Use of dopamine in acute renal failure

Objective: To review the current understanding of dopamine and its use in the prevention and treatment of acute renal failure (ARF). Data sources: Original research articles and scientific reviews. Human data synthesis: Low‐dose dopamine administration has been shown to increase natriuresis and urinary output in both healthy individuals and in a few small studies in human patients with renal insufficiency. However, in several large meta‐analyses, dopamine treatment did not change mortality or the need for dialysis. Due to the potential side effects, the use of dopamine for prevention and treatment of ARF is no longer recommended in human medicine. Veterinary data synthesis: Low‐dose dopamine increases urinary output in healthy animals and animal models of ARF if given before the insult. There are no available studies looking at the effect of low‐dose dopamine therapy in naturally occurring ARF in dogs or cats. Conclusion: Due to the potential side effects of low‐dose dopamine therapy, the results from large human trials, and the lack of information in veterinary medicine, the use of dopamine for treatment of ARF in veterinary patients should be further evaluated.     

Surgical Treatment of Male Dogs With Urinary Incontinence Due to Urethral Sphincter Mechanism Incompetence

A modified technique for fixation of the deferent ducts to the abdominal wall as a therapy for urinary incontinence caused by urethral sphincter mechanism incompetence (USMI) in male dogs is described, and the results in seven dogs are reported. The goal of this treatment was to achieve an effect similar to colposuspension in female dogs with USMI. An increase in urethral length of an average of 28 mm was obtained (range, 5 to 50 mm, measured radiographically). Preoperatively, the neck of the bladder was located intrapelvically in five of seven dogs. Postoperatively, the neck of the bladder was located intra-abdominally, near the caudo-ventral abdominal wall, in all dogs. After a follow-up period of 12 to 49 months, the response to surgery, based on lack of or decrease of incontinence, was excellent in three dogs, good in another three, and poor in one dog.     

Triangulated Flap Technique for Nasofrontal Surgery Results in Five Horses

A modified bone-flap technique was used to expose space occupying lesions that involved the conchofrontal sinus, ethmoturbinates, and caudal nasal cavity in five horses. The most common clinical findings were chronic nasal discharge and upper airway obstruction. Surgical intervention was based on endoscopic and radiographic interpretation. The triangulated bone-flap technique increased surgical exposure to the conchofrontal sinus by almost twice the area observed in previously described surgical techniques. The major advantages were that this technique allowed excellent visualization, thorough palpation, and surgical manipulation within the sinus and associated structures. Complications were minimal. One horse was euthanized 1 month postoperatively with recurrence and spread of a mycotic granuloma. The technique extended the usefulness of the other four horses in a 9 to 24 month follow-up period, although the obstructing lesion recurred after 2 years in one of the four horses.     

Surgical Repair of Tibial Tuberosity Avulsion Fractures in Four Horses

Four horses, 2 to 17 years old, were treated for unilateral avulsion fractures of the tibial tuberosity. Two horses were treated successfully with tension band wiring or plating in combination with lag screw fixation. One horse was euthanatized because of implant failure during recovery and one was euthanatized on day 11 because a longitudinal fracture of the tibial tuberosity occurred through the plane of the screws used for stabilization.     

Partial Arytenoidectomy in Horses

Unilateral partial arytenoidectomy was performed in 22 horses. Six horses had arytenoid chondritis, 14 horses had idiopathic laryngeal hemiplegia (11 of which had been treated unsuccessfully by insertion of a laryngeal abductor muscle prosthesis), and two horses had laryngeal hemiplegia resulting from perivascular injection of an irritant drug. After surgery, eight horses (36%) developed a nasal discharge of food and/or water that was of clinical significance in only two of them. The operation resulted in marked improvement in exercise tolerance in all 20 horses tested, although two could not work because of severe exercise-associated coughing. Mild inspiratory stertor was present in eight horses and was excessive in one. It was concluded that the high incidence of problems related to swallowing rendered the method unacceptable. Modification of partial arytenoidectomy by silicon augmentation produced improvement in one horse.     

