Conservative management of uroperitoneum in a gelding.

Uroperitoneum as a sequela to urethral calculus in an adult gelding was successfully managed by use of subischial urethrotomy and abdominal drainage. Necrosis of bladder mucosa was seen endoscopically, but a tear or rupture was never identified. Peritonitis developed but was controlled with antibacterial treatment. Although uroperitoneum is usually a sequela to bladder rupture and the ideal treatment is surgical repair, conservative management may be warranted in selected cases.     

Soft tissue sarcoma in the dog – part 1: a current review

Soft tissue sarcomas are derived from tissues of mesenchymal origin. Although local recurrence following surgical resection is the characteristic challenge in their management, 40% dogs with high‐grade tumours may also develop metastatic disease, despite successful local control. Soft tissue sarcoma is a complex disease and there are many uncertainties regarding the biology and optimal clinical management. There are currently no diagnostic tests that can reliably predict the amount of surgical margin required for a particular tumour, so there can be a mismatch between treatment and disease. Historically, the tendency has been to always recommend wide excision margins but this is not fully supported by recent evidence. A selection bias for less aggressive soft tissue sarcomas in primary care practice can account for good outcomes that are achieved despite narrow surgical excision margins. On the other hand, inappropriately conservative treatment will adversely affect outcomes for patients with more aggressive disease. This review provides an update on the current understanding of management of canine soft tissue sarcomas.     

Nonweightbearing lameness secondary to synovial sarcoma in a young dog

Synovial sarcoma was diagnosed in the right carpus of a 2 1/2-year-old mixed-breed dog. The dog had developed a right forelimb lameness before one year of age. The lameness was progressive for nearly 2 years, resulting in severe disuse atrophy of the right forelimb musculature and pronounced osteopenia. A definitive diagnosis was not made until the dog was referred after 2 years of conservative treatment was ineffectual. Right forelimb amputation was done and the dog survived an additional 15 months. The protracted clinical course before definitive diagnosis underscores the need for aggressive pursuit of a diagnosis when conservative treatment of a lameness is not efficacious.     

Thoracic oesophageal foreign bodies in the dog: a review of ninety cases

This paper describes the management of ninety dogs referred with thoracic oesophageal foreign bodies. The diagnosis, treatment and complications are discussed and an overall recovery rate of 83/90 (92.2 per cent) recorded. A conservative approach using oesophagoscopy and forceps delivery was employed in all but seven cases. The advantages of passing the largest possible rigid endoscope under conditions provided by muscle relaxation are emphasized.     

Management of bladder rupture in mature horses

Rupture of the urinary bladder of adult horses is rare with both reports of surgical repair and conservative management in the literature. The case report by Gosling et al. in this issue describes the successful treatment of an iatrogenic bladder tear in an adult gelding. The aim of this commentary is to review the described treatment options.     

Supernumerary cheek teeth (n = 24): clinical features, diagnosis, treatment and outcome in 15 horses

REASONS FOR PERFORMING STUDY: There are few reports of case series of horses with supernumerary cheek teeth (SCT) that document clinical findings, treatment and long-term outcome. OBJECTIVES: To review the clinical and ancillary diagnostic findings and responses to different treatments in horses with SCT. METHODS: The case records of 15 horses were reviewed and long-term outcomes obtained by telephone interview. RESULTS: Fifteen horses with a total of 24 SCT were identified. Two SCT were incidental findings and were not treated. Clinical signs were improved or resolved in 11 of 13 of the teeth treated conservatively and all 6 treated by extraction had a favourable outcome. Four horses were subjected to euthanasia within a short period of diagnosis, either due to a poor prognosis at the outset or failure to respond to initial conservative treatment. CONCLUSIONS: Some SCT are chance findings and do not cause clinical signs. In those instances where clinical signs of dental disease are mild, conservative treatment including the management of diastema and reduction of overgrowths is often effective. Horses with severe clinical signs attributable to an SCT are likely to require extraction of the offending tooth. POTENTIAL RELEVANCE: An SCT is an uncommon dental anomaly but should be considered in the differential diagnosis of cases with signs of severe dental disease. The preferred management for SCT is very variable and determined by the severity of the associated changes, but ranges from conservative measures through forceps extraction per os to major facial flap surgery.     

The surgical management of oesophageal obstruction in a horse

Oesophageal obstruction or 'choke' is a condition seen occasionally in the horse; most cases are due to food impaction and resolve with conservative treatment. Rarely is surgical intervention required and there are few reports of oesophagotomy being used in clinical cases. This communication reports the successful surgical management of a cervical oesophageal obstruction due to the ingestion of wood.     

