Splenic Torsion in an Alpaca

[Diaphragmatic hernia in a female alpaca (Vicugna pacos)]

A 3-year-old pregnant female alpaca was noticed due to increased lying and decreased feed intake after shearing. Twelve days after shearing, she aborted an almost completely developed cria. After another two days, the alpaca was recumbent and subsequently died during transport to the clinic. A dissection of the carcass revealed a diaphragmatic hernia. Diaphragmatic hernias have been described in many different species, diagnosis can be made by radiography or ultrasound. Depending on the extent, surgical therapy may be successful.

Treatment and outcomes of two pigs treated for hemoabdomen secondary to splenic disease

OBJECTIVE

To report the management and outcomes of two pigs undergoing emergency surgery for hemoabdomen secondary to splenic disease.

STUDY DESIGN

Case report.

ANIMAL

Two adult pigs with hemoabdomen and suspected splenic pathology.

METHODS

Pigs were admitted for several clinical signs including lethargy, inappetence, vomiting, abdominal distention, hypothermia, and tachycardia. Abdominal ultrasound and abdominocentesis led to a diagnosis of hemoabdomen secondary to splenic disease.

RESULTS

The spleen was confirmed as the source of hemorrhage during midline exploratory celiotomy in both pigs. Splenic rupture resulted from splenic vein thrombosis in one pig and splenic torsion in the other. Complications included intraoperative hemorrhage and intraabdominal adhesion formation. Four years following splenectomy, one pig was euthanized because of widespread small intestinal adhesions causing luminal obstruction, while the other pig was euthanized following a diagnosis of chronic myeloid leukemia.

CONCLUSIONS

A ventral midline celiotomy provided adequate exposure for splenectomy. The procedure allowed resolution of signs in both pigs. Splenic pathology, such as vessel thrombosis or torsion, may result in splenic rupture and should be considered as a differential in pigs with hemoabdomen.

Diagnosis and surgical treatment of a primary splenic torsion in a domestic ferret (Mustela putorius furo)

A 4-year-old female spayed domestic ferret (Mustela putorius furo) presented with a history of vomiting over 24 hours. On physical examination, a significantly enlarged, firm spleen was palpated. Abdominal radiographs and abdominal ultrasound were suggestive of a splenic torsion or splenic infarction. An exploratory laparotomy confirmed the initial diagnosis and splenectomy was performed using a vessel sealing device. Histologic evaluation and culture of the spleen were consistent with primary torsion without evidence of infection or neoplasia. The patient recovered from surgery without complications. Based on a literature search, this is the first report of the clinical diagnosis and successful surgical treatment of a primary splenic torsion in a ferret. Although it appears to be a rare and potentially life-threatening disease in ferrets, splenic torsion should be considered as a differential diagnosis in ferrets that present with non-specific signs and a palpably enlarged spleen.

ultrasonography of kidney and spleen in clinically healthy llamas and alpacas

Background

The ultrasonographic examination technique is a well-established, non-invasive diagnostic tool for diverse conditions in humans and different animal species. The purpose of our study was to describe ultrasonographic localisation, sonographic appearance and dimensions of the kidneys and spleen of clinically healthy llamas and alpacas. Differences between llamas and alpacas and the influence of sex and ages were investigated. Results of this study may aid veterinarians performing ultrasonography in diseased animals and the technique can be used for routine protocol screening.

Results

Ultrasonography was performed in 135 clinically healthy, non-sedated llamas and alpacas. Screening was performed with a 6.6 MHz curve linear transducer with only alcohol as contact medium between the probe and unclipped skin. The kidneys could be imaged from the paralumbar region. The right kidney only was visualized when scanning from the right and the left kidney only from the left. While the left kidney appeared in sagittal view as an oval shape in most llamas and alpacas, in one third of animals the left kidney had a triangular shape. The L-shaped base of the spleen, with its homogeneous, echoic pattern, could be seen craniolateral to the left kidney. Anechoic areas displaying vessels inside the spleen and a thin echoic capsule surrounding the splenic tissue could be differentiated. While sonographic appearances of the examined organs showed no differences between llamas and alpacas, selected dimensions of both of kidney and spleen showed significant differences between species. In terms of age and sex, significant differences in respect of kidney size could be found only in alpacas. Sex seemed to have no influence on kidney and spleen sizes in llamas.

Conclusions

The present study provides species-specific information on ultrasonographic appearance and reference values for kidney and spleen dimensions of clinically healthy llamas and alpacas. Results show differences in organ sizes between llamas and alpacas and in alpacas of different sex and age. The results of this study can be used as references for veterinarians performing ultrasound examinations in diseased animals.

