Fascial plane mapping for superficial tumor resection in dogs. Part III: Hindlimb and pelvis.

OBJECTIVES: To categorize the fascial planes and the intersections of these fascial planes in the hindlimb of the dog to facilitate preoperative planning for superficial cancers. STUDY DESIGN: Qualitative anatomical study. SAMPLE POPULATION: Four male and five female mixed breed dogs, weighing ~15-35 kg. METHODS: Skin and subcutaneous fat were removed, and fascial planes were explored to determine borders and quality. Fascia was categorized as type I (discrete sheets), type II (adhered to thin muscles), type III (adhered to thick muscles), or type IV (associated with periosteum). Digital modification of specimen photographs was performed to map tissues. RESULTS: Differences in dogs were noted due to either size or sex but were sufficiently minor to allow mapping. Fasciae of the hindlimb were predominantly type II or III, with type I fascia primarily at the lateral gluteal region, fascia lata, and lateral crus. Type IV fascia was seen at the iliac wing, ischium, patella, tibial tuberosity, medial tibia, distal crus, and pes. Fascia for surgical use was thin or absent at the ischiorectal fossa, femoral triangle, extensor mechanism, medial and distal crus, and pes. Intersections and tissues at the ventral perineum may also pose challenges for maintenance of a deep margin. CONCLUSION: Fascial types and integrity of the hindlimb varied with location, with the perineum, cranial stifle, and distal limb presenting the greatest challenges. CLINICAL SIGNIFICANCE: These images may be used to guide both therapeutic decision-making and intraoperative excision of superficial tumors of the hindlimb and pelvis.

Buccal transposition flap for closure of maxillary lip defects in 5 dogs.

OBJECTIVE: To describe the technique and outcomes of the closure of maxillary lip defects using a buccal transposition flap and to identify potential routes of vascular supply to the flap. ANIMALS: Five dogs treated clinically and 1 cadaveric dog head. STUDY DESIGN: Short case series and cadaveric study. METHODS: A left maxillary labial defect and a buccal transposition flap were created on a cadaver head. Iodinated contrast was injected into the left common carotid artery and computed tomography was performed to assess the vascular supply. Medical records were reviewed for all dogs that underwent tumor excision with maxillary lip resection, reconstructed with a buccal transposition flap. RESULTS: The buccal transposition flap was perfused by branches of the angularis oris artery and superior labial artery. Five dogs were included in this study. All flaps survived. Three dogs developed postoperative complications, including oronasal fistula (n = 2) and partial flap dehiscence (n = 1). The cosmetic and functional outcomes were considered satisfactory in all cases. CONCLUSION: Buccal transposition flaps for the closure of large maxillary lip defects provided adequate functional and cosmetic outcomes. The buccal transposition flap had vascular contributions from the angularis oris artery and the superior labial artery.

Fascial plane mapping for superficial tumor resection in dogs. Part I: Neck and trunk.

OBJECTIVE: To provide qualitative fascial categories and classify the intersections of various fascial planes of the trunk of the dog to facilitate preoperative planning for superficial cancers. STUDY DESIGN: Qualitative anatomical study. SAMPLE POPULATION: Two male and three female mixed breed canine cadavers weighing approximately 15 to 35 kg. METHODS: The skin and subcutaneous fat were excised. Fascial planes were incised and elevated to allow exploration of their quality and borders. Fascia was categorized as type I (discrete sheets), type II (tightly adhered to thin muscles), type III (tightly adhered to thick muscles), or type IV (associated with periosteum). Photographs of specimens were digitally modified with overlays to map tissue types. RESULTS: Differences between cadavers were largely associated with muscle mass or sex, with only minor anatomical differences and enough subjective similarity among specimens to allow mapping. The fasciae of the neck and trunk were predominantly type I or type II, with type III fascia at the shoulder and type IV fascia at the scapular spine, 13th rib, dorsal spinous processes, and the wing of the ilium. CONCLUSION: The superficial fasciae of the canine trunk were consistent among the dogs evaluated and can be classified as four broad fascial types. The population used was small, and individual variation should be considered when using these images in a clinical setting. CLINICAL SIGNIFICANCE: The images and categorization of fascia and transitions between fascial layers detailed here provide a visual and written reference for surgeons to facilitate preoperative planning and excision of superficial cancers.

Fascial plane mapping for superficial tumor resection in dogs. Part II: Forelimb.

