Evaluation of the intervertebral disk, vertebral body, and spinal cord for changes secondary to percutaneous laser disk ablation.

OBJECTIVE: To evaluate the intervertebral disk, vertebral endplates, and spinal cord for perioperative changes secondary to percutaneous laser disk ablation (PLDA) and correlate findings to clinical outcomes in dogs receiving thoracolumbar PLDA. STUDY DESIGN: Blinded study. ANIMALS: Thirty dogs. METHODS: Magnetic resonance imaging (MRI) was performed before PLDA (control/Group C), immediately following PLDA (Group I), and 3 months later (perioperative/Group P). Dogs were followed 3 years. Groups and dogs were randomized for evaluation. Two radiologists were blinded to each MRI study and dog. Each radiologist evaluated the disk, vertebral body, and spinal cord at each disk space receiving PLDA. RESULTS: Mean disk degeneration was increased in Group P at L1-2 (p < .0001) and L2-3 (p = .0081). Both radiologists identified mild diskitis (1%-15%) in Group P (radiologist 1, p < .0001; radiologist 2, p = .0012). Cranial endplate lesions were identified in Group P at T11-12 (p = .0353), T13-L1 (p = .0026), and L4-5 (p = .0210). Lesions were identified in the caudal endplates of all eight disk spaces in Group P: T10-11 (p = .0004), T11-12 (p < .0001), T12-13 (p < .0001), T13-L1 (p < .0001), L1-2 (p < .0001), L2-3 (p < .0001), L3-4 (p < .0001), and L4-5 (p < .0001). There was no disk extrusion or spinal cord lesions identified. CONCLUSION: This study evaluated effects that may occur secondary to PLDA, using MRI. Although vertebral body changes were identified, they did not correlate with clinical complications. CLINICAL SIGNIFICANCE: PLDA appears to be a safe, effective procedure performed on thoracolumbar disks to reduce recurrence of intervertebral disk herniation (IVDH) in dogs that previously experienced IVDH, despite the appearance of visible vertebral endplate lesions and mild diskitis on MRI.

Outcomes of dogs undergoing immediate or delayed surgical treatment for gastrointestinal foreign body obstruction: A retrospective study by the Society of Veterinary Soft Tissue Surgery.

OBJECTIVE: To evaluate gastrointestinal injury and outcomes between dogs treated with immediate surgical intervention vs those treated with delayed surgical intervention for gastrointestinal foreign body obstruction (GIFBO). STUDY DESIGN: Retrospective cohort study. SAMPLE POPULATION: Client-owned dogs (n = 855) from five referral hospitals. METHODS: Medical records of dogs in which GIFBO had been diagnosed between 2007 and 2017 were reviewed for preoperative management, timing of surgery, intraoperative findings, postoperative management, outcome, and survival. Surgical intervention was classified as immediate when it occurred within 6 hours of presentation and delayed when it occurred >6 hours after presentation. RESULTS: Outcomes did not differ between dogs treated immediately (n = 584) or over 6 hours after presentation (n = 210). Intestinal necrosis and perforations were more common when surgery was delayed (P = .008; P = .019) but became nonsignificant after controlling for preoperative differences. Risk factors for necrosis and perforations included duration of clinical signs, increased lactate, linear foreign material, and timing of surgery. Enterectomies (P = .004) as well as the duration of surgery (P = .004) and anesthesia (P = .001) were increased when surgery was delayed. Immediate surgery was associated with earlier return to feeding (P = .004) and discharge from the hospital (P < .001); (5%) dogs in each group (n = 33 immediate; n = 11 delayed) either had a negative explore or the foreign body was milked aborally into the colon at the time of surgery. CONCLUSION: Although outcomes were not associated with surgical timing, the unadjusted prevalence of gastrointestinal injury and, thus, the requirement for complex surgical procedures was higher in the delayed group. CLINICAL SIGNIFICANCE: Earlier surgical treatment of stabilized dogs with GIFBO may involve fewer complex procedures and accelerate recovery.

Transcutaneous transmission of photobiomodulation light to the spinal canal of dog as measured from cadaver dogs using a multi-channel intra-spinal probe.

