The use of bipolar electrosurgical forceps for haemostasis in open surgical ovariectomy of bitches and queens and castration of dogs

Objectives

To describe a technique using bipolar electrosurgical forceps for haemostasis during open ovariectomy of bitches and queens and for castration of dogs and to determine whether these forceps reduced surgical time compared to ligation with suture.

Materials and Methods

Bipolar electrosurgical forceps were used for haemostasis in 3744 open surgeries including ovariectomies in bitches (n=1406) and queens (n=859) and castrations in dogs (n=1335). The forceps were also used to assist with ovariohysterectomy in bitches (n=89) and queens (n=55). The effect of bipolar electrocoagulation and other likely factors influencing surgical time was examined using linear regression analysis of 367 surgeries.

Results

The use of the forceps reduced surgical time by 9·7 ±2·8 minutes in bitches and by 3·0 ±1·5 minutes in queens. The complications encountered initially were small superficial skin burns requiring topical treatment and one case of haemorrhage associated with surgical technique.

Clinical Significance

Bipolar electrosurgical forceps reduce surgical time in ovariectomies, and complications are rare. This technique has promise for widespread application in veterinary practice to assist with haemostasis in ovariectomy of bitches and queens.     

Urethropexy for the management of urethral sphincter mechanism incompetence in the bitch

Urethropexy was performed on 100 bitches for the management of urethral sphincter mechanism incompetence (SMI). The dogs ranged in age from 12 months to nine years (mean 4.5 years). Diagnosis of the condition was based upon clinical, laboratory and contrast radiographic examinations, and clinical response to medical management. In all bitches, incontinence developed in the adult individual and in the majority (89 bitches) after spaying. Radiographic findings were unremarkable in 22 bitches, apart from the presence of an intrapelvic bladder neck. Follow-up periods ranged from 12 months to seven years (mean 2.9 years). Fifty-six bitches were completely cured by surgery, 27 became less incontinent and 17 either failed to respond (nine animals) or showed an initial improvement in urinary function, but then relapsed (eight animals). Nine of these 17 animals underwent a second urethropexy procedure, resulting in a cure in six and an improvement in three cases (follow-up 12 to 41 months, mean 22.2 months). A deterioration in the response rate was observed over time. Postoperative complications were seen in 21 bitches and included an increased frequency of micturition (14 bitches), dysuria (six bitches) and anuria (three bitches).     

Concentrations of progesterone and luteinizing hormone in the serum of diestrous bitches before and after hysterectomy

Blood was collected from 6 adult bitches (3 pregnant and 3 nonpregnant) daily for 59 days after the onset of diestrus, and serum progesterone concentrations were determined. The bitches were hysterectomized at various times during diestrus [diestrus day (DD) 5, 15, or 25] to determine whether the uterus has a role in maintaining luteal function in the pregnant or nonpregnant bitch. Concentrations of serum luteinizing hormone (LH) were also measured to determine whether LH concentrations decrease when luteal function abates (experiment 1). All 6 bitches in experiment 1 had progesterone concentrations greater than 1.0 ng/ml during the 2-month period, indicating that neither the pregnant nor nonpregnant uterus was necessary for maintaining luteal function in the bitch. Concentrations of LH appeared to increase in the serum of 5 of the 6 bitches when progesterone concentrations were declining, indicating that cessation of luteal function does not appear to result from a lack of LH. Blood was collected from the 6 bitches used in experiment 1 twice weekly during the 2nd diestrus after hysterectomy (experiment 2) to determine whether alterations in luteal function that might be observed during experiment 1 were due to some aspect of the surgical procedure, rather than to absence of a uterus. Progesterone concentrations in the serum were lower (P less than 0.05) during the 10 days after surgery in the 2 bitches hysterectomized on DD 5 than in the 4 bitches remaining intact during this period (experiment 1).(ABSTRACT TRUNCATED AT 250 WORDS)     

Review of the technique and complications of median J sternotomy in the dog and cat

The surgical and medical records of 67 dogs and nine cats which underwent median sternotomy over a five-year period were reviewed. The indication for median sternotomy and the short and longer term complications were recorded. Twenty-six of the dogs died or were euthanased within 48 hours of the surgery as a consequence of the pre-existing disease or complications of the intrathoracic surgical procedure. A further four dogs were enthanased between 48 hours and 14 days following confirmation of neoplastic processes. Thirty-seven dogs were alive at 14 days; of these, seven dogs (19 per cent) experienced short-term wound complications, including haemorrhage, wound infection, thoracic limb neurological deficits and excessive postoperative discomfort. Of the 37 dogs alive for longer term follow-up, eight dogs (22 per cent) experienced wound complications, including haemorrhage, sternal fracture, sternal osteomyelitis and delayed wound healing. No complications were noted in the cats.     