OBJECTIVE: To detail the qualitative fascial categories and fascial intersections of the forelimb of the dog to facilitate preoperative planning for superficial cancers. STUDY DESIGN: Qualitative anatomical study. SAMPLE POPULATION: Three male and four female mixed breed canine cadavers weighing approximately 20-35 kg. METHODS: The skin and subcutaneous fat were excised. Fascial planes were incised and elevated to allow exploration of their quality and borders. Fascia was categorized as type I (discrete sheets), type II (tightly adhered to thin muscles), type III (tightly adhered to thick muscles), or type IV (associated with periosteum). Photographs of specimens were digitally modified with overlays to map tissue types. RESULTS: Differences between the cadavers used were largely based on muscle mass and sex, with minimal other subjective differences affecting fascial mapping. The fasciae of the forelimb were largely type II or type III, with type I fascia at the antebrachium and type IV fascia at the olecranon, scapular spine, and accessory carpal bone. Fascial integrity was often questionable or lacking distal to the distal quarter of the antebrachium. CONCLUSION: The fascial types and integrity of the forelimb varied with anatomic location with thin or absent fascia for surgical use at the elbow, carpus, and manus. CLINICAL SIGNIFICANCE: This study provides information for preoperative planning and excision of superficial tumors of the forelimb. Knowledge of the potential limitations of fascia to provide a deep margin may influence selection of treatment modalities.

The development of ventricular fibrillation as a complication of pericardiectomy in 16 dogs.

OBJECTIVE: To describe the clinical characteristics, perioperative protocols, and outcomes in dogs diagnosed with ventricular fibrillation (VF) while undergoing pericardiectomy. STUDY DESIGN: Retrospective, multi-institutional study. ANIMALS: Sixteen client-owned dogs. METHODS: Cases were accrued through a listserve request posted to 3 subspecialty veterinary societies. Dogs were included if they developed VF during a pericardiectomy performed through an open or thoracoscopic approach. Data collected included signalment, history and physical examination, surgical approach, histopathology, treatment, and outcome. RESULTS: Indications for pericardiectomy included idiopathic chylothorax (n = 7), neoplasia (4), idiopathic pericardial effusion (4), and foreign body granuloma (1). Surgical approaches included thoracoscopy (12), intercostal thoracotomy (3) and median sternotomy (1). Electrosurgical devices were used to complete at least part of the pericardiectomy in 15 of 16 dogs. Ventricular fibrillation appeared to be initiated during electrosurgical use in 8/15 dogs. However, in 5/15 dogs it was not obviously associated with electrosurgical use. In 3/16 dogs the timing of initiation of VF was unclear. In 7/16 dogs, cardiac arrhythmias were noted prior to the development of VF. Fourteen of 16 dogs died from intraoperative VF. CONCLUSION: In most dogs ventricular fibrillation was a fatal complication of pericardiectomy. Ventricular fibrillation might be associated with the use of electrosurgical devices and cardiac manipulation during pericardiectomy although a causal link could not be established from the data in this study. CLINICAL SIGNIFICANCE: Surgeons must be aware of the risk of VF during pericardial surgery. Electrosurgery might need to be used judiciously during pericardiectomy, particularly in dogs exhibiting cardiac arrythmias.

Complications associated with iliosacral lymphadenectomy in dogs with metastatic apocrine gland anal sac adenocarcinoma.

Objective: To report intraoperative and immediate postoperative complications associated with removal of metastatic iliosacral lymph nodes in dogs with apocrine gland anal sac adenocarcinoma. Animals: There were 136 client-owned dogs in the study. Procedure: Retrospective multi-institutional study. The database of collaborating institutions was searched for dogs with metastatic apocrine gland anal sac adenocarcinoma that underwent lymphadenectomy for removal of one or more iliosacral lymph nodes. Information of signalment, hematological abnormalities, abdominal computed tomography or ultrasound findings, number and size of enlarged lymph nodes, intraoperative and postoperative complications, treatment and outcome were collected. Results: The overall complication rate associated with metastatic iliosacral lymphadenectomy was 26.1%. The only intraoperative complication recorded was hemorrhage and was reported in 24 (17.6%) surgeries, 11 (45.8%) of which received a blood transfusion. Postoperative complications were reported in 10.4% of surgeries, and included edema formation (n = 4, 2.6%), unilateral or bilateral paraparesis (n = 4, 2.6%), hypotension (n = 3, 2.0%), surgical site infection (n = 2, 1.3%), abdominal incision dehiscence (n = 1, 0.6%), urinary incontinence (n = 1, 0.6%), and death (n = 1, 0.6%). The size of the iliosacral lymph nodes was significantly associated with a greater risk of complications, hemorrhage, and the need of transfusion during lymphadenectomy for metastatic apocrine gland anal sac adenocarcinoma. Conclusion: Complications associated with iliosacral lymphadenectomy for metastatic apocrine gland anal sac adenocarcinoma are relatively common and mostly relate to hemorrhage. These complications are significantly associated with the size of the extirpated metastatic lymph nodes. Clinical relevance: This retrospective study provides information for the clinician regarding the potential surgical complications for extirpation of metastatic iliosacral lymph nodes. These complications, although not common, can be severe and should be discussed with owners before surgery.

