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OBJECTIVE: To evaluate the outcomes and complications of video-assisted thoracoscopic (VATS) treatment of chylothorax in cats. STUDY DESIGN: Multi-institutional retrospective study. ANIMALS: Fifteen client-owned cats. METHODS: The medical records of cats undergoing thoracoscopic thoracic duct ligation (TDL) for treatment of idiopathic chylothorax were reviewed. Cats undergoing additional procedures including thoracoscopic pericardectomy and/or laparoscopic cisterna chyli ablation (CCA)_were included. Follow up was obtained through communication with the referring veterinarian or owner. RESULTS: All cats underwent thoracoscopic TDL. Thirteen cats underwent simultaneous pericardectomy and two cats underwent laparoscopic CCA without pericardectomy. Conversion from a thoracoscopic to open approach was necessary in 2/15 (13%) of thoracic duct ligations and 1/11 (9%) of pericardectomies. The most common postoperative complication was persistent pleural effusion in five cats (33%). Four of 15 cats (27%) died or were euthanized prior to hospital discharge following surgery. Recurrence of effusion occurred in 1/7 (14%) of cats that sustained resolution of the effusion at the time of surgery with a median follow up of 8 months. The overall mortality attributed to chylothorax was 47%. CONCLUSION: Thoracoscopic treatment of idiopathic chylothorax resulted in a low incidence of intraoperative complications or conversion in the study population; however, mortality related to feline idiopathic chylothorax remained high. CLINICAL SIGNIFICANCE: While VATS treatment of idiopathic chylothorax is technically feasible, further consideration of the underlying pathology and current treatment algorithm is needed to improve outcomes as this remains a frustrating disease to treat in the feline population.
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Doenças do Gato , Quilotórax , Cirurgia Torácica Vídeoassistida , Animais , Quilotórax/veterinária , Quilotórax/cirurgia , Gatos , Doenças do Gato/cirurgia , Cirurgia Torácica Vídeoassistida/veterinária , Cirurgia Torácica Vídeoassistida/métodos , Estudos Retrospectivos , Masculino , Feminino , Resultado do Tratamento , Ducto Torácico/cirurgia , Complicações Pós-Operatórias/veterináriaRESUMO
A 3 yr old spayed female Cavalier King Charles spaniel was referred for insidious ataxia and paraparesis. A thoracolumbar lesion was suspected. Computed tomography showed focal osteolysis of the vertebral body and pedicles of T5. In addition, a hyperdense, extradural material within the vertebral canal, causing spinal cord compression on the right side, was present. The lesion was confirmed with magnetic resonance imaging. A T4-T5 hemi-dorsal laminectomy was performed to decompress the spinal cord. Histopathological examination was consistent with vertebral angiomatosis. After the surgery, the dog rapidly improved; however, 5 mo later the clinical signs relapsed. Vertebral angiomatosis is a vasoproliferative disorder, rarely reported as a cause of myelopathy in cats. This condition has not previously been reported in dogs. This case report describes the clinical features, the diagnostic findings, and the follow-up of a young dog with vertebral angiomatosis.
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Angiomatose , Doenças do Cão , Compressão da Medula Espinal , Doenças da Medula Espinal , Animais , Cães , Feminino , Angiomatose/diagnóstico , Angiomatose/cirurgia , Angiomatose/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Compressão da Medula Espinal/diagnóstico por imagem , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/cirurgia , Compressão da Medula Espinal/veterinária , Doenças da Medula Espinal/veterinária , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To describe the technique, complications, and outcome of the laparoscopic extra-abdominal transfascial suturing method for diaphragmatic rupture repair in a cat. STUDY DESIGN: Case report. ANIMALS: A 10 year old, female domestic shorthair cat. METHODS: An acute traumatic diaphragmatic rupture was diagnosed in a cat. Following initial stabilization, 3-port laparoscopic surgery was performed. After the laparoscopic reduction of herniating organs, a circumferential diaphragmatic tear was diagnosed, which was repaired using a multiple extra-abdominal transfascial suture technique. The total surgical time was 50 min with no intraoperative complications encountered. RESULTS: The successful procedure was confirmed by normalization of chest radiography, clinical signs, and blood gas analysis in the perioperative and postoperative periods. Mild skin irritation occurred 3 weeks after surgery but was resolved following the removal of sutures. The cat recovered well without major complications; the final reexamination was performed 3 months postoperatively. CONCLUSION: The laparoscopic extra-abdominal transfascial suturing technique appears to be a feasible, and effective technique for feline diaphragmatic circumferential rupture repair. This technique may be an alternative option to intracorporeal suturing for diaphragmatic rupture treatment in the cat.
