Surgical management of umbilical masses with associated umbilical cord remnant infections in calves

Intra-abdominal umbilical cord remnant infections were diagnosed in 21 calves during a 5-year period. The urachal remnant alone was involved in 15 calves, umbilical artery remnant alone in 1 calf, and the umbilical vein remnant alone in 4 calves. Both urachus and umbilical vein were involved in 1 calf. All cases were managed surgically by ventral celiotomy. Infected urachal remnants not extending to the bladder, infected umbilical artery remnant, and infected umbilical vein remnants not extending to the liver were dissected free of surrounding adhered structures, ligated proximal to the infected segment, transected, and removed. Infected urachal remnants extending to the bladder were similarly isolated and removed after resection of the attached bladder apex. Infected umbilical vein remnants extending to the liver were marsupialized. Of 19 calves available for follow-up from 1 to 32 months after surgery, 15 recovered without any postoperative complications, 3 had short-term complications, and 1 calf developed an incisional hernia.     

A One-Stage Marsupialization Procedure for Management of Infected Umbilical Vein Remnants in Calves and Foals

Five Holstein calves and two foals with omphalophlebitis were treated by surgical marsupialization of the umbilical vein remnant because complete resection of the infected tract was not possible. The infected umbilical stalk was resected, and the umbilical vein remnant was marsupialized in a one-stage procedure by suturing it into the abdominal wall lateral to the abdominal incision. Antimicrobial drugs were administered, and the marsupialized tract was irrigated until closure by second intention healing. Cellulitis associated with the marsupialization site occurred in two calves but resolved with antimicrobial therapy. Owners reported that, 9 to 60 months after surgery, there were no complications associated with the procedure.     

Gauged attenuation of congenital portosystemic shunts: results in 160 dogs and 15 cats

Portosystemic shunts were ligated over a gauged stainless steel rod in 160 dogs and 15 cats, using a midline celiotomy. The diameter of the rod varied with the size of the shunt and the diameter of the portal vein cranial to the shunt. Shunts were narrowed to the smallest diameter that did not cause signs of portal hypertension such as cyanosis of the stomach, pancreas, and small intestine. A slight discoloration was accepted only if the heart rate, end-expiratory CO2%, or arterial blood pressure (if available) did not deviate more than 15% from the values that were recorded at the beginning of the surgical procedure. The perioperative mortality (0-30 days) was 29%. The most common cause of death was euthanasia because of hypoplasia of the portal vein cranial to the shunt. Animals with intrahepatic shunts had a significantly lower probability of survival than animals with extrahepatic portocaval or portoazygos shunts. In dogs, large breed and a high body weight were also significant risk factors for non-survival. Age had a significant effect on risk of non-survival, with an increased risk for older dogs, irrespective of the breed of the dog (large breed vs. small breed). The probability of survival without recurrence of hepatoencephalopathy (HE) after 1 and 4 years was 61.3% and 55.7%, respectively. The only variable that was significantly associated with non-recurrence of HE was the breed of the dog, there being a lower probability for large breeds. Among the animals that survived surgery for more than 30 days, there was a significant higher probability of recurrence of HE in cats than in dogs.     

Omentalization of a nonresectable uterine stump abscess in a dog

One month after ovariohysterectomy, a 2-year-old spayed female Golden Retriever was evaluated because of an extensive uterine stump abscess. Clinical signs included intermittent vomiting, signs of depression, lethargy, and pollakiuria. The dog underwent abdominal surgery; the greatly enlarged uterine stump was tightly adhered to the dorsal surface of the bladder, encompassing the distal portions of the ureters and the bladder's neurovascular supply. En bloc resection of the uterine stump was not considered an acceptable treatment option because of the risk of surgical damage to and subsequent devitalization of the bladder or ureters, urinary incontinence, or urinary tract obstruction. Therefore, the diseased uterine tissue that extended cranial to the bladder was resected, and the remaining abscess cavity was lavaged and packed with omentum. The dog recovered fully from the procedure. The omentum is an effective physiologic drain; its extensive vascular and lymphatic networks absorb fluid and actively promote elimination of infection. Omentalization appears to be an option for surgical management of nonresectable uterine stump abscesses in dogs.     

