Transesophageal monitoring of aortic blood flow during nonemergent canine surgeries

Objective: To establish baseline values for descending thoracic aortic blood flow parameters as determined with a transesophageal combined M‐mode and pulsed Doppler ultrasound‐based monitoring method. Design: Preliminary observational study. Setting: University small animal teaching hospital. Animals: The study population consisted of anesthetized canine patients undergoing nonemergent surgeries. Prospectively set criteria for inclusion were adequate body size for placement of the esophageal probe and a nonemergent reason for surgery. The criterion for exclusion was recent trauma. Interventions: Placement of the transesophageal probe. Measurements and main results: Data was collected during 15 surgeries. Data from three dogs was excluded from data analysis (two recently hit by motor vehicles, one recently having undergone a total hip replacement). Each parameter was stable across time within each individual dog. The ranges of the descending thoracic aortic parameters across the 12 nonemergent cases were as follows: blood flow, 0.038–0.085 L min^?1 kg^?1; blood flow per beat, 0.31–0.84 mL kg^?1; blood acceleration, 6–29 m s^2?1; blood peak velocity, 38–105 m s^?1; left ventricular ejection time interval 331–492 ms; and diameter, 0.30–0.93 mm kg^?1. Conclusions: The range of descending thoracic aortic blood flow parameters encountered in this small group of dogs during nonemergent surgeries was broad; however, each parameter was quite stable across time with little change occurring in any dog during monitoring.     

Postanesthetic Pulmonary Edema In an Arab Stallion

A six-year-old arabian stallion was admitted to The Ohio State University Veterinary Hospital for evaluation and repair of a comminuted fracture of the second phalanx. The horse developed impaired arterial oxygenation during surgey and pulmonary edema post-operatively. We postulate that impaired arterial oxygenation resulted from atelectasis of the dependent lung during annesthesia, and the pulmonary edema occurred following re-expansion of the atelectatic of the initiating cause of the edema, removal of excess lung water from the alveoli, and restoration of normal arterial oxygenation. The horse was fully recovered within 12 hours of initiation of clinical signs of respiratory compromise. The horse was fully recovered within 12 hours of initiation of clinical signs of respiratory compromise. This report describes re-expansion pulmonary edema due to reperfusion injury in a horse, treatment of the condition, and a possible explanation of the pathogenesis of this pulmonary pathology.     

Comparison of an Antimicrobial Adhesive Drape and Povidone-lodine Preoperative Skin Preparation in Dogs

The antimicrobial efficacy of an adhesive drape applied after a 1-minute alcohol scrub was compared to a povidone-iodine (PI) skin preparation technique in dogs. Each technique was applied to both sides of 15 adult anesthetized dogs on premeasured, clipped areas of skin. Skin bacteria were quantified before, immediately after, and 1 hour after skin preparation. Predominant skin bacteria were isolated by swabbing the skin. The percentages of bacterial reduction immediately after and 1 hour after skin preparation, percentages of negative culture results, cultures with more than five colony-forming units, and the frequency of skin reactions were calculated and analyzed statistically. Drape adhesion was assessed subjectively. The percentage reduction in skin bacteria was significant for both techniques and comparable to that reported in humans. The adhesive drape was significantly less effective in both the immediate and 1-hour periods. Lift occurred in 66% of drape applications but was not associated with high bacterial counts. Acute contact dermatitis was more frequent after skin preparation with PI. There was no difference between the techniques in recovery of potential skin pathogens. The authors conclude that application of this antimicrobial adhesive drape after a 1-minute alcohol scrub is not as effective in the reduction of skin bacteria in dogs as is PI preparation of the skin.     

