Surgical management of brachycephalic obstructive airway syndrome: An update on options and outcomes.

Dogs with a brachycephalic conformation often experience a collection of abnormalities related to their craniofacial conformation, which can lead to a variety of clinical signs such as stertor, exercise intolerance, respiratory distress, and gastrointestinal signs such as regurgitation, among others. This collection of abnormalities is termed brachycephalic obstructive airway syndrome (BOAS). With the rise in popularity of several brachycephalic breeds, veterinarians and veterinary surgery specialists are seeing these dogs with increasing frequency for surgical and medical treatment of these clinical signs, leading to an increased interest in developing surgical techniques for dogs with BOAS and evaluating objective methods of determining outcome after surgery. Advances in anesthetic management including standardized protocols and use of local nerve blocks to decrease opiate use may decrease postoperative complications. A variety of new or modified surgical techniques to manage hyperplastic soft palate and stenotic nares, among other BOAS components, have been developed and studied in recent years. Newer studies have also focused on risk factors for development of major complications in the postoperative period and on objective measurements that may help determine which patients will receive the most benefit from BOAS surgery. In this review, the newest studies focused on updates in anesthetic management, surgical techniques, and postoperative care will be discussed. Additionally, updated information on complication rates and outcomes for dogs undergoing surgical management of BOAS will be included.

Clinical presentation and short-term outcomes of dogs ≥15 kg with extrahepatic portosystemic shunts.

OBJECTIVE: To describe demographics, clinical presentation, shunt anatomy, clinical progression, and complications in large dogs ≥15 kg with single extrahepatic portosystemic shunts (EHPSS) treated with or without surgery. STUDY DESIGN: Multicenter retrospective (10 university hospitals, one private referral institution). ANIMALS: Dogs ≥15 kg (n = 63). METHODS: Medical records of dogs ≥15 kg diagnosed with EHPSS between January 01, 2005 and December 31, 2020 were reviewed. Dogs had a minimum follow-up of 90 days. Signalment, clinical signs, diagnostics, shunt anatomy, treatment interventions, and perioperative complications were assessed. RESULTS: Median age was 21.9 months (IQR: 9-36.8). The breed most represented was the Golden retriever (17/63 dogs). Portocaval (17/63) and splenocaval (15/63) shunt configurations were most common. Portal vein hypoplasia was noted in 18 imaging reports. Of the surgically treated dogs, 14/45 (35.6%) had short-term complications, and 3/45 (6.7%) had shunt-related deaths. Medical management was discontinued in 15/40 and reduced in 9/40 of surviving dogs who had surgical attenuation. All medically managed, nonattenuated dogs (18/18) were maintained on their original shunt-related medication regimens. CONCLUSIONS: Clinical presentation of dogs ≥15 kg with extrahepatic portosystemic shunts was similar to the more commonly reported small breed dogs. Surgical management of single EHPSS in large dogs ≥15 kg had similar clinical short-term outcomes as small breed dogs. CLINICAL SIGNIFICANCE: Clinicians should be aware that large breed dogs with EHPSS share similar characteristics and clinical outcomes to small breed dogs. The significance of the presence of a hypoplastic portal vein warrants further research. Surgical treatment is a viable option for large breed dogs with EHPSS.

Anatomical classification of feline congenital extrahepatic portosystemic shunts based on CT angiography: A SVSTS and VIRIES multi-institutional study in 231 cats.

The prevalence of anatomical-based subtypes of feline congenital extrahepatic portosystemic shunts (EHPSS) has not been completely elucidated. The goal of this study was to use CT angiography to create an anatomical-based nomenclature system for feline congenital EHPSS. Additionally, subjective portal perfusion scores were generated to determine if intrinsic portal vein development was associated with different shunt conformations or patient age at the time of CT. The SVSTS and VIRIES list services were used to recruit cases. Data collected included patient DOB, gender, breed, weight, CT date, and reported diagnosis. Shunts were classified based upon (1) the shunt portal vessel(s) of origin, (2) the shunt systemic vessel(s) of insertion, and (3) any substantial portal vessels contributing to the shunt. Additionally, hepatic portal perfusion was subjectively scored between 1 (poor/none) and 5 (good/normal) based on the caliber of the intrahepatic PVs. A total of 264 CT scans were submitted from 29 institutions. Due to exclusion criteria, 33 (13%) were removed, leaving 231 CT scans to be included. Twenty-five different EHPSS anatomies were identified with five classifications accounting for 78% of all shunts (LGP [53%], LGC-post [11%], LCG [7%], LGC-pre [4%], and PC [4%]). Shunt origin involved the left gastric vein in 75% of the described classifications. Significant differences were identified among the five most common shunt types with respect to age at the time of CT scan (P = .002), breed (P < .001), and subjective portal perfusion score (P < .001). This refined anatomical classification system for feline EHPSS may enable improved understanding, treatment comparisons, and outcome prediction for cats with these anomalies.