Objectif: Rapporter les complications peropératoires et postopératoires immédiates associées à l'ablation des ganglions lymphatiques ilio-sacrés métastatiques chez les chiens atteints d'un adénocarcinome des glandes apocrines des sacs anaux. Animaux: Il y avait 136 chiens appartenant à des clients dans l'étude. Procédure: Étude multi-institutionnelle rétrospective. La base de données des institutions collaboratrices a été recherchée pour les chiens atteints d'un adénocarcinome métastatique des glandes apocrines des sacs anaux qui ont subi une lymphadénectomie pour l'ablation d'un ou plusieurs ganglions lymphatiques ilio-sacrés. Des informations sur le signalement, les anomalies hématologiques, les résultats de la tomodensitométrie abdominale ou de l'échographie, le nombre et la taille des ganglions élargis, les complications peropératoires et postopératoires, le traitement et les résultats ont été recueillis. Résultats: Le taux global de complications associées à la lymphadénectomie ilio-sacrée métastatique était de 26,1 %. La seule complication peropératoire enregistrée était une hémorragie et a été rapportée dans 24 (17,6 %) chirurgies, dont 11 (45,8 %) ont reçu une transfusion sanguine. Des complications postopératoires ont été signalées dans 10,4 % des interventions chirurgicales et comprenaient la formation d'oedème (n = 4, 2,6 %), la paraparésie unilatérale ou bilatérale (n = 4, 2,6 %), l'hypotension (n = 3, 2,0 %), l'infection du site opératoire (n = 2, 1,3 %), la déhiscence de l'incision abdominale (n = 1, 0,6 %), l'incontinence urinaire (n = 1, 0,6 %) et le décès (n = 1, 0,6 %). La taille des ganglions ilio-sacrés était significativement associée à un risque accru de complications, d'hémorragie et à la nécessité d'une transfusion lors d'une lymphadénectomie pour un adénocarcinome métastatique des glandes apocrines des sacs anaux. Conclusion: Les complications associées à la lymphadénectomie ilio-sacrée pour l'adénocarcinome métastatique des glandes apocrines des sacs anaux sont relativement fréquentes et concernent principalement l'hémorragie. Ces complications sont significativement associées à la taille des ganglions lymphatiques métastatiques retirés. Pertinence clinique: Cette étude rétrospective fournit des informations au clinicien concernant les complications chirurgicales potentielles pour le retrait des ganglions lymphatiques ilio-sacrés métastatiques. Ces complications, bien que rares, peuvent être graves et doivent être discutées avec les propriétaires avant la chirurgie.(Traduit par Dr Serge Messier).

Influence of intraoperative closed glove exchange on glove contamination during clean soft tissue surgeries.