Simultaneous Torsion of a Uterine Horn and Spleen in a Pregnant Two-Year-Old Crossbreed Bitch: A Case Report

A pregnant 2-year-old mixed-breed dog was admitted with a 2-day history of lethargy, anorexia and painful abdominal distension. Clinical manifestations were unspecific and mainly suggested hypovolemic shock. Physical examination, ultrasonographic evaluation and radiographs confirmed mid-late pregnancy and evident signs of fetal death and peritoneal effusion. An exploratory laparotomy was immediately initiated which revealed torsion of the right gravid uterine horn over the left one and, simultaneously, the unexpected presence of splenic torsion and rupture, with a stretched omentum covering and exerting tension on the spleen's cranial pole. Histopathology revealed hemorrhagic infarction of the uterus and spleen. The animal recovered uneventfully and was later submitted to a preventive gastropexy.

Laparoscopic splenectomy in goats

OBJECTIVE

To report laparoscopic splenectomy in goats.

STUDY DESIGN

Experimental study.

ANIMALS

Healthy female goats (n=9); aged, 10-18 months; weighing, 22-30 kg.

METHODS

Food was withheld for 24 hours and water for 10 hours. Anesthetized right laterally recumbent goats had a laparoscopic portal and 3 instrumental portals created in the left flank. Splenic attachments were dissected with monopolar electrocautery and blunt dissection through 2 instrument portals. Exposure and isolation of splenic vessels was performed with laparoscopic "right-angle" preparation forceps. Vessels were ligated with a medium-titanium clip and 2 silk sutures and then transected between the silk sutures. The detached spleen was manipulated into a specimen retrieval bag, morcellated, and the bag retrieved through an enlarged portal. Repeat laparoscopic examination was performed at 1 month.

RESULTS

Laparoscopic splenectomy required 70 minutes (range, 52-88 minutes) and was successful without major intraoperative and postoperative complications. Postoperatively, all goats had signs of mild abdominal discomfort. On repeat laparoscopy, with the exception of 1 goat that had a focal omental adhesion to the enlarged portal site, no other abnormalities were identified.

CONCLUSIONS

Laparoscopic splenectomy can be accomplished in goats using 4 portals in the left flank and a combination of monopolar cautery dissection of splenic attachments, ligation of vessels using metal clips and intracorporeal ligatures, and intra-abdominal morcellation of the detached spleen in a specimen retrieval bag.

CLINICAL RELEVANCE

Laparoscopic splenectomy is an effective and safe technique in goats.

Gastrointestinal surgery in alpacas and llamas

The clinical signs associated with acute abdominal pain in South American camelids tend to be subtle and less frequent (similar to ruminants) as compared with that of horses. Abdominocentesis and transabdominal ultrasound are useful tools in determining the necessity of an exploratory laparotomy. Preoperative anticipation of the lesion location helps determine the surgical approach to the abdomen. Perioperative management is vital to improve chances for survival. Timely surgical intervention for correctable gastrointestinal lesions is expected to minimize postoperative complications and improve outcomes.

Reproductive emergencies in camelids

Emergencies in theriogenology practice go beyond just saving the life of the patient, but also preserving its reproductive abilities. Camelid emergency medicine is a relatively new field. This paper discusses the most common reproductive emergencies, their diagnosis, treatment, and prognosis in male and female camelids. The conclusions drawn are based primarily on clinical observations by the authors over the last 25 years. Special consideration is given to peculiarities of the species, particularly in the choice of obstetrical manipulations and therapies.

Comparison of Nd:YAG Surgical Laser and Remorgida Bipolar Electrosurgery Forceps for Canine Laparoscopic Ovariectomy

OBJECTIVE

To investigate and compare technique, surgical time, and complications of canine laparoscopic ovariectomy using Nd:YAG surgical laser and Remorgida bipolar electrosurgery forceps.

STUDY DESIGN

Randomized, prospective clinical trial.

ANIMALS

Female dogs (n=40) for elective ovariectomy.

METHODS

Dogs had bilateral ovariectomy with one ovary randomly assigned to removal by use of Nd:YAG surgical laser with a 600 mum optical fiber in contact mode and the other ovary to removal by use of a Remorgida forceps (featuring bipolar electrocoagulation with simultaneous sharp resection). Duration of predetermined surgery intervals and complications were compared between techniques. Additionally, the effects of several intraoperative variables on surgical time were evaluated.

RESULTS

Ovariectomy by use of Remorgida forceps required significantly less time than laser ovariectomy but intraoperative hemorrhage was not reduced. Surgical time was significantly increased in obese dogs, depending on the amount of fat in the ovarian ligament. Intraoperative hemorrhage had no significant influence on surgical time.

CONCLUSION

Both ovariectomy techniques were effective but the Remorgida forceps can be used as a relatively inexpensive, stand-alone device that decreases surgical time compared with Nd:YAG laser ovariectomy.

CLINICAL RELEVANCE

Novel techniques, such as laser and combined bipolar electrosurgical and cutting forceps aim to reduce surgery duration, complication rates and recovery time in laparoscopic surgery.