The target level photobiomodulation (PBM) irradiances along the thoracic to lumbar segment of the interior spinal canal in six cadaver dogs resulting from surface illumination at 980 nm were measured. Following a lateral hemi-laminectomy, a flexible probe fabricated on a plastic tubular substrate of 6.325 mm diameter incorporating nine miniature photodetectors was embedded in the thoracic to lumbar segment of the spinal canal. Intra-spinal irradiances at the nine photodetector sites, spanning an approximate 8 cm length caudal to T13, were measured for various applied powers of continuous wave (CW) surface illumination at 980 nm with a maximal power of 10 W corresponding to a surface irradiance of 3.14 W/cm2. The surface illumination conditions differed in skin transmission when the probe was off-contact with tissue and probe-skin contact when the skin was in place. For each condition of surface illumination, the beam was directed to respectively T13 (surface site 1), a spinal column site 4 cm caudal to T13 (surface site 5), and a spinal column site 8 cm caudal to T13 (surface site 9). Off-contact surface irradiation of 3.14 W/cm2 at surface sites 1, 5, and 9 transmitted respectively 234.0 ± 120.7 µW/cm2, 230.7 ± 178.3 µW/cm2, and 130.2 ± 169.6 µW/cm2 to the spinal canal without the skin, and respectively 35.7 ± 33.2 µW/cm2, 50.9 ± 75.3 µW/cm2, and 15.7 ± 16.3 µW/cm2 with the skin. Transmission with skin was as low as 12% of the transmission without the skin. On-contact surface irradiation of 3.14 W/cm2 at surface sites 1, 5, and 9 transmitted respectively 44.6 ± 43.1 µW/cm2, 85.4 ± 139.1 µW/cm2, and 22.0 ± 23.6 µW/cm2 to the spinal canal. On-contact application increased transmission by a maximum of 67% comparing to off-contact application. The information gathered highlights the need to clinically consider the impact of skin transmission and on-contact application technique when attempting to treat spinal cord disease with PBM.

Surgical ligation of patent ductus arteriosus in a dorper sheep.

OBJECTIVE: To report the diagnosis and treatment of a companion dorper wether with patent ductus arteriosus (PDA). STUDY DESIGN: Case report. ANIMAL: An 8-month-old dorper wether presented to its primary care veterinarian for a persistent cough and was referred for suspected heart failure on the basis of physical examination and thoracic radiography. A PDA was diagnosed on echocardiography. METHODS: The sheep underwent cardiac catheterization and angiogram to measure pulmonary arterial and right ventricular (RV) pressures, identify the morphology of the PDA, and determine whether an intravascular occlusion of the PDA was feasible. Pulmonary artery pressure was 84/53 mm Hg (mean = 66), and RV pressures were 79/5 mm Hg (mean = 45); these were consistent with pulmonary hypertension. The size and shape of the PDA precluded vascular occlusion. Instead, the PDA was ligate through a left fourth intercostal approach. RESULTS: The sheep improved clinically after surgery. The PDA seemed closed on echocardiogram 3 days after surgery. Measurement of postoperative fractional shortening was consistent with decreased left ventricular systolic function that had resolved according to follow-up echocardiography. CONCLUSION: We report the first known diagnostic evaluation and successful treatment of naturally occurring PDA in a companion sheep. CLINICAL SIGNIFICANCE: For economically valuable small ruminants, radiographs, echocardiography and cardiac catheterization can be used to diagnose and plan surgical treatment of PDAs, with a potential for a good long-term outcome.

Comparison of methohexital and propofol as induction agents for evaluation of laryngeal function in healthy dogs.

OBJECTIVE: To determine the influence of propofol or methohexital, with and without doxapram, on the examination of laryngeal function in dogs. STUDY DESIGN: Experimental study. ANIMALS: Forty healthy dogs randomly assigned to 4 groups: propofol with saline (n = 10), propofol with doxapram (n = 10), methohexital with saline (n = 10), or methohexital with doxapram (n = 10). METHODS: Propofol and methohexital were administered to effect. Investigators examined laryngeal function (initial) simultaneously with video laryngoscopy. Doxapram or saline was administered, and laryngeal function was reevaluated (second). Laryngeal motion, quality of laryngeal exposure, and the degree of swallowing, laryngospasm, and jaw tone were scored at each evaluation. Adverse events were recorded. Initial and second videos were evaluated by a masked observer, and still images obtained from both evaluations were evaluated for change in rima glottidis size by 2 masked observers. RESULTS: Administration of doxapram and saline was delayed with propofol (P = .001). Laryngeal function did not differ between dogs receiving propofol or methohexital, irrespective of doxapram administration. Doxapram improved breathing scores in both groups (P < .001). Jaw tone increased with propofol during the second evaluation (P = .049). Swallowing was more prevalent at initial examination (P = .020). Methohexital resulted in an increased heart rate (P < .001) compared with propofol. Twenty-five percent of dogs receiving methohexital developed seizure-like activity (n = 5/20). CONCLUSION: Evaluation of laryngeal function did not differ between healthy dogs anesthetized with propofol or methohexital. Methohexital provided shorter examination times with less jaw tone but was associated with adverse events. CLINICAL SIGNIFICANCE: This study provides evidence to recommend propofol over methohexital as an induction agent for laryngeal function examination.

