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Malignant splenic lesions in dogs are common, with hemangiosarcoma diagnosed most frequently, and there have been no consistent clinicopathologic, gross, or imaging characteristics identified that differentiate malignant from benign splenic lesions. Histopathology is required for definitive diagnosis, and given the poor long-term prognosis of malignant splenic lesions, a noninvasive tool to aid in diagnosis would be valuable. This prospective cohort study utilized gadoxetate disodium, a liver-specific contrast agent (Gd-EOB-DPTA; Eovist), to identify the general lesion and pre- and postcontrast signal characteristics of benign and malignant splenic and hepatic lesions in dogs with naturally occurring disease. Twenty-five dogs were enrolled, Eovist-enhanced MRI was performed, and dogs were taken to surgery for splenectomy and other organ biopsy. All histopathology and MRI studies were evaluated by a single pathologist and a single radiologist, respectively. The associations between the tumor type and numerous variables defined on MRI were evaluated using Fisher's exact tests, and the significance was identified at a P-value of .05. Malignant splenic masses were identified in 11/25 (44%) dogs, and 5/11 malignancies represented hemangiosarcoma. The presence of abdominal effusion (P = .017) and the presence of hepatic nodules on MRI (P = .009) were associated with splenic malignancy. There were no benign T2 hyperintense and no malignant T2 hypointense lesions (P = .021). Utilization of the T2 W MRI sequence may aid in the identification of malignant splenic lesions, particularly when accompanied by abdominal effusion and hepatic lesions.
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OBJECTIVE: To compare short- and long-term clinical variables between dogs undergoing a modified percutaneous cystolithotomy (PCCLm) and open cystotomy (OC) and evaluate for risk factors associated with complications and outcomes within the groups. STUDY DESIGN: Retrospective study. ANIMALS: A total of 218 dogs. METHODS: Records were reviewed for dogs that underwent PCCLm or OC between January 2010 and December 2019. Signalment; history and diagnostic findings; procedural, anesthetic, and hospitalized care data; complications; urolith recurrence; and follow-up were recorded. Logistic regression analysis was used to evaluate effects of clinical variables on outcomes within PCCLm and OC groups and to identify significant categorical variables between PCCLm and OC groups. Two sample t-tests were used to identify significant numerical variables between PCCLm and OC groups. RESULTS: A total of 60.1% (131/218) of dogs underwent the PCCLm procedure and 39.9% (87/218) of dogs underwent the OC procedure. Anesthesia time (p < .001) was significantly longer in the OC group. No significant difference in incomplete urolith removal was noted between groups. Although surgical site infection and inflammation rates were not significantly different between OC and PCCLm groups, incisional infections were significantly associated with complications occurring during PCCLm (p = .027). Significantly reduced postoperative lower urinary tract signs (p = .022) were noted in the PCCLm group. CONCLUSION: The PCCLm may result in reduced lower urinary tract signs postoperatively compared to OC, but other clear advantages of the PCCLm were not identified in this study. CLINICAL SIGNIFICANCE: PCCLm procedures are an effective alternative to OC for urolith removal in dogs.
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Anestesia , Doenças do Cão , Cães , Animais , Cistotomia/veterinária , Estudos Retrospectivos , Anestesia/veterinária , Inflamação/veterinária , Período Pós-Operatório , Infecção da Ferida Cirúrgica/veterinária , Doenças do Cão/cirurgiaRESUMO
Wound healing is a complicated process consisting of overlapping phases directed and regulated by many mediators of healing produced locally at the wound. The end goal of wound healing is the production of tissue at the site of injury which has a similar structure and provides protection to the body. Any alterations in the normal healing process can lead to delayed healing or additional tissue damage. Factors that contribute to aberrant wound healing can be species-specific and include both intrinsic (systemic) factors and extrinsic (environmental) factors. Management of wounds and recognition of alterations can be optimised by adoption of a structured framework for wound assessment, such as the TIME principle (acronym referring to the following categories: tissue, inflammation or infection, moisture, and edge of wound or epithelial advancement). This review article provides an overview of the phases of wound healing, variation of healing among different species, factors reported to delay healing, and an introduction to the TIME principle as a structured approach to clinical evaluation of wounds.
