奶水牛瘤胃大口径瘘管安装手术及术后护理

瘤胃瘘管是用于研究反刍动物消化代谢、瘤胃微生态环境、生理生化等指标试验的手段之一,可广泛应用于反刍动物营养科研实验中。试验采用外科手术方法对 4 头奶水牛进行人造瘤胃瘘管安装,经约4周的术后护理。结果表明：术牛精神状态、体温、食欲、大小便等指标均表现正常。术后15d经检查发现,术牛的瘤胃壁与腹膜、腹肌及皮肤愈合粘连在一起,形成自然瘘口,没有出现刀口或腹腔感染的现象。说明该手术方法可操作性强,过程简单,用时短,术后瘘管密闭性好,创口恢复快、无感染;奶水牛能正常存活。     

山羊人造瘤胃瘘管术改进的几点体会

因科研需要，我们于2003年9月对16只青年山羊做了永久性人造瘤胃瘘管手术，术后全部山羊的瘤胃瘘管都保持良好，术后健康状况正常。现总结如下。     

微创外科技术建立犬胃内异物和膀胱结石疾病模型的研究

本试验采用腹腔镜微创技术构建用于动物临床实践教学的大动物疾病模型,试验选取6只杂种犬随机分为两组,3只犬制作胃内异物模型,用电刀在胃壁做一小切口,经过套管将5 cm左右的鸡骨放入胃中;另外3只造膀胱结石模型,将膀胱做一小切口,经过套管将相符合的石子放入膀胱中。术后6只犬均表现出呕吐、尿血、尿淋漓等典型症状。影像学检查显示,胃以及膀胱中的有明显异物存在。经过半个月术后护理,皮肤创口一期愈合,腹部长出被毛,与健康犬从外观上无差别。腹腔镜微创技术可成功建立犬的胃内和膀胱异物模型,将其应用到临床教学课程中能够提高学生对疾病的诊断和治疗水平。     

奶牛人造瘤胃瘘管及十二指肠瘘管的手术体会

永久性瘤胃瘘及十二指肠瘘是研究反刍动物消化功能试验的主要手段之一，广泛应用于教学和科研等实践中。因科研需要，笔者于2006年3月对3头体重为450～500kg的奶牛做了永久性人造瘤胃及十二指肠瘘管手术，由于手术方法合理，瘘管材料优良，术后护理得当，手术成功率较高。手术后1个月，3头牛的创口均愈合良好，均可满足科研需要。为了推广奶牛人造瘤胃瘘管技术在营养研究方面的应用，现将奶牛人造瘤胃及十二指肠瘘管安装技术总结如下。     

内窥镜引导下经皮胃造瘘留置管的应用

胃造瘘管是由病人口腔通过胃镜进入胃中,在腹部造瘘进行手术的医用导管。经皮内窥镜胃造瘘术(简称PEG)是一种无需外科手术的胃造瘘技术。[1]胃插管造口术主要用于重症病畜的长期营养补充。插管可通过外科手术或使用内窥镜进行放置。目前插管有几种规格:18～20Fr适用于猫及小型犬,24Fr适用于大型犬。可以使用橡胶及硅胶管。橡胶管比较便宜,但是由于其容易磨损,因此8～12     

四种手术方法治疗犬髋关节脱位的效果比较

为探讨犬髋关节脱位几种手术方法的实际疗效及其优缺点,选择健康家犬制作髋关节脱位模型,分别施行人造圆韧带植入术、髋关节囊外固定术、股骨头切除术和髋关节囊单纯缝合术,术后对实验犬术肢的运动机能、负重耐力及髋关节结构等进行了观察。实验表明,以上各种手术对犬的年龄或髋关节结构各有要求,其中以股骨头切除术疗效肯定、适应范围广,而人造圆韧带植入术的疗效最差。     

