Journal of Small Animal Practice最新文献

Objectives: To develop a palatine approach to the canine maxillary nerve and compare its feasibility and the spread of dye and contrast medium with that of the infraorbital technique.

Materials and methods: Ten canine cadaveric heads were used in this study. The maxillary nerve was approached bilaterally by inserting hypodermic needles into either the infraorbital or the palatine foramen on each side. Dye/contrast injections (1:1 solution) were followed by CT and anatomical dissections, performed to isolate the maxillary nerves and measure their stained portions. Procedural failure was defined as a nerve stain <6 mm in length. Descriptive statistics, analysis of proportions and comparison of either means or medians were used for data analysis.

Results: The stained portion of the maxillary nerve was shorter for the palatine technique (0 (0 to 10) mm) than the infraorbital technique (35 (17 to 52) mm) (P = .015). Procedural failure rate was higher for the palatine technique (80%) compared to the infraorbital technique (20%; P = .025). For both techniques, imaging showed contrast spread along the nerve pathway in 70% of injections. Contrast medium contamination of nasal turbinates and nasal passages did not differ between approaches and was observed in 50% of palatine and 30% of infraorbital injections (P = .057).

Clinical significance: The novel palatine approach produced a higher procedural failure rate than the infraorbital technique and cannot be recommended as a suitable alternative to existing methods for canine maxillary nerve block.

Objectives: Like all antimicrobial use, surgical antimicrobial prophylaxis should only be administered when the benefits outweigh potential harms. The aim of this systematic review and meta-analysis was to assess the effectiveness of surgical antimicrobial prophylaxis to reduce surgical site infections in dogs and cats.

Materials and methods: Population, intervention, comparator and outcome were generated by a multidisciplinary guideline panel and clinical decision thresholds were derived from stakeholder interviews. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to evaluate the certainty of the evidence.

Results: Eight randomised controlled trials and seven observational studies met the eligibility criteria and were included in the review. Nine categories of surgical procedures were created based on organ system and wound classification and outcomes included surgical site infections, adverse events and mortality. Very low to moderate certainty evidence showed that surgical antimicrobial prophylaxis only had a trivial or small clinical effect on surgical site infection incidence in all surgical procedures. No adverse effects or mortalities related to surgical site infections were reported in any of the studies.

Clinical significance: The results of this study will be used to create evidence-based treatment guidelines.

Objectives: To describe the clinical application and outcome associated with the intraoperative use of N-butyl cyanoacrylate for managing small air leaks following lung lobectomies, lung lacerations and pulmonary bullae in a cohort of eight dogs.

Materials and methods: Medical and surgical records of eight client-owned dogs were retrospectively reviewed to evaluate the intraoperative use of topical N-butyl cyanoacrylate adhesive in pulmonary surgery. Data on intra- and postoperative complications, hospitalisation time, thoracostomy tube output, duration of thoracostomy tube placement and outcome were assessed.

Results: Eight dogs were included in the study, with a total of ten applications of N-butyl cyanoacrylate: seven applied directly to bullae (Dogs 1, 3 and 4) or parenchymal lacerations (Dogs 5-8) and two used to reinforce staple lines (Dogs 2 and 5). All dogs survived to discharge. The median duration of hospitalisation was 3 days, while thoracostomy tubes remained in situ for a median of 1 day. No complications associated with the use of adhesive were reported at the latest follow-up.

Clinical significance: The intraoperative use of N-butyl cyanoacrylate adhesive provided effective management of small air leaks (<7 mm) across various clinical scenarios, either as an adjunctive or as a primary intervention. Further studies are needed to assess its long-term biocompatibility and refine application techniques.

Objectives: To describe the electrophoretic pattern of proteinuria in dogs with naturally occurring Cushing's syndrome. We hypothesised that urine protein electrophoresis in dogs with spontaneous Cushing's syndrome will reveal glomerular proteinuria. We also hypothesised that the severity of proteinuria would decrease during treatment with trilostane.

Materials and methods: This prospective study included dogs with spontaneous Cushing's syndrome (n = 19) and healthy dogs (n = 10) serving as controls for urine protein electrophoresis. Urinary proteins were evaluated using sodium dodecyl sulphate agarose gel electrophoresis.

