Objective: To report the incidence of postattenuation seizures (PAS) in dogs that underwent single congenital extrahepatic portosystemic shunt (cEHPSS) attenuation and to compare incidence of PAS in dogs that either did or did not receive prophylactic treatment with levetiracetam (LEV). Study design: Multi-institutional retrospective study. Population: Nine hundred forty dogs. Methods: Medical records were reviewed to identify dogs that underwent surgical attenuation of a single cEHPSS from January 2005 through July 2017 and developed PAS within 7 days postoperatively. Dogs were divided into 3 groups: no LEV (LEV−); LEV at ≥15 mg/kg every 8 hours for ≥24 hours preoperatively or a 60 mg/kg intravenous loading dose perioperatively, followed by ≥15 mg/kg every 8 hours postoperatively (LEV1); and LEV at <15 mg/kg every 8 hours, for <24 hours preoperatively, or continued at <15 mg/kg every 8 hours postoperatively (LEV2).Preliminary results of this study were presented at the Association
Objective: To identify prognostic factors for short-term survival of dogs that experienced seizures within seven days following surgical correction of single congenital extrahepatic portosystemic shunts (cEHPSS).Study Design: Multi-institutional retrospective study. Sample Population: Ninety-three client-owned dogs. Methods: Medical records at 14 veterinary institutions were reviewed to identify dogs that underwent surgical attenuation of a single cEHPSS from January 1 st 2005 through February 28 th 2018 and experienced post-attenuation seizures (PAS) within seven days postoperatively. Logistic regression analysis was performed to identify factors associated with one month survival. Factors investigated included participating institution, signalment, shunt morphology, concurrent/historical conditions, presence of preoperative neurologic signs, presence of preoperative seizures, aspects of preoperative medical management, surgical details including method and degree of shunt attenuation, type of PAS (focal only or generalized +/-focal), drugs administered as part of the treatment of PAS, and development of complications during treatment of PAS. Results: Thirty (32.3%) dogs survived to 30 days. Seventy-six (81.7%) dogs experienced generalized PAS. Factors positively associated with short-term survival included having a history of preoperative seizures (p=0.004) and development of focal PAS only (p=0.0003).The majority of non-survivors were humanely euthanized due to uncontrolled or recurrent seizures.Conclusions: Dogs that experienced PAS that had a history of preoperative seizures and those that experienced focal PAS only had significantly improved short-term survival. Clinical Significance:The results of this study will help in the counseling of owners who seek treatment for PAS following surgical correction of cEHPSS.
CASE DESCRIPTION A 6-year-old neutered male domestic shorthair cat was evaluated because of signs of abdominal pain and anuria of 12 hours' duration after vehicular trauma. CLINICAL FINDINGS Lethargy, mydriasis, bradycardia, abdominal distension, and signs of pain on abdominal palpation were observed. Abdominal ultrasonography revealed moderate urinary bladder distension without evidence of free abdominal fluid; hematologic evaluation revealed leukocytosis with high BUN and serum creatinine concentrations. TREATMENT AND OUTCOME The patient was hospitalized, medical stabilization was attempted, and an indwelling urinary catheter was placed. Urinary output was < 1 mL/kg/h (< 0.45 mL/lb/h), and signs of abdominal pain persisted despite treatment. The next day, ultrasonographic examination revealed fluid in the retroperitoneal space, and ureteral rupture was suspected. Exploratory laparotomy confirmed retroperitoneal fluid accumulation; a large hematoma surrounded the right kidney and perirenal structures. An abdominal drain was placed to aid patient stabilization. Three days later, IV pyelography revealed rupture of the proximal part of the right ureter. Ureteroneocystostomy was performed with elongated cystoplasty through a Boari flap and caudal transposition of the right kidney (renal descensus). On follow-up examination 18 months after treatment, the cat was free of clinical signs, and results of ultrasonography, CBC, and serum biochemical analysis were unremarkable. CLINICAL RELEVANCE Results suggested that a Boari flap procedure with renal descensus could be a feasible alternative in the management of proximal ureteral rupture in cats, but research is needed in this area.
There is an important morbidity associated with parotidectomy. The most commonly reported permanent complication is facial nerve injury. Methylene blue staining has been used as an intra-operative tool to improve tissue visualisation and preserve facial nerve integrity. objectIves: To describe the functionality and feasibility of the use of methylene blue for parotidectomy in dogs. MaterIals and Methods: Retrospective study included seven client-owned dogs that underwent parotidectomy after injection of methylene blue from 2016 to 2019 in a referral centre. Cross-sectional imaging was used to confirm parotid gland surgical disease and for staging purposes. All dogs underwent parotid resection and removal of the parotid duct after injection of methylene blue. Methylene blue was either administered via cannulation of the parotid duct or directly injected into the abnormal gland. results: In all cases, the gland stained dark blue within seconds without any evident leakage. Complete parotid gland resection and removal of the parotid duct was achieved successfully in all dogs with a mean surgical time of 97 minutes. Subjectively, the staining was useful to identify innervation outside the coloured gland and facilitated dissection. No complications, including facial nerve injury, were recorded. clInIcal sIgnIfIcance: Methylene blue staining for complete parotidectomy was feasible, rapid and easy in these dogs. It can be used as an indirect facial nerve identification technique, and can therefore facilitate dissection and possibly reduce the incidence of post-operative facial nerve paralysis.