The use of haemostatic gelatin sponges in veterinary surgery

Objectives : To describe the use of absorbable gelatin sponges as haemostatic implants in clinical veterinary surgical cases and to document any related postoperative complications. Methods : Practice databases were searched for the product names “Gelfoam” and “Spongostan”. Patient records were retrieved and data regarding patient signalment, surgical procedure, National Resource Council (NRC) wound classification, source of haemorrhage, pre‐ and postoperative body temperature, postoperative complications, time to discharge and details of any postoperative imaging were recorded and reviewed. Follow‐up information was obtained by repeat clinical examination or telephone interview with either the owner or referring veterinary surgeon. Cases with incomplete surgical records or those which were not recovered from anaesthesia were excluded from the analysis. Results : Fifty cases (44 dogs and 6 cats) satisfied the inclusion criteria. Satisfactory haemostasis was achieved in 49 cases with one case requiring reoperation during which a second gelatin sponge was used. There were no detected hypersensitivity responses or confirmed postoperative complications relating to the use of gelatin sponges during the follow‐up period (median 13 months). Clinical Significance : This is the first review of the use of gelatin sponges in clinical veterinary surgery and suggests that gelatin sponges are safe to use in cats and dogs.     

The development of cystic endometrial hyperplasia in the bitch following serial uterine biopsies

Serial uterine biopsies were performed on two bitches during three oestrous cycles. The uterus was biopsied once in one other bitch and twice in another case following exteriorization and palpation of the uterine horn on four occasions earlier in the cycle. Following the serial biopsies both bitches developed a vulval discharge for a duration of 8-21 days. This first appeared between metoestrus days 14 and 30. By the 5th week after oestrus the uteri of both bitches developed cystic endometrial hyperplasia with inflammatory cell infiltration which regressed spontaneously. This lesion did not develop in the two other bitches, and it may have been caused by the surgical interference with the endometrium during the period of luteal development.     

Transobturator vaginal tape inside out for treatment of urethral sphincter mechanism incompetence in female dogs: cadaveric study and preliminary study in continent female dogs

Objectives: (1) To describe a surgical technique adapted from the “transobturator vaginal tape inside‐out” (TVT‐O) used in women and to define the trajectory of the tape on canine cadavers, and (2) to determine the urodynamic and morphological effects of the TVT‐O in continent bitches. Study Design: Cadaveric and experimental in vivo study. Animals: Fresh female canine cadavers (n=12) and spayed female Beagle dogs (2). Methods: (1) TVT‐O was inserted in 12 cadavers. Dissection was performed and distances between the tape and neighboring structures were recorded. (2) TVT‐O was inserted in 2 continent female Beagle dogs. Urethral pressure profilometry and vaginourethrograms were performed preoperatively, immediately after surgery, and 2, 4, and 6 months postoperatively. Histopathology was performed 6 months after surgery. Results: (1) TVT‐O tape was consistently located in a perineal space before entering the obturator foramina and was located at a safe distance from major neurovascular structures including the femoral vessels and obturator nerve. (2) TVT‐O was performed without any surgical or postoperative complications in 2 continent bitches. Histopathologic examination of the tissues surrounding the tape revealed a mild fibroblastic proliferation with a mild to minimal lymphoplasmacytic inflammatory infiltration. Conclusions: TVT‐O is a feasible and accurate procedure that can be performed in continent bitches with a low risk of complications.     

The effects of ovariohysterectomy plus different combinations of halothane anaesthesia and butorphanol analgesia on behaviour in the bitch

One hundred and sixty-six behaviours were identified as possible indices of post-operative pain-induced distress in the bitch. These were assessed in bitches after treatment with different combinations of halothane and butorphanol in the absence of surgery and following ovariohysterectomy under halothane anaesthesia with or without butorphanol analgesia given at different stages during the operation. Behaviour was monitored while the bitches were alone (non-interactive) and when routinely examined and handled prior to blood sampling (interactive). Seventy-six of the 166 behaviours occurred so infrequently (less than two occurrences per hour) as to be of no value as indices. Non-interactive behaviours associated with surgery were a decrease in normal speed cage circling and an increase in drawing the rear limbs up in the pike position. The infrequent non-interactive behaviours of incision licking, vomiting and flank gazing were considered to be expressions of pain caused by ovariohysterectomy. During the post-surgical period, bitches given analgesic moved less frequently than those not receiving analgesic. Vocalisation was associated with dysphoria of analgesia rather than pain-induced distress. The behaviour of bitches after ovariohysterectomy suggests that this is a painful procedure which warrants analgesia.     

