The palliative efficacy of modified Mohs paste for controlling canine and feline malignant skin wounds

In veterinary medicine, the management of malignant skin wounds is highly challenging. We conducted a study on seven case animals (four dogs and three cats) which presented with malignant skin wounds. All seven animals had signs and symptoms which were controlled following treatment with a modified Mohs paste. Upon obtaining informed consent from their owners, the animals requiring management of malignant wounds were enrolled in this study. The modified Mohs paste was prepared by mixing zinc chloride, zinc oxide starch powder, glycerin, and distilled water. The modified Mohs paste was topically applied to and left to remain on the malignant wounds for one hour, under controlled conditions. Once the paste was removed, the wounds were irrigated with a solution of sterile saline. At the first examination, the wounds of each animal were observed for signs of exudate, malodor, and bleeding. In every case, visible improvement was observed immediately after the modified Mohs paste treatment. Specifically, the size of the malignant wounds, and the number of times the dressing gauze required changing, significantly decreased (p < 0.05 and p < 0.01, respectively). The open malignant skin wounds caused by mammary gland tumors disappeared in two cases. The Mohs paste has been shown to be a viable option for the palliative treatment in canine and feline malignant skin wound management.     

Bilateral skin fold rotation-advancement flaps for the closure of large lumbosacral wounds in three dogs

Three dogs were presented for the management of disease processes resulting in large skin defects over the dorsal lumbosacral region. One had severe dog bite wounds, one had a large burn sustained from a heating pad and one had a large myxosarcoma in the region. In each case, the extent and location of the resulting skin defect were assessed as factors likely to prevent reconstruction using simple tension-relieving techniques alone or in combination with established reconstructive techniques, such as axial pattern flaps or skin stretching devices. Bilateral skin fold rotation-advancement flaps (SFRAFs) based on the flank folds were mobilised dorsally and allowed complete wound closure in two dogs and subtotal closure in the other dog. All wounds healed without major complications and an acceptable cosmetic outcome was achieved in each case. Minor flap debridement was required in two dogs. The use of bilateral SFRAFs is a useful technique alone or in combination with other reconstructive techniques for the closure of large dorsal lumbosacral skin defects when existing techniques are not sufficient. Small flank folds, such as those of obese dogs, may yield unexpectedly large SFRAFs.     

Osteomyelitis in dogs and cats caused by anaerobic bacteria

Localised osteomyelitis was diagnosed in 2 dogs and 2 cats. The disease was caused by fight wounds in 3 cases. Radiographic examination demonstrated a circumscribed zone of cortical bone lysis, sequestra and periosteal new bone. Each case was treated surgically by sequestrectomy and debridement. Infection was due mainly to anaerobic bacteria. The pathogenic bacteria isolated from the lesions of dogs were Actinomyces viscosus, Fusobacterium nucleatum and Bacteroides spp, and from the lesions in cats were Clostridium villosum , Peptostreptococcus anaerobius, Wolinella recta and Bacteroides gingivalis. As all the bacteria were sensitive to penicillin, each case was treated with penicillin and by irrigation of the wound. This resulted in resolution of the disease, within 4 weeks, in all cases.     

Severe carpal and tarsal shearing injuries treated with an immediate arthrodesis in seven dogs

The medical records of seven dogs with severe, grade 3, open shearing wounds of the carpus or tarsus that were treated with an immediate arthrodesis were reviewed. Six dogs were managed with a transarticular external skeletal fixator (ESF), and one dog was treated with plate fixation. The soft tissues were managed simultaneously along with the definitive joint stabilization in all cases. Minor complications occurred in four dogs: one dog that required a skin graft, one dog in which a skin graft was recommended but not performed, one dog in which a secondary skin closure was performed, and one dog in which a delayed cancellous bone graft was placed. Major complications occurred in three dogs: two dogs that required restabilization of the arthrodesis and one dog that required implant (i.e., plate) removal due to infection. All dogs healed with acceptable functional and cosmetic results. Further long-term evaluation of five dogs revealed that all but one dog had either excellent or good functional outcomes, and the remaining dog had a fair outcome. Similarly, five dogs had either excellent or good cosmetic outcomes, with the remaining dog having a fair outcome. All owners were very satisfied with the overall results. This clinical study demonstrated that an immediate, definitive management technique, in which bone fusion and wound management are undertaken as simultaneous objectives, is a viable technique of managing severe periarticular shearing injuries. Transarticular stabilization with an ESF is the technique recommended.     