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Doenças do Gato , Laparoscopia , Gatos , Animais , Feminino , Laparoscopia/métodos , Laparoscopia/veterinária , Diafragma/cirurgia , Abdome/cirurgia , Ruptura/cirurgia , Ruptura/veterinária , Técnicas de Sutura/veterinária , Técnicas de Sutura/efeitos adversos , Doenças do Gato/cirurgiaRESUMO
OBJECTIVE: To describe the surgical management and outcome of dogs undergoing laparoscopic pancreatic mass resection (LPMR). STUDY DESIGN: Retrospective study. ANIMALS: Twelve client-owned dogs. METHODS: Data collected from medical records of dogs that underwent LPMR between 2012 and 2023 included signalment, clinical signs, mass location within pancreas, preoperative diagnostic imaging, laparoscopic approach, number of portals and device type used for LPMR, operating time, complications and clinical outcome. RESULTS: Pancreatic tumors were located in the left lobe (7), in the right lobe (4) and in the body of the pancreas (1). A 3- or 4-port technique was used in nine and three dogs, respectively. LPMR was performed with the Ligasure in nine dogs, a harmonic scalpel in two dogs and an endoscopic stapler in one dog. The procedure was performed successfully, with no conversion to open laparotomy, in all cases with a median operating time of 69 min. Postoperative complications occurred in four dogs, which resolved with medical treatments. All dogs survived the surgical procedure, were discharged from the hospital and alive a minimum of 90 days postoperatively. The final follow-up time ranged between 105 and 245 days (median 147). Histopathological diagnosis included insulinoma (9) and pancreatic carcinoma (3). CONCLUSION: LPMR was performed successfully using a 3- or 4-port technique and was associated with a low complication rate and a good clinical outcome. CLINICAL SIGNIFICANCE: LPMR may be considered as an alternative to open celiotomy in dogs, particularly for small tumors located in the distal aspect of the pancreatic lobes.
RESUMO
Anecdotally, during the review of CT and MRI studies of canine patients including the cranial cervical spine, authors have identified a small osseous structure between the atlas (C1) and axis (C2) with no relevant clinical signs. This structure appeared comparable to a "persistent ossiculum terminale" in humans. The aim of this retrospective, multi-center, case series study was to describe the CT and MRI features of presumed persistent ossiculum terminale in a group of dogs presented with unrelated medical conditions. Two databases (the imaging database of the teleradiology service VetCT Specialists and the clinical database of the University of Vienna) were scrutinized by different approaches. Medical records of dogs that underwent imaging investigation (CT and/or MRI) that included the atlanto-axial junction were reviewed. Data collected included signalment, sex, breed, age, presenting symptoms, and final diagnosis. Eighteen dogs met the inclusion criteria. Mean age was 85 months (6-166) and breed variation was present. A total of 20 imaging studies were evaluated: CT was performed in 17 dogs; MRI in three dogs; two dogs had both MRI and CT performed. In all cases the presence of at least one small osseous body on the cranial aspect of the odontoid process compatible with a persistent ossiculum terminale was identified as a possible incidental finding without any overt clinical implications. Findings indicated that a small osseous body on the cranial aspect of the odontoid process (presumed persistent ossiculum terminale) in CT and MRI studies may be present in dogs with no clinical signs of neurologic disease.
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Processo Odontoide , Humanos , Cães , Animais , Estudos Retrospectivos , Imageamento por Ressonância Magnética/veterinária , Vértebras Cervicais , Tomografia Computadorizada por Raios X/veterináriaRESUMO
OBJECTIVE: To report complications and long-term outcomes after submucosal resections of benign and malignant epithelial rectal masses. STUDY DESIGN: Retrospective multicentric study. SAMPLE POPULATION: Medical records of 93 dogs at 7 referral hospitals. METHODS: Records were reviewed for surgical time, diagnosis, margins, complications, and recurrences. Survival of dogs was evaluated based on tumor types, categorized as benign, carcinoma in situ, and carcinoma. The Kaplan-Meier survival curve and Cox proportional hazards analysis were used to determine the association of a range of variables with recurrence and survival time. RESULTS: Duration of follow up was 708 days (range, 25-4383). Twenty-seven dogs (29%) developed complications. Recurrence was identified in 20/93 (21%), with 12/20 recurrent masses treated with repeat submucosal resection. Median survival was not reached in any group. The 1-,2-, 5-year survival rates for carcinomas were 95%, 89%, and 73% respectively. However, overall survival was longer for benign tumors than carcinomas (P = .001). Recurrence was more likely when complications (P = .032) or incomplete margins (P = .023) were present. Recurrence was associated with an increased risk of death (P = .046). CONCLUSION: Submucosal resection of both benign and malignant rectal masses was associated with a low rate of severe complications and prolonged survival in the 93 dogs described here. CLINICAL SIGNIFICANCE: Submucosal resection is a suitable technique for resection of selected rectal masses.
