To characterize abdominal lymphatic drainage in cats after thoracic duct ligation (TDL) and cisterna chyli ablation (CCA).7 purpose-bred research cats.Baseline CT lymphangiography was performed. A popliteal lymph node was injected with iohexol, and images were acquired at 5-minute intervals for 15 minutes. Cats underwent TDL and CCA; methylene blue was used to aid in identifying lymphatic vessels. The CT lymphangiography was repeated immediately after and 30 days after surgery. All cats were euthanized and necropsied.Results of baseline CT lymphangiography were unremarkable for all 7 cats. Only 5 cats completed the study. Leakage of contrast medium at the level of the cisterna chyli was seen on CT lymphangiography images obtained from all cats immediately after surgery. Evaluation of 30-day postoperative CT lymphangiography images revealed small branches entering the caudal vena cava in 2 cats, leakage of contrast medium into the caudal vena cava with no visible branches in 1 cat, and no contrast medium in the caudal vena cava in 2 cats. Contrast medium did not flow beyond the level of the cisterna chyli in any cat. Gross examination during necropsy revealed that all cats had small lymphatic vessels that appeared to connect to local vasculature identified in the region of the cisterna chyli.Abdominal lymphaticovenous anastomoses formed after TDL and CCA in cats. This would support use of these procedures for treatment of cats with idiopathic chylothorax, although additional studies with clinically affected cats are warranted.
Abstract Progressive disease is common following anal sacculectomy for apocrine gland anal sac adenocarcinoma (AGASACA); additional therapy may prolong survival. Adherence to medical recommendations influences therapeutic success in humans. The purpose of this study was to assess the adherence to follow‐up recommendations in dogs with AGASACA. Medical records of patients that underwent anal sacculectomy for AGASACA, with or without iliosacral lymphadenectomy, between July 2015 and July 2018, were reviewed at eight referral institutions to assess post‐operative recommendations and owner adherence to recommendations. One hundred and seventy‐four dogs were included, of which 162 underwent unilateral anal sacculectomy, 12 underwent bilateral anal sacculectomy and 39 underwent concurrent iliosacral lymphadenectomy. Seventy‐six owners (44%) received recommendations for staging at the time of discharge, histopathology results or at the first follow‐up visit. One hundred and forty owners (80%) received recommendations for treatment following the initial surgery. Fifty of seventy‐six (66%) owners pursued at least one staging recommendation and 69 of 140 (49%) owners pursued some kind of adjuvant treatment recommendation. Overall, 16 of 76 (21%) were adherent to staging recommendations with 20 adherent for the first year following surgery (26%). Forty‐seven of 140 (34%) were adherent to treatment recommendations with 54 (39%) adherent for the first year. Owners that were adherent to restaging recommendations at 1 year following surgery were significantly more likely to pursue treatment for progressive disease ( P = .014). Further work is required to assess owner motivation and evaluate strategies to improve adherence, given the potential impact on patient treatment.
Objective To describe the clinical features and outcome of functional thyroid tumours in dogs. Materials and Methods Retrospective multi‐institutional study of 70 dogs diagnosed with thyroid mass and concurrent hyperthyroidism. Clinical data regarding presentation, treatment, outcome and functional thyroid status were retrieved. Results Overall median survival of dogs with functional thyroid tumours was 35.1 months and 1‐ and 3‐year survival rates were 83 and 49%, respectively. Median survival time was 72.6 months for dogs treated with surgical excision and 15.7 months for dogs that did not receive surgery. Of the 50 dogs treated by surgery and for which thyroid status was known following treatment, 64% developed hypothyroidism after surgery. Histopathologically confirmed metastasis was identified in 3% of dogs. Clinical Significance Dogs with functional thyroid tumours may survive a long time after surgical excision, although post‐operative hypothyroidism is common.
