Veterinary Surgery

Objective— To report clinical and diagnostic imaging features, and outcome after surgical treatment of ventral intraspinal cysts in dogs. Study Design— Retrospective study. Animals— Dogs (n=7) with ventral intraspinal cysts. Methods— Clinical signs, magnetic resonance imaging (MRI) findings and surgical findings of 7 dogs and histologic findings (1 dog) with intraspinal cysts associated with the intervertebral disc were reviewed. Results— Ventral intraspinal cyst is characterized by: (1) clinical signs indistinguishable from those of typical disc herniation; (2) an extradural, round to oval, mass lesion with low T1 and high T2 signal intensity on MRI, compatible with a liquid-containing cyst; (3) cyst is in close proximity to the intervertebral disc; and (4) MRI signs of disc degeneration. Although the exact cause is unknown, underlying minor disc injury may predispose to cyst formation. Conclusion— Intraspinal cysts have clinical signs identical to those of disc herniation. Given the close proximity of the cyst to the corresponding disc and the similarity of MRI findings to discal cysts in humans, we propose the term “canine discal cyst” to describe this observation. Clinical Relevance— Discal cysts should be considered in the differential choices for cystic extradural compressing lesions.

Objective To report meningoencephalitis as a complication after paranasal sinus surgery in 5 horses. Study Design Case series. Animals Adult horses (n = 5). Methods Medical records (2005–2010) of 5 horses that developed neurologic signs after sinus surgery were reviewed to identify potential risk factors, cause(s), or common pathways for infection. Results Underlying diseases were primary (n = 1) and secondary sinusitis (4) because of apical dental infection (1), sinus cyst (2), or masses in the ethmoturbinate region (2). Horses were treated by conventional surgical approaches and aftercare including repeated sinus lavage. Four horses had undulating pyrexia postoperatively despite antimicrobial therapy. All horses developed neurologic signs, eventually unresponsive to treatment. Suppurative meningoencephalitis was diagnosed macro- and/or microscopically on necropsy in all horses. Conclusion Meningitis is a rare but fatal complication after sinus surgery in horses.

To determine (1) the effect of elbow incongruity on contact mechanics and (2) the effect of treatment of this incongruity with 1 of 2 ulnar ostectomies in the canine elbow.Ex vivo biomechanical study.Unpaired cadaveric canine forelimbs (n = 17).In a servohydraulic testing frame, thin-film pressure sensors were placed into the lateral and medial compartments of the elbow. Specimens were tested in 135° of elbow joint flexion at 200 N of cyclic axial force, followed by a 20 seconds hold. Intra-articular contact area (CA), mean contact pressure (mCP) and peak contact pressure (pCP) were measured in each compartment. After radial shortening, testing was repeated and limbs randomized into proximal ulnar ostectomy with IM pin (PUO) or sequential distal ulnar ostectomy (DUO), interosseous ligament release (DUO-L), and ulnar attachment of the abductor pollicis longus muscle and interosseous membrane release (DUO-ML). Paired t-tests were used to compare each treatment to baseline values. Differences between treatment groups were evaluated with a mixed model with random effect to adjust for the clustering of limbs within dog. P < .05 was considered significant.Radial shortening resulted in shift of mCP and pCP from the lateral to the medial compartment. The PUO group resulted in normalization of medial compartment mCP and decrease of pCP, whereas in the DUO group return to baseline was achieved only after DUO-ML.PUO is effective in unloading medial compartment pCP in an incongruent joint.

Objective To determine if shock wave therapy (SWT) after tibial plateau leveling osteotomy (TPLO) has a beneficial effect on patellar ligament inflammation assessed by thickening of the ligament and ligament fiber disruption. Study Design Prospective, randomized, controlled clinical trial. Animals Dogs (n = 30). Materials and Methods Dogs that had TPLO (July 1, 2009 to June 1, 2010) were enrolled. The affected stifle was examined by radiographs and ultrasonography preoperatively and 4, 6, and 8 weeks after TPLO. At 4 and 6 weeks, dogs in the treatment group were briefly anesthetized and treated with SWT. Patellar ligament thickness on a lateral radiographic projection was measured at 1/4, 1/2, 3/4 of the distance from origin to insertion. Ultrasound images were evaluated for patellar ligament disruption and periligament edema. Results There was significant difference in thickness (P = .0264) only at the distal point; therefore, only this point was used to measure difference between the control and treatment groups. A significant difference between groups was reached at 6 and 8 weeks (P = .0059 and P = .0095, respectively) postoperatively. No significant ultrasonographic differences were found. Conclusion Based on these results, SWT decreases the radiographic signs of patellar ligament desmitis.

