Ventral surgical approach to the caudal brain stem in dogs

OBJECTIVE: To develop a safe neurosurgical procedure that accessed the ventral pons and medulla of the dog primarily for the removal of brain stem neoplasms. STUDY DESIGN: In vivo study. METHODS: A cadaver study was performed on mesocephalic dog heads to develop a neurosurgical approach to the ventral brain stem. Based on this study, an approach to the ventral brain stem was developed by basioccipital craniectomy. This procedure was performed on 4 young neurologically normal Beagle dogs to assess morbidity and mortality associated with the procedure. Morbidity was evaluated by subjective criteria, daily complete neurologic examinations, comparison of preoperative and postoperative brain stem auditory evoked response (BAER) tests, and postmortem examinations. RESULTS: Three dogs developed a transient cough but were neurologically normal after surgery. One dog was euthanatized within 12 hours of surgery because of severe postoperative morbidity associated with basilar artery disruption due to improper development of the craniectomy. Prolongations of postoperative BAER latencies were observed in 2 dogs but did not appear to be associated with clinical deficits or histopathologic changes in the brain stem. Minimal histopathologic changes were observed except in the dog with basilar artery disruption. Results of this study indicate that, although technically challenging, this procedure can be performed with minimal morbidity. CLINICAL IMPLICATIONS: The main indication for this procedure is surgical reduction or biopsy of ventrally located brain stem neoplasms in dogs. The major disadvantage is anatomic restrictions that prevent access to laterally oriented ventral brain stem masses.     

A practical approach to hemoperitoneum in the dog and cat.

Hemoperitoneum can occur in animals of any age and can result from many different disease processes. Neoplastic and traumatic conditions are the most common causes. Many of these patients present with hemodynamic instability but stabilize with rational intravenous fluid therapy and abdominal counterpressure. Surgical exploration of the abdomen is indicated in many situations. Surgical therapy is aimed at resection or control of the bleeding focus, removal of any devitalized tissue, and biopsy of additional sites of suspicion. Optimal treatment for all patients with hemoperitoneum frequently requires advanced critical care, anesthesia, and surgical techniques. Finally, the treatment outcome is variable and dependent on the underlying cause and its severity.     

Intraosseous approach to the nasolacrimal duct for removal of a foreign body in a dog

A Labrador retriever was evaluated because of chronic mucopurulent discharge from the left eye. A foreign body was identified in the nasolacrimal duct by use of dacryocystorhinography. Attempts to alleviate the inflammation by use of flushing and administration of antimicrobials were unsuccessful. At surgery, the infraorbital foramen was used as a landmark for a skin incision, because the nasolacrimal duct courses dorsal and parallel to the infraorbital canal. An air drill was used to remove the portion of the maxillary bone overlying the nasolacrimal duct, which exposed the intraosseous portion of the duct and allowed removal of a plant-material foreign body. The incision in the duct was allowed to heal by second intention, and the dog recovered without complications.     

A modified ventral approach to the atlantoaxial junction in the dog

Objective— To describe and evaluate a surgical technique using a modified ventral approach for stabilization of the atlantoaxial (AA) junction in dogs with AA subluxation.
Study Design— Retrospective study.
Animals— Dogs (n=5) with AA subluxation.
Methods— Medical records (2000–2006) of 5 dogs with AA treated by stabilization via a right parasagittal approach were reviewed and outcome assessed by clinical examination and phone interviews with owners.
Results— The AA joint was clearly visualized and fixation devices were placed in all dogs. A right parasagittal approach provided excellent access to the AA junction and avoided dissection around the thyroid gland, trachea, and recurrent laryngeal nerve. Recovery was considered good to excellent by owners, and dogs returned to good function.
Conclusions— A right parasagittal approach to the AA junction provides improved exposure and allows for surgical stabilization with minimal complications.
Clinical Relevance— In dogs that require surgical stabilization of the AA joint, a right parasagittal approach should be considered. This approach offers advantages over the standard ventral median approach by improved surgical exposure, less dissection, and provides protection of vital structures during insertion of fixation devices used for ventral AA stabilization.     