Assuntos
Carcinoma , Doenças do Cão , Recidiva Local de Neoplasia , Neoplasias Retais , Animais , Carcinoma/cirurgia , Carcinoma/veterinária , Doenças do Cão/cirurgia , Cães , Recidiva Local de Neoplasia/cirurgia , Recidiva Local de Neoplasia/veterinária , Neoplasias Retais/cirurgia , Neoplasias Retais/veterinária , Reto/patologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: To describe the technique, complications, and outcome of laparoscopic portosystemic shunt attenuation (LPSSA) in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Twenty client-owned dogs. METHODS: Medical records were searched for dogs with a single congenital extrahepatic portosystemic shunt (CEPSS) that was treated with LPSSA. Signalment, clinical signs, CEPSS location, diagnostic imaging, laparoscopic approach, operative technique, complications, and clinical outcome were reviewed. RESULTS: Fourteen dogs with CEPSS located in the epiploic foramen had a right (13/14) or left (1/14) paramedian approach. In 6 dogs a CEPSS was not located in the epiploic foramen, and a left paramedian approach was used. A 3 or 4-port technique was used in 7 and 13 dogs, respectively. A thin film band was used for CEPSS attenuation in all dogs. The median operating time for LPSSA was 62 min (range 27-98 min). Intraoperative complications requiring conversion to an open technique occurred in 5 dogs. Mild perioperative self-limiting portal hypertension occurred in 3 dogs, while severe portal hypertension with surgical revision occurred in 1 case. The complications were resolved, and all dogs had a good outcome. CONCLUSION: Laparoscopic portosystemic shunt attenuation can be performed in dogs, in particular for a CEPSS located in the epiploic foramen using a right paramedian approach. For CEPSS not located in the epiploic foramen, a left paramedian approach is recommended. Conversion to open celiotomy was required in around a third of cases. CLINICAL SIGNIFICANCE: Laparoscopic attenuation of CEPSSs can be performed in dogs and has a good clinical outcome, particularly for CEPSS located in the epiploic foramen.
Assuntos
Doenças do Cão , Hipertensão Portal , Laparoscopia , Derivação Portossistêmica Transjugular Intra-Hepática , Malformações Vasculares , Animais , Doenças do Cão/congênito , Doenças do Cão/cirurgia , Cães , Hipertensão Portal/cirurgia , Hipertensão Portal/veterinária , Laparoscopia/veterinária , Sistema Porta/anormalidades , Sistema Porta/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática/veterinária , Estudos Retrospectivos , Resultado do Tratamento , Malformações Vasculares/cirurgia , Malformações Vasculares/veterináriaRESUMO
OBJECTIVE: To describe the technique and outcomes after placement of sutures around the sacrotuberous ligament during perineal hernia (PH) repair in dogs. STUDY DESIGN: Retrospective single-center study. ANIMALS: Dogs (n = 47) with PH. METHODS: Medical records of dogs treated for PH between 2002 and 2020 were reviewed. Dogs were included when sutures had been placed around the sacrotuberous ligament. Short-term outcomes and intraoperative and postoperative complications were recorded. Long-term outcome was assessed with a questionnaire completed by owners. RESULTS: Twenty-eight of 47 dogs were medium or large breeds. The primary clinical sign was tenesmus in 43 dogs and dysuria-stranguria in four dogs. Bilateral hernias were detected in 17 dogs. No intraoperative complications occurred. Median surgical time was 50 minutes for unilateral PH and 120 minutes for bilateral PH. Minor postoperative complications consisting of surgical wound swelling (9), wound dehiscence (4), and temporary tenesmus (2) occurred in 10 dogs. No major complications or recurrence were reported. The only factors associated with an increased risk of complications included increasing age (P = .019) and surgical treatment of a recurrent PH (P = .043). Owners consistently reported good long-term outcomes. CONCLUSION: The PH repair described in this study resulted in good long-term outcomes without major complications. CLINICAL SIGNIFICANCE: Placement of sutures around the sacrotuberous ligament represents an alternative during PH, but anatomical knowledge of the sciatic nerve and caudal gluteal vessels is required.
