ABSTRACT

Heart rate variability (HRV) is a physiologic phenomenon that occurs due to changing autonomic tone resulting in variable RR intervals. A reduction in HRV is used as an index of pain in neonatal human patients. Objective measures of pain would be valuable in the evaluation of canine patients and assessment of response to pain management strategies. We hypothesized that dogs with diseases associated with discomfort (osteoarthritis and bone neoplasia) would have reduced HRV compared with normal, healthy dogs. The aim of the study was to calculate the sample size necessary to investigate this hypothesis.

Seventeen dogs from the Ryan Veterinary Hospital of the University of Pennsylvania patient population or owned by Ryan Veterinary Hospital of the University of Pennsylvania staff were enrolled in this single-blind, prospective pilot study. A 30 min electrocardiogram (ECG) was obtained from each dog using an ambulatory electrocardiographic monitor. All ECGs were obtained between 10 a.m. and 2 p.m. ECGs were analyzed and time-domain HRV indices computed.

Sample size calculations suggest that 207 dogs would be necessary to ascertain if HRV is reduced in dogs experiencing discomfort or pain (50 in the arthritis group, 79 in the bone cancer group, and 78 in the control group).

ABSTRACT

Gastropexy is a surgical technique performed to prevent and decrease the recurrence rate of gastric dilatation and volvulus (GDV). The objective of this prospective, a descriptive cohort study on 100 client-owned dogs who were presented with GDV, is to describe a modified belt-loop gastropexy and determine its intraoperative complications and long-term efficacy.

The transversus abdominis muscle was used to make an oblique belt-loop. A seromuscular antral fold, instead of a seromuscular antral flap, was passed through the belt-loop, and then, the passed portion of the antral fold was sutured to the dissected edge of the abdominal wall. Intraoperative complications related to gastropexy were recorded, and the incidence of GDV recurrence was determined a minimum of 1 yr postoperatively via telephone with the referring veterinarians and the owners. There were no intraoperative complications related to the modified belt-loop gastropexy technique. Based on follow-up conversations, none of the dogs presented signs of GDV recurrence during the follow-up period. Based on the results, there is strong clinical evidence that a modified belt-loop gastropexy prevents recurrence of GDV in dogs surviving an acute episode.

ABSTRACT

This descriptive study was designed to ascertain the current heartworm treatment strategies employed by veterinary graduates of a single college of veterinary medicine, to assess the frequency with which each of these treatment strategies is prescribed, and to report the motivation behind the use of these treatment strategies. A survey containing a combination of multiple-choice and open-ended questions was distributed via e-mail with an online link during 2013 to graduates of the University of Georgia College of Veterinary Medicine. Demographic data and opinions regarding treatment for cases of canine heartworm disease (HWD) were obtained, and motivation for recommending different treatment strategies was assessed. Nearly all 170 respondents (99%) indicated that they recommend melarsomine dihydrochloride for first-line treatment of canine HWD. Exercise restriction (80%) and monthly heartworm preventive (75%) were components of the treatment approach to HWD with no clinical signs. The majority of respondents (74%) indicated that when first-line treatment recommendations were declined, they endorsed long-term administration of ivermectin (i.e., “slow-kill” method) despite current American Heartworm Society guidelines that recommend against the use of long-term macrocyclic lactone administration for the monotherapy treatment of canine HWD. Respondents also indicated that owners’ financial concerns frequently result in modification of HWD treatment. Routine inclusion of exercise restriction is commonly, but not universally, utilized and may represent an opportunity for improvement in the management of this disease. In addition, when first-line recommendations for heartworm disease treatment are declined, a two-dose melarsomine protocol instead of the slow-kill method should be considered.

ABSTRACT

Septic peritonitis is a common, life-threatening condition encountered in dogs and cats. Efficacy of peritoneal lavage has not been proven in veterinary studies. Our objective was to evaluate differences in bacterial identity and susceptibility in samples obtained pre- and postlavage in animals who underwent laparotomy for treatment of septic peritonitis and to assess the effect of empirical antimicrobial selection on survival. Culture samples were collected from the peritoneal surface pre- and postlavage from dogs and cats treated surgically for septic peritonitis. Culture results were compared for each patient with regard to bacterial isolates and bacterial susceptibility profiles. Survival to discharge was evaluated.

Microbial growth occurred in at least one culture in 88.6% of patients. There was no significant difference in bacterial isolates or susceptibility profiles pre- versus postlavage. Positive culture pre- or postlavage and appropriate antimicrobial selection did not significantly affect survival. For individual animals, culture results differed between pre- and postlavage samples, although no definitive effect of peritoneal lavage was seen for the population as a whole. Antimicrobials most commonly effective against isolates were Cefotaxime, Ceftazidime, and Imipenem. If prompt surgical source control is employed, antibiotic choice may not affect clinical outcome.

