Development and verification of saphenous, tibial and common peroneal nerve block techniques for analgesia below the thigh in the nonchondrodystrophoid dog

OBJECTIVE: To document simple and reliable local, infiltrating nerve blocks for the saphenous, tibial and common peroneal nerves in the dog. STUDY DESIGN: Laboratory technique development; in vivo blind, controlled, prospective study. ANIMALS: Twenty canine cadavers and 18 clinically normal, client-owned dogs. METHODS: A peripheral nerve blockade technique of the tibial, common peroneal, and saphenous nerves was perfected through anatomic dissection. Injections were planned in the caudal thigh for the tibial and common peroneal nerves, and in the medial thigh for the saphenous nerve. Cadaver limbs were injected with methylene blue dye and subsequently dissected to confirm successful dye placement. Clinically normal dogs undergoing general anesthesia for unrelated, elective procedures were randomly assigned to treatment (bupivacaine; n = 8) or control (saline; n = 8) nerve blocks of the nerves under study. Upon recovery from general anesthesia, skin sensation in selected dermatomes was evaluated for 24 hours. RESULTS: Cadaver tibial, common peroneal, and saphenous perineural infiltrations were successful in nonchondrodystrophoid dogs (100, 100, and 97%, respectively.) Intraneural injection was rare (1%; 1/105; tibial nerve) in cadaver dogs. In the treatment group of normal dogs, duration of loss of cutaneous sensation in some dermatomes (saphenous, superficial and deep peroneal nerve) was significantly different than control dogs; the range of desensitization occurred for 1-20 hours. No clinical morbidity was detected. CONCLUSIONS: This technique for local blockade of the tibial, common peroneal, and saphenous nerves just proximal to the stifle is easy to perform, requires minimal supplies and results in significant desensitization of the associated dermatomes in clinically normal, nonchondrodystrophoid dogs. CLINICAL RELEVANCE: This technique may be an effective tool for post-operative analgesia to the femoro-tibial joint and distal pelvic limb. Other applications, using sustained-release drugs or methods, may include anesthesia/analgesia in high-risk patients or as a treatment for chronic pelvic limb pain or self-mutilation.     

Tolerance of cutaneous or mucosal flaps placed into a radiation therapy field in dogs

OBJECTIVE: To determine the clinical outcome and factors affecting cutaneous or mucosal flaps in dogs treated with radiation therapy (RT). STUDY DESIGN: Longitudinal clinical study. ANIMALS: Twenty-six client-owned dogs. METHODS: Dogs entered in the study had a flapping procedure and RT as part of their treatment. The sequence of flapping and RT included: (1) planned preoperative RT, (2) postoperative RT, and (3) flapping as a salvage procedure for management of complications or local tumor recurrence after RT. Flap complications were defined as necrosis, local infection, dehiscence, and ulceration. The risk and severity of flap complication were analyzed independently. RESULTS: Twenty (77%) dogs had a complication; 6 dogs required an additional flapping procedure; and 4 dogs had an unresolved complication. Flapping procedures performed to correct a complication, or failure of RT, had a significantly greater risk for complication; however, postoperative RT decreased the severity of complication. A dose per fraction of 4 Gy compared with 3 Gy was prognostic for increased severity of complications, whereas the head and neck location was prognostic for decreased severity of complication. CONCLUSIONS: Although morbidity was substantial, cutaneous or mucosal flaps were used successfully in an RT field in 85% of the dogs. Flaps that were part of the planned therapy as opposed to those used to correct a complication or failure of RT had a better clinical outcome. CLINICAL RELEVANCE: Cutaneous or mucosal flaps can be part of the treatment of dogs with tumor when adjuvant or neoadjuvant RT is to be used.     

Degenerative myelopathy.

DM in the German Shepherd is an immune-related disorder whose clinical signs are explained by a widespread degeneration of the white matter pathways in the thoracolumbar spinal cord. Therapy includes exercise, vitamin supplementation, and EACA medication. Avoiding unnecessary surgical procedures is also important to preclude permanent deterioration that can result following surgery in DM patients. In dogs other than German Shepherds, other identifiable causes should be treated. Additional confirmation of the diagnosis of DM may be assisted by performing cell-mediated immune studies or other serodiagnostic tests as they become available.     

Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 4: Early (acute) relaparotomy

REASONS FOR PERFORMING STUDY: Early (acute) relaparotomy after surgery for equine colic is widely considered to be an acceptable treatment option for management of certain post operative complications. However, there is relatively little published information about resulting complication rates and short- and long-term outcomes. OBJECTIVES: To document the proportions, indications, complication rates and survival rates of horses undergoing acute relaparatomy following colic surgery. METHODS: History, clinical findings, surgical findings and procedures, post operative treatments and outcome of 300 consecutive surgical colic cases (1994-2001) were reviewed. Long-term follow-up information was retrieved from case records and telephone enquiries from owners. RESULTS: Acute relaparotomy was performed in 27/254 horses (10.6%) that recovered from initial general anaesthesia. The indications for relaparotomy included persistent pain, persistent ileus, peritonitis and wound breakdown. Of these 27 horses, 21 (77.8%) recovered from the second surgery, of which 8 (29.6%) died during the immediate post operative period. Thirteen of the 27 horses (48.2%) were discharged. Of these 13 horses, 5 (38.5%) were re-admitted to the hospital for surgical treatment of a subsequent bout of colic. The long-term survival rate for the 27 horses that underwent relaparotomy was 22.2%. Colic following discharge after relaparotomy was recorded in 69.2% of cases. CONCLUSIONS: Relaparotomy is necessary in approximately 10% of horses undergoing surgery for acute colic. Persistent pain and post operative ileus were the most common indications. The short-term survival rate for horses requiring relaparotomy was approximately 50% and the long-term survival rate 22%. Nearly 40% of horses surviving relaparotomy developed episodes of acute colic that necessitated further surgery. POTENTIAL RELEVANCE: Owners of horses requiring early (acute) relaparotomy should be advised of the high complication rates for this procedure.     

Fixation of Cancellous Bone and Physeal Fractures in Dogs and Cats. A Comparison of the Use of Self-reinforced Biodegradable Devices to the Use of Metallic Devices and External Fixations

The use of self-reinforced biodegradable devices made of polyglycolide in the cancellous bone and physeal fractures of dogs and cats was compared to the use of metallic devices and external fixations on similar fractures. The series consisted of 64 dogs and 22 cats divided into 6 comparable groups. The patients in the 2 groups fixed with biodegradable devices started to use their operated limbs earlier than in the other groups. The same 2 groups also healed clinically (showed no lameness) earlier than the other groups. Radiographically there was no statistical difference between the 6 groups.On the basis of this study it may be concluded that the fixation with self-reinforced biodegradable devices is as suitable for the fixation of cancellous bone and physeal fractures of dogs and cats as the fixation with metallic devices or external fixation. This biodegradable technique has additional benefits allowing the patients to feel less pain in their operated limbs and making secondary operations to remove the devices unnecessary.     

Surgical Management of Atlantoaxial Subluxation in 23 Dogs

Twenty-eight surgical procedures were performed in 23 dogs with atlantoaxial subluxation. Dorsal stabilization in seven dogs resulted in two recoveries and five failures of fixation. Ventral decompression and stabilization in 18 dogs resulted in eight recoveries and four failures of fixation. Six dogs died or were euthanatized within 7 days of ventral stabilization. Using either technique, four of seven nonambulatory dogs recovered.     

Radiographic evaluation of nonanesthetized and nonsedated dogs for hip dysplasia

The use of chemical or gas restraint was unnecessary in most large breed dogs being evaluated radiographically for hip dysplasia. Of 100 large-breed dogs, 97 were successfully radiographed for hip dysplasia evaluation without the use of sedation or anesthesia.     

