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1.
Objective – To evaluate clinical characteristics and outcomes of cats undergoing surgical intervention in the course of treatment for severe acute pancreatitis. Design – Retrospective observational study from 2003 to 2007 with a median follow‐up period of 2.2 years (range 11 d–5.4 y) postoperatively. Setting – Private referral veterinary center. Animals – Eight cats. Interventions – None. Measurements and Main Results – Quantitative data included preoperative physical and clinicopathologic values. Qualitative parameters included preoperative ultrasonographic interpretation, perioperative and intraoperative feeding tube placement, presence of free abdominal fluid, intraoperative closed suction abdominal drain placement, postoperative complications, microbiological culture, and histopathology. Common presenting clinical signs included lethargy, anorexia, and vomiting. Leukocytosis and hyponatremia were present in 5 of 8 cats. Hypokalemia, increased total bilirubin, and hyperglycemia were present in 6 of 8 cats. Elevated alanine aminotransferase and aspartate transferase were present in all cats. Surgery for extrahepatic biliary obstruction was performed in 6 cats, pancreatic abscess in 3 cats, and pancreatic necrosis in 1 cat. Six of the 8 cats survived. Five of the 6 cats that underwent surgery for extrahepatic biliary obstruction and 1 cat that underwent pancreatic necrosectomy survived. All 5 of the cats with extrahepatic biliary obstruction secondary to pancreatitis survived. The 2 nonsurvivors included a cat with a pancreatic abscess and a cat with severe pancreatitis and extrahepatic biliary obstruction secondary to a mass at the gastroduodenal junction. Postoperative complications included progression of diabetes mellitus, septic peritonitis, local gastrostomy tube stoma inflammation, local gastrostomy tube stoma infection, and mild dermal suture reaction. Conclusion – Cats with severe acute pancreatitis and concomitant extrahepatic biliary obstruction, pancreatic necrosis, or pancreatic abscesses may benefit from surgical intervention. Cats with extrahepatic biliary obstruction secondary to severe acute pancreatitis may have a good prognosis.  相似文献   

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Objective: To describe and compare the patient population, treatment, and outcome in dogs with septic peritonitis from 2 time periods at the same institution. Design: Retrospective study. Setting: The Matthew J. Ryan Veterinary Hospital at the University of Pennsylvania. Animals: Dogs treated surgically for septic peritonitis between 1988–1993 and 1999–2003. Interventions: None. Measurements: Preoperative physical and clinicopathologic data, surgical findings, anesthetic parameters, treatment, and outcome. Main results: No significant difference in survival among dogs treated surgically for septic peritonitis between 1988 and 1993 (21/33 [64%]) and 1999–2003 (29/51 [57%]) was detected. The patient populations of the two time periods were similar. Changes in treatment between the study periods reflected availability of new antibiotics and synthetic colloids, as well as greater attention to pain management and ulcer prevention. Duration of hospitalization was not significantly different between the two time periods, but the daily cost adjusted to 2005 dollars was higher in 1999–2003. Potential prognostic indicators were compared between survivors and non‐survivors after combining the data from both time periods, and although several parameters reached statistical significance, of greatest clinical significance were the higher blood pressure and preoperative serum albumin in survivors. Conclusions: Although new treatments were added to the supportive care of dogs with septic peritonitis, survival did not change sufficiently to detect a significant difference between the time periods evaluated. Identifying reliable prognostic indicators for septic peritonitis remains a challenge, but hypotension and decreased preoperative serum albumin were associated with non‐survival in this group of dogs.  相似文献   

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Ultrastructural alterations of pancreatic tissues in growing pigs caused by surgical ligation of the main pancreatic duct are described. Five animals aged 6 to 7 weeks were operated on and necropsied 2, 6 or 8 weeks later. In addition, 3 pigs that were sham-operated served as controls. Obstruction of the ducts caused progressive luminal dilatations and rupture of intercellular connections of the epithelium followed by destruction and atrophy of acinar parenchyma and proliferations of immature ductular epithelial cells free from zymogen granules.  相似文献   

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Oesophageal leiomyosarcoma has yet to be reported in dogs. This retrospective case series describes the case management and clinical outcome of four dogs with oesophageal leiomyosarcoma treated by marginal excision alone. Histological features used to determine tumour grade included capsular invasion, percent necrosis, pleomorphism and mitotic rate. All tumours were designated grade 1 leiomyosarcoma. Excision of all grossly evident tumour tissue was achieved in two of the four cases; however, histopathologic evaluation showed tumour cells at the surgical margins in one of these two cases. Two dogs had grossly incomplete excision. Two dogs died from unrelated conditions, one 3 years and 5.5 months after surgery, the other at 65 days. One dog had persistent mega‐oesophagus and was lost to follow‐up 388 days after surgery and one dog is still alive (last follow‐up 405 days after surgery). Despite large tumour size and incomplete excision, surgical removal of low‐grade leiomyosarcomas can result in long‐term resolution of clinical signs.  相似文献   