The Diagnosis and Surgical Correction of Congenital Portosystemic Vascular Anomalies in Two Calves and Two Foals

Two calves and two foals presented with episodic clinical signs of diffuse central nervous system disease. Portosystemic anomalies were tentatively diagnosed based on the history, clinical signs, and increased serum concentrations of blood ammonia and total serum bile acids with normal concentrations of liver derived enzymes. One calf died before intraoperative contrast portography, whereas the other calf and both foals had marked clinical improvement after intensive medical therapy. Surgical correction was attempted in these three animals and was successful in one foal. A right paracostal celiotomy was superior to a ventral median approach for exposure to the portal vascular system and shunt access.     

The Etiology and Surgical Management of Tracheal Collapse in Calves

The mean ages of 10 calves with tracheal collapse were 2.7 weeks at onset of clinical signs and 9.4 weeks at presentation for treatment. Inspiratory and expiratory dyspnea and stunted growth were the most common clinical signs. There were abnormalities of the cranial ribs consistent with healing fractures with redundant callus in eight lateral thoracic radiographs. Tracheal collapse in calves may result from cranial thoracic trauma during or soon after birth. Short polypropylene ring prostheses made from 60 ml syringe barrels were placed on the tracheas of four calves with cervical tracheal collapse. There were cranial rib masses in all calves and resection of the right first and second ribs was necessary in one calf to allow placement of prostheses. Dyspnea was relieved in all calves. One calf died of unrelated causes in year 3, and one calf had recurrence of clinical signs at month 5 and was euthanatized. In both calves, tracheal stenosis resulted from continued growth and infolding of the trachea within the constraints of the prostheses. One calf was alive at month 11, and one calf died of acute bronchopneumonia on day 2. Removal of tracheal prostheses in calves is recommended after 2 to 3 months if clinical signs recur.     

A Comparison of Surgical Training with Live Anesthetized Dogs and Cadavers

Cadavers were compared with live anesthetized dogs for their effectiveness as models for surgical training of veterinary medical students. One group of students was trained using cadavers, and a peer group was trained using live anesthetized dogs. Both groups then performed an intestinal anastomosis using a live subject. The time to completion of the procedure was recorded. The anastomoses and celiotomy closures were evaluated. Each anastomosis was isolated and pressure tested. Reviewers blindly scored each surgical team's performance based on actual inspection of the surgical site and on viewing videotapes of the procedure. The participants' attitudes toward the use of live animals in teaching and research were documented before and after training. No statistically significant differences could be detected between the two groups. The results suggest that some substitution of cadavers for live dogs in surgical training might be feasible.     

Surgical Correction of Uterine Torsion and Mare–Foal Survival in Advance Pregnant Equine Patients

This article describes the surgical management of uterine torsion by midline celiotomy and cesarean section on 12 mares presented with signs of colic to a teaching veterinary hospital. The mares were either in full term of gestation (n = 7) or in advanced stage of pregnancy (n = 5). Six mares were in first parity. Uterine torsion was diagnosed by per rectal and per vaginal examinations. For surgical intervention, mares were anesthetized using a combination of xylazine (1.1 mg/kg) and ketamine (2.2 mg/kg), intravenously. After intubation, the animals were maintained on halothane (n = 4) or isoflurane (n = 8) inhalation anesthesia. Midline celiotomy was performed, and foals were delivered by cesarean section. In 11 mares, before closing the abdominal wound, the uterus was detorted manually and confirmed for its normal position. Both anesthetic protocols using halothane and isoflurane were found satisfactory for surgical correction of uterine torsion. After long-term follow-up, the study reported 75.0% (9/12) survival rate for mares. One mare was euthanized because of devitalized, necrosed, and adhered uterus to the abdominal wall. Of the nine surviving mares, seven were successfully bred. Three foals were born alive, and only one could survive on long-term basis. Of the nine dead foals, two had umbilical cord torsion.     