La cicatrisation des plaies est un processus compliqué composé de phases superposées dirigées et régulées par de nombreux médiateurs de cicatrisation produits localement au niveau de la plaie. L'objectif final de la cicatrisation est la production de tissu sur le site de la blessure qui a une structure similaire et offre une protection au corps. Toute altération du processus normal de cicatrisation peut entraîner un retard de cicatrisation ou des lésions tissulaires supplémentaires. Les facteurs qui contribuent à une cicatrisation aberrante des plaies peuvent être spécifiques à l'espèce et inclure à la fois des facteurs intrinsèques (systémiques) et des facteurs extrinsèques (environnementaux). La gestion des plaies et la reconnaissance des altérations peuvent être optimisées par l'adoption d'un cadre structuré pour l'évaluation des plaies, tel que le principe du TIME (acronyme faisant référence aux catégories suivantes : tissu, inflammation ou infection, humidité et bord de la plaie ou avancement épithélial). Cet article de synthèse donne un aperçu des phases de cicatrisation des plaies, de la variation de la cicatrisation entre les différentes espèces, des facteurs signalés comme retardant la cicatrisation et une introduction au principe TIME en tant qu'approche structurée de l'évaluation clinique des plaies.
La cicatrización de heridas es un proceso complicado que consta de fases superpuestas dirigidas y reguladas por muchos mediadores de cicatrización producidos localmente en la herida. El objetivo final de la cicatrización de heridas es la producción de tejido en la zona lesional que tenga una estructura similar y brinde protección al cuerpo. Cualquier alteración en el proceso de cicatrización normal puede provocar un retraso en la curación o daño adicional en los tejidos. Los factores que contribuyen a la cicatrización aberrante de heridas pueden ser específicos de la especie e incluyen tanto factores intrínsecos (sistémicos) como factores extrínsecos (ambientales). El manejo de heridas y el reconocimiento de alteraciones se pueden optimizar mediante la adopción de un marco estructurado para la evaluación de heridas, como el principio TIME (acrónimo que se refiere a las siguientes categorías: tejido, inflamación o infección, humedad y borde de la herida o avance epitelial). Este artículo de revisión proporciona una descripción general de las fases de cicatrización de heridas, la variación de la cicatrización entre diferentes especies, los factores que retrasan la cicatrización y una introducción al principio TIME como un enfoque estructurado para la evaluación clínica de heridas.
A cicatrização de feridas é um processo complicado que consiste em fases sobrepostas direcionadas e reguladas por diversos mediadores de cicatrização produzidos localmente na ferida. O objetivo final da cicatrização de feridas é a produção de tecido no local da lesão que apresenta estrutura similar e fornece proteção para o corpo. Quaisquer alterações no processo normal de cicatrização por levar a um retardo na cicatrização ou dano adicional ao tecido. Fatores que contribuem para a cicatrização de feridas aberrante podem ser espécie-específicos e incluem tanto fatores intrínsecos (sistêmicos) quanto extrínsecos (ambientais). O manejo de feridas e o reconhecimento das alterações podem ser otimizados pela adoção de um roteiro estruturado para avaliação de feridas, como o princípio TIME (sigla que se refere às seguintes categorias: tecido, inflamação ou infecção, umidade e borda da ferida ou avanço epitelial). Este artigo de revisão fornece uma visão geral das fases de cicatrização de feridas, variação da cicatrização entre diferentes espécies, fatores que podem atrasar a cicatrização e uma introdução ao princípio TIME como uma abordagem estruturada para avaliação clínica de feridas.
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Inflamação , Cicatrização , Animais , Inflamação/veterináriaRESUMO
With the increasing use of CT and MRI for diagnostic imaging and planning of interventional procedures, it is important for veterinary radiologists to be familiar with variations in normal vascular anatomy and not mistake them for pathology. The arterial blood supply to the cranial abdominal viscera is provided by the celiac and the cranial mesenteric arteries. A common celiacomesenteric trunk (CMT) has been reported as a rare anatomical variant in dogs. The goals of this retrospective, observational, cross-sectional prevalence study were to determine the prevalence of a CMT in dogs with non-abdominal disease and compare it to the prevalence in dogs with portosystemic shunts (PSS). Magnetic resonance imaging studies of the thoracolumbar and lumbosacral spine in dogs that included the origin of the celiac and cranial mesenteric arteries and dual-phase CT angiography studies of the abdomen in dogs with portosystemic shunts were retrospectively reviewed by a veterinary student and a board-certified veterinary radiologist. The prevalence of a CMT was determined as the proportion of dogs diagnosed with this vascular anomaly in the MRI and CT group, respectively. Fisher's exact test was used to determine any association of a CMT with the concurrent presence of a PSS, sex, and breed size. A CMT was identified in seven of 606 (1.2%) MRI studies and in none of 47 abdominal CT studies. There was no association between the presence of a CMT and PSS (P = 1.000), sex (P = .4694), or breed size (P = 1.000). A CMT is a rare incidental finding in dogs.