Assuntos
Doenças do Cão/cirurgia , Hérnia/veterinária , Herniorrafia/veterinária , Ligamentos Articulares/cirurgia , Períneo , Animais , Cães , Herniorrafia/métodos , Complicações Intraoperatórias/veterinária , Masculino , Complicações Pós-Operatórias/veterinária , Reto/lesões , Estudos Retrospectivos , Nervo Isquiático/lesões , Técnicas de Sutura/veterináriaRESUMO
OBJECTIVE: To describe the surgical treatment and outcome of a large cohort of dogs with sterile prostatic cysts (PCs). STUDY DESIGN: Retrospective study. ANIMALS: Forty-four client-owned dogs. METHODS: Dogs with sterile PCs with at least 6 months of follow-up were included. Clinical variables, type of surgery, complications, recurrences, and outcomes (telephonic interviews or rechecks) were recorded. RESULTS: Extra- and intraparenchymal cysts were diagnosed in 29 and 11 dogs, respectively. Four dogs had both types. Extraparenchymal cysts were treated by partial resection and omentalization (n = 22) and complete resection (n = 7). Drainage and intracapsular omentalization were performed in all dogs with intraparenchymal cysts. The four dogs with both types of cyst were treated by omentalization. Resolution was documented in 39/44 dogs (88.6%). Intraoperative complications occurred in one dog (urethral tear). Major complications resulting in death occurred in three dogs (oliguric kidney injury, cardiac arrhythmia, and persisting urinary tract obstruction). Minor complications (n = 10) consisted of temporary urinary incontinence (n = 2), permanent urinary incontinence (n = 5), urinary retention (n = 2), and dysuria (n = 1). Recurrence occurred in two dogs with extraparenchymal cysts. Median long-term follow-up was 528 days (range, 250-730 days). Thirty-nine dogs had no signs associated with prostatic disease at long-term follow-up. CONCLUSION: Partial or complete resection and/or omentalization of sterile PCs led to resolution of clinical signs in most dogs, although postoperative urinary incontinence was frequent. IMPACT: This study is the largest case series relative to canine sterile PCs treated surgically and provides evidence on the prognosis and rate of complications.
Assuntos
Cistos/veterinária , Doenças do Cão/cirurgia , Doenças Prostáticas/veterinária , Animais , Cistos/cirurgia , Cães , Masculino , Recidiva Local de Neoplasia/veterinária , Complicações Pós-Operatórias/veterinária , Prognóstico , Doenças Prostáticas/cirurgia , Neoplasias da Próstata/cirurgia , Neoplasias da Próstata/veterinária , Estudos Retrospectivos , Resultado do Tratamento , Doenças Uretrais/veterinária , Incontinência Urinária/veterináriaRESUMO
OBJECTIVE: To compare complications of dogs treated with mandibular and sublingual sialoadenectomy for sialocele using a lateral (LAT) or ventral paramedian (VPM) approach. STUDY DESIGN: Retrospective multicenter study. ANIMALS: Dogs (140) with mandibular and sublingual sialocele. METHODS: Medical records of dogs that underwent mandibular and sublingual sialoadenectomy through a LAT or VPM approach from 2004 to 2020 were reviewed. Clinical and histopathological findings were analyzed to compare the groups. RESULTS: Seventy dogs were included in each group. The most represented breed was crossbreed (26%), and males (99/140 [71%], intact/neutered) were overrepresented. Dogs in the VPM approach group were more likely to undergo digastricus tunnelization and placement of a drain or a bandage. Dogs in the LAT approach group were heavier and more likely to undergo excision of an inflammatory pseudocapsule. No difference was detected in complication rates between groups (LAT [20%], VPM [31%], P = .116). Recurrences were more likely after LAT approach (5/70 vs 0/70, respectively; P = .029), whereas wound-related complications were more likely after VPM approach (20/70 vs 9/70, respectively; P = .018). Prolonged duration of surgery was associated with an increased risk of recurrence, and none of the other variables affected the complication rate. CONCLUSION: Ventral paramedian approach for mandibular and sublingual sialoadenectomy was associated with a lower risk of recurrence but a higher risk of wound-related complications compared with LAT approach. CLINICAL SIGNIFICANCE: Ventral paramedian approach for mandibular and sublingual sialoadenectomy may be preferred to reduce recurrence in dogs with sialoceles, but wound-related complications are common.