Saline, chlorhexidine, and povidone-iodine alone or in combination with iodine povacrylex are effective antiseptics in chickens (Gallus gallus domesticus).

OBJECTIVE: To evaluate the topical antiseptic activity of saline, chlorhexidine (CHX), and povidone-iodine (PI) scrubs on the skin of chickens with or without the addition of DuraPrep (DP). ANIMALS: 7 healthy adult Orpington hens (Gallus gallus domesticus). METHODS: The right apterium corporale laterale was swabbed for standard aerobic bacterial culture and colony-forming unit (CFU) determination. The apterium was divided into 3 areas and treated with sterile saline, CHX, or PI. Samples were collected by swabbing each area before and after additional treatment with DP. CFU's were counted after 48 hours of incubation. Statistical analysis was performed using a linear mixed model with a continuous outcome. RESULTS: Compared to saline, CHX and PI treatment without DP decreased CFU count by 119 (95% CI, 55 to 183; P < .001) and 123 (95% CI, 58 to 187; P < .001), respectively. The application of DP after CHX and PI further decreased CFU counts by 6 (P = .01) and 9 (P = .01), respectively. DP after saline treatment decreased counts by 128 CFU (95% CI, 63 to 192; P < .001). No significant difference was detected between saline, PI, or CHX after DP application (-1.0 CFU; 95% CI, 63.4 to -65.4; P = .98 for both PI and CHX). CLINICAL RELEVANCE: CHX or PI provided greater reductions in bacterial CFU than saline, and all combinations with DP provided similar results. No notable cutaneous reactions were detected at any point. This data suggests that a scrub protocol including CHX or PI with DP is acceptable in surgical site preparation of chickens.

Enabling Chemo-Immunotherapy with HIFU in Canine Cancer Patients.

High intensity focused ultrasound (HIFU) is a promising non-invasive technique for treating solid tumors using thermal and histotripsy-based mechanical ablation. However, its clinical significance in different tumor types is not fully understood. To assess its therapeutic efficacy and immunomodulatory properties, we compared HIFU thermal ablation and histotripsy ablation in dogs with spontaneous tumors. We also evaluated the ability of non-ablative HIFU-based mild hyperthermia (40-45 ºC) to improve Doxorubicin delivery and immunomodulation. Our results showed that HIFU thermal ablation induced tumor remission in the majority of treated patients over 60 days, while histotripsy achieved partial response to stable disease persistence. The adverse effects of thermal ablation were minor to moderate, while histotripsy exposures were relatively well-tolerated. Furthermore, we observed a correlation between HIFU-therapeutic response and serum anti-tumor cytokine profiles and the presence of functionally active cytotoxic immune cells in patients. Similarly, Doxorubicin-treated patients showed improved drug delivery, efficacy, and anti-tumor immune responses with HIFU hyperthermia. In conclusion, our study demonstrates that depending on the tumor type and treatment parameters, HIFU treatments can enable tumor growth control, immune activation, and chemotherapy in veterinary patient. These findings have significant clinical implications and highlight the potential of HIFU as a promising cancer treatment approach.

Diagnostic utility of ultrasound-guided fine-needle aspiration and needle-core biopsy sampling of canine splenic masses.