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Angiografia por Tomografia Computadorizada , Derivação Portossistêmica Cirúrgica , Abdome , Animais , Angiografia por Tomografia Computadorizada/veterinária , Estudos Transversais , Cães , Humanos , Derivação Portossistêmica Cirúrgica/veterinária , Estudos RetrospectivosRESUMO
OBJECTIVE: To determine the effects of low-level laser therapy (LLLT) on primarily closed incisions and full thickness open wounds in dogs. STUDY DESIGN: Prospective, masked, placebo-controlled design. ANIMAL POPULATION: Healthy intact female dogs (n = 10). METHODS: Dogs underwent bilateral flank ovariectomy procedures, and open wounds were created bilaterally with a punch biopsy. Each side of the dog (incision and open wound) was randomly assigned to the treatment (TX) group or the control (CN) group. The TX group received LLLT once daily for 5 days with a 980-nm laser and a total energy density of 5 J/cm2 . The CN group received a sham treatment (laser turned off) for an identical amount of time each day. The wounds were assessed visually; measured; photographed at postoperative days 3, 7, 11, and 14; and biopsied on postoperative days 7 and 14. A 2-way repeated measures multivariate analysis of variance was used to analyze differences between groups. RESULTS: There was no difference between groups for subjective assessment of healing time and wound measurements (P = .7). There was no difference in histopathologic assessment except that the CN group had more necrosis and perivascular lymphocytes and macrophages at day 7 (P = .03). The TX group had more perivascular lymphocytes and macrophages at day 14 (P = .01). CONCLUSION: LLLT did not appear to influence the healing of surgically created incisions and small wounds with the methodology reported here. CLINICAL SIGNIFICANCE: Results of this study do not support recommending LLLT to stimulate healing of uncomplicated, small wounds and incisions.
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Cães , Terapia com Luz de Baixa Intensidade/veterinária , Ferida Cirúrgica/veterinária , Cicatrização/efeitos da radiação , Animais , Biópsia , Feminino , Ovariectomia/veterinária , Estudos Prospectivos , Pele/patologiaRESUMO
OBJECTIVE: To determine the safety of a hyperbaric oxygen therapy (HBOT) protocol and its influence on the healing of uncomplicated open and incisional wounds in dogs. STUDY DESIGN: Prospective, controlled experimental study. ANIMALS: Adult dogs (n = 10). METHODS: Two 2 × 2-cm open wounds and two 3-cm-long full-thickness dermal incisions were created on the dorsum of each dog. Dogs in the hyperbaric oxygen treatment group (HBO) received HBOT once daily (1.7 atmospheres absolute [ATA], 30 minutes on day 1; 2.0 ATA, 40 minutes on days 2-7) for 7 consecutive days, and dogs in the control group (CON) received standardized wound care. Dogs were monitored during HBOT for adverse side effects. Total wound area, percentage epithelialization, and percentage contraction were compared for the open wounds. Subjective wound scores were compared for the open and incisional wounds. Biopsies of both wound types were taken and used to determine histopathology scores. Bacterial cultures were completed on open wounds. RESULTS: No difference was detected between HBO and CON uncomplicated open and incisional wounds at any time for contraction, epithelialization, subjective wound scores, histopathology scores, or bacterial loads. All HBO dogs tolerated hyperbaric oxygen treatments with no adverse effects. CONCLUSION: The HBOT protocol tested here was safe but did not enhance the healing of uncomplicated acute wounds and incisions of dogs. CLINICAL SIGNIFICANCE: These results do not provide evidence to support the use of HBOT to manage uncomplicated wounds in dogs.
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Cães/lesões , Oxigenoterapia Hiperbárica/veterinária , Ferida Cirúrgica/veterinária , Cicatrização , Animais , Feminino , Masculino , Estudos Prospectivos , Distribuição Aleatória , Ferida Cirúrgica/terapiaRESUMO
Identification of nasal neoplasia extension and tumor staging in dogs is most commonly performed using computed tomography (CT), however magnetic resonance imaging (MRI) is routinely used in human medicine. A prospective pilot study enrolling six dogs with nasal neoplasia was performed with CT and MRI studies acquired under the same anesthetic episode. Interobserver comparison and comparison between the two imaging modalities with regard to bidimensional measurements of the nasal tumors, tumor staging using historical schemes, and assignment of an ordinal scale of tumor margin clarity at the tumor-soft tissue interface were performed. The hypotheses included that MRI would have greater tumor measurements, result in higher tumor staging, and more clearly define the tumor soft tissue interface when compared to CT. Evaluation of bone involvement of the nasal cavity and head showed a high level of agreement between CT and MRI. Estimation of tumor volume using bidimensional measurements was higher on MRI imaging in 5/6 dogs, and resulted in a median tumor volume which was 18.4% higher than CT imaging. Disagreement between CT and MRI was noted with meningeal enhancement, in which two dogs were positive for meningeal enhancement on MRI and negative on CT. One of six dogs had a higher tumor stage on MRI compared to CT, while the remaining five agreed. Magnetic resonance imaging resulted in larger bidimensional measurements and tumor volume estimates, along with a higher likelihood of identifying meningeal enhancement when compared to CT imaging. Magnetic resonance imaging may provide integral information for tumor staging, prognosis, and treatment planning.