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Objective: To assess efficacy and safety of intravenous (IV) diltiazem as a treatment for acute renal failure (ARF) secondary to leptospirosis in dogs. Design: Retrospective study Animals: Eighteen dogs with ARF caused by Leptospira spp treated during the months of September to December (1998–2001). Procedure: All dogs treated for ARF caused by Leptospira spp were enrolled in the study and were treated with standard care consisting of IV fluids, +/? furosemide, and antibiotics. With owner consent some dogs were treated with diltiazem at 0.1–0.5 mg/kg (0.045–0.22 mg/lb) IV slowly, followed by 1–5 μg/kg/minutes (0.45–2.2 mg/lb/minutes) constant rate infusion. Outcome measures were compared between the 2 groups (diltiazem versus standard). Diltiazem was administered within 60 hours of admission until serum creatinine fell into the normal range or stabilized. The primary outcome measurement of safety was systolic blood pressure (SBP). The primary measurement of efficacy outcome was the rate and magnitude of reduction of serum creatinine Results: Eleven out of 18 dogs received diltiazem. The rate of reduction in creatinine in the diltiazem group was 1.76 times faster than the standard group (P=0.054). Recovery of renal function showed a trend towards significant association with treatment group (exact P=0.08, odds ratio=3.62). This effect may be clinically relevant. Diltiazem had no clinically relevant effect on SBP. Conclusions and clinical relevance: Renal recovery in dogs with acute renal failure secondary to leptospirosis is improved with the administration of diltiazem in addition to ‘standard’ therapy.  相似文献   

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Objective – To identify and characterize the syndrome of immune‐mediated hemolytic anemia (IMHA) with concurrent severe thrombocytopenia (≤15.0 × 109 platelets/L; [15.0 × 103 platelets/μL]), and to evaluate prognostic factors, clinicopathologic findings, complications, treatment, outcome, and survival of dogs with this hematologic disorder. Design – Retrospective, observational study. Setting – Veterinary teaching hospital. Animals – Twelve client‐owned dogs with IMHA and severe thrombocytopenia (≤15.0 × 109 platelets/L; [15.0 × 103 platelets/μL]), without evidence of overt disseminated intravascular coagulation. Interventions – The following data were recorded and analyzed from the electronic medical record: signalment, history, concurrent diseases, clinical signs at presentation, clinicopathologic data, diagnostic testing, radiographic findings, treatment modalities, length of hospitalization, complications, and clinical outcome. All dogs were treated with immunosuppressive doses of corticosteroids. Measurements and Main Results – Twelve dogs were identified with the diagnosis of IMHA and severe thrombocytopenia; of these, 9 (75%) survived, 3 (25%) were euthanized, and none died. Dogs that survived were significantly younger than nonsurvivors (P=0.03). There were no specific clinical signs or therapies associated with survival. Conclusions – Dogs in this study had a mortality rate similar to reported rates for dogs with either disease alone. Overall, younger dogs were more likely to survive. No association between different treatment modalities and overall survival was identified.  相似文献   

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OBJECTIVE: To compare outcomes of dogs with pyothorax treated medically versus surgically and to identify prognostic indicators for dogs with pyothorax. DESIGN: Retrospective study. ANIMALS: 26 dogs. PROCEDURE: Medical records were reviewed to obtain information regarding signalment, results of physical and laboratory evaluations at the time of initial examination, results of bacterial culture of pleural fluid, radiographic abnormalities, treatment (surgical vs medical), complications, whether the disease recurred, disease-free interval, survival time, and cause of death. RESULTS: Calculated proportions of dogs free from disease 1 year after treatment were 25 and 78%, respectively, for dogs treated medically and surgically. Treatment was 5.4 times as likely to fail in dogs treated medically as in dogs treated surgically. Two regression models relating treatment group (medical vs surgical) to disease-free interval were found to be significant. The first contained terms for medical treatment and isolation of Actinomyces spp from pleural fluid; the second contained terms for medical treatment and radiographic detection of mediastinal or pulmonary lesions at the time of initial examination. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that surgical treatment is associated with a better outcome than medical treatment in dogs with pyothorax. In addition, surgery should be considered if radiographic evidence of mediastinal or pulmonary lesions is detected or if Actinomyces spp is isolated from the pleural fluid.  相似文献   

