Veterinary Surgery最新文献

Objective: To compare the effectiveness of a modified surface gelatin sponge to a plain collagen sponge for hemostasis of parenchymal hepatic bleeding.

Study design: Prospective, randomized trial of two hemostatic agents.

Animals: A total of 45 dogs undergoing elective liver surgery were randomly allocated into two groups: 22 in the adhesive gelatin (AG) group and 23 in the plain collagen (PC) group. A total of 20 patients per group underwent liver biopsy to create a uniformly sized bleeding surface, with the remaining patients (AG = 2, PC = 3) undergoing liver lobectomy.

Methods: Evaluation of hemostatic effectiveness and tissue adhesion of each sponge type was performed by the operating surgeon using structured scoring systems. Hemostatic parameters were primarily evaluated at the liver biopsy site to maintain homogeneity of bleeding surface size.

Results: For the liver biopsy group (n = 40), 5 min after hemostatic sponge application, 10/20 dogs were bleeding in the PC group, compared to 2/20 in AG group (p = .0138). The PC bleeding was significantly higher than AG across the 3 to 6 min evaluation period (p < .001). When surgeons tested the adhesion of the sponge across the whole cohort (n = 45), AG scored 2 (of 3) against 1 for PC (p < .001). In group PC, 5/23 sponges dislodged during abdominal lavage and preparations for closure and had to be replaced due to recurrence of bleeding, compared with no AG sponges dislodging (p = .042). There were no further complications related to the use of either sponge.

Conclusion: In the dogs with hepatic parenchymal incision, use of an adhesive gelatin sponge improved intraoperative attachment and haemostatic effectiveness, compared to a collagen sponge.

Clinical significance: Based on our clinical experience in these cases, adhesive gelatin sponges could be considered an effective option when selecting a hemostatic agent for liver surgery in dogs.

Objective: To describe sacroiliac luxation stabilization in cats using two screws and to report clinical and radiographic short-term outcomes.

Study design: Retrospective clinical cohort study.

Sample population: Cats (n = 67) with sacroiliac luxation.

Methods: Case records of cats presented for sacroiliac luxation stabilized using two screws per side affected, one lag and one positional, between 2014 and 2023 were reviewed. The percentage of sacral purchase (PoSP) for each screw, percentage of reduction (PoR), and pelvic canal width ratio (PCWR) were measured and calculated.

Results: Eighty-two sacroiliac luxations were stabilized. Two 2.0 mm screws were used in 69 cases; two 2.4-mm screws in nine cases, and one 2.4 mm with one 2.0 mm screw in four cases. The mean PoSPs for lag and positional screws were 46% ± 12 and 31% ± 11, respectively. The median PoR was 89% (41 to 100). The mean PCWR was 1.23 ± 0.11. Clinical follow up was available for 42 cats with 53 sacroiliac luxations at a median of 87 days (36 to 2503). The full function was noted in 34 patients (81%). Screw failure occurred in five sacroiliac joints (4.7%), including loosening (n = 3), and breakage (n = 2) of the positional screws (n = 1). Pelvic canal diameter was maintained in all cases.

Conclusion: Excellent functional and radiographic outcomes were obtained for cats with sacroiliac luxation stabilized with two sacroiliac screws.

Clinical significance: Feline sacroiliac luxation can be stabilized using two sacroiliac screws.

Objective: We aimed to study the antimicrobial and pro-healing potential of equine mesenchymal stromal cell secreted products (i.e. secretome), collected as conditioned media (mesenchymal stromal cell-conditioned media, MSC CM), in a novel in vivo model of methicillin-resistant Staphylococcus aureus (MRSA)-inoculated equine thorax wounds.

Study design: Prospective in vivo study.

Animals: Two Thoroughbred geldings.

Methods: Six full-thickness cutaneous wounds were created bilaterally on the dorsal thorax of two horses (n = 12 wounds/horse). Wounds on the left thoraces were inoculated with MRSA on day 0. All wounds were then treated with either mupirocin ointment, MSC CM, or vehicle control (n = 4 wounds per group) once daily for 3 days. Photographs were taken to quantify wound scores and sizes, as well as samples to determine bacterial colony forming units (CFUs), at days 0, 1, 2, 3, 7, 14, 21, and 28. The wound edge was biopsied on days 0, 7, and 28, and scored histologically.

Results: Inoculated wounds had more bacterial CFUs at day 1 (p < .0001) and were larger in size at day 28 (p = .0009) than noninoculated wounds. Mupirocin-treated wounds were smaller than MSC CM and vehicle control-treated wounds at day 28 (p = .003). Mesenchymal stromal cell-conditioned media did not affect CFU numbers in inoculated and noninoculated wounds. Moreover, MSC CM did not affect the parameters of wound size or gross or microscopic wound scores over time.

Conclusion: Mesenchymal stromal cell-conditioned media did not exhibit antimicrobial or pro-healing properties in the current study; however, the in vivo model of inoculated equine thorax wounds requires further optimization.

