Use of the Kishigami Atlantoaxial Tension Band in Eight Toy Breed Dogs with Atlantoaxial Subluxation

Objective— To determine the applicability, complications, and long-term functional outcome of the Kishigami Atlantoaxial Tension Band (Kishigami AATB) for management of congenital and traumatic atlantoaxial (AA) instability in toy breed dogs.
Study Design— Case series.
Animals— Toy breed dogs (n=8) with congenital or traumatic AA instability.
Methods— The AA joint of each dog was surgically stabilized through a dorsal approach using the original or a modified version of the Kishigami AATB. Pre- and postoperative neurologic status, radiographs, and complications were reviewed. Follow-up examination was performed at 1 and 12 months.
Results— Functional improvement occurred in 5 dogs; 1 dog did not improve or worsen and 2 dogs were euthanatized at owner request. Adequate reduction and stabilization was achieved in 7 dogs based on immediate postoperative radiographs; failure of reduction was evident in 1 dog. No relevant complications occurred.
Conclusions— Kishigami AATB may be acceptable as an alternative method for dorsal stabilization of AA subluxation in toy breed dogs in which use of ventral screws or pins is challenging. Experience with this technique in a larger population is necessary to compare our results to those reported by ventral approach.
Clinical Relevance— The surgical technique described is effective, safe, and simple in the surgical treatment of AA subluxation in toy breed dogs.     

Surgical Management of Lateral Luxation and Subluxation of the Canine Radial Head

The causes and pathogenesis of radial head luxation and subluxation are reviewed. A surgical technique is described for repair of the condition that permits direct visualization of the joint, reestablishment of normal joint anatomy by ulnar osteotomy, and stabilization of the radioulnar articulation with a lag screw. Two clinical cases are presented.     

Surgical Management of Multiple Congenital Intrahepatic Shunts in Two Dogs

Objective —To present details of an unusual type of portosystemic shunt and its surgical management in two dogs.
Animals —Two young dogs that had a tentative diagnosis of a portosystemic shunt on the basis of clinical signs and serum biochemical abnormalities. Abdominal ultrasonography and contrast portography demonstrated multiple intrahepatic shunts. In both cases, the multiple shunts arose from a single branch of the portal vein.
Outcome—It was possible to locate and attenuate flow through the shunts via a transportal venotomy under conditions of hepatic vascular occlusion. Clinical and biochemical abnormalities resolved after surgery in both dogs. Postoperative sonography revealed complete obliteration of the shunt plexus in one of the dogs.     

Application of Ventral Pins and Polymethylmethacrylate for the Management of Atlantoaxial Instability: Results in Nine Dogs

Objective — The purpose of this report was to determine the efficacy of the application of ventral pins and polymethylmethacrylate for the management of congenital and traumatic atlantoaxial instability (AAI) in dogs.
Study Design — Medical records and radiographs of nine dogs with AAI were reviewed for neurological deficits, clinical diagnosis, surgical technique, and long-term outcome.
Sample Population — Six toy breed dogs with congenital AAI and three medium or large breed dogs with traumatic AAI were identified for inclusion in the study.
Methods — The atlantoaxial joints of nine dogs with AAI were surgically stabilized using ventral application of pins and polymethylmethacrylate. Follow-up evaluation for resolution of clinical signs and possible complications of surgery was performed in all dogs. The median follow-up time for surviving dogs (8) was 11.5 months with a mean of 13 months.
Results — An excellent outcome was identified in five patients. Three dogs had a good outcome and one dog died of respiratory complications. Cervical pain was eliminated or significantly reduced in all dogs that survived and none of the dogs had major residual neurological deficits.
Conclusions — Arthrodesis could not be confirmed on follow-up radiographs due to the presence of the polymethylmethacrylate; however, adequate stabilization of C1-C2 appears to have been achieved based on the resolution of clinical signs.
Clinical Relevance — Application of ventral pins and polymethylmethacrylate is an effective means of surgical treatment for congenital and traumatic AAI.     

