Journal of Small Animal Practice最新文献

Objectives: To determine the difference in complication rate, gastrointestinal grade and requirement for ongoing medical and/or surgical management following hiatal hernia repair in dogs with and without gastropexy.

Materials and methods: Clinical records were reviewed retrospectively for dogs that had undergone surgical hiatal hernia repair at two veterinary referral centres between April 2012 and March 2022. Pre-operative grading of gastrointestinal signs and brachycephalic obstructive airway syndrome was performed. All dogs had an oesophagopexy and phrenoplasty. Referring primary veterinary practices and clients were contacted to obtain follow-up information. Fisher's exact tests and Mann Whitney tests were used to assess pre- and intra-operative similarities between groups. Wilcoxon signed rank tests were used to determine the changes in gastrointestinal grade at short- (<6 months) and long-term (>6 months) follow-up.

Results: Forty-one dogs which underwent oesophagopexy and phrenoplasty were included. Fifteen dogs had no gastropexy performed and 26 dogs had left-sided gastropexy performed. Dogs that underwent gastropexy (n=8, 29%, 95% CI: 13 to 51%) were significantly more likely to require further surgery related to the initial surgery or persistence of gastrointestinal signs compared to dogs that had no gastropexy (n=0, 0%, 95% CI: 0 to 18%) . This difference was not significant when dogs which had further surgery to address brachycephalic obstructive airway syndrome were excluded. Gastrointestinal grade significantly improved for both groups at both short- and long-term follow-up. There was no significant difference in overall complication rate, gastrointestinal grade or requirement for further medical treatment between groups.

Clinical significance: A left-sided gastropexy is not required for successful surgical repair of hiatal hernia in dogs provided oesophagopexy and phrenoplasty are performed.

Objectives: Recently, tissue motion annular displacement by speckle tracking has been shown to be a reliable method for evaluating deformation of the left atrium in healthy dogs. The aim of this study was to investigate whether tissue motion annular displacement is a feasible alternative method for studying left atrial function.

Materials and methods: One hundred healthy dogs were included. Left atrial function was assessed by tissue motion annular displacement, which was correlated to the left atrial strain and biplane area-length method-derived volumes. Left atrial reservoir function was evaluated by left atrial global tissue motion annular displacement, global left atrial strain and left atrial emptying fraction, while left atrial systolic tissue motion annular displacement and left atrial ejection fraction were used to assess left atrial systolic function.

Results: A statistically significant association between body weight and the dependent variables others than age was found. Indexed global and systolic tissue motion annular displacement decreased as body weight increased. Global iTMAD_AIIometric (mm/∛kg) showed a moderate, positive correlation with left atrial emptying fraction and with global left atrial strain. Systolic iTMAD_AIIometric (mm/∛kg) showed a moderate correlation with left atrial ejection fraction. Coefficients of variation for the intraobserver and interobserver analyses were 8.3% and 20.3% for global and 10.5% and 18.9% for systolic tissue motion annular displacement, respectively.

Clinical significance: Tissue motion annular displacement is a feasible and simple method for the evaluation of left atrial function. Our study documented the effects of body weight on left atrial tissue motion annular displacement, indicating that tissue motion annular displacement must be indexed to body weight. No influence of age or heart rate was observed on tissue motion annular displacement.

Type III von Willebrand disease is a rare coagulopathy, with published reports only existing for four canine breeds - Dutch Kooiker Hounds, Shetland Sheepdogs, Chesapeake Bay Retrievers and Scottish Terriers. A 2-year and 9-month-old male neutered standard dachshund was presented for hypovolaemic shock and a ventral neck mass. One previous bleeding episode following routine castration was reported. The patient's packed cell volume fell from 27% to 15% during hospitalisation, and computed tomography identified changes to the ventral neck consistent with fluid accumulation, assumed to represent haemorrhage. A further, similar lesion was identified within the cranial mediastinum. The patient was managed with a combination of isotonic crystalloids (Hartmann's solution), synthetic colloid (Geloplasma), alongside administration of blood products (packed red blood cells and fresh frozen plasma). A Von Willebrand factor antigen assay confirmed Type III von Willebrand disease. The patient made a full recovery. This report is the first to describe Type III von Willebrand disease in a standard dachshund.