Can spleen aspirations be safely used for the parasitological diagnosis of canine visceral leishmaniosis? A study on assymptomatic and polysymptomatic animals

The purpose of this study was to evaluate the safety of spleen aspiration as a sampling technique for the parasitological detection by culture and microscopy of Leishmania (chagasi) infantum. Two hundred and nine domiciled dogs from an endemic area for visceral leishmaniasis in Bahia State, Brazil, were studied. Most dogs (87%) were seropositive for anti-L. chagasi antibodies by ELISA. Clinical signs of disease were recorded and the animals monitored during and after spleen puncture in order to detect possible complications associated with the procedure. From a total of 257 splenic punctures in the 209 animals, only three minor events occurred, with no significant consequence for the animals and no association with risk factors. Leishmania was isolated from 149/180 (83%) seropositive dogs, and from 6/26 (23%) seronegative animals. The procedure did not cause adverse side effects or unnecessary suffering and confirmed the diagnosis in a large percentage of dogs. We conclude that spleen aspiration can be considered an effective and safe procedure for the definitive diagnosis of canine visceral leishmaniosis.     

Symposium on surgical techniques in small animal practice. Surgery of the esophagus.

There are many anastomotic techniques available that have been used successfully but no one technique guarantees 100 per cent success. Therefore the surgeon should be capable of altering his planned approach according to the circumstances. No matter what anastomotic technique is selected, for a consistently successful outcome it is imperative that the whole animal be considered in all aspects of care and rude handling of tissues be avoided during the surgical procedure. The simple interrupted approximating suture technique is recommend as one which meets the general goals of intestinal anastomosis in dogs and cats.     

The diagnosis and management of paraprostatic and prostatic retention cysts in the dog

Eleven dogs were diagnosed as having solitary or multiple prostatic cysts in an abdominal, pelvic or perineal position. Common presenting signs included urinary dysfunction, faecal tenesmus and abdominal distension. Cystography was found to be the most consistently accurate technique for differentiating the cysts from the bladder and other abdominal soft tissue masses whilst urethrography often highlighted their prostatic origin. Complete surgical resection of the cysts was attempted in nine dogs, the complexity of dissection being dictated by cyst size and the extent of adhesions to adjacent organs. Nine dogs were castrated. Urinary incontinence continued post-operatively in four dogs but later resolved in three of these. Seven dogs were alive and symptom-free over post-operative periods ranging from one to three years. Despite some of its technical difficulties, surgical excision appears to be a successful approach to even the larger prostatic cysts. Few of the post-operative complications associated with other surgical procedures described for the management of cysts were encountered.     

Sentinel lymph node mapping of the canine anal sac using lymphoscintigraphy: A pilot study

Sentinel lymph node mapping and biopsy are important parts of oncologic staging in human medicine. Sentinel lymph node mapping enables identification of the first lymph node to receive lymphatic drainage while avoiding unnecessary lymph node dissection. Anal sac adenocarcinoma is the most common malignant neoplasm of the canine perineal area. For dogs with anal sac adenocarcinoma, lympadenectomy and metastasis to the iliosacral lymphocentrum are negative prognostics indicators. The objectives of this prospective, two by two, crossover pilot study were to establish the feasibility of lymphoscintigraphy using Technetium‐99 sulfur colloid of the canine anal sac of healthy dogs, compare two injection techniques, and the time for identification of sentinel lymph nodes using each technique. We hypothesized that both intramural and perimural injections of the canine anal sac would identify similar sentinel lymph node drainage. The sentinel lymph node was identified in all dogs using either technique. Intramural injection of the canine anal sac showed radiopharmaceutical uptake faster than perimural injection technique (P = 0.040). There was concordance between intramual and perimural techniques for the sentinel lymph node identified in 50% of cases. A sacral lymph node was identified as sentinel in three of eight dogs (37.5%). Lymphoscintigraphy of the canine anal sac is safe and feasible in normal dogs; however, the method of injection technique seems to have a significant effect on the sentinel lymph node identified.     

Evaluation of Toenail Blood Samples for Blood Gas Analysis in the Dog

Blood gas values were compared in blood collected from cut toenails and femoral arteries in 50 healthy crossbred dogs that were sedated and allowed to breathe room air spontaneously. Blood samples from cut toenails were collected by microcapillary technique with Natelson tubes. Femoral artery samples were collected by arterial puncture. Blood values for PO2, PCO2, pH, and HCO3 were compared. There was good correlation for pH, PCO2, and bicarbonate, but not for PO2. Microcapillary samples should be collected in 10 seconds or less for the most accurate results. A metal mixing "flea" was unnecessary. When properly handled, the Natelson tube technique provides an alternative method for collection of blood gas samples.     