介绍一种新的瘤胃、皱胃软瘘管技术

传统的胃瘘管通常采用硬质材料做成“T”型筒状 ,经过外科手术打开腹腔 ,缝合固定到胃壁和腹壁上。这种创伤性手术一方面对动物造成较大的伤害 ,另一方面更重要的是影响到动物正常功能 ,尤其在反刍动物瘤胃 ,不能完全进行厌氧发酵。在单胃和皱胃安装传统瘘管 ,常由于解剖结构的特点 ,瘘管部位的腹部肌肉张力很大 ,瘘管极易脱落。此外 ,皱胃液中盐酸的腐蚀和胃蛋白酶的消化作用造成皱胃瘘管周围组织溃烂 ,瘘管无法固定 ,导致研究工作无法进行。本方法采用医用橡胶管进行复合穿刺固定技术 ,代替传统瘤胃、皱胃瘘管的制备安装 ,显示了简洁、实…     

中药配合针灸治疗圣伯纳犬肛门腺炎术后尿闭

犬的肛门腺炎发展到严重阶段可至肛周穿孔形成瘘管,这时必须通过手术进行治疗。近来,笔者曾对一例圣伯纳犬肛周穿孔病例实施了手术,术后出现了尿闭,经过采用内服五苓散加味,配合针灸治疗,取得了较好的疗效,现报告如下。1发病情况2011年7月,笔者接诊一例严重肛门腺炎患犬,该犬年龄已近11岁,患病多年,就诊时肛周部已破溃穿孔,形成瘘管。经检查:体温38.7℃,插入体温计时表现敏感、疼痛。患犬肛门周围散在有8～9个半愈合破溃孔,孔周围有大小不等的愈合在一起的肉芽组织增生。挤压肛门腺有脓血混合物从肛门周围破溃孔流出。     

内窥镜配合胃切开方法对犬食道梗阻的治疗

研究旨在探讨犬食道梗阻的诊疗方法。以遵义某动物医院接诊一只吞食异物后进食困难且反复呕吐的犬为例,采用临床基本检查、实验室检查,诊断患犬为胸腔后方食道梗阻。在内窥镜帮助下行胃切开术,采用肠钳从胃贲门处进入食道取出异物。术后48 h患犬可正常进食,精神状态良好。内窥镜配合胃切开取出食道异物能够快速定位并精准取出异物,避免残留,治疗效果良好。     

犬尿石症临床诊治

本文对某宠物门诊2015年3-5月的就诊犬进行了临床诊断、治疗和预防措施等研究。在临床检查的基础上,视情况进行X光检查、B超、尿液常规、血液常规或血清生化等检查,最终确诊尿结石病例7例。其中有5例给予手术治疗,1例进行药物消炎的保守疗法,1例伴发肾衰的患犬按主人要求实施安乐死。5例手术取石病例中,4例进行了膀胱切开取石术,术后均恢复良好,1例进行了尿道再造手术,恢复良好。表明手术治疗是有效手段,术后护理是治愈的关键。     

A rapid and strong laparoscopic-assisted gastropexy in dogs

OBJECTIVE: To develop a technique for laparoscopic gastropexy in dogs and evaluate effects on stomach position and strength of the adhesion between the stomach and abdominal wall. ANIMALS: 8 healthy dogs. PROCEDURE: Dogs were anesthetized, and the abdomen was insufflated with carbon dioxide. A laparoscope was placed through a cannula inserted on the abdominal midline caudal to the umbilicus. Babcock forceps placed through a cannula inserted lateral to the right margin of the rectus abdominus muscle were used to exteriorize the pyloric antrum, a longitudinal incision was made through the serosa and muscular layer of the pyloric antrum, and the seromuscular layer of the pyloric antrum was sutured to the transversus abdominus muscle. After surgery, positive-contrast gastrography was used to evaluate stomach position and the onset of gastric emptying, and ultrasonography was used to assess stomach wall activity and mobility. Dogs were euthanatized 1 month after surgery, and tensile strength of the adhesion was tested. RESULTS: In all dogs, stomach position and the onset of gastric emptying were normal 25 days after surgery, and the pyloric antrum was firmly attached to the abdominal wall 30 days after surgery. Mean +/- SD ultimate load of the adhesion in tension was 106.5 +/- 45.6 N. CONCLUSIONS AND CLINICAL RELEVANCE: The laparoscopic gastropexy technique described in the present study could be performed quickly and easily by an experienced surgeon, resulted in a strong fibrous adhesion between the stomach and abdominal wall, and appeared to cause minimal stress to the dogs.     

