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Cola V, Ferrari C, Del Magno S, Foglia A, Zanardi S, Ciammaichella L, Capitani O, Pietra M, Pisoni L. Laparotomy-assisted endoscopic removal of gastrointestinal foreign bodies: Evaluation of this technique and postoperative recovery in dogs and cats. Vet Surg 2024. [PMID: 38922967 DOI: 10.1111/vsu.14126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 04/16/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE To compare the outcome of the laparotomy-assisted endoscopic removal (LAER) of gastrointestinal foreign bodies (FBs) with traditional enterotomy, and to determine which factors affected the ability to remove FBs. STUDY DESIGN Retrospective observational study. SAMPLE POPULATION Dogs and cats (n = 81) with gastrointestinal FBs. METHODS Dogs and cats were divided into Group 1 (LAER, n = 40) and Group 2 (Enterotomy, n = 41). The localization and characteristics of the FBs (sharp or blunt; discrete or linear; single or multiple) were evaluated statistically to identify the factors that affected the ability of LAER to remove, partially or completely, the FBs (χ2 test). The length of the postoperative stay, postoperative analgesia, and resumption of spontaneous feeding were compared between groups (Mann-Whitney U-test). Short-term follow up (14 days) was recorded. RESULTS Laparotomy-assisted endoscopic removal allowed complete or partial removal of FBs in 35/40 dogs and cats, regardless of the characteristics or the localization of the FBs. The presence of intestinal wall damage (p = .043) was associated with the conversion to an enterotomy. Group 1 required a shorter postoperative hospital stay (p = .006), less need for analgesia (p < .001), and experienced a faster resumption of spontaneous feeding (p = .012), and similar complication rate to Group 2. CONCLUSION Laparotomy-assisted endoscopic removal resulted in a faster postoperative recovery when compared with an enterotomy. The FBs' characteristics or localization did not affect the efficacy of the technique to remove FBs. CLINICAL SIGNIFICANCE Laparotomy-assisted endoscopic removal allows the removal of a variety of FBs, avoiding intestinal incision and resulting in a fast postoperative recovery.
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Affiliation(s)
- Veronica Cola
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Chiara Ferrari
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Sara Del Magno
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Armando Foglia
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Stefano Zanardi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Luca Ciammaichella
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Ombretta Capitani
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Marco Pietra
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Luciano Pisoni
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
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Berlin N, Pfaff A, Rozanski EA, Chalifoux NV, Hess RS, Donnino MW, Silverstein DC. Establishment of a reference interval for thiamine concentrations in healthy dogs and evaluation of the prevalence of absolute thiamine deficiency in critically ill dogs with and without sepsis using high-performance liquid chromatography. J Vet Emerg Crit Care (San Antonio) 2024; 34:49-56. [PMID: 37987121 PMCID: PMC11007751 DOI: 10.1111/vec.13341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/11/2022] [Accepted: 07/29/2022] [Indexed: 11/22/2023]
Abstract
OBJECTIVE To determine the normal reference interval (RI) for thiamine concentrations in healthy dogs and investigate the prevalence of thiamine deficiency in critically ill dogs with and without sepsis. DESIGN Prospective, observational, multicenter study, conducted between 2019 and 2021. SETTING Two veterinary university teaching hospitals. ANIMALS A total of 109 dogs were enrolled into 3 groups: 40 healthy dogs, 33 dogs with suspected or confirmed sepsis and evidence of tissue hypoperfusion (Doppler blood pressure ≤90 mm Hg or plasma lactate ≥3 mmol/L), and 36 dogs with other critical illnesses and evidence of tissue hypoperfusion. INTERVENTIONS For each dog, CBC, serum biochemistry, plasma lactate concentration, whole-blood thiamine concentration, blood pressure, vital parameters, Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast score, and clinical outcomes were recorded, alongside basic patient parameters and dietary history. Whole-blood thiamine pyrophosphate (TPP) concentrations were measured using high-performance liquid chromatography. MEASUREMENTS AND MAIN RESULTS The RI for whole-blood TPP in healthy dogs was 70.9-135.3 μg/L. Median TPP concentrations were significantly lower in septic dogs compared to healthy controls (P = 0.036). No significant difference in median TPP concentrations was found between septic dogs and nonseptic critically ill dogs, or between healthy dogs and nonseptic critically ill dogs. TPP concentrations were below the normal RI in 27.3% of septic dogs, compared to 19.4% of nonseptic critically ill dogs (P = 0.57). No correlations were found between TPP concentrations and lactate concentrations, age, body condition scores, time since last meal, RBC count, serum alanine aminotransferase, APPLEfast scores, or patient outcomes. CONCLUSIONS TPP concentrations were significantly lower in septic dogs compared to healthy controls, with an absolute thiamine deficiency found in 27.3% of septic dogs. The established TPP RI allows for further investigation of thiamine deficiency in critically ill dogs.
