Thoracic Trauma Causing an Acquired Gerbode Defect, Aortic Sinus Rupture, and Third-Degree Atrioventricular Block With Secondary Endocarditis in a Dog

•Gerbode defects are high-velocity, systolic LV-RA shunts. •Gerbode defects are rare across species; the most common etiology is acquired. •IE and arrhythmias can be fatal complications of Gerbode defects. •Aortic sinus rupture may be traumatic in origin in the dog.

Hybrid Balloon Mitral Valvuloplasty in an Adult Dog with Congenital Mitral Stenosis and Left Atrial Thrombus

•Congenital MS is a rare cardiac disease in canines. •BMV may improve the mobility of stenotic mitral leaflets. •AF and LA thrombi may occur in congenital MS.

Ex vivo comparison of different thoracoabdominal stapler sizes for typhlectomy in canine cadavers

OBJECTIVE

To determine the influence of staple size on leakage pressure of typhlectomy sites in canine cadavers.

STUDY DESIGN

Randomized, experimental cadaveric study.

ANIMALS

Twenty-four fresh canine cadavers.

METHODS

Ileocecocolic segments were exteriorized following right paracostal laparotomy after euthanasia. Cecal base length and wall thickness were measured. Each cecum was randomly assigned to 1 of 3 groups (TA 30 V3 2.5 mm, TA 60 3.5 mm, and TA 60 4.8 mm). The cecal base was stapled and the cecum was removed. A 10 cm segment including the stapled cecal excision site was tested for initial leak pressure.

RESULTS

The mean ± standard deviation body weights across the groups were 18.7 ± 6.1 kg, 16.2 ± 7.5 kg, and 14.2 ± 5.5 kg for the TA 30 V3 2.5 mm, TA 60 3.5 mm, and TA 60 4.8 mm groups, respectively (P = .48). There were no differences for mean cecal base length or wall thickness. Mean initial leak pressure (ILP) across groups was 182 ± 111 mmHg (TA 30 V3 2.5 mm), 112 ± 57 mmHg (TA 60 3.5 mm), and 77 ± 60 mmHg (TA 60 4.8 mm) (P = .78).

CONCLUSION

Each stapler size that was evaluated resulted in a mean ILP in excess of typical intraluminal pressures under normal circumstances. There were no differences among groups.

CLINICAL SIGNIFICANCE

The results of this cadaveric study support the use of any of the stapler sizes evaluated in similarly sized dogs. A prospective study is needed to be able to correlate stapler size and clinical outcome.

Influence of stapler type on in vitro leakage pressures and location of functional end-to-end stapled anastomoses

The objective of this study was to compare maximal leakage pressures and locations of 2 functional end-to-end stapled anastomosis (FEESA) constructs. Grossly normal jejunum was harvested from 4 large breed dogs. Thirty-two 8-cm segments of bowel were used to construct 16 FEESA. Construct type was divided into 2 groups: traditional FEESA (tFEESA) and modified FEESA (mFEESA). Leakage pressures and locations were recorded and compared for the 2 groups. There was no difference in the leakage pressures of the tFEESA and the mFEESA. However, 1 tFEESA did leak at subphysiologic intestinal peristaltic pressures. Although no difference in maximal leakage pressure was detected between the 2 constructs, mFEESA is an attractive alternative to tFEESA, as it requires less equipment and none of the mFEESA constructs leaked at subphysiologic pressures.

Sentinel lymph node detection differs when comparing lymphoscintigraphy to lymphography using water soluble iodinated contrast medium and digital radiography in dogs

