TRANS-SPLENIC PORTAL SCINTIGRAPHY IN NORMAL DOGS

The purpose of this study was to (1) establish a technique for ultrasound-guided trans-splenic portal scintigraphy (TSPS) using 99mTcO4(-), (2) evaluate portal vein morphology, (3) compare the radiation exposures for TSPS vs. per-rectal portal scintigraphy (PRPS), and (4) compare the quality of numerical data from the TSPS vs. PRPS. Eight juvenile dogs underwent PRPS and TSPS (minimum of 48h between studies) after initial screening tests. PRPS was done according to established protocol using 425 +/- 36MBq (mean +/- SD) of 99mTcO4(-). TSPS was done with the dogs in right lateral recumbency over the gamma camera. 99mTcO4(-) (57 +/- 13.9 MBq) was injected into the spleen 1-2s following initiation of the dynamic acquisition. The frame rate was 4 frames/s for 5 min. There was significantly lower radioactivity of 99mTcO4(-) given and significantly higher total counts recorded in the liver and heart during the TSPS compared with PRPS. The total counts for the TSPS and PRPS were 7120 +/- 4386 and 830 +/- 523, respectively. Percent absorption from the spleen was 52.5 +/- 19.1% compared with 9.2 +/- 5.7% for the colon. Calculated transit time for the TSPS studies was 7 +/- 2.3s. In TSPS studies, the splenic and portal veins were clearly identified. Radiation exposure levels of the dogs were significantly lower following TSPS than after PRPS. TSPS appears superior to PRPS as a method to image the portal venous system representing a valid alternative diagnostic test for animals with suspected portosystemic shunts.     

Use of transcolonic portal scintigraphy to evaluate efficacy of cellophane banding of congenital extrahepatic portosystemic shunts in 16 dogs

OBJECTIVE: To evaluate the efficacy of cellophane banding of single congenital extrahepatic portosystemic shunts in dogs using transcolonic portal scintigraphy. To investigate the portal circulation of those dogs with elevated postoperative shunt fractions to determine the cause of the persistent shunting. Further, to evaluate whether presenting signs, clinical pathology findings and liver histopathology are predictive of outcome. DESIGN: Prospective study of 16 dogs presenting with single congenital extrahepatic portosystemic shunts. PROCEDURE: Dogs with single extrahepatic portosystemic shunts attenuated by cellophane banding underwent portal scintigraphy and bile acids tolerance testing pre- and post-operatively. Dogs identified with elevated shunt fractions at 10 weeks post-operatively underwent mesenteric portovenography. Qualitative hepatic histopathology from all dogs was reviewed by a veterinary pathologist and assigned a semi-quantitative score to identify any abnormalities that may predict surgical outcome. RESULTS: At 10 weeks post cellophane banding, 10 of 16 cases (63%) had normal shunt fractions, whilst six dogs (37%) had increased shunt fractions and seven dogs (44%) had increased serum bile acids. Of these dogs, mesenteric portovenography revealed incomplete closure of the shunt in three dogs (18.6%) and multiple acquired shunts in three dogs (18.6%). Liver histopathology findings were similar for all dogs, regardless of outcome. CONCLUSIONS: Cellophane banding is an efficacious method for complete gradual occlusion of single extrahepatic shunts when the shunt vessel is attenuated to < or = 3 mm. Transcolonic portal scintigraphy is a reliable method for assessment of shunt attenuation and, unlike serum bile acids, is not influenced by other causes of liver dysfunction.     