Clinical significance: This pilot study contributes to a growing understanding of the equine MSC secretome as an antimicrobial and pro-healing therapeutic for equine wounds.

Objective: To describe and report the outcome of a cricotracheostomy (CT) technique for the creation of a permanent upper airway ventral cervical stoma in dogs.

Study design: Short case series.

Animals: Eight client-owned dogs.

Methods: Upper airway obstruction due to various disease processes was confirmed via upper airway examination and appropriate imaging. Medical records were reviewed to assess complications experienced during and following permanent CT. Owner questionnaires regarding quality of life (QoL) following permanent CT were performed.

Results: All dogs experienced a routine recovery. The CT provided a robust dorsolateral. wall to the stoma from the cricoid cartilage. The stomata did not show any evidence of dorsal wall collapse or stenosis. Four dogs required further skin fold resection. The high position of this stoma also appears to be appropriate functionally with bilateral cervical skin fold resections. The owner questionnaires reported high satisfaction in the postoperative QoL.

Conclusion: CT was feasible and led to a reliable outcome for surgical patients and improvement in QoL. Comparative clinical investigation of the CT technique with traditional permanent tracheostomy techniques is indicated to definitively prove the validity and any superiority of the CT technique.

Objective: To compare the reliability of respiratory function grading (RFG) scores assigned in-person and remotely via video and electronic stethoscope recordings, evaluated by novice and expert graders.

Study design: Prospective study.

Sample population: Fifty-seven brachycephalic dogs.

Methods: Dogs were evaluated in person by expert graders and RFG scores were assigned. Audio and video recordings were made during the in-person evaluations. Four expert and four novice graders evaluated the recordings and assigned an RFG score to each dog. Agreement between in-person and remote RFG scores was assessed using Cohen's kappa statistic. Interobserver reliability was assessed using Fleiss' kappa statistic.

Results: The median RFG score from the in-person assessment was 1 (range, 0-3). Distribution of RFG scores included 12 grade 0 scores, 19 grade 1 scores, 25 grade 2 scores, and 1 grade 3 score. The raw percentage agreements between remote and in-person scores were 68.4%, 59.6%, 64.9%, and 61.4% for the four experts, and 52.6%, 64.9%, 50.9%, and 42.1% for the four novices. Reliability between remote and in-person RFG scores was poor to moderate both for the experts (Cohen's kappa: .48, .37, .46, .41) and novices (Cohen's kappa: .28, .47, .28, .21). Interobserver reliability was moderate among the experts (Fleiss' kappa: .59) and poor among the novices (Fleiss' kappa: .39).

Conclusion: Remote RFG scores had poor to moderate interassessment and interobserver reliability. Novice evaluators performed worse than experts for remote or in-person RFG evaluations.

Clinical significance: Remote RFG, as measured in this study, is not reliable for assigning RFG scores. Modifications could be made to remote evaluation to improve reliability. Based upon the performance of novice evaluators, training of evaluators is justified.

Objective: The aim of the present study was to investigate the long-term survival and postoperative complications in horses that had undergone small intestinal resection and a modified anastomosis technique using a partially stapled, functional end-to-end anastomosis.

Study design: Observational retrospective case series.

Animals: A total of 25 horses underwent small intestinal resection and a partially stapled, functional end-to-end anastomosis.

Methods: A modified technique to create a partially stapled, functional end-to-end anastomosis is described. The clinical case records of all horses that fulfilled the criteria between January 1, 2010 and January 1, 2020 were reviewed. Data on short-term survival and postoperative complications were collated. A telephone questionnaire of owners was undertaken to evaluate long-term survival.

Results: Duration of follow up was from one to 4232 days (median 785 days). A total of 21/25 (84%) of horses survived to discharge, 19/25 (76%) horses were alive at 6 and 12 months and 64% survived to 2 years. A total of 64% of horses developed at least one postoperative complication. Two horses developed a small intestinal volvulus necessitating repeat laparotomy. One horse had kinking at the anastomosis site diagnosed at post-mortem examination.

Conclusion: Partially stapled functional end-to-end anastomosis technique in this study had similar short- and long-term survival to those reported in previous studies using handsewn techniques, but severe complications at the anastomosis site occurred in >10% of cases.

Clinical relevance: The anastomosis technique described appears to have similar short- and long-term survival and complication rates, compared to more commonly used anastomosis techniques. However, there is potential for severe complications at the anastomosis site.

Objective: The aim of the study was to describe the surgical technique and outcome of a combined forequarter amputation and hemilaminectomy (FAHL) for excision of canine peripheral nerve sheath tumors (PNSTs) of the brachial plexus extending into the vertebral canal.

Study design: Retrospective case series.

Animals: Nine client-owned dogs.

Methods: Dogs which underwent FAHL for resection of a brachial plexus PNST extending into the vertebral canal were included. Data from medical records including signalment, clinical findings, MRI data, histopathology reports, interval between appearance of the clinical signs and surgical intervention, affected spinal nerves and nerve roots, time to ambulate postoperatively, survival time, tumor grade and completeness of surgical margins were collected.

