Radical Lateral Body-Wall Resection for Fibrosarcoma With Reconstruction Using Polypropylene Mesh and a Caudal Superficial Epigastric Axial Pattern Flap: A Prospective Clinical Study of the Technique and Results in 6 Cats

OBJECTIVE: To describe and evaluate a technique for radical resection of the lateral body wall for treatment of fibrosarcoma with reconstruction using polypropylene mesh and a caudal superficial epigastric axial pattern flap in cats. STUDY DESIGN: Prospective, clinical study. ANIMALS OR SAMPLE POPULATION: Six client-owned cats with fibrosarcoma. METHODS: Six cats with histologically confirmed fibrosarcoma of the lateral body wall were staged using radiography and/or computer tomography scanning. Preoperative radiotherapy was used in 3 cats. All cats had the lateral abdominal wall resected and reconstructed with polypropylene mesh. A caudal superficial epigastric flap was mobilized and rotated to close the skin deficit. The animals were evaluated after surgery for wound complications, tumor recurrence, and metastasis. Outcome was assessed by patient examination and client consultation. RESULTS: Minor dehiscence of the skin flaps occurred in 2 cats, and 1 other cat was successfully resuscitated from respiratory and cardiac arrest after surgery. All tissue specimens were tumor-free at the surgical margins. Follow-up times ranged from 12 to 21 months, with a mean time of 17.2 months. None of the cats had evidence of local tumor recurrence or metastasis; outcome was judged good to excellent in all cats. CONCLUSIONS AND CLINICAL RELEVANCE: Radical lateral body-wall resection and reconstruction is an effective technique for achieving local tumor control with acceptable patient morbidity. Further studies are needed to assess whether the technique will result in improved tumor-free intervals and survival times.     

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.     

Minimally Invasive Inguinal Approach for Tube Cystostomy

Objective— To report a technique for tube cystostomy placement via a minimally invasive inguinal approach and outcome in 9 dogs and 6 cats with urinary tract obstruction or detrusor atony.
Study Design— Case series.
Animals— Dogs (n=9) and cats (6).
Methods— Medical records (January 2004–January 2008) of dogs and cats that had tube cystostomy via an inguinal approach were reviewed. Retrieved data included signalment, diagnosis, surgical technique, and complications. Access to the bladder was through a muscle splitting approach in the inguinal region with the cystostomy tube placed through a skin incision made several centimeters proximal to this incision and secured in the bladder by a purse string suture. Cystopexy during closure of the muscle layers ensured secure closure and minimized the likelihood of uroabdomen if tube dislodgment occurred.
Results— Cystostomy tubes were placed in 5 cats as an emergency procedure for treatment of acute urinary tract obstruction or urethral rupture, and as an elective procedure in 9 dogs and 1 cat. No complications occurred during cystostomy tube placement. Postprocedural complications were minor (peristomal irritation in 2 dogs with latex catheters, catheter laceration, premature removal) and only occurred when tubes were retained for >4 weeks. Urinary tract infection at catheter removal in 6 dogs resolved with antibiotic administration.
Conclusions— An inguinal approach for cystostomy tube placement facilitated rapid catheter placement into the bladder with minimal soft tissue dissection. Cystopexy during abdominal wall closure provided peritoneal protection should premature dislodgement of the cystostomy tube occur.
Clinical Relevance— An inguinal approach should be considered for rapid tube cystostomy particularly in metabolically compromised animals.     

Evaluation of a Joint Distractor to Facilitate Arthroscopy of the Canine Stifle

Objectives— To assess a novel technique for arthroscopic evaluation of the canine stifle avoiding the need for fat pad debridement.
Study Design— Prospective study.
Sample Population— Cadaveric canine stifles (n=10); Client-owned dogs (15).
Methods— In cadaveric stifles, the femoropatellar space was assessed before placement of a joint distractor and examination of the femorotibial joint. Time to complete evaluation of the femoropatellar space, to observe the cruciate ligaments, and to completion of examination of the femorotibial joint were recorded. Distractor-assisted arthroscopy was then performed in 15 consecutive clinical cases. Clinical information, time to complete joint evaluation, and ability to perform any additional arthroscopic surgery were recorded.
Results— Observation and palpation of intra-articular structures were possible in all cadaveric stifles. Mean time to evaluate the femoropatellar space was 3.2 minutes (range, 2–4 minutes); to observe the cruciate ligaments, 5.8 minutes (range, 3–8 minutes); and to completion of joint inspection, 9.1 minutes (range 6–13 minutes). In the clinical cases, observation of intra-articular structures was also possible in all stifles. Mean time to complete joint inspection was 21 minutes (range, 10–40 minutes). Partial meniscectomy was performed successfully in 5 stifles.
Conclusions— Use of a joint distractor allowed arthroscopic observation of all relevant structures. Partial meniscectomy was readily performed.
Clinical Relevance— Use of a joint distractor may simplify arthroscopic assessment of the canine stifle and avoid potential morbidity associated with fat pad debridement.