Major goals in maxillofacial fracture treatment include to restore the dental occlusion, stabilise the major skeletal supports, restore the contour of the face and achieve proper function and appearance of the face. Titanium is considered an optimal material for maxillofacial reconstruction due to its biocompatibility, high strength, minimal inflammatory reaction and minimal imaging artefact.objectIves: To describe the clinical details, surgical technique, pre-and postoperative imaging and short-and long-term follow-up of severely comminuted maxillofacial fractures treated with titanium mesh and titanium screws in dogs.MaterIals and Methods: Retrospective short case series included four client-owned dogs with maxillofacial fractures. After appropriate medical stabilisation, preoperative CT examination of the head was obtained in all patients for evaluation of fracture configuration and surgical planning. The maxillofacial fractures were stabilised by titanium mesh osteosynthesis. Short-and long-term clinical and radiographic follow-ups were available for all dogs.results: Proper dental occlusion and reconstruction of the anatomic buttresses was achieved in all cases.All dogs recovered uneventfully from the surgery and no complications were recorded on the long-term follow-up up to 43 months. Occlusion was maintained in all dogs, as well as excellent cosmesis of the midface. clInIcal sIgnIfIcance: Titanium mesh osteosynthesis can achieve sufficient rigidity and lead to uncomplicated healing of severely comminuted maxillofacial fractures. This internal fixation method can be considered a valuable option to treat maxillofacial fractures in particular in cases of large bone defect and midface reconstruction.
ObjectivesTo report early results of uniportal video‐assisted thoracoscopic surgery in dogs using a single‐incision subxiphoid approach.Materials and MethodsRetrospective study of 10 client‐owned dogs with: pyothorax (n=5), pericardial effusion (n=2), bilateral pneumothorax (n=1), retained surgical swab (n=1), cranial mediastinal mass (n=1). With the dog in dorsal recumbency a 3‐4 cm incision was made over the xiphoid process. After resection of the xiphoid process, a tunnel was created towards the pleura and open access maintained with an Alexis™ wound retractor. The pleural cavity was explored with a 10 mm 30° or 5 mm 0° telescope and straight laparoscopic instruments.ResultsMedian surgical time was 75 minutes. The SISA technique was performed successfully in five of 10 cases and allowed easy and adequate inspection of the intra‐thoracic structures. One case was converted to lateral thoracotomy after laceration of the vena cava and one converted to median sternotomy because of adhesions. An additional port was placed in three cases to facilitate triangulation and surgical manipulation. No other intra‐operative complications were encountered.Clinical SignificanceIn this initial report of uniportal thoracic approach in dogs, this technique allowed excellent access and treatment of mediastinal structures. Further cases are required to assess its suitability for pulmonary surgery.
Computer-aided design (CAD) and computer-aided manufacturing (CAM) technology is routinely used in various fields of human dentistry, particularly prosthodontics. Reverse engineering and additive manufacturing allow the technician to create an easier, faster and more accurate restoration, with a natural design and adequate strength. Eighteen titanium alloy full crowns were produced for canine teeth of 7 working dogs using CAD/CAM technology (3D BioCare, Nobel Biocare). Reasons for crown therapy included abrasion, enamel infraction, and crown fracture. Crown preparation was routinely performed, and impressions were delivered to the laboratory where digital impressions were performed with a lab scanner. Using 3D dental design software, the metal crown was designed and sent for manufacture. Each prosthodontic crown was then carved from a solid titanium alloy block to obtain the final crown. All prosthodontic crowns were an adequate fit, and cementation was routinely performed. Crowns were lost from 2 canine teeth during the dogs' normal working activity, in one case, for 2 times. In all cases, replicas were requested. In the first case, the second cementation was successful. In the second case, the second crown was again lost and only the third cementation was successful. Follow up of all cases range from 12 to 62 months. Mean survival time for the crowns was 58.0 months. Here, CAD/CAM technology is shown to be a useful tool for manufacturing accurate prosthodontic crowns for veterinary patients. Moreover, CAD/CAM enables the production of prosthodontic crown replicas in a very short time and at relatively low cost compared to traditional methods, consequently eliminating the need for at least one anesthetic procedure in the incidence of crown cementation failure.
A three-year-old female spayed Lurcher was referred for the treatment of a highly comminuted distal tibial articular fracture. Resection of the area of comminution with a transverse osteotomy of the tibial diaphysis and talar ridges was performed, followed by modified pantarsal arthrodesis and a calcaneotibial screw. The treatment resulted in 7 cm of tibial shortening, equating to a 28% reduction in the total tibial length. Radiographic union of the arthrodesis was successful. Fair use of the pelvic limb was documented long-term. Combined acute limb shortening and modified pantarsal arthrodesis resulted in an acceptable outcome and could be considered in cases of highly comminuted distal tibial fractures.
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