The use of vacuum-assisted closure therapy for the treatment of distal extremity wounds in 15 dogs

Objective— To evaluate clinical outcome after vacuum-assisted closure (VAC) therapy in dogs with traumatic wounds located in the distal extremities and report our early experience with VAC.
Study Design— Retrospective study.
Animals— Dogs (n=15) with traumatic distal extremity wounds.
Methods— Medical records (1999–2003) of dogs with traumatic injuries to the distal extremities managed by VAC were evaluated. Data included signalment, location of wound, time until surgical intervention, wound reconstruction methods, orthopedic procedures, outcome, complications associated with VAC, and length of hospitalization.
Results— The mean number of days until reconstruction was 4.6 days (range, 2–7 days). Reconstructive surgery was successful in all cases. Mean hospitalization was 9.7 days (range, 6–16 days). Complications included dermatitis at the wound margin and loss of vacuum causing wound desiccation.
Conclusion— VAC therapy can be used to achieve adequate management of traumatic distal extremity wounds. VAC provides an effective method of securing skin grafts over the wound bed.
Clinical Relevance— VAC therapy can be used as an ancillary treatment for distal extremity wounds in dogs before surgical repair as well as a method for securing skin grafts to the wound bed.     

Percutaneous endoscopic tube gastrostomy in dogs

Percutaneous endoscopic tube gastrostomy was performed in 10 dogs, using mushroom-tip catheters (16 to 24 F) maintained in place for 5 to 32 days. Dogs were observed daily. Although placement of the catheter was simple and quick, 3 dogs destroyed their catheters. Patency of the catheter was maintained with or without regular flushings with saline solution. Pyrexia (greater than or equal to 39.4 C) developed in 3 dogs, but the rectal temperature returned to base line within 24 hours after catheter removal. After catheter removal, all wounds healed without complication. All dogs were euthanatized. Five were examined radiographically before euthanasia to determine the fate of the mushroom tip after transection of the catheter at skin level between days 5 and 21, and 5 dogs were evaluated at postmortem examination between days 10 and 32. In all dogs, the tip was not present in the gastrointestinal tract by 96 hours after catheter transection. During postmortem examination of the 5 dogs, minimal inflammatory lesions were seen in the gastric tissue. A gastrocutaneous fistula had formed in each dog, resulting in an adhesion between the stomach and peritoneum.     

Ehlers-Danlos-like syndrome in 2 dogs: clinical,histologic, and ultrastructural findings

Background: Ehlers-Danlos syndrome comprises a group of rare inherited connective tissue diseases characterized by skin hyperextensibility, joint laxity, skin and vessel fragility, and poor wound healing.
Objective: The purpose of this report was to describe the clinical, histologic, and ultrastructural findings in 2 dogs with collagenopathies consistent with Ehlers-Danlos syndrome.
Methods: Two dogs were examined clinically; skin extensibility index was calculated. Skin biopsies obtained from the dorsum were examined by light and electron microscopy.
Results: Both dogs had clinical signs of skin hyperextensibility and fragility, lower skin elasticity, vessel fragility, and poor wound healing. One dog had a hip dislocation, and the other had bilateral medial patellar luxation (grade II), subcutaneous hematomas produced by minimal trauma, and generalized periodontitis. Histologic and ultrastructural examination confirmed abnormalities in the structure and arrangement of collagen fibrils. Fibroblasts were characterized by variable dilatation of the rough endoplasmic reticulum, and anomalous elastic fibers (elaunin fibers) were present in the dermis.
Conclusion: Although the primary defects underlying collagenopathies in animals are still unknown, analysis of the ultrastructural changes in collagen fibrils and clinical findings could facilitate better characterization of these disorders in dogs.     

