Indwelling Cecal Catheters for Fluid Administration in Ponies

Two different fluid solutions were infused through percutaneous cecal catheters in 6 healthy ponies to determine the effects on body weight; CBC; packed cell volume (PCV); total plasma protein concentration; plasma fibrinogen concentration; abdominal fluid analysis; concentrations of blood urea nitrogen (BUN), serum creatinine, Ca, total CO₂ (TCO₂), Na, CI, K, and P; and fractional clearance (FC) of Na, CI, K, and P. During intracecal administration of solution 1, FC_Na and FC_CI were significantly increased, whereas FC_K and BUN were significantly decreased. During administration of solution 2, FC_Na and serum P were significantly increased, while PCV was significantly decreased. All ponies developed peritonitis during the study. Complications included catheter-related problems, diarrhea, laminitis, and hypocalcemia. We concluded that hydration and electrolyte balance could be maintained by administration of crystalloid solutions intracecally, but that complications were associated with the procedure.     

A Comparison of Arterial and Lingual Venous Blood Gases in Anethetized Dogs

The purpose of this study was to determine whether lingual vanous blood gas samples reflect arterial acid-base gas status in anethetized dogs. Heparinized blood samples were drawn simultaneously from the lingual vein and a peripheral artery in 50 anestheized dogs that were clinical surgical patients, as well as from four experimental dogs in which hemorrahaic shock was being studied. Blood pH, oxygen tension (PO₂), and bicarbonate (HCO_3-)) from the two sources in clinical patients showed significant liner correlation, although arterial PO₂)(PaO₂)) tended to be approximately 110mm Hg higher than lingual venous PO₂). During hemorrahgic shock, however, PaO₂) and PaCO₂) were significantly different from lingual venous PO₂) and PCO₂), Lingula venous blood gas analysis may be useful in assessing acid-base and blood gas status in routline cases, but should not be relied upon in dogs with low cardiac output or poor perfusion.     

Long‐Term Totally Implantable Venous Access Ports in Dogs and Cats Receiving Chemotherapy

Introduction:  We evaluated the totally implantable subcutaneous vascular access port (VAP) in 16 cancer patients undergoing intermittent chemotherapy for more than 30 months.
Methods:  Ports were surgically placed (The CompanionPort, Norfolk Vet Products, Skokie, Illinois 60076) in the jugular vein of 12 dogs and 4 cats between 1/2002 and 7/2004. Body weight determined polyurethane catheter size (4, 5, 7 fr.). The polysulfone port, surrounded by titanium, was anchored to subcutaneous tissue in the dorsolateral neck and confirmed with C‐arm fluoroscopy. All blood samples were obtained via VAP. Nine anticancer agents, other medications, crystalloids/colloids, and whole blood were administered. Ports were flushed every 4–5 weeks with heparinized saline solution (100 IU/ml). Removed catheters were submitted for bacteriology.
Results:  Seven of 16 animals are still alive. VAP were used for 1.5 to more than 30 months with 4–60 injections/port. Catheter tips were visualized from the left atrium distally into the caudal vena cava. Adverse events included post‐operative subcutaneous bruising and/or hematoma (4/16), difficult aspiration (4/16), catheter malposition (1/16), positional flushing (1/16), and occlusion requiring replacement (1/16). No thrombus formation or extravasation was evident. Bacterial colonization without signs of septicemia was observed in 3/4 catheters.
Conclusions:  VAP are an effective way of achieving long‐term venous access in the dog and cat. Complications are typically minor and infrequent.     

Central Nervous System Infection Associated With Anaerobic Bacteria in Two Dogs and Two Cats

Central nervous system (CNS) infection caused by anaerobic bacteria (including Bacteroides, Fusobacterium, Peptostreptococcus, and Eubacterium) was diagnosed in two dogs and two cats. In one dog there was extensive meningomyeloencephalitis, presumably the result of hematogenous spread of bacteria from lung abscesses and bacterial endocarditis. Subdural empyema of unknown origin was found in a second dog and two cats. Clinical signs in all four animals included mental depression and focal neurologic deficits, without fever.     