Mitral Valve Replacement in Dogs Surgical Technique and Postoperative Management

Although techniques for the perioperative management of patients undergoing mitral valve replacement have been well established in humans, the use of these techniques has not been widely accepted in veterinary practice. The purpose of this study is to demonstrate that low morbidity and mortality could be achieved in the dog undergoing mitral valve replacement. Nine mongrel dogs (25-45 kg body weight) were subject to left thoracotomy and mitral valve replacement using cardiopulmonary bypass (CPB). The average time on CPB was 1 hour with an aortic cross-clamping time of 40 minutes using chemically induced cardiac arrest. CPB was performed under conditions of moderate systemic hypothermia (28-30 degrees C) and hemodilution (hematocrit, 25-35%). Operative mortality was 22% (2/9) with one death from excessive bleeding and the other from cerebral air embolism. All other animals recovered and were clinically normal 3 weeks after surgery. The authors conclude that successful mitral valve replacement is possible in the large dog.     

Resection of Subvalvular Aortic Stenosis Surgical and Perioperative Management in Seven Dogs

Open heart surgery was performed during cardiopulmonary bypass (CPB) to surgically correct subvalvular aortic stenosis in seven dogs. After initiation of total CPB, cardiac arrest was induced by antegrade and retrograde administration of blood cardioplegia. The subvalvular fibrous stenosis was resected through a transverse aortotomy. Intraoperatively and postop-eratively, dobutamine, nitroprusside, lidocaine, blood(-products), and crystalloid solutions were used to manage hypotension and optimize cardiac index.
Aortic cross-clamp time varied from 73 to 166 minutes, and duration of CPB varied from 130 to 210 minutes, latrogenic incision into the mitral valve in two dogs was the most significant introperative complication. Postoperative complications included: hypoproteinemia (n = 7), premature ventricular depolarization (n = 6), increased systemic vascular resistance index (n = 5), increased O₂ extraction (n = 3), pulmonary edema (n = 2), and decreased cardiac index (n = 1). All seven dogs were discharged alive and in stable condition. Six dogs are alive and in stable condition after a mean follow up of 15.8 months.
This is the first detailed report of CPB in a series of clinical veterinary patients. Using the techniques described in this paper, open heart surgery of considerable duration can be performed successfully in dogs with significant myocardial hypertrophy and endomyocardial fibrosis secondary to subvalvular aortic stenosis.     

犬的手术去势方法

犬去势后可消除其性欲和繁殖能力,纠正和消除其不良性行为,使犬性情变得温顺,容易饲养便于管理;肉用犬的生长速度快,肉质细嫩;同时还可以控制其交配行为,有利于良种的繁殖和选育,并可避免某些疾病的发生和传播。     

Ventral Surgical Fixation and Fusion for Atlanto-occipital Subluxation in a Goat

Atlanto-occipital subluxation causing tetraplegia in a mature Pygmy goat was treated by ventral surgical fixation and fusion. Radiographic evidence of fusion and clinical improvement were noted two months after surgery.     

Dorsolateral Subluxation of Hip Joints in Dogs Measured in a Weight-Bearing Position With Radiography and Computed Tomography

