Objective
To evaluate the intervertebral disk, vertebral endplates, and spinal cord for perioperative changes secondary to percutaneous laser disk ablation (PLDA) and correlate findings to clinical ...outcomes in dogs receiving thoracolumbar PLDA.
Study Design
Blinded study.
Animals
Thirty dogs.
Methods
Magnetic resonance imaging (MRI) was performed before PLDA (control/Group C), immediately following PLDA (Group I), and 3 months later (perioperative/Group P). Dogs were followed 3 years. Groups and dogs were randomized for evaluation. Two radiologists were blinded to each MRI study and dog. Each radiologist evaluated the disk, vertebral body, and spinal cord at each disk space receiving PLDA.
Results
Mean disk degeneration was increased in Group P at L1‐2 (p < .0001) and L2‐3 (p = .0081). Both radiologists identified mild diskitis (1%–15%) in Group P (radiologist 1, p < .0001; radiologist 2, p = .0012). Cranial endplate lesions were identified in Group P at T11‐12 (p = .0353), T13‐L1 (p = .0026), and L4‐5 (p = .0210). Lesions were identified in the caudal endplates of all eight disk spaces in Group P: T10‐11 (p = .0004), T11‐12 (p < .0001), T12‐13 (p < .0001), T13‐L1 (p < .0001), L1‐2 (p < .0001), L2‐3 (p < .0001), L3‐4 (p < .0001), and L4‐5 (p < .0001). There was no disk extrusion or spinal cord lesions identified.
Conclusion
This study evaluated effects that may occur secondary to PLDA, using MRI. Although vertebral body changes were identified, they did not correlate with clinical complications.
Clinical Significance
PLDA appears to be a safe, effective procedure performed on thoracolumbar disks to reduce recurrence of intervertebral disk herniation (IVDH) in dogs that previously experienced IVDH, despite the appearance of visible vertebral endplate lesions and mild diskitis on MRI.
Objective
To evaluate gastrointestinal injury and outcomes between dogs treated with immediate surgical intervention vs those treated with delayed surgical intervention for gastrointestinal foreign ...body obstruction (GIFBO).
Study design
Retrospective cohort study.
Sample population
Client‐owned dogs (n = 855) from five referral hospitals.
Methods
Medical records of dogs in which GIFBO had been diagnosed between 2007 and 2017 were reviewed for preoperative management, timing of surgery, intraoperative findings, postoperative management, outcome, and survival. Surgical intervention was classified as immediate when it occurred within 6 hours of presentation and delayed when it occurred >6 hours after presentation.
Results
Outcomes did not differ between dogs treated immediately (n = 584) or over 6 hours after presentation (n = 210). Intestinal necrosis and perforations were more common when surgery was delayed (P = .008; P = .019) but became nonsignificant after controlling for preoperative differences. Risk factors for necrosis and perforations included duration of clinical signs, increased lactate, linear foreign material, and timing of surgery. Enterectomies (P = .004) as well as the duration of surgery (P = .004) and anesthesia (P = .001) were increased when surgery was delayed. Immediate surgery was associated with earlier return to feeding (P = .004) and discharge from the hospital (P < .001); (5%) dogs in each group (n = 33 immediate; n = 11 delayed) either had a negative explore or the foreign body was milked aborally into the colon at the time of surgery.
Conclusion
Although outcomes were not associated with surgical timing, the unadjusted prevalence of gastrointestinal injury and, thus, the requirement for complex surgical procedures was higher in the delayed group.
Clinical significance: Earlier surgical treatment of stabilized dogs with GIFBO may involve fewer complex procedures and accelerate recovery.
This prospective clinical study sought to determine the accuracy of cytopathologic examination and needle-core biopsy (NCB) against diagnoses obtained by excisional histopathology (EH) for canine ...splenic masses. Twenty-five masses were evaluated ex vivo by ultrasound-guided fine-needle
aspiration (FNA) and NCB tissue sampling. Each spleen was placed in a container and artificial skin placed over its surface. Ultrasound-guided FNA using a 22-gauge needle and 2 NCB samples 14-gauge (NCB-14), 16-gauge (NCB-16) were obtained and submitted for analysis. Results were compared
to results obtained by splenic excisional histopathology (EH). There was no difference noted between FNA, NCB-14, or NCB-16 analyses. In addition, there was no difference in accuracy between FNA and NCB-14 or between FNA and NCB-14 versus NCB-16. Reported accuracy of FNA was 0.72, NCB-14
was 0.72, and NCB-16 was 0.64, respectively. Both FNA and NCB-14 displayed a sensitivity of 71% and NCB-16 a sensitivity of 53%. Both FNA and NCB-14 displayed a specificity of 75% and NCB-16 a specificity of 88%. The results demonstrated that NCB had no advantage clinically over FNA at diagnosing
splenic pathology. This study further demonstrates that preoperative diagnostic evaluation of the spleen is not highly accurate and cannot be recommended prior to splenectomy.