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Affiliation(s)
- Noa Berlin
- Foster Hospital for Small Animals, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
- Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alexandra Pfaff
- Foster Hospital for Small Animals, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | - Elizabeth A Rozanski
- Foster Hospital for Small Animals, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | - Nolan V Chalifoux
- Matthew J Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecka S Hess
- Matthew J Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Michael W Donnino
- Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Deborah C Silverstein
- Matthew J Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Puzio CE, Rudloff E, Pigott AM. Delay of definitive care in cats and dogs with gastrointestinal foreign body obstruction following antiemetic administration: 537 cases (2012-2020). J Vet Emerg Crit Care (San Antonio) 2023; 33:442-446. [PMID: 37436922 DOI: 10.1111/vec.13315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 05/03/2022] [Accepted: 06/02/2022] [Indexed: 07/14/2023]
Abstract
OBJECTIVE To determine whether administration of antiemetic medication to dogs and cats with gastrointestinal foreign body obstruction (GIFBO) delays time to definitive care (surgery or endoscopy) and increases the risk of complications. DESIGN Retrospective study (January 2012-July 2020). SETTING Private referral center. ANIMALS Five hundred and thirty-seven (440 dogs and 97 cats). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Medical records of dogs and cats with GIFBO were reviewed for antiemetic administration at the onset of clinical signs, time from onset of clinical signs to first intervention and definitive care, GIFBO-related complications, and length of hospitalization. Antiemetics were prescribed for 200 of 537 patients (158 dogs, 42 cats). Antiemetic administration was associated with an increased time between the onset of clinical signs and definitive care (3.2 days [95% confidence interval, CI, 2.8-3.5] vs. 1.6 days [95% CI, 1.4-2.0]; P < 0.001) but not with GIFBO-associated complications (P = 0.45). Antiemetic administration was associated with an increased length of hospitalization (1.6 days [95% CI, 1.4-1.7] vs. 1.1 days [95% CI, 1.1-1.2]; P < 0.001). A longer duration of clinical signs prior to intervention was associated with GIFBO-related complications (P < 0.001) regardless of antiemetic administration. CONCLUSIONS Antiemetic administration in patients with GIFBO was associated with increased time to definitive care and length of hospitalization but not GIFBO-associated complications. Antiemetics are not inherently contraindicated in patients for whom GIFBO is a differential, but clients should be counseled to monitor for progression of clinical signs and follow-up accordingly.
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Affiliation(s)
- Claire E Puzio
- Department of Emergency and Critical Care, BluePearl Specialty and Emergency Pet Hospital, Glendale, Wisconsin, USA
| | - Elke Rudloff
- Department of Emergency and Critical Care, BluePearl Specialty and Emergency Pet Hospital, Glendale, Wisconsin, USA
| | - Armi M Pigott
- Department of Emergency and Critical Care, BluePearl Specialty and Emergency Pet Hospital, Glendale, Wisconsin, USA
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Gollnick HR, Schmiedt CW, Wallace ML, Sutherland BJ, Grimes JA. Retrospective evaluation of surgical treatment of linear and discrete gastrointestinal foreign bodies in cats: 2009-2021. J Feline Med Surg 2023; 25:1098612X231178140. [PMID: 37350262 PMCID: PMC10811983 DOI: 10.1177/1098612x231178140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
OBJECTIVES Gastrointestinal foreign bodies (FBs) are an important cause of emergency surgical intervention in cats, but little information exists in the literature evaluating the risks and outcomes in this species. The study purpose was to describe cases of feline FBs and compare perioperative factors and outcomes between linear foreign body (LFB) and discrete foreign body (DFB) surgery in cats. METHODS The medical records from the University of Georgia Veterinary Teaching Hospital were searched for cats that had undergone surgery for FB removal between August 2009 and August 2021. Perioperative data were collected and described. Data were compared between cats with an LFB and cats with a DFB. A binomial probability series was used to estimate the likelihood of postoperative septic peritonitis or mortality in an additional cat in the series. RESULTS A total of 56 cats were included in this study; 38 cats had a DFB and 18 had an LFB. No cats developed postoperative septic peritonitis, and all cats survived. The likelihood of postoperative septic peritonitis or mortality in an additional cat was estimated to be <5.2%. Cats with an LFB were found to have a significantly higher body condition score (P = 0.047), albumin (P = 0.025), American Society of Anesthesiologists status (P = 0.027), surgery length (P <0.001) and total cost of visit (P = 0.006) when compared with cats with a DFB. Cats with LFBs were more likely to develop a surgical site infection (SSI; P = 0.007) and be administered postoperative antibiotics (P = 0.017). CONCLUSIONS AND RELEVANCE Cats undergoing surgery for gastrointestinal FBs had a low incidence of postoperative complications. Cats with LFBs had longer surgeries and were more likely to develop postoperative SSIs.