Results: In seven of nine cases the PNST affected the eighth cervical nerve root. Five of the nine cases were ambulatory within the first 3 days postoperatively and in one case unassisted ambulation was delayed and achieved 28 days postoperatively. The median survival time was calculated to be 317 days and the mean 522 days (range 120-1620 days). Four of nine dogs were euthanized 120, 270, 306 and 317 days postoperatively, because of suspected tumor recurrence. In one of those four cases the histological margins were reported as complete.

Conclusion: FAHL appeared to be a reliable technique for excision of PNSTs of the brachial plexus invading the spinal canal, with similar outcomes to previously reported for PNSTs not extending into the vertebral canal.

Objective: To describe the successful treatment of traumatic nasal avulsion injury resulting in dynamic nasal stenosis and rostroventral deviation of the nasal cartilage.

Animals: A 6-year-old spayed female pug presented with traumatic nasal avulsion injuries.

Study design: Case report.

Methods: The initial surgical intervention involved facial reconstructive surgery to repair a maxillary lip avulsion. Following the diagnosis of stenosis in both common nasal meatuses resulting in respiratory distress a week after the initial surgery, balloon dilatation of the nasal passages and rhinoplasty were additionally performed. Ten weeks after the traumatic event, the diagnosis of dynamic nasal stenosis and rostroventral nasal cartilage deviation secondary to dorsal and lateral nasal ligament injuries was made. Balloon dilatation was repeated, along with nasal skin fold resection and realignment of the nasal passages. To stabilize nasal alignment, dorsal and lateral nasal ligaments were reconstructed to stabilize the alignment. Bilateral temporary endonasal stents were inserted into the nasal meatuses to maintain alignment and patency of the dilated passage during recovery.

Results: No complications were observed after the final surgery. The stents were subsequently removed 4 weeks after placement. An 8-month follow-up examination following the final surgical procedure revealed improved and subjectively normal airflow through both nares. The dog died 2 years after the last surgery due to severe bronchitis. Until her death, the dog tolerated exercise well and maintained good breathing even at night without snoring during sleep.

Conclusion: This case report describes the successful surgical treatment of traumatic nasal avulsion injury in a brachycephalic dog.

Objective: To describe a modified closed sacculectomy technique for non-neoplastic anal sac disease in dogs, and to describe the management and short-term outcomes in dogs undergoing sacculectomy by the described technique.

Study design: Retrospective case series.

Sample population: A total of 50 dogs.

Methods: Electronic medical records were reviewed to identify dogs undergoing bilateral anal sacculectomy for non-neoplastic anal sac disease using the described closed technique between January 1, 2013 and February 1, 2024.

Results: A total of 50 dogs underwent bilateral anal sacculectomy for non-neoplastic anal sac disease. Intraoperative anal sac perforation was reported in five dogs (10%). A total of 43 dogs were available for two-week follow-up. Grade 1 complications were reported in 14/43 dogs (32%), grade 2 complications in 2/43 dogs (5%), and grade 3B in 2/43 dogs (5%). At two-weeks postoperatively, 13/14 dogs (93%) had resolution of grade 1 complications. Both dogs with grade 2 complications had resolution reported at two weeks postoperatively, and both dogs with grade 3B complications had resolution reported at two weeks following revision surgery.

Conclusion: Intraoperative complications consisted of anal sac perforation without further complication. Minor postoperative complications were mostly self-limiting, supporting previous literature. Major complications were infrequent and resolved following single revision surgery.

Clinical significance: The technique reported provides an alternative to excise intact and non-neoplastic anal sacs in dogs. The key features of this technique are immediate anal sac identification by following the anatomic path of the duct, minimal peri-saccular dissection, no requirement for packing of the anal sac, and complete removal of the duct and anal sac.

Objective: The aim of the study was to describe laparoscopic ultrasound (LUS) to guide microwave ablation (MWA) of hepatocellular carcinoma (HCC) in a dog.

Animals: A 13-year-old female spayed Husky.

Study design: Case report.

Methods: The dog was referred for laparoscopic MWA of a caudate lobe HCC measuring 2.7 cm × 1.9 cm× 2.3 cm. Laparoscopic ultrasound was used to guide percutaneous placement of a MWA probe within the caudate lobe mass. LUS was used to determine the tumor margins for placement of the probe within the medial and lateral aspects as well as the center of the mass. Additionally, LUS allowed visualization of vessels within the tumor so they could be avoided during probe placement.

Results: Safe ablation was accomplished, and the dog recovered uneventfully with no complications. Follow-up computed tomography (CT) 3- and 12-months postoperatively revealed complete ablation of the caudate lobe mass. However, progressive increase in size of the right medial lobe mass occurred. Right medial liver lobectomy was performed 13 months after MWA, with a histopathologic diagnosis of HCC. The dog was euthanized 777 days post MWA and 1445 days post initial left lateral lobectomy for HCC.

Conclusion: Laparoscopic ultrasound was useful in guiding complete and safe MWA of an HCC in this dog. Laparoscopic ultrasound should be considered when performing laparoscopic MWA of liver lesions in dogs.