Adjuvant post-operative chemotherapy in bitches with mammary cancer

The survival time in a group of eight bitches with malignant mammary tumours given adjuvant post-operative chemotherapy was compared with survival in another group of eight bitches with mammary cancer which were treated by surgical excision alone. The same surgical procedure was used in both groups. All bitches had stage III disease according to the World Health Organization clinical staging system. Histologically, 10 of the bitches had complex carcinomas (carcinomatous mixed tumours), the remaining six bitches had carcinosarcomas. The chemotherapeutic protocol used was a combination of 5-fluorouracil (150 mg/m2 of body surface area) and cyclophosphamide (100 mg/m2) given on the same day, intravenously, every week for four consecutive weeks. Chemotherapy was started one week post-surgery. Selected haematological parameters (packed cell volume, white blood cell count, platelet count and differential white blood cell count) and serum biochemical parameters (alanine aminotransferase, alkaline phosphatase, blood urea nitrogen and creatinine) were measured before and during chemotherapy. Survival analysis indicated that the chemotherapeutic regimen had a positive influence on the disease-free interval and the survival time of the eight bitches (P < 0.05). Although leucocyte numbers were significantly decreased (P < 0.001) during chemotherapy, the mean leucocyte counts remained within normal limits. Temporary leukopenia was noted only in one bitch. Packed cell volume and alkaline phosphatase increased significantly (P < 0.05) but within normal limits. Creatinine was also increased significantly (P < 0.01) but the mean creatinine concentrations were within normal limits, although in half of the bitches the concentrations occasionally rose above normal.     

Description and evaluation of a right flank, mini-laparotomy approach to canine ovariohysterectomy

Surgical ovariohysterectomy (OVH) using a right flank approach was performed in 114 bitches as part of the Animal Birth Control (ABC) Programme at Help in Suffering, Jaipur, India. Incision length, duration of surgery and postoperative pain scores were recorded for each animal. The mean weight of the bitches was 13.7 kg, and the mean body condition score was 4.5 on a 1-9 scale. Mean surgical incision length and time were 22 mm and 11 minutes 4 seconds, respectively. It was seen that 86.1 per cent of bitches required no additional postoperative analgesia. These findings compare favourably with other techniques for OVH, including laparoscopic techniques. The surgical approach described may be an alternative for canine OVH, particularly in a shelter setting.     

Termination of mid-term pregnancy in the dog with oral RU 486

A total of four pregnancies were terminated in three bitches (two beagles and one flatcoated retriever) with a single dose of 20 mg/kg (one case), two doses of 8-3 mg/kg (one case) or 20 mg/kg plus 40 mg/kg (two cases) RU 486 by mouth (Mifepristone; Roussel-Uclaf, France) from day 26 to day 36 after the first day of mating of the bitch. Abortions occurred within two, four, 11 and 11 days after the initial treatment, respectively. The clinical status of the bitches was similar to that observed during a normal parturition, ie, lowering of the body temperature, shivering, panting and nesting behaviour. No side effects were seen. The beagle bitch that aborted twice, was mated at the first oestrus after the first abortion, conceived and aborted the same number of puppies the second time. The peripheral plasma progesterone concentration at the time of treatment in all bitches was < 75 nmol/litre. It had decreased to between 24-2 and 13-1 nmol/litre at the time of abortion and to between 4-0 to 0–5 nmol/litre at four to 15 days after the initial treatment. Peripheral plasma levels of prolactin increased three- to fourfold within 24 to 48 hours after treatment, concomitant with the drop in progesterone and had returned to basal levels within two to three days. Prolactin concentrations also increased around the time of intrauterine fetal death. Prostaglandin F_2aα-metabolite concentrations increased slowly after treatment, and around the time of abortion the levels increased five- to 10-fold. RU 486 seems to be a safe and effective abortifacient for use during mid-term pregnancy in the dog.     