Peripheral and Central Venous Blood Glucose Concentrations in Dogs and Cats with Acute Arterial Thromboembolism

Background

Acute limb paralysis because of arterial thromboembolism (ATE) occurs in cats and less commonly in dogs. ATE is diagnosed based on physical examination findings and, occasionally, advanced imaging.

Hypothesis/Objectives

Peripheral, affected limb venous glucose concentration is decreased in ATE, whereas its systemic concentration is within or above reference interval.

Animals

Client‐owned cats and dogs were divided into 3 respective groups: acute limb paralysis because of ATE (22 cats and 9 dogs); acute limb paralysis secondary to orthopedic or neurologic conditions (nonambulatory controls; 10 cats and 11 dogs); ambulatory animals presented because of various diseases (ambulatory controls; 10 cats and 9 dogs).

Methods

Prospective observational, clinical study. Systemic and local (affected limb) blood glucose concentrations were measured. Their absolute and relative differences (ΔGlu and %ΔGlu, respectively) were compared among groups.

Results

ΔGlu and %ΔGlu were significantly higher in the ATE cats and dogs groups, compared to both of their respective controls (P < .0001 and P < .001, respectively). No significant differences were observed between the control groups. Receiver operator characteristics analysis of ΔGlu and %ΔGlu as predictors of ATE had area under the curve of 0.96 and 0.99 in cats, respectively, and 1.00 and 1.00, in dogs, respectively. ΔGlu cutoffs of 30 mg/dL and 16 mg/dL, in cats and dogs, respectively, corresponded to sensitivity and specificity of 100% and 90% in cats, respectively, and 100% in dogs.

Conclusions and Clinical Importance

ΔGlu and %ΔGlu are accurate, readily available, diagnostic markers of acute ATE in paralyzed cats and dogs.     

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.     

A Comparison of Two Surgical Approaches to the Scapulohumeral Joint in Dogs

Two scapulohumeral arthrotomy techniques were evaluated and compared in 10 normal, young adult greyhounds. A caudolateral approach with craniodorsal retraction of the teres minor muscle (no-tenotomy) and a craniolateral approach with tenotomy of the infraspinatus tendon were each performed unilaterally in 5 dogs. The dogs were evaluated using force plate gait analysis, lameness evaluation, radiography, and goniometry for 5 weeks and then euthanatized. Tenotomy sites and sections of the humeral articular cartilage were collected from shoulder joints that had been operated on and examined microscopically. The same surgical approach was then performed on the contralateral shoulder in the cadavers and exposure of the humeral articular cartilage was measured using planimetry. Peak vertical force applied to the operated limbs in the tenotomy group was significantly less than preoperative levels on day 3 and significantly less than the no-tenotomy group on days 21 and 28. The peak vertical force applied to the operated limbs in the no-tenotomy group was not significantly different from preoperative levels during the study. Scapulohumeral arthrotomy by tenotomy of the infraspinatus resulted in decreased range-of-motion and joint extension compared with joints operated on without tenotomies, but provided significantly greater exposure to the articular surface. Scapulohumeral arthrotomy with craniodorsal retraction of the teres minor muscle did not significantly alter goniometric measurements compared with unoperated joints. Both techniques resulted in similar subjective lameness scores and caused no gross microscopic or radiographic evidence of articular cartilage damage.     

Biomechanical Comparison of Two Plating Techniques for Fixation of Acetabular Osteotomies in Dogs

OBJECTIVE: To compare the failure properties of a 5-hole, 2.7-mm curved acetabular plate (AP) to a 5-hole, 3.5-mm reconstruction plate (RP) when applied to acetabular osteotomies. STUDY DESIGN: Cadaver study. ANIMALS OR SAMPLE POPULATION: Pelves of 8 mature, large-breed dogs. METHODS: A 5-hole, 2.7-mm AP and a 5-hole, 3.5-mm RP were contoured and applied to the dorsal acetabulum of each pelvis. A central acetabular fracture was simulated after plate application by a transverse osteotomy with a fine saw. Each acetabulum was loaded in a weight-bearing direction. A load-deformation curve was produced for each construct, and biomechanical properties of the AP and RP were compared with the Student's paired t-test. A P value of < .05 was considered significant. RESULTS: For the AP and RP composite respectively, the mean +/- SD maximum load to failure was 2,721 +/- 632 N and 2,488 +/- 800 N, the stiffness was 4.8 +/- 1.8 N/m and 5.3 +/- 1.9 N/m, and the energy absorbed was 15.1 +/- 5.2 Nm and 16.3 +/- 8.3 Nm. None of these differences was statistically significant. CONCLUSIONS: Both fixation techniques provided comparable strength, stiffness, and energy absorbed under the loading conditions of this study. CLINICAL RELEVANCE: Because of the relative ease of application, the 2.7-mm curved AP may be the practical choice for acetabular fracture repair in large dogs.     

