine the pH of intact skin in healthy dogs and to study the influence of different physiological factors on the pH level of canine skin. ANIMALS: Seventy-seven client-owned dogs of various breeds, age and sex. METHODS AND MATERIALS: A prospective study was designed and the pH of intact skin was measured at the concave surface of both pinnae, and in both axillary and inguinal regions. For each location, the colour and density of the hairs also was recorded. Each dog's rectal body temperature and body condition scores also were determined. RESULTS: The skin pH in dogs <12 weeks of age was significantly lower (3.97-5.70) than in older dogs (4.40-8.18) (P < 0.001). In dogs >12 weeks of age, skin pH was significantly lower in the inguinal regions compared to the pinnae (P = 0.008), and female dogs had a significantly lower skin pH in the inguinal regions than male dogs (P = 0.043). Pinnae covered with light-coloured hair had a lower skin pH than those with dark-coloured hair (P = 0.04). No significant differences were found between dogs with different body condition scores, body temperatures or differences in hair density. CONCLUSIONS AND CLINICAL RELEVANCE: The pH of intact healthy skin is lower in puppies of <12 weeks of age. Regional differences of body location also were seen which were variably affected by hair colour and sex. A baseline assessment of skin pH in healthy dogs is important for future studies of disease and wound healing.

Total lipid concentration of hairs increases after successful attenuation of extrahepatic portosystemic shunts in dogs.

BACKGROUND: Skin and coat quality can reflect nutritional deficiencies in humans and dogs with liver diseases. HYPOTHESIS/OBJECTIVES: Determine skin and coat quality based on a scoring protocol and skin biopsies in dogs with an extrahepatic portosystemic shunt (EHPSS), and determine total lipid concentrations in hairs of dogs at time of surgery and 3 months after successful shunt closure. ANIMALS: Ten client-owned dogs that underwent successful gradual attenuation of EHPSS, as defined by transsplenic portal scintigraphy, were included. MATERIALS AND METHODS: A prospective cohort study was performed. All dogs underwent gradual attenuation of the EHPSS. Skin and coat scoring was performed at diagnosis, surgery, and 1 and 3 months postoperatively. Hair was plucked from the lumbar region for total lipid analysis and an 8 mm punch skin biopsy was taken at time of surgery and 3 months postoperatively, when the dogs underwent transsplenic portal scintigraphy to determine EHPSS closure. RESULTS: No significant differences were observed in skin and coat scoring over time. Total lipid concentrations of hairs increased significantly from surgery to 3 months postoperatively [30 µg/mg hair (13-56 µg/mg hair) to 47 µg/mg hair (25-63 µg/mg hair); p = 0.005]. Skin biopsies showed the presence of significantly more scales 3 months postoperatively (p = 0.018). CONCLUSIONS AND CLINICAL RELEVANCE: A significant increase in total lipid concentrations in hairs suggests that successful surgical attenuation of EHPSS improves either intestinal absorption of lipids, fat metabolism in the liver, or a combination of both.

Contexte - La qualité de la peau et du pelage peut refléter des carences nutritionnelles chez les humains et les chiens atteints de maladies du foie. Hypothèse/Objectifs - Déterminer la qualité de la peau et du pelage sur la base d'un protocole de notation et de biopsies cutanées chez les chiens avec un shunt portosystémique extrahépatique (EHPSS), et déterminer les concentrations totales de lipides dans les poils des chiens au moment de la chirurgie et trois mois après la fermeture réussie du shunt. Animaux - Dix chiens appartenant à des clients qui ont subi une atténuation progressive réussie de l'EHPSS, telle que définie par la scintigraphie portale trans-splénique, ont été inclus. Matériels et méthodes - Une étude de cohorte prospective a été réalisée. Tous les chiens ont subi une atténuation progressive de l'EHPSS. Une notation de la peau et du pelage a été réalisée au moment du diagnostic, de la chirurgie et un et trois mois après l'opération. Les cheveux ont été prélevés dans la région lombaire pour une analyse des lipides totaux et une biopsie cutanée à l'emporte-pièce de 8 mm a été effectuée au moment de la chirurgie et trois mois après l'opération, lorsque les chiens ont subi une scintigraphie portale trans-splénique pour déterminer la fermeture de l'EHPSS. Résultats - Aucune différence significative n'a été observée dans la notation de la peau et du pelage au fil du temps. Les concentrations totales de lipides dans les poils ont augmenté de manière significative entre la chirurgie et trois mois après l'opération [30 µg/mg de poils (13-56 µg/mg de poils) à 47 µg/mg de poils (25-63 µg/mg de poils) ; P = 0,005]. Les biopsies cutanées ont montré la présence de significativement plus d'écailles trois mois après l'opération (P = 0,018). Conclusions et pertinence clinique - Une augmentation significative des concentrations totales de lipides dans les cheveux suggère qu'une atténuation chirurgicale réussie de l'EHPSS améliore soit l'absorption intestinale des lipides, soit le métabolisme des graisses dans le foie, soit une combinaison des deux.