This prospective clinical study sought to determine the accuracy of cytopathologic examination and needle-core biopsy (NCB) against diagnoses obtained by excisional histopathology (EH) for canine splenic masses. Twenty-five masses were evaluated ex vivo by ultrasound-guided fine-needle aspiration (FNA) and NCB tissue sampling. Each spleen was placed in a container and artificial skin placed over its surface. Ultrasound-guided FNA using a 22-gauge needle and 2 NCB samples [14-gauge (NCB-14), 16-gauge (NCB-16)] were obtained and submitted for analysis. Results were compared to results obtained by splenic excisional histopathology (EH). There was no difference noted between FNA, NCB-14, or NCB-16 analyses. In addition, there was no difference in accuracy between FNA and NCB-14 or between FNA and NCB-14 versus NCB-16. Reported accuracy of FNA was 0.72, NCB-14 was 0.72, and NCB-16 was 0.64, respectively. Both FNA and NCB-14 displayed a sensitivity of 71% and NCB-16 a sensitivity of 53%. Both FNA and NCB-14 displayed a specificity of 75% and NCB-16 a specificity of 88%. The results demonstrated that NCB had no advantage clinically over FNA at diagnosing splenic pathology. This study further demonstrates that preoperative diagnostic evaluation of the spleen is not highly accurate and cannot be recommended prior to splenectomy.

Cette étude clinique prospective visait à déterminer la précision de l'examen cytopathologique et de la biopsie au trocart (NCB) par rapport aux diagnostics obtenus par histopathologie excisionnelle (EH) pour les masses spléniques canines. Vingt-cinq masses ont été évaluées ex vivo par aspiration à l'aiguille fine guidée par ultrasons (FNA) et prélèvement de tissu par NCB. Chaque rate a été placée dans un récipient et une peau artificielle placée sur sa surface. Une FNA guidée par ultrasons à l'aide d'une aiguille de calibre 22 et de 2 échantillons de NCB (calibre 14 (NCB-14), calibre 16 (NCB-16)) ont été obtenues et soumises pour analyse. Les résultats ont été comparés aux résultats obtenus par histopathologie excisionnelle splénique (EH). Aucune différence n'a été notée entre les analyses FNA, NCB-14 ou NCB-16. De plus, il n'y avait aucune différence de précision entre FNA et NCB-14 ou entre FNA et NCB-14 par rapport à NCB-16. La précision rapportée de FNA était de 0,72, celle de NCB-14 de 0,72 et de NCB-16 était de 0,64, respectivement. FNA et NCB-14 ont affiché une sensibilité de 71 % et NCB-16 une sensibilité de 53 %. FNA et NCB-14 ont affiché une spécificité de 75 % et NCB-16 une spécificité de 88 %. Les résultats ont démontré que la NCB n'avait aucun avantage clinique sur la FNA pour diagnostiquer la pathologie splénique. Cette étude démontre en outre que l'évaluation diagnostique préopératoire de la rate n'est pas très précise et ne peut être recommandée avant la splénectomie.(Traduit par Docteur Serge Messier).

Risk factors for intraoperative hemorrhage and perioperative complications and short- and long-term outcomes during surgical patent ductus arteriosus ligation in 417 dogs.

OBJECTIVE: To evaluate the short- and long-term outcomes of dogs undergoing surgical ligation for a left-to-right shunting patent ductus arteriosus (PDA), identify risk factors for intraoperative hemorrhage and intra- and postoperative complications, and report overall mortality rates. ANIMALS: 417 client-owned dogs undergoing surgical ligation for a left-to-right shunting PDA between January 2010 and January 2020. PROCEDURES: Data recorded included patient signalment, echocardiogram findings, intraoperative complications and mortality, postoperative complications, and short- and long-term outcomes. RESULTS: There was no association between age and risk of intraoperative hemorrhage (P = .7), weight and intraoperative hemorrhage (P = .96), or increasing left atrium-to-aortic (LA:Ao) ratio and intraoperative hemorrhage (P = .08). Intraoperative hemorrhage occurred in 10.8% of patients. Intraoperative mortality was 2%. Ninety-five percent of dogs experiencing intraoperative hemorrhage survived to discharge. Survival to discharge was 97%. One- and 5-year survival rates were 96.4% and 87%, respectively. CLINICAL RELEVANCE: Surgical ligation for a left-to-right shunting PDA is recommended due to the good long-term prognosis. Certain preoperative factors such as age, weight, and the presence and degree of mitral valve regurgitation had no detectable association with risks of intraoperative hemorrhage and, therefore, should not preclude surgical treatment for a left-to-right shunting PDA. Future studies are needed to further assess the association between increasing LA:Ao ratio and risk of intraoperative hemorrhage.

Effect of Bidirectional Insertion of External Skeletal Fixation Pins on Axial Pullout Strength in Canine Cadaveric Bone.