Cecal-Colic Volvulus in Two Dogs

Cecal-colic volvulus was confirmed by surgery in two dogs. Both dogs were intact, male Great Danes. The clinical and diagnostic findings were not specific for large bowel volvulus. Clinical signs included peracute to acute onset of vomiting, mild abdominal distention and pain, lack of feces, and tenesmus. Abdominal radiographs demonstrated severe dilatation of bowel loops in both dogs. One dog survived.     

Effect of Therapy on Susceptibility to Urinary Tract Infection in Male Cats with Indwelling Urethral Catheters

Indwelling urinary catheters with a closed urine collection system were maintained in 30 male cats for 3 days after induction of irritant cystitis. All cats received subcutaneous fluids during the 3 days the catheters were in place. The effects of four different treatment regimens on urinary tract infection rates, incidence of urethral obstruction, and development of urinary tract lesions over a 10-day period were compared with results in a nontreated group. Treatments were 1) amoxicillin for 5 days PO; 2) prednisolone for 5 days PO; 3) both amoxicillin and prednisolone for 5 days PO; and 4) dimethylsulfoxide (DMSO) for 3 days intravesicularly. Euthanasia was done before the end of the 10-day experimental period if the cats had two bouts of urethral obstruction or if the cats became uremic for causes unrelated to urethral obstruction. Seven cats were euthanatized before the conclusion of the experiment. These cats had been treated with prednisolone, prednisolone and amoxicillin, or DMSO. All cats that received amoxicillin alone or no therapy survived the 10-day period. Mortality was due to repeated urethral obstruction or to uremia associated with pyelonephritis or papillitis. Urinary tract infection rate was similar in all groups. The group treated with prednisolone alone had the highest incidence of renal infection. Inflammatory lesions in the lower urinary tract were similar in all groups. In conclusion, persistent urinary tract infection often develops in cats with cystitis after indwelling urethral catheterization even when closed systems of urine drainage are used.(ABSTRACT TRUNCATED AT 250 WORDS)     

Bacterial Isolates from Blood Cultures of Dogs Undergoing Dentistry

Bacteria in blood cultures in 30 dogs undergoing high-speed dental scaling and tooth extraction were examined. One or more positive blood cultures were identified in 9 of 30 (30%) dogs. Pasteurella spp. were most frequently (5 dogs) isolated and were sensitive to ampicillin, penicillin, cephalothin, chloramphenicol, tetracycline, amoxicillin with clavulanic acid, and sul-famethoxazole with trimethoprim. Twg groups of 15 dogs each, anesthetized or sedated but not undergoing dental procedures, served as non-dentistry controls. There were no significant (p < .05) differences between the number of positive cultures in dentistry and non-dentistry groups. In healthy dogs undergoing high-speed dental scaling and tooth extraction, the occurrence of bacteria in blood cultures was much lower than previously reported. The clinical significance of positive blood cultures was uncertain.     

Ventricular Arrhythmias in Dogs Undergoing Splenectomy: A Prospective Study

Fifty dogs undergoing splenectomy for splenic masses (n = 40), torsion of the splenic pedicle (n = 5), and immune-mediated disease (n = 5) were evaluated preoperatively and postoperatively for ventricular arrhythmias and the relationship between ventricular arrythmia and splenic disease. The ability of 1 -minute electrocardiograms recorded every 6 hours (ECGs/q6hr) to detect ventricular arrythmia was compared with continuous 48-hour Holter monitoring. Based on continuous Holter monitoring, splenectomized dogs had a high incidence (22 of 50) of rapid ventricular tachycardia. The incidence of rapid ventricular tachycardia was significantly higher in dogs with ruptured splenic masses (16 of 23) than without rupture (1 of 17) ( P < .001). When the results of ECG/q6hr were compared with the results of continuous Holter monitoring, ECG/q6hr was normal in 29% (4 of 14) of dogs with rapid ventricular tachycardia at > 3,000 ventricular extrasystoles (VE)/hr; 50% (4 of 8) of dogs with rapid ventricular tachycardia at 1,000 to 3,000 VE/hr and 100% (6 of 6) of dogs with 10 to 300 VE/hr without rapid ventricular tachycardia. Although dogs undergoing splenectomy had a high incidence of ventricular arrythmias, one-minute ECGs/q6h were unreliable for detection of ventricular arrythmias even when high-frequency extrasystoles occurred.     