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Affiliation(s)
- Hailey R Gollnick
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine at the University of Georgia, Athens, GA, USA
| | - Chad W Schmiedt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine at the University of Georgia, Athens, GA, USA
| | - Mandy L Wallace
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine at the University of Georgia, Athens, GA, USA
| | - Brian J Sutherland
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine at the University of Georgia, Athens, GA, USA
| | - Janet A Grimes
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine at the University of Georgia, Athens, GA, USA
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Park S, Park G, Rieu MS, Kim T, Kim D, Lee S, Kim G. Evaluating Disease Patterns of Military Working Dogs in the Republic of Korea: A Retrospective Study. Animals (Basel) 2023; 13:ani13081400. [PMID: 37106963 PMCID: PMC10135106 DOI: 10.3390/ani13081400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
The purpose of this study was to evaluate disease patterns among military working dogs (MWDs) at the Armed Forces Medical Research Institute (AFMRI) to provide basic medical data on Korean MWDs. The medical records of procedures performed at AFMRI between November 2017 and March 2021 were reviewed. Physical examination, diagnostic imaging, and laboratory tests were performed according to the status of each dog. A total of 353 MWDs (215 males and 138 females; mean age, 6 ± 3 years) were analyzed in this study. Among Korean MWDs, gastrointestinal (GI) disorders are the most frequently diagnosed, followed by dental and musculoskeletal disorders. Foreign body (FB) ingestion had the highest prevalence of GI disorders, with the most common FB being a leather collar or leash. General and dental surgeries, including removal of gastric FB and tooth extraction, were routinely performed at the AFMRI. Preventative care focusing on dental disease and FB ingestion may be helpful for effective performance and good quality of life in MWDs, with the regular assessment and prevention of environmental factors that may contribute to behavioral problems such as FB ingestion, coprophagy, and anorexia.
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Affiliation(s)
- Sanghyeon Park
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Gyeonggook Park
- Department of Veterinary Medicine, Armed Forces Medical Research Institute, Daejeon 34059, Republic of Korea
| | - Mi-Sun Rieu
- Department of Veterinary Medicine, Armed Forces Medical Research Institute, Daejeon 34059, Republic of Korea
| | - Taewoo Kim
- Department of Veterinary Medicine, Armed Forces Medical Research Institute, Daejeon 34059, Republic of Korea
| | - Dongwook Kim
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Sungin Lee
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Gonhyung Kim
- Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea
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Schoelkopf AC, Stewart SD, Casale SA, Fryer KJ. Associations of abdominal discomfort and length of clinical signs with surgical procedure in 181 cases of canine small intestinal foreign body obstruction. Vet Med Sci 2023; 9:670-678. [PMID: 36632768 PMCID: PMC10029870 DOI: 10.1002/vms3.1045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Gastrointestinal foreign bodies are a common indication for abdominal exploratory surgery. OBJECTIVES The objective of this study was to evaluate the relationship of pre-operative abdominal discomfort and duration of clinical signs with surgical resolution of canine small intestinal foreign body obstructions (SIFBO). METHODS We performed a retrospective study of 181 canine abdominal exploratory surgeries for confirmed SIFBO at two referral hospitals. Animals were categorized into five surgical groups (gastrotomy after manipulation into the stomach, enterotomy, resection-and-anastomosis [R&A], manipulated into colon, already in colon) and further grouped by whether entry into the gastrointestinal tract (GIT) was required. RESULTS Abdominal discomfort was noted in 107/181 cases (59.1%), but no significant differences in abdominal discomfort rates were present among the surgical groups or between GIT entry and no entry groups. Clinical sign duration was associated with surgical procedure; median durations were R&A = 3 days (range, 1-9), enterotomy = 2 days (range, 1-14), gastrotomy = 2 days (range, 1-6), already in colon = 1.5 days (range, 1-2), and manipulated into colon = 1 day (range, 1-7). In a pairwise comparison, differences in the duration of clinical signs were found for obstructions manipulated into the colon versus R&A, gastrotomy versus R&A, and in colon versus R&A. When patients were grouped according to GIT entry, cases with entry had a longer duration of clinical signs (median = 2 days [range, 1-14] versus 1 day [range, 1-7], respectively). CONCLUSIONS Abdominal discomfort was not associated with surgical complexity; however, the duration of clinical signs was associated with surgical complexity, with longer duration being associated with entry into the GIT and R&A. Despite statistical significance, the maximum difference of 2 days between surgical groups is unlikely to be clinically relevant.