Introducción- la calidad de la piel y el pelaje puede reflejar deficiencias nutricionales en humanos y perros con enfermedades hepáticas. Hipótesis/Objetivos- determinar la calidad de la piel y el pelaje según un protocolo de valoración y en biopsias de piel en perros con shunt portosistémico extrahepática (EHPSS) y determinar las concentraciones totales de lípidos en el pelo de los perros en el momento de la cirugía y tres meses después del tratamiento exitoso del shunt. Animales- se incluyeron diez perros de propietarios particulares que se sometieron a una atenuación gradual exitosa de EHPSS, según se identificó mediante por gammagrafía portal transesplénica. Materiales y métodos - Se realizó un estudio de cohorte prospectivo. A todos los perros se les realizó una atenuación gradual del EHPSS. La valoración de la piel y el pelaje se realizó en el momento del diagnóstico, la cirugía y uno y tres meses después de la operación. Se arrancó el pelo de la región lumbar para el análisis de lípidos totales y se tomó una biopsia de piel con sacabocados (punch) de 8 mm en el momento de la cirugía y tres meses después de la operación, cuando los perros se sometieron a una gammagrafía portal transesplénica para determinar el cierre de EHPSS. Resultados- no se observaron diferencias significativas en la valoración de la piel y el pelaje a lo largo del tiempo. Las concentraciones de lípidos totales del pelo aumentó significativamente desde la cirugía hasta los tres meses posteriores a la operación [30 µg/mg de pelo (13-56 µg/mg de pelo) a 47 µg/mg de cabello (25-63 µg/mg de pelo); P = 0,005]. Las biopsias de piel mostraron la presencia de mayor cantidad de escamas de forma significativa tres meses después de la operación (P = 0,018). Conclusiones y relevancia clínica- un aumento significativo en las concentraciones de lípidos totales en el pelo sugiere que la atenuación quirúrgica exitosa de EHPSS mejora la absorción intestinal de lípidos, el metabolismo de las grasas en el hígado o una combinación de ambos.

Contexto - A qualidade da pele e dos pelos pode refletir deficiências nutricionais em humanos e cães com hepatopatias. Hipótese/Objetivos - Determinar a qualidade da pele e pelos baseada em um protocolo de escore e biópsias cutâneas em cães com shunt portossistêmico extra-hepático (EHPSS) e determinar as concentrações lipídicas totais nos pelos de cães no momento da cirurgia e três meses após o fechamento bem-sucedido do shunt. Animais - Foram incluídos dez cães de proprietários submetidos à atenuação gradual do EHPSS bem-sucedida, confirmada por cintilografia portal transesplênica. Materiais e métodos - Realizou-se um estudo de coorte prospectivo. Todos os cães foram submetidos à atenuação gradual do EHPSS. A classificação de pele e pelos em escores foi realizada no diagnóstico, cirurgia, e com um e três meses de pós-operatório. Os pelos foram arrancados da região lombar para análise lipídica total e uma biópsia com punch de 8mm foi coletada no momento da cirurgia e com três meses de pós-operatório, quando os cães foram submetidos à cintilografia portal transesplênica para determinar o fechamento do EHPSS. Resultados - Não foram observadas diferenças significativas nos escores de pele e pelos ao longo do tempo. As concentrações de lipídicas totais aumentaram significativamente da cirurgia aos três meses de pós-operatório [30 µg/mg de pelo (13-56 µg/mg pelo) para 47 µg/mg de pelo (25-63 µg/mg de pelo); P = 0,005]. As biópsias cutâneas revelaram a presença de significativamente mais escamas com três meses de pós-operatório (P = 0,018). Conclusões e relevância clínica - O aumento significativo de concentrações lipídicas totais nos pelos sugere que a atenuação cirúrgica de EHPSS bem-sucedida melhora tanto a absorção intestinal de lipídeos quanto o metabolismo de gordura no fígado, ou uma combinação dos dois.

