Stapled functional end-to-end intestinal anastomosis with endovascular gastrointestinal anastomosis staplers in cats and small dogs

OBJECTIVES

To investigate the use of endovascular gastrointestinal stapling devices to perform intestinal functional end-to-end stapled anastomosis in small dogs and cats.

MATERIALS AND METHODS

Medical records of dogs (≤10 kg) and cats that underwent intestinal resection and functional end-to-end stapled anastomosis with an endovascular gastrointestinal anastomosis (endovascular-GIA) stapling device at five small animal referral centres between April 2014 and September 2023 were retrospectively reviewed. Data including clinical findings, surgical technique, histopathology and complications were collected. A minimum follow-up of 10 days was required. Patients with follow-up of less than 10 days were included if they developed a major complication. Outcome was obtained from assessing the clinical records and contacting the referring veterinarians or owners. Estimated survival was generated according to the Kaplan-Meier method. Differences between survival curves were tested by log-rank test.

RESULTS

Twenty-five patients (10 dogs and 15 cats) were included. The median bodyweight was 4.6 kg (range 2.6 to 10 kg). Nine patients were diagnosed with intestinal neoplasia, 16 with non-neoplastic intestinal disease. The median follow-up was 126 days (range 18 to 896 days). Five patients developed minor postoperative complications, including three superficial surgical site infections. No major postoperative complications were reported. Eighteen patients were alive at the end of the study, one patient was lost to follow-up. Kaplan-Meier estimated median survival time was not reached. Survival was significantly longer for patients with non-neoplastic versus neoplastic intestinal.

CLINICAL SIGNIFICANCE

The study suggests that the use of endovascular gastrointestinal anastomosis staplers is safe and effective to perform intestinal functional end-to-end stapled anastomosis in dogs ≤10 kg and cats.

Radiographic diagnosis of small intestinal obstruction in pet rabbits (Oryctolagus cuniculus): 63 cases

OBJECTIVES

To identify radiographic features that can be used to aid in the diagnosis of small intestinal obstruction in pet rabbits.

MATERIALS AND METHODS

Retrospective study comparing radiographic features of 63 cases of confirmed intestinal obstruction with 50 abdominal radiographs taken of rabbits without gastrointestinal disease. Abdominal radiographs were examined for gastric size, gastric contents, small intestinal dilatation and gas within the large intestine and caecum.

RESULTS

Gastric size, gastric contents, small intestinal dilatation and gas within the large intestine and caecum were all features that differed between rabbits with small intestinal obstruction and rabbits without gastrointestinal disease. Radiographic features associated with small intestinal obstruction included severe gastric dilation, gastric contents primarily consisting of liquid and gas, small intestinal dilation and absence of large amounts of gas in the caecum and large intestine.

CLINICAL SIGNIFICANCE

Observation on gastric size, small intestinal dilatation and gas within the large intestine and caecum aid in radiological diagnosis of small intestinal obstruction in rabbits and so can guide appropriate treatment.

Performing both lateral abdominal radiographs may not improve the visualization of gas in the gastric outflow tract of cats

Reports in the veterinary literature support three-view abdominal radiographs as a standard of practice for evaluating dogs with suspected gastrointestinal (GI) diseases. The usefulness of three-view abdominal studies has not been evaluated in cats. Images from a prospective crossover group study with 20 healthy cats, and those from a retrospective cohort study of 110 cats, were reviewed and the location and degree of gas was assessed in the gastric outflow tract. Comparisons of the frequency of luminal gas were made between the views and between cats with GI disease versus cats without and between cats having sedation versus those without. Chi-Square analysis was performed with P < .05 being considered significant. No significant difference was found in the location and degree of luminal gas in left versus right lateral views in all cats regardless of the order in which the views were obtained or in cats with GI disease versus cats without. Cats with gastric dilation had a higher overall frequency of gas; those with dilation with homogeneous material were higher than those with dilation with heterogeneous material. A higher frequency of gas was found in sedated cats than nonsedated, but further study is needed to determine the underlying cause. Based on these findings, a three-view abdominal study for cats as a standard of practice may not be necessary, but obtaining the additional lateral view when gastric dilation is present might allow better visualization of the pyloric antrum and duodenum.

RADIOGRAPHIC ABDOMINAL ANATOMY IN CAPTIVE RED PANDAS ( AILURUS FULGENS)

The red panda ( Ailurus fulgens) is classified as an endangered species by the International Union for Conservation of Nature and Natural Resources. The aim of this study was to describe the normal radiographic abdominal anatomy in red pandas to provide guidance for clinical use. Radiography of the abdomen was performed in nine captive red pandas during their annual health examinations. Seven of nine animals had six lumbar vertebrae. The sacrum consisted mainly (8/9) of three fused segments. Hypaxial muscles were easily seen in animals weighing 5 kg and above. The pylorus was located to the right of the midline and cranially to the fundus in 8/9 individuals. Bunching of small intestine in the right central abdomen occurred in animals weighing 6 kg and above. The spleen was prominent. Knowledge of the normal radiographic abdominal anatomy of red pandas is important in the diagnosis of diseases and in routine health examinations.

RADIOGRAPHIC AND ULTRASONOGRAPHIC ABDOMINAL ANATOMY IN CAPTIVE RING-TAILED LEMURS (LEMUR CATTA)

The ring-tailed lemur (Lemur catta) is primarily distributed in south and southwestern Madagascar. It is classified as an endangered species by the International Union for Conservation of Nature. Various abdominal diseases, such as hepatic lipidosis, intestinal ulcers, cystitis, urinary tract obstruction, and neoplasia (e.g., colonic adenocarcinoma and cholangiocarcinoma), have been reported in this species. The aim of this study was to describe the normal radiographic and ultrasonographic abdominal anatomy in captive ring-tailed lemurs to provide guidance for clinical use. Radiography of the abdomen and ultrasonography of the liver, spleen, kidneys, and urinary bladder were performed in 13 and 9 healthy captive ring-tailed lemurs, respectively, during their annual health examinations. Normal radiographic and ultrasonographic reference ranges for abdominal organs were established and ratios were calculated. The majority (12/13) of animals had seven lumbar vertebrae. The sacrum had mainly (12/13) three segments. Abdominal serosal detail was excellent in all animals, and hypaxial muscles were conspicuous in the majority (11/13) of animals. The spleen was frequently (12/13) seen on the ventrodorsal (VD) view and rarely (3/13) on the right lateral (RL) view. The liver was less prominent and well contained within the ribcage. The pylorus was mostly (11/13) located to the right of the midline. The right and left kidneys were visible on the RL and VD views, with the right kidney positioned more cranial and dorsal to the left kidney. On ultrasonography, the kidneys appeared ovoid on transverse and longitudinal views. The medulla was hypoechoic to the renal cortex. The renal cortex was frequently (8/9) isoechoic and rarely (1/9) hyperechoic to the splenic parenchyma. The liver parenchyma was hypoechoic (5/5) to the renal cortex. Knowledge of the normal radiographic and ultrasonographic abdominal anatomy of ring-tailed lemurs may be useful in the diagnosis of diseases and in routine health examinations.