Dual-Energy X-Ray Absorptiometry and Force-Plate Analysis of Gait in Dogs With Healed Femora After Leg-Lengthening Plate Fixation

Dual-energy x-ray absorptiometry was used to measure bone mineral density of four regions in healed femora of nine dogs after fracture fixation with a leg-lengthening plate. Six to 85 months (mean, 46 months) after surgery, the bone mineral density of healed femora was not significantly different from the contralateral uninjured femora ( P >.05; power = 0.8 at Δ= 15%). Radio-lucencies around the proximal screws, apparently associated with screw loosening, were seen on radiographic views of the healed femora of three dogs. In one of these dogs, one screw in the proximal metaphysis had broken. Force-plate analysis of gait was also performed on dogs at the time of bone mineral density measurement. Peak vertical force was decreased in the pelvic limb with the healed fracture compared with the contralateral unoperated limb ( P < 0.05). Clinically apparent lameness in three dogs did not appear to be associated with altered bone mineral density and may have been caused by hip osteoarthritis, a nondisplaced hairline diaphyseal fracture, and screw loosening in conjunction with extensive post-traumatic soft tissue injury.     

Evaluation of Tissue Adhesive to Contain Axonal Regeneration in Horses

Bilateral palmar and plantar digital neurectomies were completed in 10 horses (a total of 80 neurectomies) using one of three methods: (1) simple transection (guillotine method); (2) epineural capping; (3) n-butyl cyanoacrylate injected into the epineural sheath to act as a nerve sealant. Horses were regularly evaluated clinically for tenderness in and around the surgical site, as well as skin sensation at the coronary band in the heel region, during the 12-week course of the study. None of the surgical sites exhibited any signs of drainage or infection. Horses were then euthanatized, the nerve stumps were dissected from surrounding tissues, and the length and width of the tissue mass that had formed on the end of the nerve was recorded. Longitudinal and transverse sections of the nerve endings were examined histologically for numbers of proliferating axon sprouts (neuroma formation); whether the axons had penetrated the epineurium; degree of Schwann cell proliferation; degree of chronic inflammation; extent of foreign body reaction; extent of retrograde degeneration of the nerve bundles; and amount of fibro vascular proliferation. The proportion of legs exhibiting tenderness or heel sensation did not differ significantly between the three different treatments at any of the six different times they were examined. There was no difference between the three treatments in the length or width of the fibrous tissue scar on the ends of the nerves or in the number of sprouting axons from the ends of the nerves. Of 80 nerves examined, only two nerves were not confined to the epineurium. Both these nerves had been treated by simple transection. Statistically there was more chronic inflammation and foreign body reaction in the acrylic treated nerves, but no difference in Schwann cell proliferation or retrograde degeneration between the three treatments. There was slightly less fibrovascular proliferation in the transected nerves than in those subjected to epineural capping or acrylic, but the difference was not statistically significant. The use of the tissue adhesive n-butyl cyanoacrylate to prevent the continuous growth of axons after digital neurectomy seems to offer little advantage over more traditional methods of neurectomy.     

Use of 64Copper Measurements to Diagnose Canine Copper Toxicosis

Inherited canine copper toxicosis is a serious problem in Bedlington terriers and West Highland White terriers, and may also be a problem in other less-studied breeds. Affected dogs become ill at midlife with progressive and ultimately fatal liver disease. Treatments for removal of copper and prevention of copper accumulation are available, but are most effective if begun before the dog becomes ill. Until recently diagnosis has not been available until the dog is 1 year of age, and then only by an invasive liver biopsy with determination of liver copper concentration. The authors studied the use of 64copper for early diagnosis of canine copper toxicosis. Two procedures were evaluated. The first involved measuring the concentration of 64copper in blood 24 hours after oral administration of the radioisotope. At this time, 64copper was associated primarily with ceruloplasmin secreted into the blood by the liver. This procedure is useful in the diagnosis of the human counterpart, Wilson's disease. However, the authors found it to be nondiscriminatory between affected and unaffected dogs. In contrast, the second procedure, which involved measuring 64copper excreted in stool during 48 hours after an intravenous dose of radioisotope, yielded results that differentiated most affected and unaffected dogs.     

Treatment of Humeroulnar Subluxation with a Dynamic Proximal Ulnar Osteotomy A Review of 13 Cases

Humeroulnar subluxation was treated surgically in 13 dogs with 18 affected elbows using a proximal osteotomy of the ulna that allowed the ulna to elongate dynamically. Distal humeroulnar subluxation was secondary to premature closure of the distal ulnar physis in 16 elbows. One distal subluxation was secondary to a radioulnar synostosis, and one proximal subluxation developed after premature closure of the distal radial physis. The mean follow-up time was 22 months. Twenty-eight percent of the elbows were judged to have excellent results, 22% good results, 50% fair results, and none was judged to have a poor outcome. The presenting lameness grade and the severity of preoperative and postoperative humeroulnar subluxation had significant correlations with the prognosis. Associated orthopedic abnormalities and complications of concurrent surgical procedures affected the outcome in several dogs. Overall, the dynamic proximal ulnar osteotomy was a simple and effective technique for the treatment of uncomplicated humeroulnar subluxation.     