CASE DESCRIPTION A 6-month-old sexually intact male domestic shorthair cat was referred for evaluation of a heart murmur and ventricular septal defect (VSD). CLINICAL FINDINGS Physical examination ...revealed a grade 5/6 right apical systolic heart murmur. Findings on thoracic radiography were consistent with moderate right and left ventricular enlargement, left atrial enlargement, and enlargement of the pulmonary arteries and veins; an interstitial pulmonary pattern was also evident. Echocardiography revealed a perimembranous VSD with left-to-right shunting combined with trace mitral valve regurgitation. The cat later developed a dry cough, the intensity of the heart murmur increased to grade 6/6, and signs of left-sided congestive heart failure developed. TREATMENT AND OUTCOME Medical treatment included enalapril maleate and furosemide. When the cat's condition worsened despite medical treatment, palliative pulmonary artery banding was performed. During surgery, blood pressure in the pulmonary artery was measured with a pulmonary artery catheter, and pulmonary artery banding was successfully achieved with a polytetrafluoroethylene band and hemoclips. The pulmonary-to-systemic blood flow ratio was reduced from 3 to 1.5, and signs of congestive heart failure resolved within 2 weeks after surgery. CLINICAL RELEVANCE Findings suggested that cats with a VSD and pulmonary-to-systemic flow ratio > 3 or with congestive heart failure attributable to a VSD could be considered candidates for palliative pulmonary artery banding to alleviate clinical signs. However, further investigation into long-term prognosis with objective outcome measurements and with multiple cases is needed. (J Am Vet Med Assoc 2019;254:723-727).
OBJECTIVE To determine rate of recurrence of disk herniation in dogs that underwent percutaneous laser disk ablation (PLDA) because of a previous episode of suspected or confirmed thoracolumbar ...intervertebral disk herniation (IVDH). DESIGN Retrospective case series. ANIMALS 303 dogs that underwent PLDA and for which a minimum of 3 years of follow-up information was available (n = 294) or for which recurrence was documented within 3 years after the procedure (9). PROCEDURES Information on signalment, previous episodes of IVDH, specifics of the PLDA procedure, and recurrence was obtained from the medical records. Owners were contacted to complete a questionnaire regarding outcome and recurrence. RESULTS 60 of the 303 (19.8%) dogs had an episode of suspected or confirmed IVDH after undergoing PLDA, but only 11 of the 303 (3.6%) dogs had a recurrence of IVDH confirmed by means of CT or MRI and hemilaminectomy. Recurrence rate following PLDA was not significantly different between dogs that had been treated medically for previous episodes of IVDH and dogs that had been treated surgically. Overall, 270 of 286 (94.4%) owners reported that their dog was the same (109 38.1%) or improved (161 56.3%) immediately after PLDA, and 265 (92.7%) owners rated their satisfaction with the procedure as ≥ 9 on a scale from 1 (completely dissatisfied) to 10 (completely satisfied). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that PLDA was a relatively safe, minimally invasive procedure associated with a low rate of recurrence of disk herniation when performed in dogs with a history of previous episodes of suspected or confirmed IVDH.
To describe outcomes for dogs after treatment of craniodorsal hip luxation with closed reduction and Ehmer sling placement and investigate potential risk factors for sling-associated tissue injury or ...reluxation of the affected hip at or near the time of sling removal.
Retrospective multicenter cohort study.
92 dogs.
Case information was solicited from 10 veterinary medical facilities through electronic communications. Data on patient demographic information, cause of injury, presence of concurrent injuries, details of Ehmer sling placement and management, and outcome at sling removal were collected. Data were analyzed for associations with outcomes.
40 of 92 (43.5%) dogs had reluxation of the affected hip joint at or near the time of sling removal. Odds of reluxation occurring for dogs that had the initial injury attributed to trauma were 5 times those for dogs without known trauma (OR, 5.0; 95% confidence interval, 1.3 to 18.7). Forty-six (50%) dogs had soft tissue injuries secondary to sling use; 17 of these dogs had injuries classified as severe, including 1 dog that required limb amputation. Odds of severe sling injury for dogs that had poor owner compliance with home care instructions noted in the record, those that had the sling placed by an intern rather than a board-certified surgeon or resident, and those that were noted to have a soiled or wet bandage on ≥ 1 occasion were 12.5, 4.0, and 5.7 times those for dogs without these findings, respectively.
