The purpose of this study was to describe elective and nonelective post-cholecystectomy complications and mortality rates in dogs with a gall bladder mucocele. The secondary purpose was to report complications and mortality rates for different methods of common bile duct catheterisation.Materials and MethOds: A multi-institutional retrospective case series was performed to identify dogs with a gall bladder mucocele between 2004 and 2018 that underwent a cholecystectomy. Dogs were classified into nonelective or elective based on the presence or absence, respectively, of gall bladder rupture, biliary duct distension, clinical signs or hyperbilirubinemia. Each cholecystectomy was classified into three groups: duodenotomy and retrograde catheterisation, normograde catheterisation or no catheterisation. Complications were divided into four grades based on increasing severity and mortality rates were assessed for each. results: The mortality rate was 2 (6%) out of 31 for dogs undergoing an elective cholecystectomy and 21 (23%) out of 90 for dogs undergoing a nonelective cholecystectomy. The complication rate was 52% for the elective cholecystectomy and 50% for nonelective cholecystectomy. The majority of the complications in the elective category were grade 1 (mild). Post-operative hyperthermia developed in 35% of dogs that had a duodenotomy and retrograde common bile duct catheterisation, in 4% of dogs with a normograde common bile duct catheterisation and in 7% of dogs that did not have the common bile duct catheterised. clinical significance: Elective cholecystectomy in dogs with a gall bladder mucocele in this study carried a low mortality rate and a relatively high frequency of minor complications.
Objective: To determine the incidence of and risk factors for surgical site infection (SSI) following canine thoracic and pelvic limb amputations.Study design: Retrospective, multicenter study. Animals: Dogs (n = 248).Methods: Medical records were reviewed for preoperative, intraoperative, and postoperative variables including indication for amputation, amputation type, method of muscle transection, duration of surgery and anesthesia, and wound classification. Follow up was ≥30 days or until SSI development. Logistic regression and Fisher's exact tests were used to compare SSI incidence to variables of interest.Results: The incidence of SSI was 12.5% for all procedures and 10.9% for clean procedures. Factors increasing odds of SSI were muscle transection with a bipolar vessel sealing device (P = .023 for all procedures, P = .025 for clean procedures), procedure classified as other than clean (P = .003), and indication for amputation of bacterial infection (P = .041) or traumatic injury (P = .003) compared to neoplasia. Conclusion:Use of bipolar vessel sealing devices for muscle transection increased the odds of developing an SSI whereas use of electrosurgery and/or sharp transection did not. Dogs with surgical sites that were other than clean, or with bacterial infection and/or traumatic injury were also at increased odds of SSI.Clinical significance: Use of electrosurgery or sharp transection for muscle transection should be considered rather than use of bipolar vessel sealing devices to decrease odds of SSI in dogs undergoing limb amputation. Further studies across a variety of procedures are needed to validate these findings given the increasing popularity of these devices in veterinary medicine. | INTRODUCTIONThoracic and pelvic limb amputations are commonly performed in dogs for neoplasia, orthopedic injuries, severe soft tissue trauma, neurologic diseases, unresolvable infections, congenital deformities, and vascular compromise. 1,2 The most common postoperative complications following limb amputations include
To evaluate the prognostic utility of the quick sequential organ failure assessment score in dogs with severe sepsis and septic shock presenting to an emergency service, and evaluate the clinical value of the quick sequential organ failure assessment score to predict severe sepsis and septic shock. Materials and MethOds:The quick sequential organ failure assessment score was calculated by evaluating respiratory rate (>22 breaths per minute), arterial systolic blood pressure (≤100 mmHg) and altered mentation. The quick sequential organ failure assessment scores with respiratory rate cut-offs of greater than 22, greater than 30 and greater than 40 were compared. Cases were defined as dogs presented to the emergency room and met at least 2 systemic inflammatory response syndrome criteria, had documented infection, and at least one organ dysfunction. A control population of dogs included animals with non-infectious systemic inflammatory response syndrome.results: Forty-five dogs with severe sepsis and septic shock and 45 dogs with non-infectious systemic inflammatory response syndrome were included in the final analysis. The quick sequential organ failure assessment provided poor discrimination between survivors and non-survivors for severe sepsis and septic shock (area under receiving operating characteristic curve, 0.51; 95% confidence interval, 0.35 to 0.67). Discrimination remained poor when quick sequential organ failure assessment greater than 30 and quick sequential organ failure assessment greater than 40 scores were calculated (area under receiving operating characteristic curve, 0.56; 95% confidence interval, 0.39 to 0.72, and 0.54; 95% confidence interval, 0.36 to 0.71). The quick sequential organ failure assessment of at least 2, quick sequential organ failure assessment greater than 30 of at least 2 and quick sequential organ failure assessment greater than 40 of at least 2 produced sensitivity and specificity to detect severe sepsis and septic shock of 66. 7% and 64.5%, 62.2% and 71.1%, 44.4% and 80%, respectively. cOnclusiOn and clinical significance: Scoring systems utilised in emergency rooms should have high sensitivity to reduce missed sepsis cases and treatment delays. The use of the quick sequential organ failure assessment for severe sepsis and septic shock demonstrated poor mortality prediction and low sensitivity to detect canine patients with severe sepsis and septic shock and should not be used alone when screening for sepsis.
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