Laparoscopic cryptorchidectomy in horses.

Laparoscopic cryptorchidectomy was successfully performed in 15 standing or recumbent horses. In 3 horses, owners believed that castrations had been performed, but the horses had retained stallion-like behavior. Successful removal of undescended testes in these horses stopped this behavior. Laparoscopy offered excellent visualization of the structures of the vaginal ring and facilitated removal of the abdominally located testis. The internal and external inguinal rings were not invaded, thus the chance of serious complications that may result during open cryptorchidectomy procedures was minimized.     

Use of laparoscopic-assisted cryptorchidectomy in dogs and cats

A laparoscopic-assisted technique for localization and removal of retained testes was performed on 13 client-owned dogs and cats. Operative time and intraoperative complications were recorded. One month after surgery, follow-up examinations were performed on all animals and owners were asked to complete questionnaires concerning signs of illness and complications observed after surgery and their overall satisfaction with the procedure. The laparoscopic-assisted technique was effective in identifying and removing retained testes. Owners were satisfied with the procedure. Laparoscopic-assisted crytorchidectomy can be used to minimize the invasiveness of the procedure while maintaining the safety associated with good visibility of abdominal structures.     

Laparoscopic cryptorchidectomy using electrosurgical instrumentation in standing horses

OBJECTIVE: To describe a technique for laparoscopic cryptorchidectomy in standing horses using electrosurgical instrumentation. STUDY DESIGN: Retrospective clinical study. ANIMALS OR SAMPLE POPULATION: Ten horses, 1 to 7 years of age, with unilaterally or bilaterally retained testes. METHODS: Food was withheld for a minimum of 12 to 24 hours. Horses were sedated using xylazine hydrochloride (0.5 to 1 mg/kg) and butorphanol tartrate (0.02 mg/kg) or detomidine hydrochloride (0.02 to 0.03 mg/kg) and restrained in standing stocks. Three portal sites in the paralumbar fossae were locally desensitized using 2% mepivacaine. After trocar and laparoscope insertion, the ipsilateral testicle, mesorchium, and ductus deferens were identified. The cranial mesorchium was coagulated with either monopolar (one horse) or bipolar (nine horses) electrosurgical forceps, and then the mesorchium, ductus deferens, and ligament of the tail of the epididymis were transected from cranial to caudal using laparoscopic scissors. Once the testis was freed, the transected mesorchium was inspected for hemorrhage and the testis was removed by connecting the two instrument portals (eight horses). In two horses, the testis was placed within a laparoscopic retrieval bag and then removed without enlarging the portal incision. If the testes were retained bilaterally, the retained contralateral testis was removed similarly through the opposite paralumbar fossa. If the contralateral testis was descended, it was removed by a standard, standing castration technique. RESULTS: Vessels of the mesorchium were adequately coagulated using bipolar and monopolar electrosurgical forceps. No immediate or short-term complications occurred in 10 horses at 3 to 11 months after surgery. CONCLUSION: Standing laparoscopic cryptorchidectomy can be performed easily and safely using electrosurgical instrumentation as the sole means of providing hemostasis of the equine mesorchium. CLINICAL RELEVANCE: Standing laparoscopic cryptorchidectomy using electrosurgical instrumentation provides a safe, reliable, and efficient alternative to achieve hemostasis of the equine mesorchium.     

Use of an inguinal approach adapted from equine surgery for cryptorchidectomy in dogs and cats: 26 cases (1999-2010)

OBJECTIVE-To determine whether a surgical technique used in cryptorchid horses can be used successfully to remove testicles retained in the inguinal region or abdominal cavity in dogs and cats. DESIGN-Retrospective case series. ANIMALS-22 dogs and 4 cats with cryptorchidism. PROCEDURES-In 1999 through 2010, 26 cryptorchid patients underwent surgery during which an incision was made over the inguinal ring and the undescended testicle was located for removal via identification of the vaginal process and the embryonic gubernaculum. Castration was performed once a testicle was located in the inguinal region or via removal of an intra-abdominally located testicle through the inguinal canal. RESULTS-4 dogs and 1 cat were bilaterally cryptorchid. Testicles were retained in the abdominal cavity in 18 dogs and in the inguinal region in 4 dogs; in all 4 cats, undescended testicles were located in the inguinal region. Twenty-one dogs and 4 cats were castrated without breaching the abdominal cavity; in one of those dogs, the inguinal ring was enlarged to permit extraction of a tumorous testicle. In 1 dog, the inguinal ring was enlarged into a paramedian laparotomy and viscera were manipulated to exteriorize an intra-abdominally located testicle because the gubernaculum had ruptured. Major intraoperative or long-term complications did not occur. CONCLUSIONS AND CLINICAL RELEVANCE-Results suggested that as in horses, the surgical approach over the inguinal ring, wherein the vaginal process and the remnant of the gubernaculum are identified and used to locate an undescended testicle for removal, can be used successfully in dogs and cats.     