Accuracy, precision, and interobserver and intraobserver agreements related to pressure-measurement devices.

OBJECTIVE: To evaluate the accuracy, precision, and observer agreement of three pressure measurement devices. STUDY DESIGN: In vitro model study. SAMPLE POPULATION: Water manometer with built-in gauge (WMg), arterial pressure transducer (APT), and Compass CT (CCT). METHODS: The model was set to five predetermined pressures (4, 8, 13, 17, and 24 cm H2 O) using a water manometer with a ruler (WMr) as the gold standard. Each device was tested at each pressure in a randomized order by three investigators. Bland-Altman plots were used to assess agreement between devices. Intraclass correlation coefficients (ICC) were calculated for interobserver and intraobserver agreements. RESULTS: The mean differences (cm H2 O) ± SEM in comparison with the set pressure were -0.020 ± 0.010 (WMg), -0.390 ± 0.077 (APT), and -1.267 ± 0.213 (CCT). Pressures measured by WMg did not differ from those measured by WMr. Pressures measured by all devices did not differ from each other (p > .062 for all comparisons). Interobserver agreement was excellent (1.000), and intraobserver agreement was excellent (0.985, 0.990, 0.998 for each observer). CONCLUSION: Compared to the WMr, the WMg was the most accurate and precise, followed by the APT; the CCT was the least accurate and precise. Interobserver and intraobserver agreements for all three devices were excellent. CLINICAL SIGNIFICANCE: The largest mean difference of all devices was within 1.3 cm H2 O of the set pressure, indicating possible clinical utility of any of the devices. However, WMr or WMg should be considered first due to their high precision and accuracy.

Complications and outcomes of thoracoscopic-assisted lung lobectomy in dogs.

OBJECTIVE: To describe complications and outcomes of dogs undergoing thoracoscopic-assisted (TA) lung lobectomy. STUDY DESIGN: Multi-institutional, retrospective study. ANIMALS: Client-owned dogs (n = 30). METHODS: Medical records of dogs that underwent TA lung lobectomy were reviewed. Signalment, bodyweight, clinical signs, imaging findings, surgical variables, complications, and short-term/long-term outcome were assessed. Thoracoscopic-assisted lung lobectomy was performed with a mini-thoracotomy. RESULTS: Twelve intraoperative complications were recorded in 11 dogs, 6 requiring conversion to open thoracotomy. Reasons for conversion were reported in 5/6 dogs and included adhesions (2), difficultly manipulating the lesion through the mini-thoracotomy (2), and acute oxygen desaturation (1). One lung ventilation was successful in 4 of the 7 dogs in which this was attempted. A linear stapling device (DST series Medtronic, Minneapolis, Minnesota) was used for lung lobe ligation in 14 dogs. Twenty-three dogs underwent surgery for a neoplastic lesion, with 19 of these being carcinoma. The median lesion size was 4.3 cm (range 1-10 cm); margins were clean, except in 1 dog. Complications were documented in 8 dogs prior to discharge, 5 of these being classified as mild. Twenty-nine dogs were discharged at a median of 47 h postoperatively (range 24-120 h). Death was reported in 9 dogs, with a median survival time of 168 days (range 70-868 days). CONCLUSION: Thoracoscopic-assisted lung lobectomy was achieved with few major complications in the population reported here. Dogs were able to be discharged from hospital quickly, with most surviving beyond the follow-up period. CLINICAL SIGNIFICANCE: Thoracoscopic-assisted lung lobectomy may be considered to facilitate the excision of larger pulmonary lesions or to treat smaller dogs, in which a thoracoscopic excision may be technically more challenging.

Scar revision for incompletely or narrowly excised soft tissue sarcomas in dogs.

Objective: Describe clinical features of dogs undergoing scar revision for incompletely or narrowly excised soft tissue sarcomas (STSs) in the absence of gross disease and to determine local recurrence rates following scar revision. Animals: Thirty-three dogs with 33 scars. Procedures: Medical records were reviewed to collect data on signalment, tumor details, pre-surgical diagnostic tests, surgical and pathologic findings for both the initial and revision surgeries, and clinical outcomes. Descriptive statistics were generated. Results: For the initial excision, cytology was performed before surgery in 45.5% (15/33) of dogs, and information on surgical margins was rarely reported [4.0% (1/25) of circumferential and 12.0% (3/25) of deep margins]. Microscopic evidence of residual STS was identified in 18.2% of scars. Recurrence occurred in 3.0% (1/33) of dogs [median follow-up of 1127 d (1 to 3192 d)]; this dog had had no evidence of residual tumor in the scar revision pathology. Conclusions: Despite the low identification rate of residual tumor, the local tumor recurrence rate was 3.0%, which is lower than what is historically reported for incompletely or narrowly excised STSs. Clinical relevance: Scar revision for incompletely or narrowly excised STSs resulted in durable tumor remission in the dogs of this study. Pre-surgical diagnostic tests were not often performed in this study; these may be considered before the first excision to plan surgical margins for potentially reducing the incidence of incomplete or narrow excision. Surgical reports should include details on circumferential and deep margins to guide pathologic interpretation and future scar revision, if required.