To describe the successful management of gastric dilatation and volvulus (GDV) in a red panda.Clinical report.Red panda diagnosed with GDV.A 12-year-old male red panda (Ailurus fulgens) was evaluated for acute onset inappetence, staggering, collapse, and tachypnea. Gastric dilatation and volvulus (GDV) was diagnosed by radiography, abdominal ultrasonography, and exploratory celiotomy. Torsion of the stomach was corrected and an incisional gastropexy performed to prevent recurrence. No organs were devitalized, no other abnormalities detected, and the red panda recovered fully within 72 hours.GDV should be considered as a differential diagnosis for red pandas presenting with acute onset of unspecific signs such as collapse, inappetence, and abdominal distension. GDV in red pandas can be diagnosed and successfully treated as described in dogs.

To determine the effects of uniaxial cyclic tensile load amplitude and duration on gene expression in cranial cruciate ligamentocytes cultured in monolayer.In vitro experimental study.Adult dogs (n=9) weighing 20-35 kg.Cranial cruciate ligaments (CCL, n=18) were aseptically collected, diced, digested using clostridial collagenase, and primary monolayer cultures were established. CCL cells were seeded at a concentration of 3 x 10(5) cells/mL onto a specialized collagen membrane. After 24 hours to allow attachment, ligamentocytes were subjected to 0%, 4%, or 8% uniaxial strain for 24 or 48 hours using a sinusoidal strain profile at 0.5 Hz. At the end of each time point, the ligamentocytes were harvested and analyzed for collagen 1 (COL1), collagen 3 (COL3), and matrix metalloproteinase-3 (MMP-3) gene expression using reverse transcriptase real-time polymerase chain reaction.Approximately 33% of CCL processed for this study yielded viable cell cultures compared with 100% of the medial collateral ligaments processed. For CCL cells under uniaxial strain, gene expression for COL1 was variable, but higher strains and longer time in culture resulted in increased COL1 expression. There were no significant differences found for COL3 at any time point or between strain regimens. In general, MMP-3 gene expression was increased early in tissue culture and at higher strains.COL1 and MMP-3 gene expression can be influenced by amplitude and duration of strain on CCL cells in monolayer culture.These data have implications for modeling and understanding canine cruciate ligament pathophysiology. In particular, MMP-3 could serve as a potential preventative or therapeutic target in cruciate disease.

To report technique for, and outcome after, nephrectomy through a ventral median celiotomy in equids.Case series.Equids with unilateral renal disease (n = 6), aged 2 months to 18 years, weighing 90-434 kg.A ventral median celiotomy was used to access the left or right kidney. To facilitate surgical exposure, the small intestine was reflected towards the diaphragm using laparotomy sponges and the ascending colon was exteriorized and in some cases evacuated. The peritoneum over the affected kidney was incised and blunt dissection used to free the kidney from the retroperitoneal fat, then the renal artery, vein, and ureter were isolated and ligated. Abdominal lavage with sterile saline solution was performed before abdominal closure.Four horses, 1 donkey, and 1 mule had unilateral nephrectomy to treat verminous nephritis (1), idiopathic hematuria (1), and ectopic ureter (4). A ventral median approach provided adequate access to the kidney in all 6 cases. Two horses had postoperative complications (peritonitis, chylous abdominal effusion) that resolved with medical therapy. No complications attributable to nephrectomy were reported by the owners upon follow-up 1-8 years after surgery.A ventral median approach for nephrectomy can be used for unilateral nephrectomy in equids weighing up to 434 kg.

To compare 2 sutured techniques with a skin stapled technique for typhlotomy closure in bovines.Ex-vivo study.Bovine fresh cadaveric ceca (n = 27).Typhlotomies (4 cm in length) were made on the cecal apex and closed with 1 of the following techniques: hand-sewn, 2-layer suture consisting of a continuous, full-thickness layer oversewn with a Cushing layer (Group FC); hand-sewn, double inverting suture consisting of a 1st Cushing layer oversewn with an additional Cushing layer (Group CC); skin staples (Group S). Closure time, bursting pressure, and related costs of each technique were calculated and compared.Median (range) construction time for group S was 1.12 (0.49-1.3) min and was significantly shorter than for group FC 5.14 min (3.45-7.44), and for group CC 4.26 min (2.3-5.52) (95% CI 3.342-4.851), (P = .007). There was no significant difference between bursting pressures of group S (91.67 ± 15.41 mmHg, 95% CI 79.82-103.5) compared with group FC (119.4 ± 40.03 mmHg, 95% CI 88.67-150.2) (P = .160) and compared with group CC (103.3 ± 32.31 mmHg, 95% CI 78.5-128.2) (P = .707) CONCLUSION: Hand-sewn techniques are effective but fairly demanding in terms of time. Skin staples are less time-consuming, and resist pressures comparable to those resisted by handsewn techniques. For this reason, an SKS technique may be a valid option for typhlotomy closure in cattle.