Intraoperative contrast echocardiography to verify the surgical occlusion of a single extrahepatic portosystemic shunt in a dog

This report details a bubble echocardiographic study carried out during the surgical treatment of a congenital single extrahepatic portosystemic shunt (PSS) in a Labrador Retriever. After celiotomy, agitated saline was injected through a jejunal vein and microbubbles appeared rapidly in the right cardiac chambers. The test confirmed the presence of a PSS, helping the surgeon to identify the vessel concerned and to rule out a second shunt. Successively, portography confirmed what the exploratory celiotomy had revealed before with the aid of the bubble study: a single shunt was located between the portal vein and the right renal vein. It was completely ligated, as all the criteria for this solution were met. Intraoperative contrast echocardiography (ICE) was easy to perform, helpful and undemanding. It is proposed here as an intraoperative ancillary test to diagnose all PSS and to confirm successful treatment when complete shunt closure is possible.     

Successful surgical management of abdominal abscessation secondary to Strongylus edentatus migration

This report describes the successful surgical management of abdominal abscessation secondary to Strongylus edentatus migration. Abdominal abscesses are a relatively common source of recurrent fever in the horse and are primarily managed with long‐term antimicrobial administration. However, identification of the definitive cause, extent of the abscesses and successful resolution in this case were not possible without an exploratory celiotomy to facilitate surgical resection.     

A RETROSPECTIVE STUDY OF UMBILICAL SONOGRAPHY IN CALVES

The purpose of this study was to assess the usefulness of diagnostic ultrasound for the detection of umbilical defects in calves. The medical records of 25 calves having undergone an ultrasound examination and for which a final diagnosis was available were reviewed retrospectively. Ultrasound was accurate (p = 0.05) for the diagnosis of umbilical defects in calves. Overall sensitivity (0.89) and specificity (0.83) were similar. Ultrasound was a better predictor of abnormal (PV' = 0.94) than normal PV- = 0.71) structures. Ultrasound was a good predictor (p < 0.05) of disease and normalcy in all umbilical region subdivisions except the umbilical vein (p = 0.16). Specificity was greater than sensitivity in all areas except the umbilical stalk. Sensitivity was lowest (0.50) for detection of umbilical herniae and lesions in the umbilical vein. When multiple umbilical areas were affected, ultrasound identified all lesions in 4 of 7 calves. Criteria determined to be subjectively useful in the sonographic diagnosis of infection in umbilical remnants were gas andlor echogenic fluid in the lumen and a thickened, hypoechoic wall.     

Use of an Endoscopic Suturing Device for Laparoscopic Resection of the Apex of the Bladder and Umbilical Structures in Normal Neonatal Calves

OBJECTIVE: To develop a laparoscopic technique using an endoscopic suturing device for the resection of the apex of the bladder and the umbilical structures in large-animal neonates. Study Design-Experimental study. Animals or Sample Population-Seven healthy male Holstein calves. METHODS: A laparoscopic technique for resection of the apex of the bladder was developed on 2 calf cadavers, then evaluated on 5 anesthetized calves. The calves were positioned in dorsal recumbency, and 4 ventral abdominal portals were used. The umbilical vessels were double-ligated using an endoscopic suturing device and subsequently transected. The apex of the bladder was transected between a row of laparoscopic clips applied near the apex and atraumatic laparoscopic forceps applied distally; then, the edges were apposed using an endoscopic suturing device. The dissected umbilical remnants were removed from the abdomen through a small incision centered at the umbilicus. One month later, the calves were euthanatized and a second-look laparoscopy performed; then, bladders were collected for gross and histologic examination. RESULTS: No major complications occurred during or after surgery. The endoscopic suturing device permitted both effective ligation of the umbilical vessels and closure of the bladder. During second-look laparoscopy, healing of the peritoneal surface of the bladder and umbilical vessels was assessed to be excellent in 4 calves. A focal adhesion of omentum to the bladder suture line was observed in 1 calf. Focal adhesions of the omentum to the umbilical incision site occurred in 2 calves. The bladder mucosa was completely healed at the surgical sites. CONCLUSION AND CLINICAL RELEVANCE: Resection of the apex of the bladder and umbilical vessels in calves can be accomplished laparoscopically using an endoscopic suturing device.     

Implantation of temperature loggers in 100 Danish dairy calves: surgical procedure and follow-up.