Révision des cicatrice pour les sarcomes des tissus mous incomplètement ou étroitement excisés chez le chien. Objectif: Décrire les caractéristiques cliniques des chiens subissant une révision de cicatrice pour des sarcomes des tissus mous (STSs) incomplètement ou étroitement excisés en l'absence de maladie macroscopique et pour déterminer les taux de récidive locale après la révision de cicatrice. Animaux: Trente-trois chiens avec 33 cicatrices. Procédures: Les dossiers médicaux ont été examinés pour recueillir des données sur le signalement, les détails de la tumeur, les tests de diagnostic pré-chirurgicaux, les résultats chirurgicaux et pathologiques pour les chirurgies initiales et de révision, et les résultats cliniques. Des statistiques descriptives ont été générées. Résultats: Pour l'excision initiale, une cytologie a été réalisée avant la chirurgie chez 45,5 % (15/33) des chiens, et les informations sur les marges chirurgicales ont été rarement rapportées [4,0 % (1/25) des marges circonférentielles et 12,0 % (3/25) des marges profondes]. Des preuves microscopiques de STS résiduel ont été identifiées dans 18,2 % des cicatrices. Une récidive est survenue chez 3,0 % (1/33) des chiens [suivi médian de 1127 jours (1 à 3192 jours)]; ce chien n'avait eu aucun signe de tumeur résiduelle dans la pathologie de révision de la cicatrice. Conclusions: Malgré le faible taux d'identification de tumeur résiduelle, le taux de récidive tumorale locale était de 3,0 %, ce qui est inférieur à ce qui est historiquement rapporté pour les STS incomplètement ou étroitement excisés. Pertinence clinique: La révision des cicatrices pour les STS incomplètement ou étroitement excisés a entraîné une rémission tumorale durable chez les chiens de cette étude. Les tests diagnostiques pré-chirurgicaux n'ont pas souvent été effectués dans cette étude; ceux-ci peuvent être envisagés avant la première excision pour planifier les marges chirurgicales afin de réduire potentiellement l'incidence de l'excision incomplète ou étroite. Les rapports chirurgicaux doivent inclure des détails sur les marges circonférentielles et profondes pour guider l'interprétation pathologique et la révision future de la cicatrice, si nécessaire.(Traduit par Dr Serge Messier).

Scar revision for incompletely or narrowly excised cutaneous mast cell tumors in dogs.

Objective: Describe clinical features and outcomes of dogs undergoing scar revision for incompletely or narrowly excised cutaneous mast cell tumors without gross disease. Animals: 52 dogs undergoing 54 scar revisions. Procedures: Retrospective record review with information collected on signalment, tumor type/location, pre-surgical diagnostics, surgical and pathologic findings for the first excision and scar revision surgeries, and follow-up. Descriptive statistics were generated. Results: Prior to initial excision, cytology was performed on 38.9% (21/54) of tumors and the initial surgery report rarely described surgical resection margins [14.6% (7/48) of surgeries]. Residual tumor was identified pathologically in 29.6% (16/54) of scars. Local recurrence following scar revision occurred in 3.7% (2/54) of all scars [median follow-up 881.5 d (range: 0 to 3317 d)]; both scars had either complete excision of residual mast cell tumor or no evidence of mast cell tumor on scar revision and neither dog received radiation therapy. Conclusions: Identification of residual disease was uncommon, and local recurrence was less common than previously reported for incomplete/narrow mast cell tumor excision. Clinical relevance: Scar revision of unplanned primary excisions appears to yield a high likelihood of durable tumor remission in patients. First opinion practitioners are encouraged to avoid unplanned excisions by informing the surgical plan with cytology of the primary tumor and detailing surgical margin excision which may facilitate revision, if necessary.