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Doenças do Cão/diagnóstico por imagem , Imageamento por Ressonância Magnética/veterinária , Estadiamento de Neoplasias/métodos , Neoplasias Nasais/veterinária , Tomografia Computadorizada por Raios X/veterinária , Animais , Cães , Feminino , Imageamento por Ressonância Magnética/métodos , Masculino , Neoplasias Nasais/diagnóstico por imagem , Projetos Piloto , Estudos Prospectivos , Tomografia Computadorizada por Raios X/métodosRESUMO
PURPOSE: To evaluate feasibility of left gastric artery (LGA) yttrium-90 ((90)Y) radioembolization as potential treatment for obesity in a porcine model. MATERIALS AND METHODS: This study included 8 young female pigs (12-13 weeks, 21.8-28.1 kg). Six animals received infusions of (90)Y resin microspheres (46.3-105.1 MBq) into the main LGA and the gastric artery arising from the splenic artery. Animal weight and serum ghrelin were measured before treatment and weekly thereafter. Animals were euthanized 69-74 days after treatment, and histologic analyses of mucosal integrity and ghrelin immunoreactive cell density were performed. RESULTS: Superficial mucosal ulcerations < 3.0 cm(2) were noted in 5 of 6 treated animals. Ghrelin immunoreactive cell density was significantly lower in treated versus untreated animals in the stomach fundus (13.5 vs 34.8, P < .05) and stomach body (11.2 vs 19.8, P < .05). Treated animals gained less weight than untreated animals over the study duration (40.2 kg ± 5.4 vs 54.7 kg ± 6.5, P = .053). Average fundic parietal area (165 cm(2) vs 282 cm(2), P = .067) and average stomach weight (297.2 g vs 397.0 g, P = .067) were decreased in treated versus untreated animals. Trichrome staining revealed significantly more fibrosis in treatment animals compared with control animals (13.0 vs 8.6, P < .05). No significant differences were identified in plasma ghrelin concentrations (P = .24). CONCLUSIONS: LGA (90)Y radioembolization is promising as a potential treatment for obesity. A larger preclinical study is needed to evaluate the safety and efficacy of this procedure further.
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Artérias , Embolização Terapêutica/métodos , Obesidade/terapia , Compostos Radiofarmacêuticos/administração & dosagem , Estômago/irrigação sanguínea , Radioisótopos de Ítrio/administração & dosagem , Animais , Biomarcadores/sangue , Estudos de Viabilidade , Feminino , Fibrose , Mucosa Gástrica/metabolismo , Grelina/sangue , Infusões Intra-Arteriais , Modelos Animais , Obesidade/sangue , Obesidade/fisiopatologia , Projetos Piloto , Estômago/patologia , Sus scrofa , Fatores de Tempo , Redução de PesoRESUMO
Hepatocellular carcinoma is the most common primary hepatic tumor in dogs and is amenable to surgical resection in many cases. Unfortunately, overlap of sonographic findings between benign and malignant hepatic lesions typically requires more invasive diagnostic tests to be performed (e.g., biopsy for histopathology). The availability of a noninvasive diagnostic test to identify hepatocellular carcinoma would be beneficial. The use of a liver-specific magnetic resonance imaging (MRI) contrast agent such as gadoxetate disodium (Gd-EOB-DTPA; Eovist® or Primovist®) has improved lesion detection in human patients. In this descriptive study, gadoxetate disodium contrast-enhanced MRI characteristics in dogs were evaluated in seven dogs (total of eight lesions). The imaging characteristics were variable with the exception of all lesions being hypointense to surrounding normal hepatic parenchyma on 3D T1-weighted gradient recalled echo images at all postcontrast time points. All lesions displayed signal intensity ratios less than 1, consistent with retained but impaired hepatocyte function. Hepatic lesions not identified on previous imaging were found in 3/7 patients which may affect surgical planning. In two patients, several hepatic nodules were identified during surgery which had not been visualized on MRI and were found to be benign on histopathology. This descriptive study reports the MRI characteristics of hepatocellular carcinoma in dogs using the liver-specific contrast agent gadoxetate disodium.