Portal streamlining as a cause of nonuniform hepatic distribution of sodium pertechnetate during per-rectal portal scintigraphy in the dog

The purpose of this study was to evaluate nonuniform patterns of vascular distribution of pertechnetate in the dog during per-rectal portal scintigraphy. Ninety-two studies were reviewed retrospectively to document the patterns of radionuclide distribution. Forty-five studies were classified as normal and 47 were classified as diagnostic for a macrovascular portosystemic shunt. In these dogs, shunt fractions were calculated and compared using a t-test. In dogs with sufficient liver radioactivity for evaluation, the study was classified as having uniform, dorsal, central, or ventral radiopharmaceutical distributions. There were 51 animals (45 normal and six dogs with low-magnitude portosystemic shunts) with sufficient liver activity to assess the radionuclide distribution within the liver. A one-way ANOVA was used to compare shunt fractions between each of the distribution patterns. Two dogs were anesthetized and selective portovenograms were performed. Portovenograms were compared with the scintigraphic images to correlate the vascular distribution of the right, central, and left divisional branches of the portal vein. The shunt fraction in the 45 normal dogs was significantly lower than in the dogs with portosystemic shunts (5.7% +/- 4.8% vs. 78.6% +/- 20.0% (mean +/- SD), P < 0.001). Of the 51 dogs with sufficient liver activity to classify the pattern of distribution, there were 15/51 (31.4%) with uniform radionuclide distribution, 10/51 (19.6%) with focal dorsal distribution, 15/51 (29.4%) with focal ventral distribution, and 10/51 (19.6%) with focal central distribution. There was no significant difference in the shunt fractions between the groups. There were six dogs diagnosed with low-magnitude portosystemic shunt with sufficient liver radioactivity to categorize the vascular distribution of the radionuclide within the liver. Of these six dogs, two had focal dorsal distribution, one had focal central, one had focal ventral and two had uniform distribution. Focal dorsal distribution could result from streamlining of the radionuclide into the right divisional branch of the portal vein. Focal ventral distribution could result from streamlining the radionuclide into the left divisional branch of the portal vein. Focal central distribution could result from streamlining the radionuclide into the central divisional branch of the portal vein.     

Per rectal portal scintigraphy in the diagnosis and management of feline congenital portosystemic shunts

Five cats with a congenital portosystemic shunt (CPSS) were examined using transcolonic portal scintigraphy before and after surgical ligation of the shunting vessel. The mean shunt index before surgery was 52 per cent (range 45 to 61 per cent). Repeat portal scintigraphy, six to eight weeks after surgery, indicated a significant reduction in shunt index (mean 13 per cent, range 5 to 25 per cent) in four cats. In one of these cats a marked reduction in the shunt index, as determined by scintigraphy, preceded normal fasting blood ammonia. In the fifth cat there was no significant change in the shunt index, fasting serum bile acids and blood ammonia six months after surgery, although its clinical signs of hepatic encephalopathy had improved. Portal scintigraphy is useful in the diagnosis of CPSS and enables a quantitative assessment of the effects of surgery and may be a more accurate indicator of the degree of shunting after surgery than blood ammonia and serum bile acids.     

Liver Size,Bodyweight, and Tolerance to Acute Complete Occlusion of Congenital Extrahepatic Portosystemic Shunts in Dogs

Objective— To investigate the relationship between preoperative liver size, bodyweight, and tolerance to shunt occlusion in dogs with congenital extrahepatic portosystemic shunt(s) (CPSS). Study Design— Longitudinal cohort study. Animals— Dogs with CPSS (n=35). Methods— Ultrasonography was used to measure preoperative maximum transverse dimension of the liver (TS) of each dog. Intraoperative portal pressures were measured, before and after CPSS occlusion, via a jejunal vein catheter. Tolerance to shunt occlusion was judged on gross visceral observations, and on changes in portal pressure, central venous and mean arterial pressures. Results— TS was significantly related to bodyweight (P<.05). Mean ratios for TS/bodyweight were calculated for dogs tolerant and intolerant of acute complete shunt occlusion. Dogs tolerant to occlusion had significantly higher TS/bodyweight ratios than dogs intolerant to occlusion (P=.025). Dogs with a TS/bodyweight ratio of >7 were more likely to tolerate CPSS occlusion than dogs with a TS/bodyweight ratio of <5 (P=.036). A model was generated to predict portal pressure rise after shunt occlusion, based on liver dimensions and bodyweight (R=0.668). Intestinal oxygenation did not correlate significantly with tolerance to CPSS occlusion (P=.29). Conclusion— In dogs with CPSS, liver size (relative to bodyweight) is significantly greater (P=.025) in dogs that are tolerant of full ligation than intolerant of occlusion. Clinical Relevance— Preoperative measurement of bodyweight and liver size help indicate the likelihood of tolerance to acute complete occlusion of CPSS in dogs.     

