The Omentum-A Forgotten Structure in Veterinary Surgery in Small Animals' Surgery

The greater and lesser omentum are derived from embryonic mesogastrium. The expansive greater omentum in dogs covers intestinal coils, while in cats, it is smaller. Comprising distinct portions, the greater omentum is rich in lymphatics and blood vessels. Conversely, the lesser omentum spans the liver, stomach, and duodenum. Studies on canine omentum reveal unique immune cell composition and regenerative potential attributed to adipose tissue-derived stromal cells (ADSCs). These cells hold promise in regenerative medicine, showing enhanced abilities compared with ADSCs from other sources. The omentum is critical in tissue repair and pathology, making it invaluable in veterinary surgery across various medical fields. The aim of this article was to research current knowledge about the applications of the omentum in veterinary surgery and the possibilities of using this structure in the future.

Feline radial and ulnar diaphyseal fractures: a retrospective study of 49 cases comparing single bone fixation and dual bone fixation

OBJECTIVES

The objectives of this study were to report the complications in radial and ulnar diaphyseal fractures in cats and to compare the differences in outcome between single and dual bone internal fixation.

METHODS

Medical records between 2004 and 2022 were searched retrospectively for cats with antebrachial diaphyseal fractures treated with internal bone-plate fixation. In total, 49 cases were included from six referral hospitals, including one teaching hospital. Patient information was collated, including fracture configuration, location, repair method and clinical outcome as assessed by veterinary physical examination, radiography and owner questionnaire.

RESULTS

A total of 47 cats (mean age 4.2 years) were included. Fractures were located distally (24/49, 49%), proximally (13/49, 26.5%) and mid-diaphyseally (12/49, 24.5%). Dual bone fixation was used in 13/49 (26.5%) cases, with only 1/13 (7.7%) having major complications. By comparison, 4/36 (11.1%) of single plated fractures had major complications. Single bone fixation was 14.25 times more likely (95% confidence interval [CI] 2.07-97.99) to have a successful outcome (veterinarian-assigned score of 0) compared with dual bone fixation (P = 0.007). When evaluating owner-assessed outcomes, single bone fixation was 9.4 times more likely (95% CI 1.4-61.96) to have a successful outcome (owner score of 0) compared with dual bone fixation (P = 0.019).

CONCLUSIONS AND RELEVANCE

Fractures that were repaired with single bone fixation had a greater chance of a better outcome. Although the difference was not significant, there was a higher major complication rate and a lower minor complication rate for cases treated with single bone fixation compared with dual bone fixation. The majority of fractures were located in the distal diaphysis. Comminution of the fracture and concurrent orthopaedic issues did not significantly affect the outcome. Further prospective studies with standardised follow-up, radiographic assessment, surgeon and implants are required to truly assess the difference between dual and single bone fixation.

Free omental graft without vascular microanastomosis in the cutaneous wound healing of rabbits

ABSTRACT This study aims to evaluate the influence of free omental graft without vascular microanastomosis (FOGWVA) on experimental skin healing in rabbits. Through celiotomy, a 9cm2 free omental fragment was collected in 36 rabbits, with subsequent production of a deep linear cutaneous wound in the dorsal midline measuring 3cm. In 18 animals from the omental group (OG), the omental fragment collected was fixed subcutaneously with six simple interrupted stitches using a 4-0 polyamide thread. In both treated and control (CG) groups, intradermal dermorrhaphy was performed with 4-0 polyamide thread. Experimental wounds were clinically evaluated every day. Each of the groups was divided into three subgroups of 6 animals each for histopathological evaluation on the 7th, 14th, and 28th days of postoperative. In the OG wounds, the increase in volume (omentum activation) stood out after the second postoperative day. Macroscopy showed an organic reaction to the graft on day 7, with a progressive reduction in addition to neovascularization towards the omental graft. The intense presence of mononuclear cells and collagen deposition on day 7 demonstrated an accelerated process of tissue remodeling and repair. The FOGWVA omental graft remained viable and positively influenced the cutaneous healing of the experimental wounds in rabbits.

Forelimb Examination, Lameness Assessment, and Kinetic and Kinematic Gait Analysis

This article contains a guide for small animal practitioners to use when confronted with the challenge of diagnosing a forelimb lameness. The examination begins by monitoring the dog at a stance and a visual gait assessment. A hands-on evaluation includes the initial examination, checking for asymmetry and muscle atrophy while the dog is standing, and step-by-step instructions for a thorough forelimb examination.

Treatment of a femoral septic nonunion in a dog with interlocking nail stabilization associated to corticospongious bone autograft and greater omentum flap: case report

ABSTRACT Chronic septic bone nonunion requires a well-designed therapeutic planning, demanding a multimodal treatment to achieve bone consolidation and elimination of infection. A successful case of an association of the major omentum flap with surgical stabilization with an interlocking nail for treatment of a femoral septic nonunion in dog is reported. The patient had partial functional return of the limb 30 days after surgery, negative bacterial culture with radiographic signs of bone healing and total functional return of the limb at 90th days after the surgical procedure.

Locking compression plate stabilization of 20 distal radial and ulnar fractures in toy and miniature breed dogs

Objective: To evaluate retrospectively the effectiveness of the Locking Compression Plate® (LCP), in the form of either a straight or notched head T-plate, for the treatment of fractures of the distal radius and ulna in a series of 20 toy and miniature breed dogs.

Methods: The medical records of toy and miniature breed dogs (<6 kg), greater than six months of age, with fractures of the distal radius and ulna from two veterinary hospitals were reviewed. The inclusion criteria included: fractures of the distal 1/3 of the radius and ulna and repair with open reduction and internal fixation utilizing an LCP (straight or notched head T-plate).