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Carcinoma Hepatocelular/veterinária , Meios de Contraste , Doenças do Cão/diagnóstico por imagem , Gadolínio DTPA , Imageamento Tridimensional/veterinária , Neoplasias Hepáticas/veterinária , Imageamento por Ressonância Magnética/veterinária , Animais , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/etiologia , Doenças do Cão/etiologia , Cães , Feminino , Imageamento Tridimensional/métodos , Neoplasias Hepáticas/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , MasculinoRESUMO
Emergency surgery was performed on a 6-year-old castrated male springer spaniel dog with evisceration of most of the small intestinal tract through the perineal region, secondary to a dog attack. This is the first report describing successful treatment of perineal evisceration secondary to dog attack at an untreated perineal hernia, employing abdominal and perineal approaches.
Éviscération périnéale secondaire à une blessure de morsure chez un chien ayant une hernie périnéale non traitée. Une chirurgie d'urgence a été réalisée chez un chien épagneul Springer mâle stérilisé âgé de 6 ans présentant l'éviscération de la majeure partie du tractus du petit intestin dans la région périnéale secondaire à une attaque par un chien. Il s'agit du premier rapport décrivant le traitement réussi d'une éviscération périnéale secondaire à une attaque de chien sur une hernie périnéale non traitée à l'aide des approches abdominale et périnéale.(Traduit par Isabelle Vallières).
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Mordeduras e Picadas/veterinária , Doenças do Cão/patologia , Hérnia/veterinária , Períneo/patologia , Animais , Mordeduras e Picadas/patologia , Doenças do Cão/cirurgia , Cães , Masculino , Períneo/cirurgiaRESUMO
An approximately 30-year-old intact female Asiatic black bear (Ursus thibetanus) was presented for annual examination and a history of ptyalism. A large 9.5â cm × 5â cm × 5â cm, firm, round mass was identified attached to the hard palate on physical examination. A computed tomography scan was performed, and the heterogeneous, mineral-attenuating mass was seen arising from the right aspect of the palatine bone and extending rostrally to the level of the last maxillary molars, caudally into the oropharynx, and dorsally into the nasal choana. Surgical debulking was performed to remove the portion of the mass within the oral cavity. Histopathologic analysis was consistent with a keratinizing ameloblastoma. Nine months postoperatively, the patient was asymptomatic for the tumor. The patient was euthanized 23-months postoperatively, and severe diffuse pustular dermatitis, growth of the ameloblastoma on the hard palate, and various degenerative and aging changes were noted on necropsy at that time. This is the first report of an ameloblastoma in a member of the Ursidae family.
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Ameloblastoma , Ursidae , Animais , Feminino , Ameloblastoma/diagnóstico , Ameloblastoma/cirurgia , Ameloblastoma/veterináriaRESUMO
OBJECTIVE: To report the clinical characteristics, treatments, and outcomes in a cohort of dogs with histologically confirmed retroperitoneal sarcoma (RPS) and to identify potential variables of prognostic significance. ANIMALS: 46 client-owned dogs from 10 clinics with histopathologic diagnosis of a sarcoma originating from the retroperitoneal space. METHODS: Medical records were retrospectively reviewed to obtain information regarding clinical characteristics, treatments, and outcomes. Recorded variables were analyzed to report descriptive data for all cases and overall survival time. Multivariate analysis was utilized to evaluate prognostic factors for overall survival. RESULTS: Hemangiosarcoma was the most common histologic subtype diagnosed (76.1%). Cytoreductive and curative intent surgical excision of the RPS was attempted in 12 and 22 dogs, respectively; 12 dogs underwent no surgery or had an exploratory laparotomy with incisional biopsy only. Nineteen dogs received adjuvant chemotherapy, either injectable or metronomic, and 1 dog received adjuvant radiation therapy. Fourteen of the 34 (41.2%) surgically treated dogs developed evidence of local recurrence, but there was no difference in local recurrence when comparing dogs categorized as curative intent versus cytoreductive surgery. The median overall survival time was 238 days. On multivariable analysis, treatment approach was associated with survival with surgical excision (vs palliative treatment) and adjuvant chemotherapy following surgery being protective against death. A diagnosis of hemangiosarcoma was associated with a greater hazard of death. CLINICAL RELEVANCE: This study demonstrates a substantially greater survival time than previously published and suggests a survival benefit from surgical excision and adjuvant chemotherapy.