Endogenous Benzodiazepine Activity in the Peripheral and Portal Blood of Dogs With Congenital Portosystemic Shunts

Objective- The purpose of this study was to determine whether an endogenous benzodiazepine receptor ligand (EBZ) was present in the arterial and portal blood of dogs with congenital portosystemic shunts (CPSS).
Study Design- The presence or absence of an EBZ was determined by the collection of systemic and portal blood from dogs with CPSS.
Animals- Fifteen client-owned dogs with a confirmed CPSS. All dogs had historical signs compatible with hepatic encephalopathy. Eight healthy dogs were used as controls.
Methods- In all dogs, systemic blood samples were collected after they were anesthetized. Portal blood samples were collected intraoperatively. EBZ was measured by radioreceptor assay.
Results- In 10 of 15 dogs, the portal blood concentration of EBZ was significantly elevated compared with normal dogs (mean, 13.2 ±18.55 ng/mL). Five dogs had elevated systemic blood EBZ levels (mean, 8.2 ±16.08 ng/mL). Eleven of 15 dogs had a higher portal than systemic blood concentration of EBZ. In contrast, control dogs had extremely low EBZ concentrations detected in their portal blood (mean, 0.16 ±0.3 ng/mL) and systemic blood (0 ng/mL). The mean portal and systemic blood concentrations in dogs with CPSS were significantly greater than in control dogs ( P <.05).
Conclusions- Elevated blood levels of EBZ were found in dogs with CPSS. The portosystemic gradient noted in 11 dogs suggests the gastrointestinal tract as a possible source for the endogenous ligand.
Clinical Relevance- Generalized motor seizures have been reported in dogs after surgical correction of CPSS. If the presence of a CPSS results in stimulation of brain receptors for benzodiazepines, post-CPSS ligation seizures may result from a withdrawal of EBZ after ligation of the portosystemic shunt.     

USE OF 99MTCO TRANS-SPLENIC PORTAL SCINTIGRAPHY FOR DIAGNOSIS OF PORTOSYSTEMIC SHUNTS IN 28 DOGS

Ultrasound-guided percutaneous trans-splenic portal scintigraphy (TSPS) using 99mTcO4(-) has been used to image the portal venous system in normal dogs. Compared with per-rectal portal scintigraphy, it provides higher count density, consistent nuclear venograms of the splenic and portal vein, and significantly decreased radiation exposures. This paper describes the use of TSPS for the diagnosis of portosystemic shunts in 28 dogs. TSPS was performed injecting 70 +/- 28 MBq of 99mTcO4(-) (mean +/- SD) into the splenic parenchyma with ultrasound guidance. A dynamic acquisition at a frame rate of four frames/s for 5 min was initiated after placement of the needle and approximately 2s prior to injection. All dogs had diagnoses confirmed via exploratory laparotomy or ultrasonographic identification of the shunting vessel(s). Three studies (10.7%) were nondiagnostic because of intraperitoneal rather than intrasplenic injection of the radionuclide. Three pathways were recognized on the scintigraphic images: (1) portoazygos shunts--the 99mTcO4(-) bolus traveled dorsally, running parallel to the spine and entering the heart craniodorsally; (2) single portocaval or splenocaval shunts--the 99mTcO4(-) bolus ran from the area of the portal vein/splenic vein junction in a linear fashion toward the caudal vena cava entering the heart caudally; (3) internal thoracic shunt-the 99mTcO4 bolus traveled ventrally along the thorax and abdomen entering the cranial aspect of the heart. Single and multiple shunts were easily distinguished. There were no distinguishing features between single intra and extrahepatic portocaval shunts.     