Results: Twenty fractures (20 dogs) satisfied the inclusion criteria; eight straight and 12 notched head T-plates were used, either 2.0 mm (n = 13) or 2.4 mm (n = 7). Hybrid fixation was performed in all dogs in one or both fragments. Mean time to radiographic union was 6.9 ± 2.5 weeks (range: 4–12 weeks) in 18/20 dogs with radiographic follow-up. One complication was observed: infection that resolved with antibiotic medication and implant removal. No other major complications occurred by the time of last follow-up. In all cases (mean follow-up: 15 ± 7 months), the reported limb function as evaluated by the referring veterinarian or owner was excellent.

Clinical significance: The LCP, used as a hybrid construct for the treatment of distal radial and ulnar fractures was shown to yield excellent clinical results with both uncomplicated healing and excellent functional outcomes in this series of toy and miniature breed dogs.

Short and long-term outcome following surgical stabilization of tarsocrural instability in dogs

Objectives: To evaluate the outcome and complications following surgical stabilization of canine tarsocrural luxations.

Methods: Medical records of dogs which were surgically treated for tarsocrural joint instability between February 2007 and June 2014 were reviewed. Surgical technique, complications and long-term outcome (via questionnaire and Canine Brief Pain Inventory) were assessed.

Results: Twenty-four dogs (26 joints) were included. All injuries were traumatic. All joints had associated fractures; malleolar in 21/26 limbs (13/26 medial). Eight joints had internal fracture fixation and transarticular external skeletal fixator, six had external fixator alone, four had prosthetic ligaments with external fixator, and four had prosthetic ligaments with external coaptation. Two joints had pantarsal arthrodesis and two primary ligament repair. Complications occurred in 24/26 limbs giving 45 distinct complications; 16 were minor, 29 major, and 31 complications were external fixator associated. Prosthetic ligaments were significantly associated with major complications (p = 0.017); five out of eight required subsequent removal between 105–1006 days. Cost was significantly associated with major complications (p = 0.017) and soft tissue wounds (p = 0.03). Long-term lameness was seen in nine of 14 dogs. There was no association between pain severity (p = 0.3) and pain interference scores (p = 0.198) when comparing stabilization methods.

Clinical significance: Complications are common; however many are external fixator related. Prosthetic ligaments are significantly associated with major complications. Regardless of technique, a degree of ongoing lameness is likely.

Radial and ulnar fracture treatment with paraosseous clamp-cerclage stabilisation technique in 17 toy breed dogs

Objective

Description of surgical technique, complications and outcome of radius/ulna fractures in toy and miniature breed dogs treated with the paraosseous clamp-cerclage stabilisation (PCCS) method.

Study design

Retrospective study.

Methods

Clinical records of small breed dogs with fractures of the radius and ulna were reviewed between January 2011 and January 2016. Inclusion criteria were bodyweight of ≤3.5 kg, fracture of the radius and ulna of one or two limbs without previous repair attempts, available follow-up information, and the use of PCCS for repair of the fracture as the sole method of fixation.

Results

Seventeen fractures in 17 dogs were included in the study. Radiographic union was documented in 13/17 cases. Median time to radiographic union was 13 weeks (range: 5–53 weeks). Major complications occurred in 24 per cent (4/17) due to implant failure, and for revision surgery the PCCS method was chosen in all four cases. Three of four revised fractures healed radiographically. One of the four dogs was lost for radiographic follow-up, but the owner could be contacted for a telephone questionnaire. Eleven of 17 dogs achieved an excellent return to function without any lameness during clinical examination, but 5/17 dogs showed an intermittent mild lameness despite full radiographic union. Routine implant removal was performed in 9/17 dogs. The owners of 15/17 dogs could be contacted for a telephone questionnaire for a long-term follow-up. No further complications were reported.

Conclusions

PCCS is a feasible low-cost internal fixation technique for repairing radial and ulnar fractures in toy breed dogs. Further biomechanical and clinical studies are needed for better evaluation of the PCCS method.

The Omental Pedicle Flap in Dogs Revised and Refined: A Cadaver Study

OBJECTIVE

To expand current knowledge on the canine omental vasculature and refine the existing lengthening technique of the canine omentum.

STUDY DESIGN

Ex vivo study.

ANIMALS

Canine cadavers (n=20).

METHODS

In 10 canine cadavers the omental arteries were mapped using intravascular latex injection and these results were used to create an omental pedicle flap based on the splenic artery in 10 additional cadavers. The operating range of the flap was recorded with particular attention to the main regions of interest for omental transposition in dogs (axillary and inguinal regions).

RESULTS

The superficial and deep omental leaves were each predominantly supplied by a left and a right marginal omental artery that anastomosed near the caudal omental border into a superficial and a deep omental arch, respectively. Anastomoses between arteries of the superficial and the deep omental leaves were weak and inconsistent, except for 1 anastomosis that was found in 8 of 10 dogs. By transposing the intact omentum, the right axilla could be reached in 3 dogs, both axillae in 1 dog, and both groins in all cadavers. In all cases, the omental pedicle reached to and beyond the axillary and inguinal regions. By unfolding the pedicle leaves, the width of the pedicle tip could be doubled.

CONCLUSION

When lengthening the omentum is necessary to reach extra-abdominal structures, the omental pedicle flap based on the splenic artery appears to preserve the omental vascular supply. These observations warrant further clinical trials to evaluate this new omtental flap technique in vivo.