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Second-opinion histopathology is intended to detect clinically significant discrepancies that have a direct impact on patient care. We sought to determine if this practice at our institution affected patient management and prognosis. First- and second-opinion histopathology reports from cases were retrospectively reviewed. Reports were considered to be in diagnostic agreement, partial diagnostic disagreement or complete diagnostic disagreement. Four hundred and thirty cases were studied. In 70% of cases there was a diagnostic agreement. In 20% of cases, there was partial diagnostic disagreement, where diagnoses were the same but information such as grade or lymphatic and/or vascular invasion was changed. In 10% of cases, complete diagnostic disagreement resulted from a change in degree of malignancy (malignant to benign, or converse; 7%) or a change in cell type (3%). In 17% of the cases evaluated, the histopathology review prompted a change in treatment or prognosis. These findings support the use of second-opinion histopathology as an important part of patient care.  相似文献   

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OBJECTIVE: To determine outcome of and complications associated with cricopharyngeal myotomy or myectomy for treatment of cricopharyngeal dysphagia (CPD) in dogs. DESIGN: Retrospective study. ANIMALS: 14 dogs. PROCEDURE: Medical records of dogs with CPD that underwent cricopharyngeal myotomy or myectomy were examined. Follow-up information was obtained through telephone interviews with owners and referring veterinarians and clinical examinations when feasible. RESULTS: 16 surgical procedures were performed on the 14 dogs. Dysphagia was completely resolved immediately after surgery in 1 dog, and clinical signs did not recur (follow-up time of 8 years); a second dog also had immediate complete resolution of dysphagia, but follow-up time was only 10 days. Three dogs had transient complete resolution with a mean time to recurrence of dysphagia of 12.3 weeks (range, 2 to 36 weeks). Three dogs had permanent partial resolution. Six dogs had no improvement after surgery. Eight of the 14 dogs were euthanatized because of problems related to CPD, including persistent dysphagia (n = 8) and aspiration pneumonia (5). CONCLUSIONS AND CLINICAL RELEVANCE: The failure rate for dogs undergoing surgical treatment of CPD may be high, particularly if concurrent aspiration pneumonia or malnutrition is not addressed prior to surgery. For those dogs with concurrent diseases, more aggressive medical management, such as enteral tube feeding, may be warranted rather than surgery. In dogs with CPD complicated by other anatomic or functional conditions, such as myasthenia gravis, laryngeal paralysis, and esophageal stricture, surgery may also not be indicated.  相似文献   

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Objective – To characterize the clinical presentation, management, and in‐hospital outcomes of dogs and cats diagnosed with acute congestive heart failure (CHF). Design – Retrospective study of animals seen between January 2007 and May 2008. Setting – Emergency service at a university teaching hospital. Animals – Ninety dogs and 55 cats with CHF. Measurements and Main Results – Patient characteristics, including age, clinical signs, clinicopathologic abnormalities, diagnostic testing, and outcome were recorded. Forty‐eight of the animals already were receiving cardiac medications at the time of presentation. The most common diseases represented were chronic valvular disease and cardiomyopathies. Cats had significantly lower median body temperature at admission compared with dogs (P<0.001). The most common abnormalities were elevated lactate (64%), elevated BUN (52%), hypochloremia (31%), hyperglycemia (27%), and elevated liver enzymes (26%). Many of these became even more prevalent during hospitalization. One hundred and sixteen animals were discharged from the hospital, for a survival rate of 80%. There was no survival difference between dogs and cats (P=0.39). Dogs that developed hypokalemia during hospital stay (P=0.04) were more likely to survive compared with those without hypokalemia and initial body temperature was lower for those cats that did not survive (P=0.02). Of those that did not survive, the majority were euthanized (n=25), while 4 dogs died. Conclusions – Dogs and cats presented to the emergency service with CHF had a high survival rate. In cats, initial body temperature was lower for those cats that did not survive. Although clinicopathologic abnormalities were common in both species, only dogs with hypokalemia had improved survival to hospital discharge.  相似文献   

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Background: Portal vein thrombosis (PVT) in cats is sparsely reported.
Purpose of Study: To evaluate the clinical signs and diseases associated with PVT in cats.
Animals: 6 client-owned cats.
Methods: Medical records for cats with a portal vein thrombus diagnosed on abdominal ultrasound or at necropsy were reviewed. Signalment, historical data, underlying disorders, clinical findings, clinicopathologic and histopathologic data, diagnostic imaging findings, treatment, and outcome were recorded.
Results: All 6 cats identified with PVT also had hepatic disease. Evidence of a congenital portosystemic shunt was present in 3/6 cats. Two cats had primary or metastatic hepatic neoplasia. One cat had acute cholangitis, acute pancreatitis, and locally extensive acute centrilobular hepatic necrosis. Two cats were suspected to have acute thrombi and 4 cats had chronic thrombi.
Conclusion and Clinical Significance: PVT might be an important concurrent finding in cats with hepatic disease.  相似文献   