OBJECTIVE: The aim of this study was to evaluate the effect of bidirectional insertion on axial pullout strength of tapered run out (TRO), traditional negative profile (TNP) and positive profile (PP) pins. STUDY DESIGN: Cadaveric adult canine tibiae were harvested. Tapered run out pins (Group 1) were inserted unidirectionally to the desired position; bidirectionally past the desired position, then withdrawn to the desired position (Group 2); and bidirectionally as described for Group 2, repeated twice (Group 3). Traditional negative profile pins (Group 4-6) and PP pins (Group 9-11) were placed in the same manner. Tapered run out (Group 7), TNP (Group 8) and PP pins (Group 12) were driven unidirectionally such that the shaft of the pin violated the cis-cortex. A servohydraulic testing machine extracted the pins and measured axial peak pullout strength. RESULTS: Positive profile pins had significantly greater pullout strength than TRO and TNP pins placed unidirectionally to the desired position. Method of insertion had no effect on peak pullout strength of TNP pins. TRO and PP pins inserted unidirectionally to the desired position had significantly greater peak pullout strengths than insertion bidirectionally or if the shaft of the pin violated the cis-cortex. CONCLUSION: The authors recommend that pins used for external skeletal fixation should be placed unidirectionally to the desired position with fluoroscopic guidance, intra-operative depth gauge measurements or measurements from preoperative radiographs. Repositioning pins results in loss of peak pullout strength with TRO and PP pins.

In vitro effect of hydroxyethyl starch on coagulation in dogs as assessed by dynamic viscoelastic coagulometry.

OBJECTIVE: To evaluate the effect of 6% hydroxyethyl starch (HES) 670/0.75 and 6% HES 130/0.4 dilution of canine whole blood on coagulation using dynamic viscoelastic coagulometry (DVC). ANIMALS: 56 healthy adult dogs. PROCEDURES: 2 blood samples were obtained from each dog and randomized to 1 of 7 groups-undiluted or 2 dilutions (1:3 or 1:10) of 3 different fluids: saline (0.9% NaCl) solution, 6% HES 670/0.75, or 6% HES 130/0.4. Dilutions were calculated to simulate approximately a 10- or 30-mL/kg body weight IV bolus of each fluid. DVC was performed on each sample. Coagulation parameters compared between groups included clot rate (CR), platelet function (PF), and activated clotting time. RESULTS: Dilution with saline solution did not significantly affect coagulation, while dilution with HES 670/0.75 and HES 130/0.4 caused a dose-dependent significant decrease in CR (1:3 HES 670/0.75, P = 0.007; 1:10 HES 670/0.75, P = 0.002; 1:3 HES130/0.4, P < 0.0001; and 1:10 HES 130/0.4, P = 0.0003) and PF (1:3 HES 670/0.75, P < 0.0001; 1:10 HES 670/0.75, P < 0.0001; 1:3 HES130/0.4, P < 0.0001; and 1:10 HES 130/0.4, P = 0.0015). CLINICAL RELEVANCE: Dilution of canine blood with HES 670/0.75 and HES 130/0.4, at clinically relevant doses (10 and 30 mL/kg), led to significant hypocoagulability beyond dilutional effect. This was, in part, due to impaired PF, which was significantly greater with HES 670/0.75. Further research using DVC to assess the effects of HES on coagulation in dogs, ideally with clinical conditions warranting HES administration, is needed.

American Canine Hepatozoonosis Causes Multifocal Periosteal Proliferation on CT: A Case Report of 4 Dogs.

American canine hepatozoonosis (ACH) represents an important but relatively uncommon differential diagnosis in a dog with fever, muscle wasting, profound leukocytosis, and/or musculoskeletal pain. Despite this, obtaining a definitive diagnosis can prove difficult. Peripheral blood smears and whole-blood polymerase chain reaction (PCR) rely on rare parasitemia, and the gold standard diagnostic test (skeletal muscle biopsy) is uncommonly pursued due to its invasive and costly nature. Demonstration of characteristic periosteal proliferative lesions aids diagnosis. The lesions typically involve the more proximal long bones of the appendicular skeleton. The periosteal proliferation is of currently unknown pathogenesis, but its distribution is characteristic of this disease with few differential diagnoses. This case series describes the findings on computed tomography (CT) in 4 dogs with PCR- or cytologically-confirmed Hepatozoon americanum. All dogs had multifocal, bilaterally asymmetric, irregularly marginated, non-destructive, non-articular, periosteal proliferative lesions. Recognition of this unusual CT finding and awareness of this disease could assist in the diagnosis and subsequent treatment of dogs with ACH and may offer an additional indication for CT in cases of fever, muscle wasting, and myalgia.

