Free jejunal segment for treatment of cervical esophageal stricture in a dog

A 2-year-old female Chinese Shar Pei was admitted with a 20-cm cervical esophageal stricture that was untreatable by conventional medical and surgical methods. A free jejunal segment was used to replace the strictured portion of the esophagus. Twenty-one months after surgery, the dog was able to eat liquefied canned dog food with minimal regurgitation and was maintaining normal body weight. Free jejunal transfer offers a treatment method for otherwise fatal esophageal lesions that are not responsive to conventional methods of medical and surgical treatment.     

Use of a Vascular Skeletal Muscle Graft for Canine Esophageal Reconstruction

A technique for reconstruction of the thoracic esophagus was evaluated in 13 dogs. A 9 x 10 cm section of transversus abdominis muscle was harvested, fashioned into a tubular graft, and vascularized via the greater omentum. The vascularized tube was advanced into the caudal thorax through the diaphragm at a second surgery 20 to 44 days after harvesting the section of the transversus abdominis muscle. A 5 cm section of caudal thoracic esophagus was replaced with the vascular tubular graft. One dog died because of incarceration of the intestine within the tube and two dogs were euthanized because of infected tubes. One dog died due to an anesthetic complication, one dog had a diaphragmatic hernia and died, and one dog died from pyothorax. Leakage of luminal contents at the anastomoses did not occur in any dog. Seven dogs survived both surgeries but showed deglutitory difficulty 6 days postoperatively due to the grafted esophageal segments becoming severely strictured in each case. Angiography demonstrated vascularization of the full thickness of the graft in each of the seven dogs. An unacceptably high incidence of infection and stricture formation made this technique unsuitable for clinical use.     

Esophageal obstruction by antibiotic boluses in a thoroughbred filly: A case report

A case of equine midcervical esophageal obstruction by medicinal boluses is described. A discussion of the physical and endoscopic examination is included. Attempts at medical and manipulative therapy including massage, intraesophageal probing and endoscopically assisted efforts to snare the obstruction were nonrewarding. A standing midcervical esophagotomy was performed to facilitate the removal of the entrapped boluses. A positive contrast esophagram obtained five days after surgery indicated an absence of leakage of contrast media from the lumen of the esophagus. The filly was returned to athletic competition at seven days following surgery. No evidence of dysphagia or esophageal obstruction was reported six months following surgery. In this particular case, a standing midcervical esophagotomy afforded a successful alternative when manipulative and medical therapy proved inadequate.     

Esophageal ectasia in a quarterhorse colt

A one month old Quarterhorse colt was presented after a week history of bilateral nasal discharge and respiratory difficulty. The cervical esophagus was greatly dilated, tortuous and filled with diluted milk. A nasogastric tube could not be passed beyond the base of the heart. An aspiration pneumonia was found at postmortem examination and the esophageal segment from the pharynx to the base of the heart was dilated, thin-walled, had degenerative muscular changes, and a reduction in size and number of ganglion cells of the myenteric plexus. Muscular hypertrophy of the terminal esophagus had reduced its lumen size. Some similarities and disparities of this condition to achalasia of man and megaesophagus of dogs are discussed.     

Tubular duplication of the cervical portion of the esophagus in a foal.

Tubular duplication of the cervical portion of the esophagus was diagnosed in a 10-day-old female Quarter Horse. The foal was examined because of the development of a 12- to 15-cm diameter mass at the caudal aspect of the mandible after suckling. The foal was dyspneic when in lateral recumbency. Radiography and ultrasonography revealed a fluid- and gas-filled mass. Endoscopy revealed a normal-appearing upper airway and esophagus. Complete surgical resection of the mass was successful. The mass had a 3-mm diameter communication with the esophageal lumen at the pharyngoesophageal oriface. Histologic examination revealed stratified squamous epithelium lining the cyst-like cavity. The wall of the mass had circumferential and longitudinal layers of smooth muscle with few submucosal glands. The clinical, gross pathologic, and histopathologic findings were consistent with tubular duplication of the cervical portion of the esophagus.     

Persistent right aortic arch and aberrant left subclavian artery in a white Bengal tiger (Panthera tigris).

A 3-mo-old male white Bengal tiger (Panthera tigris) presented with the chief complaint of regurgitation of solid food since weaning at 2 mo of age. Compared with its littermates, the tiger was in poor body condition and weighed only 10.3 kg when its littermates were estimated at 20-25 kg. Thoracic radiographs showed a megaesophagus cranial to the heart base. A contrast esophagram more clearly outlined the megaesophagus, and fluoroscopy demonstrated normal motility of the caudal esophagus. Endoscopic examination revealed a structure coursing dorsally from right to left over the esophagus and a constrictive band on the left of the esophagus at the heart base. Nonselective angiography confirmed the presence of a persistent right aortic arch, as well as an aberrant left subclavian artery. A left fourth intercostal thoracotomy was performed, and the ligamentum arteriosum was double ligated and divided. The left subclavian artery did not cause significant compromise of the esophagus and was not manipulated at surgery. The tiger recovered well from anesthesia and surgery. Solid food was slowly introduced over a 2-mo period without any regurgitation. The cub gained weight rapidly after surgery.     