Evaluation of different blood tests in dogs with extrahepatic portosystemic shunts to assess shunt closure after surgical treatment.

OBJECTIVE: To determine the sensitivity and specificity of different individual and combined blood tests to assess extrahepatic portosystemic shunt (EHPSS) closure after gradual attenuation of EHPSS in dogs. STUDY DESIGN: Clinical prospective study. ANIMALS: Twenty client-owned dogs with EHPSS. METHODS: Fasting ammonia (FA), preprandial, postprandial, and paired serum bile acids (SBA), the lidocaine/monoethylglycylxylidide (L/MEGX) test, and serum hyaluronic acid (SHA) were performed at diagnosis, and 1, 3, and 6 months postoperatively. Transsplenic portal scintigraphy was performed to determine EHPSS closure 3 months postoperatively. Their sensitivity and specificity in determining shunt closure postoperatively were calculated. RESULTS: When assessing a single blood parameter, FA had the highest specificity (100%), whereas SHA and MEGX measured 15 min after lidocaine administration (T15) had the highest sensitivity (96.9% and 96.2%, respectively) for determining shunt closure postoperatively. The most promising blood test combinations were SHA (sensitivity 96.9%, specificity 81.8%), combined with the L/MEGX test (MEGX at T15: sensitivity 100%, specificity 72.4%) or the L/MEGX test (MEGX at T15) combined with either FA (sensitivity 100%, specificity 82.8%) or postprandial SBA (sensitivity 100%, specificity 81.5%). CONCLUSION: Both SHA and the L/MEGX test were sensitive tests for determining shunt closure after gradual attenuation of EHPSS. Test performances could even be improved by combining these tests with each other or with traditional tests such as FA or postprandial SBA. CLINICAL SIGNIFICANCE: Although SHA and the L/MEGX test are sensitive blood tests for determining EHPSS closure, especially when combined with traditional blood tests, imaging is still needed to confirm EHPSS closure.

Postattenuation neurologic signs after surgical attenuation of congenital portosystemic shunts in dogs: A review.

The development of postattenuation neurologic signs (PANS) is a poorly understood and potentially devastating complication after surgical attenuation of congenital portosystemic shunts in dogs. Postattenuation neurologic signs include seizures but also more subtle neurologic signs such as depression, behavioral changes, tremors, and twitching. They most commonly occur within 7 days postoperatively and are typically unrelated to hyperammonemia, hypoglycemia, or electrolyte disturbances. This narrative review summarizes the findings of 50 publications from 1988-2020 that report occurrence of PANS. While most published reports included only dogs affected by postattenuation seizures (PAS), others included dogs with any form of PANS. Overall, PANS (including PAS) affected 1.6%-27.3% of dogs, whereas incidence of PAS ranged from 0%-18.2%. The etiology of PANS remains unknown; however, several theories have been proposed. Risk factors include preoperative hepatic encephalopathy, increasing age, and possibly certain breeds and extrahepatic shunt morphology. There is increasing evidence that prophylactic antiepileptic drugs do not prevent PANS. Treatment is centered around controlling neurologic signs with antiepileptic drugs and providing supportive intensive care. The 30-day survival rate in studies that included a minimum of four dogs affected by PANS was 0%-100% (median, 50.0%) and 0%-75.0% (median, 37.5%) for those with PAS. Mortality associated with PANS was typically related to occurrence of generalized seizure activity. Prognostic factors positively associated with short-term survival included having a history of preoperative seizures and development of focal seizures only. If affected dogs survived to discharge, survival for several years was possible, and the majority of neurologic signs manifested as part of the phenomenon of PANS appeared to resolve.

Shear wave velocity measurements obtained in different regions are repeatable for presumed normal canine lymph nodes: A pilot study.