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Doenças do Cão , Neoplasias Retroperitoneais , Sarcoma , Animais , Cães , Doenças do Cão/terapia , Doenças do Cão/mortalidade , Doenças do Cão/cirurgia , Doenças do Cão/patologia , Sarcoma/veterinária , Sarcoma/terapia , Sarcoma/mortalidade , Sarcoma/cirurgia , Neoplasias Retroperitoneais/veterinária , Neoplasias Retroperitoneais/mortalidade , Neoplasias Retroperitoneais/cirurgia , Neoplasias Retroperitoneais/terapia , Neoplasias Retroperitoneais/patologia , Masculino , Feminino , Estudos Retrospectivos , Resultado do Tratamento , Análise de Sobrevida , Estudos de Coortes , Hemangiossarcoma/veterinária , Hemangiossarcoma/mortalidade , Hemangiossarcoma/terapia , Hemangiossarcoma/cirurgia , Hemangiossarcoma/patologiaRESUMO
An 11-week-old, sexually intact female Catahoula Leopard dog was evaluated for a multiple-week history of exercise intolerance and intermittent periods of respiratory distress. Thoracic radiographs revealed a markedly hyperinflated right lung field, with compression of the surrounding lung lobes. Thoracic computed tomography further localized the hyperinflation to the right middle lung lobe, with suspicion of congenital lobar emphysema. A right intercostal thoracotomy with right middle lung lobectomy was performed successfully. Histopathology results confirmed bronchial cartilage hypoplasia with marked emphysema and pleural fibrosis. The puppy recovered from surgery uneventfully and was discharged from the hospital without any postoperative complications. At 18 months postoperatively, the dog was clinically normal with no return of respiratory distress. This case report describes successful surgical treatment of a large breed puppy with the uncommonly reported condition of congenital lobar emphysema.
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OBJECTIVE: To evaluate dogs and cats undergoing total ear canal ablation with lateral bulla osteotomy (TECA-LBO), document antimicrobial choices, and determine relationships associated with infection-related and neurologic postoperative complications. ANIMALS: 107 client-owned dogs and 13 client-owned cats that underwent TECA-LBO. PROCEDURES: A retrospective analysis of medicals records of dogs and cats with TECA-LBO from 2 veterinary hospitals with postoperative data for at least 6 months was performed. All information associated with the TECA-LBO surgery including follow-up was recorded. Logistic regression analyses were performed and corrected using a false discovery rate to identify significance between antimicrobial administration and other perioperative variables and the outcomes of short- and long-term neurologic and infection-related complications, need for revision surgery, and euthanasia due to recurrence of infection-related signs. RESULTS: Intraoperative cultures were performed in 111 animals, and 95 (85.5%) had bacterial growth, with Staphylococcus spp most commonly isolated. Revision surgeries due to infection-related signs occurred in 13 of 120 (10.8%) patients. If intraoperative bacterial cultures were positive and antimicrobials were administered within 1 month of surgery, patients were 85.8% less likely to exhibit infection-related complications, whereas patients not administered antimicrobials were 10.3 times as likely to require a revision surgery. Longer durations of postoperative antimicrobial administration were associated with revision surgery and euthanasia due to infection-related signs. CLINICAL RELEVANCE: Administration of systemic antimicrobials within the first postoperative month may be necessary to prevent complications when intraoperative cultures exhibit bacterial growth and plays a role in the successful outcome of TECA-LBO.
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Doenças do Gato , Doenças do Cão , Animais , Antibacterianos/uso terapêutico , Vesícula/etiologia , Vesícula/veterinária , Doenças do Gato/etiologia , Doenças do Gato/cirurgia , Gatos , Doenças do Cão/etiologia , Cães , Meato Acústico Externo/cirurgia , Osteotomia/efeitos adversos , Osteotomia/veterinária , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/veterinária , Estudos RetrospectivosRESUMO
Background: The GI microbiome has not been characterized in dogs being medically managed for congenital portosystemic shunts (CPSS). Objectives: To characterize the fecal microbiome in a population of dogs being medically managed for CPSS. Animals: 27 client-owned dogs. Methods: Prospective cohort study enrollment of fecal samples was performed with follow-up data collected retrospectively. The overall fecal dysbiosis index (DI) and individual bacterial abundances were determined using real-time qPCR. Medical management, clinical findings, clinicopathologic, and outcome variables were collected, and logistic regression analyses were performed to evaluate associations between these variables and overall DI and bacterial abundances. Numerical variables were evaluated with general linear models for normality and equal variance using Shapiro-Wilk test and Levene's test, respectively. Results: All dogs were administered a hepatic diet and lactulose, while antibiotics were used in 22 (81.5%) and acid suppressants in 7 (25.9%). Seventeen dogs (63.0%) had a DI >2. The median DI in this population was 3.02 (range 4.23-8.42), and the median DI in dogs receiving and not receiving antibiotics was 4.3 (range -4.23-8.42) and 1.52 (range -1.62-5.43), respectively. No significant association between any of the analyzed variables and the DI was identified. There was a significant association between the use of metronidazole and a larger abundance of E. coli (p = 0.024). Conclusions and Clinical Importance: Dysbiosis appears to be common in dogs that are being medically managed for CPSS, though the clinical significance remains unclear.
