Compendium-Continuing Education for Veterinarians最新文献

Laparoscopic removal of the gonads from male and female horses is regularly performed for a variety of reasons. In female horses, common indications for ovariectomy include behavioral problems and signs of abdominal pain that are linked to estrus. Another indication is an abnormal, enlarged ovary, typically due to ovarian neoplasia, the most common being granulosa thecal cell tumor. Ovariectomy is also a treatment option for ovarian hematomas and other abnormalities. In addition, ovariectomy is used to sterilize mares intended for artificial insemination or embryo transfer programs.

Urolithiasis is a common clinical problem in small animal veterinary patients. Management of upper urinary tract calculi can be particularly challenging in small animals, as traditional surgical removal can be associated with significant morbidity. In humans, minimally invasive treatment options have replaced traditional surgical removal in many cases. This article reviews the current literature on the various types of lithotripsy and some of the newer minimally invasive options available for management of nephrolithiasis in small animal veterinary patients. An article in the January 2013 issue addressed management of lower urinary tract uroliths; a future article will discuss current management strategies for ureteroliths.

A 2-year-old, intact female guinea pig presented to the clinic for a history of squealing and straining to urinate for 2 days. The husbandry of this animal was acceptable, and the diet consisted of commercial alfalfa-based guinea pig pellets, alfalfa hay, a variety of vegetables, and a water-soluble vitamin C supplement.

In ferrets, urinary tract catheterization is most often indicated for neutered males with a urethral obstruction. Obstructions are commonly caused by prostatic enlargement secondary to adrenal tumor hormone production or, less commonly, by urolithiasis. A ferret with a urethral obstruction needs immediate intervention to relieve the obstruction.

Ingestion of tremorgenic mycotoxins formed in spoiled food can cause an acute tremor syndrome, the severity of which can range from mild to life-threatening. Swift recognition of the likely cause is required for accurate prognostication and rapid institution of appropriate therapy, which leads to complete resolution in most cases.

Skin disease is one of the most common reasons dogs and cats are taken to the veterinarian. While many dermatologic conditions cause mild, localized signs, some, such as erythema multiforme, toxic epidermal necrolysis, cutaneous vasculitis, cutaneous drug eruptions, and thermal burns, can cause severe cutaneous signs and may have serious systemic consequences. These patients may present on an emergency basis and require intensive monitoring, diagnostics, and care. Lack of familiarity with these conditions may delay diagnosis and appropriate treatment. Pyotraumatic dermatitis may also prompt owners to seek emergency veterinary care due to the severe appearance of associated lesions.

Corneal ulceration is commonly diagnosed by equine veterinarians. A complete ophthalmic examination as well as fluorescein staining, corneal cytology, and corneal bacterial (aerobic) and fungal culture and sensitivity testing are necessary for all infected corneal ulcers. Appropriate topical antibiotics, topical atropine, and systemic NSAIDs are indicated for all corneal ulcers. If keratomalacia (melting) is observed, anticollagenase/antiprotease therapy, such as autologous serum, is indicated. If fungal infection is suspected, antifungal therapy is a necessity. Subpalpebral lavage systems allow convenient, frequent, and potentially long-term therapy. Referral corneal surgeries provide additional therapeutic options when the globe's integrity is threatened or when improvement has not been detected after appropriate therapy.

In small animals, removal is indicated for lower urinary tract calculi that are not amenable to medical dissolution and are causing, or may cause, urinary tract obstruction, inflammation, or recurrent infection. Surgical removal of lower urinary tract uroliths by cystotomy or urethrotomy has been the traditional method. The current standard of care for human urinary tract stones involves the use of lithotripsy and is minimally invasive. This article reviews the current literature on the various minimally invasive options available for managing lower urinary tract stones in small animal veterinary patients. Options for managing nephroliths and ureteroliths will be presented in forthcoming companion articles.

Thoracoscopic surgery offers an exciting method for treating a variety of thoracic disease processes. To date, several thoracoscopic procedures have been described in veterinary patients. This article discusses the basic principles of thoracoscopic surgery and thoracic access, anesthetic concerns, and required instrumentation. A companion article discussing the surgical techniques of thoracoscopic pericardial window creation, subphrenic pericardectomy, thoracoscopic lung biopsy, lung lobectomy, thoracic duct ligation, and cranial mediastinal mass excision will be published in the February 2013 issue.

Managing traumatic foot wounds in horses may require surgical intervention. These wounds include coronary-band and heel-bulb lacerations, septic pedal osteitis, septic navicular bursitis, sepsis of the collateral cartilages, and hoof-wall injuries. This article provides a practical overview of the surgical management of these types of wounds.