Objective —To develop a radiographic procedure to measure dorsolateral subluxation (DLS) of the femoral head in canine coxofemoral (hip) joints in a weight-bearing position. Study Design —DLS measured on a radiographic projection was compared with DLS measured on computed tomography (CT) images of hip joints in a weight-bearing position. Animals —A total of 24 dogs of varying ages were examined including Labrador retrievers, greyhounds, and Labrador-greyhound crossbreeds. Methods —Anesthetized dogs were placed in sternal recumbency in a kneeling position in a foam rubber mold. The stifles were flexed and adducted with the femora perpendicular to, and in contact with, the table. To test for DLS, dogs were imaged in this weight-bearing position (DLS test) with routine radiography and CT. For each hip, the DLS score was determined by measuring the percentage of the femoral head medial to the lateralmost point of the cranial acetabular rim on the dorsoventral radiographic projection and the lateralmost point of the central, dorsal acetabular rim on the CT image. Higher DLS scores indicated better coverage of the femoral head by the acetabulum. DLS scores were compared with the distraction index (DI) by grouping joints according to their probability of developing osteoarthritis (OA) as predicted by the DI. Results —The DLS score in the new position ranged from 29% to 71% for radiography and 15% to 59% for CT. Joints classified as OA unsusceptible had a mean score of 64%± 1.5% for radiography and 55%± 0.8% for CT (n = 10); hip joints having a high probability of developing OA had a score of 39%± 2.6% for radiography and 26%± 1.9% for CT (n = 8). When the DLS test was repeated on the same dogs at a different time, the intraclass correlation coefficient for the DLS score on the radiographs was 0.85 (left hip) and 0.89 (right hip). There was a strong correlation (r = .89 for both hips) between the DLS score measured on the weight-bearing radiograph and the CT image. A strong correlation also was observed between the DLS score and the DI (r = -.87). The DLS scores for OA unsusceptible joints and joints with a high probability of developing OA were significantly different (P < .05). Conclusions and Clinical Relevance —The DLS test can be performed with CT or routine radiography to measure variable amounts of DLS in weight-bearing hip joints oriented similarly to those of a standing dog. After additional long-term follow-up studies evaluating the development of OA and breed effects are performed, the DLS method may prove useful in studies of normal and abnormal hip joint development related to canine hip dysplasia.     

犬黏液瘤样二尖瓣病手术疗法

犬黏液瘤样二尖瓣病是犬常见的获得性心脏病.临床大多以药物治疗为主,手术治疗为临床突破的方向.手术治疗方法分为二尖瓣替换术、二尖瓣修复术以及心脏介入疗法,三种方法各有优缺点及适用范围,前二者多需进行开胸手术且需要体外循环及心脏停跳技术的支持,其中二尖瓣替换术的即时效果较好,但预后不良;二尖瓣修复术操作更复杂,但预后良好;...     

Lung Resection Using Surgical Staples in Dogs and Cats

Thirty seven dogs and cats were subjected to lobectomy, partial lobectomy, or pneumonectomy using stapling equipment. The most common indication was neoplasia. No operative, perioperative, or long-term deaths could be attributed to the use of staples: complications were minimal. Staple resection was believed to be safe, fast, and efficient for removal of various segments of canine and feline lung.     

犬腰椎间盘切除术入路探索

为了探索治疗犬腰椎间盘突出症的合理手术入路,选择2月龄～1岁龄临床健康的本地杂交犬5只,分别编为1号～5号犬,其中1号、2号、3号犬施行半侧椎板切除术,4号、5号犬施行全椎板切除术,手术2周后进行X线摄片并剖检其腰椎结构变化。结果显示,术后1号～3号犬精神状态良好,饮食欲及体温正常,术部切口正常愈合,椎间盘部分或全部髓核被顺利取出;4号、5号犬手术中大出血,经治疗4号犬痊愈,而5号犬因衰弱而死亡。结果表明,腰椎间盘切除术要求严格的无菌操作和有效控制的麻醉,术犬侧卧位保定行半侧椎板切除是良好的手术入路,能够充分显露椎间盘、打开纤维环通道和切除髓核,有利于提高手术的安全性和保持腰椎的完整性与稳定性。     

Urinary Incontinence after Surgical Repair of Ureteral Ectopia in Dogs

Eleven of 20 dogs (55%) were incontinent after surgical treatment of ureteral ectopia. Ureterocystostomy was performed in 15 dogs, ureteral transection and bladder reimplantation in four dogs, and ureteronephrectomy in one dog. Siberian huskies had a significantly higher rate of persistent postoperative incontinence than other breeds. There was no difference in postoperative incontinence between dogs with unilateral and bilateral ectopia. Concurrent bacterial cystitis was not associated with persistent postoperative incontinence. Age at the time of surgical correction had no effect on the rate of postoperative incontinence. Eight incontinent dogs were treated medically; three are continent with medication, three are improved but still incontinent, and two did not improve.