The effect of two modifications of unilateral arytenoid lateralization on rima glottidis area in dogs

OBJECTIVES: To evaluate the clinical outcome and percentage increase in rima glottidis area achieved using a combined technique of cricoarytenoid and thyroarytenoid cartilage lateralization compared with cricoarytenoid cartilage lateralization alone in live anesthetized dogs clinically affected with bilateral laryngeal paralysis. STUDY DESIGN: Randomized prospective clinical study. ANIMALS: Twenty dogs with bilateral laryngeal paralysis. Methods-Bilateral laryngeal paralysis was diagnosed by direct laryngoscopy. Each dog was allocated randomly to 1 of 2 surgical groups: CAL (cricoarytenoid lateralization) and CTAL (cricoarytenoid and thyroarytenoid lateralization). Photographs were taken of each larynx before and after surgery, the images were digitized, and the preoperative and postoperative areas of each rima glottidis were measured. The percentage increase in rima glottidis area produced by each of the arytenoid lateralization procedures was compared. Follow-up was obtained by telephone survey of owners and referring veterinarians. RESULTS: There was no significant difference in mean (+/- SD) percentage increase in rima glottidis area for the CAL group (241.5 +/- 42.9%) or the CTAL group (236.4 +/- 44.5%). Clinical follow-up (median, 18 months postoperatively) indicated 60% of the dogs were still alive and only 1 dog had died as a result of complications related to surgery. CONCLUSIONS: CTAL for the treatment of canine laryngeal paralysis does not significantly increase rima glottidis area compared with CAL alone. The mean percentage increase in rima glottidis area obtained with both procedures was comparable to previously reported mean increases with CAL in live anesthetized dogs. Both procedures resulted in good long-term clinical outcome. CLINICAL RELEVANCE: CTAL is as effective as CAL in providing an increased rima glottidis for the treatment of bilateral laryngeal paralysis in dogs.     

Improved nasogastric intubation technique for administration of nutritional support in dogs.

Established procedures for nasogastric intubation are difficult to perform in dogs because of anatomic variation of nasal passages and turbinate structures. Twenty-five clinically normal dogs were used to improve and refine the technique of nasogastric tube placement, and 13 clinical patients at our teaching hospital were evaluated for malnutrition and were considered candidates for nutritional support by nasogastric tube feeding. An improved method for the placement of nasogastric tubes in dogs was used. By pushing the external nares dorsally while advancing the tube in a caudoventral, medial direction, the tube passed through the ventral meatus and into the oropharynx and esophagus easily. The procedure does not require chemical restraint, and the complication of epistaxis was not observed in any dog. Materials required to perform this technique are inexpensive, and the method can be used for the administration of nutritional support, fluids, drugs, or contrast material.     

Diaphragmatic Advancement for Defects of the Caudal Thoracic Wall in the Dog

Reconstruction of the caudal thoracic wall using the technique of diaphragmatic advancement is described in two dogs. The technique effectively reestablishes integrity of the thoracic cavity following resection of the thoracic wall supported by ribs 9 through 13. The diaphragm is incised near its peripheral attachments, advanced forward, and sutured to the epaxial musculature and the intercostal muscles of the most caudal intact rib. Diaphragmatic advancement is simple to perform and gives satisfactory cosmetic results, eliminating the need for more complex procedures such as tissue grafts or the use of prosthetic materials.     