Effects of a hydrolyzed collagen dressing on the healing of open wounds in dogs

OBJECTIVE: To determine the effects of a hydrolyzed bovine collagen dressing (HBCD) on healing of open wounds in healthy dogs. ANIMALS: 9 female Beagles. PROCEDURES: 2 full-thickness skin wounds were made bilaterally on the trunk of each dog. Wounds on 1 side were treated with powdered HBCD covered with a semiocclusive nonadherent bandage. Wounds on the other side (control wounds) were covered with a semiocclusive nonadherent bandage only. Wound healing was subjectively assessed, and percentage increase in tissue perfusion was assessed by use of laser Doppler perfusion imaging (LDPI). Planimetry was performed to determine the percentages of contraction, epithelialization, and total wound healing. Biopsy specimens were examined microscopically to evaluate histologic changes. RESULTS: The HBCD did not induce a strong inflammatory reaction, as reflected by results of LDPI and histologic examination. Moreover, HBCD appeared hydrophilic and provided an environment to keep wounds clean and enhance early epithelialization. After treatment for 7 days, treated wounds had a significantly greater percentage of epithelialization than control wounds (12.13 vs. 7.03%). CONCLUSION AND CLINICAL RELEVANCE: The hydrophilic property of HBCD may cleanse contaminated wounds with the body's homeostatic fluids and enhance early wound epithelialization.     

Hyperadrenocorticism in 10 dogs with skin lesions as the only presenting clinical signs

Ten dogs that had skin lesions as the only presenting signs of hyperadrenocorticism (HAC) and as the owners' primary complaint are described. Dogs were included if the initial examination was for skin disease, there were no signs of systemic illness on initial presentation and there was a confirmed diagnosis of HAC by specific screening tests. Dogs were excluded if they had a severe disease that might interfere with screening tests for HAC or if the screening tests were not diagnostic. There were five males and five females; six dogs were intact. Nine dogs were diagnosed at ≥7 years. Eight dogs weighed ≤10 kg. Alopecia was present in nine dogs. Eight dogs had bacterial pyoderma, five had hyperpigmentation, and four had thin skin. One dog had unresolved dermatophytosis. Skin lesions resolved after treatment in eight dogs. One dog was not treated and one was lost to follow-up. This study showed that skin lesions may be the only clinical signs of HAC. The presence of the more common clinical signs of HAC, such as a non-pruritic, truncal alopecia and/or thin skin, without any systemic signs of HAC and/or the presence of poorly responsive skin infections warrant screening for this disease.     

Clinical, radiological and pathological features of 12 Irish setters with canine leucocyte adhesion deficiency

The clinical, radiological and pathological findings in 12 dogs with canine leucocyte adhesion deficiency (CLAD) from six litters are described. All the dogs were younger than 15 weeks at admission, all had been febrile and 11 had been treated with antibiotics. Seven had been treated for omphalophlebitis. At admission, all had gingivitis, lymph node enlargement and profound neutrophilia. Ten dogs were radiographed and showed various skeletal lesions compatible with metaphyseal osteopathy, craniomandibular osteopathy and osteomyelitis. Four dogs had clinical signs of respiratory distress and seven exhibited a mild interstitial pneumonia at necropsy. Six dogs had skin wounds, with strikingly few neutrophils seen on stained sections. All dogs were euthanased before six months of age due to severe and incurable infections. The clinical signs, radiological features and haematology were strongly suggestive of CLAD. The diagnosis was confirmed by granulocyte function tests and flow cytometry, which revealed impaired adhesion, impaired C3b-mediated phagocytosis and absence of adhesion proteins CD11b/CD18.     

Electrical stimulation on skin wound healing in the horse: preliminary studies

The effect of low-level direct-current stimulation on skin wound healing in the horse was assessed. Self-sustaining electrical circuits with electrodes were implanted subcutaneously in or near the wound. Stimulation by direct current (10 or 20 microA) was used to determine the effect on equine skin healing. The efficacy of electrotherapy was evaluated by sequentially comparing the clinical appearance of the wound and measuring the size of the granulating wound bed. The histologic appearance of the healing stimulated wounds was compared with that in nonstimulated control wounds created on 9 horses. Seemingly, electrical stimulation had no discernible effect on experimentally created skin wounds. Clinical observation and histologic examination of the wounds indicated that severe tissue reaction from the implanted electrodes and concurrent local infection produced local detrimental effects to wound healing.     

Rectus abdominis free muscle flap for reconstruction in nine dogs

OBJECTIVE: To evaluate the clinical use and outcome of a rectus abdominis microvascular free flap for wound closure in dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n=9) with complex extremity or oral wounds. METHODS: Medical records (2002-2006) of dogs that had a rectus abdominis free tissue transfer to close an extremity or oral wound were reviewed. RESULTS: Nine dogs were identified: 5 had distal extremity wounds, 3 had oral palatal defects, and 1 had a large hygroma excised. A rectus abdominis free tissue transfer with a caudal epigastric vascular pedicle was successfully used for management of these wounds. No major complications occurred with the donor site and a good cosmetic and functional outcome occurred in all dogs. CONCLUSION: The rectus abdominis is a versatile muscle that can be used for reconstructing cutaneous and oral defects with repeatable success. CLINICAL RELEVANCE: Free tissue transfer of the rectus abdominis muscle is a clinically useful technique for closure of a variety of difficult soft tissue wounds.     