Révision des cicatrices pour des mastocytes cutanés incomplètement ou étroitement excisés chez le chien. Objectif: Décrire les caractéristiques cliniques et les résultats des chiens subissant une révision de cicatrice pour des tumeurs mastocytaires incomplètement ou étroitement excisées sans maladie grave. Animaux: Cinquante-deux chiens soumis à 54 révisions de cicatrice. Procédures: Examen rétrospectif des dossiers avec des informations recueillies sur le signalement, le type/l'emplacement de la tumeur, les diagnostics pré-chirurgicaux, les résultats chirurgicaux et pathologiques pour les premières chirurgies d'excision et de révision de cicatrice, et le suivi. Des statistiques descriptives ont été générées. Résultats: Avant l'excision initiale, une cytologie a été réalisée sur 38,9 % (21/54) des tumeurs et le rapport chirurgical initial décrivait rarement les marges de résection chirurgicale [14,6 % (7/48) des chirurgies]. Une tumeur résiduelle a été identifiée pathologiquement dans 29,6 % (16/54) des cicatrices. Une récidive locale après révision des cicatrices s'est produite dans 3,7 % (2/54) de toutes les cicatrices [suivi médian de 881,5 jours (intervalle : 0 à 3317 jours)] les deux cicatrices présentaient soit une excision complète du tumeur mastocytaire résiduel, soit aucun signe de tumeur mastocytaire lors de la révision de la cicatrice et aucun chien n'a reçu de radiothérapie. Conclusions: L'identification de la maladie résiduelle était rare et la récidive locale était moins fréquente que précédemment rapportée pour l'excision incomplète/étroite du tumeur mastocytaire. Pertinence clinique: La révision de la cicatrice des excisions primaires non planifiées semble donner une forte probabilité de rémission tumorale durable chez les patients. Les praticiens de première opinion sont encouragés à éviter les excisions non planifiées en informant le plan chirurgical avec la cytologie de la tumeur primaire et en détaillant les marges de l'excision chirurgicale ce qui peut faciliter la révision, si nécessaire.(Traduit par Dr Serge Messier).

Perioperative characteristics, histologic diagnosis, complications, and outcomes of dogs undergoing percutaneous drainage, sclerotherapy or surgical management of intrarenal cystic lesions: 18 dogs (2004-2021).

BACKGROUND: Canine intrarenal cystic lesions (ICLs) are infrequently reported in the veterinary literature. Several treatment options have been described including cyst fenestration (partial nephrectomy/deroofing) +/- omentalization, sclerotherapy using alcohol as a sclerosing agent, percutaneous cyst drainage (PCD), and ureteronephrectomy. Information regarding presenting clinical signs, physical examination findings, histologic diagnosis and outcomes of dogs with ICLs treated by different methods is limited. Medical records of 11 institutions were retrospectively reviewed to identify dogs that underwent PCD, sclerotherapy, surgical deroofing +/- omentalization, or ureteronephrectomy for management of ICLs from 2004 to 2021. Six weeks postoperative/post-procedural follow-up was required. Cases suspected to represent malignancy on preoperative imaging were excluded. The study objective was to provide information regarding perioperative characteristics, complications, and outcomes of dogs undergoing treatment of ICLs. RESULTS: Eighteen dogs were included, with 24 ICLs treated. Ten had bilateral. There were 15 males and 3 females, with crossbreeds predominating. PCD, sclerotherapy, deroofing and ureteronephrectomy were performed in 5 (5 ICLs treated), 7 (11 ICLs), 6 (6), and 7 (7) dogs, respectively, with 5 dogs undergoing > 1 treatment. Seven dogs experienced 8 complications, with requirement for additional intervention commonest. PCD, sclerotherapy and deroofing resulted in ICL resolution in 0/5, 3/11 and 3/6 treated ICLs, respectively. Histopathology identified renal cysts (RCs) in 7/13 dogs with histopathology available and neoplasia in 6/13 (4 malignant, 2 benign). Of 5 dogs diagnosed histopathologically with neoplasia, cytology of cystic fluid failed to identify neoplastic cells. Among 7 dogs with histologically confirmed RCs, 4 had concurrent ICLs in ipsilateral/contralateral kidney, compared with 2/6 dogs with histologically confirmed neoplasia. CONCLUSIONS: Benign and neoplastic ICLs were approximately equally common and cystic fluid cytology failed to differentiate the 2. Among renal-sparing treatments, deroofing most commonly resulted in ICL resolution. Presence of concurrent ICLs in ipsilateral/contralateral kidney does not appear reliable in differentiating benign from malignant ICLs.

Incidence of and risk factors for surgical site infection following canine limb amputation.

OBJECTIVE: To determine the incidence of and risk factors for surgical site infection (SSI) following canine thoracic and pelvic limb amputations. STUDY DESIGN: Retrospective, multicenter study. ANIMALS: Dogs (n = 248). METHODS: Medical records were reviewed for preoperative, intraoperative, and postoperative variables including indication for amputation, amputation type, method of muscle transection, duration of surgery and anesthesia, and wound classification. Follow up was ≥30 days or until SSI development. Logistic regression and Fisher's exact tests were used to compare SSI incidence to variables of interest. RESULTS: The incidence of SSI was 12.5% for all procedures and 10.9% for clean procedures. Factors increasing odds of SSI were muscle transection with a bipolar vessel sealing device (P = .023 for all procedures, P = .025 for clean procedures), procedure classified as other than clean (P = .003), and indication for amputation of bacterial infection (P = .041) or traumatic injury (P = .003) compared to neoplasia. CONCLUSION: Use of bipolar vessel sealing devices for muscle transection increased the odds of developing an SSI whereas use of electrosurgery and/or sharp transection did not. Dogs with surgical sites that were other than clean, or with bacterial infection and/or traumatic injury were also at increased odds of SSI. CLINICAL SIGNIFICANCE: Use of electrosurgery or sharp transection for muscle transection should be considered rather than use of bipolar vessel sealing devices to decrease odds of SSI in dogs undergoing limb amputation. Further studies across a variety of procedures are needed to validate these findings given the increasing popularity of these devices in veterinary medicine.

