一例犬胃内异物的诊疗

胃内异物是犬临床常见的消化道疾病,在临床诊断中经常会出现误诊,引起动物的死亡.作者通过一例典型病例,从发病情况、临床症状、实验室检查(血液学和影像学检查)和手术治疗及预后各个方面对犬胃内异物的诊治进行了分析和探讨.     

Intraocular lead foreign bodies in four canine eyes

Retained intraocular lead foreign bodies are well tolerated by the canine eye. Three cases (four eyes) of intraocular lead shot are the subject of this report.     

Case series evaluating the use of absorbable staples compared with metallic staples in equine ventral midline incisions

The objective was to evaluate the use of subcuticular absorbable staples (SAS) and compare them with metallic staples (MS) in abdominal skin closure for equine abdominal surgery in terms of surgical site infection (SSI) reduction. A prospective, randomised clinical trial was carried out on client owned horses presenting for abdominal surgery (n = 42 horses). During surgery, horses were randomly assigned to receive either SAS or MS. Preoperative criteria recorded included age, breed and sex of horse; surgical variables included lesion type, anaesthetic, surgical and stapling times; post operative variables included an anaesthetic recovery quality score and an incisional assessment score. Mean ± s.d. anaesthesia times for small intestinal surgeries between the MS and SAS (228 ± 58.8 min, 234 ± 38.7 min, respectively) and surgical times between MS and SAS (158 ± 58.8 min, 174 ± 26.5 min, respectively) were not significantly different from each other. There was no significant difference in closure times for the MS and SAS (61 ± 14.1 s, 85 ± 35.3 s, respectively). Wound scores for the MS (median score 6) were significantly greater than the SAS (median score 3) until Day 14, after which there was no significant difference between the 2 techniques. No horses in this case series developed a SSI. Although no SSIs were identified in either group, the superior wound score with the SAS together with other in vitro and clinical evaluations in other species suggest that the use of SAS may be potentially beneficial in horses.     

Comparative evaluation of metallic skin staples or polypropylene sutures for primary closure of teat wounds in sheep

ABSTRACT

Aims

To compare stainless steel staples and polypropylene suture material for primary closure of wounds after teat amputation in ewes and to assess progress of healing in the presence or absence of intramammary infection (IMI).     

Acid-base and electrolyte abnormalities in dogs with gastrointestinal foreign bodies

Gastrointestinal foreign bodies occur commonly in dogs. The objective of the study was to describe the acid-base and electrolyte abnormalities identified in dogs with gastrointestinal foreign bodies and determine if these abnormalities are related to the site or type of foreign body present. Medical records of 138 dogs were reviewed, and information on signalment, initial venous electrolyte and acid-base values, surgical findings, relevant historical information, imaging modalities used, cost of hospital visit, intra- or postoperative complications, and survival was obtained. The site of the foreign body was recorded in 94.9% of cases and the most common site was the stomach (50%), followed by the jejunum (27.5%). The foreign bodies were linear in 36.2% of cases. The most common electrolyte and acid-base abnormalities regardless of the site or type of foreign body were hypochloremia (51.2%), metabolic alkalosis (45.2%), hypokalemia (25%), and hyponatremia (20.5%). No significant association was found between electrolyte or acid-base abnormalities and the site of foreign body. Linear, as opposed to discrete, foreign bodies were more likely to be associated with a low serum sodium concentration (odds ratio, 0.85; 95% confidence interval, 0.75-0.95). Hyperlactatemia (> 2.4 mmol/L) was seen in 40.5% of dogs. A wide variety of electrolyte and acid-base derangements are found in dogs with gastrointestinal foreign bodies. Hypochloremia and metabolic alkalosis are common in these dogs. Hypochloremic, hypokalemic metabolic alkalosis is seen with both proximal and distal gastrointestinal foreign bodies.     

Comparison of gross and histologic tissue responses of skin incisions closed by use of absorbable subcuticular staples, cutaneous metal staples, and polyglactin 910 suture in pigs

OBJECTIVE: To assess gross and histologic tissue responses of skin incisions closed by use of absorbable subcuticular staples, cutaneous metal staples, and polyglactin 910 suture in pigs. ANIMALS: 8 purpose-bred disease-free pigs. PROCEDURE: Pigs were randomly allocated to 1 of 4 groups from which tissues were collected after death on postoperative days (PODs) 7, 14, 21, or 42. In each pig, 4 incisions were made; 1 was closed subcuticularly with 3-0 polyglactin 910 suture, 1 was closed with metal staples, and 2 were closed with absorbable subcuticular staples. Incision sites were grossly evaluated every 3 days after closure. At necropsy, incision sites and surrounding tissues were examined histologically; a histopathologic scoring system was used to quantitate healing and tissue response directed against the closure material. RESULTS: Postoperatively, the metal staples induced a severe inflammatory response, compared with minimal inflammation associated with the suture or absorbable subcuticular staples. Histologic evaluation of incisions on PODs 7, 14, and 21 revealed less severe inflammation associated with absorbable subcuticular staples than that associated with the other materials. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that absorbable subcuticular staples induced a less severe inflammatory response in the early stages of healing in pigs, compared with other commonly used methods of wound closure. Use of absorbable staples potentially combines the benefits of subcuticular closure with the speed and precision of staple placement.     