Patient 1 was seen for severe pelvic limb lameness and evaluated radiographically and via computed tomography. A diagnosis of femoral head osteochondritis dissecans was obtained. The diagnosis was confirmed arthroscopically and treated with flap removal and abrasion arthroplasty. A micro-total hip arthroplasty was performed 4 weeks later. Patient 2 was also seen for severe pelvic limb lameness and evaluated radiographically. A suspected large osteochondritis dissecans lesion was present. This was confirmed grossly during a total hip arthroplasty procedure and the femoral head submitted for histopathology. In patient 1, the lameness improved from non-weight-bearing to mild lameness at re-evaluation 4 weeks post-operatively. Due to the extent of the lesion, which was confirmed as osteochondritis dissecans by a team of pathologists, revision to micro-total hip arthroplasty was performed. Surgery was uneventful and at 12 weeks post-operatively the patient was fully weight-bearing with no lameness and normal limb function. In patient 2, the lameness immediately resolved after successful management via uncomplicated total hip arthroplasty. Follow-up for both patients at the time of publication exceeds 3 years.

Objectives: Description of clinical presentation and diagnostic findings in dogs and cats with confirmed nasal foreign bodies.

Materials and methods: This was a retrospective descriptive study. Clinical presentation, imaging and rhinoscopy findings of dogs and cats, between January 2010 and December 2022, were reviewed.

Results: A total of 63 dogs and eight cats met the criteria. Median length of clinical signs was 7 and 45 days in dogs and cats, respectively. Most common clinical signs in both groups were sneezing (46/71, 64.8%) and nasal discharge (44/71, 62%). The discharge was unilateral in the majority of cases (38/44, 86.4%). Computed tomography was the predominant form of imaging modality used in 40 cases (40/71, 56.3%). Visualisation of a foreign body using computed tomography was possible in only 14 cases (14/40, 35%). The vast majority of cases had unilateral changes (33/40, 82.5%), including fluid accumulation (33/40, 82.5%) and mucosal thickening (29/40, 72.5%). More severe changes such as turbinate destruction were evident in 26 cases (26/40, 65%). Foreign body removal was achieved through rhinoscopy or nasal flushing in 66 and four cases, respectively.

Clinical significance: Based on the findings of this study, although unilateral discharge was more common, nasal foreign bodies should remain a differential diagnosis in bilateral cases. In comparison to dogs, cats had a more chronic presentation. Computed tomography was the most common imaging modality, but visualisation of a foreign body remains difficult and was not improved with contrast study; inability to identify a foreign body does not exclude it.

Objectives: To report clinical findings, management strategies and outcomes in pet rabbits with maxillofacial fractures.

Materials and methods: Medical records of pet rabbits with confirmed maxillofacial fractures from three exotic animal veterinary services between 2008 and 2022 were reviewed.

Results: Forty-five fractured maxillofacial bones were reported in 27 rabbits, including mandibular symphyseal separation in 13 rabbits. Median age was 18 months (interquartile range, 7 to 38 months), and median bodyweight was 1.70 kg (interquartile range, 1.36 to 2.33 kg). The most common aetiology was anthropogenic accidents (16/27). Hyporexia/anorexia was the most frequent presenting complaint (17/27). Common clinical findings included dental malocclusion (12/27), craniofacial pain (9/27), crepitus (9/27) and swelling (7/27). Three (3/27) rabbits were euthanised after diagnosis. Mandibular symphyseal separation in 11 of 12 treated rabbits were addressed using circummandibular cerclage wiring. All remaining fractures were conservatively managed. Twenty-three of 27 rabbits survived to hospital discharge. Median time of return to normal or near-normal eating was 1 day (interquartile range, <1 to 3 days). Median survival time was 859 days (interquartile range, 567 to 1092 days). Dental malocclusion was a reported complication in 12 of 16 rabbits with follow-up data. However, only five of 12 rabbits developed associated clinical signs requiring corrective dentistry.

Clinical significance: Maxillofacial fracture in rabbits may present with similar clinical signs and findings to other conditions such as odontogenic disease. Successful outcomes with infrequent long-term clinical complications are associated with management strategies that emphasise early functional recovery.

Objectives: To describe the use of a three-dimensional-printed patient-specific guide system for the treatment of distal tibial varus deformity in Dachshunds and retrospectively report the clinical and radiographic outcome.