Results: Thirteen dogs with Cushing's syndrome had glomerular proteinuria, with high molecular weight bands between 66 and 150 kDa. Three dogs with Cushing's syndrome had mixed glomerular and tubular proteinuria, with low molecular weight bands between 14.3 and 26 kDa, in addition to high molecular weight bands. Three dogs with Cushing's syndrome had a physiological pattern of urine protein electrophoresis and these dogs were non-proteinuric. Seven dogs were re-evaluated 4 to 6 months after initiating treatment with trilostane. Before treatment, six dogs were proteinuric and one dog was non-proteinuric. After the treatment, three dogs were non-proteinuric and four dogs were proteinuric. Of these, proteinuria decreased in one dog (50%) and increased (up to 70%) in three dogs.

Clinical significance: Dogs with Cushing's syndrome predominantly exhibit glomerular proteinuria. No systematic improvement was observed during trilostane treatment.

Objectives: To assess chronic kidney disease in dogs after azotaemic acute kidney injury utilising serum creatinine, symmetric dimethylarginine and estimated glomerular filtration rate.

Materials and methods: Client-owned dogs hospitalised for azotaemic acute kidney injury (T0) were evaluated at discharge (T1), 3 months (T2) and 12 (T3) months with serum creatinine and symmetric dimethylarginine measured. In non-azotaemic dogs (serum creatinine <145 μmol/L) at T1 and T2, glomerular filtration rate was estimated by iohexol clearance. Acute kidney injury grade and chronic kidney disease stage were determined according to International Renal Interest Society guidelines. Non-azotaemic dogs were considered to have kidney dysfunction if glomerular filtration rate was reduced ≥20% below the mean of the body weight category.

Results: Fifteen dogs with azotaemic acute kidney injury were recruited. At T0 peak, acute kidney injury grade was III (n = 4), IV (n = 8) and V (n = 3). At T1, 10/15 dogs remained azotaemic. At T2, 3/15 dogs remained azotaemic; this persisted in 2/3 dogs at T3. One dog was euthanised prior to T3 due to progression of azotaemia (stage 4). Based on glomerular filtration rate assessment, 4/12 and 5/12 non-azotaemic dogs had evidence of kidney dysfunction at T2 and T3, respectively. Ten out of 15 dogs were classified as International Renal Interest Society chronic kidney disease stage 1 and 4/15 dogs were stage 2 and 1/15 dog that did not survive to T3 was stage 4.

Clinical significance: Persistent azotaemia occurs infrequently in dogs surviving beyond 3 months after acute kidney injury. Estimated glomerular filtration rate may identify continued kidney dysfunction in non-azotaemic dogs.

Objectives: Gastroesophageal reflux during anaesthesia is a common event occurring in dogs with the potential to cause oesophageal injury and aspiration pneumonia. The objective of the current study was to evaluate the effect of the novel metabotropic glutamate receptor 5 antagonist TT001 on gastroesophageal reflux during anaesthesia in dogs using two different protocols.

Materials and methods: One hundred and nineteen client-owned dogs were included and randomly assigned to receive test-drug containing either active TT001 (n = 58) or placebo vehicle (n = 61). In protocol 1 (n = 77), test-drug was administered shortly before induction and in protocol 2 (n = 42) test-drug was administered 15 minutes before standardised pre-anaesthetic drugs. Gastroesophageal reflux (pH <4) was measured and recorded using oesophageal pH-metry throughout the duration of the anaesthesia.

Results: Gastroesophageal reflux was registered in 45.4% of dogs, in protocol 1: 44.2%, and in protocol 2: 47.6%. No overall statistically significant difference between the dogs receiving active TT001 (group A, 48.3%) and placebo (group B, 42.6%) was observed, regardless of the protocol tested (protocol 1: group A: 47.4%, group B: 41.0%; protocol 2: group A: 50.0%, group B: 45.5%).

Clinical significance: Administration of metabotropic glutamate receptor 5 antagonist TT001 as a single intravenous bolus injection before or after pre-anaesthetic drugs has limited effect on the incidence of gastroesophageal reflux in anaesthetised dogs.