Sentinel lymph node (SLN) mapping by various means has become standard of care in certain types of human cancers and is receiving more attention in veterinary oncology. Current SLN mapping techniques can be costly and often require advanced imaging equipment. The objective of this prospective, method comparison study was to compare an SLN mapping protocol of lymphoscintigraphy to lymphography using water soluble iodinated contrast medium (WIC) and digital radiography for identification of an SLN. Lymphoscintigraphy and lymphography were performed on eight healthy purpose-bred dogs using technetium-99m sulfur colloid and WIC injected into the subcutaneous tissues in a four-quadrant technique around a predefined area of skin on the brachium. Images were obtained using a gamma camera and digital radiography at different time points post-injection. Image sequences were evaluated by one of two American College of Veterinary Radiology board-certified veterinary radiologists. Data obtained were compared between methods using descriptive statistics. An SLN was identified in all dogs with lymphoscintigraphy and seven of eight dogs with lymphography. Agreement between results of the lymphoscintigraphy and lymphography studies was a complete match in three dogs, a partial match in four dogs, and no match in one dog. The SLN detected differed based on the imaging modality used.

Long-term outcome and risk factors associated with death or the need for revision surgery in dogs with permanent tracheostomies

OBJECTIVE

To evaluate long-term outcomes and identify factors associated with death or the need for revision surgery in dogs with permanent tracheostomies (PTs).

DESIGN

Retrospective cohort study.

ANIMALS

69 client-owned dogs that received a PT between January 2002 and June 2016 at 1 of 4 veterinary teaching hospitals.

PROCEDURES

Medical records were reviewed, and data extracted included signalment, history, clinical signs, radiographic and laryngeal examination findings, presence of esophageal abnormalities, date and reason for receiving a PT, postoperative complications, cause of death, and survival time. Dogs surviving < 2 weeks after receiving a PT were excluded.

RESULTS

Major complications occurred in 42 of 69 (61%) dogs, with aspiration pneumonia (13 [19%]), skinfold occlusion (13 [19%]), and stoma stenosis (12 [17%]) being most common. Revision surgery was performed in 24 of 69 (35%) dogs, most commonly because of stoma stenosis or skinfold occlusion (9/24 [38%] each). Brachycephalic dogs were more likely (OR, 3.5; 95% confidence interval, 1.2 to 10.2) to require revision surgery than were nonbrachycephalic dogs. The overall median survival time was 1,825 days, and dogs that received corticosteroids before receiving a PT, had tracheal collapse, or were older had shorter survival times.

CONCLUSIONS AND CLINICAL RELEVANCE

Results of the present study indicated that creation of a PT was a viable treatment option for obstructive upper airway diseases in dogs and that long-term survival after receiving a PT was possible; however, a PT may not reduce the risk of aspiration pneumonia in dogs.

The effect of surgery on lymphoscintigraphy drainage patterns from the canine brachium in a simulated tumor model

OBJECTIVE

To determine the effect of surgery on lymphoscintigraphy drainage patterns from the canine brachium.

STUDY DESIGN

Experimental study.

ANIMALS

Eight healthy research beagles.

METHODS

A predefined area of skin measuring 2 × 1.5 cm in dimension was designated on either the right or left brachium. Preoperative lymphoscintigraphy was performed with technetium sulfur colloid injected into the subcutaneous tissues around the predefined anatomic location in a four-quadrant technique. Dogs underwent surgery for excision of the predefined area of skin, subcutis, and fascia of the lateral head of the triceps muscle with 1-cm margins. Eighteen days after surgery, lymphoscintigraphy was again performed with technetium sulfur colloid injected into the subcutaneous tissues around the surgical scar in a four-quadrant technique.

RESULTS

Sentinel lymph nodes were identified in eight of eight dogs preoperatively and in eight of eight dogs postoperatively. Agreement between the results of the preoperative and postoperative lymphoscintigraphy studies was identified as complete in four of eight dogs and partial in four of eight dogs. Sentinel lymph node identification occurred immediately in three of eight dogs preoperatively and in eight of eight dogs postoperatively.

CONCLUSION

Sentinel lymph node identification occurred faster postoperatively. Agreement or partial agreement between the results of the preoperative and postoperative lymphoscintigraphy studies was observed in eight of eight dogs.

CLINICAL SIGNIFICANCE

Surgery appears to have an effect on lymphoscintigraphy drainage patterns. Additional studies are required to compare preoperative and postoperative sentinel lymph node mapping patterns in tumor-bearing dogs. However, this study provides preliminary information regarding the effect of surgery on sentinel lymph node identification.