Transport of spermatozoa in the reproductive tract of the bitch: observations through uterine fistula

Using unilateral uterine fistulas, the time required for spermatozoa to reach the end of the fistula after natural mating, artificial insemination (AI) in a normal standing posture (NP), and AI standing on the head (SH) was investigated in each of three stages of estrus. Conceptivity in these bitches was also investigated. Five experimental bitches were tested during a total of 8 estrous periods. The results are as follows; the time required for spermatozoa to reach the end of the fistula was almost the same in the early and middle stages, i.e., 30 sec to 1 min after natural mating and SH and less than 2 min for half the bitches in NP, although no intrauterine transport could be observed in the other half. In most cases of mating during the late stage no spermatozoa were found after any of the 3 methods of insemination. Five animals became pregnant in these experiments, but the other three failed to conceive. The implantation of fertilized ova occurred also in the fistulated uterine horn in all cases of pregnancy.     

Fertility and whelping complications in bitches following correction of vaginal abnormalities

The fertility and whelping complications of normal bitches and of bitches that had had surgery to correct a vaginal abnormality of varying severities were compared retrospectively. Reproductive performance and whelping statistics were compared between 37 bitches that had been diagnosed with a vaginal abnormality and 37 age- and breed-matched bitches with no history of vaginal abnormalities. There were no significant differences in reproductive performance between the affected and control bitches. When analysed by the severity of the abnormality, pregnancy rates were significantly lower for the group of bitches with the most severe abnormalities compared with the group of bitches that had mild vaginal abnormalities. Furthermore, the bitches that had severe abnormalities were significantly more likely to require a caesarean section than those with mild abnormalities.     

Canine vaginal and uterine bacterial flora

Vaginal swab specimens were obtained from 41 prepuberal and 81 postpuberal bitches. Uterine swab specimens were obtained from 22 bitches at ovariohysterectomy and from 4 bitches during cesarean section. The specimens were cultured for aerobic bacteria. Most bitches harbored some type of bacteria in the vagina, but coagulase-positive staphylococci were isolated more frequently from prepuberal bitches than from postpuberal bitches. Postpuberal bitches were placed in various groups, based on the stage of the estrous cycle at the time specimens were obtained. Differences in bacterial types isolated from the postpuberal groups were not statistically significant. Uterine culture results suggested that bitches do not normally harbor aerobic bacteria in the uterus.     

Vaginourethroplasty for Treatment of Urethral Obstruction in the Bitch

Vaginourethroplasty was performed in six bitches with infiltrative, obstructive urethral disease. The initial clinical signs included dysuria, hematuria, pollakiuria, and stranguria. Diagnosis was based on the clinical signs, plain radiography and contrast vagino-urethrogram examination, and urethral biopsy. Five dogs were diagnosed as having urethral neoplasia; the sixth dog had granulomatous urethritis. In all six dogs, up to 50% of the urethra and the urethral tubercle were resected to ensure adequate surgical margins. One dog was euthanatized 4 months after surgery for recurrence of a transitional cell carcinoma at the surgical site. Long-term resolution of the problem (minimum of 12 months) was achieved in the other five dogs. The frequency of serious complications, including urinary incontinence and ascending lower urinary tract infections, was low.     

Elective Caesarean Operation in the Bitch Using Aglepristone Before the Pre-Partum Decline in Peripheral Progesterone Concentration

The aim of this study was to investigate caesarean operation (CO) undertaken before the pre-partum decrease of progesterone but following administration of a progesterone receptor antagonist and to evaluate the innocuity of this procedure for the dam and pups. Thirty seven bitches of 15 different breeds, received an injection of 15 mg/kg aglepristone 59 or 60 days after the estimated day of ovulation, determined by progesterone quantitative assays, and caesarean section (CS) was performed between 20 and 24 h after administration. Progesterone remained above 6 nmol/l at the time of CS (mean = 15.75, SD = 3.84). No post-operative clinical complications were reported in any of the bitches. All bitches were able to nurse and feed their puppies in the first 24 h following surgery. No pups showed any signs of prematurity and 5 out of 188 pups (2.6) died in the first 2 weeks after delivery. This small study demonstrates that a CS may be safely and successfully performed an average of 2 days before the expected date of parturition following the administration of aglepristone, without any harmful consequence for the dam and her neonates.     