Chronic Otitis Externa and Otitis Media Treated by Total Ear Canal Ablation and Ventral Bulla Osteotomy in Thirteen Dogs

Ventral bulla osteotomy was combined with total ear canal ablation for the treatment of chronic otitis externa and otitis media in 13 dogs (14 ears) that had been refractory to medical and surgical treatments. Resolution of disease occurred in 11 dogs (12 ears). One dog with unilateral disease underwent a second operation before achieving a good result. One dog was euthanatized for persistent unilateral disease after three surgical procedures. The recurrence of disease in these two dogs (15%) was associated with remnants of ear canal integument within the osseous horizontal canal or tympanic bulla. Facial paralysis occurred in four dogs (31%) and there were no complications in eight dogs (62%). This technique shows no advantage over lateral bulla osteotomy combined with total ear canal ablation for the treatment of chronic otitis externa and otitis media.     

Thermal cautery of the cornea for treatment of spontaneous chronic corneal epithelial defects in dogs and horses

A thermal cautery technique was used to treat spontaneous chronic corneal epithelial defects (SCCEDs) in 9 eyes of 8 dogs and 2 eyes of 2 horses. Animals were sedated, and a topical anesthetic was applied. A handheld thermal cautery unit was then used to make multiple, small (< or = 1 mm in diameter), superficial burns throughout the affected area. The cautery unit was applied just until the slightest degree of contraction of the collagen fibrils was observed. After the stromal bed of the defect was treated, a rim of epithelium that extended approximately 1 mm around the denuded stroma was also subjected to thermal cautery. Following surgery, a contact lens was placed in dogs but not in horses, and the eye was treated with broad-spectrum antimicrobial ophthalmic solutions. Defects in all 11 eyes healed with minimal scarring; mean time to healing in dogs was 2.1 weeks (range, 2 to 3 weeks). The defect healed in 1 week in 1 horse and in 2 weeks in the other. Many therapeutic options are available for the treatment of SCCEDs. Procedures such as epithelial debridement and anterior stromal puncture have been shown to have a high rate of success. In cases for which these less invasive procedures fail, our results suggest that thermal cautery may be a reasonable alternative to previously described treatments for SCCEDs in dogs and horses prior to more invasive procedures such as superficial keratectomy.     

Comparison of intratesticular injection of zinc gluconate versus surgical castration to sterilize male dogs

OBJECTIVE: To compare castration of dogs by use of intratesticular injection of zinc gluconate with traditional surgical procedures in terms of acceptance by pet owners, ease of use, and short-term outcomes on Isabela Island of the Galápagos Islands. ANIMALS: 161 privately owned male dogs admitted to a neuter program. PROCEDURES: Medical records of male dogs neutered during a 4-week animal control campaign were reviewed to collect information regarding signalment, method of castration, complication rate, and treatment outcomes. RESULTS: Of the 161 dogs admitted for castration, 58 were surgically castrated and 103 were treated with zinc gluconate. Dogs were returned to their owners for observation following castration. Wound dehiscence occurred in 2 skin incisions, representing 3.4% of the 58 dogs that underwent bilateral orchiectomy. Necrotizing zinc-gluconate injection-site reactions occurred in 4 dogs receiving injection volumes near the maximum label dose (0.8 to 1.0 mL), representing 3.9% of the zinc-gluconate procedures. Surgical wound complications were treated by superficial wound debridement and resuturing, in contrast to zinc-gluconate injection-site reactions, which all required orchiectomy and extensive surgical debridement, including scrotal ablation in 2 dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Low cost, ease of use, and cultural acceptance of a castration technique that does not require removal of the testes make zinc gluconate a valuable option for large-scale use in dogs, particularly in remote locations lacking sophisticated clinical facilities or skilled surgeons and staff. Further investigation is needed to identify risk factors in dogs for adverse reactions to zinc gluconate and to develop strategies for avoidance.     

The suitability of dogs as guide dogs for the blind: criteria and testing procedures

Criteria and testing procedures with regard to the suitability of dogs as guide dogs for the blind were developed on the basis of a literature study and own observations. A profile of the guide dog comprising physical characteristics, skillfulness, behaviour, and obedience was drawn up. As a rule, the testing procedures concern health and skills of the dogs. In the skill test some elements of the behavioural and obedience test were included. The final evaluation is based on the results of physical examination and the skill test, unless testing of behaviour and/or obedience appears necessary as well. A method for evaluating the performance of the dogs as objectively as possible is described. Some implications of using and testing guide dogs are discussed.