Plasma Cell Myeloma in the Horse

Plasma cell myelomas in horses have been reported infrequently. Data from 10 cases, 9 from the literature and 1 new case, are used to characterize the disease in the horse. Hot-blooded horses (7/10), specifically Quarter Horses (4/10), were most often affected. Median age at diagnosis was 11 years (range, 3 mo-22 yr) and both male (5) and female horses (5) were represented equally. Clinical findings included weight loss (6/8), anorexia (4/8), fever (4/8), limb edema (4/8), pneumonia (3/8), rear leg paresis/ataxia (3/8), epistaxis (3/8), palpable lymphadenopathy (2/8), and bone pain (2/8). Anemia (8/8) was present routinely, and in three horses, RBCs were macrocytic. Leukopenia (2/8), thrombocy-topenia (2/8), and circulating plasma cells (3/8) were variable findings. Except for abnormal protein concentrations and hyponatremia (3), abnormal results from serum biochemical analysis including hypo-cholesterolemia (1), hypercalcemia (1), and azotemia (1) were reported infrequently. Hyperproteinemia (8/9), hypoalbuminemia (7/9), and hyperglobulinemia (8/9) were characteristic but not invariable findings. Monoclonal proteins (7/7) were detected in the α₂, β, or γ region by serum electrophoresis. The paraprotein's heavy chain, determined in four horses, was a subclass of IgG. Three horses had decreased concentrations of normal immunoglobulins. Variable proteinuria (trace to 4+) was detected by routine urinalysis in four of six horses. Bence Jones proteinuria was detected in one of five horses (heat precipitation) and monoclonal proteins were detected in two of three electrophoresed urine samples. Three of the horses had lytic bone lesions detected radiographically. Bone marrow aspirates were diagnostic in two of five horses. Atypical plasma cells or increased numbers of plasma cells or both were present in histologic sections of bone marrow in six of eight horses. Common extraosseous sites of plasma cell infiltration included lymph nodes (8/8), kidney (5/8), spleen (5/8), liver (3/8), lung (3/8), brain (2/8), and orbit (2/8). Two horses had intracellular and extracellular crystalline deposits.     

BACTERIAL ENDOCARDITIS WITH THROMBUS FORMATION AND ABSCESSATION IN A HORSE

A 2.5 year old Appaloosa stallion with progressive weight loss and a heart murmur was diagnosed as having vegetative endocarditis of the right atrioventricular valves with a mass in the right atrium. The ultrasonographic appearance of the lesion was characterized by extreme reverberation. On postmortem examination, a 9 cm diameter thrombus was found within the right atrium and auricle, occupying approximately 80% of the chamber volume. Additionally, a lenticular abscess extended throughout the parietal cusp of the right atrioventricular valve. Histologic examination revealed that the lesions were septic with numerous gram positive cocci in short chains, suggestive of Streptococcus equi , and gram negative rods.     

COLLAGENASE CHEMONUCLEOLYSIS—A LONG TERM RADIOGRAPHIC STUDY IN NORMAL DOGS

Five clinically normal five year old dogs were used in this study. From a randomised table inter ver tebral discs were each injected with either collagenase or calcium chloride diluent. The surgically exposed cervical discs were injected with 50 units whereas thoracic and lumbar discs were injected under fluoroscopic guidance with 100 units of the enzyme. Postinjection radiographs revealed significant (p ≤ .05) disc space narrowing in enzyme injected discs. The cervical discs had the highest frequency of radiographic narrowing (87%) followed by the thoracic (70%) and lumbar (53%) discs. Spondylosis deformans developed at the sites of cervical enzyme injections. None of the dogs had neurologic abnormalities one year postinjection.