Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003-2017).

OBJECTIVE: To report intraoperative and major postoperative complications in dogs treated surgically for epiglottic retroversion (ER), compare the incidence of major postoperative complications between procedures, and report survival of surgically treated dogs. STUDY DESIGN: Multi-institutional retrospective study. SAMPLE POPULATION: Fifty dogs treated with 78 procedures. METHODS: Medical records of dogs diagnosed and surgically treated for ER from 2003 to 2017 at 11 institutions were reviewed. Complications were divided into intraoperative and major postoperative complications. RESULTS: Intraoperative complications occurred during 2 of 78 (2.6%) procedures. Thirty-six major postoperative complications were documented in 22 dogs after 36 of 74 (48.7%) procedures. Postoperative complications occurred after 7 of 12 (58.3%) nonincisional epiglottopexy, 23 of 43 (53.5%) incisional epiglottopexy, 2 of 4 (50%) partial epiglottectomy, 2 of 12 (16.7%) subtotal epiglottectomy, and 2 of 3 (66.7%) other surgical procedures. Epiglottopexy failure was the most common major postoperative complication. The incidence of major postoperative complications did not differ between procedures (P = .1239), although, when combined, epiglottopexy procedures (30/55) had a higher incidence of complications than epiglottectomy procedures (4/16; P = .048). Thirty (60%) dogs were alive at a median of 928 days (range, 114-2805), 8 (16%) were lost to follow-up after 411 days (range, 43-1158), and 12 (24%) were dead/euthanized after 301.5 days (range, 3-1212). Median survival time was not reached after a median of 716 days. CONCLUSION: Although intraoperative complications were uncommon, major postoperative complications were common, especially after epiglottopexy procedures. CLINICAL SIGNIFICANCE: Although surgical treatment of ER is associated with a high rate of major postoperative complications, especially epiglottopexy procedures, long-term survival can be achieved.

Lateral caudal axial pattern flap in 13 dogs.

OBJECTIVE: To describe the frequency and extent of complications associated with lateral caudal axial pattern flaps used to cover large traumatic or excision skin defects on the dorsum, gluteal, and perineal region in 13 dogs. STUDY DESIGN: Case series. ANIMALS: Thirteen client-owned dogs. METHODS: Medical records from 8 institutions were reviewed for dogs treated with a lateral caudal axial pattern flap, including cases in which the procedure was combined with other reconstructive techniques. The flap length relative to the tail length, location of tail skin incision, size and cause of the defect, and short- and long-term complications were recorded. RESULTS: Thirteen dogs were included, 11 with tumors and 2 with traumatic skin loss. The mean estimated length of the flap relative to tail length was 51% (range 33-70%). Four dogs had wound complications. This included 2 dogs with minor postoperative wound complications (mild distal dehiscence) that did not require surgical revision and 2 dogs with major complications that required surgical revision. Two of these 4 dogs had distal flap necrosis, one was revised surgically and one was managed conservatively. In these 2 dogs, the flap length was estimated as 80% and 65% of the tail length, respectively. At 30 days, flaps in all dogs were completely healed. No long-term complications were recorded in any dog. For some dogs, the reconstruction was not obvious, with only the change in hair direction and color noticeable. CONCLUSION: Lateral caudal axial pattern flap is a reconstructive option for gluteal, dorsal, and perineal skin defects in dogs. Distal flap necrosis and dehiscence due to wound infection occurred in 4 dogs that required additional wound care but not always surgical revision.

Closed suction drainage for treatment of septic peritonitis of confirmed gastrointestinal origin in 20 dogs.

OBJECTIVE: To determine survival rate in dogs with septic peritonitis of confirmed gastrointestinal origin treated with closed suction drainage. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n = 20) with septic peritonitis. METHODS: Medical records (2007-2010) of dogs with septic peritonitis of confirmed gastrointestinal origin treated by closed suction drainage were reviewed. Information on signalment, clinicopathologic abnormalities, underlying cause, surgical procedure performed, postoperative management, complications, and outcome was obtained. RESULTS: Dehiscence of a previous anastomosis was the most common source of contamination (80%). Drains remained in place, collecting fluid produced within the abdomen, for a median of 6 days (range, 2-11 days). Eighteen dogs received nutritional support, and 14 received plasma transfusions. Seventeen dogs (85%) survived to discharge. CONCLUSIONS: Closed suction drainage together with resolution of the underlying cause of peritonitis and appropriate postoperative management is an effective technique for treatment of septic peritonitis of confirmed gastrointestinal origin in dogs.

Caudal mediastinal paraesophageal abscesses in 7 dogs.