Materials and methods: Pes varus deformity in nine limbs of seven dachshunds was treated with corrective osteotomy using a three-dimensional-printed patient-specific guide system. Data from computed tomography were processed to obtain virtual 3D-models of the tibias, which were used for computer-aided design-based surgical planning, three-dimensional-printed patient-specific guide system design and evaluation of planned versus achieved tibial correction. Clinical outcomes were evaluated by lameness score and post-operative owner-reported questionnaire at a minimum of 15 months.

Results: The gait abnormality resolved in all limbs. The osteotomy healed uneventfully in eight tibiae. Implant failure occurred in one tibia but was successfully revised. There was good correlation between planned and achieved deformity correction, with mean translational error <1 mm in all planes, and mean angulation correction error <2° in all planes.

Clinical significance: A 3D-printed patient-specific osteotomy and reduction guide system facilitates the accurate correction of tibial pes varus deformity with very good clinical outcomes. Opening osteotomy, stabilised with orthogonal locking plates and without the application of bone graft led to satisfactory bone healing in all cases.

A 3-year-old male neutered Golden Retriever with nasal swelling and lymphadenopathy was diagnosed with diffuse Mycobacterium avium infection. Treatment with 9 months of enrofloxacin, clarithromycin and rifampicin was successful, but relapsed 10 months later with lymphadenopathy, skin plaques and testicular involvement. Repeat treatment for 12 months was effective but 15 months later a second relapse responded to the same therapy which is ongoing with survival from diagnosis of 82 months. A 1-year-old male neutered Portuguese Podengo was diagnosed with polyarthritis and M. avium infection and treated with enrofloxacin, clarithromycin and rifampicin for 4 months but relapsed, subsequently responding to combined pradofloxacin, rifampicin, doxycycline and ethambutol. After 12 months of treatment, M. avium was detected and treatment extended to 17 months before stopping when no organism was detected. Relapse occurred after 6 weeks, responding to retreatment but relapsing (polyarthropathy, lymphadenomegaly) after 15 months, with euthanasia 38 months after diagnosis. Dogs with M. avium are challenging to treat with frequent relapse; however, long-term survival is possible.

Objective: The purposes of this study were to assess the frequency of detection of clinically relevant findings by abdominal radiographs and abdominal ultrasound during restaging of solid, soft tissue tumours in dogs and to determine the cost per clinically relevant finding for both modalities.

Materials and methods: The medical records of 159 dogs which underwent a total of 223 restaging episodes following a diagnosis of a solid, soft tissue tumour within, or with potential for metastasis to, the abdomen were reviewed. Data collected from the sample dogs were reviewed for clinically relevant findings, including local recurrence, lymph node or intra-abdominal metastasis, and other changes that would influence prognosis or management. The clinically relevant findings were compared between abdominal radiographs and abdominal ultrasound. The cost per clinically relevant finding was calculated per modality based on current hospital costs.

Results: Clinically relevant findings were observed in 158 restaging episodes. Ninety-two clinically relevant findings were detected with ultrasound alone, and 65 clinically relevant findings were detected with a combination of both modalities. Only one dog had a clinically relevant finding detected with radiographs alone. Findings were identified significantly more frequently with ultrasound than radiographs. Cost per clinically relevant finding was 495 USD (approx. 373 GBP/448 EUR) for abdominal radiographs and 323 USD (approx. 242 GBP/292 EUR) for abdominal ultrasound.

Clinical significance: Abdominal radiographs were of minimal use beyond abdominal ultrasound for restaging in this study, despite a higher cost per clinically relevant finding than abdominal ultrasound. This study does not support routine use of abdominal radiographs during routine restaging of solid, soft tissue tumours.

An 8-year-old male cross-Labrador retriever was presented for a progressive appearance of folds all over the body of the dog. Scleromyxoedema was diagnosed based on clinical signs and histopathological features. Clinical signs were characterised by a papular and vesicular eruption and severe skin thickening causing exuberant folds along with concurrent severe osteoarthritis of the coxofemoral joints. Thyroid disorders were excluded and the condition was not associated with monoclonal gammopathy. Histopathological features consisted of mucin deposition, fibroblast proliferation and fibrosis. Prednisolone was prescribed to decrease mucin synthesis which allowed a marked clinical improvement. Due to the progressive inability to walk, the dog was euthanased 6 months after the first consultation.