Per Rectal Portal Scintigraphy Using 99mTechnetium Pertechnetate to Diagnose Portosystemic Shunts in Dogs and Cats

Per rectal portal scintigraphy using 99mTechnetium pertechnetate (99mTcO4-) was used to diagnose portosystemic shunts (PSS) before surgical confirmation in seven dogs and two cats. Shunt fractions, representing the percent of portal blood that bypasses the liver, were determined by computer analysis of the scintigraphic images. Animals with portosystemic shunts had a mean preoperative shunt fraction of 84.02% (n = 9). The mean postoperative shunt fraction in four animals was 58.22%. The mean shunt fraction in ten control dogs was 5.00%. Per rectal portal scintigraphy is an innovative, easily performed, inexpensive method to diagnose congenital portosystemic shunts in dogs and cats.     

Hepatic Volume Measurements in Dogs with Extrahepatic Congenital Portosystemic Shunts before and after Surgical Attenuation

Background: In dogs with congenital portosystemic shunts (CPSS), the ability of the hypoplastic liver to grow is considered important for recovery after surgical shunt attenuation.
Objectives: This study investigated hepatic growth after extrahepatic shunt attenuation in dogs using magnetic resonance imaging (MRI) and computed tomography (CT).
Animals: Ten client-owned dogs with single extrahepatic CPSS.
Methods: Abdominal MRI, CT, or both were performed before and 8 days, 1, and 2 months after shunt attenuation. Liver volumes were calculated from the areas of the MRI or CT images.
Results: Before surgery, median liver volume was 18.2 cm³/kg body weight. Liver volume increased significantly after surgery. Growth was highest between days 0 and 8 and decreased afterward. Median liver volume was 28.8 cm³/kg at 2 months after attenuation. No significant differences in growth were found between dogs with complete or partial shunt closure or between dogs with complete or incomplete metabolic recovery. Volumes measured from consecutively performed MRI and CT images correlated well ( r = 0.980), but volumes from MRI images were significantly larger than volumes from CT images (6.8%; P = .008).
Conclusion and Clinical Importance: After shunt attenuation, rapid normalization of liver size was observed. Hepatic growth was not decreased in dogs after partial closure of CPSS or in dogs with subclinical, persistent shunting 2 months after surgery. CT is the preferred imaging method for volumetric estimation because of speed.     

Hemostatic profiles in 39 dogs with congenital portosystemic shunts

OBJECTIVES: To determine if there were significant changes in prothrombin time (PT), partial thromboplastin time (PTT), and fibrinogen levels in dogs with naturally occurring congenital portosystemic shunts (CPSS) and to determine if there was any association between these values, serum albumin concentration, and the ability to attenuate the shunt vessel. STUDY DESIGN: Retrospective clinical study. ANIMALS: Thirty-nine client-owned dogs. METHODS: Medical records of 60 dogs with confirmed CPSS were retrospectively evaluated. Hemostatic profiles had been performed before surgery in 39 cases. RESULTS: Dogs with CPSS had significantly higher values for PTT (P < .001) when compared with normal dogs. Of the total number of dogs, 64.1% had a PTT greater than 16 seconds (25/39). PTT was prolonged by 25% or more in 51.3% of dogs (20/39). PT tended to be higher in dogs with CPSS (P = .036), although only 7.7% (3/39) of dogs had a PT greater than 12 seconds (the maximum reference value). Dogs with CPSS had significantly lower values for albumin and fibrinogen (P < .001). Platelet numbers were within the normal range in 87.2% of cases (34/39). Of the 5 dogs with platelet numbers outside the normal range, 3 were mildly thrombocytopenic. Fibrin degradation product concentrations were not elevated in any dogs tested (N = 22). There was no significant difference in any of the measured variables between dogs with extrahepatic shunts and those with intrahepatic shunts (P > .1). For PT, PTT, albumin, and fibrinogen, there was no significant difference between dogs that underwent total, partial, or no attenuation (P > .3). CONCLUSIONS: Dogs with CPSS have a tendency to have a prolonged PTT. There was no significant difference in hemostatic profile results between dogs with intrahepatic shunts versus extrahepatic shunts. Preoperative hemostatic profile abnormalities were not useful as predictors of ability to attenuate CPSS. CLINICAL RELEVANCE: Prolonged PTT was not associated with bleeding tendencies in any of the dogs. Assays of individual clotting factors may help to further characterize the abnormalities present in animals with CPSS and may identify specific factor deficiencies. This might enable identification of a noninvasive diagnostic or prognostic indicator.     