ABSTRACT

The objective of this study was to compare the clinical, biological, macroscopic, and histologic outcomes after resection of the soft palate by plasma-mediated bipolar radiofrequency ablation (PBRA) or traditional incisional techniques (incisional soft palate resection [INC]) in dogs.

Ten dogs were divided in two groups. In the INC group, the soft palate was incised with scissors and the wound was sutured in a continuous pattern. In the PBRA group, a wand was used to ablate the desired portion of the soft palate, without suture. Clinical, biological, macroscopic, and histologic assessments were scheduled over 14 days.

The duration of surgery was significantly shorter for the PBRA group. The C-reactive protein concentrations were significantly higher in the PBRA group at 6 hr and on day 3 (P < .05) but with values very close to the baseline. C-reactive protein concentrations were maximal, but with low values (<25 mg/L), at day 1 for both techniques. The irregularity scores for the soft palate caudal border on days 1, 3, and 14 were significantly higher in the INC group than in the PBRA group (P < .05). The main histopathologic changes were the presence of superficial granulomas and a significantly greater depth of tissue damage in the INC group (2.5 ± 0.3 mm) compared with the PBRA group (1.5 ± 0.1 mm; P < .05).

PBRA compared favorably with the traditional technique in terms of ease, duration of surgery, and depth of tissue damage. Future studies are warranted to validate its effectiveness for treating brachycephalic airway obstruction syndrome in dogs.

ABSTRACT

The purpose of the study was to report the postoperative outcome, complications, and long-term follow-up of the use of a static hydraulic urethral sphincter for the management of urethral sphincter mechanism incompetence in female dogs. Medical records were reviewed to extract information on long-term (>365 days) outcome data. Telephone owner questionnaire was performed to assess postoperative urinary continence scores (scale 1–10, where 10 is complete continence) and the presence and frequency of complications. Twenty female dogs were included. Mean (±standard deviation) time to follow-up was 1,205.1 (±627.4) days. Median continence score/10 (range) was 3.5 (2–6) preoperatively, and 9.0 (7–10) at the last follow-up. Median continence score was significantly higher at all time points postoperatively compared with before surgery (P < .001). Complete continence was achieved in 90% of bitches. Minor complications occurred in 13 bitches and included dysuria (8), bacterial cystitis (8), longer urination time (10), incisional seroma (5), urinary retention (3), hematuria (2), and pain when urinating (2). Major complications occurred in one dog (static hydraulic urethral sphincter removed 28 mo after placement). Continence scores were sustainably improved in the long-term. Complications were mostly minor. Urinary tract infections were the most common but resolved with conventional antibiotic treatment.

ABSTRACT

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.

ABSTRACT

Feline exocrine pancreatic carcinoma has been reported to be an aggressive tumor with a high metastatic rate and poor prognosis. Studies reporting long-term outcome of cats after surgical removal of solitary pancreatic carcinomas are rare, due to the uncommon diagnosis and paucity of cats who undergo treatment. In this study, nine cases of feline exocrine pancreatic carcinoma from seven academic and private practice veterinary hospitals were reviewed to examine the outcome in cats undergoing surgical removal of the mass. The median postsurgical survival time for the nine cats was 316.5 days (range, 25–964 days), with three cats alive at a median follow-up time of 309 days. This study demonstrates that surgical removal of pancreatic exocrine tumors in cats with localized disease can result in survival times of over 300 days.

ABSTRACT

A 7 yr old spayed female shih tzu was evaluated for anorexia of 4 days duration. Conservative treatment for gastroenteritis had been administered by another veterinarian 2 days before presentation. Abdominal radiography revealed two round, disk-shaped, metallic-opacity foreign objects within the bowel with loss of serosal detail. Exploratory laparotomy was performed and revealed circumferential full-thickness necrosis and perforation of the intestines at the ileocolic junction with a small amount of peritoneal effusion. Two disk batteries were palpated in the colon and milked out of the rectum. An ileocolic anastomosis was performed without complication. However, the dog died following cardiopulmonary arrest shortly after extubation. Disk batteries are capable of causing severe tissue necrosis due to the generation of electric current when prolonged contact with mucosal surfaces occurs. Immediate removal is recommended to prevent gastrointestinal perforation and potential fatalities.