OBJECTIVES: To determine the influence of intraoperative glove exchange on glove contamination during clean soft tissue surgery. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Two hundred pairs of gloves and gowns from 50 clean soft tissue surgeries. METHODS: Gloves and gown cuffs were cultured from the primary surgeon and first assistant using a standardized protocol. Cultures were taken from outer surface of both gown cuffs prior to surgery and after gloves were removed at the end of surgery; gloves were cultured prior to surgery, at end of surgery and after a new pair was donned after closed glove exchange. Cultures were evaluated for colony-forming units after 72 h of inoculation. RESULTS: Bacterial contamination was documented in 41 of the 50 surgeries (82%). The most common species cultured was Streptocococcus spp. There was no difference (p = .719) in the bacterial contamination rate of gown cuffs prior to surgery (10%; 20/200) compared to after surgery (9.5%; 19/200). The bacterial contamination rate for gloves was 10.5% (21/200) prior to surgery, 19.5% (39/196) after surgery, and 11% (22/200) after regloving. Gloves cultured following surgery were significantly more contaminated than gloves cultured preoperatively (p = .010) or gloves cultured following regloving (p = .018). CONCLUSION: Glove exchange did not increase bacterial contamination of gloves during the clean soft tissue surgeries tested here. CLINICAL SIGNIFICANCE: The outside of the gown cuff does not seem to represent a major source of contamination during clean procedures. This study does not provide evidence to support a change in current practices for intraoperative closed glove exchange.

Metastasis to ipsilateral medial retropharyngeal and deep cervical lymph nodes in 22 dogs with thyroid carcinoma.

OBJECTIVE: To determine the rate of nodal metastasis to the medial retropharyngeal (MRP) and deep cervical lymph nodes in dogs surgically treated for thyroid carcinoma. STUDY DESIGN: Retrospective study. ANIMALS: Twenty-two client-owned dogs. METHODS: Medical records between July 2015 and October 2019 at the Universities of Missouri and Florida were reviewed. Dogs that underwent thyroidectomy with concurrent elective MRP lymphadenectomy ± deep cervical lymphadenectomy were included. Tumor site, preoperative staging, and histopathological findings were recorded. RESULTS: Twenty-two dogs with 26 total thyroid carcinomas were included. Primary tumors were lateralized in 19 dogs, bilateral in two dogs, and bilateral and midline ectopic in one dog. All dogs underwent ipsilateral MRP resection, including bilateral resection in dogs with bilateral tumors. Three contralateral MRP lymph nodes were excised from dogs with unilateral carcinomas. Four deep cervical lymph nodes and one superficial cervical lymph node were excised. Metastases were identified in 14 lymph nodes in 10 of 22 (45%) dogs. All four excised deep cervical lymph nodes and one contralateral MRP lymph node were identified as metastatic. Size of deposit could be classified in 13 of 14 metastatic lymph nodes. Macrometastasis was detected in seven lymph nodes, micrometastasis was detected in one node, and isolated tumor cells were detected in five lymph nodes. CONCLUSION: Regional metastasis was common within the lymph nodes sampled in this population of dogs with thyroid carcinoma. CLINICAL SIGNIFICANCE: These results provide evidence to justify further exploration of a larger population to verify the rate of regional metastasis and determine the prognostic impact of nodal metastasis.

Staged mandibular lip flap for closure of a large palatal defect after maxillectomy in a dog.

OBJECTIVE: To report closure of an oronasal defect secondary to maxillectomy with a staged mandibular lip flap. STUDY DESIGN: Case report ANIMALS: One 9-year-old female spayed golden retriever. METHODS: A combined dorsolateral and intraoral approach was used to perform a central maxillectomy to excise a 2.4- × 2- × 2.7-cm oral osteosarcoma with 1-cm margins. A buccal mucosal flap was used to close the palatal defect but the site subsequently dehisced. A staged mandibular lip flap was performed to close the defect. An incision was made on the mandible at the intersection of the buccal mucosa and gingiva from the mandibular canine to the level of the commissure. A second incision was made 3 cm ventral to the lip margin. The flap pedicle was based at the commissure. The flap was rotated to cover the palatal defect from rostral to the canine tooth to the fourth premolar. A second procedure was performed 4 weeks after flap placement to desquamate the haired skin and transect the flap pedicle. RESULTS: Partial dehiscence at the caudal aspect of the flap occurred after the first revision. The defect was closed after pedicle transection on day 41, with acceptable cosmesis. The dog was eating canned food with no evidence of discomfort 159 days after the maxillectomy. Recurrence was noted on day 270 postoperatively. CONCLUSION: Closure of a large palatal defect with a staged mandibular lip flap led to good cosmesis and function.

Survival time of juvenile dogs with oral squamous cell carcinoma treated with surgery alone: A Veterinary Society of Surgical Oncology retrospective study.

