Enteroplication in cats, using suture of N-butyl cyanoacrylate adhesive

Enteroplication in cats with intussusception: a retrospective study (2001-2016)

OBJECTIVES

The aim of this study was to report complications, as well as short- and long-term clinical outcomes of cats suffering from surgically reduced intussusception with and without enteroplication.

METHODS

Medical records of cats presented at our institution with intussusception between 2001 and 2016 were reviewed. The following data were retrieved: signalment; history; physical examination; diagnostic imaging, surgical and histological findings; and outcomes. Animals were grouped as with or without enteroplication. Duration of surgery, survival, complication and recurrence rates, duration of hospitalisation, and short- and long-term outcomes were compared.

RESULTS

Cats with intussusception presented with unspecific type and duration of clinical signs. Male or male castrated cats and Maine Coons were over-represented in both groups. Enteroplication was performed in 48% (10/21) of the cats. Cats in the enteroplication group were significantly younger than those in the non-enteroplication group ( P = 0.023). Duration of surgery, time of hospitalisation, complication rate and outcomes did not differ between the two groups. Two complications in the short term and one complication in the long term were possibly associated with enteroplication. A recurrence of intussusception was seen in 2/17 cats approximately 12 months after initial surgery, both previously treated with enteroplication.

CONCLUSIONS AND RELEVANCE

Although the number of cases was limited, our results suggest that enteroplication should be cautiously performed in cats with intussusception as it may be associated with major complications in the short and long term, and its efficacy remains unclear. Based on this study, the need for enteroplication in cats following a correction of intussusception could be questioned.

Is the use of cyanoacrylate in intestinal anastomosis a good and reliable alternative?

PURPOSE

The present study aims to compare strength, healing, and operation time of experimental intestinal anastomoses performed by polyglactin 910 (Vicryl; Ethicon, Edinburgh, United Kingdom) sutures with ethyl-2-cyanoacrylate glue (Pattex; Henkel, Dusseldorf, Germany).

MATERIAL AND METHODS

Ninety-six Sprague-Dawley rats were divided into 2 (groups E and L). Each group was further subdivided into 6 subgroups (EA1, EA2, EA3, EB1, EB2, EB3, LA1, LA2, LA3, LB1, LB2, LB3), each containing 8 rats. Intestinal anastomosis was performed by polyglactin 910 sutures in A subgroups and with ethyl-2-cyanoacrylate in B subgroups. The anastomosis was end to end in A1 and B1, side to side in A2 and B2, and end to side in A3 and B3. Time for anastomosis performance (AT) was recorded. In group E, bursting pressures and hydroxyproline levels were determined on the second postoperative day, whereas in group L, the same measurements were made on the sixth postoperative day. One-way analysis of variance was used for analyses of variance in the groups. Quantitative data were analyzed with Student's t test. P value was considered significant at less than .05.

RESULTS

There was no significant difference between bursting pressures of subgroup pairs on both postoperative days 2 and 6. Hydroxyproline levels and AT were significantly better in B subgroups.

CONCLUSION

Better healing, shorter AT, and equal strength were achieved with ethyl-2-cyanoacrylate compared with polyglactin 910 sutures in intestinal anastomosis in the experimental setting.

Localised mid-jejunal volvulus following intussusception and enteroplication in a dog

Ileocolic intussusception was successfully treated surgically by partial enterectomy and enteroplication in an 11-month-old, male neutered German shepherd dog. Segmental intestinal volvulus was identified in the same dog two months later and was managed successfully by a second partial enterectomy. The dog made an uneventful recovery and was free of clinical disease six months after the second surgery. Both conditions are reviewed in this case report and a possible relationship between these two episodes in this dog is discussed.