Conservative management of fourth tarsal bone fracture in a draft horse.

A fourth tarsal bone fracture was treated conservatively in an adult draft horse. Seven months after the injury, the horse had no evidence of lameness and was able to compete in athletic events. It has been suggested that conservative management of these fractures be considered for brood animals or animals used for less strenuous activities. The outcome of this case suggests that fourth tarsal bone fractures can be successfully treated in athletic animals with conservative management.     

Treatment of canine hip dysplasia: a review.

This article discusses the treatment approaches and recommendations for canine hip dysplasia. A search of the literature database MEDLINE (1969-1994) was conducted and relevant journal articles regarding the medical and surgical treatment of hip dysplasia were selected and reviewed. Dysplastic dogs can be divided, for treatment purposes, into those with no or minimal osteoarthrosis, and those with moderate to severe osteoarthrosis. In young animals with joint laxity and pain, but with no or minimal radiographic evidence of osteoarthrosis, the treatment approach is controversial. Conservative management may be effective in the short term, but progressive development of osteoarthrosis occurs and clinical signs may manifest at an older age. Options for surgical treatments in these young dogs include pectineal myectomy, lengthening of the femoral neck, and corrective osteotomies. Corrective osteotomies are advocated to reestablish joint congruency and prevent development of osteoarthrosis. In the mature osteoarthritic dog, effective conservative management depends on the severity of the degenerative joint disease. Proposed surgical treatments for clinically debilitating hip dysplasia include biocompatible osteoconductive/shelf arthroplasty; femoral head and neck excision arthroplasty, with or without muscle sling interposition; and total hip replacement. Although research directly comparing the salvage procedures has not been reported, studies suggest that total hip replacement is more effective in returning large dogs to full functional weight bearing.     

Conservative Management of a Distal Epiphyseal Metacarpal Fracture in a Skyros Pony

Epiphyseal fracture, also known as epiphysiolysis, is the loosening or separation, either partial or complete, of an epiphysis from the shaft of a long bone. Distal epiphyseal fractures in foals pose a substantial challenge due to their guarded prognosis. This report describes the clinical signs, diagnosis, successful conservative treatment of an 1-month-old, male Skyros pony with an epiphyseal fracture of the right third metacarpal bone (type II Salter-Harris). The owner declined surgical treatment because of financial considerations along with the unfavorable prognosis. Conservative fracture treatment was pursued through external reduction and coaptation. The total duration of the conservative treatment was eighteen weeks and the foal returned to complete health.     

Treatment of a metallic foreign body in the cranial cervical region of a horse

Ingestion of foreign bodies is uncommon in horses when compared with indiscriminate grazers such as cattle. This case report describes the diagnosis and treatment of a cervical abscess in a Thoroughbred racehorse thought to be associated with ingestion of wire. Radiographic and ultrasonographic examination provided a diagnosis, and conservative treatment of the lesion with antimicrobials initially allowed the lesion to localise closer to the skin for safer surgical exploration. Intra-operative ultrasonographic imaging facilitated surgical access, removal of the foreign body, and drainage. While surgical treatment is usually necessary to resolve an abscess, initially conservative therapy may help to improve the prognosis by simplifying surgical access and reducing the risk of surgical complications.     

Nutrition and Exercise in the Management of Horses and Ponies at High Risk for Laminitis

Obesity, insulin resistance (IR) and hyperinsulinemia are risk factors for laminitis in horses and ponies. Alterations in management, especially diet and physical activity, can be helpful in the management of these risk factors. Caloric restriction, ideally combined with increased physical activity, to promote weight loss and improve insulin sensitivity is indicated for the management of obese animals. Strict control of dietary NSC through the elimination of grains and sweet feeds and by restricted access to NSC-rich pastures is recommended for insulin-resistant animals, regardless of whether they are obese or not. Medical treatment with levothyroxine or metformin may be indicated in obese or insulin-resistant animals that do not respond to conservative management.     

Medical management of urethral and colonic perforation associated with urinary catheterization in a kitten

A 6-week-old male kitten was evaluated because of stranguria and possible urethral blockage; a urinary catheter placed during general anesthesia penetrated the urethral and colonic walls and entered the colon. Treatment was conservative, with fluids administered i.v., administration of piperacillin, and supportive care. The kitten never became febrile or clinically ill and continued to thrive. There was no development of clinical signs consistent with stricture, diverticulum, or fistula formation. Complications from urethral perforation include infection and urethral stricture. Reconstructive surgery is considered the treatment of choice for traumatic urethral-colonic perforation. However, surgery may not be feasible or may be cost-prohibitive in certain situations. In such instances, medical management may provide a reasonable alternative to euthanasia.     