ABSTRACT

An 11 yr old female spayed golden retriever weighing 30.3 kg presented for evaluation of progressive lethargy, anorexia, tachypnea, stiff gait, and nonlocalized pain. On physical exam, the patient was febrile and tachycardic, and an arrhythmia with pulse deficits was noted. Clinicopathological abnormalities included thrombocytopenia, leukocytosis, nonregenerative anemia, and mild hypoalbuminemia. The patient progressed overnight to develop a productive cough, and an echocardiogram performed the next morning revealed irregular proliferative lesions of the pulmonic valve with moderate pulmonic regurgitation. Subsequent blood cultures grew two organisms: alpha-hemolytic streptococci spp. and Empedobacter brevis. The dog was treated with appropriate intravenous antibiotics for 2 wk and then switched to oral therapy. The clinicopathologic abnormalities, fever, and clinical signs resolved with oral antibiotic treatment. To the authors' knowledge, this case report represents the first detailed published case of bacterial endocarditis with E brevis bacteremia involving the pulmonic valve. The clinical presentation, diagnosis, treatment, and follow-up are discussed.

ABSTRACT

A 5 mo old English setter dog was presented with mild left forelimb lameness. Physical examination revealed pain upon shoulder palpation and extension. Mediolateral radiographs of both shoulders showed a subchondral bone defect in the mid-portion of the glenoid cavity. Computed tomography arthrography and arthroscopy revealed a cartilage flap, suggesting osteochondritis dissecans of the glenoid cavity. Subchondral bone cysts of the glenoid cavity and incomplete fusion of the supraglenoid tubercle were also observed. Arthroscopic removal of the fragment led to a favorable outcome.

ABSTRACT

A 10 yr old papillon was evaluated for lethargy, inappetence, tachypnea, and labored breathing. Physical examination findings included dehydration, tachypnea, tachycardia, and muffled heart sounds. Thoracic radiographs revealed an enlarged cardiac silhouette. Echocardiography revealed a mild volume of pericardial effusion and no evidence of right atrial tamponade or a cardiac-associated mass. Cytological analysis of the pericardial effusion was consistent with blood. There was no evidence of neoplasia. Coagulation parameters were within normal limits. Initial treatment consisted of pericardiocentesis. A subtotal pericardiectomy was later performed. No surgical complications were noted, and the dog was discharged 2 days following surgery. Results of the histological examination of the pericardium revealed hemangiosarcoma. Treatment with doxorubicin was initiated 12 days after surgery, at which time, pulmonary metastasis was suspected. The dog survived for 18 days after subtotal pericardiectomy, when it was euthanized because of complications presumably related to pulmonary metastatic disease. This is the first published report of primary pericardial hemangiosarcoma. The dog had a short survival time; thus, the response to subtotal pericardiectomy combined with adjuvant doxorubicin treatment could not be determined. Pulmonary metastatic disease was suspected 12 days following surgery. Based on this case report, pericardial hemangiosarcoma carries a guarded prognosis.

ABSTRACT

A 2 yr old male castrated golden retriever was evaluated for a rapidly progressing maxillofacial spindle cell tumor. On examination, an ill-defined left maxillary mass, a 2 cm swelling under the left eye, and an enlarged left mandibular lymph node were noted. The dog was bright and alert but appeared painful upon jaw extension. Cytology from the lymph node revealed metastatic disease. Thoracic radiographs and computed tomography scan revealed pulmonary nodules. Computed tomography of the head and neck revealed a 6.7 × 4.1 × 6.5 cm mass at the rostral aspect of the left zygomatic arch invading the orbit. A second opinion of the biopsy specimen in conjunction with positive immunohistochemical staining for desmin led to a revised diagnosis of rhabdomyosarcoma. Treatment consisted of three doses of palliative radiation therapy, in 8 Gy fractions, and chemotherapy with vincristine, cyclophosphamide, and doxorubicin. A rapid clinical response was noted shortly after treatment initiation; however, the response was temporary, and the dog was euthanized due to widespread metastatic disease and associated clinical signs 74 days after initial therapy. This is one of the first reports describing positive results from multimodal treatment with chemotherapy and radiation therapy of a maxillofacial juvenile rhabdomyosarcoma in the veterinary literature.

ABSTRACT

This case report documents a novel late surgical complication in a 2 yr old dog following an enterotomy to remove a jejunal foreign body. Twenty-six days following the original surgery, the dog was re-presented with signs consistent with an intestinal obstruction. A mural intestinal abscess was found as the cause of the obstruction during exploratory surgery, and the site was successfully removed with a resection and anastomosis. Histopathology showed multifocal abscessation with cyst-like structures partially lined with mucosa. The dog recovered without complication and remains healthy 4 mo later. The exact cause of the lesion is not known; however, local contamination through a focal mucosal defect or complications related to the use of barbed suture in the original enterotomy repair may have contributed.