Veterinary Surgery最新文献

Objective: To describe postoperative subsidence observed after total hip replacement (THR) with the BFX standard stem.

Study design: Retrospective case series.

Sample population: A total of 177 THR procedures in 145 dogs.

Methods: Clinical and radiographic follow-up data were collected between 12 weeks and six months postoperatively. A proportion correction was used to calculate subsidence between immediate postoperative and follow-up radiographs. Canal flare index, coronal canal fill, sagittal canal fill, coronal stem orientation and sagittal stem orientation were measured.

Results: There were 24/177 (13.6%) intra- and postoperative complications. Of these, 11/177 (6.2%) were stem complications. Eight stem complications were intraoperative femoral fissures; one fissure progressed to postoperative femoral fracture. Subsidence was associated with stem complications (p = .005) and was not associated with non-stem complications (p = .76) or prosthetic luxation (p = .07). There were seven stems with more than 5.0 mm of subsidence; of these only 1/7 had a stem complication. There were 26 stems with more than 3.0 mm of subsidence; of these only 3/26 had a stem complication. There was no association between any femoral or stem measurements and subsidence.

Conclusion: Subsidence of the BFX standard stem was associated with stem complications, which were mostly intraoperative femoral fissures. Thresholds of 3.0 and 5.0 mm were poorly predictive of complications, and substantial subsidence was often clinically inconsequential.

Clinical significance: Cutoffs for excessive subsidence may have limited clinical utility. The significance of postoperative subsidence should be interpreted in the context of other clinical findings.

Objective: To quantify how increasing axial loads, femoral fixation methods (rigid vs. flexion-extension mobility) and joint angles reflecting early versus mid-stance impact simulated quadriceps and gastrocnemius forces.

Study design: Non-randomized, cadaveric experimental study.

Sample population: Unpaired canine pelvic limbs (n = 10) from adult large-breed dogs.

Methods: Limbs were mounted in a custom limb press with the femur sequentially rigidly fixed at 70° to horizontal or allowed flexion-extension. Quadriceps and gastrocnemius muscles were simulated with load cells and turnbuckles. Axial loads of 10%, 20% and 30% bodyweight (BW) were applied. Stifle and hock angles were sequentially fixed to represent mid- (135° and 145°) or early stance (145° and 135°). Outcome measures were BW normalized simulated muscle loads and their ratio. Data were analyzed using non-parametric repeated measures.

Results: Quadriceps and gastrocnemius forces increased with axial load (p < .001). Quadriceps force was unaffected by fixation method but showed higher mid-stance values in flexion-extension models at 20% and 30% loads (p = .03). Gastrocnemius force varied by configuration (p = .01) and showed significant load-configuration interactions (p = .003); mid-stance values were lower than early stance in flexion-extension models. Muscle force ratios were consistent across loads (p = .2) but differed by configuration (p = .02), with higher mid-stance values in flexion-extension models.

Conclusion: Femoral fixation method and stance configuration had limited impact on simulated muscle forces. Flexion-extension mobility did not substantially increase muscle loading.

Impact: Rigid femoral fixation remains a valid approach for canine limb press models.

Objective: The objective of the study was to describe a single incision laparoscopic approach to ovariectomy (OVE) and ovariohysterectomy (OVH) in companion pigs. Additionally, we aimed to compare complications and outcomes between production breed and miniature pigs.

Study design: Descriptive clinical case series.

Animals: Twenty intact female, client-owned companion pigs.

Methods: Records from a university teaching hospital were reviewed for pigs undergoing elective OVE or OVH by single incision laparoscopic surgery (SILS) over 1 year (2023-2024). Patient signalment, presenting complaint, surgical and anesthetic techniques as well as complications were recorded. Patient follow-up was obtained by owner phone communication at least 1 year postoperatively. Complications and outcomes were compared between production breed and miniature pig populations with Mann-Whitney and χ² testing for continuous and categorical variables, respectively.

Results: Production breed (9/20, 45%) and miniature pigs (11/20, 55%) underwent SILS OVE (16/20, 80%) or OVH (4/20, 20%). SILS OVE was successfully performed in all cases. SILS OVH was achieved in one case (25%) in which the uterus was near-normal; additional OVH procedures (3/4, 75%) performed on miniature pigs with an abnormal uterus were converted to open because of challenges with tissue manipulation. No difference in complications or outcomes was noted between production breed and miniature pigs.

Conclusion: SILS OVE appears to be a feasible and safe surgical option for both production breed and miniature pigs, with no significant differences observed between groups, while SILS OVH is feasible in select cases.

Clinical significance: Single incision laparoscopic OVE is a safe and viable alternative to traditional three port laparoscopy for production breed and miniature companion pigs. SILS is an adequate technique for OVH in select patients, suggesting that further investigation of laparoscopy for porcine OVH is warranted.

