To determine whether results of histologic examination of hepatic biopsy samples could be used as an indicator of survival time in dogs that underwent surgical correction of a congenital ...portosystemic shunt (PSS).
Retrospective case series.
64 dogs that underwent exploratory laparotomy for an extrahepatic (n = 39) or intrahepatic (25) congenital PSS.
All H&E-stained histologic slides of hepatic biopsy samples obtained at the time of surgery were reviewed by a single individual, and severity of histologic abnormalities (ie, arteriolar hyperplasia, biliary hyperplasia, fibrosis, cell swelling, lipidosis, lymphoplasmacytic cholangiohepatitis, suppurative cholangiohepatitis, lipid granulomas, and dilated sinusoids) was graded. A Cox proportional hazards regression model was used to determine whether each histologic feature was associated with survival time.
Median follow-up time was 35.7 months, and median survival time was 50.6 months. Thirty-eight dogs were alive at the time of final follow-up; 15 had died of causes associated with the PSS, including 4 that died immediately after surgery; 3 had died of unrelated causes; and 8 were lost to follow-up. None of the histologic features examined were significantly associated with survival time.
Findings suggested that results of histologic examination of hepatic biopsy samples obtained at the time of surgery cannot be used to predict long-term outcome in dogs undergoing surgical correction of a PSS.
To determine factors associated with long-term survival after biliary surgery in dogs.
Retrospective case series.
34 dogs that underwent biliary surgery.
Data extracted from medical records included ...sex, breed, body weight, age at surgery, history and clinical examination findings, preoperative and postoperative CBC, serum biochemical panel and coagulation profiles results, abdominal ultrasonographic findings, results of bacteriologic culture and histologic examination, surgical findings, postoperative complications, and survival time. Follow-up information was obtained from medical records or phone conversations with owners and referring veterinarians.
Primary biliary findings included gallbladder mucocele (n = 20 dogs), inflammatory diseases (4), trauma (3), and neoplasia (1). Secondary biliary diseases included pancreatitis (n = 4), pancreatic neoplasia (1), and duodenal perforation (1). One- and 2-year survival rates were both 66%. Increasing age; gamma-glutamyltransferase activity; preanesthetic heart rate; BUN, phosphorus, and bilirubin concentrations; and the use of biliary diversion procedures were risk factors for death, although pancreatitis was not. However, poor long-term survival was associated with pancreatitis.
Long-term prognosis was guarded after biliary surgery in dogs. However, dogs that survived the early postoperative period had good long-term prognosis. Dogs with pancreatitis had poor prognosis. Overall, the prognosis was worse for dogs that underwent a biliary diversion, compared with dogs that did not.
Laparoscopy Monnet, Eric; Twedt, David C
The Veterinary clinics of North America. Small animal practice,
09/2003, Letnik:
33, Številka:
5
Journal Article
Recenzirano
Laparoscopy is a minimally invasive technique for both diagnostic biopsy and surgical procedures. After the basic technique of laparoscopy is mastered and the appropriate indications are learned, ...these procedures become an easy and rewarding addition to any small animal veterinary practice.
To evaluate changes in pH of peritoneal fluid associated with CO2 insufflation during laparoscopy in dogs.
13 client-owned dogs and 10 purpose-bred teaching dogs.
Laparotomy was performed on control ...dogs; peritoneal fluid pH was measured at time of incision of the abdominal cavity (time 0) and 30 minutes later. Laparoscopic insufflation with CO2 was performed and routine laparoscopic procedures conducted on the teaching dogs. Insufflation pressure was limited to 12 mm Hg. Intraperitoneal fluid pH was measured by use of pH indicator paper at 4 time points. Arterial blood gas analysis was performed at the same time points.
Peritoneal fluid pH did not change significantly between 0 and 30 minutes in the control dogs. For dogs with CO2 insufflation, measurements obtained were a mean of 8.5, 24.5, 44.5, and 72.0 minutes after insufflation. The pH of peritoneal fluid decreased significantly between the first (7.825 +/- 0.350) and second (7.672 +/- 0.366) time point. Blood pH decreased significantly between the first (7.343 +/- 0.078), third (7.235 +/- 0.042), and fourth (7.225 +/- 0.038) time points. The PaCO2 increased significantly between the first (39.9 +/- 9.8 mm Hg) and fourth (54.6 +/- 4.4 mm Hg) time points. Base excess decreased significantly between the first and all subsequent time points.
Pneumoperitoneum attributable to CO2 insufflation caused a mild and transient decrease in peritoneal fluid pH in dogs. Changes in peritoneal fluid associated with CO2 insufflation in dogs were similar to those in other animals.
The Mississippi Alluvial Valley is a floodplain along the southern extent of the Mississippi River extending from southern Missouri to the Gulf of Mexico. This area once encompassed nearly 10 million ...ha of floodplain forests, most of which has been converted to agriculture over the past two centuries. Conservation programs in this region revolve around protection of existing forest and reforestation of converted lands. Therefore, an accurate and up to date classification of forest cover is essential for conservation planning, including efforts that prioritize areas for conservation activities. We used object-based image analysis with Random Forest classification to quickly and accurately classify forest cover. We used Landsat band, band ratio, and band index statistics to identify and define similar objects as our training sets instead of selecting individual training points. This provided a single rule-set that was used to classify each of the 11 Landsat 5 Thematic Mapper scenes that encompassed the Mississippi Alluvial Valley. We classified 3,307,910±85,344ha (32% of this region) as forest. Our overall classification accuracy was 96.9% with Kappa statistic of 0.96. Because this method of forest classification is rapid and accurate, assessment of forest cover can be regularly updated and progress toward forest habitat goals identified in conservation plans can be periodically evaluated.