A cranial intercondylar arthroscopic approach to the caudal medial femorotibial joint of the horse

Reason for performing study: Current noninvasive techniques for imaging the soft tissue structures of the stifle have limitations. Arthroscopy is commonly used for the investigation and treatment of stifle pain. Cranial and caudal arthroscopic approaches to the femorotibial joints are used. However, complete examination of the axial aspect of the medial femorotibial joint (MFTJ) is not possible currently. Objective: To develop a cranial approach to the caudal pouch of the MFTJ and to assess whether it would allow a more complete examination of the compartment and facilitate the caudomedial approach. Method: The regional anatomy was reviewed and the technique developed on cadavers. A series of nonrecovery surgeries were performed to evaluate the procedure, which was then used in 7 clinical cases. Advantages compared to existing techniques and complications encountered were recorded. Results: Successful entry into the caudal pouch of the MFTJ was achieved in 20 of 22 cadaver legs, 8 of 8 joints of nonrecovery surgery horses and 6 of 7 clinical cases operated. The caudal ligament of the medial meniscus could be visualised, along with other axial structures of the caudal joint pouch. The technique was used to facilitate a caudomedial approach and allowed better triangulation within the joint space. Complications were minor and included puncture of the caudal joint capsule and scoring of the axial medial femoral condyle. Conclusions and potential relevance: It is possible to access the caudal pouch of the MFTJ arthroscopically using a cranial intercondylar approach. The technique has advantages when compared to existing techniques and is associated with few significant complications. A cranial approach to the caudal pouch of the MFTJ could complement existing techniques and be useful clinically.     

Segmental aplasia of the caudal vena cava in a dog

Ultrasonography, angiography, magnetic resonance imaging, and exploratory laparotomy of a 2-year-old wheaten terrier with lethargy, exercise intolerance, and ascites revealed segmental aplasia of the caudal vena cava with azygos continuation, complicated by thrombus formation. Surgeries were performed on the blind-ended vessel to remove thrombi, enhancing shunting of blood through the azygos vein.     

Use of mandibular symphysiotomy to allow extensive caudal hemimaxillectomy in a dog

A 5-year-old dog was presented with a large caudal maxillary osteosarcoma, which was causing extreme pain on opening of the mouth. The mass was not resectable through a standard oral approach. This article describes the successful use of mandibular symphysiotomy to allow extensive caudal hemimaxillectomy to remove the mass and provide excellent postoperative quality of life for the dog.     

A novel approach to treatment of lymphangiosarcoma in a boxer dog

A five‐year‐old female boxer presented with a swelling in the area of the caudal mammary gland. The mass was surgically excised and histopathological examination revealed a poorly demarcated lesion, extending into mammary tissue and infiltrating the sinuses of adjacent lymph nodes. The diagnosis was lymphangiosarcoma. Full blood work, thoracic radiographs, abdominal and scar ultrasound were unremarkable, apart from possible inflammatory reactions in the latter and reactive/metastatic changes in inguinal lymph nodes. Doxorubicin treatment resulted in a 6‐month recurrence free interval. At relapse, the dog was treated with metronomic chemotherapy using chlorambucil and meloxicam, which failed to adequately control the disease. Toceranib phosphate was introduced and resulted in almost complete regression of the mass, leaving just a skin plaque. To the authors’ knowledge this is the first report describing the use of two novel therapeutic approaches to treat canine lymphangiosarcoma that resulted in a higher than previously described survival time.     

Chronic peritoneal effusion secondary to partial caudal vena cava obstruction following traumatic pneumothorax in a dog.

A three-year old, female Boxer Dog was treated initially with thoracocentesis for a right-sided pneumothorax. The dog was re-evaluated after three weeks because of an enlargement of the abdomen. A positive venogram revealed a ventral displacement of the caudal vena cava between the diaphragm and the heart, with a severe reduction of the diameter of the vein. An exploratory thoracotomy showed a displaced accessory lung lobe with an adhesion to the parietal pleura. Inflation of this lung lobe created a dynamic obstruction of the caudal vena cava, which resulted in ascites. Surgery offered successful treatment.     

A surgical approach to treatment of suprascapular nerve injury in the horse

Suprascapular nerve decompression has proven to be a useful treatment for refractory neuropraxia in horses. The surgical procedure used to effect that decompression is described. The surgery can be undertaken when conservative treatment has failed, but the sooner the surgery is done, the more likely the muscle mass is to be cosmetically satisfactory.     