To retrospectively compare the incidence of incisional complications in dogs undergoing surgery for mast cell tumors (MCTs) and soft tissue sarcomas (STSs).218 dogs.Dogs that underwent excision of ≥ 1 MCT, STS, or both from January 2014 to July 2019 and had ≥ 30 days postoperative follow-up were included. Signalment; anesthesia and surgery time; administration of propofol; tumor type, grade, location, and size; intended surgical margins; histologic margins; perioperative radiation, chemotherapy, and corticosteroid and antihistamine (MCT group) treatments; and incisional complications (classified as major or minor) were recorded. Follow-up information was obtained from owners or primary care veterinarians, if needed. Incidence and severity of incisional complications were compared between the MCT and STS groups. Potential risk factors were assessed for associations with incisional complications by simple and multiple logistic regression analysis.The 218 dogs underwent surgery for 293 tumors (209 MCTs and 84 STSs). Complication rates did not differ between MCT (28/209 [13%]) and STS (12/84 [14%]) groups. For the MCT group, incomplete margins (vs complete or narrow), increasing Patnaik tumor grade, and postoperative chemotherapy (yes vs no) were associated with increased odds of incisional complications on simple regression. On multiple logistic regression, postoperative chemotherapy was associated with increased odds of incisional complications for the MCT group and both groups combined.On the basis of the results, we suggest that chemotherapy be used with caution ≤ 30 days after surgery for dogs with MCTs. Corticosteroid administration was not associated with incisional complications for the MCT group in this study.
To evaluate the occlusion of an intra-abdominal vessel as a model of an extrahepatic portosystemic shunt by thin film banding in a controlled setting and to document histologically the perivascular region's response to thin film banding after 8 weeks.Experimental study.Six purpose-bred healthy domestic short hair cats.Thin film bands were placed around the external iliac vein, with a sham procedure on the contralateral vessel. Closure rates were monitored via computed tomographic angiography (CTA) every 2 weeks for a total of 8 weeks. After 8 weeks, the vessels were resected, if possible, and submitted for histopathologic evaluation.All cats tolerated the procedure without surgical complications. Eight weeks after surgery, closure was evaluated as complete in one cat, marked in two cats, moderate in one cat, and mild in two cats according to CTA. Histological examination (in three cats) was consistent with chronic, multifocal, granulomatous inflammation with moderate fibrosis and collagen degeneration.Venous occlusion was inconsistent and often incomplete 8 weeks after thin film banding of the external iliac vein despite the presence of moderate to abundant perivascular fibrous tissue.Vascular occlusion by thin film banding in cats is mainly incomplete after 2 months. This study supports the theory that high level of residual shunting may be expected in some cats after thin film banding.
Abstract OBJECTIVE To determine whether folded-flap palatoplasty (FFP) results in improved respiratory outcomes compared to standard staphylectomy (SS). METHODS English Bulldogs were randomized to receive FFP or SS in a parallel, equal-allocation, prospective study design at a single institution. Exercise-tolerance testing (ETT), arterial blood gas, head CT, and an owner survey were completed preoperatively and at recheck (approx 30 days postoperatively). Soft palate (SP) length and thickness and pharyngeal air volume were measured on blinded CT images. Linear mixed models and Mann-Whitney U tests were performed. RESULTS 16 dogs completed the study (FFP group, 8; SS group, 8) and 3 did not (excluded due to FFP dehiscence [2] and lack of recheck [1]). Median preoperative ETT grade was not different between groups (SS group, 1 [0 to 3]; FFP group, 1.5 [1 to 3]). Standard staphylectomy resulted in a greater reduction in SP length compared to FFP ( P = .020; FFP, 5.79 ± 0.50 cm preoperatively, 4.86 ± 0.52 cm at recheck; SS, 6.13 ± 0.53 cm preoperatively, 4.57 ± 0.47 cm at recheck). No other variables differed between groups. At recheck, owners subjectively rated their dogs as improved (FFP group, 5; SS group, 8), unchanged (FFP group, 2), and not rated (FFP group, 1). CONCLUSIONS Folded-flap palatoplasty did not improve SP thickness, pharyngeal air volume, ETT, arterial blood gas values, or owner survey variables more than SS in these English Bulldogs. Standard staphylectomy resulted in a greater reduction in SP length than FFP. CLINICAL RELEVANCE Standard staphylectomy or FFP can be performed in English Bulldogs. Standard staphylectomy may be preferable due to dehiscence potential with FFP.