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Affiliation(s)
| | - Samuel D Stewart
- Ethos Veterinary Health, Woburn, Massachusetts, USA
- Ethos Discovery, San Diego, California, USA
| | - Sue A Casale
- Surgery Department, Angell Animal Medical Center, Boston, Massachusetts, USA
| | - Katy J Fryer
- Ethos Veterinary Health, Woburn, Massachusetts, USA
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Demars C, Boland L, Minier K. Surgical removal of intestinal foreign bodies using a laparotomy-assisted endoscopic approach in dogs and cats and comparison with enterotomy. J Small Anim Pract 2023; 64:43-50. [PMID: 36300788 DOI: 10.1111/jsap.13550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 07/13/2022] [Accepted: 08/01/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To describe a novel surgical technique for intestinal foreign body removal without enterotomy using a laparotomy-assisted endoscopic approach and compare short-term outcomes to enterotomy. MATERIALS AND METHODS Medical records of dogs and cats with intestinal foreign bodies that underwent attempted treatment with a laparotomy-assisted endoscopic approach between June 2019 and July 2021 were extracted. The approach consisted in manoeuvring the intestinal foreign body into the stomach during laparotomy and then removing it via a gastroscopy. If the foreign body was unmovable, an enterotomy was performed. RESULTS Fifty-eight cases were enrolled and foreign bodies were successfully removed in 25 cases using a laparotomy-assisted endoscopic approach. The median distance between the pylorus and the proximal part of the foreign body was 55 cm (range: 0 to 300). The mean surgical time and median endoscopic time were 49 minutes (±sd 12.8) and 5 minutes (range: 2 to 28), respectively. All but two cases were discharged 1 day postoperatively. In 20 cases, the foreign body was not easily movable, and an enterotomy was performed. In three of these cases, conversion to enterotomy was required due to serosal tears that occurred as a consequence of the attempted retrograde manipulation of the foreign body. Foreign body width, length and distance to pylorus were not significantly different between the two techniques. Mean surgical time was significantly shorter for laparotomy-assisted endoscopic approach compared to enterotomy: 49 minutes (±SD 12.8) versus 61.7 minutes (±SD 14.6). CLINICAL SIGNIFICANCE Surgical removal of intestinal foreign bodies through a laparotomy-assisted endoscopic approach is a feasible technique that offers satisfactory outcomes and shorter surgical time than enterotomy. Retrograde manipulation of the intestinal foreign body may result in serosal tears.
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Affiliation(s)
- C Demars
- AniCura Nordvet, La Madeleine, France.,OncoVet, Villeneuve d'Ascq, France
| | - L Boland
- AniCura Nordvet, La Madeleine, France
| | - K Minier
- OncoVet, Villeneuve d'Ascq, France
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Luce BD, Hans EC. Gastrointestinal foreign body obstruction is not associated with abnormal point-of-care pancreas-specific lipase test results in dogs. J Am Vet Med Assoc 2022; 260:1187-1193. [PMID: 35482568 DOI: 10.2460/javma.22.01.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the proportion of abnormal results for a point-of-care pancreas-specific lipase assay screening test in dogs lacking clinical evidence of acute pancreatitis with and without gastrointestinal foreign body obstruction (GIFBO). ANIMALS 50 client-owned dogs with acute abdomen syndrome between April 2019 and January 2021. PROCEDURES In this prospective observational cohort study, dogs were enrolled into a control non-GIFBO group (n = 25) or GIFBO group (25) on the basis of clinical diagnostics performed at presentation. Dogs with evidence of pancreatitis were excluded. Data collected included signalment, body weight, clinical signs, hematologic test results, abdominal imaging findings, and intraoperative findings. SNAP canine pancreatic lipase (cPL) tests were performed for all dogs within 24 hours of presentation and prior to any surgical procedure. Results were analyzed across all dogs for any clinical associations. RESULTS The proportions of abnormal SNAP cPL test results in the GIFBO and non-GIFBO groups were 12% (3/25) and 16% (4/25), respectively, with no significant difference. The only differences between groups were that GIFBO canines were more likely to be male (P = 0.02) and had a slightly longer duration of clinical signs at presentation (P = 0.01). Abnormal SNAP cPL test results were associated with increasing age (P = 0.01). CLINICAL RELEVANCE SNAP cPL test results are mostly reliable but can still be abnormal in a small percentage of dogs with GIFBO. Abnormal results in dogs without pancreatitis occurred more frequently in older dogs of the present study. Abdominal imaging is advised for dogs with abnormal SNAP cPL test results.
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Affiliation(s)
| | - Eric C. Hans
- Surgery Service, BluePearl Pet Hospital, Southfield, MI
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