Laparoscopic ovariohysterectomy in nine dogs

Minimally invasive surgery has been found in humans to reduce pain, incidence of infections, and duration of hospitalization. Minimally invasive procedures are also being described in veterinary medicine. Laparoscopic ovariohysterectomy (OHE) was performed on nine, healthy, intact female dogs using a Harmonic scalpel. Creatine kinase values were determined both before and 12 hours following the laparoscopic OHE; the magnitude of the difference between preoperative and postoperative creatine kinase values did not correlate with length of operative time, length of incisions, or amount of hemorrhage. Complications included one dog that had an omental herniation that was primarily repaired and one dog with seroma formation. Median surgical time for all dogs was 60 minutes (range, 35 to 100 minutes).     

Juvenile cellulitis in dogs: 15 cases (1979-1988)

The records of 15 dogs diagnosed as having juvenile cellulitis (juvenile pyoderma, puppy strangles) were evaluated for clinical, laboratory, and therapeutic results. Mandibular lymphadenopathy was observed in 14 dogs, and was not associated with skin lesions in 5 dogs. Edema, pustules, papules, or crusts were noticed periorally, periocularly, on the chin or muzzle, or in the ears of those dogs with skin lesions. Eight dogs were lethargic; fever and anorexia were inconsistent findings. Four dogs had signs of pain on manipulation of their joints. Complete blood counts revealed leukocytosis with neutrophilia in 4 dogs, and normocytic, normochromic anemia in 6 dogs. Three dogs had suppurative lymphadenitis with many neutrophils. Cytology of the aspirate of pustules or abscesses in 6 dogs revealed many neutrophils without bacteria. Coagulase-positive Staphylococcus spp were isolated from draining lesions in 2 dogs. Intact abscesses and lymph nodes were negative for bacterial growth in 4 dogs. Three of these dogs were being administered antibiotics at the time of bacterial culturing. Cytology of the aspirates of joints in 3 of the 4 dogs with joint pain revealed suppurative arthritis with no bacteria, and the aspirates were negative for bacterial growth on culturing, although all 3 dogs were being administered antibiotics at the time of culturing. Of 12 dogs initially treated with antibiotics, only 4 (33%) responded favorably; the other 8 dogs were then given antibiotics and corticosteroids. Three dogs were initially given antibiotics and corticosteroids. All dogs treated concurrently with antibiotics and corticosteroids responded favorably. One of these dogs had a relapse after treatment was discontinued. The concurrent arthritis in 4 of the dogs resolved with treatment of the juvenile cellulitis and did not redevelop once the medication was discontinued. Concurrent treatment with antibiotics (cephalosporins) and prednisone (2.2 mg/kg of body weight/day) was the most consistently effective treatment in the dogs in this study.     

Massive transfusion in dogs: 15 cases (1997-2001)

OBJECTIVE: To determine clinical characteristics of dogs that received massive transfusion and identify the underlying diseases, complications, and outcomes. DESIGN: Retrospective study. ANIMALS: 15 dogs. PROCEDURE: Medical records of dogs receiving a massive blood transfusion were evaluated for transfusion volume, underlying disease process or injury, benefits and complications of transfusion, and outcome. A massive transfusion was defined as transfusion of a volume of blood products in excess of the patient's estimated blood volume (90 ml/kg [40 ml/lb]) in a 24-hour period or transfusion of a volume of blood products in excess of half the patient's estimated blood volume in a 3-hour period. RESULTS: Six dogs had intra-abdominal neoplasia resulting in hemoabdomen, 3 had suffered a traumatic incident resulting in hemoabdomen, and 6 had non-traumatic, non-neoplastic blood loss. Mean volumes of packed RBC and fresh-frozen plasma administered were 66.5 ml/kg (30 ml/lb) and 22.2 ml/kg (10 ml/lb), respectively. All dogs evaluated developed low ionized calcium concentrations and thrombocytopenia. Transfusion reactions were recognized in 6 dogs. Four dogs survived to hospital discharge. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that massive transfusion is possible and potentially successful in dogs. Predictable changes in electrolyte concentrations and platelet count develop.     

Unilateral laparoscopic cryptorchidectomy in a llama

Cryptorchism is an inherited congenital abnormality characterized by the failure of one or both testes to descend into the scrotum. Diagnosis can be difficult if the retained testicular tissue cannot be localized during clinical examination and the history of the animal is unknown, or if the animal shows persistent male behaviour despite the history of successful previous castration. The present case report describes the history of a cryptorchid Lama and the techniques of general anesthesia and laparoscopic cryptorchidectomy advocated.     