Previously an uninterrupted recovery could confidently have been expected in this type of poisoning once the patient had regained consciousness.This case would suggest that relapse and sudden death may occur in poisoning by tricyclic antidepressant compounds after apparent recovery.The forced diuresis may have kept the patient alive initially and there could be an argument for continuing this treatment in order to wash out the possible second wave of metabolites, which would otherwise contribute to an unexpected relapse.
A possible association between the development of nontraumatic, acquired inguinal hernias (NAIH) and perineal hernias (PH) has been postulated in adult dogs. The objective of this study was to evaluate the frequency of concurrent diagnosis of PH in dogs presented with NAIH and determine potential risk factors for concurrent PH and NAIH. Medical records of adult male dogs presented for NAIH to 4 hospitals between 2007 and 2017 were retrospectively reviewed. Twenty-one dogs with NAIH were included, 8 of which had concurrent PH. There were no significant differences between dogs with and without PH; however, among dogs with both conditions, intact dogs (8.1 ± 1.4 years) were younger than neutered dogs (11.7 ± 1.0 years; P = 0.007). Thirty-eight percent of male dogs presenting for NAIH had concurrent PH, indicating that these conditions commonly occur together. Dogs presenting for NAIH should be carefully evaluated for concurrent PH before surgical intervention.
Abstract Background Lower urinary tract transitional cell carcinoma (TCC) is an important but rarely described disease of cats. Objectives To report the clinical characteristics, treatments, and outcomes in a cohort of cats with lower urinary tract TCC and to test identified variables for prognostic relevance. Animals One‐hundred eighteen client‐owned cats with lower urinary tract carcinoma. Methods Medical records were retrospectively reviewed to obtain information regarding clinical characteristics, treatments, and outcomes. Recorded variables were analyzed statistically. Results Median age of affected cats was 15 years (range, 5.0‐20.8 years) and median duration of clinical signs was 30 days (range, 0‐730 days). The trigone was the most common tumor location (32/118; 27.1%) as assessed by ultrasound examination, cystoscopy, or both. Treatment was carried out in 73 of 118 (61.9%) cats. Metastatic disease was documented in 25 of 118 (21.2%) cats. Median progression‐free survival and survival time for all cats were 113 days (95% confidence interval [CI], 69‐153) and 155 days (95% CI, 110‐222), respectively. Survival increased significantly ( P < .001) when comparing cats across the ordered treatment groups: no treatment, treatment without partial cystectomy, and treatment with partial cystectomy. Partial cystectomy (hazard ratio [HR], 0.31; 95% CI, 0.17‐0.87) and treatment with nonsteroidal anti‐inflammatory drugs (HR, 0.55; 95% CI, 0.33‐0.93) were significantly associated with longer survival times. Conclusions and Clinical Importance The results support treatment using partial cystectomy and NSAIDs in cats with TCC.
To compare surgical models for teaching enterotomies to students.Prospective, randomized study.Second-year veterinary students (n = 59) and faculty surgeons/surgery residents (n = 19).Participants performed an enterotomy on each of 3 models (equine cadaver intestine, SurgiReal small intestine simulator, and SynDaver canine bowel) and completed a survey comparing them to either an enterotomy on an anesthetized pig (students) or intestinal surgery experience (faculty/residents). Surveys results were compiled and analyzed.Both student and faculty/resident groups rated cadaver intestine as more similar to live intestine compared with the synthetic models for incision, tissue handling, mucosal eversion, needle passage, knot tying, and best preparing for live intestine. Students rated SynDaver as more similar to live intestine than SurgiReal for incision and ranked SurgiReal as more similar to live intestine than SynDaver for mucosal eversion. There was no difference between the ranks assigned to SurgiReal and SynDaver for faculty/residents. Faculty/residents responded most often that cadaver intestine would be the model they recommend for training students.Cadaver intestine was the model most similar to live intestine for all variables tested. SurgiReal and SynDaver models were comparable to each other but did not simulate live intestine as well as cadaver intestine.Cadaver intestine more closely approximated live intestine compared with either synthetic model. SurgiReal and SynDaver may be adequate alternatives if cadaver intestine is unavailable.