Shear wave elastography (SWE) has been applied as a noninvasive method for predicting regional lymph node (LN) metastases in human and veterinary patients. However, published studies describing standardized protocols and repeatability of this technique are currently lacking. The objective of this prospective, pilot, observer agreement study was to determine whether different shear wave velocity (SWV) measurements obtained in different regions of presumed normal canine LNs would be repeatable. Two imagers consecutively performed shear wave elastography of submandibular, superficial inguinal, and popliteal LNs in 10, clinically healthy adult dogs. Ten elastograms of each LN were acquired by each imager. In each adequate elastogram, three regions of interest (ROIs) were placed in the softest and stiffest region of the LN. Additionally, one ROI was drawn covering the entire LN. In each ROI, mean, median, and maximum SWVs were calculated. Mean values for the mean, median, and maximum SWVs varied from 2.33 to 3.10 m/s, 2.32 to 3.10 m/s, and 2.61 to 4.09 m/s, respectively. Intra- and interobserver agreements were acceptable. Superficial inguinal LNs demonstrated the highest intra- and interobserver agreement, followed by the popliteal and the submandibular LNs, respectively. Using the different measurements (mean, median, or maximum SWVs) had no significant effect on the intra- and interobserver variability, neither did the region (softest, stiffest, or entire LN). Findings indicated that all evaluated measurements and regions could be used to obtain reliable elastography data of presumed normal canine LNs. Clinical trials in dogs with cancer are necessary to compare SWVs of metastatic LNs with the reported SWVs and evaluate whether various measurements and regions can also be used in metastatic LNs.

In vitro antimicrobial efficacy of two medical grade honey formulations against common high-risk meticillin-resistant staphylococci and Pseudomonas spp. pathogens.

BACKGROUND: Antimicrobial resistance is a problem in human and animal healthcare. Honey may be used for its wound healing properties and antimicrobial effects. OBJECTIVE: To investigate the antimicrobial activity of two commercially available medical grade honeys (MGHs) against Staphylococcus spp. and Pseudomonas spp. isolates. METHODS AND MATERIALS: Two formulations, MGH1 (40% w/v honey) and MGH2 (80% w/v Manuka honey), were tested in vitro for minimal inhibitory concentrations (MIC) and minimal bactericidal concentrations (MBC) against 11 Staphylococcus and 11 Pseudomonas isolates at low [1.5 × 104  colony forming units (cfu)/well] and high (1.5 × 106  cfu/well) concentrations of inoculum, representing systemic and cutaneous bacterial loads during infection, respectively. RESULTS: MGH2 showed a lower MIC against staphylococci than MGH1, although this was not statistically significant. MGH1 had stronger bactericidal effects against staphylococci than MGH2, although this effect was statistically significant only at the higher bacterial concentration (P < 0.01). For Pseudomonas spp., MGH1 had significantly higher antimicrobial activity (both MIC and MBC) than MGH2 against all isolates tested and at both bacterial concentrations (P < 0.05). CONCLUSIONS AND CLINICAL IMPORTANCE: Both MGHs were effective in vitro against common cutaneous pathogens including meticillin-resistant staphylococci and Pseudomonas species. The higher efficacy of the MGH1 formulation against Pseudomonas and its consistent effects against staphylococci, while containing only half of the amount of honey compared to MGH2, invites further investigation of the mechanisms and clinical applications of MGH1.

First robot-assisted radical prostatectomy in a client-owned Bernese mountain dog with prostatic adenocarcinoma.

OBJECTIVE: To describe robot-assisted radical prostatectomy (RARP) and report the short-term outcome of a dog with prostatic cancer treated with RARP. STUDY DESIGN: Case report ANIMALS: Client-owned 6-year-old male-neutered Bernese mountain dog. METHODS: Robot-assisted radical prostatectomy was performed with a daVinci Si Surgical System through a transperitoneal approach. An interfascial nerve-sparing approach was used to preserve the neurovascular bundles and increase the likelihood of postoperative urinary continence. Urinary continence was assessed by placing white cloth bedding in the kennel during hospitalization and by owners' observation at home. RESULTS: The console time was 120 minutes, and the estimated intraoperative blood loss was 30 mL. No intraoperative complications were observed. The urinary catheter was removed after 7 days, at which point the dog urinated normally. Peritoneal carcinomatosis was diagnosed 43 days after surgery, and the dog was euthanized. CONCLUSION: Robot-assisted radical prostatectomy was successfully completed in a dog with prostatic neoplasia and led to postoperative urinary continence. CLINICAL SIGNIFICANCE: This single-case report provides evidence to justify further evaluation of RARP in dogs with prostatic neoplasms.

Prognostic factors for short-term survival of dogs that experience postattenuation seizures after surgical correction of single congenital extrahepatic portosystemic shunts: 93 cases (2005-2018).