Incidence, survival time, and surgical treatment of parathyroid carcinomas in dogs: 100 cases (2010-2019).

OBJECTIVE: To evaluate outcomes of dogs with parathyroid carcinoma (PTC) treated by surgical excision and to describe the incidence of postoperative hypocalcemia, degree of hypocalcemia, duration of hospitalization, duration of calcium supplementation, and survival time. ANIMALS: 100 client-owned dogs with PTC admitted to academic, referral veterinary institutions. PROCEDURES: In a retrospective multi-institutional study, medical records of dogs undergoing surgical excision of PTC between 2010 to 2019 were reviewed. Signalment, relevant medical history, clinical signs, clinicopathologic testing, imaging, surgical findings, intraoperative complications, histologic examination, and survival time were recorded. RESULTS: 100 dogs with PTC were included, and 96 dogs had clinical or incidental hypercalcemia. Common clinical signs included polyuria (44%), polydipsia (43%), hind limb paresis (22%), lethargy (21%), and hyporexia (20%). Cervical ultrasonography detected a parathyroid nodule in 91 of 91 dogs, with a single nodule in 70.3% (64/91), 2 nodules in 25.3% (23/91), and ≥ 3 nodules in 4 (4/91)% of dogs. Hypercalcemia resolved in 89 of 96 dogs within 7 days after surgery. Thirty-four percent of dogs developed hypocalcemia, on the basis of individual analyzer ranges, within 1 week after surgery. One dog had metastatic PTC to the prescapular lymph node, and 3 dogs were euthanized for refractory postoperative hypocalcemia. Estimated 1-, 2-, and 3-year survival rates were 84%, 65%, and 51% respectively, with a median survival time of 2 years. CONCLUSIONS AND CLINICAL RELEVANCE: Excision of PTC results in resolution of hypercalcemia and excellent long-term tumor control. Surgical excision of PTC is recommended because of resolution of hypercalcemia and a good long-term prognosis. Future prospective studies and long-term follow-up are needed to further assess primary tumor recurrence, metastasis, and incidence of postoperative hypocalcemia.

Retrospective multicentric study comparing durations of surgery and anesthesia and likelihoods of short- and long-term complications between cats positioned in sternal or dorsal recumbency for perineal urethrostomy.

OBJECTIVE: To compare the durations of surgery and anesthesia and the likelihoods of short- and long-term postoperative complications between cats positioned in sternal recumbency versus dorsal recumbency for perineal urethrostomy (PU). ANIMALS: 247 client-owned cats that underwent PU between January 2004 and December 2015 at 6 veterinary teaching hospitals and 1 private veterinary referral hospital. PROCEDURES: Medical records were reviewed, and signalment, presenting complaints, previous history of urethral obstruction or PU, diet fed, medications administered, indication for PU, durations of surgery and anesthesia for PU, suture type and size, suture pattern for skin closure, and short- and long-term postoperative complications were recorded. Univariable and multivariable analyses were performed to identify differences in durations of surgery and anesthesia and the likelihoods of short- and long-term complications between cats positioned in sternal recumbency and those positioned in dorsal recumbency. RESULTS: Patient position was not associated with durations of surgery and anesthesia for PU, even if a concurrent cystotomy was necessary or the patient required repositioning from sternal to dorsal recumbency. Likewise, patient position was not associated with the likelihood of short- and long-term complications. CONCLUSIONS AND CLINICAL RELEVANCE: The observed lack of differences in outcomes between sternal and dorsal recumbency suggested that logistic considerations and personal preference can continue to guide veterinarians when positioning cats for PU.

Pulmonary artery banding in a cat with a perimembranous ventricular septal defect and left-sided congestive heart failure.