To test the efficacy of a piezoelectric instrument (PI) for bone removal during ventral slot surgery.Ex vivo feasibility study.Cadaveric canine cervical spinal specimens (n = 3; C1-7; C1-T1; C2-T1).The spinal cord of each explanted spinal unit was replaced with a saline-filled latex condom. In 8 disc spaces, ventral slot surgery was performed using a previously reported technique. Bone removal was achieved using a motorized burr (MB). In 8 disc spaces, bone was removed via en bloc ostectomy with a PI that selectively cuts mineralized tissue. Surgical duration and operating field visibility were recorded. Rupture of the fluid filled condom was used as a measure of iatrogenic collateral trauma. Computed tomography was used to measure ventral slot morphometry.Mean surgical duration for PI (23.4 minutes) was significantly shorter than for MB (34.1 minutes; P = .049). Using a 4 point Likert scale (4 = excellent, 3 = good, 2 = fair, 1 = poor), median visibility score was significantly higher for PI (2) than for MB (1; P = .03). The condom burst twice (1MB, 1PI) during elevation of the dorsal longitudinal ligament; there was no significant difference between techniques for incidence of collateral trauma (P = .99). Regardless of surgical technique, there was a bias in slot deviation towards the right (i.e., the surgeon's left; P = .021).The PI allowed completion of ventral slots in a significantly shorter time, without an increased incidence of iatrogenic trauma. The right-handed surgeon showed a left-sided aiming bias, regardless of surgical technique.

To compare the proportion of the proximal recess of the navicular bursa that could be examined through a single endoscopic portal and the severity of iatrogenic lesions between conventional and modified approaches.Descriptive study.Equine cadaver forelimbs (n=16).Arthroscopic access to the navicular bursa in 1 limb of each pair was by a conventional approach and in the other limb, by a modified approach using sharp dissection through the distal digital flexor sheath, immediately palmar to the T ligament. The time required to access the bursa and the estimated proportion of the navicular bone that could be seen with each approach were recorded. Iatrogenic damage to the navicular bone and the deep digital flexor tendon (DDFT) were quantified.The mean access time to the navicular bursa using the conventional approach was 1.21+/-0.41 minutes compared with 2.09+/-0.86 minutes using the modified technique. The estimated proportions of the bursa visible through a single endoscopic portal using the conventional and modified approaches were 60% and 80%, respectively. Scores for navicular bone (P=.003) and DDFT (P=.012) damage using the conventional approach were significantly higher than those using the modified approach.A modified, transthecal approach to the navicular bursa under direct observation resulted in significantly less iatrogenic damage than the conventional approach.With experience, the modified approach is straightforward, reasonably rapid, and allows near-complete examination of the navicular bursa through a single portal, with minimal iatrogenic damage to the intrabursal structures.

(1) To describe a surgical technique adapted from the "transobturator vaginal tape inside-out" (TVT-O) used in women and to define the trajectory of the tape on canine cadavers, and (2) to determine the urodynamic and morphological effects of the TVT-O in continent bitches.Cadaveric and experimental in vivo study.Fresh female canine cadavers (n=12) and spayed female Beagle dogs (2).(1) TVT-O was inserted in 12 cadavers. Dissection was performed and distances between the tape and neighboring structures were recorded. (2) TVT-O was inserted in 2 continent female Beagle dogs. Urethral pressure profilometry and vaginourethrograms were performed preoperatively, immediately after surgery, and 2, 4, and 6 months postoperatively. Histopathology was performed 6 months after surgery.(1) TVT-O tape was consistently located in a perineal space before entering the obturator foramina and was located at a safe distance from major neurovascular structures including the femoral vessels and obturator nerve. (2) TVT-O was performed without any surgical or postoperative complications in 2 continent bitches. Histopathologic examination of the tissues surrounding the tape revealed a mild fibroblastic proliferation with a mild to minimal lymphoplasmacytic inflammatory infiltration.TVT-O is a feasible and accurate procedure that can be performed in continent bitches with a low risk of complications.