OBJECTIVE: To identify prognostic factors for short-term survival of dogs that experience seizures within 7 days after surgical correction of single congenital extrahepatic portosystemic shunts (cEHPSS). STUDY DESIGN: Multi-institutional retrospective study. SAMPLE POPULATION: Ninety-three client-owned dogs. METHODS: Medical records at 14 veterinary institutions were reviewed to identify dogs that underwent surgical attenuation of a single cEHPSS from January 1, 2005 through February 28, 2018 and experienced postattenuation seizures (PAS) within 7 days postoperatively. Logistic regression analysis was performed to identify factors associated with 1-month survival. Factors investigated included participating institution, signalment, shunt morphology, concurrent/historical conditions, presence of preoperative neurologic signs, presence of preoperative seizures, aspects of preoperative medical management, surgical details including method and degree of shunt attenuation, type of PAS (focal only or generalized ± focal), drugs administered as part of the treatment of PAS, and development of complications during treatment of PAS. RESULTS: Thirty (32.3%) dogs survived to 30 days. Seventy-six (81.7%) dogs experienced generalized PAS. Factors positively associated with short-term survival included having a history of preoperative seizures (P = .004) and development of focal PAS only (P = .0003). Most nonsurvivors were humanely euthanized because of uncontrolled or recurrent seizures. CONCLUSION: Dogs that experienced PAS that had a history of preoperative seizures and those that experienced focal PAS only had significantly improved short-term survival. CLINICAL SIGNIFICANCE: The results of this study provide information that will help in the counseling of owners who seek treatment for PAS after surgical correction of cEHPSS. © 2020 The American College of Veterinary Surgeons.

Use of contrast-enhanced ultrasonography in the diagnosis of a liver lobe torsion in a rabbit (Oryctolagus cuniculus).

A 1-year-old male French Lop rabbit (Oryctolagus cuniculus) was presented with a sudden onset of hyporexia. Physical examination revealed cranial abdominal discomfort. Liver enzymes were elevated on serum biochemistry profile. Abdominal radiographs showed diffusely gas-dilated small intestinal loops. On abdominal ultrasound, a lobe in the right aspect of the liver was hypoechoic with rounded margins and was surrounded by hyperechoic fat and anechoic fluid. Contrast-enhanced ultrasonography showed complete lack of perfusion in the abnormal right liver lobe. Exploratory laparotomy revealed torsion of the quadrate liver lobe. Diffuse coagulation necrosis was noted on histopathologic examination. The rabbit fully recovered after surgery.

Effect of prophylactic treatment with levetiracetam on the incidence of postattenuation seizures in dogs undergoing surgical management of single congenital extrahepatic portosystemic shunts.

OBJECTIVE: To report the incidence of postattenuation seizures (PAS) in dogs that underwent single congenital extrahepatic portosystemic shunt (cEHPSS) attenuation and to compare incidence of PAS in dogs that either did or did not receive prophylactic treatment with levetiracetam (LEV). STUDY DESIGN: Multi-institutional retrospective study. POPULATION: Nine hundred forty dogs. METHODS: Medical records were reviewed to identify dogs that underwent surgical attenuation of a single cEHPSS from January 2005 through July 2017 and developed PAS within 7 days postoperatively. Dogs were divided into 3 groups: no LEV (LEV-); LEV at ≥15 mg/kg every 8 hours for ≥24 hours preoperatively or a 60 mg/kg intravenous loading dose perioperatively, followed by ≥15 mg/kg every 8 hours postoperatively (LEV1); and LEV at <15 mg/kg every 8 hours, for <24 hours preoperatively, or continued at <15 mg/kg every 8 hours postoperatively (LEV2). RESULTS: Seventy-five (8.0%) dogs developed PAS. Incidence of PAS was 35 of 523 (6.7%), 21 of 188 (11.2%), and 19 of 228 (8.3%) in groups LEV-, LEV1, and LEV2, respectively. This difference was not statistically significant (P = .14). No differences between groups of dogs that seized with respect to investigated variables were identified. CONCLUSION: The overall incidence of PAS was low (8%). Prophylactic treatment with LEV according to the protocols that were investigated in our study was not associated with a reduced incidence of PAS. CLINICAL SIGNIFICANCE: Prophylactic treatment with LEV does not afford protection against development of PAS. Surgically treated dogs should continue to be monitored closely during the first 7 days postoperatively for seizures.

Effect of premedication on dose requirement, cardiovascular effects and recovery quality of alfaxalone total intravenous anaesthesia in dogs.