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Objective – To describe the patient population, disease severity, and outcome in dogs with immune-mediated hemolytic anemia (IMHA) that underwent splenectomy. To compare presurgical and postsurgical data.
Design – Retrospective case series.
Setting – Emergency clinic/referral hospital.
Animals – Ten dogs diagnosed with IMHA.
Interventions – Splenectomy in addition to standard medical management for IMHA.
Measurements – Medical records of 10 dogs with IMHA, in which a splenectomy was performed were reviewed. The population was analyzed with regards to physical and clinicopathologic data, severity, treatment, and outcome. Outcome was defined as survival at 30 days, percentage of dogs on medications at 30 days, and number of relapses documented by 30 days. The presurgical and postsurgical PCV and transfusion requirements were documented and compared for each dog.
Results – Nine of 10 dogs survived to 30 days. Four of the 9 that survived were not on any immunosuppressive medications. There were no relapses during the 30 days. The 3-day postsplenectomy PCVs were significantly higher than presplenectomy. The number of transfusions administered postsplenectomy was significantly less than those administered presplenectomy.
Conclusion – The use of splenectomy may be associated with an improved outcome in dogs with IMHA.  相似文献   

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Objective: To describe the clinical parameters, treatment, and prognosis of dogs with left atrial rupture secondary to chronic mitral valve insufficiency. Design: Retrospective study. Setting: University referral hospital. Animals: 14 dogs with left atrial rupture. Interventions: None. Measurements and main results: Mixed breed dogs (n=6, 43%) and Shetland Sheepdogs (n=3, 21%) were most commonly affected. The median age was 12 years (range 5.8–18 y). The median weight was 11 kg (range 4–30 kg). Eight dogs had been previously diagnosed with chronic valvular disease. The most common presenting complaints included collapse (13/14), cough (9/14), and dyspnea (8/14). Four dogs were presented in either respiratory or cardiac arrest. Pericardial effusion was present in 13 dogs. The median left atrium:aortic outflow ratio was 2.66 (range 1.66:1–5.52:1). Pericardiocentesis was performed to alleviate tamponade in 3 dogs. Five dogs were discharged from the hospital, 3 of which were euthanized within 35 days of initial diagnosis for recurrence of clinical signs (n=2) and for hematochezia and lethargy (n=1). Five dogs were euthanized while in the hospital for a variety of reasons including DIC, progressive azotemia, collapse and recurrence of pericardial effusion, or possible seizure episode. Conclusions: Although rare, left atrial rupture resulting in pericardial effusion should be considered in older small‐ to medium‐sized dogs presenting with collapse, cough, and dyspnea. The overall prognosis appears poor.  相似文献   

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BACKGROUND: Increased serum lipase activity has been used historically to support the diagnosis of acute pancreatitis, a common disease in dogs. Most of the lipase assays that are currently in use lack optimum sensitivity and specificity. OBJECTIVE: The objectives of this study were to 1) validate the 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) assay for determination of lipase activity in canine serum and 2) compare results, reference intervals, sensitivity, and specificity of the DGGR assay with a standard 1,2-diglyceride (1,2 DiG) assay for diagnosing acute pancreatitis in dogs. METHODS: Precision, linearity, and interference studies were performed for method validation on a Hitachi 911 analyzer. Lipase results from the DGGR and 1,2 DiG assays were compared by linear regression analysis. Sensitivity, specificity, and diagnostic efficacy were determined for both assays on a population of 30 dogs, 15 of which had acute pancreatitis based on history, clinical signs, and ultrasound findings. RESULTS: Within-run and within-day coefficients of variation (CVs) were low (<3%), with higher day-to-day CVs (< or =14 %). The assay was linear between 8 and 2792 U/L. No significant interference by hemolysis and lipemia was found. Poor correlation was found between the assays (r(s)=0.84). The lipase reference interval was 8-120 U/L for the DGGR assay and 30-699 U/L for the 1,2 DiG assay. Sensitivity and specificity for the diagnosis of pancreatitis were 93% and 53%, respectively, for the DGGR assay and 60% and 73% for the 1,2 DiG assay. Receiver operating characteristic curve analysis showed similar areas under the curve. CONCLUSIONS: On the basis of this study, the DGGR method is considered adequate for assaying serum lipase activity in dogs. The high sensitivity of the DGGR assay suggests it may be a useful screening test for canine pancreatitis.  相似文献   

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