OBJECTIVE: To report the signalment, staging, surgical treatment, and survival time of juvenile dogs treated surgically for oral squamous cell carcinoma (OSCC). STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: Twenty-five dogs, <2 years of age with OSCC treated with surgery. METHODS: Cases were solicited from the Veterinary Society of Surgical Oncology. Data retrieved included sex, breed, age, weight, clinical signs, tumor location, preoperative diagnostics and staging, histopathological diagnosis with margin evaluation, disease-free interval, and date and cause of death. A minimum follow-up time of 3 months was required for inclusion. RESULTS: Eighteen dogs were <12 months of age, and seven were <24 months. Various breeds were represented, with a mean body weight of 22.3 ± 14.4 kg. No dogs had evidence of metastatic disease prior to surgery. All dogs underwent partial maxillectomy or mandibulectomy. Histological margins were complete in 24 dogs and incomplete in one. No dogs had evidence of metastatic disease or tumor recurrence. The median follow-up time was 1556 days (92 to 4234 days). All dogs were alive at the last follow-up except for one documented death, due to dilated cardiomyopathy. Median disease-specific survival time was not reached. CONCLUSION: The prognosis after wide surgical excision of OSCC in juvenile dogs was excellent. CLINICAL SIGNIFICANCE: OSCC in juvenile dogs can be effectively treated with surgery alone.

Determination of the lateral extent of the subcutaneous wound bed in canine cadavers after closure of skin defects to replicate tumor excision.

OBJECTIVE: To determine the extent of subcutaneous involvement after primary closure of experimental skin defects. STUDY DESIGN: Experimental study. ANIMALS: Eight large, mixed breed dog cadavers. METHODS: Standardized, circular skin defects with diameters of 2, 4, 6, or 8 cm were created at the lateral thorax or abdomen by using a matrix to ensure even distribution, with eight defects of each diameter. The wound beds were covered in 60% barium sulfate paste prior to primary closure. Computed tomography and a dedicated viewing program were used to measure the distance from the edge of the subcutaneous defect to the incision at set intervals along the incision. RESULTS: The mean ± SD maximum lateral extension was 6.4 ± 1.9, 14.1 ± 4.9, 18.5 ± 6.9, and 26.0 ± 9.6 mm for 2-, 4-, 6-, and 8-cm defects, respectively. Extension >2 cm from the incision occurred in zero of eight, one of eight, five of eight, and six of eight defects after closure of 2-, 4-, 6-, and 8-cm defects, respectively. Extension >3 cm from the incision occurred in zero of eight, zero of eight, two of eight, and five of eight defects after closure of 2-, 4-, 6-, and 8-cm defects, respectively. CONCLUSION: The lateral extent of the subcutaneous wound bed extended past previously recommended revision margins of 2 to 3 cm in some defects measuring greater than 4 cm in diameter. CLINICAL SIGNIFICANCE: Surgeons and radiation oncologists should consider the potential extent of the subcutaneous defect when planning revision therapy, especially after large resections.

Iliectomy with limb preservation for a dog with ilial osteosarcoma: Surgical description and case report.

OBJECTIVE: To report the surgical technique for iliectomy and outcome in a single clinical case. STUDY DESIGN: Case report. ANIMAL: A 10-year-old female spayed Rottweiler. METHODS: A dog presented with left pelvic limb lameness due to a mass involving the left ilium. Fine needle aspirates were indicative of a sarcoma and suspicious for osteosarcoma. Computed tomography of thorax, abdomen, and pelvis was performed as well as skeletal scintigraphy, with no evidence of metastasis seen. The dog underwent iliectomy with preservation of the ipsilateral limb and was ambulatory 24 hours after surgery. Results of histopathology confirmed the diagnosis of an osteosarcoma. RESULTS: A right ischial fracture was noted 8 days postoperatively and was conservatively managed. Local recurrence was reported 385 days postoperatively, with no overt metastatic disease revealed by computed tomography of the thorax and abdomen. The dog was euthanized because of local recurrence 430 days after surgery. CONCLUSION: Iliectomy was well tolerated in this dog and afforded good function of the pelvic limbs. Local recurrence developed with no evidence of metastasis at the last follow-up. Iliectomy can be considered for a mass confined to the ilium when preservation of the limb is desired. Additional studies are required to determine the local recurrence and complication rates associated with this procedure in dogs with axial skeletal osteosarcoma. CLINICAL SIGNIFICANCE: To the authors' knowledge, this case report represents the fist surgical description and clinical outcome for an iliectomy in dogs.