The first report of autochthonous non-vector-borne transmission of canine leishmaniosis in the Nordic countries

Background

Leishmania spp. are zoonotic protozoans that infect humans and other mammals such as dogs. The most significant causative species in dogs is L. infantum. In dogs, leishmaniosis is a potentially progressive, chronic disease with varying clinical outcomes. Autochthonous cases of canine leishmaniosis have not previously been reported in the Nordic countries.

Results

In this report we describe the first diagnosed autochthonous cases of canine leishmaniosis in Finland, in which transmission via a suitable arthropod vector was absent. Two Finnish boxers that had never been in endemic areas of Leishmania spp., had never received blood transfusions, nor were infested by ectoparasites were diagnosed with leishmaniosis. Another dog was found with elevated Leishmania antibodies. A fourth boxer dog that had been in Spain was considered to be the source of these infections. Transmission occurred through biting wounds and semen, however, transplacental infection in one of the dogs could not be ruled out.Two of the infected dogs developed a serious disease and were euthanized and sent for necropsy. The first one suffered from membranoproliferative glomerulonephritis and the second one had a chronic systemic disease. Leishmania sp. was detected from tissues by PCR and/or IHC in both dogs. The third infected dog was serologically positive for Leishmania sp. but remained free of clinical signs.

Conclusions

This case report shows that imported Leishmania-infected dogs may pose a risk for domestic dogs, even without suitable local arthropod vectors.     

Skin-fold advancement flaps for closing large proximal limb and trunk defects in dogs and cats

OBJECTIVE: To describe the use of skin-fold advancement flaps for covering large skin defects in dogs and cats. STUDY DESIGN: Clinical study. ANIMALS: Eight client-owned animals: 6 dogs and 2 cats. METHODS: Six dogs and 2 cats underwent reconstruction of soft-tissue wounds resulting from traumatic, neoplastic, or infectious lesions. Skin-fold flaps were created by division of the medial and lateral attachment to the proximal limb or the dorsal and ventral attachment to the trunk, enabling closure of adjacent defects on the trunk or proximal limb, respectively. RESULTS: Skin-fold flaps proved effective for closing defects in all animals. Necrosis of a portion of the flap occurred in 2 dogs due to technical errors, but the resultant defects remained amenable to primary closure. All wounds ultimately healed primarily, without major complications. CONCLUSION AND CLINICAL RELEVANCE: The skin-fold advancement flap is a versatile technique that lends itself to use in a variety of locations, depending on which attachments are divided. The clinical results are comparable with those reported for axial pattern and subdermal plexus flaps.     

3例犬急性肾衰竭的诊断与治疗

通过病史调查、临床特征观察、血液学指标、尿比重检测以及影像学检验等进行确诊,对某宠物医院接诊的3例犬急性肾衰竭诊断分析。结果显示,3例犬急性肾衰竭的临床症状主要为精神沉郁、厌食或食欲下降、呕吐、腹泻、尿量异常等;患犬血液中白细胞总数增多,血肌酐、尿素氮和无机磷指标都高于标准值的上限;患犬的尿比重均较低;影像学检查有2例肾脏体积无变化,1例肿大。     

Serum and skin IgA concentrations in normal and atopic dogs

Objective To compare serum and skin surface IgA concentrations from atopic and normal dogs.
Procedure IgA concentrations in sera and skin washings of 20 clinically normal dogs that had no history of pruritus or skin disease were compared to those obtained in 20 dogs with a diagnosis of atopy determined by history, clinical examination and positive intradermal skin test.
Results There was no significant difference in the mean serum IgA concentration in normal dogs (252 ± 187 mg/L) versus atopic animals (314 ± 327). When skin washings from all sites in both groups were compared, atopic dogs had significantly greater concentrations of IgA in their skin washings than normal dogs as evaluated by an enzyme-linked immunoassay (P < 0.001). However, there was no significant difference between the individual sites of the skin washings of atopic and normal dogs.
Conclusion IgA concentrations of skin washings in atopic dogs were greater than in normal dogs. Further investigations need to determine if the greater concentrations were caused by nonspecific inflammation or by secretion of allergen-specific IgA onto the skin surface.     

