In the present study, factors associated with death and failure to be discharged from the hospital included tachycardia, a requirement for massive transfusion with blood products, and the development of respiratory disease secondary to suspected pulmonary thromboembolism or acute respiratory distress syndrome. The presence of disease within the spleen was positively associated with survival to discharge. Surgical intervention for treatment of hemoperitoneum, regardless of etiology, resulted in discharge from the hospital for 70 of the 83 (84%) dogs in this series.
Laryngeal dysfunction induced by gastroesophageal reflux as occurred in the patient described in this report is a previously undocumented association in the veterinary literature. This association could be a potential consideration in dogs with concurrent respiratory and gastrointestinal signs. The present report may provide a basis for further studies investigating this association.
Background: Lower urinary tract transitional cell carcinoma (TCC) is an important but rarely described disease of cats.Objectives: To report the clinical characteristics, treatments, and outcomes in a cohort of cats with lower urinary tract TCC and to test identified variables for prognostic relevance.Animals: One-hundred eighteen client-owned cats with lower urinary tract carcinoma.Methods: Medical records were retrospectively reviewed to obtain information regarding clinical characteristics, treatments, and outcomes. Recorded variables were analyzed statistically. Results: Median age of affected cats was 15 years (range, 5.0-20.8 years) and median duration of clinical signs was 30 days (range, 0-730 days). The trigone was the most common tumor location (32/118; 27.1%) as assessed by ultrasound examination, cystoscopy, or both. Treatment was carried out in 73 of 118 (61.9%) cats. Metastatic disease was documented in 25 of 118 (21.2%) cats. Median progression-free survival Abbreviations: BUN, blood urea nitrogen; CI, confidence interval; COX, cyclooxygenase; FNA, fine-needle aspirate; HR, hazard ratio; IQR, interquartile range; NSAIDs, nonsteroidal antiinflammatory drugs; OR, odds ratio; TCC, transitional cell carcinoma.and survival time for all cats were 113 days (95% confidence interval [CI], and 155 days (95% CI, 110-222), respectively. Survival increased significantly (P < .001) when comparing cats across the ordered treatment groups: no treatment, treatment without partial cystectomy, and treatment with partial cystectomy. Partial cystectomy (hazard ratio [HR], 0.31; 95% CI, 0.17-0.87) and treatment with nonsteroidal anti-inflammatory drugs (HR, 0.55; 95% CI, 0.33-0.93) were significantly associated with longer survival times.Conclusions and Clinical Importance: The results support treatment using partial cystectomy and NSAIDs in cats with TCC.
OBJECTIVE To evaluate perioperative morbidity and outcome in dogs and cats undergoing esophageal surgery. DESIGN Retrospective case series. ANIMALS 63 client-owned dogs and 9 client-owned cats. PROCEDURES Medical records of dogs and cats that underwent esophageal surgery were reviewed for information on signalment, history, results of preoperative diagnostic testing, condition treated, details of surgery, intraoperative complications, and postoperative complications. Long-term follow-up data were obtained via veterinarian and client telephone conversations. The relationship between complications and survival to hospital discharge was evaluated by means of regression analysis. RESULTS The most common indication for surgical intervention was an esophageal foreign body in dogs (50/63 [79%]) and esophageal stricture in cats (3/9). Complications were documented in 54% (34/63) of dogs and 3 of 9 cats. The most common immediate postoperative complications were respiratory in nature (9 dogs, 1 cat). Partial esophagectomy and resection with anastomosis were significantly associated with the development of immediate postoperative complications in dogs. The most common delayed postoperative complications were persistent regurgitation (7 dogs) and esophageal stricture formation (3 dogs, 1 cat). For dogs, a mass lesion and increasing lesion size were significantly associated with the development of delayed postoperative complications. Six dogs (10%) and 1 cat died or were euthanized prior to discharge, and pneumomediastinum and leukopenia were negative prognostic factors for dogs being discharged from the hospital. CONCLUSIONS AND CLINICAL RELEVANCE Results of this study suggested that the short-term prognosis for dogs and cats that survive surgery for treatment of esophageal lesions is favorable, with 90% of patients discharged from the hospital (57/63 dogs; 8/9 cats). However, dogs treated for more extensive esophageal lesions as well as those undergoing esophagectomy or resection and anastomosis were more likely to develop postoperative complications.
