Objective: To determine the outcome and prognostic variables associated with long-term survival and complications in dogs undergoing hepatic lobectomy of the central division. Study design: Multi-institutional retrospective case series. Animals: Sixty-one client-owned dogs with central division masses. Methods: Medical records of dogs undergoing hepatic lobectomy of the central division from January 1, 2000 to January 1, 2015 were reviewed for signalment, clinical signs, preoperative staging, preoperative cytology or biopsy results, date of procedure, location of mass, surgical technique, whether cholecystectomy or cholecystopexy was performed, complications, histopathologic diagnosis and margin evaluation, date of local recurrence or detection of metastatic disease, and survival. Results: Hilar resection was associated with increased intraoperative and postoperative complications. Intraoperative complications occurred in 29 dogs, with 20 dogs experiencing intraoperative hemorrhage. Nineteen dogs required transfusions. Immediate postoperative complications occurred in 20 dogs. Perioperative mortality rate was 11%, and 2-week mortality rate was 14.7%. The median survival time for dogs with hepatocellular carcinoma (HCC) was not reached. The 1-and 3-year censored survival rates for dogs with HCC was 82.1% and 82.1%, respectively. Margin status did not impact survival time. Conclusion: Hepatic lobectomy of the central division was associated with hemorrhage in approximately 33% of dogs, but there was a relatively low perioperative mortality rate. Hepatic lobectomy for HCC resulted in long-term survival, regardless of margin status. Clinical significance: Surgeons should anticipate the requirement for blood products in dogs that may require hepatic lobectomy of the central division. Long-term survival can be expected after surgical treatment of HCC, regardless of margin status.

BackgroundAnterior cruciate ligament rupture (ACLR) is a debilitating and potentially life-changing condition in humans, as there is a high prevalence of early-onset osteoarthritis after injury. Identification of high-risk individuals before they become patients is important, as post-treatment lifetime burden of ACLR in the USA ranges from $7.6 to $17.7 billion annually. ACLR is a complex disease with multiple risk factors including genetic predisposition. Naturally occurring ACLR in the dog is an excellent model for human ACLR, as risk factors and disease characteristics in humans and dogs are similar. In a univariate genome-wide association study (GWAS) of 237 Labrador Retrievers, we identified 99 ACLR candidate loci. It is likely that additional variants remain to be identified. Joint analysis of multiple correlated phenotypes is an underutilized technique that increases statistical power, even when only one phenotype is associated with the trait. Proximal tibial morphology has been shown to affect ACLR risk in both humans and dogs. In the present study, tibial plateau angle (TPA) and relative tibial tuberosity width (rTTW) were measured on bilateral radiographs from purebred Labrador Retrievers that were recruited to our initial GWAS. We performed a multivariate genome wide association analysis of ACLR status, TPA, and rTTW.ResultsOur analysis identified 3 loci with moderate evidence of association that were not previously associated with ACLR. A locus on Chr1 associated with both ACLR and rTTW is located within ROR2, a gene important for cartilage and bone development. A locus on Chr4 associated with both ACLR and TPA resides within DOCK2, a gene that has been shown to promote immune cell migration and invasion in synovitis, an important predictor of ACLR. A third locus on Chr23 associated with only ACLR is located near a long non-coding RNA (lncRNA). LncRNA’s are important for regulation of gene transcription and translation.ConclusionsThese results did not overlap with our previous GWAS, which is reflective of the different methods used, and supports the need for further work. The results of the present study are highly relevant to ACLR pathogenesis, and identify potential drug targets for medical treatment.Electronic supplementary materialThe online version of this article (10.1186/s12863-018-0626-7) contains supplementary material, which is available to authorized users.

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BackgroundTotal hip arthroplasty is a common procedure being performed at an increasing rate in the United States. Recovering from this surgery to the extent that one can participate in criteria for discharge relies heavily on effective postoperative analgesia. Many regional anesthetic techniques are deployed in this realm. The recent utilization of quadratus lumborum (QL) blocks with success in other procedures warrants investigation in the hip arthroplasty population.MethodsTwenty patients received general anesthesia for elective total hip arthroplasty. Ten cases included a preoperative ultrasound-guided transmuscular quadratus lumborum block with 30 cc 0.5% ropivacaine. Ten cases that lacked this regional procedure. The primary outcome was length of hospital stay. Secondary outcomes include total procedure time, intraoperative and postoperative fentanyl administration, and mean postoperative visual analog pain scores (VAS 1 - 10).ResultsLength of stay was shorter in patients receiving QL block (2.9 days) versus patients not receiving QL block (5.1 days) (P value 0.0146). Intra-operative use of fentanyl was lower in patients receiving QL block (183.5 mcg) versus patients not receiving QL block (240 mcg) (P value 0.0376). PACU narcotic utilization, 24-hour VAS score, and length of operative procedure lacked statistical significance, though the study was not powered for these outcomes.ConclusionsQL block employment in hip surgery produces significant reduction in length of stay and intraoperative fentanyl use. While quadratus lumborum blocks are rapidly becoming a popular option due to its quality and spread of analgesia, more adequately powered prospective research must be performed to appropriately elucidate significant trends.

Peripheral nerve blocks are an often-utilized and efficacious method of analgesia for orthopaedic surgery about the knee. Benefits include decreased pain and narcotic use, increased participation in postoperative physical therapy, and decreased length of hospital stay. Adductor canal blocks have the advantage of preserving quadriceps function for early postoperative range of motion and walking. The risk of serious complications resulting from a peripheral nerve block is relatively low, ranging from 0% to 3%.