Congenital portosystemic shunts in dogs: 46 cases (1979-1986)

Congenital portosystemic shunts (CPSS) were diagnosed in 46 dogs. The historic, physical, and laboratory findings were tabulated. Half of the affected males were cryptorchid. Urolithiasis was detected in 20% of the dogs. The biochemical tests with the best sensitivity for the diagnosis of CPSS were sulfobromophthalein retention, fasting serum ammonia concentration, and serum alkaline phosphatase activity. The survival time and quality of life were assessed by physical and biochemical reevaluation of the dogs and by means of a questionnaire that was completed by the owners. Five dogs were treated medically. Thirty-three dogs were treated surgically. Dogs that had complete surgical occlusion of the CPSS became normal, and quality of life was excellent. Dogs that had partial occlusion of the CPSS improved, and some became clinically normal. Dogs that did not have surgical correction of the CPSS had continuation of signs, but several survived for years.     

Thoracoscopic Thoracic Duct Ligation and Thoracoscopic Pericardectomy for Treatment of Chylothorax in Dogs

Objective— To report the use of thoracoscopic thoracic duct ligation (TDL) and pericardectomy for treatment of chylothorax.
Study Design— Case series.
Animals— Dogs with chylothorax (n=12).
Methods— Dogs with secondary or idiopathic chylothorax had thoracoscopy performed in sternal recumbency through 3 portals in the caudal right hemithorax for TDL and were then repositioned in dorsal recumbency for pericardectomy. Portals were placed in the 5th and 7th intercostal spaces of the right hemithorax with 1 transdiaphragmatic portal in the right paraxiphoid position. Follow-up was performed by recheck examination or telephone interview to determine outcome.
Results— Seven dogs (58%) had idiopathic chylothorax; 6 dogs (85.7%) had complete resolution of their effusion, whereas only 2 of the 5 nonidiopathic dogs (40%) had complete resolution.
Conclusions— Thoracoscopy is minimally invasive, provides excellent observation, and allows for ligation of the thoracic duct in the caudal thorax. Patients with idiopathic chylothorax may have a better prognosis after TDL and pericardectomy than dogs with nonidiopathic chylothorax.
Clinical Relevance— Thoracoscopy for ligation of the thoracic duct and pericardectomy is an acceptable surgical technique for treatment of chylothorax.     

Prognostic implications of the degree of shunt narrowing and of the portal vein diameter in dogs with congenital portosystemic shunts