Nonendoscopic Antegrade Percutaneous Gastrostomy: The Effect of Preplacement Gastric Insufflation on Tube Position and Intra-Abdominal Anatomy

Nonendoscopic tube gastrostomy was performed on 41 anesthetized dogs using the technique of Fulton and Dennis with or without gastric insufflation prior to tube placement. Immediately after tube placement, dogs were euthanized and postmortem examinations performed. When gastric insufflation was not performed (group I), gastrostomy tubes penetrated the visceral surface of the stomach in 25% of dogs. The deep leaf of the omentum was interposed between stomach and body wall in the majority of these dogs, exposing other intra-abdominal organs to potential injury. Additionally, displacement and tethering of the spleen cranial to the gastrostomy site were observed in 33% of dogs in group I. Similar results were obtained when preplacement gastric insufflation was performed after the orogastric tube was inserted sufficiently far to displace the stomach laterally against the body wall (group II). In contrast, consistent positioning of gastrostomy tubes through the parietal surface of the stomach was achieved when the stomach was insufflated prior to lateralizing the left abdominal wall with the gastric end of the orogastric tube (group III). It was concluded that the blind percutaneous gastrostomy technique is made safer by insufflating the stomach immediately prior to pushing the gastric wall laterally into contact with the parietal peritoneum. J Vet Intern Med 1996;10:15–20. Copyright © 1996 by the American College of Veterinary Internal Medicine .     

Prospective evaluation of laparoscopic-assisted gastropexy in dogs susceptible to gastric dilatation

OBJECTIVE: To determine long-term outcome associated with laparoscopic-assisted gastropexy in prevention of gastric dilatation-volvulus (GDV) in susceptible dogs and to evaluate use of laparoscopy to correct GDV. DESIGN: Prospective study. ANIMALS: 25 client-owned large-breed dogs. PROCEDURE: 23 dogs susceptible to GDV were referred as candidates for elective gastropexy. These dogs had a history of treatment for gastric dilatation, clinical signs of gastric dilatation, or family members with gastric dilatation. Laparoscopic-assisted gastropexy was performed. One year after surgery, abdominal ultrasonography was performed to evaluate the attachment of the stomach to the abdominal wall. Two dogs with GDV were also treated with laparoscopic-assisted derotation of the stomach and gastropexy. RESULTS: None of the dogs developed GDV during the year after gastropexy, and all 20 dogs examined ultrasonographically had an intact attachment. Another dog was euthanatized at 11.5 months for unrelated problems. Two dogs with GDV successfully underwent laparoscopic-assisted gastropexy after the stomach was repositioned. CONCLUSIONS AND CLINICAL RELEVANCE: Laparoscopic-assisted gastropexy resulted in a persisting attachment between the stomach and abdominal wall, an absence of GDV development, and few complications. Dogs with a high probability for development of GDV should be considered candidates for minimally invasive gastropexy. Carefully selected dogs with GDV can be treated laparoscopically.     

Partial Gastrectomy as Treatment of Gastric Volvulus Results in 30 Dogs

Of 285 dogs with gastric volvulus treated surgically, 30 (10.5%) required partial gastrectomy because of necrosis along the greater curvature of the body or fundic region of the stomach. Initially, the 30 dogs were treated with intravenous administration of lactated Ringer's solution, antibiotics, and corticosteroids. The stomach was decompressed with an oral gastric tube or by percutaneous gastrocentesis. Diagnosis of gastric volvulus was made by abdominal radiography and confirmed at surgery. At surgery, the stomach was decompressed and repositioned. Gastric viability was determined by evaluation of serosal color and perfusion, vascular patency, the degree of active bleeding from the incised gastric wall, and by palpation of the gastric wall; intravenous fluorescein dye evaluation was performed in some dogs. Twenty-seven dogs developed postoperative complications, 19 (63%) of which died. Eleven dogs recovered.     