Double aortic arch in a Siamese cat.

A double aortic arch is described in an 8-week-old female Siamese cat. In this case a vascular ring anomaly consistent with a double aortic arch is described in a cat. Stridor and dysphagia were noted in the cat. Radiography showed an esophageal dilation, with constriction at the fifth intercostal space. At necropsy, the esophagus and trachea were constricted at the base of the heart. The cause of the constriction of both the esophagus and trachea was a vascular ring formed by well-developed right and left aortic arches. The ascending aorta divided into two asymmetrical arches. The right aortic arch was larger than the left. The origin of the major arteries from the aortic arches were anomalous.     

Benign esophageal stricture in the dog and cat: A retrospective study of 20 cases

Twenty animals with benign esophageal strictures are presented. Most of the esophageal strictures were thought to be related to gastroesophageal reflux during ovariohysterectomy and were located at the distal portion of the thoracic esophagus (caudal to the base of the heart). For the dilation procedure, the endoscope tip or a balloon catheter was used and the outcome was generally considered to be good. The endoscope tip was an adequate instrument for dilation in some cases.     

Megaesophagus and aspiration pneumonia secondary to gastric ulceration in a foal

A 3-month-old foal with a history of persistent fever and leukocytosis was found to have pneumonia, ulceration of the squamous portion of the stomach, and dilatation of the distal portion of the esophagus. The foal was euthanatized and necropsied. The distal portion of the esophagus was severely dilated, and there was severe ulceration and mural thickening of the stomach at the cardia. Because of the severe gastric ulceration and mural thickening, the gastroesophageal junction was fixed in an open position, permitting gastroesophageal reflux. The megaesophagus and pneumonia were considered to have resulted from chronic gastroesophageal reflux.     

Medical and surgical management of esophageal foreign body in a ferret

A ferret was examined because of anorexia, repeated episodes of regurgitation, and subsequent dehydration. Radiography had revealed a radiodense midesophageal foreign body. Results of endoscopy of the esophagus, however, could not confirm the diagnosis. Contrast radiography revealed esophageal perforation, with subsequent penetration of the foreign body into the right pleural space, causing pleural effusion. Surgical repair of the esophagus was performed, and a gastrostomy feeding tube was inserted to provide adequate nutrition during esophageal healing. Nine days after surgery, radiography revealed a severe stricture at the esophageal surgical site. Surgery was repeated; the esophagus was transected, the stricture was removed, and esophageal tissues were closed in 2 layers. Systemically administered antibiotics and gastrostomy tube feedings were continued throughout the post-operative healing period. The esophagus healed with a mild stricture that diminished over time in response to corticosteroid administration.     

Ulnar osteotomy for treatment of cubital subluxation,following locking compression plate osteosynthesis of a radius fracture in a foal

A closed mid‐diaphyseal fracture in a one‐day‐old foal was treated using a 3.5 mm locking compression plate on the cranial aspect of the radius. The foal showed good fracture healing, but a radio‐ulnar synostosis developed despite the absence of transfixation by any implant into the ulna. Four months after surgery the radiographs revealed a cubital subluxation, which was managed by an osteotomy of the ulna at the time of plate removal, allowing the ulna to adjust into a normal position. One year after surgery the foal was clinically sound; the radiographs showed good healing of the osteotomy gap as well as good remodelling of the radius; however, a slight elbow subluxation was present.     

Closed reduction and blind cross-pinning for repair of a proximal tibial fracture in a foal

A 4-day-old foal underwent repair of a proximal metaphyseal fracture of the tibia. After closed reduction, fixation was achieved by use of blind cross-pinning. Thirty-five days after surgery, radiography demonstrated complete healing. The foal was mildly lame 4 months after repair of the fracture. Blind cross-pinning may be considered as a method of repair for certain long bone fractures in small foals.     

Megavesica in a neonatal foal

A newborn male foal was diagnosed with a greatly enlarged urinary bladder (megavesica), a urinary bladder diverticulum, and a herniated and abnormal umbilical remnant. Approximately 50% of the cranial bladder including the abnormal structures was surgically resected; the foal recovered and was still asymptomatic 15 months after surgery. The aetiology of megavesica in foals is unknown but successful outcome may be achieved with surgical intervention and adequate medical support.     