One hundred Danish dairy calves had temperature loggers implanted subcutaneously on the neck. Post-operatively, the calves were given a single antibiotic treatment, and tissue reactions were assessed on 6 post-operative visits. After approximately 5 months, the loggers were removed and material submitted for histologic examination. This paper presents 1) the surgical procedure, 2) the prevalence of tissue reaction at the post-operative visits, 3) the degree of implant recovery, 4) the results of histopathologic examinations, 5) an evaluation of age at implantation or veterinary practitioner as risk factors for tissue reaction and missing implant recovery 5 months after implantation, and 6) evaluation of tissue reaction as a risk factor for lack of recovery 5 months after implantation. The implant was rejected on 7 calves (7%). Additionally, 5 calves (5%) had the temperature logger removed because of presence of an abcess. No migration of the temperature loggers were observed. The results of a repeated measures analysis and the histopathological findings indicate that contamination during the surgery resulted in inflammation and abcess formation. It is recommended that in the presence of an abcess, the temperature logger should be removed.     

Clinical management and surgical repair of atresia coli in calves: 66 cases (1977-1988).

The medical records of 66 calves with atresia coli were reviewed; 64 calves were examined at the New York State College of Veterinary Medicine, and 2 calves were examined at the New Bolton Center. In each case, the site of the atresia was within the spiral loop of the ascending colon. In 1 of these calves, a segment of jejunum was also atretic. Absence of feces, progressive weakness, and abdominal distension were the most common clinical signs observed. Other congenital abnormalities were detected in 12 (18%) of 66 calves. Of the 66 calves examined, 5 were euthanatized or died on admission, and 61 had an exploratory celiotomy performed. Eight calves were euthanatized or died during the surgery. In the remaining 53 calves, surgical treatment consisted of enterotomy followed by meconium evacuation, resection of the proximal blind end (in 30 calves), and restoration of intestinal continuity. Restoration of intestinal continuity was done either by side-to-side anastomosis of the proximal to distal blind ends (5 calves), or by side-to-side or end-to-side anastomosis of the proximal blind end to the descending colon (48 calves). Of the 66 calves seen, 27 (41%) were discharged from the hospital, and 11 of these reached reproductive age (11 calves were lost to follow-up before they were 2 years old). From the 11 calves reaching reproductive age, 33 calves were born, one of which may have had atresia coli. The owners should anticipate that long-term survivors likely will have loose feces and normal offspring, but may not grow as well as otherwise expected.     

Removal of an ectopic left kidney through a ventral midline celiotomy in a calf

A 4-month-old Holstein heifer was examined because of poor growth, weight loss, dysuria, hematuria, pyuria, and a palpable mass in the right caudal quadrant of the abdomen. Clinicopathologic abnormalities included hyperfibrinogenemia, hyperproteinemia, anemia, and leukocytosis, and were consistent with chronic inflammation. Results of ultrasonographic evaluation of the umbilical cord remnants were suggestive of urachal abscess formation. Transabdominal ultrasonography of the kidneys was attempted; the right kidney appeared normal, but the left kidney could not be imaged. The calf was anesthetized and a ventral midline celiotomy was performed. The left kidney was larger than normal, was multilobulated, and contained multiple abscess. It had also broken through the peritoneum and was located in the peritoneal cavity. Unilateral nephrectomy and resection of umbilical cord remnants were performed. The calf recovered without complications and was healthy 5 years later. In this calf, ventral midline celiotomy provided sufficient surgical exposure for removal of the ectopic left kidney and resection of umbilical cord remnants.     

Umbilical cord remnant infections in foals: 16 cases (1975-1985)

Infection of the umbilical cord remnants was diagnosed in 16 foals. The infection was found in the urachus alone in 3 foals, the umbilical arteries in 2 foals, the urachus and umbilical arteries in 3 foals, the urachus and umbilical vein in 2 foals, and the urachus, umbilical vein, and umbilical arteries in 2 foals. The specific location of the infection was not determined in 4 foals. Eleven foals developed an acquired patent urachus between 4 and 16 days of age. Seven foals had one or more joints infected. All foals with umbilical cord remnant infections were treated with orally, intramuscularly, or intravenously administered antibiotics and 9 foals had the umbilical cord remnants excised. Nine foals survived, 6 of which had had excision of the infected remnants. Only 2 foals with joint infections survived.     