CASE DESCRIPTION A 6-month-old sexually intact male domestic shorthair cat was referred for evaluation of a heart murmur and ventricular septal defect (VSD). CLINICAL FINDINGS Physical examination revealed a grade 5/6 right apical systolic heart murmur. Findings on thoracic radiography were consistent with moderate right and left ventricular enlargement, left atrial enlargement, and enlargement of the pulmonary arteries and veins; an interstitial pulmonary pattern was also evident. Echocardiography revealed a perimembranous VSD with left-to-right shunting combined with trace mitral valve regurgitation. The cat later developed a dry cough, the intensity of the heart murmur increased to grade 6/6, and signs of left-sided congestive heart failure developed. TREATMENT AND OUTCOME Medical treatment included enalapril maleate and furosemide. When the cat's condition worsened despite medical treatment, palliative pulmonary artery banding was performed. During surgery, blood pressure in the pulmonary artery was measured with a pulmonary artery catheter, and pulmonary artery banding was successfully achieved with a polytetrafluoroethylene band and hemoclips. The pulmonary-to-systemic blood flow ratio was reduced from 3 to 1.5, and signs of congestive heart failure resolved within 2 weeks after surgery. CLINICAL RELEVANCE Findings suggested that cats with a VSD and pulmonary-to-systemic flow ratio > 3 or with congestive heart failure attributable to a VSD could be considered candidates for palliative pulmonary artery banding to alleviate clinical signs. However, further investigation into long-term prognosis with objective outcome measurements and with multiple cases is needed. (J Am Vet Med Assoc 2019;254:723-727).

Analysis of outcomes following treatment of craniodorsal hip luxation with closed reduction and Ehmer sling application in dogs.

OBJECTIVE To describe outcomes for dogs after treatment of craniodorsal hip luxation with closed reduction and Ehmer sling placement and investigate potential risk factors for sling-associated tissue injury or reluxation of the affected hip at or near the time of sling removal. DESIGN Retrospective multicenter cohort study. ANIMALS 92 dogs. PROCEDURES Case information was solicited from 10 veterinary medical facilities through electronic communications. Data on patient demographic information, cause of injury, presence of concurrent injuries, details of Ehmer sling placement and management, and outcome at sling removal were collected. Data were analyzed for associations with outcomes. RESULTS 40 of 92 (43.5%) dogs had reluxation of the affected hip joint at or near the time of sling removal. Odds of reluxation occurring for dogs that had the initial injury attributed to trauma were 5 times those for dogs without known trauma (OR, 5.0; 95% confidence interval, 1.3 to 18.7). Forty-six (50%) dogs had soft tissue injuries secondary to sling use; 17 of these dogs had injuries classified as severe, including 1 dog that required limb amputation. Odds of severe sling injury for dogs that had poor owner compliance with home care instructions noted in the record, those that had the sling placed by an intern rather than a board-certified surgeon or resident, and those that were noted to have a soiled or wet bandage on ≥ 1 occasion were 12.5, 4.0, and 5.7 times those for dogs without these findings, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Placement of an Ehmer sling following closed reduction of a craniodorsal hip luxation had a low success rate and high complication rate.

High Intensity Focused Ultrasound (HIFU) Heating Improves Perfusion and Antimicrobial Efficacy in Mouse Staphylococcus Abscess.

Chronic wounds typically require long-duration treatment with a combination of antibiotics administered systemically. This incurs adverse side effects and can require aversive surgical treatments and limb amputations. To improve non-invasive antimicrobial therapy, the objective of this study was to investigate antimicrobial chemotherapy combined with high-intensity focused ultrasound (HIFU) heating (HT). A Staphylococcus aureus abscess (80 ± 30 mm3) was generated in the mouse flank region. Once the average temperature (~42 °C-46 °C) in the abscess was reached with HIFU-HT, a broad-spectrum antimicrobial (ciprofloxacin, 10 mg/kg) and perfusion marker (Evans blue dye, 40 mg/kg wt) were administered intravenously via the tail vein. Four hours later, mean abscess perfusion and colony-forming units (CFUs) per gram of abscess were determined. HIFU-HT increased abscess perfusion by ~2.5-fold (4 ± 0.6 µg/mL Evans blue) compared with control (1.5 ± 0.7 µg/mL), and improved antimicrobial efficacy to decrease percentage average survival of S. aureus by ~20% (46 ± 7 CFUs/g of abscess) versus that seen with ciprofloxacin alone (61 ± 4 CFU/g). Our in vivo data suggest that HIFU-HT can improve antimicrobial treatment responses against deep-seated bacteria in abscess wounds via enhanced perfusion.