Interventions and experience after complicated total cystectomy in a dog with transitional cell carcinoma.

OBJECTIVE: To report surgical and postoperative management of complicated total cystectomy in a dog with transitional cell carcinoma (TCC). STUDY DESIGN: Case report. ANIMALS: One male neutered Shetland sheepdog. METHODS: The dog was presented after a 1-month history of stranguria, unresponsive to oral antibiotic therapy. A craniodorsal bladder mass was identified by computed tomography (CT), and partial cystectomy was performed with 1-cm gross lateral margins (day 1). Results of histopathology provided evidence for a diagnosis of TCC, and the dog was treated with adjuvant mitoxantrone. The dog presented with uroperitoneum on day 67 after recurrence and spontaneous perforation. Total cystectomy and ureterourethral anastomosis were performed. Ureteral obstruction developed after removal of catheters that had been placed intraoperatively. Surgical revision included resection of the anastomosis site, bilateral ureteral stenting, and transection and reorientation of the distal urethra to facilitate tension-free closure. Postoperative leakage was managed with bilateral percutaneous nephrostomy tube placement. RESULTS: The dog was discharged on day 88. Adjuvant treatment with vinblastine was pursued. Local recurrence was noted at day 154. Subcutaneous ureteral bypass was performed on day 247 to manage repeat obstruction. Repeated urinary tract infections were subsequently encountered. The dog was euthanized on day 368 because of abdominal discomfort and inappetence, with evidence of progressive urethral, ureteric, and abdominal wall TCC. CONCLUSION: Complicated cystectomy can be managed to provide survival comparable to previous reports regarding total cystectomy. CLINICAL SIGNIFICANCE: Nephrostomy tube placement, ureteral stenting, and subcutaneous ureteral bypass may be considered to manage complicated cystectomy. Preemptive stenting or urinary diversion may help prevent complications.

Influence of speaker's gender on speaker introductions at the 2018 ACVS Surgical Summit.

OBJECTIVE: To evaluate whether formality of introduction differed between male vs female speakers at the 2018 American College of Veterinary Surgeons (ACVS) scientific meeting and identify other variables that predisposed introducers or chairs to informal introduction. STUDY DESIGN: Observational study. SAMPLE POPULATION: Thirteen session chairs introducing 68 lectures (41 by females, 27 by males) by 63 speakers. METHODS: Observers recorded the session introducer, speaker, and whether speakers were introduced with a formal or informal title. Information evaluated included type of oral presentation; introducer gender, year, and country of graduation from veterinary school; speaker gender; whether the speaker was a resident; and speaker's year of graduation. RESULTS: Female speakers were introduced by their first name in 9 of 41 introductions compared to in 1 of 27 introductions for male speakers. This difference reached statistical significance when data independence was assumed (P = .043); however, this significance was narrowly lost when data clustering on session introducer was controlled for (P = .067). CONCLUSION: In this study, female speakers were more likely than male speakers to be introduced by their first and last names rather than with their professional title at a recent ACVS scientific meeting. IMPACT: Additional research is required to determine the effect of this type of subordinate language and gender bias in veterinary surgery.

Limb shortening as a strategy for limb sparing treatment of appendicular osteosarcoma of the distal radius in a dog.

OBJECTIVE: To develop and report a novel limb sparing technique for the distal radius in a dog. STUDY DESIGN: Case report. ANIMAL: A 14-year-old, female spayed Labrador Retriever with an osteosarcoma of the right distal radius and a pathological fracture. A previous mast cell tumor had been treated 5 years prior to presentation with marginal excision and a full-course radiation over the right metacarpal bones. The dog had received 2 doses of palliative radiation just prior to presentation. METHODS: A standard resection of the distal radius was used as a strategy to salvage the limb. Instead of replacing the 6-cm bone defect with an endoprosthesis, the limb was acutely shortened and a carpal arthrodesis plate was applied. RESULTS: Postoperative function was good and limb shortening was well-tolerated. Radiographic evidence of early bone healing was noted at the osteotomy site. The dog experienced 3 postoperative complications: a focal area of skin necrosis managed successfully via surgical revision; infection resolving after long-term antibiotherapy; and a fracture of the third metacarpal bone through a screw hole, managed via screw removal and a custom external prosthesis. The patient was euthanatized due to presumptive chemotherapy complications 127 days after the procedure. CONCLUSION: Limb shortening limb salvage is technically feasible and can result in excellent limb use postoperatively, in spite of a significant loss in limb length.