Risk factors for neonatal mortality prior to hospital discharge in brachycephalic and nonbrachycephalic dogs undergoing cesarean section.

OBJECTIVES: To compare neonatal survival to discharge rates between brachycephalic and nonbrachycephalic dogs undergoing cesarean section (c-section) and identify risk factors for neonatal mortality. STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: A total of 480 puppies from 90 bitches undergoing 106 c-sections. METHODS: Medical records of c-sections performed between January 2012 and September 2021 were reviewed. Data collected included brachycephalic versus nonbrachycephalic breed, elective versus emergency c-section, litter size (c-section and total [including those born prior to and via c-section]), and neonatal survival to discharge. A generalized linear mixed model (univariable and multivariable) was performed to evaluate variables versus neonatal survival. RESULTS: Overall neonatal survival to discharge was 93.1% (447/480); survival was similar between brachycephalic and nonbrachycephalic breeds (p = .221, 202/213 [94.8%] brachycephalic survival, 245/267 [91.8%] nonbrachycephalic survival). Puppies delivered via elective c-section were more likely to survive compared to emergency c-section (p < .001, 238/240 [99.2%] elective survival, 209/240 [87.1%] emergency survival). Puppies delivered in larger c-section litters were more likely to survive (p < .004) compared to smaller litters. Total litter size had no effect on survival. CONCLUSION: Brachycephalism had no effect on neonatal survival. Puppies delivered via elective c-section were more likely to survive compared to puppies delivered via emergency c-section. CLINICAL SIGNIFICANCE: Outcomes following c-section are similar between brachycephalic and nonbrachycephalic breeds. While it is preferable to encourage selective breeding for bitches that are able to whelp naturally, elective c-section should be considered in bitches at high risk for dystocia to maximize neonatal survival.

Comparison of Veterinary Student Understanding of Extrahepatic Portosystemic Shunts when Given a Pre-Lecture Activity of a Text-Only Narrative versus an Interactive Electronic Book.

Complex vascular anomalies are often difficult concepts for veterinary medical students to comprehend, as knowledge of normal anatomy, visualization of the abnormal anatomy, and understanding of the physiologic implications of that abnormality are all required to appreciate the clinical impacts of the anomaly. Access to interactive three-dimensional models of both the normal and abnormal vasculatures may improve student comprehension. In this study, third-year veterinary medical students in a core small animal digestive diseases course completed a pre-lecture assignment consisting of a text-only narrative (n = 100) or an interactive electronic book (e-book; n = 102) focused on extrahepatic portosystemic shunts, followed by two generative learning activities in which they described portal anatomy and extrahepatic portosystemic shunts. An optional, anonymous post-lecture learning assessment was given to both groups. Although no difference in post-lecture assessment scores was identified between the groups, students using the interactive e-book spent significantly longer on the pre-lecture assignment and activities than students in the text-only narrative group. Students in the text-only narrative group were more likely to use spatial visualization strategies during the generative learning activities than students in the e-book group. There was no correlation between time spent on the pre-lecture tasks and learning assessment score. Interactive e-books and generative learning activities may be useful adjunct pre-lecture learning tools for teaching of complex vascular anomalies to veterinary medical students.

Influence of doxapram and intermittent 10% carbon dioxide inspiration on cardiovascular and laryngeal functions in anesthetized dogs.

OBJECTIVE: To compare the effects of two doses of doxapram intravenous injection and carbon dioxide inhalation on the cardiovascular and laryngeal functions of anesthetized hounds. STUDY DESIGN: Experimental study. ANIMALS: Six healthy adult dogs. METHODS: In a Latin-square design, the mean arterial blood pressure (MABP) and heart rate (HR) were recorded continuously. The inspiratory normalized glottic gap areas (iNGGA) were measured before and after each stimulation with 0.55 mg/kg of doxapram (L-DOX), 2.2 mg/kg of doxapram (H-DOX), or 90 s of inhalation of 10% carbon dioxide in oxygen (I-CO2 ). The stimulations were tested in duplicate or triplicate. Video clips of the laryngeal movement were scored by board-certified surgeons masked to the treatment. RESULTS: The MABP increased with L-DOX and H-DOX up to 81% (both p < .001 compared to I-CO2 ), and persisted during the other stimulations (both p < .001). An intermittent tachycardic effect of up to 79% increase in HR was observed with doxapram. The HR following H-DOX was higher than L-DOX and I-CO2 (both p < .016). Neither hypertension nor tachycardia was observed with I-CO2 . The iNGGA increased with all treatments (p < .001). The iNGGA was greater with H-DOX than L-DOX and I-CO2 (both p < .007). All treatments received higher scores (all p < .001) with acceptable inter- and intra-observers Krippendorff's alphas. CONCLUSION: All treatments were effective respiratory stimulants in anesthetized dogs; however, doxapram caused hypertension and tachycardia. CLINICAL SIGNIFICANCE: Carbon dioxide inhalation might improve arytenoid motion without cardiovascular effects in dogs during clinical airway examinations.