Phacoemulsification and +14 diopter intraocular lens placement in a Saddlebred foal

A 2‐month‐old, 110‐kg Saddlebred filly presented for evaluation of bilateral cataracts. A hypermature cataract in the left eye (OS) and an incipient nuclear cataract in the right eye (OD) were diagnosed. Electroretinography and ocular ultrasound revealed no contraindications for surgical removal of the cataractous lens OS. Phacoemulsification and implantation of a +14 diopter (D) intraocular lens (IOL) OS were performed at 4 months of age without complication, with the exception of a partial iridectomy performed on a small iris section that prolapsed through the corneal incision. Complete ophthalmic examinations, including ocular ultrasound and streak retinoscopy, were performed 1, 2, 6 weeks, 4 months, 1, and 2 years postoperatively. Diffuse corneal edema and a superficial corneal ulcer developed OS during the early postoperative period and resolved without complication. Dyscoria was identified owing to anterior synechia of the dorsomedial iris at the incision site. Two years after surgery, menace response, palpebral reflex, dazzle reflex, and pupillary light reflexes were present in both eyes (OU). The IOL remained centrally positioned within the capsule, with mild anterior tilting of the superior portion of the IOL and mild fibrosis of the lens capsule. The postoperative net refractive error was +0.31 D OS. Based on this report, a +14 D IOL may be the appropriate choice following lens extraction in a foal to achieve refraction near emmetropia at maturity. To our knowledge, this is the first report of phacoemulsification and IOL implantation in a foal with long‐term follow‐up.     

Successful outcome after surgical correction of large colon atresia in a colt foal

This report describes successful surgical correction and long-term survival of a case of large colon atresia in a 24-h-old Warmblood colt, referred with signs of unrelenting abdominal pain and a suspicion of meconium impaction. Radiographic and ultrasonographic examination was indicative of large colon meconium impaction with secondary ileus. Due to deterioration of the foal, surgery was recommended. An atretic segment was found between the left ventral and dorsal large (ascending) colon. A band of fibrous tissue with no identifiable lumen connected the segments. Surgical correction was done by performing a stapled side-to-side anastomosis. Twelve days after surgery, the foal was discharged. Twenty-two months after discharge, the owner reported the foal developing as expected compared with its peers, but had a mild, self-limiting episode of colic at 20 months of age.     

Platelet-Rich Plasma as an Adjunctive Therapy for the Management of a Severe Chronic Distal Limb Wound in a Foal

Distal limb wounds are frequent in horses after traumatic events. The use of platelet-rich plasma (PRP) represents a simple method of treating wounds in equines. A case of a chronic severely contaminated distal limb wound in an 8-month-old foal is presented. The patient was managed with the combination of standard wound therapy (debridement and bandages), surgery, and PRP obtained by a manual tube protocol. No complications were observed with the PRP treatment, and the foal was fully recovered 2 months later. The results from this case report indicate that PRP and its by-products (platelet-poor plasma) could be used as an adjunctive treatment in severe distal limb wounds in horses. A clinical controlled study should be performed to test this hypothesis.     

Tracheal reconstruction in a foal

A 6-month-old Standardbred foal was admitted for repair of an acquired tracheal deformity. At 2 months of age, 4 midcervical tracheal rings had been transected and, as a result, that portion of the trachea would collapse when the foal became excited or was exercising. At surgery, partial chondrotomies allowed remodeling of the deformed rings, which were then anchored to 2 partially encircling, polypropylene prostheses. After surgical repair, the horse raced successfully.     

Internal fixation of comminuted transverse scapular fracture in a foal

A comminuted scapular fracture in a foal was treated surgically by use of 2 dynamic compression plates. The plates were applied upside down, so that the convex surface of the plate faced the bone. At 5 months after surgery, the plates were removed, and the foal recovered without complications.     

Double aortic arch and persistent left vena cava in a white lion cub (Panthera leo).

A 4-mo-old female white lion (Panthera leo) cub was presented with a 2-wk history of persistent postprandial regurgitation, mild dyspnea, and poor weight gain. The cub was weak and thin but otherwise alert. Survey and contrast radiography revealed a large dilated esophagus cranial to the heart base, with an esophageal filling defect present at the level of the fourth thoracic vertebra. A vascular ring anomaly was tentatively diagnosed. Exploratory thoracotomy revealed a double aortic arch and a persistent left vena cava. The left aortic arch was ligated and divided, and recovery was uneventful. A single episode of regurgitation occurred within the first postoperative month, and the cub gained 5.5 kg in weight during the same time period. Neither double aortic arch nor persistent left vena cava has been reported in a nondomestic felid.