Retrospective evaluation of 24 cases of gastrostomy tube usage in dogs with septic peritonitis (2009-2016)

OBJECTIVE

To describe the postoperative use of gastrostomy tubes (GT) in dogs with septic peritonitis. A secondary objective was to identify factors associated with GT placement and use that may be related to outcome.

DESIGN

Retrospective study.

SETTING

University teaching hospital.

ANIMALS

Twenty-four dogs diagnosed with septic peritonitis with GT placement at the time of exploratory laparotomy.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Eighteen dogs (75%) survived to discharge. Eighteen dogs (75%) had a gastrointestinal source of septic peritonitis. Complications were reported in 12/24 (50%) patients. Four dogs (16.6%) had non-GT-related complications such as vomiting, regurgitation, or increased gastric residual volume. GT-related complications occurred in 8/24 (33.3%) dogs, the majority of which (6/8 [75%]) were minor and did not necessitate removal of the GT. Two dogs had major complications that required removal of the GT. Significant differences between survivors and nonsurvivors were found between the length of time after placement of the GT to when they began eating and outcome (discharge versus death versus euthanasia) (P = 0.03), and GT dwell time (length of time the GT was in place) and outcome (P = 0.006). Clinically relevant correlations were found between the time after placement of the GT until feeding and time after placement until voluntarily eating (P = 0.0349), time after placement of the GT until voluntarily eating and length of hospitalization (P = 0.0391), and time after placement of the GT until feeding and length of hospitalization (P = 0.036).

CONCLUSIONS

GTs can be placed during exploratory laparotomy in dogs with septic peritonitis. They facilitate early enteral nutrition and are associated with few clinically significant complications. Prospective studies are needed to determine the optimal postoperative feeding plan and the effects of early enteral nutrition on serum albumin concentration in this patient population.

Description of a novel technique for surgical placement of gastrostomy tubes in dogs

BACKGROUND

Early enteral nutrition in dogs with critical illnesses, including septic peritonitis, has been shown to have a positive influence on patient outcome. Surgical placement of a gastrostomy tube (GT) is one option for providing early enteral nutrition. Complications, including premature tube removal or separation of the stomach from the body wall, can result in leakage of gastric contents into the abdominal cavity and subsequent peritonitis. A safe and reliable technique for the placement of a GT is desirable to minimize such complications.

KEY CONCEPTS

A modified method for surgical placement of a GT is described. A thoracic trocar catheter (TTC) with an attached Pezzer tube is inserted through a gastrotomy incision and exited through the left gastric body and body wall. A left-sided tube gastropexy is performed using an interlocking box (ILB) pattern.

SIGNIFICANCE

GT placement using a TTC is efficient, requiring minimal additional anesthesia time. The gastric defect created by the TTC conforms well with the Pezzer tube. As such, placement and utilization of the ILB suture pattern enables removal of the GT in the early postoperative period, if appropriate.

Owner Perception of Outcome Following Permanent Tracheostomy in Dogs

The purpose of this study was to evaluate owner perception of outcome following permanent tracheostomy (PT) in dogs. Medical records of dogs who received PT from 2002 to 2016 were reviewed. A questionnaire was given to owners verbally or by e-mail to ascertain their perception of their dog’s outcome after PT. Median time to questionnaire administration from PT surgery was 608 days (64–3,708). Owner satisfaction after PT was high (89.7%), with the majority stating they would have the procedure performed again (79.5%). Owners reported an improvement in their dog's personality (30.8%) and increased activity (41%). Median survival time was 1,825 days (64–2,663), with 6 of 39 dogs (15.4%) alive at study end. Of the 33 dogs who died, 11 (33.3%) died from underlying respiratory conditions suspected to be related to the PT. The overall complication rate was 82.1%, with mucus secretion being the most common. Revision surgery was required in 30.8% of dogs (most commonly due to skin occlusion), and aspiration pneumonia occurred in 17.9% of dogs. Overall, owner satisfaction after PT in dogs is high despite intensive postoperative management, and long survival times can be achieved.