Evaluation of concurrent perineal hernia in adult male dogs presenting with nontraumatic, acquired inguinal hernias.

A possible association between the development of nontraumatic, acquired inguinal hernias (NAIH) and perineal hernias (PH) has been postulated in adult dogs. The objective of this study was to evaluate the frequency of concurrent diagnosis of PH in dogs presented with NAIH and determine potential risk factors for concurrent PH and NAIH. Medical records of adult male dogs presented for NAIH to 4 hospitals between 2007 and 2017 were retrospectively reviewed. Twenty-one dogs with NAIH were included, 8 of which had concurrent PH. There were no significant differences between dogs with and without PH; however, among dogs with both conditions, intact dogs (8.1 ± 1.4 years) were younger than neutered dogs (11.7 ± 1.0 years; P = 0.007). Thirty-eight percent of male dogs presenting for NAIH had concurrent PH, indicating that these conditions commonly occur together. Dogs presenting for NAIH should be carefully evaluated for concurrent PH before surgical intervention.

Évaluation d'hernie périnéale concomitante chez des chiens mâles adultes présentant des hernies inguinales acquises non traumatiques. Une association possible entre le développement d'hernies inguinales acquises non traumatiques (NAIH) et les hernies périnéales (PH) a été postulée chez les chiens adultes. L'objectif de cette étude était d'évaluer la fréquence des diagnostics simultanés d'HP chez les chiens présentés avec NAIH et de déterminer les facteurs de risque potentiels de PH et NAIH concomitantes. Les dossiers médicaux de chiens mâles adultes présentés pour NAIH à quatre hôpitaux entre 2007 et 2017 ont été revus rétrospectivement. Vingt et un chiens atteints de NAIH ont été inclus, dont huit avaient une PH concomitante. Il n'y avait aucune différence significative entre les chiens avec et sans PH; cependant, parmi les chiens atteints des deux conditions, les chiens intacts (8,1 ± 1,4 ans) étaient plus jeunes que les chiens castrés (11,7 ± 1,0 ans; P = 0,007). Trente-huit pour cent des chiens mâles se présentant pour NAIH avaient une PH concomitante, ce qui indique que ces conditions se produisent généralement ensemble. Les chiens présentant un NAIH doivent être soigneusement évalués pour une PH concomitante avant une intervention chirurgicale.(Traduit par Dr Serge Messier).

Thin film occlusion of an intra-abdominal vein in cats.

OBJECTIVE: To evaluate the occlusion of an intra-abdominal vessel as a model of an extrahepatic portosystemic shunt by thin film banding in a controlled setting and to document histologically the perivascular region's response to thin film banding after 8 weeks. STUDY DESIGN: Experimental study. ANIMALS: Six purpose-bred healthy domestic short hair cats. METHODS: Thin film bands were placed around the external iliac vein, with a sham procedure on the contralateral vessel. Closure rates were monitored via computed tomographic angiography (CTA) every 2 weeks for a total of 8 weeks. After 8 weeks, the vessels were resected, if possible, and submitted for histopathologic evaluation. RESULTS: All cats tolerated the procedure without surgical complications. Eight weeks after surgery, closure was evaluated as complete in one cat, marked in two cats, moderate in one cat, and mild in two cats according to CTA. Histological examination (in three cats) was consistent with chronic, multifocal, granulomatous inflammation with moderate fibrosis and collagen degeneration. CONCLUSION: Venous occlusion was inconsistent and often incomplete 8 weeks after thin film banding of the external iliac vein despite the presence of moderate to abundant perivascular fibrous tissue. CLINICAL SIGNIFICANCE: Vascular occlusion by thin film banding in cats is mainly incomplete after 2 months. This study supports the theory that high level of residual shunting may be expected in some cats after thin film banding.

Dorsal offset rhinoplasty for treatment of stenotic nares in 34 brachycephalic dogs.

OBJECTIVE: To describe the technique, outcome, and owner satisfaction associated with dorsal offset rhinoplasty (DOR) to treat stenotic nares in brachycephalic dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Thirty-four client-owned dogs. METHODS: Medical records of dogs treated with DOR at a veterinary teaching hospital over a 6-year period were identified. Dorsal offset rhinoplasty was defined as removal of a dorsal wedge of nasal planum from each naris with apposition of the rostral abaxial tissue to the caudal axial tissue, resulting in translocation of the alar cartilage in both median and dorsal planes. Immediate and postoperative complications were recorded. Owners were asked to report any complications with healing of the nares and to score their satisfaction with the appearance of the nares. RESULTS: Thirty-four dogs met the inclusion criteria. Twenty-nine (85%) dogs were examined a median of 402.5 days (range, 23-2042) postoperatively, with no major complications related to the rhinoplasty recorded. Eighteen owners responded a median of 701 days (range, 37-1622) postoperatively. One owner reported that self-trauma led to collapse of one naris. One owner reported collapse of both nares within 4 years; timing and cause were unknown. Sixteen of 17 responding owners reported that they were very satisfied with the outcome of the rhinoplasty. The owner of the dog with the collapsed naris was very unsatisfied. One owner did not provide a satisfaction score. CONCLUSION: Owners were generally highly satisfied with DOR, and complications were uncommon. CLINICAL SIGNIFICANCE: This report describes an alternate technique to treat stenotic nares.