Objective: To determine the natural progression of tarsal osteochondrosis (OC) in a cohort of Standardbred foals and assess the impact of gait preference (trotting vs. pacing).

Study design: Longitudinal observational cohort study.

Animals: Client-owned Standardbred foals (n = 148).

Methods: Tarsal radiographs were taken every 2 months from 2 to 12 months of age and foals were video monitored to document time spent pacing or trotting. Differences between groups were assessed using χ² analysis. Survival analysis was used to determine if lesion healing differed between groups over time.

Results: Of 148 horses, 103 (69.6%) had OC lesions at 2 months of age but only 32 (21.6%) still had OC lesions by 12 months. In 28 of these horses, the lesions had progressed to osteochondrosis dissecans (OCD). Of 71 horses with lesions that healed, 60 (84.5%) did so by 6 months of age. Gait was not associated with presence or absence of OC lesions or healing of lesions over time. Foals spent less than 1% of their observed time trotting or pacing.

Conclusion: Tarsal OC lesions were prevalent in this cohort of young Standardbreds, and most lesions healed within the first few months of life. There was no evidence for direct biomechanical forces from movement at the pace or trot affecting the location of OCD fragment development.

Clinical significance: The critical window for tarsal OC lesion healing was prior to 6 months of age and further investigation of risk factors present during this time frame is warranted.

Objective: To compare the systemic inflammatory and oxidative stress responses after elective ovariectomy via open surgery (OPEN) or laparoscopy (LAP) in anestrus bitches.

Study design: Prospective, blinded, randomized clinical trial. Animals A total of 26 healthy bitches.

Methods: A total of 26 healthy bitches in anestrus were randomly assigned to undergo either LAP or OPEN ovariectomy (n = 13 per group). Blood samples were collected at four timepoints (preoperative-Tpre, 2 h-T2, 24 h-T24, and 7 days postoperative-T7) for quantification of interleukin-6 (IL-6) and paraoxonase-1 (PON-1), biological antioxidant potential (BAP), and reactive oxygen metabolites (d-ROMs).

Results: IL-6 levels were higher in the OPEN group at Tpre, T24 and T7, while the LAP group exhibited a transient peak at T2 with a return to baseline by T7. PON-1 levels decreased in both groups at T2 but remained lower in the LAP group at T24 and T7. d-ROM levels were higher in the OPEN group, with an increase through T7, whereas the LAP group showed only a transient peak at T24. BAP levels increased in the OPEN group, but not in the LAP group by T7.

Conclusion: LAP ovariectomy induced a milder and more transient inflammatory and oxidative response compared to OPEN surgery in bitches, likely due to reduced surgical trauma.

Clinical significance: This study included only animals in anestrus. This is the first application of both canine-specific biomarkers of inflammation and canine-validated biomarkers of oxidative stress to compare techniques of elective canine spaying. These findings suggest that minimally invasive ovariectomy attenuates inflammatory and oxidative stress responses compared to OPEN technique in dogs.

Objective: To compare the biomechanical performance of adjunctive locking plating and double-loop cerclage wiring in feline femora implanted with Zurich cementless total hip replacement (THR) stems.

Study design: Cadaveric biomechanical study.

Animals: Paired femora (n = 32) from 16 feline cadavers.

Methods: Two sequential studies were performed. First, femora implanted with Zurich cementless stems alone were compared with those stabilized by an adjunctive locking plate. Second, femora with locking plates were compared with those with cerclage wires. Constructs underwent cyclic axial and torsional loading followed by load-to-failure testing. Outcome measures included residual axial and torsional displacement, yield and ultimate forces and torques, energy absorption, and brittle failure frequency. Parameters were normalized to bone volume.

Results: The locking plate group demonstrated substantially reduced residual torsional displacement and a trend toward lower axial displacement compared with the stem-only group. Yield and ultimate failure strength did not differ. The cerclage group exhibited 36% greater ultimate axial displacement, 76% greater energy absorption, and 32% greater torsional displacement than the locking plate group. Normalization accentuated these differences. Cerclage wire fixation was associated with a lower frequency of brittle failure.

Conclusion: Locking plates improved cyclic stability by reducing micromotion, while cerclage wires enhanced compliance and energy absorption under destructive loading. Neither method increased load to failure.

Clinical significance: Adjunctive plate or cerclage wire provided biomechanical advantages in femora implanted with Zurich cementless THR stems. Locking plates may support implant stability, whereas cerclage wiring improves energy dissipation under supraphysiologic loading. Adjunctive fixation strategies should be tailored to patient-specific femoral morphology and fracture risk in feline THR.

Objective: To determine the role of each part of the collateral ligaments and the olecranon ligament in traumatic elbow luxation pathophysiology in cats.

Study design: Feline cadaveric study.

Sample population: A total of 15 cats and 30 thoracic limbs tested.