Survey of Intraoperative Bacterial Contamination in Dogs Undergoing Elective Orthopedic Surgery

Objective

To investigate the frequency, source, and risk factors of intraoperative (IO) surgeon and patient bacterial contamination during clean orthopedic surgeries, and to investigate the relationship between IO contamination and surgical site infection (SSI) in dogs.

Study Design

Prospective clinical study.

Sample Population

Client‐owned dogs undergoing stifle surgery (n = 100).

Methods

IO cultures were taken in each case from surgical foot wrap, peri‐incisional skin, surgical gloves, and the surgical team's hands. The environment (operating room [OR] lights, computers, scrub sink faucet, anesthesia gurney, and radiology table) was sampled every 5 months. Bacteria were identified and the contamination of each case was categorized. All gloves from the surgical team were collected and tested for perforations using a water infusion test. Cases were followed for at least 8 weeks to determine the presence or absence of SSI. Perioperative variables were evaluated for association with IO contamination and SSI.

Results

Bacterial isolates were yielded from 81% of procedures from 1 or more sources; 58% had positive hand cultures, 46% had positive glove cultures, 23% had positive patient skin cultures, and 12% had positive foot wrap cultures. Staphylococcus spp. was the most commonly recovered bacteria. There was no apparent association between IO contamination and SSI. The highest level of environmental contamination was associated with the scrub sink faucet, followed by the radiology table, anesthesia gurney, and OR computers. The IO glove perforation rate was 18%.

Conclusion

Clean orthopedic procedures commonly had clinically insignificant bacterial contamination. In our study, bacteria responsible for SSI did not appear to colonize the patient in the OR.     

Comparison of Single,Averaged, and Pooled Urine Protein:Creatinine Ratios in Proteinuric Dogs Undergoing Medical Treatment

Background

Monitoring urine protein:creatinine ratios (UPC ) in dogs with protein‐losing nephropathy (PLN ) is challenging because of day‐to‐day variation in UPC results.

Hypothesis/Objectives

Determine whether single, averaged, or pooled samples from PLN dogs receiving medical treatment yield comparable UPC s, regardless of degree of proteinuria.

Animals

Twenty‐five client‐owned PLN dogs receiving medical treatment.

Methods

UPC ratios were prospectively measured in each dog utilizing 3 methods: single in‐hospital sample (day 3), average sample (days 1–3), and pooled sample (equal pooling of urine from days 1–3). Bland‐Altman analysis was performed to evaluate agreement between methods for all dogs, as well as in subgroups of dogs (UPC ≤4 or UPC >4).

Results

For all dogs, Bland‐Altman log‐transformed 95% limits of agreement were ?0.07–0.18 (single versus pooled UPC ), ?0.06–0.16 (single versus average UPC ), and ?0.06–0.04 (pooled versus average UPC ). For dogs with UPC ≤4, Bland‐Altman 95% limits of agreement were ?0.42–0.82 (single versus pooled UPC ), ?0.38–0.76 (single versus average UPC ), and ?0.27–0.25 (pooled versus average UPC ). For dogs with UPC >4, Bland‐Altman 95% limits of agreement were ?0.17–2.4 (single versus pooled UPC ), ?0.40–2.2 (single versus average UPC ), and ?0.85–0.43 (pooled versus average UPC ).

Conclusions and Clinical Importance

UPC ratios from all methods were comparable in PLN dogs receiving medical treatment. In PLN dogs with UPC >4, more variability between methods exists likely because of higher in‐hospital results, but whether this finding is clinically relevant is unknown.