Treatment of urinary incontinence in bitches by endoscopic injection of glutaraldehyde cross-linked collagen

Thirty-two spayed bitches with urinary incontinence due to urethral sphincter incompetence, non-responsive to phenylpropanolamine administration, were treated by urethral submucosal injection of glutaraldehyde cross-linked collagen. Urinary incontinence resolved after a single injection in 19 of the bitches. Additional medication with phenylpropanolamine was necessary in five of these dogs, however. Of the 13 bitches that remained incontinent, the injections were repeated in nine. This resulted in a return to continence in five dogs, although two of these required additional medication for complete continence. The cure rate due to collagen injections alone is 53 per cent (17 of the 32 cases). A total of 41 injections were performed and no postoperative complications were observed.     

Age‐Related Pregnancy Results and Further Examination of Bitches after Aglepristone Treatment of Pyometra

The cystic endometrial hyperplasia and pyometra complex is one of the most common uterine diseases in bitches. The appearance of pharmacological preparations containing anti‐progestagens created new possibilities for pyometra treatment. The aim of this study was to evaluate the curative effect of the anti‐progestagen aglepristone treatment of pyometra in bitches of different ages. Twenty four bitches of different breeds, aged from 0.8 to 9.5 years (21–48 kg) exhibiting clinical pyometra symptoms (two groups – I ≤ 5 years, n = 14 and II >5 years, n = 10) were evaluated. Information about the general reproductive health was collected up to 54 months after anti‐progestagen treatment. Remission of clinical symptoms and return of blood chemistry results and total leucocyte count to referential values were achieved in all cases within 14 days of treatment. Bitches were naturally mated at the first, and when unsuccessful, the second oestrus after treatment. In group I, no recurrence of pyometra symptoms was observed during following cycle(s). Eight bitches (57.1%) had a full‐term pregnancy and the number of newborn pups ranged from 1 to 12. None of the bitches from the group II became pregnant. In conclusion, the basic indication for conservative pharmacological treatment of pyometra is preserving female fertility and obtaining offspring. The important conditions for successful aglepristone treatment are: the young age (up to 5 years) and the lack of detectible ovarian cysts. It seems necessary to mate bitches in the first or second oestrus after finishing treatment. The efficacy of treatment can be measured by the after‐treatment pregnancy rate.     

Efficacy and toxicity of estrogens commonly used to terminate canine pregnancy

Three groups of bitches were treated with diethylstilbestrol (75 micrograms/kg) orally for 7 days (n = 12), estradiol cypionate intramuscularly once (22 micrograms/kg; n = 12), or estradiol cypionate intramuscularly once (44 micrograms/kg; n = 12). Treatments commenced during late proestrus (n = 4/group), the fourth day of behavioral estrus (n = 4/group), or the second day of diestrus (n = 4/group). All bitches were bred on alternate days throughout estrus to stud dogs of known fertility. Ovariohysterectomies were performed on day 25 of diestrus to diagnose pregnancy and to assess any pathologic changes in the uterus. Eleven bitches treated with diethylstilbestrol, 6 bitches treated with the low dosage of estradiol cypionate, and 4 bitches receiving the high dosage of estradiol cypionate were pregnant at the time of surgery. Ten of the bitches treated with estrogens during proestrus, 6 treated during estrus, and 4 treated during diestrus were pregnant. The serum concentration of progesterone in 2 bitches treated with the high dosage of estradiol cypionate decreased to less than 2 ng/ml by day 25 of diestrus, suggesting premature luteal regression. Diethylstilbestrol appeared to have little efficacy in terminating pregnancy. Estradiol cypionate appeared to have greater efficacy when administered during estrus or early diestrus; however, pyometra developed in 2 bitches treated with this estrogen during diestrus.     

Investigations into the prevention of neonatal Ancylostoma caninum infections in puppies by application of moxidectin to the bitch.

The aim of this investigation was to examine whether reactivated Ancylostoma caninum larvae can be eliminated by the administration of moxidectin to pregnant bitches. Four pregnant bitches infected experimentally with 20,000 third-stage larvae of A. caninum were treated subcutaneously with 1 mg moxidectin/kg body weight on day 55 of the pregnancy (5-8 days before parturition). Another four experimentally infected pregnant bitches served as controls. The single moxidectin treatment completely prevented lactogenic infections in the puppies. Neither intestinal stages nor somatic larvae could be found. The administration of moxidectin caused no local or systemic side-effects in the bitches. All 22 puppies of the treated bitches were born healthy and remained so during the whole trial period. Beginning during the third week after birth, all 20 puppies of the untreated bitches developed a severe microcytic, hypochromic anaemia and they revealed a total of 8649 intestinal stages of A. caninum after autopsy.