OBJECTIVE: To investigate alfaxalone total intravenous anaesthesia (TIVA) following premedication with methadone combined with acepromazine (ACP) or dexmedetomidine in bitches undergoing ovariohysterectomy. STUDY DESIGN: Prospective, blinded, randomized, experimental study. ANIMALS: A group of 12 female Beagles. METHODS: Dogs were premedicated intravenously with methadone (0.2 mg kg-1) combined with ACP (20 µg kg-1, group AM) or dexmedetomidine (5 µg kg-1, group DM). Anaesthesia was induced with alfaxalone (2 mg kg-1). Anaesthetic maintenance was obtained with an alfaxalone variable rate infusion (VRI) started at 0.15 mg kg-1 minute-1 and adjusted every 5 minutes based on clinical assessment. Mechanical ventilation was initiated when necessary to maintain normocapnia. Anaesthetic monitoring included electrocardiogram, heart rate (HR), invasive diastolic (DAP), systolic (SAP) and mean arterial blood pressure, arterial haemoglobin oxygen saturation, respiratory variables and oesophageal temperature. Data were recorded every 5 minutes. A mixed model statistical approach was used to compare cardiovascular variables within and between groups (α = 0.05). A Wilcoxon rank-sum test was used to compare body temperature, VRI alfaxalone rate, administered rescue analgesia, sedation, induction, intubation, recovery scores and recovery times between treatments. RESULTS: Overall HR, SAP and DAP differed between groups (p = 0.001, 0.016, 0.019, respectively). The mean VRI dose rate of alfaxalone differed between groups DM [0.13 (0.11-0.14) mg kg-1 minute-1] and AM [0.18 (0.13-0.19) mg kg-1 minute-1; p = 0.030]. Rescue analgesia was administered more in group AM (p = 0.019). No significant difference in recovery times and scores was observed between protocols. CONCLUSIONS AND CLINICAL RELEVANCE: Alfaxalone TIVA following dexmedetomidine/methadone premedication produced a more stable plane of anaesthesia to perform ovariohysterectomy than ACP/methadone. A dose reduction of alfaxalone of 27.7% was obtained in group DM compared with group AM. Recovery quality and recovery times were comparable between both groups.

Biomechanical properties of celiotomy wounds closed with tape and cyanoacrylate versus intradermal sutures.

OBJECTIVE: To compare cutaneous wound closure with mesh and 2-octyl cyanoacrylate (MOC) vs an intradermal suture pattern (ISP) in terms of time of application and biomechanical properties. SAMPLE POPULATION: Experimental study with 12 female beagle dogs. METHODS: A skin incision was created from the xiphoid to the pubis as part of an ovariohysterectomy; the linea alba and subcutaneous tissue were closed routinely. Half of the skin incision was closed with MOC, and the other half was closed with an ISP. Tissue samples were collected from both sections at days 14 and 28 and tested for ultimate strength and stiffness. RESULTS: Closure with MOC (72.8 ± 14.0 s) was faster than with an ISP (398.4 ± 36.4 s; P = .001). The ultimate load and stiffness increased with time for MOC (P = .005 and P = .005, respectively) and ISP (P < .001 and P < .001, respectively). On day 14, ultimate load and stiffness were greater in wounds closed with MOC compared with ISP (P = .014 and P = .02, respectively). No difference between groups was detected at day 28. CONCLUSION: Cutaneous wound closure with MOC was faster and resulted in superior strength at 14 days compared with closure with an ISP in this healthy population. CLINICAL SIGNIFICANCE: Mesh and 2-octyl cyanoacrylate offers an attractive alternative to ISP for skin closure after celiotomy in dogs, especially if surgical/anesthesia time is a concern.

Negative pressure wound therapy using polyvinyl alcohol foam to bolster full-thickness mesh skin grafts in dogs.

OBJECTIVE: To report the use of negative pressure wound therapy (NPWT) with polyvinyl alcohol (PVA) foam to bolster full-thickness mesh skin grafts in dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Client-owned dogs (n = 8). MATERIAL AND METHODS: Full-thickness mesh skin graft was directly covered with PVA foam. NPWT was maintained for 5 days (in 1 or 2 cycles). Grafts were evaluated on days 2, 5, 10, 15, and 30 for graft appearance and graft take, granulation tissue formation, and complications. RESULTS: Firm attachment of the graft to the recipient bed was accomplished in 7 dogs with granulation tissue quickly filling the mesh holes, and graft take considered excellent. One dog had bandage complications after cessation of the NPWT, causing partial graft loss. The PVA foam did not adhere to the graft or damage the surrounding skin. CONCLUSION: The application of NPWT with a PVA foam after full-thickness mesh skin grafting in dogs provides an effective method for securing skin grafts, with good graft acceptance. PVA foam can be used as a primary dressing for skin grafts, obviating the need for other interposing materials to protect the graft and the surrounding skin.