Standing rectal and tail surgery.

A variety of rectal, perirectal, and coccygeal surgeries can be performed in the standing equine patient if appropriate chemical and physical restraints are available and adequate regional anesthesia can be achieved. Some rectal tears and most rectal prolapses, mass lesions, perirectal abscesses, rectal biopsies, and selected injuries of the tail can be managed without prohibitive difficulty. Severe injuries that compromise the small colon cranial to the peritoneal reflection may require flank laparotomy, midline celiotomy, or humane euthanasia to manage the disease process effectively and appropriately. The foremost perioperative consideration beyond the use of effective restraint is the management of tenesmus in horses with rectal tears or prolapses. Medications to control bowel motility, epidural anesthesia, antiinflammatory analgesics, and topical compounds adequate to soothe and lubricate inflamed rectal tissues are an important adjunctive therapy in the aftercare of these surgical patients. Of nearly equal importance is the requirement that a loose fecal consistency be maintained with laxative diets, psyllium, and mineral oil. Failure to maintain a loose consistency of stool after treatment of these conditions may lead to rectal impaction or incisional dehiscence and surgical failure.     

Indirect transmission of bovine viral diarrhoea virus at calving and during the postparturient period

Two trials were designed to investigate whether bovine viral diarrhoea virus (BVDV) could be transmitted after the birth of persistently infected calves, even if they were removed immediately after birth. In trial 1, 11 calves were actively exposed to fetal fluids and uterine lochia collected from cows that had delivered calves persistently infected with type 1 BVDV. One calf that was exposed to a sample taken on the day of calving seroconverted. In trial 2, six calves were housed in stables where persistently infected calves were being born and then removed immediately from their dams and from the stable unit within two to three hours. One of four calves in close contact with the cows after delivery seroconverted and one of two calves housed within the same stable unit became infected.     

Ultrasonography of umbilical structures in clinically normal foals

The umbilical arteries, urachus, and umbilical vein were scanned ultrasonographically in 13 clinically normal foals that ranged in age from 6 hours to 4 weeks. Sonograms were obtained using a 7.5-MHz sector scanner transducer placed across the midline of the ventral portion of the foal's abdominal wall. The umbilical vein was scanned from the umbilical stalk to its entrance into the hepatic parenchyma. The mean (+/- SD) diameter of the umbilical vein was 0.61 +/- 0.20 cm immediately cranial to the umbilical stalk, 0.52 +/- 0.19 cm midway between the umbilicus and liver, and 0.6 +/- 0.19 cm at the liver. The urachus and umbilical arteries were scanned from the umbilical stalk to the apex of the urinary bladder and had a mean total diameter of 1.75 +/- 0.37 cm at the bladder apex. The umbilical arteries also were scanned along either side of the bladder and had a mean diameter of 0.85 +/- 0.21 cm. These measurements and the ultrasonographic appearance of the internal umbilical structures from clinically normal foals can be used as references to diagnose abnormalities of the umbilical structures in neonatal foals.     

Distribution of Pasteurella haemolytica in the respiratory tracts of carrier calves and those subsequently infected experimentally with Dictyocaulus viviparus

Distribution of Pasteurella haemolytica in the respiratory tracts of calves with no apparent clinical signs of illness and those infected experimentally with Dictyocaulus viviparus was determined so as to define carrier sites for this organism. The calves had been positive by nasopharyngeal swab for either P haemolytica A2 or A1 for at least two months or for over a month, respectively, before slaughter. P haemolytica A1 was acquired following horizontal spread from other infected calves. It was observed post mortem that P haemolytica A1 or A2 resided in the tonsils and retropharyngeal lymph nodes of calves of both groups. In addition to these sites, P haemolytica A1 was also isolated from the right cranial lung lobe of one of the calves from the D viviparus infected group although there was no evidence of pasteurella associated pneumonia. It was concluded that tonsil and retropharyngeal lymph nodes appear to be the most important carrier sites for P haemolytica when compared to other tissues of the bovine respiratory tract.