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OBJECTIVE: To determine the outcome in dogs diagnosed with congenital extrahepatic portosystemic shunts (EHPSS) at ≥ 5 years of age treated with medical management only (M) or with surgical attenuation (S). The hypothesis was that dogs undergoing surgical attenuation would have a longer survival time than dogs undergoing medical management only. ANIMALS: 351 dogs definitively diagnosed with EHPSS at ≥ 5 years of age. PROCEDURES: Medical records from 2009 to 2019 at 16 veterinary teaching hospitals were evaluated. Data collected included signalment, clinical signs at diagnosis, clinicopathologic data, surgical and medical treatments, shunt morphology, clinical signs and medical treatments at 6 to 12 months after diagnosis, and survival time. RESULTS: 351 dogs (M, 119 [33.9%]; S, 232 [66.1%]) were included in the study. Survival time was longer with surgery than medical management (hazard ratio, 4.2; M, 3.4 years; S, 10.9 years). Continued clinical signs at 6 to 12 months after diagnosis were more common with medical management (M, 40% [33/88]; S, 14% [21/155]). Continued medical treatments at 6 to 12 months after diagnosis were more common in the medical management group (M, 78% [69/88]; S, 34% [53/155]). Perioperative mortality rate was 7.3%. CLINICAL RELEVANCE: Dogs diagnosed at ≥ 5 years of age with EHPSS have significantly better survival times and fewer clinical signs with surgical attenuation, compared with medical management. Older dogs have similar surgical mortality rates to dogs of all ages after surgical EHPSS attenuation.
Assuntos
Doenças do Cão , Derivação Portossistêmica Transjugular Intra-Hepática , Animais , Doenças do Cão/diagnóstico , Doenças do Cão/tratamento farmacológico , Doenças do Cão/cirurgia , Cães , Sistema Porta/anormalidades , Sistema Porta/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática/veterinária , Estudos RetrospectivosRESUMO
OBJECTIVE: To identify clinical characteristics of, prognostic factors for, and long-term outcome of dogs with multiple acquired portosystemic shunts (MAPSSs) and determine whether survival time was associated with previous portosystemic shunt attenuation. ANIMALS: 72 client-owned dogs with MAPSSs. PROCEDURES: Medical records of dogs in which MAPSSs had been diagnosed between January 2000 and August 2018 were reviewed for signalment, historic and diagnostic findings, management methods, and outcome. RESULTS: Median survival time of dogs (n = 23) that died of causes related to MAPSSs was 580 days (range, 156 to 1,363 days). Factors significantly associated with dying of MAPSS-related versus unrelated causes included body weight, albumin concentration at the first and last recheck examinations, and cholesterol, total solids, and glucose concentrations at the last recheck examination. Dogs not receiving medical management or without signs of depressed mentation at the time of initial presentation were less likely to die of causes related to MAPSSs. Patient status (alive vs dead of causes related to MAPSSs vs dead of causes unrelated to MAPSSs vs dead of unknown causes) was not significantly associated with survival time. CONCLUSIONS AND CLINICAL RELEVANCE: Survival time for dogs with MAPSSs was not shortened by previous portosystemic shunt attenuation surgery and was not different when death was versus was not related to MAPSSs. Dogs with MAPSSs that had progression of biochemical changes consistent with liver dysfunction were more likely to die of causes related to MAPSSs and were unlikely to live a normal lifespan.