OBJECTIVE : To determine prognostic evaluation and correlation of the degree of narrowing and the diameter of the portal vein in dogs with a congenital portosystemic shunt (CPS). STUDY DESIGN : Longitudinal prospective study. ANIMALS : Ninety-seven dogs with CPS. METHODS : Shunt diameter was recorded before and after silk ligation to calculate degree of closure. Portal vein diameter was measured in 74 dogs. Short-term (30 days) and long-term (>1 year) outcome were evaluated. Dogs with clinical signs after 1 year were re-examined to assess the degree of portosystemic shunting and compared with matched operated dogs without clinical signs. Correlations between clinical outcome, degree of closure, and portal vein diameter were statistically analyzed. RESULTS : Short-term and long-term mortality were 27% and 2.9% respectively. Clinical recurrence occurred in 10% of dogs. The degree of closure was significantly associated with mortality, but not with clinical recurrence. A significant correlation was found between degree of closure and the diameter of the cranial part of the portal vein. Portal vein diameter was only significantly associated with mortality in extrahepatic CPS. Subclinical portosystemic shunting was confirmed in 3 of 10 dogs. CONCLUSION : The degree of shunt closure depended on portal development. Long-term outcome did not depend on the degree of closure or portal development at the time of surgery. This suggested that factors such as hepatic and portal regeneration after surgery may be important. CLINICAL RELEVANCE : Determination of factors that predict the outcome after surgical treatment of CPS in dogs is important to gain insight in treatment selection or new therapeutic options.     

USE OF QUANTITATIVE HEPATIC SCINTIGRAPHY TO EVALUATE SPONTANEOUS PORTOSYSTEMIC SHUNTS IN 12 DOGS

Quantitative hepatic scintigraphy is a valid means for estimating total liver blood flow and relative portal hepatic perfusion. The Hepatic perfusion index (HPI) was determined for a group of 12 dogs with portosystemic shunts prior to and two days after corrective surgery. HPI values for the dogs prior to operation were significantly elevated (p<0.001) as compared with those for a group of normal dogs, indicating reduced effective portal hepatic perfusion in dogs with shunts. Dogs showing a favorable clinical response after surgery had a significant decrease (p<0.02) in HPI values after operation. One dog showing a poor clinical response after operation had an increase in HPI score after operation. Quantitative hepatic scintigraphy is a valuable diagnostic test for screening presumptive cases of portosystemic shunts and monitoring the response to surgical intervention.     

Association of portovenographic findings with outcome in dogs receiving surgical treatment for single congenital portosystemic shunts: 45 cases (2000-2004)

OBJECTIVE: To determine whether hepatic portal vascularity, as assessed by intraoperative mesenteric portovenography (IMP), is related to outcome in dogs undergoing attenuation of single congenital portosystemic shunts (CPSSs). DESIGN: Retrospective case series. ANIMALS: 45 dogs, each with a single CPSS, in which IMP was performed before and after temporary complete occlusion of the shunting vessel and that underwent complete (17 dogs) or partial (28 dogs) CPSS attenuation (surgery 1). PROCEDURES: Medical records were reviewed for signalment, clinical history, and bile acids stimulation test results. Intrahepatic portal vessel (IPV) opacification in pre- and postocclusion portovenograms was graded to determine whether the degree of opacification was correlated with the degree of shunt attenuation, clinical or biochemical factors, or long-term clinical outcome. In 17 of 28 dogs that had partial CPSS attenuation, these procedures were subsequently repeated (surgery 2) to achieve complete (14 dogs) or further partial (3 dogs) CPSS attenuation. RESULTS: Compared with preattenuation findings, IPV opacification increased significantly after partial or complete CPSS attenuation. The degree of IPV opacification before and after CPSS occlusion (surgery 1) was greater in dogs that tolerated complete versus partial CPSS attenuation and was correlated positively with age. The degree of IPV opacification following CPSS occlusion (surgery 1) was maximal in all dogs without encephalopathy and was correlated negatively with follow-up preprandial serum bile acids concentrations and positively with clinical improvement. CONCLUSIONS AND CLINICAL RELEVANCE: Data suggest that IMP can be used to assess changes in IPV blood flow and help predict outcome following attenuation of single CPSSs in dogs.     