Assuntos
Cistos/veterinária , Doenças do Cão/cirurgia , Mucocele/veterinária , Complicações Pós-Operatórias/veterinária , Doenças da Glândula Submandibular/veterinária , Animais , Cistos/cirurgia , Cães , Feminino , Masculino , Mucocele/cirurgia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Doenças da Glândula Submandibular/patologia , Doenças da Glândula Submandibular/cirurgiaRESUMO
OBJECTIVE: To describe a temporary end-on colostomy to treat the dehiscence of a transanal rectal pull-through in a dog. STUDY DESIGN: Case report ANIMAL: A 7-year-old intact female Australian shepherd dog that was treated for a rectal adenocarcinoma with a transanal rectal pull-through. METHODS: Partial dehiscence of the previous end-to-end colorectal anastomosis and formation of a perianal sinus tract were diagnosed 4 days after surgery. A pararectal approach was used to revise the surgery with debridement of the sinus tract, rectal wall reconstruction with single interrupted sutures, and placement of a passive drain. Dehiscence occurred 2 days later. The colon was transected cranial to the pelvic brim, and each stump was oversewn prior to salvage temporary end-on colostomy. Postoperative care included analgesia, antibiotic therapy, and local care of the perineal/perianal area and colostomy site. After 90 days, the perineal/perianal sinus tract had healed, the colostomy was eliminated, and an end-to-end anastomosis of the colon was performed. RESULTS: Management of postoperative complications focused on dermatitis of the stoma and perineal/perianal area, stoma incontinence, and perineal/perianal medications of the sinus tract. One year after the final surgery, the dog had occasional episodes of fecal incontinence and a good quality of life without other complications. CONCLUSION: Use of a temporary end-on colostomy prior to revision surgery led to a satisfactory outcome but required long and challenging postoperative management. CLINICAL SIGNIFICANCE: Temporary end-on colostomy may be an option to manage dehiscence and potential recurrent stenosis after transanal rectal pull-through in dogs.
Assuntos
Anastomose Cirúrgica/veterinária , Colostomia/veterinária , Doenças do Cão/cirurgia , Complicações Pós-Operatórias/veterinária , Neoplasias Retais/veterinária , Deiscência da Ferida Operatória/veterinária , Anastomose Cirúrgica/efeitos adversos , Anastomose Cirúrgica/métodos , Animais , Colo/cirurgia , Cães , Feminino , Períneo/cirurgia , Neoplasias Retais/cirurgia , Reto/patologia , Deiscência da Ferida Operatória/cirurgiaRESUMO
OBJECTIVE: To report the perioperative outcome and complications in cats undergoing minimally invasive splenectomy. ANIMALS: 17 client-owned cats. METHODS: Perioperative data were collected from cats undergoing minimally invasive splenectomy from September 2010 to June 2023. Data included history, signalment, preoperative examination and diagnostic testing results, operative technique and time, perioperative outcomes, complications, hospitalization duration, histopathological diagnosis, and outcome. RESULTS: 13 spayed females and 4 neutered males were included, with a median age of 144 months (48 to 196 months). Seven cats underwent total laparoscopic splenectomy (TLS), with 1 cat requiring conversion from TLS to laparoscopic-assisted splenectomy (LAS) due to splenomegaly and an additional cat requiring conversion from TLS to open splenectomy due to uncontrollable splenic capsular hemorrhage. Ten cats underwent LAS, with 1 cat requiring conversion to open splenectomy due to splenomegaly. Additional procedures were performed in 13 cats, with the most common being liver biopsy in 10 cats. Median operative times were 50 minutes (45 to 90 minutes) for TLS and 35 minutes (25 to 80 minutes) for LAS. An intraoperative complication occurred in 1 cat. All but 1 cat survived to discharge. Median follow-up time was 234 days (18 to 1,761 days), with 15 of 16 cats confirmed alive at 30 days and 9 of 16 cats alive at 180 days postoperatively. CLINICAL RELEVANCE: Minimally invasive splenectomy in this cohort of cats was associated with short operative times and a low perioperative complication rate. Veterinary surgeons may consider minimally invasive splenectomy as an efficient and feasible technique in the treatment of splenomegaly or modestly sized splenic masses for diagnostic and therapeutic purposes in cats.