Assuntos
Doenças do Cão , Derivação Portossistêmica Transjugular Intra-Hepática , Animais , Doenças do Cão/diagnóstico , Doenças do Cão/cirurgia , Cães , Sistema Porta/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática/veterinária , Prognóstico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: To evaluate short-term risk factors associated with dehiscence and death in cats undergoing full-thickness large intestinal incisions. ANIMALS: 84 client-owned cats that had undergone full-thickness large intestinal incisions and for which information regarding outcome through postoperative day 7 was available. PROCEDURES: Medical records from 4 veterinary teaching hospitals were reviewed. For cats that met the inclusion criteria, signalment, history, laboratory test results, surgical and medical procedures, perioperative complications, and outcome were analyzed. A Fisher exact or Wilcoxon rank sum test was used to identify individual variables associated with dehiscence of intestinal incisions or patient nonsurvival to hospital discharge or both. RESULTS: 84 cats met the inclusion criteria. The overall dehiscence and survival to hospital discharge rates were 8.3% (7/84 cats) and 94% (79/84 cats), respectively. Factors associated with dehiscence and nonsurvival to hospital discharge included presence of band neutrophils, performance of partial colectomy with colonic resection and anastomosis, administration of blood products, postoperative cardiopulmonary arrest, and incisional inflammation or infection. Factors associated with nonsurvival to hospital discharge only included low serum globulin concentration, repair of colonic trauma or dehiscence, and postoperative colonic dehiscence. Factors associated with dehiscence only included hypoalbuminemia, renal dysfunction, administration of blood products or > 2 classes of antimicrobials, and intra-abdominal fecal contamination. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that intestinal dehiscence and mortality rates associated with large intestinal incisions in cats may be higher than previously proposed, although the risk of either outcome was still low. Factors suggestive of systemic illness were associated with colonic dehiscence or death, and focused prospective studies of risk factors are warranted.
Assuntos
Intestino Grosso , Anastomose Cirúrgica/veterinária , Animais , Gatos , Estudos Prospectivos , Estudos Retrospectivos , Fatores de RiscoRESUMO
Perioperative administration of desmopressin has shown to significantly decrease rates of local recurrence and metastasis, and increase survival times in dogs with grade II and III mammary carcinomas. The objective of this study was to compare the oncologic outcome of cats with mammary carcinoma treated with bilateral mastectomy with or without perioperative administration of desmopressin. Medical records from nine veterinary institutions were searched to identify cats diagnosed with mammary carcinoma treated with bilateral mastectomy. Sixty cats treated with single-session or staged bilateral mastectomy were included. There were no significant differences in oncologic outcomes found between cats treated and not treated with desmopressin. No adverse effects were seen in any of the cats treated with perioperative desmopressin. Postoperative complications occurred in 18 cats (38.3%) treated with single-session bilateral mastectomy and in three cats (23.1%) treated with staged bilateral mastectomy (P = .48). Histologic grade and a modification of a proposed five-stage histologic staging system were both prognostic for disease-free interval. Incomplete histologic excision was associated with significantly increased rates of metastasis and tumour progression, and a shorter median survival time (MST). Cats that developed local recurrence also had a significantly shorter MST. The results of this study do not support the use of perioperative desmopressin to improve outcome when performing bilateral mastectomy for the treatment of mammary carcinoma in cats.
Assuntos
Carcinoma , Doenças do Gato , Desamino Arginina Vasopressina , Neoplasias Mamárias Animais , Animais , Carcinoma/tratamento farmacológico , Carcinoma/cirurgia , Carcinoma/veterinária , Doenças do Gato/tratamento farmacológico , Doenças do Gato/cirurgia , Gatos , Desamino Arginina Vasopressina/administração & dosagem , Desamino Arginina Vasopressina/uso terapêutico , Feminino , Neoplasias Mamárias Animais/tratamento farmacológico , Neoplasias Mamárias Animais/cirurgia , Mastectomia/veterinária , Assistência PerioperatóriaRESUMO
OBJECTIVE: To evaluate outcomes in cats undergoing subtotal colectomy for the treatment of idiopathic megacolon and to determine whether removal versus nonremoval of the ileocecocolic junction (ICJ) was associated with differences in outcome. ANIMALS: 166 client-owned cats. PROCEDURES: For this retrospective cohort study, medical records databases of 18 participating veterinary hospitals were searched to identify records of cats with idiopathic megacolon treated by subtotal colectomy from January 2000 to December 2018. Data collection included perioperative and surgical variables, complications, outcome, and owner perception of the procedure. Data were analyzed for associations with outcomes of interest, and Kaplan-Meier survival time analysis was performed. RESULTS: Major perioperative complications occurred in 9.9% (15/151) of cats, and 14% (12/87) of cats died as a direct result of treatment or complications of megacolon. The median survival time was not reached. Cats with (vs without) a body condition score < 4/9 (hazard ratio [HR], 5.97), preexisting heart disease (HR, 3.21), major perioperative complications (HR, 27.8), or long-term postoperative liquid feces (HR, 10.4) had greater hazard of shorter survival time. Constipation recurrence occurred in 32% (24/74) of cats at a median time of 344 days and was not associated with retention versus removal of the ICJ; however, ICJ removal was associated with long-term liquid feces (OR, 3.45), and a fair or poor outcome on owner assessment (OR, 3.6). CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that subtotal colectomy was associated with long survival times and a high rate of owner satisfaction. Removal of the ICJ was associated with less favorable outcomes in cats of the present study.