Laparoscopic portosystemic shunt attenuation in two dogs

Laparoscopic portosystemic shunt attenuation was successfully performed in two dogs. Aberrant vessels were noted on visual examination of the abdominal vasculature. Cellophane bands were placed around the vessel laparoscopically for attenuation. The dogs had minimal postoperative morbidity, and there was biochemical evidence of adequate shunt ligation at follow-up examination.     

Acute aldicarb toxicity in dogs: 15 cases (2001–2009)

Objective – To describe the common clinical signs, laboratory abnormalities, treatment, and prognosis associated with acute aldicarb toxicosis in dogs. Design – Retrospective observational study from 2001 to 2009. Setting – Urban referral hospital. Animals – Fifteen client‐owned dogs. Interventions – None. Measurements and Main Results – The most common clinical signs associated with acute aldicarb toxicosis were vomiting, ptyalism, diarrhea, and tremors. Of the 15 dogs, 11 were admitted to the hospital for treatment, 2 were euthanized at presentation and 2 were discharged against medical advice following minimal treatment and lost to follow‐up. Laboratory abnormalities included lactic acidosis and hyperglycemia in 12 and 9 patients, respectively. Treatment of hospitalized dogs included induction of emesis with apomorphine (4 dogs), activated charcoal (5), IV fluids (11), atropine (7), methocarbamol (3), diazepam (1), pralidoxime (1) and diphenhydramine (1). Ten of 11 hospitalized dogs survived to discharge; 1 was euthanized following a respiratory arrest after 36 hours of hospitalization. One patient received mechanical ventilation and treatment for pneumonia before discharge from the hospital. The median duration of hospitalization was 22 hours (range 12–168 h). Conclusions – Acute aldicarb toxicosis carries a good prognosis for survival and hospital discharge with treatment. Supportive care should be considered for at least 18–24 hours to monitor for response to therapy and development of respiratory failure.     

Nonsurgically managed caudal acetabular fractures in dogs: 15 cases (1979-1984)

Medical records of 15 dogs with nonsurgically managed caudal one-third acetabular fractures were reviewed. In-hospital evaluation of these dogs was possible 6 to 67 months after injury. Thirteen dogs had radiographic evidence of moderate to severe degenerative joint disease in affected hips. Twelve dogs had decreased hip joint range of motion and/or signs of pain on the affected side, and 7 dogs were lame. Because of limited pain-free motion and degenerative joint disease in most affected hips, results of nonsurgical management of caudal one-third acetabular fractures in dogs were considered unsatisfactory.     

Molecular identification of Ehrlichia ewingii infection in dogs: 15 cases (1997-2001)

OBJECTIVE: To determine historical, physical examination, hematologic, and serologic findings in dogs with Ehrlichia ewingii infection. DESIGN: Retrospective study. ANIMALS: 15 dogs. PROCEDURE: In all dogs, infection with E ewingii was confirmed with a polymerase chain reaction (PCR) assay. Follow-up information and clarification of information recorded in the medical records was obtained by telephone interviews and facsimile correspondence with referring veterinarians and owners. RESULTS: Fever and lameness were the most common findings with each occurring in 8 dogs. Five dogs had neurologic abnormalities including ataxia, paresis, proprioceptive deficits, anisocoria, intention tremor, and head tilt. Neutrophilic polyarthritis was identified in 4 dogs. No clinical signs were reported in 3 dogs. The predominant hematologic abnormality was thrombocytopenia, which was identified in all 12 dogs for which a platelet count was available. Reactive lymphocytes were seen in 5 of 13 dogs. Concurrent infection with another rickettsial organism was identified in 4 dogs. Of the 13 dogs tested, 7 were seroreactive to E canis antigens. Morulae consistent with E ewingii infection were identified in neutrophils in 8 dogs. Treatment with doxycycline, with or without prednisone, resulted in a rapid, favorable clinical response in the 9 dogs for which follow-up information was available. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that PCR testing for E ewingii infection should be considered in dogs with fever, neutrophilic polyarthritis, unexplained ataxia or paresis, thrombocytopenia, or unexplained reactive lymphocytes, and in dogs with clinical signs suggestive of ehrlichiosis that are seronegative for E canis. Following treatment with doxycycline, the prognosis for recovery is good.     