Crusted scabies (sarcoptic mange) in four cats due to Sarcoptes scabiei infestation

Four new cases of sarcoptic mange in cats are described. Two cats resided in areas known to be frequented by foxes, another cohabited with a dog recently diagnosed with sarcoptic mange, while the final cat lived with a mixed breed dog that had been treated for sarcoptic mange 7 months previously. Three cases were diagnosed on the basis of characteristic mite size and morphology in skin scraping from representative lesions, situated on the head (two cases) or head and distal hind limbs (one case). Mites were highly mobile and abundant in all instances, and easily detected also in skin biopsy specimens procured from two cases. Eosinophilic inflammation, hyperkeratosis and parakeratosis were prominent in the tissue sections. In the remaining case, the diagnosis was presumptive, based on characteristic lesions, cohabitation with a canine scabies patient and positive response to scabicide therapy. Pruritus was not a prominent clinical feature in any patient and was considered to be absent in three of the four cases. Lesions in three cats with long-standing disease were reminiscent of crusted scabies (synonym: Norwegian scabies, parakeratotic scabies) as seen in human patients. In three cases, in-contact human carriers developed itchy cutaneous papular lesions. Two cases responded promptly to therapy with systemic avermectin drugs, while one responded to topical treatment with lime sulphur and the remaining cat received both a lime sulphur rinse and ivermectin. Sarcoptic mange should be considered in the differential diagnosis of cats with non-pruritic crusting skin diseases, especially when there is contact with foxes or dogs, and when owners have itchy papular lesions.     

Evaluation of papillomaviruses associated with cyclosporine-induced hyperplastic verrucous lesions in dogs

OBJECTIVE: To determine whether cyclosporine A-induced hyperplastic skin lesions of dogs were associated with papillomavirus infections. ANIMALS: 9 dogs that were treated with cyclosporine A and developed hyperplastic skin lesions. PROCEDURE: History and clinical and histopathologic data were collected. Paraffin-embedded skin biopsy specimens from hyperplastic skin lesions were immunostained for common papillomavirus genus-specific structural antigens by use of a polyclonal rabbit anti-bovine papillomavirus type 1 antiserum. Sections from each tissue block underwent DNA extraction, and polymerase chain reaction (PCR) assays were performed with several sets of primers to amplify a wide range of papillomavirus DNA from humans and other animals. RESULTS: In 7 of 9 dogs, there were more than 10 hyperplastic skin lesions that microscopically resembled those of psoriasiform lichenoid dermatosis. In those dogs, results of testing for papillomavirus via immunohistochemical analyses and PCR assays were negative. In the other 2 dogs, there were only 1 and 3 verrucous lesions, and in those dogs, histologic evaluation revealed koilocytes and nuclear viral inclusions that were immunoreactive for papillomavirus antigens. Papillomavirus DNA was amplified from both dogs. One of the sequences was characteristic for the canine oral papillomavirus, whereas the other had similarities with the recently described canine papillomavirus 2. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs, hyperplastic skin lesions occasionally develop during treatment with cyclosporine A. Most of the lesions resemble those of psoriasiform lichenoid dermatosis, although papillomavirus can be detected in some instances.     

Idiopathic hemorrhagic pericardial effusion in eight dogs

Idiopathic hemorrhagic pericardial effusion was diagnosed in 8 dogs. The patients were typically males of large or giant breeds and a wide age range was represented. In all dogs clinical features of acute or chronic cardiac tamponade and right-sided heart failure were present. The pericardial effusion in each case was identified by thoracic radiography, electrocardiography, and echocardiography. Cytologic examination of the fluid did not allow differentiation from hemorrhagic effusions caused by neoplasia. Bacterial and fungal cultures were negative in 5 dogs. In 6 cases, a presumptive diagnosis was based on the absence of cardiac masses on 2-dimensional echocardiography, contrast pericardiography, or both. The condition was managed successfully by partial pericardiectomy in 5 cases. The definitive diagnosis in each case was established by gross cardiac examination at surgery or necropsy and by histologic examination of tissues. Blood vessels and lymphatics of the parietal and visceral pericardia appeared to be the primary targets of the disease process.