Adrenal response to adrenocorticotropic hormone in dogs before and after surgical attenuation of a single congenital portosystemic shunt

BACKGROUND: Dogs with single congenital portosystemic shunts (CPSS) often develop postoperative hypoglycemia and prolonged anesthetic recovery. These abnormalities could be attributable to inadequate adrenal response. However, adequacy of adrenal response after CPSS surgery is unexplored. HYPOTHESIS: Dogs with CPSS have inadequate postoperative adrenal response. ANIMALS: Eight nonoperated, 8 ovariohysterectomy (OHE), and 16 CPSS dogs. METHODS: Consecutive day ACTH stimulation tests were performed on nonoperated healthy dogs, healthy dogs before and after OHE, and CPSS dogs before and after surgery. Adequate response was defined as >50% or >30 ng/mL increase in cortisol after ACTH administration. Blood glucose (BG) was monitored before and after surgery. Prolonged anesthetic recovery and refractory hypoglycemia episodes were recorded. RESULTS: Results of consecutive day ACTH stimulation tests did not vary in normal dogs. Results of preoperative ACTH stimulation tests of CPSS and OHE dogs were not significantly different. Dogs with CPSS had higher postoperative baseline cortisol concentrations (median, 329 ng/mL) than OHE dogs (median, 153 ng/mL). Postoperative cortisol increase after ACTH in CPSS was < or =50% in 10/16 and < or =30 ng/mL in 6/16. After surgery, BG was < or =60 mg/dL in 7/16 CPSS dogs. Cortisol concentrations were not correlated with BG. Two CPSS dogs had refractory hypoglycemia and 4 had delayed recovery; all improved with dexamethasone administration (0.1-0.2 mg/kg/IV). CONCLUSIONS AND CLINICAL IMPORTANCE: Contrary to previous reports, baseline cortisol concentrations in CPSS and healthy dogs are similar. Many CPSS dogs have postoperative hypercortisolemia. Response to ACTH does not correlate with postoperative hypoglycemia or prolonged anesthetic recovery.     

The Effect of Laparoscopic Versus Open Ovariectomy on Postsurgical Activity in Small Dogs

Objective— To describe a technique for laparoscopic ovariectomy (LapOVE) in small dogs, and compare the surgical time, complications, and postoperative activity of dogs undergoing LapOVE to those undergoing conventional traditional open ovariectomy (OOVE).
Study Design— A randomized, controlled clinical trial.
Animals— Intact small breed (<10 kg) female dogs (n=20).
Methods— Ventral median celiotomy was performed for OOVE. A 2-midline portal technique using a 3.5 mm laparoscope port and a 6 mm instrument portal was used for LapOVE. An accelerometer was attached to the collar of each dog to record 24-hour preoperative and 48-hour postoperative activity. Total activity counts recorded before surgery were compared with total counts recorded after surgery. The percent change in counts after surgery was compared between OOVE- and LapOVE-treated dogs.
Results— No major complications occurred and surgical time for LapOVE was significantly longer than for OOVE cases ( P =.005). Dogs in the LapOVE group had a 25% decrease in total activity counts after surgery (95% confidence interval [CI]: 11–38%), whereas dogs in the OOVE group had a 62% decrease in total activity counts after surgery (95% CI: 48–76%).
Conclusions— Both procedures were performed with reasonable surgical times and without major complication. Postoperative activity, as measured by accelerometry, was significantly different between the 2 groups.
Clinical Relevance— Laparoscopy is a safe method for ovariectomy in small dogs and results in increased postoperative activity counts when compared with an open technique.     

Single-phase methylene diphosphate bone scintigraphy in the diagnostic evaluation of dogs with osteosarcoma

In this study, 25 dogs each with a histopathologically diagnosed appendicular or axial osteosarcoma were prospectively and consecutively examined by methylene diphosphate nuclear scintigraphy. Scannings that revealed scintigraphically enhanced focal increased activity via bone uptake of the 99mTc methylene diphosphate radionuclide at sites other than the primary tumor site were compared with scintigrams obtained from dogs without osteosarcoma. Secondary scintigraphic sites were evaluated by survey radiography and, if possible, by histologic examination (biopsy or necropsy specimens). On the basis of our findings, scintigraphy seems to be more efficient than physical examination and radiographic bone survey for the diagnosis of multicentric, metachronous, or metastatic canine osteosarcoma.     