Laparoscopic diagnosis of pancreatic disease in dogs and cats

BACKGROUND: Histopathology is the gold standard for the diagnosis of pancreatic disease. Laparoscopy offers a minimally invasive route by which to obtain pancreatic biopsies. HYPOTHESIS: Laparoscopy is a safe and effective technique for evaluating the pancreas in small animal patients. ANIMALS: Medical records of 18 dogs and 13 cats examined between 1999 and 2007 that underwent laparoscopy during which observation or biopsy of the pancreas was recorded. METHODS: The database for the Laparoscopy Laboratory at Colorado State University was searched for records that contained "pancreatitis,"pancreas," or "pancreatic." The presenting complaints, imaging studies, and histopathologic findings of animals were recorded. All hospital admissions were searched for animals with the same presenting complaints and of those it was determined which animals had exploratory surgery and their pancreas biopsied. RESULTS: Thirteen cats and 18 dogs underwent laparoscopy for presumptive pancreatic disease or had the appearance of the pancreas described, pancreatic biopsies obtained, or both. In 14 animals a laparoscopic biopsy of the pancreas resulted in a histopathologic diagnosis when the sonographic findings or the gross assessment failed to do so. In 35% of the animals a biopsy of the pancreas was not obtained despite findings consistent with pancreatic disease. Those animals examined for vomiting or anorexia were significantly more likely to have a biopsy of the pancreas obtained through laparoscopy versus surgery (P < .0001). CONCLUSIONS AND CLINICAL IMPORTANCE: Laparoscopy and pancreatic biopsy is useful for evaluation of pancreatic disease.     

Use of a parainguinal approach for cryptorchidectomy in alpacas

Cryptorchidism is an uncommon condition in llamas and alpacas, and there are no reports detailing surgical management of this condition in llamas or alpacas; however, flank or ventral midline approaches have been mentioned. Cryptorchid castration was performed by use of a parainguinal approach in 2 alpacas. The retained testicle of each alpaca was found on the ventral aspect of the abdomen, just caudal to the incision in 1 alpaca and at the cranial edge of the incision in the other. The testicle was approximately 1 X 0.5 cm in 1 alpaca and 2 X 1 cm in the other. In an alpaca or llama with a single abdominal testicle and no history of surgery, the parainguinal approach has several advantages, including the likely proximity of the testicle to the incision; the small incision, which can be extended if needed; ease of closure; and minimal aftercare. The retained testicles were small and could be difficult to find from a more distant midline, paramedian, or flank incision.     

Radial carpal bone fractures in 15 dogs

Between 1977 and 1992, 15 adult dogs were presented to the Universities of Bristol, Glasgow, Liverpool and London with fractures of the radial carpal bone which had occurred without a known episode of violent trauma. Eleven of the dogs were boxers and the other breeds affected were a Pharaoh hound, rottweiler, springer spaniel and a greyhound. The condition was bilateral in three cases. Eleven dogs were treated surgically by cast immobilisation (four cases), fragment removal (one case), lag screw fixation (three cases), pan-carpal arthrodesis (one case) and lag screw reduction followed by pan-carpal arthrodesis (two cases). The remaining four dogs were treated conservatively with rest and tactical use of non-steroidal anti-inflammatory drugs. Follow-up periods ranged from two months to 11 years. Varying degrees of lameness, which tended to be exacerbated by exercise, persisted in all cases. The radial carpal bone appears to have at least three separate centres of ossification which eventually fuse; their planes of fusion correspond approximately to the two main fracture lines. These areas of fusion could be weak points within the radial carpal bone.     

Thirteen cases of tetanus in dogs

The records of 13 dogs with tetanus were reviewed, 12 of the dogs survived and were discharged, but the other died as a result of the acute onset of hyperthermia. Long-term follow up was available for 10 of the survivors of which nine were reported to be normal. One case was euthanased after a cervical spine fracture four months after it was discharged. Complications encountered during management included aspiration pneumonia in three cases, urinary tract infection in two cases, and upper respiratory tract obstruction, hiatal hernia, coxofemoral luxation, seizures and respiratory arrest in one case each. None of the dogs required ventilatory support, and the complications were managed successfully. The dogs were nursed intensively and monitored carefully.     

Laparoscopic ovariectomy in dogs using a single-port multiple-access device

The aim of this case series was to describe a novel technique of single-incision laparoscopic ovariectomy in dogs using the SILS Port (Covidien), a single-port multiple-access device, in 40 client-owned dogs. A single 3 cm incision was made caudal to the umbilicus and the SILS Port device was bluntly introduced. Three cannulae were inserted in the SILS Port through the access channels. In the first 20 cases, a transabdominal suspension suture was used to transfix the ovaries. In all cases, ovariectomy was performed using a standard straight non-roticulated laparoscopic grasper and a vessel sealer/divider device. Mean (sd) duration of the ovarian resection was 25.1 (6.1) minutes (range 16 to 39 minutes). In five dogs (with transabdominal suspension suture), minor bleeding in the mesovarium or in the spleen was observed. Since the SILS Port allows simultaneous use of two instruments and a telescope through a single incision, the suspension suture is not mandatory. The lack of a transabdominal suspension suture increased collision between instruments and the telescope, but triangulation capabilities remained sufficient to achieve visualisation, sufficient manoeuvrability and safe vessel sealer/divider device application. The time to perform ovarian resection remained unaltered with or without suspension suture and regardless of the fat score of the ovarian ligament. Complications were less frequent without a suspension suture.