Assuntos
Doenças do Gato , Laparoscopia , Humanos , Masculino , Feminino , Gatos , Animais , Esplenectomia/efeitos adversos , Esplenectomia/veterinária , Esplenomegalia/veterinária , Duração da Cirurgia , Resultado do Tratamento , Baço/patologia , Laparoscopia/efeitos adversos , Laparoscopia/veterinária , Laparoscopia/métodos , Estudos Retrospectivos , Doenças do Gato/cirurgia , Doenças do Gato/patologiaRESUMO
Background: Congenital extra-hepatic porto-systemic shunts (CEPS) are a non-rare vascular anomaly observed in dogs, most commonly in small and toy pure breeds. Computed tomographic angiography (CTA) examination is considered the gold standard imaging modality for the diagnosis of anomalous vascular connections. Case Description: An anomalous congenital porto-pulmonary shunt was incidentally diagnosed in a 5-year-old French Bulldog. The anomalous vessel originated from the ventral aspect of the portal vein and went cranially towards the esophageal hiatus, entering the lobar vein of the caudal left pulmonary lobe. The dog did not show any significant clinical or computed tomography angiography-perceived hepatic abnormalities and no signs of portal hypertension were evidenced. No case of porto-pulmonary shunt in veterinary medicine have ever been reported, while in humans it was rarely described secondarily to portal hypertension, severe hepatopathies or complex cardiac malformations. Conclusion: CTA must be considered the best imaging modality for the diagnosis also of unusual CEPS and in the author's opinion the congenital porto-pulmonary shunt described in the patient was of little or no clinical relevance.
Assuntos
Doenças do Cão , Hipertensão Portal , Humanos , Cães , Animais , Tomografia Computadorizada por Raios X/veterinária , Hipertensão Portal/diagnóstico por imagem , Hipertensão Portal/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgiaRESUMO
Background: There were described in veterinary literature, the possibility of pneumothorax as a complication of laparoscopic surgery in dogs undergoing laparoscopic ovariectomy associated with total laparoscopic gastropexy. Aim: To assess if spontaneous pneumothorax secondary to pneumoperitoneum is a real risk in dogs undergoing total laparoscopic gastropexy. Methods: Dogs undergoing totally laparoscopic gastropexy received chest X-rays (CXR) in lateral (left and right) and ventro-dorsal projection before and after the surgery. Two veterinary radiologists reported the x-rays and indicated the presence or not of pneumothorax. Results: Postoperative pneumothorax was not detected on postoperative CXR in the total of 76 dogs of the study. Conclusion: The odds risk of pneumothorax after total laparoscopic gastropexy surgical procedure is low.
Assuntos
Doenças do Cão , Gastropexia , Laparoscopia , Pneumoperitônio , Pneumotórax , Feminino , Cães , Animais , Gastropexia/efeitos adversos , Gastropexia/veterinária , Pneumotórax/etiologia , Pneumotórax/veterinária , Pneumotórax/cirurgia , Pneumoperitônio/veterinária , Pneumoperitônio/complicações , Doenças do Cão/etiologia , Doenças do Cão/cirurgia , Laparoscopia/efeitos adversos , Laparoscopia/veterinária , Laparoscopia/métodosRESUMO
Background: Diaphragmatic herniorraphy is the treatment of choice for traumatic diaphragmatic hernia (TDH). Several methods have been described for the removal of residual air and fluid during and after surgery, such as the insertion of chest drains, intercostal thoracentesis, and transdiaphragmatic thoracentesis. However, there are no indications regarding the most useful technique and the impact that choice of technique could have in the immediate postoperative period. Aim: To evaluate the development of complications and outcomes associated with the use of intraoperative transdiaphragmatic thoracentesis in cats undergoing diaphragmatic herniorrhaphy for TDH. Methods: Medical records of cats treated for acute and chronic TDH between 2010 and 2019 were reviewed. Cats were included if intraoperative pneumothorax was treated with transdiaphragmatic thoracentesis, without the use of intercostal chest drain. Outcome, intra- and post-operative complications were recorded. Results: Intraoperative and postoperative complication rates were 3.3% and 12.4%, respectively. Development of postoperative pneumothorax was associated with the presence of comorbidities (p = 0.046). The overall survival rate was 93.3%. Long-term survival had a significant association with the presence of comorbidities (p = 0.045), if the procedure was performed as an emergency (p = 0.041) or in older cats (p = 0.011). Conclusion: Intraoperative transdiaphragmatic thoracentesis could be considered an effective method for the removal of residual air after surgery for TDH, because it ensures a good outcome for the patient, with low development of complications, especially for uncomplicated cases. The presence of comorbidities, the need to perform a surgical procedure in emergency, and the age of the patient can be considered factors influencing the development of complications. Critical patient selection, based on assessment of potential risk factors for complications is warranted to understand which patient will benefit from thoracostomy tube placement.