Fracture-associated osteosarcoma of the femur in a cat.

This report describes a domestic shorthair cat with fracture-associated osteosarcoma 11 years after injury. A left hind limb amputation was performed using coxofemoral disarticulation. No intravenous cytotoxic chemotherapy was used after surgery. Pulmonary metastasis was identified 3 months after amputation. Fracture-associated osteosarcoma may occur in the cat more than 10 years after initial injury.

Ostéosarcome du fémur associé à une fracture chez un chat. Ce rapport décrit un chat commun domestique atteint d'un ostéosarcome associé à une fracture 11 ans après la blessure. Une amputation du membre arrière gauche a été réalisée à l'aide de la désarticulation coxofémorale. Aucune chimiothérapie cytotoxique intraveineuse n'a été utilisée après la chirurgie. La métastase pulmonaire a été identifiée 3 mois après l'amputation. Un ostéosarcome associé à une fracture peut se produire chez le chat plus de 10 ans après la blessure initiale.(Traduit par Isabelle Vallières).

Sartorius muscle flap for body wall reconstruction: Surgical technique description and retrospective case series.

The objectives of this study were to describe the sartorius muscle flap for body wall reconstruction, including description of the anatomy and surgical technique and to report its clinical application for abdominal wall reconstruction in dogs and cats. The descriptive report involves a retrospective case series for 2 dogs and 3 cats. Inclusion criteria were cats or dogs that had a tumor resection resulting in an abdominal wall defect that was reconstructed using an ipsilateral or contralateral sartorius muscle flap. Signalment, pre-operative clinical signs, location and tumor extent, diagnostic imaging and clinical pathology findings, surgical methods, and complications were recorded. Abdominal wall defect reconstructions using the sartorius muscle flap were successfully performed in all 5 patients with good return to function. All complications were minor and were successfully medically managed. This case series demonstrates that the sartorius muscle flap is a feasible option for the closure of large caudal abdominal wall defects.

Rabat du muscle sartorius pour la reconstruction de la paroi du corps: description de la technique chirurgicale et série de cas rétrospectifs. Les objectifs de cette étude étaient de décrire le rabat du muscle sartorius pour la reconstruction de la paroi du corps, y compris la description de l'anatomie et de la technique chirurgicale et de faire rapport sur son application clinique pour la reconstruction de la paroi abdominale des chiens et des chats. Le rapport descriptif porte sur une série de cas rétrospectifs pour 2 chiens et 3 chats. Les critères d'inclusion étaient des chats ou des chiens ayant subi une résection de tumeur qui avait produit un défaut de la paroi abdominale qui avait été reconstruite à l'aide d'un rabat du muscle sartorius ipsilatéral ou contralatéral. Le signalement, les signes cliniques avant l'opération, l'emplacement et l'étendue de la tumeur, les résultats de l'imagerie diagnostique et de la pathologie clinique, les méthodes chirurgicales et les complications ont été consignés. Les reconstructions du défaut de la paroi abdominale en utilisant le rabat du muscle sartorius ont été réalisées avec succès chez les 5 patients avec un bon retour de fonction. Toutes les complications étaient mineures et ont été médicalement gérées avec succès. Cette série de cas démontre que le rabat du muscle sartorius représente une option possible pour la fermeture de larges défauts de la paroi abdominale caudale.(Traduit par Isabelle Vallières).

Pericardioscopic imaging findings in cadaveric dogs: comparison of an apical pericardial window and sub-phrenic pericardectomy.

OBJECTIVE: To compare the pericardioscopic cardiovascular anatomy visible between apical pericardial window (PW) and sub-phrenic pericardectomy (SPP). STUDY DESIGN: Experimental study. ANIMALS: Canine cadavers (n = 5). METHODS: Thoracoscopy was performed using a transdiaphragmatic subxyphoid and right and left intercostal portals. A 4 cm × 4 cm apical PW was created with endoscopic scissors. The intra-pericardiac structures were then pericardioscopically assessed using a subjective ordinal scale (0: not visible, 1: <50% seen, 2: >50% seen) before SPP. Assessment was repeated after SPP. RESULTS: An apical PW provided limited access to the cardiac structures, with only the right ventricle >50% visible in all cadavers. The right atrium, right auricle, left ventricle, right coronary artery, and interventricular paraconal branch of the left coronary artery were observed but were typically <50% visible after apical PW. The left atrium and auricle, and heart base could not be consistently seen through an apical PW. Sub-phrenic pericardectomy significantly improved observation of all intrapericardiac structures assessed, except for the right atrium and right ventricle. CONCLUSIONS: PW centered over the cardiac apex limits evaluation of the pericardial space during pericardioscopy compared to SPP in cadaveric dogs.