The Effects of Fixation of the Ulna to the Radius in Young Foals

The effects of radioulnar fixation were studied in 21 Quarter horse foals by applying a bone plate to the caudal aspect of the proximal part of the ulna, with screws engaging both the radius and the ulna. The plates were applied at 1 month of age in six foals (group I), 5 months of age in six foals (group II), and 7 months of age in three foals (group III). Six foals underwent sham operations at 1 month of age to serve as controls (group IV). Ulnar dysplasia and elbow subluxation developed in all treated foals. The magnitude of ulnar dysplasia was inversely related to the patient's age at fixation and was accompanied by degenerative joint disease and lameness in foals undergoing fixation at 1 and 5 months of age. Removal of the fixation appliances 16 weeks after implantation in three foals from each of groups I and II failed to reverse the degree of ulnar dysplasia. Although foals undergoing fixation at 7 months of age (group III) were not lame, radiographic evidence of subluxation and subtle degenerative changes in the articular cartilage of the treated elbow did develop. Recommendations for avoidance of radioulnar fixation were developed from these observations.     

Feline Ilial Fractures: A Prospective Study of Dorsal Plating and Comparison with Lateral Plating

Objective— To (1) report a technique for repair of feline ilial fractures using a dorsally applied bone plate and (2) compare outcome with cats treated by a lateral plate.
Study Design— Prospective study.
Animals— Cats (n=10) with iliac fractures.
Methods— Cats with ilial fractures (January 2005–December 2006) were treated by application of a dorsally applied bone plate. Immediate postoperative radiographs were compared with those taken 4–6 weeks later to assess screw loosening, screw purchase, and pelvic canal narrowing. Owners were contacted for medium-term (>3 month) follow-up. Data were compared with a report of outcome after lateral plating (LP) in 21 cats.
Results— Mean (± SD) screw purchase (89 ± 11 mm) was significantly greater ( P <.01) with a dorsal plate compared with a lateral plate (33 ± 8 mm). Significantly more screws ( P <.01) were used with a dorsal plate (median, 7) compared with a lateral plate (median, 6). Significantly less postoperative pelvic canal narrowing developed in the dorsal plating group between postoperative and 4–6-week follow-up radiography compared with the LP group (2% versus 15%, P <.01).
Conclusion— Dorsal plating of feline ilial fractures results in significantly less screw loosening and pelvic canal narrowing at 4–6 weeks after surgery compared with LP.
Clinical Relevance— Dorsal plating of feline iliac fractures may reduce complications associated with pelvic canal narrowing such as constipation and megacolon.     

Carpometacarpal Osteoarthritis in Thirty‐Three Horses

Objective— To describe signalment, clinical, and radiographic changes associated with carpometacarpal osteoarthritis (CMC‐OA) and to report long‐term outcome. Study Design— Case series. Animals— Horses (n=33) with CMC‐OA. Methods— Medical records (1992–2007) of horses diagnosed with CMC‐OA were reviewed and signalment, clinical, and radiographic findings retrieved. Owners were contacted for information on the impact of lameness on intended use, response to treatment, progression of lameness, outcome, and owner satisfaction with response to treatment. Results— CMC‐OA identified in 39 limbs, occurred predominantly in middle‐aged and older Quarter Horses and Arabians, and caused severe lameness that prevented normal use. Characteristic swelling was centered over the 2nd metacarpal bone/2nd carpal bone articulation. Radiographic changes consisted of proliferative new bone, narrowed joint space, and subchondral lysis. Of 20 horses with follow‐up, 7 of 14 treated horses were euthanatized within 4 years and 4 of 5 nontreated horses within 3 years. Response to treatment was short lived and considered very poor by most owners. Conclusion— CMC‐OA seemingly occurs primarily in Quarter Horses and Arabians in our region. Response to conservative treatment is very poor and short‐lived with most horses being euthanatized. Clinical Relevance— Conventional treatment methods are unsuccessful for treating CMC‐OA.     

EVALUATION OF THE LOWER RESPIRATORY TRACT IN PSITTACINES USING RADIOLOGY AND COMPUTED TOMOGRAPHY

In the last 2¹/₂ years, 288 grey parrot and amazon species with symptoms of respiratory disease clinically were presented to the clinic for avian medicine at the Justus-Liebig-University in Giessen. Ventro-dorsal and latero-lateral radiographs were taken from all birds; radiologic signs of lower respiratory tract disease were noted. Radiographs were normal in 55 of the birds. The results of the radiographic examination for the remaining 233 birds were compared with the necropsy results of terminally ill parrots, with the results of laboratory examinations/endoscopy/and/or with an examination by computed tomography. Thoracic radiographs were evaluated for occurring radiological abnormalities pertaining to the respiratory tract. The frequency of these lesions and their association with a disease process and/or specific etiology was noted.