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Doenças do Gato , Hérnia Diafragmática Traumática , Pneumotórax , Gatos , Animais , Hérnia Diafragmática Traumática/cirurgia , Hérnia Diafragmática Traumática/veterinária , Estudos Retrospectivos , Pneumotórax/etiologia , Pneumotórax/veterinária , Pneumotórax/cirurgia , Herniorrafia/efeitos adversos , Herniorrafia/veterinária , Tubos Torácicos/veterinária , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/veterinária , Doenças do Gato/cirurgiaRESUMO
CASE SERIES SUMMARY: Twenty-nine cats from different institutions with confirmed or highly suspected primary hyperaldosteronism treated by unilateral adrenalectomy were retrospectively included in this study. The most frequent clinical signs were lethargy (n = 20; 69%) and neck ventroflexion (n = 17; 59%). Hypokalaemia was present in all cats, creatinine kinase was elevated in 15 and hyperaldosteronism was documented in 24. Hypertension was frequently encountered (n = 24; 89%). Preoperative treatment included potassium supplementation (n = 19; 66%), spironolactone (n = 16; 55%) and amlodipine (n = 11; 38%). There were 13 adrenal masses on the right side, 15 on the left and, in one cat, no side was reported. The median adrenal mass size was 2 × 1.5 cm (range 1-4.6 × 0.4-3.8); vascular invasion was present in five cats, involving the caudal vena cava in four cats and the renal vein in one. Median duration of surgery was 57 mins. One major intraoperative complication (3%) was reported and consisted of haemorrhage during the removal of a neoplastic thrombus from the caudal vena cava. In 4/29 cats (14%), minor postoperative complications occurred and were treated medically. One fatal complication (3%) was observed, likely due to disseminated intravascular coagulation. The median duration of hospitalisation was 4 days; 97% of cats survived to discharge. The potassium level normalised in 24 cats within 3 months of surgery; hypertension resolved in 21/23 cats. Follow-up was available for 25 cats with a median survival of 1082 days. Death in the long-term follow-up was mainly related to worsening of comorbidities. RELEVANCE AND NOVEL INFORMATION: Adrenalectomy appears to be a safe and effective treatment with a high rate of survival and a low rate of major complications. Long-term medical treatment was not required.
Assuntos
Neoplasias das Glândulas Suprarrenais , Doenças do Gato , Hiperaldosteronismo , Hipertensão , Gatos , Animais , Adrenalectomia/veterinária , Adrenalectomia/efeitos adversos , Estudos Retrospectivos , Hiperaldosteronismo/cirurgia , Hiperaldosteronismo/veterinária , Hiperaldosteronismo/complicações , Resultado do Tratamento , Hipertensão/veterinária , Potássio , Neoplasias das Glândulas Suprarrenais/complicações , Neoplasias das Glândulas Suprarrenais/cirurgia , Neoplasias das Glândulas Suprarrenais/veterinária , Doenças do Gato/cirurgiaRESUMO
OBJECTIVES: The present study aimed to document the use of the wound infusion catheter (WIC) following a variety of surgical procedures in cats, investigating complications and risk factors associated with catheter placement or local anaesthetic (LA) administration. METHODS: A retrospective, multicentric study was performed. Medical databases of eight veterinary referral hospitals from 2010 to 2021 were searched to identify records of cats where WICs were used. Information regarding signalment, type of surgery, size and type of WIC placed, and LA protocol used, as well as postoperative complications, were retrieved. RESULTS: One hundred and sixty-six cases fulfilled the inclusion criteria. Feline injection site sarcoma resection was the most common surgery. Overall complications were identified in 22/166 cats (13.2%). Thirteen cats (7.8%) experienced wound-related complications, whereas nine cats (5.4%) experienced drug-delivery complications. The only factor associated with an increased risk of complications was the amount of a single dose of LA delivered through the catheter (P <0.001). An amount higher than 2.5 ml of LA delivered at each administration was associated with an increased risk of complications. All complications were minor and self-limiting. CONCLUSIONS AND RELEVANCE: WICs were used for a large variety of surgical procedures with different protocols of LA administration as part of a multimodal analgesic plan in cats. The risk of complications was relatively low and self-limiting, suggesting its safe use in cats. Further prospective studies are required to evaluate efficacy of postoperative analgesia and to determine the suitable protocol for WIC handling and maintenance.