Use of cyanoacrylate in skin closure for ovariohysterectomy in a population control programme

N-butyl-cyanoacrylate tissue adhesive was evaluated as a skin closure material in a population control programme. Fifty-two female cats underwent ovariohysterectomy: skin closure of 25 of those cats was undertaken with nylon (3-0) and in 27 with the adhesive. Twenty-three cats spent the postoperative period confined in cages and 29 were free within a 50-square-metre fenced area. The parameters used for evaluation were: dehiscence or secretion and presence and extension of erythema at the surgical site. It was observed that the time required for closure of the surgical site with the adhesive was shorter than with nylon, saving approximately 1 min per animal. The adhesive or conventional suture allowed similar healing, and independent of material used for skin closure or the postoperative exercise, there was no statistical difference in wound cicatrization. As the adhesive eliminates the need for suture removal and decreases surgery time, without additional risk to the cat, it may be indicated for surgical population control programmes.

Gastrointestinal obstruction

For cats that present with signs of gastrointestinal disease, obstruction is a primary differential. There are numerous reasons of gastrointestinal obstruction in small animals, yet there are several specific causes that are more commonly associated with the cat. These include linear foreign bodies, trichobezoars, focal intestinal neoplasia, feline infectious peritonitis, and megacolon. Clinical signs related to gastrointestinal obstruction consist of vomiting, diarrhea, constipation, tenesmus, anorexia, or weight loss. The course and onset of disease depends on the rate at which the obstruction develops and whether the obstruction is partial and complete. The diagnosis of obstruction is typically suspected based on clinical presentation and palpation of an abdominal mass. Diagnostics tools are used for definite diagnosis and determination of location within the gastrointestinal tract. Surgical treatment is dependent on the etiology of the obstruction and various techniques are employed to remove the obstruction and prevent recurrence.

Tolerance of the rabbit cornea to an n-butyl-ester cyanoacrylate adhesive (Vetbond)

OBJECTIVE

An n-butyl-ester cyanoacrylate adhesive available for veterinary surgery (Vetbond, 3M) was tested in rabbits for corneal irritation.

PROCEDURES

Two experimental procedures were used on 24 rabbits: injection of the adhesive into an intralamellar corneal pocket (n = 10) and application of the glue to a mid-stromal corneal defect (n = 14). In both experiments the eyes were examined for 20 days for evidence of corneal irritation and tolerance. At the end of each experiment, histopathologic studies were performed on all corneas.

RESULTS

The corneal reaction to the intrastromally injected cyanoacrylate was characterized clinically by slight edema and vascularization localized to the vicinity of the adhesive. A moderate foreign body-type reaction was found histologically. Following application of the adhesive to a central stromal defect, the treated corneas remained totally clear and histopathologic examination showed that the healing process was not altered compared to the controls. The mean retention time of the glue patch was 14 days.

CONCLUSIONS

Intrastromal injection and surface application to a corneal defect of n-butyl-ester cyanoacrylate to a corneal defect induced only a mild inflammatory response and did not interfere with the reparative process. These findings suggest that this surgical adhesive would be acceptable for treating corneal ulcerations in animals.

Complications of enteroplication for the prevention of intussusception recurrence in dogs: 35 cases (1989-1999)

OBJECTIVE

To compare complication and recurrence rates in dogs treated for intussusception that underwent enteroplication to rates in dogs treated for intussusception that did not undergo enteroplication.

DESIGN

Retrospective study.

ANIMALS

35 dogs with intestinal intussusception.

PROCEDURE

Information on signalment, clinical signs, potential predisposing causes, surgical technique, opioid administration, use of enteroplication, postoperative complications, and whether the intussusception recurred was obtained from the medical records.

RESULTS

Dogs ranged from 8 weeks to 10 years old. Opioids were administered in the perioperative period in 34 dogs. Enteroplication was performed in 16 dogs. Complications of enteroplication that required a second surgery were identified in 3 dogs. None of the 16 dogs that underwent enteroplication had a recurrence of intussusception, whereas 1 of the 19 dogs that did not undergo enteroplication had a recurrence. Rate of intussusception recurrence and likelihood that a second surgical procedure would be required were not significantly different between dogs that underwent enteroplication and dogs that did not.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that enteroplication may be associated with life-threatening complications in dogs, but the likelihood of a dog requiring a second surgical procedure following surgical correction of intussusception was not different between dogs that underwent enteroplication at the time of the initial surgery and dogs that did not.