OBJECTIVE: To report clinical, imaging, and surgical findings associated with caudal mediastinal paraesophageal abscesses (CMPA) in dogs and outcome after surgical treatment. STUDY DESIGN: Case series. ANIMALS: Dogs (n = 7) with CMPA. METHODS: Medical records (April 2005-January 2010) were reviewed for dogs with CMPA treated surgically. Retrieved data were signalment, history, clinical findings, diagnostic investigations, surgical findings, surgical procedures performed, and postoperative recovery. Long-term follow-up information was obtained by telephone questionnaire of owners and referring veterinarians. RESULTS: Median sternotomy (5 dogs) or lateral thoracotomy (2 dogs) was used for access to CMPA, which were drained and partially debrided surgically. In 5 dogs, omentalization of the abscess cavity was performed through a diaphragmatic incision. Foreign material was not identified within any abscess. All dogs were discharged from the hospital and had full recovery. CONCLUSIONS: CMPA should be suspected when there is regurgitation and pyrexia associated with a mass or enlargement in the caudal mediastinum. CMPA appears to have a good prognosis after aggressive surgical therapy.

Minimally invasive inguinal approach for tube cystostomy.

OBJECTIVE: To report a technique for tube cystostomy placement via a minimally invasive inguinal approach and outcome in 9 dogs and 6 cats with urinary tract obstruction or detrusor atony. STUDY DESIGN: Case series. ANIMALS: Dogs (n=9) and cats (6). METHODS: Medical records (January 2004-January 2008) of dogs and cats that had tube cystostomy via an inguinal approach were reviewed. Retrieved data included signalment, diagnosis, surgical technique, and complications. Access to the bladder was through a muscle splitting approach in the inguinal region with the cystostomy tube placed through a skin incision made several centimeters proximal to this incision and secured in the bladder by a purse string suture. Cystopexy during closure of the muscle layers ensured secure closure and minimized the likelihood of uroabdomen if tube dislodgment occurred. RESULTS: Cystostomy tubes were placed in 5 cats as an emergency procedure for treatment of acute urinary tract obstruction or urethral rupture, and as an elective procedure in 9 dogs and 1 cat. No complications occurred during cystostomy tube placement. Postprocedural complications were minor (peristomal irritation in 2 dogs with latex catheters, catheter laceration, premature removal) and only occurred when tubes were retained for >4 weeks. Urinary tract infection at catheter removal in 6 dogs resolved with antibiotic administration. CONCLUSIONS: An inguinal approach for cystostomy tube placement facilitated rapid catheter placement into the bladder with minimal soft tissue dissection. Cystopexy during abdominal wall closure provided peritoneal protection should premature dislodgement of the cystostomy tube occur. CLINICAL RELEVANCE: An inguinal approach should be considered for rapid tube cystostomy particularly in metabolically compromised animals.

Pyothorax in a cat managed by intrathoracic debridement and postoperative ventilatory support.

: A domestic-longhair cat presented due to lethargy, dyspnoea and hypersalivation. Radiographic examination revealed a bilateral pleural effusion, which was diagnosed as pyothorax based on cytological examination. Ultrasonographic examination revealed extensive loculations within the thoracic cavity. Exploratory sternotomy, under general anaesthesia, allowed the removal of approximately 100 ml of purulent fluid and debridement of a partially walled-off abscess and necrotic material from the pleural cavity. Postoperative positive-pressure ventilation was required due to severe respiratory depression. Intensive postoperative care, including intensive continuous monitoring, thoracostomy tube drainage and lavage of the pleural cavity and oesophagostomy tube feeding, was performed. Complete resolution of clinical signs had occurred by 15 days postoperatively. Clinical or radiographic abnormalities were not detected at a follow-up examination one year after surgery.

Surgical management of 43 cases of chronic otitis externa in the dog.

: Over a seven-year period, chronic otitis externa was surgically managed in 43 dogs at the University Veterinary Hospital of University College Dublin. Lateral ear canal resection (LECR) was undertaken in nine of the 43 dogs: results were unsatisfactory, with a failure of the surgery in five of eight dogs and one dog lost to follow-up. Once end-stage otitis externa, with or without otitis media, is diagnosed, total ear canal ablation and lateral bulla osteotomy (TECA/LBO) is the best treatment option. In this series, 37 of 43 dogs underwent TECA/LBO and of the 29 dogs for which follow-up results were obtained 27 (93%) had an excellent or improved outcome to surgery. Complications following all procedures were most common in cases with a concurrent dermatopathy; therefore, definitive diagnosis and medical treatment for skin and ear disease is essential.