Circumcostal Gastropexy in the Dog A Preliminary Study

Gastric dilatation-volvulus (GDV) is a disease which causes many fatalities among large deep-chested dogs. Despite several different surgical techniques used currently, recurrence is high among dogs that survive the first episode of GDV. Circumcostal gastropexy is a new surgical technique which utilizes a muscular flap of the ventral pyloric antrum to anchor the stomach to the costochondral junction of one of the last four ribs. The gastric lumen is not entered.
This operation was performed on nine clinically normal dogs. A strong adhesion was created without altering the stomach's physiologic function and with minimal anatomic displacement. The technique has the advantage of being easy, safe, and fast (15 min). These results suggest that this operation will have great potential in preventing recurrence.     

Use of a nuclear imaging technique to detect gastric wall ischemia.

A nuclear imaging technique of the stomach, using technetium pertechnetate (99mTcO4), was evaluated in healthy dogs. The stomach was first insufflated with room air, then filled with barium sulfate to induce mild distention, outlining the gastric wall. Six dogs were imaged twice: initially without use of drugs that might affect gastric secretion of 99mTcO4, then after pretreatment with cimetidine and glycopyrrolate. These scans established the appearance of the normal (control) stomach and compared the quality of the image in the same dogs not pretreated, then pretreated with cimetidine and glycopyrrolate before administration of 99mTcO4. Avascular defects were then surgically created on the greater curvature of the stomach of the same 6 dogs, and gastroscintigraphy was performed in similar manner. Significant (P less than 0.05) quantitative differences were detected in the gastric images for scans of the avascular area, compared with various control scans. Qualitative assessment had overall accuracy of 90.28%. Results of the study reported here indicate that nuclear imaging can be a valuable diagnostic technique for detecting ischemic areas in the gastric wall of dogs.     

Hypercalcemia associated with gastric pythiosis in a dog

A 20-month-old castrated male Labrador Retriever with a 3-month history of anorexia, weight loss, and vomiting was evaluated. Plasma biochemical abnormalities included marked hyperglobulinemia and hypercalcemia. Serum levels of parathyroid hormone, parathyroid hormone-related protein, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D were either low or within reference intervals. Gastric wall thickening and abdominal lymphadenomegaly were observed with abdominal ultrasonography. Cytologic evaluation of a sample obtained via fine-needle aspiration of the gastric wall revealed pyogranulomatous inflammation and numerous poorly stained hyphae. Partial gastrectomy was performed, and a diagnosis of gastric pythiosis was made by immunohistochemical staining of infected gastric tissue, as well as by immunoblot serology. This case demonstrates that diagnostic samples for cytologic evaluation can be obtained by fine-needle aspiration of Pythium insidiosum-infected tissues and that a presumptive diagnosis can be made by examination of a Romanowsky-stained smear. Furthermore, pythiosis should be considered as a differential diagnosis for hypercalcemia, especially in young dogs with inflammatory lesions that have a granulomatous component. The mechanism for the hypercalcemia in this dog was not determined; however, calcium concentrations normalized after surgical resection of the gastric lesion.     

Surgical Management of the Trauma-Induced Colocutaneous Fistula in a Horse

There are few published reports of equine enterocutaneous fistulae, and they are almost always related to umbilical hernias. Colocutaneous fistula as a result of a penetrating wound has not been reported in horse. In this case report, surgical treatment of a traumatic colocutaneous fistula in an 8-year-old stallion is described. Under inhalation anesthesia, the fistula was removed completely, and the resultant defect on the left ventral colonic wall was closed. The defect of abdominal wall was closed routinely. The horse regained his previous performance, and no surgical complication was observed at 1 year’s follow-up.     

A case of hyperplastic gastropathy in a cat

Primary hyperplastic gastropathy is an uncommon human disease characterized by giant gastric mucosal folds and is associated with a spectrum of histopathological changes. Diagnosis is usually made on radiological and gastroscopic findings followed by full-thickness biopsy of the stomach wall. The aetiology is unknown and symptomatic treatment is usually disappointing. A similar condition has been described in a small number of dogs. A case of hyperplastic gastropathy is reported in a cat and compared with the findings in man and dogs. The cat presented with chronic vomiting and weight loss. Radiological and gastroscopic examinations revealed enlarged gastric rugae. Medical and surgical treatment was unsuccessful and the cat was destroyed. The pathological findings were similar to those described in man.