Methods: Attempts were made to manually luxate (laterally, medially, and caudally) each elbow after sequential section of each part of the medial collateral ligament, the lateral collateral ligament, and the olecranon ligament by direct and indirect forces applied to the antebrachium.

Results: No elbow luxation occurred with indirectly applied rotational forces. Luxation was only possible with direct forces applied to the antebrachium (axial compression and varus/valgus/caudal forces). Lateral elbow luxation was possible after transection of medial and lateral collateral ligaments or after transection of olecranon and medial collateral ligaments. Medial luxation was possible after transection of olecranon and lateral collateral ligaments. Caudal luxation was possible with transection of olecranon and lateral collateral ligaments.

Conclusion: Various combinations of ruptured ligaments can account for lateral, medial, and caudal luxations of the elbow. The olecranon ligament plays a major role in elbow stability.

Clinical significance: Traumatic elbow luxation in cats can happen with only one collateral ligament rupture, if the olecranon is concurrently severed. The integrity of each ligament should be assessed before any repair.

Background: Septic peritonitis (SP) is a complex disease with significant morbidity and mortality. Diagnosis can be challenging, and lack of a timely diagnosis may impact survival.

Aim: The aim of this review was to synthesize current knowledge on the diagnosis and surgical management of SP in dogs and cats.

Conclusions: Recent studies suggest refinements of previously reported clinicopathologic criteria improve diagnostic and prognostic accuracy. When evaluating blood-effusion glucose differences, clinicians should be aware of the confounding effects of point of care glucometers. Cytology specimens should be prepared immediately to avoid sample degradation. Advances in imaging have improved the relevance and diagnostic value of ultrasound and computed tomography. Surgical source control that targets the underlying cause is crucial. Accurate assessment of tissue viability may be aided by technologies under development. Anastomotic dehiscence may be reduced by using stapling devices and reinforcement with endogenous or exogenous materials. Evidence for the effectiveness of postoperative drainage via open abdomen ± vacuum-assisted closure, or closed suction drains, is unclear. Heterogeneity of patient severity and incomplete data limit direct comparisons between studies and highlight opportunities for future investigation.

Implications: Developments in diagnostic and surgical techniques may improve prognostication and outcomes in septic patients. There are many opportunities for further research into diagnosis and surgical treatment of patients with septic peritonitis.

Objective: To determine if a novel robotic system has comparable positional and angular accuracy to that achievable with patient-specific guides (PSG) when used for transcondylar screw (TCS) placement in the canine humerus.

Study design: Experimental laboratory study.

Sample population: A total of 32 synthetic humeral models (16 per group).

Methods: Bone models were three-dimensional (3D)-printed and drilled with the aid of a custom PSG or with the assistance of an image-guided surgical robot. A 2.5-mm hole was drilled medial to lateral and the entry point, exit point and angular trajectory of the drill hole were measured on postoperative computed tomography (CT) scans. Absolute differences between planned and actual positions and trajectories were compared between PSG and Robot groups.

Results: None of the drill holes in this study violated the articular surface of the humerus. Entry point positioning was significantly more accurate in the PSG group, but drill hole trajectories (angulation) were more accurate in the Robot group. Exit point positioning was similar in the two groups.

Conclusion: Robotic assistance enables safe placement of drill holes for TCS. PSG enable more accurate drill entry, but robotic assistance allows for more accurate overall drill hole trajectory.

Clinical significance: Robotic assistance allows for accurate and safe drilling of screw holes for TCS placement in the humerus. The robotic procedure allows for a more limited surgical exposure, but the technical feasibility and outcomes associated with this approach should now be evaluated in cadavers before moving to clinical evaluation in live patients.

Background: Septic peritonitis (SP) is a complex, life-threatening disease, driven by peritoneal inflammation and microbial contamination, requiring timely and dynamic perioperative management.

Aims: The aim of this review was to synthesize current knowledge on the perioperative management of SP in dogs and cats.

Conclusions: Evidence-based strategies for initial stabilization include fluid resuscitation with balanced crystalloids, asopressors, and antimicrobial therapy targeting polymicrobial infections. Anesthetic management should prioritize hemodynamic stability and a multimodal approach to analgesia. Postoperative management should include early enteral nutrition (which is associated with increased survival) and monitoring and treatment of coagulation derangements. Patients should be closely monitored for recurrent SP after surgery, which is associated with high mortality. Evidence for risk factors of dehiscence such as hypoalbuminemia and interoperative hypotension is inconsistently found in studies. Other potential complications include hospital acquired infection and intra-abdominal hypertension.

Implications: There is significant variation in the treatment approach for small animals with SP, likely due to gaps in evidence. Reported survival rates vary widely between studies due to diverse and inconsistent study populations, highlighting the need for further research to optimize care in veterinary patients.