Agreement Between Cytology and Histopathology for Regional Lymph Node Metastasis in Dogs With Melanocytic Neoplasms

Melanocytic neoplasms are common in dogs and frequently occur within the oral cavity or in haired skin. The behavior of melanocytic neoplasms is variable and depends on tumor location, size, and histopathologic features. This study compared cytopathology and histopathology of 32 lymph nodes from 27 dogs diagnosed with melanocytic neoplasms. Agreement between the original cytology report, cytology slide review, original histopathology report, and histopathology slide review was determined for each lymph node. A subset of lymph nodes was subjected to immunohistochemistry (Melan-A) and additional histochemical stains/techniques (Prussian blue, bleach) to assist in differentiation of melanocytes and melanophages. Agreement ranged from slight to fair for each of the variables evaluated with weighted kappa (κw) or kappa (κ) analysis (original cytology vs cytology review κw = 0.24; original cytology vs original histopathology κw = 0.007; original cytology vs histopathology review κw = 0.23; cytology review vs original histopathology κw = 0.008; cytology review vs histopathology review κw = 0.006; and original histopathology vs histopathology review κ = 0.18). The diagnoses (metastatic, equivocal, or negative for metastasis) of the original report and slide review for both cytology and histopathology were not significantly correlated with survival in this population of patients. Overall, agreement between cytology and histopathology was poor even with a single clinical or anatomic pathologist performing slide review. Consensus between routine cytology and histopathology for staging of lymph nodes in patients with melanocytic neoplasms is poor and does not correlate with survival.

Effect of dietary conjugated linoleic acid on marbling and intramuscular adipocytes in pork

Dietary CLA has been reported to decrease backfat and increase marbling in pigs. Our objective was to determine whether the increase in marbling involved changes in intramuscular adipocyte number or size or both. Twenty barrows (53 kg) were penned in pairs and pens were randomly assigned to receive diets containing either 1% soybean oil (SBO) or CLA (60% CLA isomers) for 6 wk. Body weight and feed intake were determined weekly. At slaughter, loin samples were obtained and flash frozen for RNA extraction and real-time reverse-transcription PCR analysis of gene expression. After a 24-h chill, loin eye area and backfat depth were measured and subjective marbling and color scores were assigned. Loin, backfat, and belly fat samples were obtained for fatty acid analysis by gas chromatography. Loin samples were also frozen in ice-cold isopentane for histological analysis of intramuscular adipocytes. Dietary CLA did not affect BW or feed intake at any point (P > 0.10), nor did treatment groups differ in HCW (P = 0.417) or loin color (P = 0.500). The CLA-fed pigs did have less (P = 0.018) backfat and smaller (P = 0.047) loin eye area than SBO-fed pigs and had a trend for an increase (P = 0.069) in marbling score. Relative gene expression for markers of preadipocytes (preadipocyte factor 1; Pref-1), differentiating adipocytes (PPARγ), and mature adipocytes [fatty acid binding protein 4 (FABP4) and perilipin (PLIN)] were determined and normalized to the expression of acidic ribosomal phosphoprotein. No significant differences were detected, but the expression of PPARγ (P = 0.265), PLIN (P = 0.265), and FABP4 (P = 0.148) was numerically greater in CLA-fed pigs than in SBO-fed pigs. Loin samples were stained with Oil Red O to identify intramuscular adipocytes. The average cell area was increased (P = 0.030) in CLA-fed pigs. The cis-9,trans-11 and trans-10,cis-12 CLA isomers were incorporated (P = 0.006) into backfat and belly fat, but only trans-10,cis-12 CLA was increased in the loin (P = 0.004) of CLA-fed pigs. The proportion of SFA was increased (P = 0.006) by CLA in all tissues. These results indicate that the increase in marbling in pigs fed CLA may be related to increased intramuscular adipocyte size, and the combination of increased marbling and degree of saturation could improve the eating quality of CLA-fed pork.