Assuntos
Anestesia Local , Anestésicos Locais , Gatos , Animais , Estudos Retrospectivos , Anestesia Local/veterinária , Catéteres , Hospitais VeterináriosRESUMO
OBJECTIVE: To determine whether end-tidal CO2 (Petco2), tidal volume (Vt), inspiratory minute volume (V.i), and respiratory rate (RR) remain within reference limits for spontaneously breathing dogs undergoing laparoscopic ovariectomy; characterize changes in these variables over time; and record the proportion of dogs requiring mechanical ventilation on the basis of predetermined criteria. ANIMALS: 22 client-owned dogs. PROCEDURES: Between January and June 2019, dogs were anesthetized for abdominal insufflation (CO2; 10 mm Hg) and laparoscopic ovariectomy. Respiratory variables (Petco2, Vt, V.i, and RR) were recorded at 5 time points: preinsufflation (T2), immediately after insufflation (T3), immediately after first ovary extraction (T4), immediately after second ovary extraction (T5), and after abdominal deflation (T6). Results for variables were assessed to identify differences with reference limits and between time points. RESULTS: At all time points (T2 to T6), Petco2 was within or above the reference limit, Vt was below or within reference limits, and V.i was either within or above reference limits. Significant temporal changes were detected in all recorded parameters. One dog had to be ventilated prior to abdominal insufflation due to inappropriately low Vt (< 6 mL/kg) and was excluded from further analysis. One of the 21 remaining dogs required rescue ventilation. CLINICAL RELEVANCE: Following insufflation, there was a tendency toward inadequate ventilation over time characterized by increased Petco2. Twenty of 21 dogs maintained Petco2 within tolerance via a mild increase in RR and did not require assisted ventilation. Dogs undergoing short surgeries may not require assisted ventilation. Clinicians are advised to monitor for hypercapnia and be prepared to assist ventilation if required.
Assuntos
Dióxido de Carbono , Laparoscopia , Feminino , Cães , Animais , Volume de Ventilação Pulmonar , Ovariectomia/veterinária , Laparoscopia/veterináriaRESUMO
OBJECTIVES: The aim of this study was to describe the clinical application and outcome of osteochondral autograft transfer using the COR system (COR; DePuy Synthes, Warsaw, Indiana, United States) for the treatment of osteochondritis dissecans (OCD) of the femoral condyle in dogs. METHODS: Medical records of dogs that were treated for OCD of the femoral condyle using the COR system between February 2013 and March 2020 were retrospectively reviewed. The results of pre- and postoperative clinical and radiographic examinations were evaluated. RESULTS: Twenty stifles (18 dogs; 15 lateral and 5 medial femoral condyles) met the inclusion criteria. A single graft transfer was done in six stifle joints and mosaicplasty in 14 (2 grafts in 9/14 stifles; 3 grafts in 5/14 stifles). Proper anatomic reconstruction was confirmed intraoperatively and radiographically in all dogs. There were no major and three minor postoperative complications. At 3 months, 15 of 20 stifles (14 of 18 dogs) had no lameness or radiographic signs of inflammation. At 6 months, 12 of 13 dogs had no lameness or discomfort, and four of 13 stifles had radiographic evidence of moderate osteoarthritis. CLINICAL SIGNIFICANCE: Treatment of OCD of the femoral condyle using the COR system is feasible in dogs, with low complications and provides a satisfactory short-term outcome.
Assuntos
Doenças do Cão , Osteocondrite Dissecante , Animais , Autoenxertos , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Cães , Fêmur/cirurgia , Osteocondrite Dissecante/diagnóstico por imagem , Osteocondrite Dissecante/cirurgia , Osteocondrite Dissecante/veterinária , Estudos Retrospectivos , Joelho de Quadrúpedes/cirurgiaRESUMO
The aim of this study is to report outcomes of dogs undergoing cholecystectomy for gall bladder mucocele (GBM) without flushing and catheterization of the common bile duct (CBD). This is a retrospective multicentric study from three veterinary referral hospitals and included 82 dogs diagnosed with GBM. Medical records were reviewed for clinical and histopathological findings. Long-term outcome was assessed with an owner questionnaire. The common bile duct was considered normal (<4 mm), mildly dilated (5−6 mm) and moderately dilated (>7 mm) in 88%, 10% and 2.4% of dogs, respectively. Surgery was uncomplicated in 83% of dogs. Intraoperative complications were recorded in 21% of dogs, with hypotension being the most common, whereas postoperative complications were documented in 20% of dogs, with vomiting/regurgitation being the most common. Ninety-six percent of dogs that underwent cholecystectomy in this study survived to discharge. Follow-up ranged from 142 to 3930 days (median: 549 days). Eighty-five percent of dogs were alive at the time of follow-up. Dogs undergoing cholecystectomy for GBM without catheterization and flushing of the CBD have a favourable prognosis for recovery and quality of life.