Expanding Hydrophobically Modified Chitosan Foam for Internal Surgical Hemostasis: Safety Evaluation in a Murine Model.

BACKGROUND: A novel injectable expanding foam based on hydrophobically modified chitosan (HM-CS) was developed to improve hemostasis during surgeries. HM-CS is an amphiphilic derivative of the natural biopolymer chitosan (CS); HM-CS has been shown to improve the natural hemostatic characteristics of CS, but its internal safety has not been systematically evaluated. The goal of this study was to compare the long-term in vivo safety of HM-CS relative to a commonly used fibrin sealant (FS), TISSEEL (Baxter). METHODS: Sixty-four Sprague-Dawley rats (275-325 g obtained from Charles River Laboratories) were randomly assigned to control (n = 16) or experimental (n = 48) groups. Samples of the test materials (HM-CS [n = 16], CS [n = 16], and FS [n = 16]) applied to a nonlethal liver excision (0.4 ± 0.3 g of the medial lobe) in rats were left inside the abdomen to degrade. Animals were observed daily for signs of morbidity and mortality. Surviving animals were sacrificed at 1 and 6 wk; the explanted injury sites were microscopically assessed. RESULTS: All animals (64/64) survived both the 1- and 6-wk time points without signs of morbidity. Histological examination showed a comparable pattern of degradation for the various test materials. FS remnants and significant adhesions to neighboring tissues were observed at 6 wk. Residual CS and HM-CS were observed at the 6 wk with fatty deposits at the site of injury. Minimal adhesions were observed for CS and HM-CS. CONCLUSIONS: The internal safety observed in the HM-CS test group after abdominal implantation indicates that injectable HM-CS expanding foam may be an appropriate internal use hemostatic candidate.

Evaluation of surgical models for training veterinary students to perform enterotomies.

OBJECTIVE: To compare surgical models for teaching enterotomies to students. STUDY DESIGN: Prospective, randomized study. SAMPLE POPULATION: Second-year veterinary students (n = 59) and faculty surgeons/surgery residents (n = 19). METHODS: Participants performed an enterotomy on each of 3 models (equine cadaver intestine, SurgiReal small intestine simulator, and SynDaver canine bowel) and completed a survey comparing them to either an enterotomy on an anesthetized pig (students) or intestinal surgery experience (faculty/residents). Surveys results were compiled and analyzed. RESULTS: Both student and faculty/resident groups rated cadaver intestine as more similar to live intestine compared with the synthetic models for incision, tissue handling, mucosal eversion, needle passage, knot tying, and best preparing for live intestine. Students rated SynDaver as more similar to live intestine than SurgiReal for incision and ranked SurgiReal as more similar to live intestine than SynDaver for mucosal eversion. There was no difference between the ranks assigned to SurgiReal and SynDaver for faculty/residents. Faculty/residents responded most often that cadaver intestine would be the model they recommend for training students. CONCLUSION: Cadaver intestine was the model most similar to live intestine for all variables tested. SurgiReal and SynDaver models were comparable to each other but did not simulate live intestine as well as cadaver intestine. CLINICAL SIGNIFICANCE: Cadaver intestine more closely approximated live intestine compared with either synthetic model. SurgiReal and SynDaver may be adequate alternatives if cadaver intestine is unavailable.

Risk factors for gastrointestinal upset and evaluation of outcome following surgical resection of canine pancreatic ß-cell tumors.

The objective of this study was to determine risk factors for vomiting and inappetence and evaluate long-term outcome after surgical treatment of pancreatic ß-cell tumors in dogs. Records of 33 dogs that underwent surgery for such tumors were retrospectively evaluated. Inappetence and vomiting occurred in 27.3% and 24.2% of dogs, respectively. Risk factors for postoperative vomiting were longer duration of clinical signs before surgery, higher preoperative total protein concentration, and lack of liver metastasis. No significant risk factors for inappetence or survival were identified. Median survival time was 723 days. Dogs with a longer duration of clinical signs before surgery may have had greater pancreatic involvement or more pronounced systemic perturbations. Higher preoperative total protein concentration may reflect preoperative dehydration or inflammation. Significance of lack of liver metastasis is unknown. The long survival time indicates a good overall prognosis with surgical treatment, justifying surgical intervention in patients with advanced disease.