Flexible nine-channel photodetector probe facilitated intraspinal multisite transcutaneous photobiomodulation therapy dosimetry in cadaver dogs.

Noninvasive photobiomodulation therapy (PBMT) of spinal cord disease remains speculative due to the lack of evidence for whether photobiomodulatory irradiances can be transcutaneously delivered to the spinal cord under a clinically acceptable PBMT surface irradiation protocol. We developed a flexible nine-channel photodetection probe for deployment within the spinal canal of a cadaver dog after hemilaminectomy to measure transcutaneously transmitted PBMT irradiance at nine sites over an eight-cm spinal canal length. The probe was built upon a 6.325-mm tubular stem, to the surface of which nine photodiodes were epoxied at approximately 1 cm apart. The photodiode has a form factor of 4.80 mm×2.10 mm×1.15 mm (length×width×height). Each photodiode was individually calibrated to deliver 1 V per 7.58 µW/cm2 continuous irradiance at 850 nm. The outputs of eight photodiodes were logged concurrently using a data acquisition module interfacing eight channels of differential analog signals, while the output of the ninth photodiode was measured by a precision multimeter. This flexible probe rendered simultaneous intraspinal (nine-site) measurements of transcutaneous PBMT irradiations at 980 nm in a pilot cadaver dog model. At a surface continuous irradiance of 3.14 W/cm2 applied off-contact between L1 and L2, intraspinal irradiances picked up by nine photodiodes had a maximum of 327.48 µW/cm2 without the skin and 5.68 µW/cm2 with the skin.

Agreement of Axillary and Auricular Temperature with Rectal Temperature in Systemically Healthy Dogs Undergoing Surgery.

Obtaining a patient's temperature is an important part of a patient's physical examination. As human medicine transitions to noninvasive temperature measurements, so does veterinary medicine. Historically, temperature measurement has been obtained from rectal readings; however, alternative methods, such as axillary and auricular temperatures, are increasing in popularity. The purpose of the study was to compare these alternative techniques to the gold standard of rectal temperature. Temperatures were obtained three ways for each patient: rectal, axillary, and auricular. Results indicated a positive linear relationship between rectal and axillary temperatures (bivariate correlation coefficient [r] = 0.65, P < .001) and axillary and auricular temperatures (r = 0.55, P < .001). Agreement was strongest between rectal and auricular temperatures (r = 0.80, P < .001). The average discrepancy between axillary and rectal temperature was 1.2°C [2.1°F] with the highest difference being 4.0°C [7.3°F]. The average discrepancy between auricular and rectal temperature was 0.6°C [1.2°F] with the highest difference being 2.2°C [4.1°F]. Despite auricular temperatures having stronger agreement, Bland-Altman Limits of Agreement testing revealed that it was a poor predictor of rectal temperature. Based on these results, axillary and auricular temperatures should not be substituted for rectal temperature.

Hypo-fractionated Radiation, Magnetic Nanoparticle Hyperthermia and a Viral Immunotherapy Treatment of Spontaneous Canine Cancer.

It has recently been shown that cancer treatments such as radiation and hyperthermia, which have conventionally been viewed to have modest immune based anti-cancer effects, may, if used appropriately stimulate a significant and potentially effective local and systemic anti-cancer immune effect (abscopal effect) and improved prognosis. Using eight spontaneous canine cancers (2 oral melanoma, 3 oral amelioblastomas and 1 carcinomas), we have shown that hypofractionated radiation (6 x 6 Gy) and/or magnetic nanoparticle hyperthermia (2 X 43°C / 45 minutes) and/or an immunogenic virus-like nanoparticle (VLP, 2 x 200 µg) are capable of delivering a highly effective cancer treatment that includes an immunogenic component. Two tumors received all three therapeutic modalities, one tumor received radiation and hyperthermia, two tumors received radiation and VLP, and three tumors received only mNP hyperthermia. The treatment regimen is conducted over a 14-day period. All patients tolerated the treatments without complication and have had local and distant tumor responses that significantly exceed responses observed following conventional therapy (surgery and/or radiation). The results suggest that both hypofractionated radiation and hyperthermia have effective immune responses that are enhanced by the intratumoral VLP treatment. Molecular data from these tumors suggest Heat Shock Protein (HSP) 70/90, calreticulin and CD47 are targets that can be exploited to enhance the local and systemic (abscopal effect) immune potential of radiation and hyperthermia cancer treatment.