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•We classified 3,307,910ha ±170,687,32% of the MAV as forest.•Overall classification accuracy of 96.9% and Kappa statistic of 0.96.•We support that this method of classification is rapid and accurate.
The objective of this study was to determine whether healthy dogs undergoing elective surgery will accept and prefer an oral recuperation fluid (ORF) to water during the perioperative time period and ...if the consumption of an ORF would lead to increased caloric intake during the final preoperative and first postoperative periods. This prospective, observational study was performed in the setting of a University Veterinary Teaching Hospital. A total of 67 healthy dogs were presented for routine ovariectomy (n = 30) or castration (n = 37). Before surgical intervention, dogs were offered an ORF to assess their voluntary acceptance of the fluid. After 2 hours, the ORF was offered alongside water to assess fluid preference. Routine castration or ovariectomy was then performed. During the immediate postoperative period, dogs were reassessed as to their acceptance and preference of the ORF. A high percentage of dogs accepted the ORF in both the preoperative (55/67, 82%) and postoperative (42/67, 63%) periods (P < .01 and P = .04, respectively). Of dogs that demonstrated a preference between the ORF and water, 87% (95% CI: 77%-93%) chose the ORF preoperatively, whereas 98% (95% CI: 87%-99.5%) chose the ORF postoperatively (P < .01 and P < .01, respectively). Dogs that consumed the ORF in each measurement period ingested a higher amount of food (measured as percentage of kilocalories offered) when compared with those that did not consume the ORF (preoperatively 83% vs. 49%, P < .01; postoperatively 51% vs. 27%, P = .01). A commercially manufactured veterinary ORF was found to be palatable, as determined by acceptance and preference testing, in healthy dogs during the preoperative and postoperative phases of routine sterilization. Further studies in dogs undergoing more intensive surgical procedures or recovering from nonsurgical illness or both are warranted.
A 15-week-old, male intact, miniature schnauzer presented for signs consistent with persistent right aortic arch (PRAA). Esophagram and esophagoscopy confirmed this diagnosis. Following selective ...intubation, the constricting ligamentum arteriosum was visualized and completely resected via thoracoscopy. No complications were noted with this procedure. Advantages of thoracoscopy for management of persistent right aortic arch observed in this case were better visualization of the ligamentum arteriosum, minor postoperative discomfort, and minimal intraoperative hypothermia. Therefore, thoracoscopy is a potential alternative to intercostal thoracotomy for correction of PRAA.
Background
The objective of this study is to describe the use of targeted therapies for the treatment of advanced renal cell carcinoma (RCC) and overall survival (OS) among patients in clinical ...practice in the Veterans Health Administration (VHA).
Methods
A retrospective cohort of 286 patients from 24 VHA Medical Centers diagnosed with advanced clear cell RCC between Fiscal Year (FY) 2010 and FY2014 was followed through September 30, 2016. Among patients who received targeted therapy, we described the medications taken, duration of therapy, and overall survival. We also assessed the effect of the first therapy received on overall survival using Cox Proportional Hazards models.
Results
There were 66 patients who did not receive therapy for their advanced RCC. Of the 220 treated patients, the mean (sd) number of medications received was 1.9 (1.1). The medications most commonly used first were sunitinib (61.8%), pazopanib (17.3%), and temsirolimus (10.9%). The median duration of first‐line therapy was 86 days (interquartile range IQR 42, 210). Median total duration of therapy was 159 days (IQR 58, 397). 62.3% of patients had ≥ 1 dose of therapy held or reduced, mainly due to an adverse drug event (ADE). Median survival from the start of treatment to death was 1.08 years (IQR 0.80, 1.31). Finally, receipt of temsirolimus vs sunitinib (HR 1.95 95%CI 1.09,3.47) as the first targeted therapy was independently associated with an increased hazard of death.
Conclusion
Our analysis of targeted therapies for advanced RCC in VHA suggests duration of treatment is shorter in a real‐world setting than in clinical trials, and dose reductions and ADEs are more common.
Our analysis of targeted therapies for advanced renal cell carcinoma in Veterans Health Administration suggests duration of treatment is shorter in a real‐world setting than in clinical trials, and dose reductions and adverse drug events are more common.
We have reported tablet‐induced focal esophagitis and esophageal stricture formation in cats. The proposed mechanism is thought to be abnormal esophageal tablet retention resulting in focal ...esophagitis with subsequent stricture formation. The objective of this study was to evaluate the passage of tablets and capsules when given alone (dry swallow) and when followed by a water bolus (wet swallow) to determine if this could, in part, explain the esophageal stricture formation we have observed in cats. Fluoroscopy was used to evaluate tablet or capsule passage after administration. The percentage of dry tablet swallows that successfully passed into the stomach was 0.0% at 30 and 60 seconds, 6.7% at 90 seconds, 13.3% at 120 seconds, 26.7% at 180 and 240 seconds, and 36.7% at 300 seconds. Wet tablet swallows successfully passed 90.0% of the time at 30 seconds, 93.3% of the time at 60 seconds, and 100.0% of the time thereafter. The percentage of dry capsule swallows that successfully passed was 16.7% at each time interval. Wet capsule swallows successfully passed 96.7% of the time at 30 seconds and 100% of the time thereafter. For each time interval, wet swallows achieved significantly greater percentage passage into the stomach when compared to dry swallows (P < .05). This study shows that tablets or capsules given by dry swallow have prolonged retention in the esophagus compared to those given by wet swallow. On the basis of this study, we recommend the routine administration of a water bolus to cats receiving tablets or capsules PO to facilitate esophageal clearance. This practice may help prevent medication‐associated esophagitis or stricture formation.
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