Facteurs de risque pour les dérangements gastro-intestinaux et évaluation des résultats à la suite de la résection chirurgicale de tumeurs des cellules ß pancréatiques canines. L'objectif de la présente étude était de déterminer les facteurs de risque pour les vomissements et l'inappétence, et d'évaluer les résultats à long terme à la suite du traitement chirurgical de tumeurs des cellules ß pancréatiques chez des chiens. Les dossiers de 33 chiens qui subirent une chirurgie pour de telles tumeurs furent évalués rétrospectivement. L'inappétence et des vomissements se produisirent chez 27,3 % et 24,2 % des chiens, respectivement. Les facteurs de risque pour des vomissements post-opératoires étaient une durée plus longue des signes cliniques avant la chirurgie, une concentration pré-opératoire des protéines totales plus élevée, et l'absence de métastase hépatique. Aucun facteur de risque significatif pour l'inappétence ou la survie ne fut identifié. La médiane du temps de survie était de 723 jours. Les chiens avec une durée plus longue de signes cliniques avant la chirurgie pourraient avoir eu une plus grande atteinte pancréatique ou des perturbations systémiques plus prononcées. Des concentrations pré-opératoires de protéines totales plus élevées pourraient refléter une déshydratation pré-opératoire ou de l'inflammation. La signification de l'absence de métastase hépatique est inconnue. Le temps de survie prolongé indique un bon pronostic général avec le traitement chirurgical, justifiant ainsi l'intervention chirurgicale chez des patients dont la maladie est à un stade avancé.(Traduit par Dr Serge Messier).

Gradual attenuation of a congenital extrahepatic portosystemic shunt with a self-retaining polyacrylic acid-silicone device in 6 dogs.

OBJECTIVE: To determine the ability of a polyacrylic acid-silicone radiolucent self-retaining gradual occlusion device (PAS-OD) to attenuate congenital extrahepatic portosystemic shunts (EHPSS) in dogs. STUDY DESIGN: Prospective clinical trial. ANIMALS: Six client-owned dogs with single, congenital EHPSS. METHODS: Serum bile acids (SBA), abdominal ultrasonography, and computed tomographic angiography (CTA) were performed preoperatively and at 4 and 8 weeks postoperatively. Each dog was treated for EHPSS by placement of a PAS-OD. RESULTS: PAS-OD were placed without complication an average of 4.3 seconds (range, 3-7) after isolation of the shunt. Median surgical time was 38.5 minutes (range, 28-84) including concurrent procedures. All dogs recovered from surgery without complications. SBA were normal in 5 of 6 dogs at 4 and 8 weeks after surgery. The shunt was completely attenuated in 2 of 6 dogs at 4 weeks and in 4 of 6 dogs at 8 weeks, without evidence of acquired shunt formation in any dog. The size and velocity of the portal vasculature were improved in 5 of 6 dogs according to 8-week postoperative CTA and ultrasonography results, respectively. The remaining dog had a persistently decreased portal vasculature size but a normal velocity according to 8-week postoperative CTA and ultrasound results, respectively. CONCLUSION: The PAS-OD led to complete attenuation in 4 of 6 dogs and partial attenuation with mild residual flow of 2 EHPSS over an 8-week period in dogs. CLINICAL SIGNIFICANCE: The PAS-OD is a new option for gradual occlusion of congenital EHPSS over 8 weeks.

Lung lobe torsion in dogs: 52 cases (2005-2017).

OBJECTIVE: To report outcomes and risk factors for mortality in dogs that underwent surgical management of lung lobe torsion. STUDY DESIGN: Retrospective case series from 5 veterinary teaching hospitals (2005-2017). ANIMALS: Fifty dogs with 52 instances of lung lobe torsion. METHODS: Data collected from medical records included signalment, clinical findings, results of clinicopathologic testing and diagnostic imaging, surgical treatment, lung lobe affected, intraoperative and postoperative complications, histopathologic and microbiologic findings, and outcome. Follow-up was obtained from medical records and telephone contact with primary care veterinarians. RESULTS: Fifty-two instances of lung lobe torsion were identified in 50 dogs, with a median follow-up of 453 days (range, 0-3075). Forty-six (92%) dogs survived to discharge. Dogs with concurrent torsion of the right cranial and middle lung lobes were less likely to survive (2/4) than those with torsion of the left cranial lung lobe (22/22). No other risk factors for mortality prior to hospital discharge were identified. Overall median survival time after hospital discharge was 1369 days. Four dogs had >1 episode of lung lobe torsion. CONCLUSION: The percentage of dogs surviving to discharge after surgical treatment of lung lobe torsion was higher than previously reported. The short- and long-term prognosis was excellent with surgical treatment of lung lobe torsion. CLINICAL SIGNIFICANCE: Surgery should be recommended when lung lobe torsion is suspected because of the high survival to discharge rate and excellent long-term prognosis.