OBJECTIVE To evaluate potential associations between surgical approach and complication rate, progression-free survival time, and disease-specific survival time in cats with mammary adenocarcinoma. DESIGN Retrospective case series. ANIMALS 107 client-owned cats. PROCEDURES Medical records of cats that underwent surgical excision of mammary adenocarcinoma by means of a unilateral or bilateral (staged or single-session) mastectomy at 9 hospitals between 1991 and 2014 were reviewed. Relevant clinicopathologic data and details of surgical and adjuvant treatments were recorded. Outcome data were obtained, including postoperative complications, progression-free survival time, and disease-specific survival time. RESULTS Complications occurred in 12 of 61 (19.7%) cats treated with unilateral mastectomy, 5 of 14 (35.7%) cats treated with staged bilateral mastectomy, and 13 of 32 (40.6%) cats treated with single-session bilateral mastectomy. Complications were significantly more likely to occur in cats undergoing bilateral versus unilateral mastectomy. Median progression-free survival time was longer for cats treated with bilateral mastectomy (542 days) than for cats treated with unilateral mastectomy (289 days). Significant risk factors for disease progression included unilateral mastectomy, tumor ulceration, lymph node metastasis, and tumors arising in the fourth mammary gland. Significant risk factors for disease-specific death included lymph node metastasis and development of regional or distant metastasis. Among cats that did not develop metastasis, unilateral mastectomy was a significant risk factor for disease-specific death. Treatment with chemotherapy was associated with a significantly decreased risk of disease-specific death. CONCLUSIONS AND CLINICAL RELEVANCE Results supported bilateral mastectomy for the treatment of mammary adenocarcinoma in cats to improve progression-free and disease-specific survival time. Performing bilateral mastectomy in a staged fashion may help to decrease the complication rate.
Wound healing is a complicated process consisting of overlapping phases directed and regulated by many mediators of healing produced locally at the wound. The end goal of wound healing is the production of tissue at the site of injury which has a similar structure and provides protection to the body. Any alterations in the normal healing process can lead to delayed healing or additional tissue damage. Factors that contribute to aberrant wound healing can be species‐specific and include both intrinsic (systemic) factors and extrinsic (environmental) factors. Management of wounds and recognition of alterations can be optimised by adoption of a structured framework for wound assessment, such as the TIME principle (acronym referring to the following categories: tissue, inflammation or infection, moisture, and edge of wound or epithelial advancement). This review article provides an overview of the phases of wound healing, variation of healing among different species, factors reported to delay healing, and an introduction to the TIME principle as a structured approach to clinical evaluation of wounds.
Brachycephalic airway syndrome (BAS) is characterized by increased upper airway resistance due to conformational abnormalities occurring in brachycephalic dogs (BD). In this prospective study, we evaluated pulse oximetry (SpO2) and arterial blood gas values in 18 healthy BD and compared these values with those of 18 healthy mesocephalic and dolichocephalic dogs (MDD). All dogs were assigned a BAS score based on an owner questionnaire. Inclusion criteria included presentation to the hospital for a problem unrelated to the respiratory system and unremarkable blood analyses and physical examination. In awake dogs, SpO2 values were obtained from a minimum of two sites. Dogs were then sedated, and SpO2 values were obtained again concurrently with an arterial blood gas sample. The SpO2 values were significantly lower in BD compared with MDD, but there were no statistically significant differences between BD and MDD for any arterial blood gas parameters. Based on the BAS score, BD who were moderately BAS-affected (n = 5), had significantly lower arterial saturation of hemoglobin with oxygen values on arterial blood gas when compared with MDD (n = 18). Although BD had statistically lower SpO2 values than MDD, the mean SpO2 values for both groups were within the normal range.
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