Fiber type composition of rostral and caudal portions of the digastric muscle in the dog

The distribution of muscle fiber types in rostral and caudal portions of the musculus digastricus (digastric muscle) was studied in 6 dogs. Staining procedures which stain specifically for type IIM fibers, a fiber type found in other muscles supplied by the trigeminal nerve, were used. Rostral and caudal portions of the muscle were compared because the rostral portion is innervated by the trigeminal nerve, and the caudal portion is innervated by the facial nerve. The musculus triceps brachii (triceps muscle), which contains fiber types I and IIA, and the musculus masseter (masseter muscle), which contains type IIM, were used as controls. Mean fiber diameters were calculated for each of the muscles. Both portions of the digastric muscle exhibited the same histochemical behavior, possessing types I and IIA myofibers. Neither portion contained type IIM fibers. Type I fibers in the masseter muscle were histochemically different from type I fibers in the other muscles studied. Type II fibers predominated in all 3 muscles, but there were significantly (P less than 0.001) more type I fibers in the triceps muscle than in either portion of the digastric muscle or in the masseter muscle. Type II fibers were significantly larger than type I fibers in the caudal digastric (P less than 0.01) and masseter (P less than 0.05) muscles. There was no difference in the size of type I or type II fibers between any of the muscles studied (P greater than 0.20).     

Transcutaneous tibial implants: a surgical procedure for restoring ambulation after amputation of the distal aspect of the tibia in a dog

Objective— To report surgical planning, technique, and long-term outcome of custom transcutaneous tibial implants used to restore ambulation after bilateral pelvic limb amputation in a dog.
Study Design— Case report.
Animals— A 4-year-old, 25.5 kg, female spayed, Siberian Husky.
Methods— Computed tomographic scans of the pelvic limbs were used to build sterolithographic models of the remaining tibia after bilateral amputation of the distal aspect of the tibiae. The sterolithographic models facilitated fabrication of implants that would replace the missing distal segments of the tibiae. Custom implants were surgically placed in both limbs.
Results— Assisted ambulation was restored immediately postoperatively and unassisted locomotion occurred at 7 days. At 14 months, aseptic loosening of the right implant occurred, it was removed and a 2nd transcutaneous implant was fabricated and implanted. At 26 months after initial surgery and 17 months after revision of the right implant, function is restored at a walk, trot, and run.
Conclusion— Based on over a 2-year follow-up, transcutaneous tibial implants allowed for restoration of locomotion.
Clinical Relevance— Transcutaneous tibial implants offer a potentially viable treatment option for restoring ambulation after amputation of the distal aspect of the tibiae in the dog.     

A method of surgical correction of glaucoma in a dog

A new surgical technique is described for the attempted relief of glaucoma in a dog. To achieve aqueous drainage a Supramid thread was placed in the anterior chamber, threaded subconjunctival^ across the globe and inserted into the nasolacrimal duct via the dorsal lacrimal punctum. It is hoped that the level of success achieved in this one case will prompt others, to investigate the nasolacrimal duct as a possible drainage route for aqueous fluid.     

A new surgical technique For repair of perineal hernias in the dog

A new surgical technique is described for the repair of perineal hernias. Transposition of both the internal obturator muscle and the superficial gluteal muscle together was used to repair 52 hernias in 44 dogs. The technique gave a strong pelvic diaphragm, fewer postoperative complications than other techniques and good long term results.     

Multilobular tumour of the caudal cranium causing severe cerebral and cerebellar compression in a dog

Multilobular tumour of bone (MTB) is an uncommon tumour and is usually located in the skull. A 13-year-old mixed breed dog was presented with a two-week history of progressively worsening vestibular dysfunction and cognitive abnormalities; it appeared demented and showed asymmetric ataxia and hypermetria of all limbs. The owner opted to have the animal euthanised. Necropsy revealed a large mass occupying the right occipital, parietal and temporal bones, severely compressing the cerebellum and the right occipital lobe. Histologically, it was characterised by the presence of multiple lobules containing osteoid or cartilage and separated by fibrous septae, features typical of MTB. Lung metastases were evident. To our knowledge, this is the first report of an MTB causing both severe cerebral and cerebellar compression and the second detailed report of an MTB of the occipital bone. MTB should be included in the differential diagnosis of bone tumours as well as in cases with central vestibular disease.