Migration of wooden skewer foreign bodies from the gastrointestinal tract in eight dogs

Wooden skewer foreign bodies were found in eight dogs. Five presented for evaluation of draining sinuses and two for inflammatory disease referrable to the thorax, abdomen or pelvic region. In an additional case, pneumothorax resulted from perforation of the stomach and diaphragm. Ingestion was considered the most likely mode of access of the foreign body in all cases. Although the wooden foreign bodies were seen radiographically in only two dogs, identification of soft tissue or bony changes, or the results of contrast sinography assisted diagnosis. Surgical retrieval led to resolution of signs in all cases.     

A comparison of 2 different suture patterns for skin closure of canine ovariohysterectomy

The purpose of this study was to compare postoperative wound healing in canine ovariohysterectomy following the use of an absorbable monofilament poliglecaprone 25 suture in 2 different skin closure techniques, the buried continuous subcuticular (BCS) suture pattern and the simple interrupted (SI) suture pattern. These 2 skin closure techniques were evaluated against a nonabsorbable polypropylene monofilament suture in an SI pattern. Wounds were assessed by using a semiquantitative scoring system at 18 to 24 hours and 10 to 14 days, postoperatively. Results indicated that the BCS closure using poliglecaprone 25 demonstrated a higher rate of tissue reactivity initially (18-24 hours postoperatively), as compared with the SI closure using either suture material. By 10 to 14 days postoperatively, poliglecaprone 25 used in a BCS closure was associated with significantly lower wound scores than was the same material used in an SI closure. It was concluded that the BCS closure may effect a better cosmetic appearance to the skin closure in a canine ovariohysterectomy at the time of the recheck appointment. Furthermore, by obviating the need for suture removal, use of the BCS pattern may eliminate the requirement for this return appointment.     

犬消化道异物诊疗1例

犬消化道异物是指某些不能或不易被消化的物体进入并存留于消化道之中,引起局部损伤、炎症乃至机械性阻塞的病变,是兽医临床上常见的急症之一.笔者曾遇到一例犬消化道前段多发性异物病例,经手术治疗后痊愈.     

Use of random pattern skin flaps for wound closure in two horses

A 9-year-old Thoroughbred broodmare presented with a mass rostral to the medial canthus of the left eye. The mass was removed under general anaesthesia and the wound bed infiltrated with carboplatin emulsion before partially closing using a Z-plasty. The mass recurred and subsequently was resected twice. It has not recurred 68 weeks post-treatment. The second case describes removal of a granulomatous mass from the metatarsus of a yearling Thoroughbred colt. Skin expanders and a rotational flap were used to allow tension-free closure. This required two separate surgeries to firstly insert the skin expanders and secondly to remove the mass, the expanders and to close the defect. The wound healed with good cosmesis. There have been few reports on the use of skin flaps in equine reconstructive surgery in the last 30 years. This report details two cases of wound closure where skin flaps were used to achieve primary intention wound healing.     

Use of cyanoacrylate in skin closure for ovariohysterectomy in a population control programme

N-butyl-cyanoacrylate tissue adhesive was evaluated as a skin closure material in a population control programme. Fifty-two female cats underwent ovariohysterectomy: skin closure of 25 of those cats was undertaken with nylon (3-0) and in 27 with the adhesive. Twenty-three cats spent the postoperative period confined in cages and 29 were free within a 50-square-metre fenced area. The parameters used for evaluation were: dehiscence or secretion and presence and extension of erythema at the surgical site. It was observed that the time required for closure of the surgical site with the adhesive was shorter than with nylon, saving approximately 1 min per animal. The adhesive or conventional suture allowed similar healing, and independent of material used for skin closure or the postoperative exercise, there was no statistical difference in wound cicatrization. As the adhesive eliminates the need for suture removal and decreases surgery time, without additional risk to the cat, it may be indicated for surgical population control programmes.     

Celiotomy in tortoises: remedy of choice for dystocia (laying distress) and gastrointestinal foreign bodies

The radiological findings regarding eggs (variation in form, size, shell thickness, degree of calcification) combined with the clinical symptoms (Ca-Gluconate and Oxytocin application as well as unsuccessful labour contractions and constipation) set up the diagnosis of dystocia in the tortoise. Celiotomy is the remedy for cesarean section, ovariosalpingotomy and gastrointestinal foreign body. A large, topographically well-placed Plastron incision, separation and reposition of the m. pectoralis and m. obliquus internus abdominis using cross-stitch sutures, as well as the careful manipulation of tissues, are of great importance. Gastrotomy is even feasible on terrapins through a partial detachment of the stomach from the liver, enabling a sufficient presentation of the stomach.