Surgical management of first caudal nerve root foraminal compression secondary to intervertebral disc disease in a Cocker Spaniel

A nine-year-old spayed female Cocker Spaniel was investigated for an eight week history of licking and rubbing at the tail base, dullness, and signs of pain on manipulation of the tail. Left-sided intraforaminal compression of the first caudal nerve root due to intervertebral disc disease was diagnosed by radiographic, computed tomography, and magnetic resonance imaging examinations. The dog was nonresponsive to conservative medical therapy. A decompressive left-sided first-second caudal (Cd1-Cd2) foraminotomy was performed. Postoperative computed tomography confirmed surgical decompression of the involved nerve root. At the one month follow-up examination there was marked improvement in clinical signs. At two months, clinical signs were completely resolved and there was not any evidence of recurrence twelve months after surgery. Intervertebral disc disease should be considered as a differential diagnosis in dogs with discomfort at the tail base or signs of pain on manipulation of the tail. Surgical decompression may be indicated for management of these cases. This is the first report of diagnosis and surgical management of caudal intervertebral disc disease by foraminotomy in the dog. Surgical decompression by foraminotomy may therefore be a treatment option for this condition.     

1例猫特发性乳糜胸胸腔镜手术治疗与保守疗法的效果比较

旨在对比猫特发性乳糜胸胸腔镜下手术治疗和保守疗法的效果.将患有特发性乳糜胸的猫采取两种方式治疗.保守治疗采用安置胸导管每日抽吸胸腔积液,同时服用芦丁药物,并采取低脂饮食的方法.手术治疗采用胸腔镜下的胸导管结扎术和心包切除术.通过检查患猫体格状况、血液检查、细胞学检查、影像学检查来判断患猫的恢复程度.结果表明:保守治疗7...     

Fractures of the distal phalanx in the horse

Fractures of the distal phalanx are an important cause of lameness referrable to the foot. Depending on the fracture configuration and articular involvement, conservative or surgical treatment may be required. Fractures of the distal phalanx have been divided into six categories based on fracture configuration. Discussion of clinical features, management, and prognosis for horses with distal phalangeal fractures is presented for each fracture type.     

A modified Maquet technique for management of cranial cruciate avulsion in a cat

This case report describes the management of cranial cruciate ligament avulsion from the femur of a four‐year‐old Norwegian Forest cat that presented with a history of lameness which had not improved with conservative treatment. During medial arthrotomy, avulsion of the cranial cruciate ligament from the caudomedial aspect of the lateral femoral condyle was suspected and the torn portion resected. A modified Maquet technique was performed on the left tibia resulting in a rapid improvement in lameness postoperatively. Histopathology of the resected cranial cruciate ligament confirmed avulsion. To the authors’ knowledge this is the first reported use of this technique in the cat, and the first of stifle instability due to cranial cruciate ligament avulsion from the femur in the cat.     

Utilization of continuous renal replacement therapy in a case of feline acute renal failure

Objective: To introduce and investigate the application, efficacy, and potential clinical complications of a continuous renal replacement therapy (CRRT) in a feline acute renal failure (ARF) patient. Case summary: A domestic short‐haired cat presented for continued management of ARF of a presumed toxic etiology. Severe azotemia and uremic complications had been identified on initial presentation to a local urgent care facility, and the cat had been referred for renal replacement therapy following approximately 9 hours of conservative management. Continuous venovenous hemodiafiltration was performed over an approximately 25‐hour period, and a significant resolution of the cat's uremic derangements was obtained. Major complications included significant hypothermia and a single episode of hypocalcemia associated with utilization of citrate anticoagulation. All complications identified were readily managed. Following hospital discharge, long‐term medical support was not required, and no evidence of significant illness was noted 6 months following therapy. New or unique information provided: CRRT represents a collection of extracorporeal blood purification techniques that utilize extended treatment periods for gradual, physiologically balanced correction of uremic toxicity. These therapies demonstrate significant promise in the treatment of ARF cats with actual or potential hemodynamic compromise, and prior advances in therapeutic administration have made these techniques readily accessible within the intensive care unit setting.