Evaluation of a portocaval venograft and ameroid ring for the occlusion of intrahepatic portocaval shunts in dogs

OBJECTIVE:To evaluate the use of a portocaval venograft and ameroid constrictor in the surgical management of intrahepatic portosystemic shunts (PSS). STUDY DESIGN: Prospective, clinical study. Animal Population: Ten client-owned dogs with intrahepatic PSS. METHODS: Portal pressure was measured after temporary suture occlusion of the intrahepatic PSS. In dogs with an increase in portal pressure greater than 8 mm Hg, a single extrahepatic portocaval shunt was created using a jugular vein. An ameroid ring was placed around the venograft and the intrahepatic PSS was attenuated. Transcolonic pertechnetate scintigraphy was performed before surgery, 5 days after surgery, and 8 to 10 weeks after surgery. Dogs with continued portosystemic shunting were evaluated further by laparotomy or portography. Clinical outcome and complications were recorded. RESULTS: Mean (+/- SD) portal pressure increased from 6 +/- 3 to 19 +/- 6 mm Hg with PSS occlusion; in all 10 dogs, the increase in portal pressure was greater than 8 mm Hg. There were no intraoperative complications, and, after creation of the portocaval shunt, the intrahepatic PSS could be completely ligated in 8 of 10 dogs. The final portal pressure was 9 +/- 4 mm Hg. Postoperative complications included coagulopathy and death (1 dog), ascites (3 dogs), and incisional discharge (3 dogs). Five of 8 dogs had continued portosystemic shunting at 8 to 10 weeks after surgery. Multiple extrahepatic PSS were demonstrated in 4 of these dogs. Clinical outcome was excellent in all 9 surviving dogs. CONCLUSIONS AND CLINICAL SIGNIFICANCE: The surgical technique resulted in a high incidence of multiple extrahepatic PSS. Short-term clinical results were promising, but long-term outcome must be evaluated further.     

Laparoscopic Ovariectomy in Dogs: Comparison Between Single Portal and Two-Portal Access

Objective: To compare surgical times and perioperative complication rates of single portal access and 2-portal laparoscopic ovariectomy (LapOVE) in dogs using a bipolar vessel sealer/divider device, and to evaluate the performance of novice laparoscopists for right ovariectomy.
Study Design: Controlled clinical trial.
Animals: Female dogs (n=42).
Methods: Dogs were divided into groups: 1=single portal and 2=2 portal. LapOVE was performed using a 5 mm vessel sealer/divider device and a 10 mm operating laparoscope (Group 1) or a 5 mm laparoscope (Group 2). Dog characteristics (weight, body condition score, ovarian ligament fat score), operative time, and perioperative complication rate were compared between groups. Right ovariectomy duration was evaluated for 2 novice laparoscopists.
Results: No significant difference was found in mean total surgical time between group 1 (21.07 min/s) and group 2 (19.06 min/s). Factors significantly affecting times included body condition scores, ovarian ligament fat score, ovarian bleeding, and surgeon expertize. Minor complications (bleeding from ovaries or after splenic trauma) occurred and were similar in both groups. Bleeding was correlated to body condition score and ovarian ligament fat score. Interindividual differences were found among surgeons for right ovariectomy time.
Conclusions: Single portal access LapOVE using vessel sealer/divider device is feasible, safe, and does not significantly increase total surgical time in comparison with 2-portal approach. Laparoscopic skills may play a role in ability to perform single portal LapOVE.
Clinical Relevance: LapOVE can be performed using single portal access.