Placement of an Ehmer sling following closed reduction of a craniodorsal hip luxation had a low success rate and high complication rate.
American canine hepatozoonosis (ACH) represents an important but relatively uncommon differential diagnosis in a dog with fever, muscle wasting, profound leukocytosis, and/or musculoskeletal pain. ...Despite this, obtaining a definitive diagnosis can prove difficult. Peripheral blood smears and whole-blood polymerase chain reaction (PCR) rely on rare parasitemia, and the gold standard diagnostic test (skeletal muscle biopsy) is uncommonly pursued due to its invasive and costly nature. Demonstration of characteristic periosteal proliferative lesions aids diagnosis. The lesions typically involve the more proximal long bones of the appendicular skeleton. The periosteal proliferation is of currently unknown pathogenesis, but its distribution is characteristic of this disease with few differential diagnoses. This case series describes the findings on computed tomography (CT) in 4 dogs with PCR- or cytologically-confirmed
. All dogs had multifocal, bilaterally asymmetric, irregularly marginated, non-destructive, non-articular, periosteal proliferative lesions. Recognition of this unusual CT finding and awareness of this disease could assist in the diagnosis and subsequent treatment of dogs with ACH and may offer an additional indication for CT in cases of fever, muscle wasting, and myalgia.
To evaluate outcomes of dogs with parathyroid carcinoma (PTC) treated by surgical excision and to describe the incidence of postoperative hypocalcemia, degree of hypocalcemia, duration of ...hospitalization, duration of calcium supplementation, and survival time.
100 client-owned dogs with PTC admitted to academic, referral veterinary institutions.
In a retrospective multi-institutional study, medical records of dogs undergoing surgical excision of PTC between 2010 to 2019 were reviewed. Signalment, relevant medical history, clinical signs, clinicopathologic testing, imaging, surgical findings, intraoperative complications, histologic examination, and survival time were recorded.
100 dogs with PTC were included, and 96 dogs had clinical or incidental hypercalcemia. Common clinical signs included polyuria (44%), polydipsia (43%), hind limb paresis (22%), lethargy (21%), and hyporexia (20%). Cervical ultrasonography detected a parathyroid nodule in 91 of 91 dogs, with a single nodule in 70.3% (64/91), 2 nodules in 25.3% (23/91), and ≥ 3 nodules in 4 (4/91)% of dogs. Hypercalcemia resolved in 89 of 96 dogs within 7 days after surgery. Thirty-four percent of dogs developed hypocalcemia, on the basis of individual analyzer ranges, within 1 week after surgery. One dog had metastatic PTC to the prescapular lymph node, and 3 dogs were euthanized for refractory postoperative hypocalcemia. Estimated 1-, 2-, and 3-year survival rates were 84%, 65%, and 51% respectively, with a median survival time of 2 years.
Excision of PTC results in resolution of hypercalcemia and excellent long-term tumor control. Surgical excision of PTC is recommended because of resolution of hypercalcemia and a good long-term prognosis. Future prospective studies and long-term follow-up are needed to further assess primary tumor recurrence, metastasis, and incidence of postoperative hypocalcemia.
Objective
To report the diagnosis and treatment of a companion dorper wether with patent ductus arteriosus (PDA).
Study design
Case report.
Animal
An 8‐month‐old dorper wether presented to its ...primary care veterinarian for a persistent cough and was referred for suspected heart failure on the basis of physical examination and thoracic radiography. A PDA was diagnosed on echocardiography.
Methods
The sheep underwent cardiac catheterization and angiogram to measure pulmonary arterial and right ventricular (RV) pressures, identify the morphology of the PDA, and determine whether an intravascular occlusion of the PDA was feasible. Pulmonary artery pressure was 84/53 mm Hg (mean = 66), and RV pressures were 79/5 mm Hg (mean = 45); these were consistent with pulmonary hypertension. The size and shape of the PDA precluded vascular occlusion. Instead, the PDA was ligate through a left fourth intercostal approach.
Results
The sheep improved clinically after surgery. The PDA seemed closed on echocardiogram 3 days after surgery. Measurement of postoperative fractional shortening was consistent with decreased left ventricular systolic function that had resolved according to follow‐up echocardiography.
Conclusion
We report the first known diagnostic evaluation and successful treatment of naturally occurring PDA in a companion sheep.
Clinical significance
For economically valuable small ruminants, radiographs, echocardiography and cardiac catheterization can be used to diagnose and plan surgical treatment of PDAs, with a potential for a good long‐term outcome.