Sodium iodide symporter immunolabelling as a predictor of clinical iodide uptake in canine thyroid carcinoma: A preliminary study.

Thyroid follicular tumours may take up iodide via the sodium-iodide symporter. Knowledge of iodide uptake could then allow treatment with I-131 in dogs with high-risk tumours. The objective of this study was to determine the relationship between clinically detectable iodide uptake (as determined by scintigraphy and/or thyroxine concentrations) and sodium iodide symporter immunohistochemical labelling on histologically fixed thyroid tumours. Nineteen dogs were identified who were diagnosed with thyroid carcinoma and underwent surgery from November 2017 to July 2021. All had recorded thyroid hormone concentrations and were hyperthyroid and/or underwent preoperative nuclear imaging using planar scintigraphy (technetium-99m or I-123), or I-124 PET-CT. All dogs subsequently underwent surgery to remove the thyroid mass. Twenty-two tumours were submitted for histopathologic analysis immediately following surgery, which confirmed a diagnosis of thyroid carcinoma for each tumour. Images and/or thyroid hormone concentrations were reviewed for the included cases, and tumours were sorted into an avid/functional group (group 1) and a non-avid/functional group (group 2). The tumour tissues were re-examined histologically using sodium iodide symporter (NIS) immunohistochemistry (IHC). Group 1 contained 15 avid/functional tumours. Twelve of these tumours had membranous NIS IHC labelling. Group 2 contained 7 non-avid tumours. One of these tumours had membranous NIS IHC labelling. This resulted in an overall sensitivity and specificity for identification of avid/functional tumours with membranous NIS of 80.0% and 85.7%, respectively. NIS IHC may predict ion trapping in canine follicular thyroid tumours. Further studies using iodide-based imaging are warranted to better determine the clinical utility of this diagnostic modality.

Prospective assessment of canine thyroid cancer-part I: nodal metastatic rate and impact of nodal immunohistochemistry in 70 dogs.

OBJECTIVE: To determine the rate of nodal metastasis in dogs with thyroid cancer and evaluate whether immunohistochemistry (IHC) identifies additional metastases beyond evaluation with H&E. ANIMALS: 70 prospectively enrolled client-owned dogs with thyroid cancer managed with thyroidectomy. METHODS: Dogs underwent thyroidectomy with concurrent elective bilateral medial retropharyngeal (MRP) ± deep cervical lymphadenectomy. Thyroid tumors and associated lymph nodes were reviewed by a single board-certified pathologist. Immunohistochemistry was used for all primary tumors (thyroid transcription factor-1 and calcitonin) to support a diagnosis of follicular or medullary carcinoma. Lymph nodes without evidence of metastasis after H&E review were labeled with the antibody associated with the wider uptake in the primary tumor. RESULTS: 77 thyroid cancers were resected from the 70 dogs enrolled, including 61 (79.2%) follicular, 8 (10.7%) medullary, and 7 (9.3%) mixed follicular/medullary carcinomas, with 1 (1.3%) carcinosarcoma. Twelve dogs had evidence of nodal metastasis following H&E review. Occult micrometastasis was identified in 1 dog following nodal IHC, resulting in documented metastasis in 13 of 70 (18.6%) dogs. Metastasis was more common with medullary (5/8) and follicular/medullary carcinoma (3/7) than follicular carcinoma (5/61). All MRP metastases were ipsilateral (7/77 [9.1%]), without contralateral MRP metastases (0/62). Fourteen of 41 (34.1%) deep cervical lymph nodes were metastatic. CLINICAL RELEVANCE: Nodal metastasis was uncommon for follicular carcinoma but was seen in > 50% of dogs with thyroid cancer involving a medullary component. Routine nodal IHC appears to be low yield for thyroid carcinoma. Extirpation of ipsilateral MRP and identifiable deep cervical lymph nodes is recommended with thyroidectomy until detailed preoperative risk stratification becomes available.